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1.
Rev Med Chil ; 149(4): 559-569, 2021 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-34479344

RESUMO

Approximately 5% of COVID-19 patients will have a severe disease requiring invasive or non-invasive mechanical ventilation. In this conditions, sedatives and analgesics are fundamental to promote tolerance, comfort and synchrony with the mechanical ventilator. High and unusual requirements for sedation, analgesics and neuromuscular blockers have been reported in these patients, contributing to prolonged exposure, a high rate of delirium and prolongation of mechanical ventilation. These factors, added to the progressive shortage of these drugs, a high demand for care and less capacity for personalized attention, have created an adverse scenario for their proper and rational use. This paper proposes different pharmacotherapeutic optimization strategies for a rational management of sedation, analgesia and neuromuscular block in critically ill patients with COVID-19, with the therapeutic alternatives available in Chile.


Assuntos
Analgesia , COVID-19 , Chile , Estado Terminal/terapia , Humanos , Hipnóticos e Sedativos , Respiração Artificial , SARS-CoV-2
2.
Rev Chilena Infectol ; 38(3): 355-361, 2021 06.
Artigo em Espanhol | MEDLINE | ID: mdl-34479292

RESUMO

In March 2020, the World Health Organization (WHO) recommended that vaccination not be interrupted as long as countries could safely maintain this service in the context of the SARS-CoV-2 pandemic. WHO also warned about the risk of interruption of programmatic vaccination that generates an increase in the number of people susceptible to infections that are sought to be prevented with the use of vaccines and, therefore, an increase in the probability of disease outbreak. Along with increased morbidity and mortality in risk groups, vaccine-preventable disease outbreaks would put additional demand on the health system already burdened by COVID-19. In August 2020, WHO reported the interruption of essential health services in different countries as a result of the SARS-CoV-2 pandemic, which mainly affected routine and extramural vaccination. In Chile, routine vaccination coverage decreased during 2020 compared to the average coverage for the 2015-2019 period. The smallest decline was 0.39% for the hexavalent vaccine at 2 months of age and the largest decrease was 12.02% at 18 months for the same vaccine. The exception to the fall in coverage in 2020 was adult pneumococcal vaccination, which showed an increase of 0.8% compared to 2015-2019.


Assuntos
COVID-19 , SARS-CoV-2 , Adulto , Chile/epidemiologia , Humanos , Programas de Imunização , Pandemias/prevenção & controle , Vacinas Pneumocócicas , Vacinação
4.
Clin Infect Dis ; 2021 Sep 19.
Artigo em Inglês | MEDLINE | ID: mdl-34537835

RESUMO

BACKGROUND: The development of effective vaccines against COVID-19 is a global priority. CoronaVac is an inactivated SARS-CoV-2 vaccine with promising safety and immunogenicity profiles. This article reports safety and immunogenicity results obtained for healthy Chilean adults aged ≥18 in a phase 3 clinical trial. METHODS: Volunteers randomly received two doses of CoronaVac or placebo, separated by two weeks. 434 volunteers were enrolled, 397 aged 18-59 years, and 37 aged ≥60 years. Solicited and unsolicited adverse reactions were registered from all volunteers. Blood samples were obtained from a subset of volunteers and analyzed for humoral and cellular measures of immunogenicity. RESULTS: The primary adverse reaction in the 434 volunteers was pain at the injection site, with a higher incidence in the vaccine than in the placebo arm. Adverse reactions observed were mostly mild and local. No severe adverse events were reported. The humoral evaluation was performed on 81 volunteers. Seroconversion rates for specific anti-S1-RBD IgG were 86.67% in the 18-59 age group and 70.37% in the ≥60 age group, two and four weeks after the second dose. A significant increase in circulating neutralizing antibodies was detected two and four weeks after the second dose. The cellular evaluation was performed on 47 volunteers. We detected a significant induction of T cell responses characterized by the secretion of IFN-γupon stimulation with Mega Pools of peptides from SARS-CoV-2. CONCLUSIONS: Immunization with CoronaVac in a 0-14 schedule in Chilean adults aged ≥18 is safe, induces anti-S1-RBD IgG with neutralizing capacity, activates T cells, and promotes the secretion of IFN-γupon stimulation with SARS-CoV-2 antigens.

