Coronavirus Disease 2019

冠状病毒病 2019
  • 文章类型: Journal Article
    背景:为了根据现有证据和专家共识得出声明(作为意大利镇痛学会肺部超声工作组成员,麻醉,复苏,和重症监护,SIAARTI)关于使用肺部超声来管理入住重症监护病房的COVID-19患者。
    方法:一组麻醉师和重症监护医师在COVID-19重症危重患者中使用肺部超声的专家采用了改良的德尔菲法,就十个临床问题达成共识,涉及肺部超声在以下方面的作用:COVID-19诊断和监测(有或没有有创机械通气),呼气末正压滴定,使用俯卧位,气胸或呼吸机相关性肺炎的早期诊断,有创机械通气的撤机过程,以及放射胸部成像的需要。
    结果:专家组总共发表了20份声明。在第一轮投票中,20份声明中有18份达成了协议(得分为7-9;“适当”),而2份声明需要第二轮才能达成协议。在两次德尔福回合结束时,20份陈述的中位数为8.5[IQR8.9],协议百分比是100%。
    结论:意大利镇痛学会肺部超声工作组,麻醉,复苏,和重症监护就入住ICU的COVID-19患者使用肺部超声发表了20项共识声明。这一专家共识强烈建议在危重COVID-19患者的临床治疗中整合肺部超声检查结果。
    BACKGROUND: To produce statements based on the available evidence and an expert consensus (as members of the Lung Ultrasound Working Group of the Italian Society of Analgesia, Anesthesia, Resuscitation, and Intensive Care, SIAARTI) on the use of lung ultrasound for the management of patients with COVID-19 admitted to the intensive care unit.
    METHODS: A modified Delphi method was applied by a panel of anesthesiologists and intensive care physicians expert in the use of lung ultrasound in COVID-19 intensive critically ill patients to reach a consensus on ten clinical questions concerning the role of lung ultrasound in the following: COVID-19 diagnosis and monitoring (with and without invasive mechanical ventilation), positive end expiratory pressure titration, the use of prone position, the early diagnosis of pneumothorax- or ventilator-associated pneumonia, the process of weaning from invasive mechanical ventilation, and the need for radiologic chest imaging.
    RESULTS: A total of 20 statements were produced by the panel. Agreement was reached on 18 out of 20 statements (scoring 7-9; \"appropriate\") in the first round of voting, while 2 statements required a second round for agreement to be reached. At the end of the two Delphi rounds, the median score for the 20 statements was 8.5 [IQR 8.9], and the agreement percentage was 100%.
    CONCLUSIONS: The Lung Ultrasound Working Group of the Italian Society of Analgesia, Anesthesia, Resuscitation, and Intensive Care produced 20 consensus statements on the use of lung ultrasound in COVID-19 patients admitted to the ICU. This expert consensus strongly suggests integrating lung ultrasound findings in the clinical management of critically ill COVID-19 patients.
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  • 文章类型: Journal Article
    未经批准:2019年冠状病毒病(COVID-19)是一个全球性的健康问题,出现从轻度非特异性症状到严重肺炎的症状。早期筛查技术在诊断和评估疾病进展中至关重要。这一共识旨在阐明肺部超声检查与其他成像方式在COVID-19大流行中的作用。
    UNASSIGNED:由不同专业的专家组成的多学科团队(即,肺部疾病,传染病,重症监护室和急诊医学,放射学,和公共卫生)将处理来自不同地理区域的COVID-19患者的患者分为任务组,以审查来自不同数据库的文献并生成10条陈述。最终的共识声明基于2021年7月在开罗举行的专家物理小组成员的讨论,然后对每个声明进行电子投票。
    未经评估:这些声明以电子方式表决为“同意”,\"\"不同意,\"或\"中性。“要接受共识的声明,它应该有80%的协议。
    未经证实:肺部超声检查是一种快速有用的工具,可以在床边进行,克服了计算机断层扫描的局限性,以公认的准确率筛查和监测COVID-19患者。
    UNASSIGNED: Coronavirus disease 2019 (COVID-19) is a global health problem, presenting with symptoms ranging from mild nonspecific symptoms to serious pneumonia. Early screening techniques are essential in the diagnosis and assessment of disease progression. This consensus was designed to clarify the role of lung ultrasonography versus other imaging modalities in the COVID-19 pandemic.
