Los antimalaricos (cloroquina e hidroxicloroquina) en la pandemia COVID-19 Antimalarials (chloroquine and hydroxychloroquine) in the COVID-19 pandemic
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ABSTRACT:
SUBMITTER: Jauregui E
PROVIDER: S-EPMC7284280 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:The COVID-19 epidemic represents a special risk for kidney patients due to their comorbidities and advanced age, and the need for hemodialysis treatment in group rooms. It also represents a risk for professionals responsible for their attention. This manuscript contains a proposal for action to prevent infection of professionals in the Nephrology Services, one of the most valuable assets at the present time.
| S-EPMC7536518 | biostudies-literature
Project description:Introduction The COVID-19 epidemic has led to the need for unprecedented decisions to be made to maintain the provision of neurological care. This article addresses operational decision-making during the epidemic. Development We report the measures taken, including the preparation of a functional reorganisation plan, strategies for hospitalisation and emergency management, the use of telephone consultations to maintain neurological care, provision of care at a unit outside the hospital for priority patients, decisions about complementary testing and periodic in-hospital treatments, and the use of a specific telephone service to prioritise patients with epileptic seizures. Conclusion Despite the situation of confinement, neurology departments must continue to provide patient care through different means of operation. Like all elements of management, these must be evaluated.
| S-EPMC7177056 | biostudies-literature
Project description:INTRODUCTION:Since the beginning of the new pandemic, COVID-19 health services have had to face a new scenario. Voice therapy faces a double challenge, interventions using telepractice, and delivering rehabilitation services to a growing population of patients at risk of functional impairment related to the COVID-19 disease. Moreover, as COVID-19 is transmitted through droplets, it is critical to understand how to mitigate these risks during assessment and treatment. OBJECTIVE:To promote safety, and effective clinical practice to voice assessment and rehabilitation in the pandemic COVID-19 context for speech-language pathologists. METHODS:A group of 11 experts in voice and swallowing disorders from 5 different countries conducted a consensus recommendation following the American Academy of Otolaryngology-Head and Neck Surgery rules building a clinical guide for speech-language pathologists during this pandemic context. RESULTS:The clinical guide provides 79 recommendations for clinicians in the management of voice disorders during the pandemic and includes advice from assessment, direct treatment, telepractice, and teamwork. The consensus was reached 95% for all topics. CONCLUSION:This guideline should be taken only as recommendations; each clinician must attempt to mitigate the risk of infection and achieve the best therapeutic results taking into account the patient's particular reality.
| S-EPMC7442931 | biostudies-literature
Project description:Background and objective There is a shortage of supplies for the protection of professionals during the COVID-19 pandemic. 3D printing offers the possibility to compensate for the production of some of the equipment needed. The objective is to describe the role of 3D printing in a health service during the COVID-19 pandemic, with an emphasis on the process to develop a final product ready to be implemented in the clinical environment. Methods A working group was formed between the healthcare administration, clinicians and other public and private institutions in Cantabria, Spain coordinated by the Valdecilla Virtual Hospital. The process included receiving the printing proposals, learning about the printing resources in the region, selecting the devices, creating a team for each project, prototyping, evaluation and redesign, manufacturing, assembly and distribution. Results The following supplies are produced: 1) devices that help protect providers: face protection screens (2400 units), personalized accessories for photophores (20 units) and ear-protection forks for face-masks (1200 units); 2) products related to the ventilation of infected patients: connectors for non-invasive ventilation systems; and 3) oral and nasopharyngeal swabs (7500 units) for the identification of coronavirus carriers with the aim of designing action protocols in clinical areas. Conclusions 3D printing is a valid resource for the production of protective material for professionals whose supply is reduced during a pandemic.
