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1.
J Acquir Immune Defic Syndr ; 85(4): 475-482, 2020 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-33136748

RESUMEN

BACKGROUND: The spread of severe acute respiratory syndrome coronavirus 2, causative agent of the coronavirus disease 2019 (COVID-19), has necessitated widespread lockdown to mitigate the pandemic. This study examines the influence of resilience on the impact of COVID-related stress and enforced lockdown on mental health, drug use, and treatment adherence among people living with HIV (PLWH) in Argentina. SETTING: PLWH residing predominantly in Buenos Aires Metropolitan Area and urban regions of Argentina were identified from a private clinic electronic database. METHODS: Participants completed an anonymous online survey to evaluate the impact of COVID-19 on economic disruption, resilience, mental health outcomes (depression, anxiety, stress, and loneliness), adherence to HIV treatment, and substance use. We performed ordinary least squares and logistic regressions to test whether resilient coping buffered the impact of economic disruption on mental health and drug use during quarantine. RESULTS: A total of 1336 PLWH aged 18-82 were enrolled. The impact of economic disruption on mental health ΔF(1,1321) = 8.86, P = 0.003 and loneliness ΔF(1,1326) = 5.77, P = 0.016 was buffered by resilience. A 3-way interaction between resilient buffering, stress, and sex was significant ΔF(1,1325) = 4.76, P = 0.029. Participants reported less than excellent adherence to medication (33%), disruption to mental health services (11%), and disruption to substance abuse treatment (1.3%) during lockdown. DISCUSSION: The impact of COVID-stress and lockdown on emotional distress seemed mitigated by resilience coping strategies, and the buffering impact of resilience on perceived stress was greater among women. Results highlight PLWH's capacity to adhere to treatment in challenging circumstances and the importance of developing resilience skills for better coping with stress and adversity.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/psicología , Infecciones por VIH/psicología , Salud Mental/tendencias , Neumonía Viral/psicología , Trastornos de Estrés Traumático Agudo/psicología , Adaptación Psicológica , Adulto , Anciano , Anciano de 80 o más Años , Argentina , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/prevención & control , Femenino , Infecciones por VIH/complicaciones , Humanos , Violencia de Pareja/tendencias , Análisis de los Mínimos Cuadrados , Modelos Logísticos , Soledad , Masculino , Servicios de Salud Mental/normas , Persona de Mediana Edad , Pandemias/economía , Pandemias/prevención & control , Neumonía Viral/complicaciones , Neumonía Viral/economía , Neumonía Viral/prevención & control , Resiliencia Psicológica , Factores Sexuales , Aislamiento Social/psicología , Apoyo Social , Trastornos de Estrés Traumático Agudo/etiología , Trastornos Relacionados con Sustancias/etiología , Trastornos Relacionados con Sustancias/terapia , Encuestas y Cuestionarios , Cumplimiento y Adherencia al Tratamiento , Adulto Joven
2.
J Med Virol ; 2020 Nov 09.
Artículo en Inglés | MEDLINE | ID: mdl-33165959

RESUMEN

There is a debate in Argentina about the effectiveness of mandatory lockdown policies containing severe acute respiratory syndrome coronavirus type 2 disease. This policy has already 6 months long making it one of the longest in the world. The population effort to comply with the lockdown has been decreasing over time given the economic and social costs that it entails. This contribution analyzes the relationship between mobility and contagion in Argentina at a provincial level. It also models issues of internal political discussion on regional contagion and the effect of protests and unexpected crowd events. I use pool, fixed, and random effects panel data modeling and results show that lockdown in Argentina has been effective in reducing mobility but not in a way that reduces the rate of contagion. Strict lockdown seems to be effective in short periods of time and but extend it without complementary mitigation measures it losses effectiveness. The contagion rate seems to be discretely displaced in time and resurges amidst slowly increasing in mobility.

3.
Rev Esp Med Nucl Imagen Mol ; 39(6): 375-379, 2020.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33222840

RESUMEN

This publication presents criteria and bases for the work organization in the safe practice of Hospital Radiopharmacy, in order to minimize the risk of viral transmission during the COVID-19 pandemic, in a reference facility of the National Energy Commission Atomic of Argentina, while continuing to perform essential services for the health system. For this purpose, documents from the National Energy Commission Atomic, IAEA, WHO and other scientific publications were consulted as reference. These recommendations are under constant review and are permanently updated. Within this framework, the present model of work organization for this essential activity is proposed, including general and specific recommendations and its epidemiological and immunological basis.

