Impact of COVID-19 on Madrid hospital system Impacto de COVID-19 en el sistema hospitalario de Madrid
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SUBMITTER: Condes E
PROVIDER: S-EPMC7315960 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:En Francia, el Ministerio de Sanidad establece en su programa nacional de prevención de infecciones asociadas a la asistencia sanitaria o infecciones nosocomiales de 2015 que los centros sanitarios, así como los establecimientos médico-sociales y los médicos locales deben prevenir este tipo de infecciones. Este artículo describe la prevención de la transmisión de microorganismos procedentes de pacientes o ambientales. Dicha prevención incluye siempre la aplicación de una serie de precauciones estándar (lavado y/o desinfección de manos, uso de guantes ante el menor riesgo de contacto con líquidos biológicos, uso de batas, gafas y mascarillas si existe un riesgo de proyección o de aerosolización de sangre o de cualquier otro producto de origen humano), así como la desinfección del material y de las superficies contaminadas. En algunos casos, es preciso adoptar precauciones específicas complementarias, como las basadas en la transmisión por contacto, por ejemplo en caso de gastroenteritis, las basadas en la transmisión por gotas, en caso de infecciones pulmonares u otorrinolaringológicas, y las específicas de la transmisión aérea, en caso de tuberculosis, sarampión o varicela. El artículo describe la prevención de infecciones asociadas a intervenciones invasivas (colocación de dispositivos urinarios, dispositivos intravasculares, actos quirúrgicos) y de infecciones en piel lesionada o en orificios de ostomía. También contempla la prevención de accidentes por exposición a la sangre (AES): uso de materiales de seguridad, definición clara y escrita de la conducta necesaria ante un AES, vacunación del personal. La emergencia de la resistencia a los antibióticos es un desafío para la salud pública. El control de la difusión de bacterias multirresistentes a los antibióticos y de bacterias altamente resistentes está basado a su vez en el control de la prescripción de antibióticos y de la prevención de la difusión de infecciones a partir de pacientes portadores (transmisión cruzada).
| S-EPMC7147674 | biostudies-literature
Project description: Not available
| S-EPMC9852305 | biostudies-literature
Project description: Not available
| S-EPMC8088136 | 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:Introducción La Organización Mundial de la Salud (OMS) recomienda las intervenciones tempranas de rehabilitación y movilización en pacientes hospitalizados por COVID-19. Los beneficios de la fisioterapia precoz, durante la estancia hospitalaria, no han sido probados en ensayos clínicos. Objetivo Evaluar los efectos de la fisioterapia precoz y educación para la salud en pacientes COVID-19 hospitalizados, en relación con los síntomas descritos en estudios previos, analizando diferencias entre grupos respecto a su acondicionamiento físico, necesidad de oxigenoterapia y estancia hospitalaria. Metodología Ensayo clínico aleatorizado con dos brazos, desarrollado en unidades de hospitalización y cuidados respiratorios intermedios (UCRI), con pacientes COVID-19. Se incluyeron 64 sujetos en el grupo experimental (implementación de un programa de fisioterapia precoz tras 48-72 horas de ingreso) y 62 en el grupo control (tratamiento habitual del centro). Variables sociodemográficas y clínicas: escala de disnea modified Medical Research Council (Mmrc), oxigenoterapia, Medical Research Council Scale sum score (MRC-SS), 30 segundos sit to stand test (30 s-STST), fuerza de prensión manual (FPM), Tinetti, escala de fragilidad (FRAIL-España) y escala Post-COVID-19Functional Status (PCFS). Se evaluaron al ingreso, al alta y a los dos meses del alta. Resultados Los experimentales tuvieron menos días de ingreso y de oxigenoterapia convencional. Al alta, presentan menor riesgo de caída (72,9 vs. 95,8%) y menor debilidad en MRC-SS (2,1 vs. 14,6%). A los dos meses tenían menor fragilidad (5,0 vs. 14,5%), mayor fuerza de prensión manual, menos disnea, mejores resultados en 30s-STST y menos limitaciones post-COVID (86,5 vs. 96,4%). Conclusión La intervención de fisioterapia precoz en pacientes COVID-19 y la educación para la salud recibida previenen la debilidad muscular durante el ingreso, mejoran el acondicionamiento físico al alta y a los dos meses y disminuyen los días de estancia hospitalaria. ClinicalTrials.gov (NCT05032885).
| S-EPMC10063570 | biostudies-literature
Project description:Introducción y objetivos La pandemia de COVID-19 causada por infección del virus SARS-CoV-2 ha puesto en una situación de sobrecarga grave al sistema sanitario español. Como consecuencia se ha visto afectada la atención de las enfermedades cardiovasculares. Queremos cuantificar a nivel estatal el impacto de la pandemia en el número de las intervenciones quirúrgicas, para poder planificar la nueva normalidad pospandemia. Métodos A instancias de la Sociedad Española de Cirugía Cardiovascular y Endovascular se envió una encuesta telemática anónima de 10 preguntas a todos los jefes de servicio de España. El período de estudio fue entre el 1 de enero de 2020 y el 30 de septiembre de 2020 (9 meses), y como período control las mismas fechas del año 2019. Resultados Se recibieron los datos de 32 centros hospitalarios. Un 22% del total de cirujanos cardiovasculares se contagiaron de COVID-19, siendo la media de 1,3 ± 1,5 adjuntos infectados/centro. Hubo fallecidos en lista de espera en el 46% de los centros, con una media de 1,5 ± 3,6 pacientes/centro. Hubo un descenso global del 13% en el número de cirugías (43 menos de media/centro respecto a 2019), desde una mediana de 300 (230-444) en 2019 y de 253 (172-389) en 2020 (p = 0,03) con un incremento del 12% (+7 pacientes/centro, p = 0,68) en las listas de espera. Conclusiones Existió un descenso global de cirugías del 13% respecto a 2019, con un incremento del 12% en las listas de espera. El 22% de los cirujanos se contagiaron de COVID-19.
