Pandemias

Pandemias
  • 文章类型: Journal Article
    背景:安蒂奥基亚大学[安蒂奥基亚大学]医学院LivingLab设计了一个远程保健心理健康计划。
    目的:描述该计划的发展和运作,并评估2020年和2021年COVID-19大流行期间接受治疗的患者的满意度。
    方法:描述性研究,详细介绍了该计划的发展。从医疗记录中提取数据以描述接受治疗的患者。将满意度量表应用于随机样本,并通过描述性统计对数据进行汇总。
    结果:在2020年3月和2021年8月,10,229名患者接受了治疗,20276人接受心灵感应学治疗,4164人接受精神病学治疗,1,808人通过远程通信,2,356人通过远程通信,共访问6,312次。最常见的诊断是抑郁症(36.8%),焦虑(12.0%),和精神病(10.7%)障碍。受访者感到满意的是,超过93%的人会将其推荐给其他人。
    结论:LivingLab远程健康心理健康计划允许在COVID-19大流行的头两年中对安蒂奥基亚患有心理健康问题和疾病的患者进行护理,受益者的满意度很高。因此,它可以在精神保健中采用。
    BACKGROUND: A telehealth mental health programme was designed at the LivingLab of the Faculty of Medicine of the Universidad de Antioquia [University of Antioquia].
    OBJECTIVE: To describe the development and operation of the programme and evaluate the satisfaction of the patients treated during the COVID-19 pandemic in 2020 and 2021.
    METHODS: Descriptive study that details the development of the programme. Data were extracted from medical records to describe the patients who were treated. A satisfaction scale was applied to a random sample and the data were summarised with descriptive statistics.
    RESULTS: In March 2020 and August 2021, 10,229 patients were treated, with 20,276 treated by telepsychology and 4,164 by psychiatry, 1,808 by telepsychiatry and 2,356 by tele-expertise, with a total of 6,312 visits. The most frequent diagnoses were depressive (36.8%), anxiety (12.0%), and psychotic (10.7%) disorders. Respondents were satisfied to the point that more than 93% would recommend it to another person.
    CONCLUSIONS: The LivingLab telehealth mental health programme allowed for the care of patients with mental health problems and disorders in Antioquia during the first two years of the COVID-19 pandemic, and there was a high degree of satisfaction among the beneficiaries. Therefore it could be adopted in mental health care.
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  • 文章类型: English Abstract
    背景:该研究旨在探讨由于2019年冠状病毒传染病(covid-19)大流行而在分娩期间帕金森病患者的生活质量。
    方法:研究是定量的,描述性和相关性。样本是51名帕金森病患者,来自Magallanes地区和智利南极洲,他们的信息是从RehabilingCorporationClubdeLeonesCruzdelSur的数据库中收集的,属于他们的。
    结果:主要结果表明,51.6%的帕金森氏病患者报告“良好且非常好”的生活质量,并且帕金森氏病问卷(PDQ-39)受影响的主要领域是:身体不适,流动性和情感幸福。根据对PDQ-39定性范围的分析,在covid-19大流行的禁闭期间受到最大损害的维度是:通信,耻辱和情感幸福。此外,女性的生活质量比男性差。最后,研究表明,症状的进展会影响帕金森病患者的生活质量。
    结论:结论:在禁闭期间,由于covid-19大流行,帕金森病患者的症状增加,生活质量下降,尤其是女人。
    BACKGROUND: The study was aimed to explore the quality of life of people with Parkinson\'s disease during confinement due to the coronavirus infectious disease 2019 (covid-19) pandemic.
    METHODS: The study was quantitative, descriptive and correlational. The sample was 51 people with Parkinson\'s disease, from the region of Magallanes and Chilean Antarctica, and whose information was collected from the database of the Rehabilitation Corporation Club de Leones Cruz del Sur, to which they belong.
    RESULTS: The main results show that 51.6% of people with Parkinson\'s disease report a «good and very good» quality of life and that the main domains of the Parkinson\'s Disease Questionnaire (PDQ-39) affected are: body discomfort, mobility and emotional well-being. According to the analysis of the qualitative ranges of the PDQ-39, the dimensions that were most compromised during the confinement by the covid-19 pandemic were: communication, stigma and emotional well-being. In addition, women had a poorer quality of life than men. Finally, it was shown that the progression of symptoms affects the quality of life of people with Parkinson\'s disease.
