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1.
World J Surg ; 45(1): 3-9, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33185723

RESUMO

BACKGOUND: Santiago, Chile underwent two separate periods of crisis over the past year. The first period, the 'social crisis,' extended over thirteen weeks in late 2019 into early 2020 due to protests over income inequality and the government response to social unrest. The second period, the 'health crisis,' began in March 2020 with Chile's first case of COVID-19 and escalated rapidly to include 'stay at home orders,' traffic restrictions, and the shuttering of most businesses. We wished to evaluate the impact of these crisis periods on trauma epidemiology. METHODS: We performed a retrospective review of the South-East Metropolitan Health Service Trauma Registry. Trauma admissions, operative volume, and in-hospital mortality were evaluated during the crisis period and the year prior. RESULTS: The social crisis saw increased levels of trauma, both blunt and penetrating, relative to the time period immediately preceding. The health crisis saw an increase in penetrating trauma with a concomitant decline in blunt trauma. Both crisis periods had decreased levels of trauma, overall, compared to the year prior. There were no statistically significant differences in in-hospital trauma mortality. CONCLUSION: Different crises may have different patterns of trauma. Crisis periods that include extended periods of lockdown and curfew may lead to increasing penetrating trauma volume. Governments and health officials should anticipate the aggregate impact of these measures on public health and develop strategies to actively mitigate them. LEVEL OF EVIDENCE: III.


Assuntos
/epidemiologia , Controle de Doenças Transmissíveis/métodos , Pandemias , Violência/estatística & dados numéricos , Ferimentos não Penetrantes/epidemiologia , Ferimentos Penetrantes/epidemiologia , Adulto , Chile/epidemiologia , Mortalidade Hospitalar , Hospitalização , Humanos , Estudos Retrospectivos , Ferimentos não Penetrantes/mortalidade , Ferimentos Penetrantes/mortalidade
3.
Eur J Dent Educ ; 2020 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-33368901

RESUMO

INTRODUCTION: The quick spread of COVID-19 has caused part of the world's population to adopt quarantine protocols that have limited professional activities, including dental training programmes. This study aimed to explore the experiences of students and personnel at a Chilean dental school during the COVID-19 pandemic. MATERIALS AND METHODS: This phenomenological descriptive qualitative study reported staff and students' experiences during the pandemic through in-depth, semi-structured interviews. These were recorded on audio and video with a digital platform. Three researchers then transcribed and analyzed the recordings and codified the answers into categories to determine the emerging topics until a saturation point was reached. RESULTS: The core emerging themes among the staff group were (1) change in the personal/professional life balance, (2) online learning through digital platforms, (3) staff perceptions of students' learning experiences, and (4) concerns about the future. For students, the themes were (1) changes in the learning process, (2) online learning through digital platforms, (3) interpersonal relationships, and (4) concerns about the future. CONCLUSION: The COVID-19 pandemic has been a period of learning for our dental school staff and students. Even though online learning has been a useful tool for delivering didactic (theoretical) concepts, it has been unable to replace conventional education, including skills training. Students and teachers reported being overwhelmed at the beginning of the pandemic, but they have shown remarkable adaptability and resilience during this period.

4.
Glob Health Promot ; : 1757975920978311, 2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33334247

RESUMO

INTRODUCCIÓN: el 18 de octubre del 2019, Chile vivió el estallido social más grande desde el retorno a la democracia en 1988. En marzo se esperaba retomar con mayor fuerza las movilizaciones, pero con la confirmación del primer caso de COVID-19, el Gobierno de Chile inició una serie de medidas de tipo preventivo, diferentes a las definidas por otros países. METODOLOGÍA: se presenta un análisis de las políticas públicas de promoción de salud adoptadas por Chile en el contexto de la COVID-19. Para esto se utiliza el análisis situacional de Adele Clarke, que incorpora la construcción de mapas situacionales, de mundos sociales y mapas de posición. Para efectos de esta investigación se construye el mapas situacional. Se incluye en el análisis documentos oficiales del Ministerio de Salud, discurso del Presidente de Chile, discursos del Ministerio de Salud. RESULTADOS: las medidas adoptadas por el Gobierno de Chile incorporan alcances del tipo de cuarentenas parciales y controles sanitarios, estado de excepción constitucional, toque de queda, plan económico de emergencia, salud, educación, comercio, transporte, control de fronteras, eventos masivos, vacunación contra la influenza y adultos mayores. CONCLUSIONES: según el análisis realizado, se observa un eje transversal de prioridades de medidas de tipo económico, con todas las implicancias sanitarias, sociales y políticas que se derivan.

