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1.
Urol Clin North Am ; 49(1): 153-159, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34776048

RESUMO

Ureteroscopy is the most common surgical modality for stone treatment. Reusable flexible ureteroscopes are delicate instruments that require expensive maintenance and repairs. Multiple single use ureteroscopes have been developed recently to combat the expensive and time-intensive sterilization and repair of ureteroscopes. Although multiple studies have looked at different aspects of reusable and single use ureteroscopes, there is significant heterogeneity in performance measures and cost between the 2 categories, and neither has a clear advantage. Both can be used successfully, and individual and institution level factors should be considered when deciding which ureteroscope to use.


Assuntos
Equipamentos Descartáveis , Meio Ambiente , Contaminação de Equipamentos , Ureteroscópios , Equipamentos Descartáveis/economia , Equipamentos Descartáveis/normas , Humanos , Manutenção/economia , Ureteroscópios/economia , Ureteroscópios/normas , Urolitíase/cirurgia
2.
Meat Sci ; 183: 108654, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34419789

RESUMO

In the European Community, conformation and fat cover of bovine carcasses is assessed using the SEUROP grading system. In this study we pursued the development of an application software (App) based on Visual Image Analysis, useful for SEUROP and Fat Cover grading of bovine carcasses using a smartphone. The App was trained using 500 bovine carcasses. Carcass conformation and Fat Cover classes were assessed in parallel by expert evaluators and by App. Overall, a high correspondence was found between the measurements of carcasses parameters by operators and by the App, as high as 84.2% for SEUROP and 86.4% for the Fat Cover. In the 15.8% of samples with discordant SEUROP evaluation, and in the 13.6% of samples with discordant Fat Cover evaluation, the operators' and App measurements deviated by only one class. All values also aligned with the requirements expected by the current legislation for the use of automated and/or semi-automated systems able to determine the market value of carcasses.


Assuntos
Tecido Adiposo/anatomia & histologia , Processamento de Imagem Assistida por Computador/métodos , Carne Vermelha/análise , Animais , Composição Corporal , Bovinos , União Europeia , Carne Vermelha/normas
3.
Breast Dis ; 41(1): 1-3, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34219707

RESUMO

During the first hit of SARS-COVID pandemic, an important reorganization of Healthcare Services has been done, and new protocols and pathways to protect frail patients like oncological patients were designed. The second hit of pandemic had stressed these new pathways and suggests to health-workers some improvements for safer management of patents.We reported our experience in organizing the clinical pathway of neoadjuvant therapy candidate patients based on the execution of sentinel lympho-node biopsy and the placement of implantable venous access port in the same access to operating room before neoadjuvant chemotherapy suggesting a possible organizational model. In the period October-December 2020 we have included in this new type of path twelve patients and we have not registered any cases of COVID among the patients included. We think this new path, adopted amid the second hit, will be useful for all Breast Units that are facing the challenge of guaranteeing the highest standards of care in a historical moment where the health emergency occupies the efforts of health workers and the economic resources of health systems.


Assuntos
Antineoplásicos/administração & dosagem , Neoplasias da Mama/tratamento farmacológico , COVID-19/prevenção & controle , Cateterismo Venoso Central/métodos , Controle de Infecções/métodos , Segurança do Paciente , Biópsia de Linfonodo Sentinela/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Cateterismo Venoso Central/instrumentação , Cateterismo Venoso Central/normas , Cateteres Venosos Centrais , Quimioterapia Adjuvante , Procedimentos Clínicos , Feminino , Humanos , Controle de Infecções/normas , Mastectomia , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estadiamento de Neoplasias , Biópsia de Linfonodo Sentinela/normas
5.
Proc Natl Acad Sci U S A ; 118(46)2021 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-34772803

RESUMO

PRACE (Partnership for Advanced Computing in Europe), an international not-for-profit association that brings together the five largest European supercomputing centers and involves 26 European countries, has allocated more than half a billion core hours to computer simulations to fight the COVID-19 pandemic. Alongside experiments, these simulations are a pillar of research to assess the risks of different scenarios and investigate mitigation strategies. While the world deals with the subsequent waves of the pandemic, we present a reflection on the use of urgent supercomputing for global societal challenges and crisis management.