    CONCLUSIONS: In conclusion, during the confinement due to the covid-19 pandemic people with Parkinson\'s disease increased symptoms and presented a lower quality of life, especially women.
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  • 文章类型: Journal Article
    流感是一种典型的传染病,通过产生它的病毒的不断变化,带来了我们必须尽快解决的新挑战。COVID-19大流行大大改变了流感和其他呼吸道病毒的行为,在未来的几年里,我们将不得不与一种新的病原体共存,这种病原体可能会以一种我们还无法一瞥的方式与现有的病原体相互作用。然而,大流行之前的知识使我们能够专注于必须修改的方面,以使流感成为未来可接受的挑战。在这次审查中,重点放在流行病学最相关的方面,疾病负担,诊断,和疫苗预防,以及这些方面的科学和临床趋势如何从先前已知的挑战流向未来。
    Influenza is a classic infectious disease that, through the continuous variation of the viruses that produce it, imposes new challenges that we must solve as quickly as possible. The COVID-19 pandemic has substantially modified the behavior of influenza and other respiratory viruses, and in the coming years we will have to coexist with a new pathogen that will probably interact with existing pathogens in a way that we cannot yet glimpse. However, knowledge prior to the pandemic allows us to focus on the aspects that must be modified to make influenza an acceptable challenge for the future. In this review, emphasis is placed on the most relevant aspects of epidemiology, disease burden, diagnosis, and vaccine prevention, and how scientific and clinical trends in these aspects flow from the previously known to future challenges.
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  • 文章类型: Observational Study
    目的:分析COVID-19大流行对西班牙国家眼内肿瘤参考单位葡萄膜黑色素瘤(Orphanet罕见疾病目录中包含的肿瘤)诊断和管理的影响。大流行的第一年。
    方法:对巴利亚多利德医院(西班牙)国家成人眼内肿瘤参考单位的葡萄膜黑色素瘤患者进行了一项观察性回顾性研究,分析COVID-19前后的时期:2019年3月15日至2020年3月15日,2020年3月16日至2021年3月16日。人口统计数据,诊断延迟,肿瘤大小,眼外延伸,收集治疗和进化。使用多变量逻辑回归模型来识别与变量相关的因素:摘除。
    结果:纳入82例葡萄膜黑色素瘤患者,其中42人(51.21%)属于COVID-19前期,40人(40.78%)属于COVID-19后期。在COVID-19后期间,观察到诊断时肿瘤大小和摘除次数增加(p<0.05)。多变量逻辑回归表明,中大型肿瘤大小和在COVID-19后时期诊断的患者均与摘除风险增加独立相关(OR250,95CI,27.69-2256.37;p<0.01和OR10;95CI,1.10-90.25;p=0.04)。
    结论:在COVID-19大流行的第一年诊断的葡萄膜黑素瘤中观察到的肿瘤大小增加可能有利于在此期间进行的摘除次数的增加。
    OBJECTIVE: To analyse the impact of the COVID-19 pandemic on the diagnosis and management of uveal melanoma (a tumour included in the Orphanet catalogue of rare diseases) in a Spanish national reference unit for intraocular tumours during the first year of the pandemic.
    METHODS: An observational retrospective study of patients with uveal melanoma in the National Reference Unit for Adult Intraocular Tumors of the Hospital Clínico Universitario de Valladolid (Spain) was performed, analysing the pre- and post-COVID-19 periods: from March 15, 2019 to March 15, 2020 and from March 16, 2020 to March 16, 2021. Demographic data, diagnostic delay, tumour size, extraocular extension, treatment and evolution were collected. A multivariable logistic regression model was used to identify factors that were associated with the variable: enucleation.