5.
Medwave ; 20(10): e8066, 2020 Nov 17.
Artigo em Espanhol | MEDLINE | ID: mdl-33361751

RESUMO

Introduction: Since the beginning of the COVID-19 pandemic, extensive research has been done on the prognosis of patients with SARS-CoV-2 associated with age, biodemographic conditions, comorbidities, social factors, clinical parameters, inflammatory blood markers, coagulation, biochemical and blood gas parameters, among others. Few studies have addressed this problem in Latin America, so it is of interest to know how the disease plays out in this region. Objective: The purpose of our study is to evaluate the course of COVID-19 in patients admitted to a tertiary center in Chile and to assess factors measured close to hospital admission that may be associated with death and the need for invasive mechanical ventilation. Methods: We did a retrospective cohort study at Indisa Clinic in Santiago, Chile. We included all patients aged 15 years and older hospitalized between March 11 and July 25, 2020. Hospital mortality and severity of the cases were analyzed, and logistic regression models were applied to identify predictors of outcome variables. Results: The sample included 785 subjects. The mean age was 59 years, 59% were men, and 61.3% had comorbidities. Forty five per cent required intensive care, and 24% invasive mechanical ventilation. The overall hospital fatality rate was 18.7%. In intensive care patients, the case fatality was 32.1%, and in those who received invasive mechanical ventilation, it was 59.4%. Independent risk factors for death included age (odds ratio 1.09; 95% confidence interval: 1.07 to 1.12), diabetes (1.68; 1.06 to 2.67), chronic lung disease (2.80; 1.48 to 5.28), increased C-reactive protein, creatinine, and ferritin. No association with sex, public health insurance, history of heart disease, oxygen saturation upon admission, or D-dimer was found. Similar factors were predictors of invasive mechanical ventilation. Discussion: The prognosis and predictive factors in this cohort of patients hospitalized in Chile for COVID-19 were comparable to those reported in similar studies from higher-income countries. Male sex was not associated with a poor prognosis in this group of patients.


Assuntos
/fisiopatologia , Cuidados Críticos/estatística & dados numéricos , Hospitalização , Respiração Artificial/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , /terapia , Chile , Estudos de Coortes , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Centros de Atenção Terciária , Adulto Jovem
6.
s.l; Ministerio de Salud; dic 03, 2020. 19 p.
Não convencional em Espanhol | LILACS | ID: biblio-1140282

RESUMO

Documento desarrollado por el Centro Nacional en Sistemas de Información en Salud (CENS), que provee recomendaciones para la prestación de servicios a través de telemedicina, que incluyen informar al paciente sobre la teleconsulta; recomendaciones a los pacientes sobre con qué contar antes de la consulta; trabajo colaborativo entre profesionales, es prioritario mantener la privacidad y confidencialidad del paciente, y; utilizar cada oportunidad disponible para educar en la prevención, e identificar casos sospechosos de COVID-19.


Assuntos
Humanos , Pneumonia Viral/prevenção & controle , Telemedicina/métodos , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Monitoramento Epidemiológico , Chile
7.
Santiago; Ministerio de Salud; dic 03, 2020. 31 p.
Não convencional em Espanhol | LILACS | ID: biblio-1140278

RESUMO

Documento que entrega indicaciones a la APS para aumentar la oferta de prestaciones de forma presencial disponible en los establecimientos de salud, dentro del contexto del Plan de gobierno Paso a Paso.


Assuntos
Equipe de Assistência ao Paciente/organização & administração , Pneumonia Viral/epidemiologia , Atenção Primária à Saúde/organização & administração , Infecções por Coronavirus/epidemiologia , Pandemias/prevenção & controle , Chile
8.
Santiago; Ministerio de Salud; dic 03, 2020. 26 p.
Não convencional em Espanhol | LILACS | ID: biblio-1140281

RESUMO

Documento del Ministerio de salud que especifica la estrategia nacional de testeo, trazabilidad y aislamiento ante la pandemia COvid-19, cuyos objetivos principales incluyen disminuir el tiempo que transcurre entre la detección del caso positivo (por clínica o laboratorio) y la investigación epidemiológica (determinación de todos sus contactos estrechos); aislar a todos los casos sospechosos desde el inicio de síntomas o desde el momento de la primera consulta, y; aumentar la efectividad de las medidas de aislamiento y cuarentena, a través de fiscalización aleatoria.