5.
Rev Med Chil ; 149(3): 339-347, 2021 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-34479312

RESUMO

BACKGROUND: Chilean higher education students have faced highly stressful events in 2020, including confinement and remote education. This population is particularly susceptible to mental health problems, such as high levels of stress, anxiety, and depression. AIM: To evaluate possible negative impacts of confinement by COVID-19 on Chilean higher education students' mental health. MATERIAL AND METHODS: The Center for Epidemiologic Studies Depression Scale (CES-D) Scale and the Profile of Mood States (POMS) were applied to 315 students during 2016 and to 301 students during 2020. RESULTS: In 2020, depression mean scores for men (24.1) and women (29.7) exceeded the cutoff point, therefore suggesting the presence of depressive disorder. Women had higher depressive and anxious symptoms in both years, however, in 2020 a significant increase was observed for depression, indicating interaction between the year of assessment andgender (0 = 6.74; p <.001). In both samples, first-year students hadsignificantly higherdepressionscores (fl = -1,909;p = 0.05). CONCLUSIONS: An increase in depression was observed in 2020. Confinement by COVID-19 had a high impact on mental health in female students. Women and first-year students appear to be high risk groups for developing depressive symptoms.


Assuntos
COVID-19/psicologia , Saúde Mental , Estudantes/psicologia , Ansiedade/epidemiologia , Chile/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Universidades
6.
Lancet Oncol ; 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34487693

RESUMO

BACKGROUND: The COVID-19 pandemic has strained health system capacity worldwide due to a surge of hospital admissions, while mitigation measures have simultaneously reduced patients' access to health care, affecting the diagnosis and treatment of other diseases such as cancer. We estimated the impact of delayed diagnosis on cancer outcomes in Chile using a novel modelling approach to inform policies and planning to mitigate the forthcoming cancer-related health impacts of the pandemic in Chile. METHODS: We developed a microsimulation model of five cancers in Chile (breast, cervix, colorectal, prostate, and stomach) for which reliable data were available, which simulates cancer incidence and progression in a nationally representative virtual population, as well as stage-specific cancer detection and survival probabilities. We calibrated the model to empirical data on monthly detected cases, as well as stage at diagnosis and 5-year net survival. We accounted for the impact of COVID-19 on excess mortality and cancer detection by month during the pandemic, and projected diagnosed cancer cases and outcomes of stage at diagnosis and survival up to 2030. For comparison, we simulated a no COVID-19 scenario in which the impacts of COVID-19 on excess mortality and cancer detection were removed. FINDINGS: Our modelling showed a sharp decrease in the number of diagnosed cancer cases during the COVID-19 pandemic, with a large projected short-term increase in future diagnosed cases. Due to the projected backlog in diagnosis, we estimated that in 2021 there will be an extra 3198 cases (95% uncertainty interval [UI] 1356-5017) diagnosed among the five modelled cancers, an increase of nearly 14% compared with the no COVID-19 scenario, falling to a projected 10% increase in 2022 with 2674 extra cases (1318-4032) diagnosed. As a result of delayed diagnosis, we found a worse stage distribution for detected cancers in 2020-22, which is estimated to lead to 3542 excess cancer deaths (95% UI 2236-4816) in 2022-30, compared with the no COVID-19 scenario, among the five modelled cancers, most of which (3299 deaths, 2151-4431) are projected to occur before 2025. INTERPRETATION: In addition to a large projected surge in diagnosed cancer cases, we found that delays in diagnosis will result in worse cancer stage at presentation, leading to worse survival outcomes. These findings can help to inform surge capacity planning and highlight the importance of ensuring appropriate health system capacity levels to detect and care for the increased cancer cases in the coming years, while maintaining the timeliness and quality of cancer care. Potential delays in treatment and adverse impacts on quality of care, which were not considered in this model, are likely to contribute to even more excess deaths from cancer than projected. FUNDING: Harvard TH Chan School of Public Health. TRANSLATIONS: For the Spanish and Portuguese translations of the abstract see Supplementary Materials section.