4.
Epilepsy Behav ; 112: 107493, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33181913

RESUMEN

OBJECTIVE: The purpose of this study was to assess parent satisfaction with the management of ketogenic diet therapies (KDTs) through telemedicine using WhatsApp as the main tool. METHODS: Parent satisfaction was longitudinally evaluated through questionnaires. The survey was developed with Google Questionnaire forms and sent via WhatsApp. The questionnaire consisted of 13 items concerning the management of KDTs using telemedicine in the context of the coronavirus disease 2019 (COVID-19) pandemic. Our population of patients has limited financial resources and low levels of education. Given that many families did not have either computers or WIFI, or any other access to information or communication technology, WhatsApp was chosen as a tool as it was available on the cell phones of all families and the professionals. RESULTS: Our survey showed that 96.3% of the parents were satisfied with the management of KDTs through telemedicine. The main benefits observed were the possibility of continuing treatment during the COVID-19 pandemic and the ease of accessing the professional team from the comfort of their home. Overall, 72.2% of the families would recommend using telemedicine for KDTs in any situation regardless of the pandemic. None of the families reported that they would recommend against treatment by telemedicine. The availability of a social support network (parents WhatsApp group) coordinated by professionals from the KDT team was considered to be useful by most respondents (90%). CONCLUSIONS: Our study suggests that management of children with DRE on KDTs through telemedicine is feasible, well accepted by the families, and probably as safe as conventional medicine. WhatsApp may be an interesting telemedicine tool to start and maintain KDTs.


Asunto(s)
Dieta Cetogénica/métodos , Epilepsia Refractaria/dietoterapia , Padres/psicología , Telemedicina , Adolescente , Adulto , Argentina , Betacoronavirus , Niño , Preescolar , Coronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Prestación de Atención de Salud , Epilepsia Refractaria/epidemiología , Femenino , Humanos , Lactante , Masculino , Pandemias , Satisfacción Personal , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Evaluación de Programas y Proyectos de Salud , Medios de Comunicación Sociales , Encuestas y Cuestionarios
5.
Preprint en Español | SciELO Preprints | ID: pps-1445

RESUMEN

INTRODUCTION: The objective of this study is to describe the spatio-temporal variations in mortality from COVID-19 within the Autonomous City of Buenos Aires (CABA). METHODS: Data referring to the day, month and year, and the place of residence of the people who died from COVID-19 in CABA from March 3 to October 3, 2020 were used. The spatial units were the 48 neighborhoods that make up the CABA and two populations were analyzed (under 60 years and from this age or older). Spatio-temporal scan statistics were used to detect high and low mortality clusters. The percentage of households with Unsatisfied Basic Needs (UBN), as a measure of structural poverty, was compared between neighborhoods belonging to high mortality clusters and neighborhoods belonging to low mortality clusters. RESULTS: The high mortality clusters were located mainly in the southern half of CABA, while the low mortality clusters were located in the west and north of the city. The neighborhoods of high mortality clusters showed higher percentages of households with UBN compared to the neighborhoods belonging to low mortality clusters. DISCUSSION: This study found socio-spatial inequalities in mortality from COVID-19 between neighborhoods in CABA, reflecting a persistent north-south socioeconomic gap for several decades.