Assuntos
Pneumonia Viral/epidemiologia , Isolamento Social , Infecções por Coronavirus/epidemiologia , Pandemias/prevenção & controle , Monitoramento Epidemiológico , Chile/epidemiologia
9.
BMC Infect Dis ; 20(1): 955, 2020 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-33317458

RESUMO

BACKGROUND: Understanding the characteristics of the Covid-19 pandemic in different geographical regions, ethnic and socioeconomic settings are of emerging importance. This study presents the demographic and clinical features of SARS-CoV-2 infected patients in a large private healthcare center in Santiago, Chile, during the first month of the pandemic. METHODS: We analyzed the demographics, laboratory and clinical characteristics including severity and outcome of all patients diagnosed with Covid-19 during the first month of the pandemic. SARS-2-CoV infection was confirmed by RT-PCR in nosopharyngeal samples. The primary outcome was a composite of ICU admission or all-cause, in-hospital mortality. Clinical and laboratory parameters of hospitalized patients were analyzed regarding their association with the primary outcome. RESULTS: From March 3 to April 4, 2020, 3679 individuals were tested for SARS-CoV-2 in our hospital. Of those, 381 had Covid-19 and were included into this analysis. Most patients (99.2%) were Chileans, 12% returning from recent travel. The median age was 39 years (IQR 31-49) and 52% were female. A total of 88 patients (23.1%) were hospitalized; 18 (3.7%) required ICU and/or died. The overall mortality was 0.7%. Increased body mass index (BMI) and elevated C-reactive protein (CRP) were independently associated with ICU care or death. CONCLUSION: During the first weeks of the pandemic in Chile, most Covid-19 patients were young, with low rates of hospitalization, ICU requirement, and fatality. BMI and CRP on admission were predictors for severity. Our data provide important information on the clinical course and outcome of Covid-19 in a Latin American setting.


Assuntos
/epidemiologia , Hospitalização/estatística & dados numéricos , Adulto , Idoso , Betacoronavirus , Chile/epidemiologia , Infecções por Coronavirus/epidemiologia , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Viagem
13.
Epidemiol Infect ; 148: e270, 2020 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-33143799

RESUMO

In this study, an analysis of the Chilean public health response to mitigate the spread of COVID-19 is presented. The analysis is based on the daily transmission rate (DTR). The Chilean response has been based on dynamic quarantines, which are established, lifted or prolonged based on the percentage of infected individuals in the fundamental administrative sections, called communes. This analysis is performed at a national level, at the level of the Metropolitan Region (MR) and at the commune level in the MR according to whether the commune did or did not enter quarantine between late March and mid-May of 2020. The analysis shows a certain degree of efficacy in controlling the pandemic using the dynamic quarantine strategy. However, it also shows that apparent control has only been partially achieved to date. With this policy, the control of the DTR partially falls to 4%, where it settles, and the MR is the primary vector of infection at the country level. For this reason, we can conclude that the MR has not managed to control the disease, with variable results within its own territory.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena , Betacoronavirus , Chile/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão
14.
Medwave ; 20(10): e8057, 2020 Nov 09.
Artigo em Espanhol | MEDLINE | ID: mdl-33231573

RESUMO

Introduction: The results of mandatory confinement have been detrimental in several respects. Nonetheless, they have resulted in reducing the number of active cases of COVID-19. Chile has begun the de-escalation and needs to know the best time to end the restrictions. Objective: We discuss the best conditions and guarantees for the end of compulsory confinement. Methods: This study is based on a trend model with prediction estimation. The data of the variables of interest were subjected to linear regression studies to determine the curve that best explained the data. The coefficient of determination, the standard deviation of y in x, and the confidence interval of the observed curve were estimated. The trend curve was chosen in accordance with the regression estimates. Outcomes: It was found that all dependent variables tended to decrease over time in a quadratic fashion, except for the new cases variable. In general, the R2 and MAPE estimates are satisfactory, except for the variable number of PCR tests per day. Conclusions: Gradual and cautious steps should be taken before ending mandatory confinement. In the current de-escalator, daily PCR tests should be increased, maintaining vigilance on indicators of incidence, prevalence, and positivity of PCR tests. Evidence suggests with some degree of confidence that mandatory confinement could be safely lifted as of August 30, 2020. Long-term preparations must be made to contain future waves of new cases.