    RESULTS: Eighty-two patients with uveal melanoma were included, of which 42 (51.21%) belonged to the pre-COVID-19 period and 40(40.78%) to the post-COVID-19 period. An increase in tumour size at diagnosis and in the number of enucleations was observed during the post-COVID-19 period (p < 0.05). Multivariable logistic regression demonstrated that both medium-large tumour size and patients diagnosed in the post-COVID-19 period were independently related to an increased risk of enucleation (OR 250, 95%CI, 27.69-2256.37; p < 0.01 and OR 10; 95%CI, 1.10-90.25; p = 0.04, respectively).
    CONCLUSIONS: The increase in tumour size observed in uveal melanomas diagnosed during the first year of the COVID-19 pandemic may have favored the increase in the number of enucleations performed during that period.
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  • 文章类型: English Abstract
    目的:比较COVID19封锁期间(2020年3月至6月)和2019年同期初级保健急诊服务提供的护理。
    方法:回顾性描述性研究。
    方法:格拉纳达基本卫生区。
    方法:10.790紧急报告,2020年为3.319,2019年为7.471。
    结果:年龄,性别,服务,班次,转介,优先级,护理时间,以前的过程,和咨询的理由。T-Student和卡方用于连续变量和分类变量。计算效应大小(Cohen'sd)和OR以及95%CI。
    结果:与2019年相比,2020年接受初级保健急诊服务的患者有所减少,但优先V病例的百分比(p<0.01),家庭出院(p=0.01)和医院转院(p<0.01)增加,家庭医生转诊率下降(p<0.01)。2020年,夜间(p<0.01)和低收入社区(p<0.01)的紧急情况百分比增加。分级等待时间减少(p<0.01),但总护理时间在2020年增加(p<0.01)。2020年就诊的患者年龄较大(p<.001),并且先前过程的数量较多(p<0.01),突出焦虑患者,抑郁症,或躯体化(p<0.01)和糖尿病(p=0.041)。与COVID19的各种症状,心理健康问题和慢性病变相关的咨询增加。
    结论:初级护理紧急服务在COVID19大流行等情况下提供了额外的优势,因为它们允许引导部分健康需求。
    To compare the care provided by primary care emergency services during the COVID19 lockdown (March-June 2020) and the same period in 2019.
    Retrospective descriptive study.
    Basic Health Area of Granada.
    10.790 emergency reports, 3.319 in 2020 and 7.471 in 2019.
    Age, sex, service, shifts, referrals, priority levels, care times, previous processes, and reasons for consultation. T-Student and Chi Square were used for continuous and categorical variables. Effect size (Cohen\'s d) and OR along with 95% CI were calculated.
    The patients attended by primary care emergency services decreased in 2020 compared to 2019, but the percentage of Priority V cases (p<0.01), home discharges (p=0.01) and hospital transfers (p<0.01) increased, and referrals to family doctors (p<0.01) decreased. In 2020, the percentage of emergencies at night (p<0.01) and in low-income neighborhoods (p<0.01) increased. Waiting time for classification decreased (p<0.01), but total care time increased in 2020 (p<0.01). The patients seen in 2020 were older (p<.001), and with a greater number of previous processes (p<0.01), highlighting patients with anxiety, depression, or somatization (p<0.01) and diabetes (p=0.041). Consultations related to various symptoms of COVID19, mental health problems and chronic pathologies increased.
    Primary care emergency services offer additional advantages in situations such as the COVID19 pandemic, as they allow channeling part of the health demand.
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  • 文章类型: Journal Article
    由于对COVID-19大流行的管理,社区参与被视为次要因素。尽管有证据表明其在公平和健康促进方面的重要性。即便如此,有许多社区参与的经验可以为我们提供线索,以应对未来潜在的紧急情况,重点是健康促进和社会决定因素。本文的主要目的是批判性地思考社区参与在大流行期间的作用,并提出一些可能有用的想法,并确保更好地管理未来的危机。它们来自西班牙的证据和经验。为了做到这一点,关键是建立和维护社区网络,同时确定共同的目标和不同社区代理人必须扮演的角色,适应不同的环境和参与性评估。社区行动不能即兴发挥:它需要时间,资源和具体的政治意愿,使其可持续和高效。
    Community participation has been put as secondary due to the management of the COVID-19 pandemic. This is despite the evidence of its importance in relation to equity and health promotion. Even so, there have been a number of experiences of community participation that can give us clues towards how to confront potential future emergencies focusing on health promotion and social determinants. The main aim of this article is reflecting critically on the role of community participation during the pandemic as well as extracting a number of ideas which could be useful and ensure a better management of a future crisis. They arise from evidence and experiences undertaken in Spain. In order to do so, it is key to build and maintain community networks whilst identifying common goals and the role that different community agents must play, adapting to different contexts and participatory assessments. Community action cannot be improvised: it demands time, resources and specific political willingness to make it sustainable and efficient.