INTRODUCCIÓN: El objetivo del presente estudio es describir las variaciones espacio-temporales de la mortalidad por COVID-19 al interior de la Ciudad Autónoma de Buenos Aires (CABA). MÉTODOS: Se utilizaron datos referidos al día, mes y año, y el lugar de residencia de las personas fallecidas por COVID-19 en la CABA desde el 3 de marzo al 3 de octubre de 2020. Las unidades espaciales fueron los 48 barrios que componen la CABA y se analizaron dos poblaciones (menores de 60 años y a partir de esta edad o mayores). Se emplearon técnicas de escaneo espacio-temporal para detectar conglomerados de mortalidad alta y baja. Se comparó el porcentaje de hogares con Necesidades Básicas Insatisfechas (NBI), como medida de pobreza estructural, entre los barrios pertenecientes a conglomerados de mortalidad alta y los barrios pertenecientes a conglomerados de mortalidad baja. RESULTADOS: Los conglomerados de mortalidad alta se localizaron mayormente en la mitad sur de la CABA, mientras que los conglomerados de mortalidad baja lo hicieron en el oeste y norte de la ciudad. Los barrios de conglomerados de mortalidad alta mostraron mayores porcentajes de hogares con NBI en comparación a los barrios pertenecientes a conglomerados de mortalidad baja. DISCUSIÓN: Este estudio encontró desigualdades socio-espaciales de la mortalidad por COVID-19 entre barrios de la CABA, reflejando una brecha socioeconómica norte-sur persistente desde hace varias décadas.

6.
Arch Argent Pediatr ; 118(6): 418-426, 2020 Dec.
Artículo en Español, Inglés | MEDLINE | ID: mdl-33231051

RESUMEN

INTRODUCTION: Despite the magnitude of the COVID-19 pandemic, the information about its development in pediatrics is still limited. This report describes the characteristics of patients admitted to a children's hospital due to COVID-19 during the first three months of the pandemic. METHOD: Descriptive study including all patients hospitalized due to COVID-19 between 4/1/2020 and 6/30/2020. RESULTS: A total of 191 patients were hospitalized due to COVID-19; their median age was 7.7 years; 89% had a history of close contact. Of them, 35.6 % were considered asymptomatic; 61.2 %, mild cases; and 3.2 %, moderate cases (no severe cases). None of them received a specific treatment for the disease. The most common symptoms were fever, sore throat, and cough. The median length of stay was 6 days. CONCLUSION: A total of 191 cases of children and adolescents admitted due to COVID-19 are reported. Most were asymptomatic or presented with a mild disease.

7.
Death Stud ; : 1-10, 2020 Oct 29.
Artículo en Inglés | MEDLINE | ID: mdl-33118860

RESUMEN

This study evaluated the psychometric properties of the Scale of Fear of COVID-19 (FCV-19S) in a sample of 1,291 Argentines. The two-related factor structure of the FCV-19S had satisfactory goodness-of-fit indices using structural equation modeling and item response theory. Further results showed that the reliability was adequate, the factor structure was strictly invariable across age groups, and the model that evaluated the relationships between fear of COVID-19, anxiety, and depression had adequate goodness of fit indices as well. The results indicated that FCV-19S has strong psychometric properties to measure fear of COVID-19 in the general population of Argentina.

8.
Medicina (B Aires) ; 80(5): 417-424, 2020.
Artículo en Español | MEDLINE | ID: mdl-33048783

RESUMEN

This is a preliminary, multicenter, retrospective cohort study, including 272 consecutive patients with COVID-19 admitted to hospitals in Buenos Aires Province, between May 15th and July 1st, 2020, included in an expanded access program to convalescent plasma. Our objectives were to analyze mortality and its independent risk factors, and to assess the occurrence of a favorable evolution, defined as hospital discharge, or stay at the ward, or transfer from ICU to ward. Patients were stratified int o 4 subgroups: admission to the ward with pneumonia and/or oxygen requirement (WARD; n = 100); ICU admission (ICU; n = 87); ICU admission with requirement of mechanical ventilation (ICU-MV; n = 56), and ICU-MV plus septic shock (ICU-MV-SS; N = 29). Mortality at 28 days was 26.1% for the entire group, 14.0% for WARD group, 18.4% for ICU, 44.6% for ICU-MV, and 55.2% for ICU-MV-SS. Mean survival time (days) was 25.6 ± 0.6 (WARD); 25.3 ± 0.7 (ICU); 20.8 ± 1.2 (ICU-MV) and 18.2 ± 1.8 (ICU-MV-SS). Independent predictors of mortality were MV, septic shock and weight. A favorable evolution occurred in 81.4% of WARD patients; in 70.9% of ICU; in 39.6% of ICU-MV and in 27.6% of ICU-MV-SS patients. Severity of illness on admission, age, weight and heart rate were independently associated with evolution. No major adverse effects were recorded. The lack of a control group precluded the estimation of efficacy. However, our 26% mortality rate was higher than that of the treatment arm of clinical trials comparing plasma with usual treatment, which might be ascribed to higher proportion of patients with MV and septic shock in our cohort.


