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Implicaciones de la pandemia en la radioterapia para el cancer de mama. Radioterapia hipofraccionada Implications of the pandemic in radiotherapy for breast cancer. Hypofractionated radiation therapy

ABSTRACT: La pandemia por el nuevo coronavirus (SARS-CoV-2) ha puesto a prueba los sistemas de salud de todo el mundo, de una forma tan apremiante que no se veía hace muchos años. Las implicaciones en la atención en salud no afectan únicamente a los pacientes con la COVID-19, sino que son transversales a todas las enfermedades. Específicamente en cáncer de mama, los esquemas de radioterapia hipofraccionada constituyen una alternativa válida y segura que ayuda a disminuir la exposición de las pacientes al nuevo virus, la congestión de las instituciones de salud y los costos propios de los tratamientos oncológicos especializados. En este artículo, se realizó una revisión de la literatura más relevante sobre los regímenes acortados de radioterapia en cáncer de mama: hipofraccionamiento e hipofraccionamiento extremo, y sobre su equivalencia con el fraccionamiento estándar. Al final, se destacan las recomendaciones de diferentes sociedades científicas y expertos internacionales, para considerar esquemas de radioterapia hipofraccionados, a propósito de la contingencia de salud mundial.

SUBMITTER: Briceno Morales X

PROVIDER: S-EPMC8767944 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Terapia de voz en el contexto de la pandemia covid-19; recomendaciones para la practica clinica.

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

Management of neurological care during the COVID-19 pandemic? La gestion de la asistencia neurologica en tiempos de la pandemia de Covid-19

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

Diagnosis and locoregional treatment of patients with breast cancer during the COVID-19 pandemic Diagnostico y tratamiento locorregional de las pacientes con cancer de mama durante la pandemia de la COVID-19

Project description:We are facing a pandemic that is going to affect a significant part of the population. At the end of April in the world there are about 3,000,000 cases, with 205,000 deaths and 860,000 patients recovered. The response to this pandemic has in many cases led to a significant change in the daily work of caring for cancer patients, the good results of which depend largely on time-adjusted protocols and multidisciplinary treatments. We present a review of local, surgical and radiotherapy treatment together with authors’ recommendations made from personal experience on ways to act in the diagnosis and surgical treatment of breast cancer during the COVID-19 pandemic. The multidisciplinary Breast Committees must continue to meet weekly in videoconference format. All surgical actions and irradiations must be carried out with maximum safety for both the patients and the participating teams. Hypofractionation in radiation therapy should be the standard treatment. Sometimes it is recommended to apply a primary systemic treatment or even a primary irradiation. Great coordination between the surgical and oncology teams, both medical and radiotherapeutic, is essential.

| S-EPMC7198217 | biostudies-literature

AEG-SEED position paper for the resumption of endoscopic activity after the peak phase of the COVID-19 pandemic? Documento de posicionamiento AEG-SEED para el reinicio de la actividad endoscopica tras la fase pico de la pandemia de COVID-19

Project description:Introduction The COVID-19 pandemic has led to the suspension of programmed activity in most of the Endoscopy Units in our environment. The aim of this document is to facilitate the resumption of elective endoscopic activity in an efficient and safe manner. Material and methods A series of questions considered to be of clinical and logistical relevance were formulated. In order to elaborate the answers, a structured bibliographic search was carried out in the main databases and the recommendations of the main Public Health and Digestive Endoscopy institutions were reviewed. The final recommendations were agreed upon through telematic means. Results A total of 33 recommendations were made. The main aspects discussed are: 1) Reassessment and prioritization of the indication, 2) Restructuring of spaces, schedules and health personnel, 3) Screening for infection, 4) Hygiene measures and personal protective equipment. Conclusion The AEG and SEED recommend restarting endoscopic activity in a phased, safe manner, adapted to local resources and the epidemiological situation of SARS-CoV-2 infection.

| S-EPMC7351450 | biostudies-literature

Trends in child and adolescent mental health in Catalonia in the context of the covid-19 pandemic during the 2020–2021 school year☆ Evolucion de la salud mental infanto-juvenil en Catalunya en el contexto de la pandemia por la COVID-19 durante el curso escolar 2020-2021