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  • 文章类型: English Abstract
    UNASSIGNED: Describe the quality of life of health personnel, the work environment, and interactions between employees and their work environment during the pandemic.
    UNASSIGNED: A scoping review was conducted. The electronic databases PubMed, Cumulative Index of Nursing and Allied Literature Complete, and Google Scholar were used, as well as the repositories of the World Health Organization and the Centers for Disease Control and Prevention. Primary, secondary, and grey literature studies published between December 2019 and March 2021 in Spanish, English, and Portuguese were included. Methodological quality was assessed using the Authority, Accuracy, Coverage, Objectivity, Date and Importance (AACODS) checklist; a tool for the measurement of multiple systematic reviews (AMSTAR); and the Critical Appraisal Checklist for Text and Opinion Papers. A thematic analysis was carried out based on the quality-of-life and well-being model.
    UNASSIGNED: Of a total of 208 articles, 11 were included. The quality of life of health personnel during the COVID-19 pandemic was affected by the characteristics of health personnel, the work environment, and interactions between employees and their work environment. Problems related to psychosocial and occupational factors were observed.
    UNASSIGNED: The quality of life of health personnel was characterized by stigmatization, stress, anxiety, and fatigue. Organizational management and the implementation of psychological interventions appear to affect interactions between employees and their work environment, and improve their quality of life.
    UNASSIGNED: Descrever a qualidade de vida do pessoal de saúde, o ambiente de trabalho e a interação entre o funcionário e o ambiente de trabalho durante a pandemia.
    UNASSIGNED: Foi realizada uma revisão exploratória. Foram utilizadas as bases de dados eletrônicas PubMed, Cumulative Index of Nursing and Allied Literature Complete, Google Scholar e os repositórios da Organização Mundial da Saúde e dos Centros de Controle e Prevenção de Doenças. Foram incluídos estudos primários, secundários e da literatura cinzenta, publicados entre dezembro de 2019 e março de 2021, em espanhol, inglês e português. A qualidade metodológica foi avaliada pelas checklists AACODS (Authority, Accuracy, Coverage, Objectivity, Date, Significance), AMSTAR (A measurement tool to assess systematic reviews) e Critical Appraisal Checklist for Text and Opinion Papers. Foi realizada uma análise temática com base no modelo de qualidade de vida e bem-estar.
    UNASSIGNED: De um total de 208 artigos, 11 foram incluídos. A qualidade de vida do pessoal de saúde durante a pandemia de COVID-19 foi influenciada pelas características do pessoal de saúde, do ambiente de trabalho e da interação entre o funcionário e o ambiente de trabalho. Constataram-se deficiências relacionadas a fatores psicossociais e ocupacionais.
    UNASSIGNED: A qualidade do pessoal de saúde foi caracterizada por estigma, estresse, ansiedade e fadiga. A gestão organizacional e a aplicação de intervenções psicológicas evidenciam um efeito na interação entre o funcionário e o ambiente de trabalho, e influenciam sua qualidade de vida.
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  • 文章类型: Case Reports
    This study aimed to evaluate the performance, before and during the COVID-19 pandemic, of the case definition of suspected influenza used in community surveillance in Mexico.
    A cross-sectional analysis of a cohort study was performed and cases that met the suspected case criteria (n = 20,511) and that had laboratory-conclusive evidence (quantitative real-time polymerase chain reaction) to confirm or discard influenza virus infection were analysed.
    A high sensitivity and modest specificity were documented, which later decreased during the COVID-19 outbreak, as well as its diagnostic accuracy. However, no significant differences were observed in the area under the receiver operating characteristics curve among the analysed periods.