Asunto(s)
Infecciones por Coronavirus/terapia , Pandemias , Neumonía Viral/terapia , Adulto , Anciano , Argentina/epidemiología , Betacoronavirus , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Femenino , Humanos , Inmunización Pasiva/métodos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Neumonía Viral/diagnóstico , Neumonía Viral/mortalidad , Estudios Retrospectivos , Resultado del Tratamiento
9.
Medicina (B Aires) ; 80(5): 425-432, 2020.
Artículo en Español | MEDLINE | ID: mdl-33048784

RESUMEN

The COVID-19 pandemic has led to measures of social isolation, labor restrictions, a strong information campaign and the suspension of scheduled medical activities. The aim of this study was to describe the impact of these measures on the number of hospitalizations in Cardiovascular Intensive Care Units, with the hypothesis that the social behavior generated by this emergency promotes a decreased demand for medical care, even when severe cardiovascular disease is involved. We compared the number of admissions in March-April 2010-2019 versus March-April 2020, based on a prospective study including six institutions (three public and three private) that use Epi-Cardio® as a multicenter registry of cardiovascular care unit discharge. Altogether, we included 6839 patients discharged during the 11-year study period (2010-2020). The average number of patient admissions on March-April 2010-19 was 595 (CI 95%: 507-683) and decreased to 348 in 2020 (fall of 46.8%, p < 0.001). The reasons for hospitalization were classified into 11 groups and a statistically significant reduction was seen in 10 of these groups: cardiovascular surgery 72.3%, electrophysiological interventions 67.8%, non-ST acute coronary syndromes 52.6%, angioplasties 47.6%, arrhythmias 48.7%, heart failure 46%, atrial fibrillation 35.7%, ST elevation myocardial infarction 34.7%, non cardiac chest pain 31.8%, others 51.6%. Although with low prevalence, hypertensive crisis increased in 89%. The abrupt decrease observed in the number of admissions due to critical pathologies may be considered an "adverse effect" related to the measures adopted, with potentially severe consequences. This trend could be reversed by improving public communication and policy adjustment.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Infecciones por Coronavirus , Hospitalización/estadística & datos numéricos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Pandemias , Admisión del Paciente/estadística & datos numéricos , Neumonía Viral , Argentina/epidemiología , Betacoronavirus , Enfermedades Cardiovasculares/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Humanos , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Estudios Prospectivos
10.
Medicina (B Aires) ; 80(5): 433-438, 2020.
Artículo en Español | MEDLINE | ID: mdl-33048785

RESUMEN

Infection with the SARS coronavirus type 2 (COVID-19) has a variety of presentations, with little data on the evolution of affected patients in Argentina. This is a retrospective and observational study of patients with virological confirmation of coronavirus treated during the months of March to May in a private third-level university hospital in Buenos Aires. O ne hundred and fifty-five adult patients were included, of which 30.3% attended only for a swab; 59.4% were admitted to the hospital and 10.3% were hospitalized at home with daily telephone follow-up. Fifty-four point two percent of participants were women and the median age was 35 years (ICQ 29 to 50). About 59.3% of patients had some risk factor, including age (65 years old or more), underlying chronic disease, were health workers or personnel/residents in a nursing home. The most frequent symptom was fever (75.9%), followed by cough (65.7%), and odyno phagia (48.2%). Globally, 93.5% experienced some symptoms while 17.6% of the participants presented some symptoms but without fever. Chest tomographies were performed to 5 patients. Their chest radiograph was normal or non-diagnostic. Fourteen patients required intensive therapy and 6 of them required mechanical ventilation, 4 of them died. The remaining 2 patients were referred to chronic care centers. No patient with home hospitalization required admission to hospital or died. While this observation is encouraging, it will need to be confirmed with new studies.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Adulto , Argentina/epidemiología , Betacoronavirus , Femenino , Hospitales Privados , Humanos , Persona de Mediana Edad , Estudios Retrospectivos
11.
Medicina (B Aires) ; 80(5): 439-441, 2020.
Artículo en Español | MEDLINE | ID: mdl-33048786