Project description:Graphical abstract Introduction The SARS-CoV-2 pandemic has had a great impact on the physical and psychological health of the population. The aim of this study was to evaluate child and adolescent mental health in a population cohort along the 2020–2021 school year. Methods This was a prospective longitudinal study of a cohort of children from 5–14 years of age in Catalonia, Spain, performed from September 2020 to July 2021. The participants were randomly selected and accompanied by their primary care paediatrician. Evaluation of risk of psychopathology was performed using the Strengths and Difficulties Questionnaire (SDQ) carried out by one of the legal guardians of the child. We also collected sociodemographic and health variables of the participants and their nuclear family. Data were collected by an online survey through the RedCap platform at the beginning of the academic year and at the end of each trimester (4 cuts). Results At the beginning of the school year, 9.8% of the patients were probable cases of psychopathology compared to 6.2% at the end of the year. The perception of the level of preoccupation of the children for their health and that of their family was related to presenting psychopathology, especially at the beginning of the year, with the perception of a good family atmosphere being always related to lower risk. No variable related to COVID-19 was associated with an altered SDQ result. Conclusions Along the 2020–2021 school year, the percentage of children with a probability of presenting psychopathology decreased from 9.8% to 6.2%.

| S-EPMC10239907 | biostudies-literature

Evolucion de la salud mental infanto-juvenil en Catalunya en el contexto de la pandemia por la COVID-19 durante el curso escolar 2020-2021☆ Trends in child and adolescent mental health in Catalonia in the context of the covid-19 pandemic during the 2020-2021 school year

Project description:Graphical abstract Introducción La pandemia por SARS-CoV-2 ha tenido un alto impacto en la salud física y psicológica de la población. Nuestro objetivo fue evaluar la salud mental infanto-juvenil de una cohorte poblacional a lo largo del curso 2020-2021. Métodos Estudio longitudinal y prospectivo de una cohorte de niños escolarizados entre 5 y 14 años en Cataluña entre septiembre de 2020 y julio de 2021. Los participantes fueron seleccionados de forma aleatoria y seguidos por el pediatra de referencia en la atención primaria. La evaluación del riesgo de psicopatología fue realizada a través del Strengths and Difficulties Questionnaire (SDQ), contestada por un tutor legal del niño. Fueron recogidas también variables sociodemográficas y de salud del individuo y su núcleo de convivencia. Los datos fueron recogidos mediante una encuesta on-line a través de la plataforma RedCap al inicio del curso y al final de cada trimestre (4 cortes). Resultados Al inicio del curso escolar el 9,8% de los alumnos fueron casos probables de psicopatología, frente al 6,2% de final de curso. La percepción del nivel de preocupación de los niños por su salud y la de su familia se relacionó con presentar psicopatología, especialmente al inicio del curso, mientras que la percepción de un buen ambiente familiar se relacionó en todo momento con menor riesgo. Ninguna variable relacionada con la COVID-19 se asoció con resultado alterado del SDQ. Conclusiones A lo largo del curso escolar 2020-2021 el porcentaje de niños con probabilidad de presentar psicopatología mejoró, y pasó del 9,8% al 6,2%.

| S-EPMC10063576 | biostudies-literature

Recommendations for eye care during the alarm state by the coronavirus disease pandemic COVID-19☆ Recomendaciones para la atencion oftalmologica durante el estado de alarma por la pandemia de enfermedad por coronavirus COVID-19

Project description:Objective Minimize exposure to the SARS-CoV-2, reduce the chances of cross-transmission between patients and healthcare personnel, and prevent the development of postoperative complications from the management of patients with eye diseases during the 2019 coronavirus disease pandemic (COVID-19). Methods COVID-19 literature review and consensus establishment between different Spanish ophthalmology societies in order to provide guidelines and recommendations of maximum resources primarily conditioned by the state of alert, confinement and social distancing that occurs in Spain since March 16, 2020. Results The recommendations will promote the adoption of action and protection measures for eye care in outpatient clinics, surgical areas and hospitalization, for unconfirmed (asymptomatic and symptomatic) and confirmed COVID-19 patients. Measures must be adapted to the circumstances and availability of personal protective equipment in each of the centers and Autonomous Communities, which will be updated according to the pandemic phases and the measures adopted by the Spanish Government. Conclusions During the COVID-19 pandemic, attention to the potential health risks to the population caused by coronavirus should prevail over the possible progression of the common eye diseases. Ophthalmologists and other eye care professionals must assume a possible progression of these diseases due to the impossibility of adequate patient follow-up.

| S-EPMC7245194 | biostudies-literature

Role of 3D printing in the protection of surgical and critical care professionals in the COVID-19 pandemic☆ Papel de la impresion 3D para la proteccion de los profesionales del area quirurgica y criticos en la pandemia de COVID-19

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

Evaluation of the impact of the COVID-19 pandemic on Gestational Diabetes screening: DIABE-COVID Survey Evaluacion del impacto de la pandemia COVID-19 en el cribado de la diabetes gestacional: encuesta DIABE-COVID

Project description: Not available

| S-EPMC9852305 | biostudies-literature

Encuesta nacional sobre el tratamiento de la colelitiasis en Espana durante la fase inicial de la pandemia por COVID-19 National survey on the treatment of cholelitiasis in Spain during the initial period of the COVID-19 pandemic

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

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