8.
Public Health ; 198: 332-339, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34509858

RESUMO

OBJECTIVES: To compare food insecurity (FI) in Chile before and during the COVID-19 pandemic according to different household types and vulnerability indicators. STUDY DESIGN: Longitudinal study based on two population-based surveys in Chile (CASEN 2017 and COVID 2020). METHODS: Descriptive analysis and multinomial regression models for FI through the Food Insecurity Experience Scale (FIES). RESULTS: FI levels increased significantly (P < 0.001) between 2017 (30%) and 2020 (49%). There was increased FI in all households, but especially in those with economically dependent persons (i.e. children, adolescents and older adults). Household vulnerability indicators showed a statistically significant relationship with FI both before and during the pandemic. The pandemic has resulted in new population groups experiencing FI. CONCLUSIONS: The COVID-19 pandemic has led to a significant increase in FI, which has also been seen in new population groups.

9.
Lancet Infect Dis ; 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34509185

RESUMO

BACKGROUND: By July 14, 2021, 81·3 % of adults (aged ≥18 years) in Chile had received a first SARS-CoV-2 vaccine and 72·3% had received a second SARS-CoV-2 vaccine, with the majority of people given Sinovac's inactivated CoronaVac vaccine (75·3% of vaccines dispensed) or Pfizer-BioNTech's mRNA BNT162b2 vaccine (20·9% of vaccines dispensed). Due to the absence of simultaneous real-world data for these vaccines, we aimed to compare SARS-CoV-2 IgG positivity between vaccines using a dynamic national monitoring strategy. METHODS: From March 12, 2021, 28 testing stations for SARS-CoV-2 IgG detection were installed in hotspots based on cellular-phone mobility tracking within the most populated cities in Chile. Individuals voluntarily approaching the testing stations were invited to do a lateral flow test by finger prick and respond to a questionnaire on sociodemographic characteristics, vaccination status (including type of vaccine if one was received), variables associated with SARS-CoV-2 exposure, and comorbidities. We compared the proportion of individuals testing positive for anti-SARS-CoV-2 IgG across sites by week since vaccination between recipients of CoronaVac and BNT162b2. Unvaccinated participants served as a control population and were matched to vaccinated individuals on the basis of date of presentation to the testing station, gender, and age group. Individuals were excluded from the analysis if they were younger than 18 years, had no declared gender, had an invalid IgG test result, had previously tested positive for SARS-CoV-2 infection on PCR, could not recall their vaccination status, or had been immunised against COVID-19 with vaccines other than CoronaVac or BNT162b2. Here, we report data collected up to July 2, 2021. FINDINGS: Of 64 813 individuals enrolled, 56 261 were included in the final analysis, of whom 33 533 (59·6%) had received at least one dose of the CoronaVac vaccine, 8947 (15·9%) had received at least one dose of the BNT162b2 vaccine, and 13 781 (24·5%) had not received a vaccine. SARS-CoV-2 IgG positivity during week 4 after the first dose of CoronaVac was 28·1% (95% CI 25·0-31·2; 220 of 783 individuals), reaching a peak of 77·4% (75·5-79·3; 1473 of 1902 individuals) during week 3 after the second dose. SARS-CoV-2 IgG positivity during week 4 after the first dose of the BNT162b2 vaccine was 79·4% (75·7-83·1; 367 of 462 individuals), increasing to 96·5% (94·9-98·1; 497 of 515 individuals) during week 3 after the second dose and remaining above 92% until the end of the study. For unvaccinated individuals, IgG seropositivity ranged from 6·0% (4·4-7·6; 49 of 810 individuals) to 18·7% (12·5-24·9; 28 of 150 individuals) during the 5 month period. Regression analyses showed that IgG seropositivity was significantly lower in men than women and in people with diabetes or chronic diseases for CoronaVac vaccine recipients (p<0·0001), and for individuals aged 60 years and older compared with people aged 18-39 years for both vaccines (p<0·0001), 3-16 weeks after the second dose. INTERPRETATION: IgG seropositivity was lower after CoronaVac than after BNT162b2 and declined over time since vaccination for CoronaVac recipients but not BNT162b2 recipients. Prolonged IgG monitoring will allow further evaluation of seropositivity overtime, providing data, in conjunction with effectiveness studies, for possible future re-assessment of vaccination strategies. FUNDING: Instituto Sistemas Complejos de Ingeniería and Ministerio de Salud Chile. TRANSLATION: For the Spanish translation of the abstract see Supplementary Materials section.