Assuntos
/epidemiologia , Pandemias , Quarentena , Reação em Cadeia da Polimerase Via Transcriptase Reversa/estatística & dados numéricos , Chile/epidemiologia , Intervalos de Confiança , Humanos , Incidência , Modelos Lineares , Prevalência , Quarentena/tendências , Reação em Cadeia da Polimerase Via Transcriptase Reversa/tendências
15.
Child Adolesc Ment Health ; 25(4): 256-257, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33063384

RESUMO

Mental health in Chile has been significantly challenged by the beginning of a social crisis in October of 2019 and the COVID-19 pandemic of 2020. Despite widening of shortage of services, both the burgeoning of Telepsychiatry and a Presidential Initiative to integrate mental health to policy making and services provided by all sectors of government have mitigated the effects of this crisis.


Assuntos
Infecções por Coronavirus/psicologia , Saúde Mental , Pandemias , Pneumonia Viral/psicologia , Adolescente , Serviços de Saúde do Adolescente , Criança , Saúde da Criança , Serviços de Saúde da Criança , Pré-Escolar , Chile/epidemiologia , Planejamento em Saúde , Humanos , Lactente , Serviços de Saúde Mental
16.
Mar Pollut Bull ; 161(Pt A): 111722, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33039790

RESUMO

During the southern summer of 2020, large phytoplankton blooms were detected using satellite technology in Chile (western Patagonia), where intensive salmonid aquaculture is carried out. Some harvesting sites recorded massive fish mortalities, which were associated with the presence of the dinoflagellate species Cochlodinium sp. The bloom included other phytoplankton species, as Lepidodinium chlorophorum, which persistently changed the colour of the ocean to green. These blooms coincided with the government-managed emergency lockdown due to the COVID-19 pandemic. Local in situ sampling was slowed down. However, imagery from the Copernicus programme allowed operational monitoring. This study shows the benefits of both Sentinel-3 and Sentinel-2 satellites in terms of their spectral, spatial and temporal capabilities for improved algal bloom monitoring. These novel tools, which can foster optimal decision-making, are available for delivering early alerts in situations of natural catastrophes and blockages, such as those occurred during the global COVID-19 lockdown.


Assuntos
Dinoflagelados , Animais , Chile , Proliferação Nociva de Algas , Humanos , Pandemias , Fitoplâncton
17.
Medwave ; 20(9): e8039, 2020 Oct 05.
Artigo em Espanhol | MEDLINE | ID: mdl-33031358

RESUMO

Introduction: SARS CoV-2 pandemic is pressing hard on the responsiveness of health systems worldwide, notably concerning the massive surge in demand for intensive care hospital beds. Aim: This study proposes a methodology to estimate the saturation moment of hospital intensive care beds (critical care beds) and determine the number of units required to compensate for this saturation. Methods: A total of 22,016 patients with diagnostic confirmation for COVID-19 caused by SARS-CoV-2 were analyzed between March 4 and May 5, 2020, nationwide. Based on information from the Chilean Ministry of Health and ministerial announcements in the media, the overall availability of critical care beds was estimated at 1,900 to 2,000. The Gompertz function was used to estimate the expected number of COVID-19 patients and to assess their exposure to the available supply of intensive care beds in various possible scenarios, taking into account the supply of total critical care beds, the average occupational index, and the demand for COVID-19 patients who would require an intensive care bed. Results: A 100% occupancy of critical care beds could be reached between May 11 and May 27. This condition could be extended for around 48 days, depending on how the expected over-demand is managed. Conclusion: A simple, easily interpretable, and applicable to all levels (nationwide, regionwide, municipalities, and hospitals) model is offered as a contribution to managing the expected demand for the coming weeks and helping reduce the adverse effects of the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Número de Leitos em Hospital/estatística & dados numéricos , Unidades de Terapia Intensiva/provisão & distribução , Modelos Estatísticos , Pneumonia Viral/epidemiologia , Chile/epidemiologia , Humanos , Pandemias
19.
Medwave ; 20(9)30-10-2020.
Artigo em Espanhol | LILACS | ID: biblio-1141137