| S-EPMC7867392 | biostudies-literature
Project description:Abstract Objective To evaluate two pooled-sample analysis strategies (a routine high-throughput approach and a novel context-sensitive approach) for mass testing during the coronavirus disease 2019 (COVID-19) pandemic, with an emphasis on the number of tests required to screen a population. Methods We used Monte Carlo simulations to compare the two testing strategies for different infection prevalences and pooled group sizes. With the routine high-throughput approach, heterogeneous sample pools are formed randomly for polymerase chain reaction (PCR) analysis. With the novel context-sensitive approach, PCR analysis is performed on pooled samples from homogeneous groups of similar people that have been purposively formed in the field. In both approaches, all samples contributing to pools that tested positive are subsequently analysed individually. Findings Both pooled-sample strategies would save substantial resources compared to individual analysis during surge testing and enhanced epidemic surveillance. The context-sensitive approach offers the greatest savings: for instance, 58–89% fewer tests would be required for a pooled group size of 3 to 25 samples in a population of 150?000 with an infection prevalence of 1% or 5%. Correspondingly, the routine high-throughput strategy would require 24–80% fewer tests than individual testing. Conclusion Pooled-sample PCR screening could save resources during COVID-19 mass testing. In particular, the novel context-sensitive approach, which uses pooled samples from homogeneous population groups, could substantially reduce the number of tests required to screen a population. Pooled-sample approaches could help countries sustain population screening over extended periods of time and thereby help contain foreseeable second-wave outbreaks.
| S-EPMC7463190 | biostudies-literature
Project description:Many patients report persistent symptoms attributable to dysfunction of the peripheral nervous and muscular systems after acute COVID-19. These symptoms may constitute part of the so-called post–acute COVID-19 syndrome (PACS), or may result from neuromuscular complications of hospitalisation in intensive care units (ICUs). This article provides an updated review of symptoms of potential neuromuscular origin in patients with PACS, differentiating symptoms according to muscle, peripheral nerve, or autonomic nervous system involvement, and analyses the forms of neuromuscular involvement in patients who were admitted to the ICU due to severe COVID-19.
| S-EPMC8669717 | biostudies-literature
Project description:Objective:To estimate the cost attributable to arterial hypertension, diabetes and obesity in the Unified Health System of Brazil in 2018. Method:The study estimated the cost attributable to non-communicable chronic diseases based on relative risk and population prevalence of hypertension, diabetes, and obesity, considering the cost of hospitalizations, outpatient procedures, and medications distributed by the SUS to treat these diseases. Cost data were obtained from SUS information systems. The analysis explored the cost of disease according to sex and age in the adult population. Results:The total cost of hypertension, diabetes, and obesity in the SUS reached R$ 3.45 billion (95%CI: 3.15-3.75) in 2018, that is, more than US$ 890 million. Of this amount, 59% referred to the treatment of hypertension, 30% to diabetes, and 11% to obesity. The age group from 30 to 69 years accounted for 72% of the total costs, and women accounted for 56%. When obesity was considered separately as a risk factor for hypertension and diabetes, the cost attributable to this diseases reached R$ 1.42 billion (95%CI: 0.98-1.87), i.e., 41% of the total cost. Conclusions:The estimates of costs attributable to the main chronic diseases associated with inadequate diet revealed a heavy economic burden of these disorders for the SUS. The data show the need to prioritize integrated and intersectoral policies for the prevention and control of hypertension, diabetes, and obesity, and may support the advocacy for interventions such as fiscal and regulatory measures to ensure that the objectives of the United Nations Decade of Action on Nutrition are met.
| S-EPMC7147115 | biostudies-literature
Project description:Dialysis patients are a risk group for SARS-CoV2 infection and possibly further complications, but we have little information. The aim of this paper is to describe the experience of the first month of the SARS-Cov2 pandemic in a hospital haemodialysis (HD) unit serving the district of Madrid with the second highest incidence of COVID19 (almost 1000 patients in 100,000 h). In the form of a diary, we present the actions undertaken, the incidence of COVID19 in patients and health staff, some clinical characteristics and the results of screening all the patients in the unit. We started with 90 patients on HD: 37 (41.1%) had COVID19, of whom 17 (45.9%) were diagnosed through symptoms detected in triage or during the session, and 15 (40.5%) through subsequent screening of those who, until that time, had not undergone SARS-CoV2 PCR testing. Fever was the most frequent symptom, 50% had lymphopenia and 18.4% <95% O2 saturation. Sixteen (43.2%) patients required hospital admission and 6 (16.2%) died. We found a cluster of infection per shift and also among those using public transport. In terms of staff, of the 44 people involved, 15 (34%) had compatible symptoms, 4 (9%) were confirmed as SARS-Cov2 PCR cases by occupational health, 9 (20%) required some period of sick leave, temporary disability to work (ILT), and 5 were considered likely cases. Conclusions We detected a high prevalence of COVID19 with a high percentage detected by screening; hence the need for proactive diagnosis to stop the pandemic. Most cases are managed as outpatients, however severe symptoms are also appearing and mortality to date is 16.2%. In terms of staff, 20% have required sick leave in relation to COVID19.
| S-EPMC7309939 | biostudies-literature