10.
Int J Infect Dis ; 2021 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-34547488

RESUMO

OBJECTIVES: Evaluate the impact on 30-day mortality of early use of corticosteroids in patients with COVID-19 with supplementary oxygen requirements and without invasive mechanical ventilation at the initiation of therapy. METHODS: Between April 15th and July 15th, 2020, all hospitalized patients with COVID-19 and oxygen requirements were prospectively included in a database. Patients who died or required intubation within the first 48 hours were excluded. Patients who received corticoids within the first 5 days of hospitalization and at least 24 hours prior to intubation were considered as in "early corticosteroids group." To compare both populations and adjust for non-random treatment assignment bias a weight adjusted propensity score model was used. RESULTS: 571 patients met the inclusion criteria, 520 had sufficient information for the analysis. Of these, 233 received early corticosteroids and 287 did not. After the analysis, a reduction of 8.5% (p = 0.038) in 30 -day mortality was observed in the early corticosteroid group. The reduction in mortality was nonsignificant when patients with corticosteroid initiation between day 5 and day 8 of hospitalization were included. CONCLUSION: Early corticosteroid use in patients with pneumonia due to COVID-19 and supplementary oxygen requirements without invasive mechanical ventilation reduces mortality.

11.
Polit Psychol ; 2021 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-34548716

RESUMO

In the context of the COVID-19 pandemic, personal protective measures (e.g., social distancing, handwashing, and mask wearing) have been adopted as a cornerstone to limit the spread of the disease. Yet, the effectiveness of these measures depends on people's levels of adherence. In this article, we apply social-psychological research to the study of compliance with personal protective measures during the COVID-19 pandemic in Chile. We consider three possible models underlying adherence: (1) sociodemographic and socioeconomic factors, (2) instrumental factors, and (3) normative factors. We draw on data from a longitudinal nonrepresentative panel study (Study 1, n = 32,304) and a cross-sectional representative survey (Study 2, n = 1,078) to explore the impact of these different factors on personal protective measures compliance. Findings show the strongest support for the role of instrumental and normative factors, in that people who comply with protective measures report to a greater extent that relatives and friends comply too and tend to perceive high risk of COVID-19. We finish by proposing policy recommendations to promote effective strategies to contain the spread of the virus.

12.
Santiago; OPS; 2021-08-30. (OPS/CHL/21-0001).
Não convencional em Espanhol | PAHO-IRIS | ID: phr2-54755

RESUMO

Establecida en 1902 como el organismo independiente especializado en salud del sistema interamericano, la Organización Panamericana de la Salud (OPS) ha desarrollado competencias y experiencia ampliamente reconocidas al brindar cooperación técnica a sus Estados Miembros para combatir las enfermedades transmisibles y no transmisibles y sus causas, fortalecer los sistemas de salud y responder a situaciones de emergencia y desastres en toda la Región de las Américas. Asimismo, en su calidad de oficina regional de la Organización Mundial de la Salud, la OPS participa activamente en los equipos de las Naciones Unidas en los países, colaborando con otros organismos, fondos y programas del sistema de las Naciones Unidas para contribuir al logro de los Objetivos de Desarrollo Sostenible (ODS) a nivel de país. En este informe anual se presenta la cooperación técnica de la OPS a nivel de país en el 2020, mediante la aplicación de la estrategia de cooperación con el país, la respuesta a las necesidades y prioridades nacionales, y el desarrollo de las actividades en el marco de los mandatos regionales y mundiales de la Organización y los ODS. En consonancia con el tema general de "la salud universal y la pandemia: sistemas de salud resilientes", se pone de relieve la respuesta de la OPS a la pandemia de COVID-19, así como sus esfuerzos continuos en esferas prioritarias como las enfermedades transmisibles, las enfermedades no transmisibles, la salud mental, la salud a lo largo del curso de vida y las emergencias de salud. También se presenta un resumen financiero del ejercicio examinado.