RESUMEN

During the SARSCoV-2 pandemic many drugs have been used as potential treatments in order to improve the clinical outcome and reduce the mortality. But since it is a currently unknown disease, the evidence about efficacy and safety is built as the drugs are prescribed. In this context, intensive pharmacovigilance allows early detection of adverse events, and thereby infer the safety profile of the indication. We conducted an observational, retrospective, single-center study involving adult patients with severe SARS-CoV-2 infection. All adverse events detected in 23 patients in the Intensive Care Unit between March 15 and June 15, 2020 were registered. We describe type and severity of the adverse events and if treatment suspension was needed. The results show a high rate of adverse events (10/23, 43%) in treatment with lopinavir/ritonavir. In most cases early treatment suspension was required. Even though the limitations of our study derived from the small sample size, these results could help in building evidence about the safety of using lopinavir/ritonavir for severe SARS-CoV-2 infection.


Asunto(s)
Infecciones por Coronavirus/tratamiento farmacológico , Inhibidores del Citocromo P-450 CYP3A/efectos adversos , Lopinavir/efectos adversos , Neumonía Viral/tratamiento farmacológico , Ritonavir/efectos adversos , Adulto , Anciano , Argentina/epidemiología , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Enfermedad Crítica , Inhibidores del Citocromo P-450 CYP3A/uso terapéutico , Femenino , Humanos , Lopinavir/uso terapéutico , Masculino , Pandemias , Neumonía Viral/epidemiología , Estudios Retrospectivos , Ritonavir/uso terapéutico , Resultado del Tratamiento
12.
Medicina (B Aires) ; 80(5): 505-511, 2020.
Artículo en Español | MEDLINE | ID: mdl-33048795

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic requires rapid medical responses. The risk of venous and arterial thromboembolism increases in critically ill patients with SARS-CoV-2 infection. There is a hypercoagulable state that includes elevated levels of D-dimer, with an increased risk of organ failure and increased mortality. The abnormalities described in hemostasis should be considered for therapeutic decision making. We analyzed the available scientific evidence for the therapeutic approach of coagulopathy in the course of the disease with the objective of designing realistic therapeutic recommendations aimed at reducing morbidity and mortality in patients with COVID-19.


Asunto(s)
Trastornos de la Coagulación Sanguínea/etiología , Infecciones por Coronavirus/sangre , Coronavirus , Pandemias , Neumonía Viral/sangre , Tromboembolia/complicaciones , Argentina/epidemiología , Betacoronavirus , Trastornos de la Coagulación Sanguínea/diagnóstico , Trastornos de la Coagulación Sanguínea/epidemiología , Trastornos de la Coagulación Sanguínea/prevención & control , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Citocinas , Coagulación Intravascular Diseminada , Heparina , Humanos , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Sepsis
13.
Sleep Med ; 76: 16-25, 2020 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-33059247

RESUMEN

OBJECTIVES: At the end of 2019 the SARS-CoV-2 outbreak spread around the globe with a late arrival to South America. The objective of this study was to evaluate the impact of the long period of mandatory social isolation that took place in Argentina on the general psychological well-being of healthcare workers due to the COVID-19 pandemic. METHODS: A survey was conducted during June 2020, in healthcare workers. Pittsburgh Sleep Quality Index, Insomnia Severity Index, Sleepiness-Wakefulness Inability and Fatigue Test, and Goldberg depression and anxiety scale, were used to analyze the effects of the SARS-Cov 2 outbreak after three months of mandatory social isolation. Analyses were performed by logistic regression and a clustering algorithm in order to classify subjects in the function of their outcome's severity. RESULTS: From 1059 surveys, the majority reported symptoms of depression (81.0%), anxiety (76.5%), poor sleep quality (84.7%), and insomnia (73.7%) with 58.9% suffering from nightmares. Logistic regression showed that being in contact with COVID-19 patients, age, gender and the consumption of sleep medication during the mandatory social isolation were relevant predictors for insomnia, anxiety, and depression. Clustering analysis classified healthcare workers in three groups with healthy/mild, moderate, and severe outcomes. The most vulnerable group was composed mainly of younger people, female, non-medical staff, or physicians in training. CONCLUSION: An extremely high proportion of Argentinian healthcare workers suffered from sleep problems, anxiety, and depression symptoms. The clustering algorithm successfully separates vulnerable from non-vulnerable populations suggesting the need to carry out future studies involving resilience and vulnerability factors.