    The evaluated case definition remains to be a cost-effective alternative for identifying patients who may benefit from influenza-specific antiviral drugs, even during the global COVID-19 outbreak.
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  • 文章类型: Journal Article
    背景:该项目的目的是评估2020年3月至9月期间家庭分娩和学校关闭对加泰罗尼亚儿童心理健康的心理病理学影响。
    方法:PEDSAME研究:第一个横断面(学年开始)和回顾性数据(锁定),从2020年9月14日至2020年10月30日,在5至14岁(包括在内)的加泰罗尼亚人口中通过初级保健儿科医生网络进行随机抽样。数据是在学年开始时通过RedCap平台通过在线调查收集的。主要变量是父母回答的优势和困难问卷的结果,以评估精神病理学的风险,除了其他相关变量。
    结果:在学年开始时获得的结果表明,9.8%的患者可能是精神病理学病例。受影响最大的是5至8岁的人群。儿童对他们的健康和家人的关注程度的看法是出现精神病理学的风险因素,而良好的家庭环境是一个保护因素。情绪和行为症状,与学年开始相比,在分娩期间发现睡眠障碍和使用屏幕有问题的频率更高。
    结论:限制和6个月不上学对儿童-青少年人群的心理健康有负面影响,他们的指标比前一年差。
    BACKGROUND: The aim of this project was to evaluate the psychopathological impact of home confinement and school closing between March and September 2020 on the mental health of Catalonian children.
    METHODS: PEDSAME study: first cross-sectional section (beginning of the school year) and retrospective data (lockdown), carried out through the network of Primary Care pediatricians in the Catalan population between 5 and 14 years (included) from 09/14/2020 to 10/30/2020 in a random sample. Data were collected with an online survey through the RedCap platform at the beginning of the school year. The main variable was the result of the Strengths and Difficulties Questionnaire answered by parents to assess the risk of psychopathology, in addition to other related variable.
    RESULTS: The results obtained at the beginning of the school year show that 9.8% of the patients were probable cases of psychopathology. The most affected group were those between 5 and 8 years. The perception of the children\'s level of concern for their health and that of their family was a risk factor for presenting psychopathology, while the good family environment was a protective factor. Emotional and behavioral symptoms, sleep disorders and problematic use of screens were detected more frequently during confinement than at the beginning of the school year.
    CONCLUSIONS: Confinement and the absence of schooling for 6 months had a negative impact on the mental health of the child-adolescent population who showed worse indicators than the previous year.
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  • 文章类型: English Abstract
    OBJECTIVE: To know the characteristics of the initial care and telephone follow-up of patients with suspected COVID-19 in the first wave of the pandemic.
    METHODS: Observational, retrospective (audit of medical records).
    METHODS: Urban Primary Care Center of Andalusia (Spain).
    METHODS: Probable cases of SARS-CoV-2 (from 20/03/15 to 20/06/15).
    METHODS: Initial medical assessment (place and modality) and telephone follow-up (number of calls and duration). Sociodemographic variables (including family structure). Clinical course (symptoms, vulnerability, tests, hospital admission and outcome).
    RESULTS: Three hundred one patients (51.5±17.8 years; 23% vulnerable people; 17% non-nuclear family structure). First assessment in Primary Care by phone (59.8%) and face-to-face (25.2%). At the hospital emergency department (11%), patients were more frequently from non-nuclear families (P<.05 χ2) and more tests were carried out (P<.05 χ2) despite having similar symptoms. Vulnerable elderly patients needed home health care (P<.01 ANOVA). 8.2±4.4 follow-up phone calls were made per patient, for 17.1±10.3 days. It increases after ≥2 face-to-face consultations (OR 4.8), the presence of alarm symptoms (OR 2.3) and age ≥45 years (OR 2.0). Few confirmatory tests were performed (19.3% antigenic, 13% serology). The 15.3% hospital admissions (all assessed previously in Primary Care), with 6.3% severe cases and 2.3% death.
    CONCLUSIONS: Population chose to be attended in Primary Care during the pandemic first wave, above all by phone. Telephone follow-up was well accepted and useful to select patients with serious complications. Initial medical assessment in the hospital emergency department was related to a lack of social support but not with greater clinical severity.
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