Assuntos
Cooperação Técnica , Sistemas de Saúde , Programas Nacionais de Saúde , Políticas, Planejamento e Administração em Saúde , Cobertura de Serviços de Saúde , Doenças não Transmissíveis , Doenças Transmissíveis , Fatores de Risco , Saúde Mental , Administração Financeira , América do Sul , Chile
13.
Artigo em Inglês | MEDLINE | ID: mdl-34360433

RESUMO

The pandemic has challenged countries to develop stringent measures to reduce infections and keep the population healthy. However, the greatest challenge is understanding the process of adopting self-care measures by individuals in different countries. In this research, we sought to understand the behavior of individuals who take self-protective action. We selected the risk homeostasis approach to identify relevant variables associated with the risk of contagion and the Protective Action Decision Model to understand protective decision-making in the pandemic. Subsequently, we conducted an exploratory survey to identify whether the same factors, as indicated in the literature, impact Chile's adoption of prevention measures. The variables gender, age, and trust in authority behave similarly to those found in the literature. However, socioeconomic level, education, and media do not impact the protection behaviors adopted to avoid contagion. Furthermore, the application of the Protective Action Decision Model is adequate to understand the protective measures in the case of a pandemic. Finally, women have a higher risk perception and adopt more protective measures, and in contrast, young people between 18 and 30 years of age are the least concerned about COVID-19 infection.


Assuntos
COVID-19 , Adolescente , Chile , Feminino , Humanos , Pandemias , SARS-CoV-2 , Inquéritos e Questionários
14.
J Stroke Cerebrovasc Dis ; 30(11): 105953, 2021 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-34464928

RESUMO

Background and purpose; Chile has been one of the most affected countries by the COVID-19 pandemic, with one of the highest case rates per population. This has affected the epidemiological behaviour of various pathologies. We analyze the impact of the pandemic on the number of admissions due to stroke, its severity and mortality in Santiago, Chile. METHODS: a multicenter observational study based on the records of the 3 hospitals of the South East health service in Santiago, Chile. We recorded the number of patients admitted for ischemic stroke between 01 January 2020 and 30 June 2020. We grouped the cases into two periods, pre-pandemic and pandemic, according to the setting of the state of emergency in Chile. RESULTS: 431 patients were admitted with ischemic stroke during the study period. There was a non-significant decrease in weekly admissions (17 vs 15 patients per week). No differences were observed in the proportion of patients with medical treatment (p = 0.810), IVT (p = 0.638), EVT (p = 0.503) or IVT + EVT (p = 0.501). There was a statistically significant increase in the NIHSS on admission (7.23 vs 8.78, p = 0.009) and mortality (5.2% vs 12.4%, p = 0.012). In a multivariate analysis the NIHSS on admission was associated with the increased mortality (RR 1.11, CI 1.04-1.19, p = 0.003). CONCLUSION: We found an increase in the severity of ischemic stroke on admission and in-hospital mortality during the pandemic period. The main factor to increase in-hospital mortality was the NIHSS on admission.

15.
Span J Psychol ; 24: e42, 2021 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-34384509

RESUMO

Analyze whether the content of three moral messages (deontological, ethical utilitarianism, ethical virtue) and a control message differentially affect the probability of engaging in four behaviors: Washing their hands, participating in public gatherings, staying at home/avoiding social contact, and forwarding the message to inform more people. In our study, the sender of the message is a university professor. These variables are measured in terms of their behavioral intentions and others' behavioral intentions (beliefs about others' behavior). Randomized Controlled Trial. Our study includes the analysis of the possible moderating effect of the country of residence (Spain n = 1,122, Chile n = 1,107, and Colombia n = 1,433). The message with content referring to ethical virtue and staying at home obtains statistically significant lower scores on the probability of carrying out public health behaviors and sharing the message received. Regarding beliefs about the behavior of others, the message of ethical virtue has the same negative effect, but only on the likelihood of other people washing their hands, staying at home, and sharing the public health message. Institutional messages aimed at promoting public health behaviors are necessary in a pandemic situation. Our recommendation is to use deontological and utilitarian, or non-moral, content.