14.
Rev Bras Ter Intensiva ; 32(3): 348-353, 2020.
Artículo en Español, Inglés | MEDLINE | ID: mdl-33053023

RESUMEN

OBJECTIVE: A novel coronavirus emerged this year as a cause of viral pneumonia. The main characteristics of the virus are rapid transmission, high contagion capacity and potential severity. The objective of this case series study is to describe the clinical characteristics of patients with confirmed coronavirus disease (COVID-19) admitted to different intensive care units in Argentina for mechanical ventilation. METHODS: A descriptive, prospective, multicenter case series study was conducted between April 1 and May 8, 2020. Data from patients older than 18 years who were admitted to the intensive care unit for mechanical ventilation for acute respiratory failure with a positive diagnosis of COVID-19 were included. RESULTS: The variables for 47 patients from 31 intensive care units were recorded: 78.7% were men (median age of 61 years), with a SAPS II score of 43 and a Charlson index score of 3. The initial ventilatory mode was volume control - continuous mandatory ventilation with a tidal volume less than 8mL/kg in 100% of cases, with a median positive end-expiratory pressure of 10.5cmH2O. At the end of the study, 29 patients died, 8 were discharged, and 10 remained hospitalized. The SAPS II score was higher among patients who died (p = 0.046). Charlson comorbidity index was associated with higher mortality (OR = 2.27, 95% CI 1.13 - 4.55, p = 0.02). CONCLUSION: Patients with COVID-19 and on mechanical ventilation in this series presented clinical variables similar to those described to date in other international reports. Our findings provide data that may predict outcomes.


Asunto(s)
Infecciones por Coronavirus/terapia , Unidades de Cuidados Intensivos , Neumonía Viral/terapia , Respiración Artificial , Insuficiencia Respiratoria/terapia , Adulto , Anciano , Argentina , Betacoronavirus , Infecciones por Coronavirus/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/fisiopatología , Respiración con Presión Positiva , Estudios Prospectivos , Insuficiencia Respiratoria/virología , Volumen de Ventilación Pulmonar
16.
Obes Surg ; 2020 Oct 06.
Artículo en Inglés | MEDLINE | ID: mdl-33025540

RESUMEN

Argentina was able to anticipate public health interventions in order to flatten the contagion curve of CoViD-19. Eighty-three surgeons answered an online survey to assess the impact of the pandemic on bariatric surgery (BS) in Argentina. Most of them showed a high economic dependence on BS. Near 90% of health institutions were on phase 0 or I. While 90% still performed other laparoscopic surgeries, BS was suspended. In many surgeries for nonsuspected CoViD-19 patients, high personnel protection resources were applied. Ninety-five percent offered virtual consults. Most surgeons would not change usual algorithms or techniques. To restart BS a scientific society recommendation was expected, including patient selection criteria. The opinions gathered by this survey were taken into account to elaborate official recommendations for restarting elective BS.

18.
Artículo en Inglés | MEDLINE | ID: mdl-32897937

RESUMEN

BACKGROUND: The spread of SARS-CoV-2, causative agent of the coronavirus disease 2019 (COVID-19), has necessitated widespread lockdown to mitigate the pandemic. This study examines the influence of resilience on the impact of COVID-related stress and enforced lockdown on mental health, drug use and treatment adherence among people living with HIV (PLWH) in Argentina. SETTING: PLWH residing predominantly in Buenos Aires Metropolitan Area and urban regions of Argentina were identified from a private clinic electronic database. METHODS: Participants completed an anonymous online survey to evaluate the impact of COVID-19 on economic disruption, resilience, mental health outcomes (depression, anxiety, stress, loneliness), adherence to HIV treatment, and substance use. We performed ordinary least squares and logistic regressions to test whether resilient coping buffered the impact of economic disruption on mental health and drug use during quarantine. RESULTS: 1336 PLWH aged 18-82 were enrolled. The impact of economic disruption on mental health ΔF(1,1321)=8.86, p=.003 and loneliness ΔF(1,1326)=5.77, p=.016 was buffered by resilience. A three-way interaction between resilient buffering, stress, and sex was significant ΔF(1,1325)=4.76, p=.029. Participants reported less than excellent adherence to medication (33%), disruption to mental health services (11%), and disruption to substance abuse treatment (1.3%) during lockdown. DISCUSSION: The impact of COVID-stress and lockdown on emotional distress appeared mitigated by resilience coping strategies and the buffering impact of resilience on perceived stress was greater among women. Results highlight PLWH's capacity to adhere to treatment in challenging circumstances and the importance of developing resilience skills for better coping with stress and adversity.