RESUMO

Introducción La pandemia por SARS CoV-2 está presionando fuertemente la capacidad de respuesta de los sistemas de salud en todo el mundo, siendo uno de los aspectos más importantes el aumento masivo de pacientes que requerirán utilizar camas hospitalarias de cuidados intensivos. Objetivo Este estudio propone una metodología para estimar el momento de saturación de las camas de cuidados intensivos hospitalarios (camas críticas) y determinar el número de unidades requeridas para compensar dicha saturación. Método Se analizaron 22 016 pacientes con confirmación diagnóstica para COVID-19 provocada por SARS-CoV-2, entre el 4 de marzo y el 5 de mayo de 2020 a nivel nacional. Sobre la base de información del Ministerio de Salud de Chile y a anuncios ministeriales en medios de prensa, se estimó una disponibilidad total actual de 1900 a 2200 camas críticas totales. Se utilizó la función de Gompertz para estimar el número esperado de pacientes COVID-19 y evaluar su exposición a la oferta disponible de camas de cuidados intensivos en varios escenarios posibles. Para ello se tomó en cuenta la oferta de camas críticas totales, el índice ocupacional promedio, y la demanda de pacientes COVID-19 que requerirán cama de cuidados intensivos. Resultados Considerando diferentes escenarios, entre el 11 y el 27 de mayo podría ser alcanzado el 100% de ocupación de camas críticas totales. Esta condición podría extenderse por unos 48 días dependiendo como se maneje la sobredemanda esperada. Conclusión Se puede establecer una ventana de operaciones relativamente estrecha, de 4 a 8 semanas, para mitigar la inminente saturación de camas críticas hospitalarias, producto de la demanda de pacientes COVID-19.


Introduction SARS CoV-2 pandemic is pressing hard on the responsiveness of health systems worldwide, notably concerning the massive surge in demand for intensive care hospital beds. Aim This study proposes a methodology to estimate the saturation moment of hospital intensive care beds (critical care beds) and determine the number of units required to compensate for this saturation. Methods A total of 22,016 patients with diagnostic confirmation for COVID-19 caused by SARS-CoV-2 were analyzed between March 4 and May 5, 2020, nationwide. Based on information from the Chilean Ministry of Health and ministerial announcements in the media, the overall availability of critical care beds was estimated at 1,900 to 2,000. The Gompertz function was used to estimate the expected number of COVID-19 patients and to assess their exposure to the available supply of intensive care beds in various possible scenarios, taking into account the supply of total critical care beds, the average occupational index, and the demand for COVID-19 patients who would require an intensive care bed. Results A 100% occupancy of critical care beds could be reached between May 11 and May 27. This condition could be extended for around 48 days, depending on how the expected over-demand is managed. Conclusion A simple, easily interpretable, and applicable to all levels (nationwide, regionwide, municipalities, and hospitals) model is offered as a contribution to managing the expected demand for the coming weeks and helping reduce the adverse effects of the COVID-19 pandemic.


Assuntos
Humanos , Pneumonia Viral/epidemiologia , Modelos Estatísticos , Infecções por Coronavirus/epidemiologia , Número de Leitos em Hospital/estatística & dados numéricos , Unidades de Terapia Intensiva/provisão & distribução , Chile/epidemiologia , Pandemias
20.
Front Public Health ; 8: 562615, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33072699

RESUMO

The pandemic caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a worldwide public health concern. First confined in China and then disseminated widely across Europe and America, SARS-CoV-2 has impacted and moved the scientific community around the world to working in a fast and coordinated way to collect all possible information about this virus and generate new strategies and protocols to try to stop the infection. During March 2020, more than 16,000 full viral genomes have been shared in public databases that allow the construction of genetic landscapes for tracking and monitoring the viral advances over time and study the genomic variations present in geographic regions. In this work, we present the occurrence of genetic variants and lineages of SARS-CoV-2 in Chile during March to April 2020. Complete genome analysis of 141 viral samples from different regions of Chile revealed a predominance of variant D614G like in Europe and the USA and the major presence of lineage B.1. These findings could help take control measures due to the similarity of the viral variants present in Chile, compared with other countries, and monitor the dynamic change of virus variants in the country.

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