Assuntos
COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , Desinfecção das Mãos , Promoção da Saúde , Princípios Morais , Comunicação Persuasiva , Saúde Pública , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Chile , Colômbia , Teoria Ética , Ética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distanciamento Físico , Política Pública , SARS-CoV-2 , Espanha , Virtudes , Adulto Jovem
16.
Artigo em Francês | MEDLINE | ID: mdl-34393032

RESUMO

POSITION DU PROBLèME: Le confinement mis en place au deuxième trimestre 2020 a entrainé une amélioration de la qualité de l'air de Santiago, capitale et plus grande ville du Chili, caractérisée par de fortes concentrations en particules fines PM2,5 liées, en grande partie, au trafic routier. L'objectif était de mettre en évidence une potentielle réduction des visites aux urgences pour infarctus du myocarde aigu (IDM) et des décès dus à une cardiopathie ischémique (CPI) attribuable à l'émission de PM2,5, en comparant les périodes équivalentes de 2019 et de 2020. MéTHODES: À Santiago, la surveillance de la qualité de l'air se fait grâce à neuf moniteurs situés dans neuf communes différentes : Cerro Navia, Cerrillos, El Bosque, Pudahuel, Independencia, La Florida, Quilicura, Santiago centre-ville et Las Condes (classées de la plus haute à la plus basse en matière de pauvreté multidimensionnelle). La concentration moyenne quotidienne de PM2,5 a été décrite avec des séries temporelles, et les visites aux urgences pour IDM et les décès dus à une CPI ont été analysés de façon trimestrielle pour chaque année. Pour estimer l'impact de l'excès de PM2,5, les fractions de risque attribuables (FRA) pour les visites aux urgences pour IDM et les décès pour CPI ont été calculées. RéSULTATS: La moyenne quotidienne des PM2,5 a diminué dans huit des neuf communes de Santiago. Cependant, la réduction n'a été significative que dans trois communes. Les visites aux urgences pour IDM et les décès par CPI attribuables aux PM2,5 ont diminué légèrement mais significativement dans ces trois communes. Les FRA dans les autres communes sont restées similaires à 2019. CONCLUSIONS: Une réduction significative de la FRA des PM2,5 pour les décès par CPI et les visites aux urgences d'IDM n'a été observée que dans les communes avec une réduction significative de la concentration quotidienne moyenne de PM2,5 pendant la pandémie de COVID-19.

17.
Rehabil. integral (Impr.) ; 15(1): 30-40, ago. 2021.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1283454

RESUMO

INTRODUCCIÓN: Producto de la pandemia por COVID-19 y para establecer continuidad a los tratamientos de usuarios y familias, Teletón Chile implementó una encuesta para describir las características demográficas, de salud, sociales, ambientales, factores asociados, atención a distancia y problemas asociados por contingencia COVID-19. OBJETIVO: Describir el servicio de atención a distancia (AD) implementado por Teletón Chile, preferencias y utilidad de redes sociales (RR.SS.) de los usuarios. MATERIALES Y MÉTODOS: Estudio descriptivo transversal de tipo censal a usuarios activos de Teletón al 30 de abril de 2020 desarrollado a través de la aplicación de una encuesta para caracterizar el servicio de AD y RR.SS. RESULTADOS: Se presentan resultados obtenidos entre junio y agosto de 2020, que representan al 31,13% (n = 8.202) de la población total atendida; El 74,54% de los participantes de la encuesta señalan haber recibido AD, de los cuales un 82,02% logra el cumplimiento de las indicaciones siendo la principal razón de no cumplimiento no ser contactado para la modalidad AD desde el área médico-terapéutica (36,55%). Los principales beneficios de la AD son: aumento de la accesibilidad en la atención (44,13%) y disminución de las problemáticas del traslado (17,67%). La preocupación principal es la pérdida de la cantidad de atenciones presenciales (34,41%). CONCLUSIONES: La AD es considerada de utilidad para la continuidad de los programas de rehabilitación. Asimismo, toma relevancia el uso de redes sociales para contacto y seguimiento. Finalmente, para implementar este servicio se requiere considerar las necesidades personales de los usuarios para una rehabilitación remota.


