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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| S-EPMC8088136 | biostudies-literature
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: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: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. 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
Project description:The Covid-19 pandemic has transformed the way we live, and after mandatory confinement, the way we interact with people will also change drastically. And without going through the traumatic experience of hospitalization, society as a whole will suffer post-traumatic stress, due to home isolation. In many cases, the disease has directly impacted close people, which will translate into a higher prevalence of mental health-related problems. In this sense, no one doubts the psychological and social footprint that the pandemic will leave on the majority of the population. The work carried out has the objective of identifying the disorders of the emotions as a result of the covid-19 and the confinement in university students of the National University Hermilio Valdizán. The type and level of research was descriptive, exploratory, explanatory, applicative, analytical, prospective and cross-sectional, with a sample of 100 university students from the different academic professional schools of the university. For data collection, the questionnaire was used and the virtual survey was used as a technique. The main results show that university students present emotional disorders such as: sleep problems (85%) and feelings of depression and hopelessness (83%). It is concluded that as a result of confinement, university students present psychological problems of anxiety and depression (46%), 22% present depression and stress, while 17% of university students present post-traumatic stress as a result of COVID-19 and confinement.
| S-EPMC8087282 | biostudies-literature
Project description:But Le but de cette étude est d’évaluer l’impact de la pandémie de la COVID-19 sur l’activité chirurgicale de trois services d’ORL d’Île-de-France, une région fortement touchée par l’épidémie. Matériel et méthodes Le nombre et la nature des interventions chirurgicales a été recueilli au sein de trois services d’ORL franciliens universitaires du 17/03/2020 au 17/04/2020 et du 18/03/2019 au 18/04/2019. Le centre 1 est un service adulte généraliste à orientation otologique. Le centre 2 est un service adulte généraliste à orientation cancérologique. Le 3e centre est exclusivement pédiatrique. Une analyse comparative de la baisse de l’activité chirurgicale a été effectuée entre 2019 et 2020. Objectif Analyser la baisse de l’activité chirurgicale. Résultats Les 3 centres ont opéré 540 patients en 2019, versus 89 en 2020, soit une baisse de 84 %. Cette diminution est de 89 % dans le centre 1, de 61 % dans le centre 2, et 95 % dans le centre pédiatrique. L’activité otologique a baissé de 97 %, endonasale de 91 %, cervicale de 54 %, plastique de 82 %, et transorale de 85 %. Le nombre de chirurgies pour cancer cutané a diminué (24 contre 9), alors que le nombre total de cervicotomies pour cancer est resté stable (18 contre 22). Le nombre de trachéotomies programmées est passé de 8 à 22. Conclusion Le nombre d’interventions chirurgicales en ORL a chuté de 84 % pendant le premier mois de l’épidémie de la COVID-19. Cette baisse d’activité est principalement aux dépens de la chirurgie fonctionnelle. L’activité oncologique a pu être préservée. Les structures hospitalières devront absorber un surplus d’activité majeur lors de l’après-crise.
| S-EPMC7293515 | biostudies-literature
Project description:ContextThe COVID-19 pandemic in France has led to the implementation of containment measures, limiting medical activity to urgent care. Heart Failure (HF) patients should have particularly been concerned. During the pandemic, movement restrictions and fear of contamination could have worsened HF patients.MethodsWe conducted two dedicated anonymous questionnaire completed at the end of the first lockdown period in France about the HF patients'symptoms and the cardiologists'pratice. In parallel, data from the SNDS (Système National des Données de Santé) were collected concerning the practices of cardiologists.ResultsRegarding HF patients, 1156 participated and filled the questionnaire. 53% were men, aged 61± 15 yo in men and 53±12 yo in women; 13% declared feeling bad during the pandemic period. 36% declared they had more dyspnea, 14% more oedema, 45% a gain of weight and 57% were more tired. 45% of patients declared having spent more than 4 weeks without any appointment with a medical doctor. Regarding Cardiologists, they proposed to perform a remotely follow-up (teleconsultation including visio, phone call management) in 23% of cases. In parallel, data from the SNDS showed that 19% of cardiologist used teleconsultations.ConclusionThrough this original survey, it emerges that despite the HF patients being more symptomatic, cardiological follow-up was difficult and challenging. We suggest that during pandemic, teleconsultations could improve the efficiency and quality of care, reduce demands on patients, and reduce healthcare costs.
| S-EPMC8432886 | biostudies-literature