    UNASSIGNED: A multidisciplinary team consisting of experts from different specialties (ie, pulmonary diseases, infectious diseases, intensive care unit and emergency medicine, radiology, and public health) who deal with patients with COVID-19 from different geographical areas was classified into task groups to review the literatures from different databases and generate 10 statements. The final consensus statements were based on expert physically panelists\' discussion held in Cairo July 2021 followed by electric voting for each statement.
    UNASSIGNED: The statements were electronically voted to be either \"agree,\" \"not agree,\" or \"neutral.\" For a statement to be accepted to the consensus, it should have 80% agreement.
    UNASSIGNED: Lung ultrasonography is a rapid and useful tool, which can be performed at bedside and overcomes computed tomography limitations, for screening and monitoring patients with COVID-19 with an accepted accuracy rate.
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  • 文章类型: Comparative Study
    Multisystem inflammatory syndrome in children (MIS-C) is a serious health condition that develops from and is linked to coronavirus disease 2019. MIS-C is considered a multi-organ dysfunction involving cardiac, renal, respiratory, hematologic, gastrointestinal and neurological symptoms and groups of signs and symptoms such as rash or bilateral non-purulent conjunctivitis, hypotension or shock and acute gastrointestinal problems, which require immediate therapeutic intervention to prevent the aggravation of the patient\'s health condition. MIS-C is relatively new in the field of evidence-based medicine; however, there are several clinical guidelines for good clinical practice. For every disorder, the guidelines have different suggestions. Hence, based on the current status of the evidence, recommendations have been combined to form a unified guideline for therapeutic management.
    This paper compares and evaluates the current MIS-C-specific clinical practice guidelines (namely, American Academy of Pediatrics, American College of Rheumatology, Helen DeVos Children\'s Hospital Foundation, Children\'s Hospital of The King\'s Daughters, and the Infectious Diseases Society of America). The compiled literature was then assessed by the authors separately, and an algorithm was proposed for each disorder, taking into consideration the various guidelines proposed for the management of the disorder.
    The features of MIS-C patients are unified; this is very helpful in managing its symptoms and decreasing mortality rates. In addition, recommendations for pharmacological treatment for MIS-C symptoms are formulated after cross-comparison across five different guidelines.
    This study provides a general interpretation of the results in the context of other evidence and implications for future research. It proposes a unified guideline based on the current evidence, with the best potential to maintain suitable clinical standards in the Saudi Arabian Ministry of Health.
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  • 文章类型: Journal Article
    随着医院迎合老年人和弱势患者,如果2019年冠状病毒病(COVID-19)爆发,预计死亡率会很高。因此,防止COVID-19在医院传播的政策至关重要。进行这项研究是为了调查国家和国际指南如何有效地为医院的感染控制问题提供建议。在选择感染控制中的重要问题后,我们在国家和国际层面对预防COVID-19在医疗机构内传播的建议和指南进行了系统回顾和分析.我们分析了世界卫生组织的指南,疾病控制和预防中心,欧洲疾病预防和控制中心,韩国疾病控制和预防机构。最近的指南没有为感染控制问题提供具体的解决方案。因此,需要努力为COVID-19控制制定一致的建议和指南。
    As hospitals cater to elderly and vulnerable patients, a high mortality rate is expected if a coronavirus disease 2019 (COVID-19) outbreak occurs. Consequently, policies to prevent the spread of COVID-19 in hospital settings are essential. This study was conducted to investigate how effectively national and international guidelines provide recommendations for infection control issues in hospitals. After selecting important issues in infection control, we performed a systematic review and analysis of recommendations and guidelines for preventing COVID-19 transmission within medical institutions at national and international levels. We analyzed guidelines from the World Health Organization, Centers for Disease Control and Prevention, European Centre for Disease Prevention and Control, and Korea Disease Control and Prevention Agency. Recent guidelines do not provide specific solutions to infection control issues. Therefore, efforts need to be made to devise consistent advice and guidelines for COVID-19 control.
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  • 文章类型: Journal Article
    OBJECTIVE: This study aimed to assess the degree of dental practitioner adherence to recommendations made during the COVID-19 pandemic.
    METHODS: An online questionnaire was distributed via social media among dental practitioners in Israel who worked during the COVID-19 outbreak.
    RESULTS: In total, 144 dental practitioners completed the survey; it was found that dental practitioner adherence to all the official PPE use recommendations was 69.8%, whereas 36.8% of dental practitioners reported the use of N95 when needed. Knowledge of self-protection against COVID-19 was rated as \"very good\" by 37.5% of responders. However, only 25.7% felt \"highly protected\" by personal protective equipment. Interestingly, many dental practitioners (46.8%) reported adherence to extra protection in addition to the required PPE communicated by the Ministry of Health guidelines.