Assuntos
COVID-19/epidemiologia , Computação em Informática Médica/normas , Europa (Continente) , Humanos , Disseminação de Informação , Sistemas de Informação/normas , Computação em Informática Médica/tendências
6.
Anticancer Res ; 41(11): 5377-5391, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34732407

RESUMO

BACKGROUND/AIM: To assess the quantity and quality of systematic reviews of in vitro cancer studies. MATERIALS AND METHODS: PubMed, MEDLINE, Embase, Web of Knowledge and PROSPERO databases were searched. Articles described as systematic reviews of in vitro studies, focused on or relevant to cancer and published in English were selected and appraised using an adapted version of AMSTAR 2 'critical domains'. RESULTS: From 4,021 records, 41 reviews described as systematic and cancer-related were identified. Publication dates indicate increasing frequency of systematic review conduct. Mean number of databases searched was three (range=1-8). Thirty-six reviews (88%) reported search methods, 35 (85%) specified inclusion criteria, 26 (63%) reported study selection methods, and 21 (51%) used reporting guidelines. Only 13 reviews (32%) involved formal quality assessment. CONCLUSION: Detailed investigation of reviews of cancer-relevant in vitro studies indicates need for further development and use of robust search strategies, appropriate quality assessment tools, and researchers with relevant skills.


Assuntos
Pesquisa Biomédica/normas , Confiabilidade dos Dados , Oncologia/normas , Publicações Periódicas como Assunto/normas , Projetos de Pesquisa/normas , Revisões Sistemáticas como Assunto/normas , Animais , Guias como Assunto/normas , Humanos , Controle de Qualidade
7.
Mayo Clin Proc ; 96(11): 2856-2860, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34736612

RESUMO

Although there have been several case reports and simulation models of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission associated with air travel, there are limited data to guide testing strategy to minimize the risk of SARS-CoV-2 exposure and transmission onboard commercial aircraft. Among 9853 passengers with a negative SARS-CoV-2 polymerase chain reaction test performed within 72 hours of departure from December 2020 through May 2021, five (0.05%) passengers with active SARS-CoV-2 infection were identified with rapid antigen tests and confirmed with rapid molecular test performed before and after an international flight from the United States to Italy. This translates to a case detection rate of 1 per 1970 travelers during a time of high prevalence of active infection in the United States. A negative molecular test for SARS-CoV-2 within 72 hours of international airline departure results in a low probability of active infection identified on antigen testing during commercial airline flight.


Assuntos
Viagem Aérea , Teste para COVID-19/normas , COVID-19/diagnóstico , SARS-CoV-2/isolamento & purificação , COVID-19/transmissão , Teste de Ácido Nucleico para COVID-19/normas , Humanos , Itália , Medição de Risco , Estados Unidos
9.
Rev Neurol ; 73(10): 345-350, 2021 Nov 16.
Artigo em Espanhol | MEDLINE | ID: mdl-34755887

RESUMO

INTRODUCTION: The health pandemic brought about by SARS-CoV-2 (COVID-19) has limited access to neurorehabilitation programmes for many patients who have suffered stroke, traumatic brain injury or acquired brain damage due to some other cause. As telerehabilitation allows for the provision of care in situations of social distancing, it may mitigate the negative effects of confinement. The aim of this study was to determine the efficacy, adherence and usability of a teleneurorehabilitation intervention for patients with acquired brain injury. PATIENTS AND METHODS: All patients included in a face-to-face neurorehabilitation programme at the time of the declaration of the state of alarm in Spain due to COVID-19 and who agreed to participate in the study were included in a teleneurorehabilitation programme. The effectiveness of the programme, understood as an improvement in independence, was quantified with the Barthel index. Adherence to the programme and usability of the tool were explored through questionnaires. RESULTS: Altogether, 46 patients, accounting for 70.6% of the total, participated in the study. Participants significantly improved their independence and showed an improvement in the Barthel index between the start (77.3 ± 28.6) and the end of the programme (82.3 ± 26). Adherence to the intervention was very high (8.1 ± 2.2 out of 10) and the online sessions were the most highly rated content. The tool used showed a high usability (50.1 ± 9.9 out of 60) and could be used without assistance by more than half the participants. CONCLUSION: The teleneurorehabilitation intervention was found to be effective in improving patients' independence, and promoted a high degree of adherence and usability.