INTRODUCTION: Due to the COVID-19 pandemic and to establish continuity in the treatment of users and families, Teletón Chile implemented a survey to describe the demographic, health, social and environmental characteristics, associated factors, distance care and associated problems due to COVID-19. Objective: To describe stance Attention (DA) service implemented by Teleton Chile, and the preferences and usefulness of users' social networks (RRSS). MATERIALS AND METHODS: A cross-sectional descriptive study of a census type which was developed through the application of a survey to characterize the DA and RRSS service, and includes active Teletón users as of April 30, 2020. RESULTS: Results obtained between June and August 2020 are presented, representing 31.13% (n = 8,202) of the total population served; 74.54% of the survey participants indicated having received of which 82.02% achieved compliance with the prescribed indications, the main reason for non-compliance was not being contacted by the medical-therapeutic area for the DA modality (36.55%). The main benefits of DA are: increased accessibility to care (44.13%) and reduction in transportation problems (17.67%). The main concern is the loss of the amount of face-to-face care (34.41%). CONCLUSIONS: DA is considered useful for the continuity of rehabilitation programs. The use of social networks for contact and follow-up is also relevant. Finally, to implement this service, it is necessary to consider the personal needs of the users for a remote rehabilitation.

19.
N Engl J Med ; 385(10): 875-884, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34233097

RESUMO

BACKGROUND: Mass vaccination campaigns to prevent coronavirus disease 2019 (Covid-19) are occurring in many countries; estimates of vaccine effectiveness are urgently needed to support decision making. A countrywide mass vaccination campaign with the use of an inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine (CoronaVac) was conducted in Chile starting on February 2, 2021. METHODS: We used a prospective national cohort, including participants 16 years of age or older who were affiliated with the public national health care system, to assess the effectiveness of the inactivated SARS-CoV-2 vaccine with regard to preventing Covid-19 and related hospitalization, admission to the intensive care unit (ICU), and death. We estimated hazard ratios using the extension of the Cox proportional-hazards model, accounting for time-varying vaccination status. We estimated the change in the hazard ratio associated with partial immunization (≥14 days after receipt of the first dose and before receipt of the second dose) and full immunization (≥14 days after receipt of the second dose). Vaccine effectiveness was estimated with adjustment for individual demographic and clinical characteristics. RESULTS: The study was conducted from February 2 through May 1, 2021, and the cohort included approximately 10.2 million persons. Among persons who were fully immunized, the adjusted vaccine effectiveness was 65.9% (95% confidence interval [CI], 65.2 to 66.6) for the prevention of Covid-19 and 87.5% (95% CI, 86.7 to 88.2) for the prevention of hospitalization, 90.3% (95% CI, 89.1 to 91.4) for the prevention of ICU admission, and 86.3% (95% CI, 84.5 to 87.9) for the prevention of Covid-19-related death. CONCLUSIONS: Our results suggest that the inactivated SARS-CoV-2 vaccine effectively prevented Covid-19, including severe disease and death, a finding that is consistent with results of phase 2 trials of the vaccine. (Funded by Agencia Nacional de Investigación y Desarrollo and others.).


Assuntos
Vacinas contra COVID-19/imunologia , COVID-19/prevenção & controle , Imunogenicidade da Vacina , Vacinação em Massa , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/epidemiologia , COVID-19/mortalidade , Chile/epidemiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Incidência , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Gravidade do Paciente , Estudos Prospectivos , Resultado do Tratamento , Vacinas de Produtos Inativados , Adulto Jovem
20.
Sensors (Basel) ; 21(12)2021 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-34198627

RESUMO

In this paper, we group South American countries based on the number of infected cases and deaths due to COVID-19. The countries considered are: Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Peru, Paraguay, Uruguay, and Venezuela. The data used are collected from a database of Johns Hopkins University, an institution that is dedicated to sensing and monitoring the evolution of the COVID-19 pandemic. A statistical analysis, based on principal components with modern and recent techniques, is conducted. Initially, utilizing the correlation matrix, standard components and varimax rotations are calculated. Then, by using disjoint components and functional components, the countries are grouped. An algorithm that allows us to keep the principal component analysis updated with a sensor in the data warehouse is designed. As reported in the conclusions, this grouping changes depending on the number of components considered, the type of principal component (standard, disjoint or functional) and the variable to be considered (infected cases or deaths). The results obtained are compared to the k-means technique. The COVID-19 cases and their deaths vary in the different countries due to diverse reasons, as reported in the conclusions.


Assuntos
COVID-19 , Pandemias , Argentina , Brasil , Chile , Colômbia , Equador , Humanos , Peru , Análise de Componente Principal , SARS-CoV-2 , Uruguai , Venezuela
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