    CONCLUSIONS: Stricter regimens should be applied for dealing with the current challenging pandemic, especially in clinical work with a higher risk for viral transmission. Specific strategies should be followed to ensure good practice to improve dental practitioners\' and patients\' safety.
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  • 文章类型: Journal Article
    In the face of the ongoing pandemic, the primary care physicians in India are dealing not only with an increased number of patients but are also facing difficulties in the management of complex critically ill patients. To guide the management plans of primary care physicians, several guidelines have been published by the central and state health bodies. In such a situation, an updated and unifying state, national and international guidelines based on critical analysis and appraisal of evolving data is the need of the hour. In this review, we critically analysed the current existing guidelines that have been formulated within India in light of recent evidence.
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  • 文章类型: Journal Article
    The aim of our paper was to present current knowledge, review literature and available practice guidelines of international hepatological associations regarding the effect of severe acute respiratory syndrome coronavirus 2 coronavirus on the liver, patients with underline liver disease, awaiting on liver transplantation (LTx) or being after LTx in the pandemic coronavirus disease 2019 area.
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  • 文章类型: Journal Article
    许多出版物都描述了精神卫生保健的策略,以应对与2019年冠状病毒病(COVID-19)相关的心理担忧和后果。目前的审查旨在总结现有的心理管理指南和建议,为普通人群提供精神卫生保健,卫生保健专业人员,孩子们,和老年人口,适用于大流行,特别是指COVID-19。通过在PubMed和Google数据库中搜索,检索了有关COVID-19此类影响的心理护理的文献。在91篇检索到的初始文章中,只有18人被选中进行最终分析,分为两类:(a)政府/公共卫生机构的指南(n=11)和(b)同行评审期刊上的出版物(n=7)。这些建议可以从可靠的来源总结但不限于心理教育,压力正常化,行为激活,安排活动,将娱乐和日常杂务结合在一起,支持性护理,保持数字连接,放松技术,确保休息,轮班和工作时间短暂休息,减少媒体消费,促进社区复原力,寻求和分享同事/主管的支持,避免滥用精神活性物质,在线咨询精神卫生专业人员的需要,与儿童以适当的方式进行参与性交流。在大流行时期缺乏关于心理管理的观察性和对照性研究的情况下,我们建议尽快进行这样的研究。
    Many publications have delineated strategies for mental health care to respond to psychological concerns and ramifications related to coronavirus disease 2019 (COVID-19). The current review aims to encapsulate existing guidelines and recommendations of psychological management for mental health care for the general population, health-care professionals, children, and elderly populations, applied to a pandemic in particular reference to COVID-19. The literature on psychological care of such repercussions of COVID-19 was retrieved via a search in PubMed and Google database. Of 91 retrieved initial articles, only 18 were selected for final analysis, which was divided into two categories: (a) guidelines by government/public health bodies (n = 11) and (b) publications in peer-reviewed journals (n = 7). The recommendations can be summed but not limited to psychoeducation from a reliable source, normalization of stress, behavioral activation, scheduling of activities with a bespoke blending of recreational and daily chores, supportive care, staying digitally connected, relaxation techniques, ensuring rest, rotating shifts and short breaks during working hours, curtailing media consumption, fostering community resilience, seeking and sharing support from colleagues/supervisors, avoidance of abusing psychoactive substances, online consultation of mental health professionals on need, and participatory communication in a developmentally appropriate way with children. In the absence of observational and controlled studies on psychological management during pandemic times, we recommend such research soon.
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  • 文章类型: Journal Article
    目标:就肺部超声(LUS)在评估已知或疑似2019年冠状病毒病(COVID-19)的有症状普通内科住院患者中的应用达成共识。
    方法:我们的LUS专家小组由14名多学科国际专家组成。专家在3轮投票中对26项建议的强度进行了投票,\"\"弱,不建议使用\"或\"。“对于达成共识的建议,不建议,进行了第四轮投票,以确定这些建议的强度,考虑了另外2项建议。
    结果:在26项建议中,专家在第一轮就6个问题达成共识,13在第二个,7在第三。由于冗余,删除了四个建议。在第四轮,专家们审议了4项就“不推荐”达成共识的建议和2种其他方案;其中4项达成共识。我们的最终建议包括24项协商一致声明;其中2项,建议的力度没有达成共识。
    结论:在已知或疑似COVID-19的有症状的内科住院患者中,我们建议使用LUS:(1)支持肺炎的诊断,但不诊断COVID-19,(2)排除超声特征,(3)监测患者临床状态的变化,(4)避免对替代或叠加诊断的预测试概率低的患者进行不必要的额外成像。我们不建议使用LUS来指导入院和出院决定。我们不建议在不改变临床状况的情况下对患者进行常规连续LUS。
    OBJECTIVE: To develop a consensus statement on the use of lung ultrasound (LUS) in the assessment of symptomatic general medical inpatients with known or suspected coronavirus disease 2019 (COVID-19).