Assuntos
Lesões Encefálicas/complicações , Lesões Encefálicas/reabilitação , COVID-19/complicações , Continuidade da Assistência ao Paciente/organização & administração , Telerreabilitação/organização & administração , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Cooperação do Paciente , Satisfação do Paciente , Distanciamento Físico , Avaliação de Programas e Projetos de Saúde , Espanha/epidemiologia , Inquéritos e Questionários/normas , Realidade Virtual
13.
Infect Dis Clin North Am ; 35(4): 1027-1053, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34752219

RESUMO

Invasive fungal infections are an important cause of morbidity and mortality in hospitalized patients and in the immunocompromised population. This article reviews the current epidemiology of nosocomial fungal infections in adult patients, with an emphasis on invasive candidiasis (IC) and invasive aspergillosis (IA). Included are descriptions of nosocomial infections caused by Candida auris, an emerging pathogen, and IC- and IA-associated with coronavirus disease 2019. The characteristics and availability of newer nonculture-based tests for identification of nosocomial fungal pathogens are discussed. Recently published recommendations and guidelines for the control and prevention of these nosocomial fungal infections are summarized.


Assuntos
Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Micoses/epidemiologia , Micoses/prevenção & controle , Antifúngicos/uso terapêutico , COVID-19/complicações , COVID-19/epidemiologia , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/etiologia , Fungos/classificação , Fungos/patogenicidade , Humanos , Hospedeiro Imunocomprometido , Controle de Infecções/normas , Micoses/diagnóstico , Micoses/etiologia , Fatores de Risco , SARS-CoV-2
14.
Infect Dis Clin North Am ; 35(4): 1055-1075, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34752220

RESUMO

Health care-acquired viral respiratory infections are common and cause increased patient morbidity and mortality. Although the threat of viral respiratory infection has been underscored by the coronavirus disease 2019 (COVID-19) pandemic, respiratory viruses have a significant impact in health care settings even under normal circumstances. Studies report decreased nosocomial transmission when aggressive infection control measures are implemented, with more success noted when using a multicomponent approach. Influenza vaccination of health care personnel furthers decrease rates of transmission; thus, mandatory vaccination is becoming more common. This article discusses the epidemiology, transmission, and control of health care-associated respiratory viral infections.


Assuntos
Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/virologia , Infecções Respiratórias/prevenção & controle , Infecções Respiratórias/virologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/transmissão , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/transmissão , Fidelidade a Diretrizes , Pessoal de Saúde/normas , Humanos , Controle de Infecções/normas , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/transmissão , SARS-CoV-2/patogenicidade , Vacinação , Vírus/classificação , Vírus/patogenicidade
15.
Infect Dis Clin North Am ; 35(4): 841-856, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34752222

RESUMO

Despite a large volume of research in prevention, central line-associated bloodstream infections and catheter-related bloodstream infections continue to cause significant morbidity, mortality, and increased health care costs. Strategies in prevention, including decision about catheter placement, insertion bundles, adherence to standard of care guidelines, and technologic innovations, shown to decrease rates of catheter-related bloodstream infections and central line-associated bloodstream infections are described in this update. The coronavirus disease 2019 pandemic has resulted in increased health care-acquired infections, including central line-associated bloodstream infections.