20.
Rev. Hosp. Ital. B. Aires (2004) ; 40(3): 117-125, sept. 2020. ilus, tab
Artículo en Español | LILACS | ID: biblio-1129078

RESUMEN

En diciembre de 2019 se identificó el virus SARS-CoV-2, cuya rápida propagación global puso en estado de emergencia al mundo entero, llevando al ser humano a una situación sin antecedente cercano. El objetivo de esta revisión es describir los métodos diagnósticos utilizados actualmente para identificar la infección por SARS-CoV-2. Las manifestaciones clínicas y el espectro imagenológico de la enfermedad son muy inespecíficos y no permiten realizar un diagnóstico certero. Por esta razón, es esencial una apropiada toma de muestra respiratoria en el momento y sitio anatómico adecuado para un diagnóstico preciso de COVID-19. La técnica de muestreo más utilizada es el hisopado nasofaríngeo y la prueba diagnóstica más fiable se basa en la retrotranscripción seguida por reacción en cadena de la polimerasa en tiempo real (RT-PCR). No obstante, existen otras técnicas moleculares, como también tests serológicos para detectar anticuerpos o fragmentos antigénicos del SARS-CoV-2. Más allá de la precisión diagnóstica, es importante tener en cuenta la probabilidad basal (pretest) para interpretar correctamente el resultado obtenido y aislar aquellos posibles falsos negativos. Con el objetivo de evitar la saturación del sistema de salud es imprescindible contar con información y métodos diagnósticos precisos para detectar tempranamente los focos de infección y reducir la transmisión comunitaria, utilizando eficazmente los diferentes recursos diagnósticos. (AU)


In December 2019, the SARS-CoV-2 virus was identified for the first time, whose rapid global spread put the entire world in a state of emergency, leading humans to an unprecedented situation with no immediate history. The main purpose of this review is to describe the diagnostic methods currently used to identify SARS-CoV-2 infection. The clinical manifestations and the imaging spectrum of the disease are nonspecific and do not allow an accurate diagnosis to be made. For this reason, an appropriate respiratory sampling at the right time and anatomical site is essential for an accurate diagnosis of COVID-19. The most widely used sampling technique is nasopharyngeal swab, and the most reliable diagnostic test is by reverse transcription followed by real-time polymerase chain reaction (RT-PCR). However, there are other molecular techniques, as well as serological tests to detect antibodies or antigenic fragments of SARS-CoV-2. Beyond the diagnostic precision, it is important to take into account the baseline probability (pre-test) to correctly interpret the result obtained and isolate those possible false negatives. In order to avoid saturation of the health system, it is essential to have accurate information and diagnostic methods to detect outbreaks of infection in early stages and to reduce communitary transmission, making effective use of the various diagnostic resources. Coronavirus infections/diagnosis, viral/diagnosis, pandemics, clinical laboratory techniques, real-time polymerase chain reaction, antigens, viral/analysis. (AU)


Asunto(s)
Humanos , Pruebas Serológicas/métodos , Infecciones por Coronavirus/diagnóstico , Reacción en Cadena en Tiempo Real de la Polimerasa/métodos , Argentina , Neumonía Viral/diagnóstico , Pruebas Serológicas/estadística & datos numéricos , Reacción en Cadena de la Polimerasa/métodos , Reacción en Cadena de la Polimerasa/estadística & datos numéricos , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/diagnóstico por imagen , Reacciones Falso Negativas , Reacciones Falso Positivas , Reacción en Cadena en Tiempo Real de la Polimerasa/estadística & datos numéricos , Betacoronavirus
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