    METHODS: Our LUS expert panel consisted of 14 multidisciplinary international experts. Experts voted in 3 rounds on the strength of 26 recommendations as \"strong,\" \"weak,\" or \"do not recommend.\" For recommendations that reached consensus for do not recommend, a fourth round was conducted to determine the strength of those recommendations, with 2 additional recommendations considered.
    RESULTS: Of the 26 recommendations, experts reached consensus on 6 in the first round, 13 in the second, and 7 in the third. Four recommendations were removed because of redundancy. In the fourth round, experts considered 4 recommendations that reached consensus for do not recommend and 2 additional scenarios; consensus was reached for 4 of these. Our final recommendations consist of 24 consensus statements; for 2 of these, the strength of the recommendations did not reach consensus.
    CONCLUSIONS: In symptomatic medical inpatients with known or suspected COVID-19, we recommend the use of LUS to: (1) support the diagnosis of pneumonitis but not diagnose COVID-19, (2) rule out concerning ultrasound features, (3) monitor patients with a change in the clinical status, and (4) avoid unnecessary additional imaging for patients whose pretest probability of an alternative or superimposed diagnosis is low. We do not recommend the use of LUS to guide admission and discharge decisions. We do not recommend routine serial LUS in patients without a change in their clinical condition.
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  • 文章类型: Journal Article
    在意大利,2019年冠状病毒病(COVID-19)的大规模爆发始于2020年1月30日,当时世界卫生组织宣布这是一场大流行。全国范围内的检疫达到了控制疫情的预期效果,尽管提出了许多挑战,考虑到其巨大的经济和社会成本。完全遵守建议可能会减缓和减少传染病的爆发。迄今为止,目前尚不清楚意大利公众对自愿家庭隔离的遵守程度,哪些因素都没有影响个人遵守检疫令的决定。这项研究的目的是调查对检疫限制的依从性程度以及与自我报告依从性相关的因素。在国家封锁的第三周,3,672名意大利隔离的成年居民(65%为女性;范围,18-85年)参加了一项在线横断面调查,重点是感染COVID-19的风险认知及其报告的遵守检疫协议。方差分析显示,人口统计群体在遵守检疫令的倾向上存在显著差异,和女人在一起,大多数受过教育的人,意大利南部的居民,中年人,卫生工作者更有可能遵守检疫准则。同样,展示感知的参与者,焦虑,发现感染COVID-19疾病的风险易感性明显更有可能遵守检疫指南。这项研究的结果可以帮助公共卫生政策制定者认识到COVID-19预防和健康教育的目标人群,并了解如何为旨在最大限度地减少疾病影响和传播的沟通策略提供信息。
    In Italy, a large outbreak of coronavirus disease 2019 (COVID-19) occurred from 2020 January 30, before the World Health Organization has stated that it is a pandemic. The nationwide quarantine had the desired impact of controlling the epidemic, although had presented many challenges, given its large economic and social costs. Complete adherence to recommendations can potentially decelerate and reduce infectious disease outbreaks. To date, it is not clear how compliant the Italian public has been with voluntary home quarantine, neither which factors have influenced an individual\'s decision to comply with a quarantine order. The purposes of this study were to investigate the degree of the adherence to quarantine restrictions and the factors associated with the self-reported adherence. During the third week of the national lockdown, 3,672 Italian quarantined adult residents (65% females; range, 18-85 years) participated in an online cross-sectional survey focused on the risk perception of contracting COVID-19 and their reported adherence to quarantine protocols. Analysis of variance showed significant differences among demographic groups in tendency to comply with quarantine orders, with women, most educated people, residents of Southern Italy, middle-aged individuals, and health workers more likely to adhere to quarantine guidelines. As well, participants exhibiting the perception, anxiety, and susceptibility of risk of contracting COVID-19 disease were found significantly more likely to adhere to quarantine guidelines. The results of this study can help public health policy makers to recognize target populations for COVID-19 prevention and health education and to understand how inform communication strategies aimed at minimizing the impact and spread of the disease.
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