| S-EPMC7546187 | biostudies-literature
Project description:Introduction The COVID-19 pandemic will give rise to long-term changes in neurological care, which are not easily predictable. Material and methods A key informant survey was used to enquire about the changes expected in the specialty over the next 5 years. The survey was completed by heads of neurology departments with broad knowledge of the situation, having been active during the pandemic. Results Despite a low level of consensus between participants, there was strong (85%) and moderate consensus (70%) about certain subjects, mainly the increase in precautions to be taken, the use of telemedicine and teleconsultations, the reduction of care provided in in-person consultations to avoid the presence of large numbers of people in waiting rooms, the development of remote training solutions, and the changes in monitoring visits during clinical trials. There was consensus that there would be no changes to the indication of complementary testing or neurological examination. Conclusion The key informant survey identified the foreseeable changes in neurological care after the pandemic.
| S-EPMC7241338 | biostudies-literature
Project description:Antecedentes La epidemia por coronavirus 2019 (COVID-19) se ha extendido por todo el mundo desde principios de 2020, sometiendo a los profesionales sanitarios a una sobrecarga laboral y a un mayor nivel de estrés físico y emocional. Objetivos El objetivo de este estudio es determinar la prevalencia de desgaste profesional y sus posibles factores asociados en los radiólogos españoles durante la COVID-19, y su comparación con la situación previa a la pandemia. Métodos Estudio observacional realizado entre los meses de abril y agosto de 2020 (durante la pandemia) mediante una encuesta en línea. Se obtuvieron un total de 150 respuestas. Se recopiló y comparó la información demográfica y laboral de los encuestados. Se determinó la presencia del desgaste profesional con el cuestionario Maslach Burnout Inventory Human Services Survey (MBI-HSS) y se comparó su prevalencia y características con el estudio realizado de la misma manera en 2019. Se hizo un análisis estadístico para identificar los posibles factores de riesgo y protectores asociados con este síndrome, así como un análisis de homogeneidad entre las dos muestras. Resultados La prevalencia del síndrome aumentó de forma significativa (p = 0,002) durante la pandemia COVID-19 (49,3% frente a 33,6%). Ningún factor de riesgo o de protección se ha identificado como constante antes y después de la pandemia. No se ha identificado ninguna correlación del desgaste con las características sociodemográficas o laborales. Conclusión Este estudio demuestra un aumento importante del desgaste profesional durante la pandemia por la COVID-19 con afectación de casi la mitad de los radiólogos encuestados. Estos resultados destacan la necesidad de valorar el apoyo orientado al bienestar profesional de los radiólogos en España. No se ha identificado correlación entre el síndrome y género, edad, número de guardias, antigüedad, ingreso anual, docencia, estado civil, número de hijos o tipo de contrato laboral.
| S-EPMC8491977 | biostudies-literature
Project description:Objective To evaluate the effect of drug interactions with chronic direct oral anticoagulants (DOAC) on mortality in older atrial fibrillation (AF) patients during the Coronavirus disease 2019(COVID-19) pandemic. Methods We followed a total of 601 elderly patients (65 years of age) from the NOEL-Drug Registry cohort who were referred to a tertiary outpatient clinic between 9 March 2020 and 1 March 2021. We recorded clinical characteristics and medications for the last 3 months. In addition, all drug interactions were identified using Lexicomp®. Finally, we recorded retrospectively all death events, COVID-19 diagnosis, and relevant deaths from the database at the end of the study. According to logistic regression, we performed propensity score (PS) matching to reduce potential bias. Factors associated with total mortality in the 12 months were analyzed using multivariable Cox proportion hazard analysis. Results The mean age [standard deviation (SD)] was 74.5 (±6.9), and the male/female ratio was 337/264. The prevalence of total mortality was 16.9% (n = 102). A total of 4472 drugs were analyzed for DOAC interaction. 81.8% of older AF patients were not at risk in terms of potential interaction. In the Cox proportional hazard model after PS-matching, previous DOAC use with class X interaction was associated with significantly higher mortality risk (adjusted hazard ratio: 2.745, 95% confidence interval: 1.465–5.172, p = 0.004). Conclusions Our study showed that while most co-medications do not have significant interactions with DOACs, few serious drug interactions contribute to mortality in elderly patients with AF during the pandemic.