Assuntos
Bacteriemia/prevenção & controle , Infecções Relacionadas a Cateter/prevenção & controle , Cateterismo Venoso Central/efeitos adversos , Bacteriemia/epidemiologia , Bacteriemia/etiologia , COVID-19/epidemiologia , Infecções Relacionadas a Cateter/epidemiologia , Infecções Relacionadas a Cateter/etiologia , Cateterismo Venoso Central/normas , Tomada de Decisão Clínica , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/etiologia , Humanos , Pacotes de Assistência ao Paciente/normas , Guias de Prática Clínica como Assunto , SARS-CoV-2
16.
Can J Surg ; 64(6): E609-E612, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34759046

RESUMO

Trauma care delivery is a complex team-based task that requires deliberate practice. The COVID-19 pandemic has not diminished the importance of excellent trauma team dynamics. However, the pandemic hampers our ability to gather safely and train together. A mitigating solution is the provision of high-fidelity simulation training in a virtual setting. The Simulated Trauma and Resuscitation Team Training (S.T.A.R.T.T.) course has provided multidisciplinary trauma team members with skills in crisis resource management (CRM) for nearly 10 years. It has promoted collaborative learning from coast to coast, as the course typically runs at our national surgical and trauma meetings. In response to COVID-19 challenges, the course content has been modified to virtually connect 2 centres in different provinces simultaneously. High participant satisfaction suggests that the new virtual E-S.T.A.R.T.T course is able to continue to help providers develop important CRM skills in a multidisciplinary setting while remaining compliant with COVID-19 safety precautions.


Assuntos
COVID-19 , Educação à Distância , Treinamento com Simulação de Alta Fidelidade , Traumatologia/educação , Ferimentos e Lesões/terapia , Canadá , Competência Clínica , Gestão de Recursos da Equipe de Assistência à Saúde , Currículo , Treinamento com Simulação de Alta Fidelidade/métodos , Treinamento com Simulação de Alta Fidelidade/normas , Humanos , Pandemias , Equipe de Assistência ao Paciente , SARS-CoV-2 , Traumatologia/normas
19.
Surg Clin North Am ; 101(6): 1007-1022, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34774264

RESUMO

This article discuses current controversies in abdominal wall reconstruction, including the standardization of outcome reporting, mesh selection, the utility of robotic surgery in ventral hernia repair, and role for prophylactic stoma mesh at the time of permanent end colostomy formation. The current state of the literature pertaining to these topics is reviewed in detail.


Assuntos
Parede Abdominal/cirurgia , Hérnia Ventral/cirurgia , Herniorrafia , Procedimentos Cirúrgicos Robóticos , Herniorrafia/métodos , Herniorrafia/normas , Humanos , Hérnia Incisional/cirurgia , Medidas de Resultados Relatados pelo Paciente , Implantação de Prótese , Procedimentos Cirúrgicos Reconstrutivos/métodos , Procedimentos Cirúrgicos Reconstrutivos/normas , Recidiva , Reoperação , Procedimentos Cirúrgicos Robóticos/normas , Telas Cirúrgicas , Resultado do Tratamento
20.
Surg Clin North Am ; 101(6): 995-1006, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34774277

RESUMO

Enhanced recovery after surgery (ERAS) protocols are comprehensive perioperative care pathways designed to mitigate the physiologic stressors associated with surgery and, in turn, improve clinical outcomes and lead to health care cost savings. Although individual components may differ, ERAS protocols are typically organized as multimodal care "bundles" that, when followed closely and in their entirety, are meant to generate amplified cumulative benefits. This manuscript examines some of the critical components, describes some areas where the science is weak (but dogma may be strong), and provides some of the evidence or lack thereof behind components of a standard ERAS protocol.


Assuntos
Recuperação Pós-Cirúrgica Melhorada , Dor Pós-Operatória/tratamento farmacológico , Pacotes de Assistência ao Paciente , Complicações Pós-Operatórias/prevenção & controle , Protocolos Clínicos/normas , Recuperação Pós-Cirúrgica Melhorada/normas , Humanos , Dor Pós-Operatória/terapia , Pacotes de Assistência ao Paciente/economia , Pacotes de Assistência ao Paciente/normas , Assistência Perioperatória/economia , Assistência Perioperatória/normas , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/terapia
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