| S-EPMC9283695 | biostudies-literature
Project description:Graphical abstract Introducción La pandemia COVID-19 ha tenido una repercusión extraordinaria sobre los hospitales españoles, que han reorganizado sus recursos para tratar a estos pacientes, limitando su capacidad de atender otras patologías frecuentes. El presente estudio analiza la repercusión sobre el tratamiento de la colelitiasis y la colecistitis aguda. Métodos Se ha realizado un estudio nacional descriptivo mediante una encuesta online voluntaria, realizada en Google Drive™, distribuida por correo electrónico desde la Asociación Española de Cirujanos (AEC) a todos los cirujanos miembros. Resultados Se han recibido 153 encuestas (una por centro). El 96,7% de ellos han suspendido las colecistectomías electivas. El tratamiento conservador de la colecistitis aguda no complicada se ha realizado en un 90% de los casos (siendo previamente del 18%) y, en las colecistitis intervenidas, el 95% ha optado por el abordaje laparoscópico. Un 49% realiza algún test preoperatorio para SARS-CoV-2, y el 57% comunica haber tenido casos de confirmación postoperatoria tras alguna intervención, con peor evolución postoperatoria en el 54%. Conclusiones Esta encuesta revela que la mayoría de los centros están siguiendo las recomendaciones de las sociedades quirúrgicas durante la pandemia por COVID-19. Sin embargo, se observan algunos datos que precisan ser tenidos en cuenta en las fases sucesivas de la pandemia.
| S-EPMC7368890 | biostudies-literature
Project description:Introducción El objetivo de este estudio fue describir el conocimiento y el uso reportado del paquete de medidas ABCDEF en las unidades de cuidados intensivos (UCI) de adultos de la República Argentina durante la pandemia por SARS-CoV-2. Métodos Se realizó un estudio cualitativo a través de una encuesta nacional dirigida a profesionales de la salud. Resultados Se recibieron 396 cuestionarios completos de profesionales de 21 provincias argentinas y la Ciudad Autónoma de Buenos Aires. El 66% de los participantes contestaron que conocen el paquete y lo aplican con diferentes grados de implementación. El 42,9% informó que usa al menos una herramienta validada para evaluar el dolor. Más de la mitad de los encuestados afirman realizar vacaciones de sedación y pruebas de ventilación espontánea diariamente. Las escalas de sedación fueron utilizadas por el 66,6% de los participantes en forma rutinaria. El 62% utiliza herramientas validadas para la detección de delirium. Respecto de la movilización temprana y ejercicio de los pacientes, el 91,8% de los profesionales entrevistados comunicaron que realizan rehabilitación neuromuscular en su UCI. Finalmente, solamente el 6,8% informó que su unidad estaba abierta las 24 horas para las visitas familiares. Las principales barreras a la aplicación del paquete de medidas fueron los recursos humanos y hospitalarios limitados, la resistencia al cambio, la falta de información y el aislamiento por COVID-19. Conclusión El 66% de los participantes contestó que conoce el paquete y lo aplica con diferentes grados de implementación.
| S-EPMC8685181 | biostudies-literature
Project description:Chloroquine and hydroxychloroquine belong to the aminoquinoline drugs. Studies revealed that chloroquine and hydroxychloroquine shows antagonism activity against COVID-19 under laboratory conditions. ARDS and ALI are conditions that occur in patients with COVID-19 as the main pathological complications of cytokine storm. Inflammasomes play a key role in the pathogenesis of many diseases associated with destructive inflammation. NLRP3 inflammasome has been shown to play a key role in the pathogenesis of viral diseases. The possible role of NLRP3 inflammasome inhibitors in the treatment of COVID-19 has been considered. We surveyed the potential inhibitory effect of chloroquine and hydroxychloroquine on inflammasome. Studies indicate that one of the possible anti-inflammatory mechanisms of chloroquine and hydroxychloroquine is inhibition of the activity of NLRP3 inflammasome.
| S-EPMC7792551 | biostudies-literature