El Colegio Médico Veterinario del Perú recomienda autorizar la venta de ivermectina de uso veterinario para tratar pacientes humanos con COVID-19, debido a la escasez del medicamento. También pide informar a la población sobre los riesgos de la automedicación y monitorear efectos entre la ivermectina y la hidroxicloroquina. Finalmente, ofrece la experiencia de los veterinarios para ayudar a combatir la pandemia.
Este documento presenta propuestas para enfrentar los efectos del COVID-19 en grupos vulnerables en el Perú. Introduce el contexto de nuevos escenarios sociales que surgirán debido a la pandemia y los cambios en la vida cotidiana. Luego, analiza siete grupos sociales clave que se verán afectados: trabajadores informales, migrantes venezolanos, mujeres, niños y jóvenes, población penitenciaria, pueblos indígenas y adultos mayores, con diagnósticos y recomendaciones de polí
1) This study analyzed clinical risk factors for death from COVID-19 using electronic health records from 17 million adults in England linked to COVID-19 death data. It found increased risks for males, older age, deprivation, uncontrolled diabetes, severe asthma, and various medical conditions.
2) Black and Asian people had higher risks of death from COVID-19 compared to white people, even after adjusting for clinical risk factors. Further research is needed to understand the drivers of this association.
3) Deprivation was also a major risk factor, with little of the excess risk explained by clinical risk factors. The findings support policies in the UK for protecting high-risk groups. The study represents the largest cohort analysis conducted on
This study evaluated the effectiveness of Ivermectin in treating COVID-19. It analyzed data from over 1,400 patients across 3 continents, comparing outcomes of patients who received Ivermectin to matched controls. It found lower mortality in the Ivermectin group (1.4% vs 8.5%), with a hazard ratio of 0.20. For patients requiring ventilation, mortality was also lower in the Ivermectin group (7.3% vs 21.3%). The study concludes Ivermectin is associated with improved survival in COVID-19 and randomized controlled trials are needed to confirm this.
This document discusses the ethical challenges of rationing scarce medical resources during the COVID-19 pandemic. It makes several key points:
1) The COVID-19 pandemic is likely to overwhelm healthcare systems and create shortages of resources like ICU beds, ventilators, and medical staff. Rationing will be necessary.
2) Ethical frameworks for rationing emphasize maximizing benefits, treating people equally, prioritizing the worst off, and rewarding those who can save others. However, no single value is sufficient.
3) The document recommends prioritizing those most likely to benefit from treatment, such as younger patients and those who can be saved with critical care. It also recommends prioritizing
This study examined the effects of hydroxychloroquine treatment on outcomes in 1376 patients hospitalized with COVID-19 at Columbia University Irving Medical Center in New York City. The primary outcome was a composite of intubation or death. 811 patients (58.9%) received hydroxychloroquine treatment. There was no significant association between hydroxychloroquine use and the primary outcome after adjusting for baseline differences, with a hazard ratio of 1.04 (95% CI, 0.82 to 1.32). Randomized controlled trials are still needed to determine if hydroxychloroquine provides any benefit for COVID-19.
This document summarizes evidence that SARS-CoV-2, the virus that causes COVID-19, may infect and damage neurological tissue. It finds that the brain expresses high levels of ACE2 receptors, which SARS-CoV-2 uses to enter cells. This raises the possibility that the virus could spread to and infect the brain. It also reviews cases that suggest neurological involvement in some COVID-19 patients. The document argues that more investigation is needed but that SARS-CoV-2 infection may contribute to COVID-19 morbidity and mortality through neurological tissue damage.
This document reviews potential pharmacologic treatments for COVID-19. It summarizes the virology of SARS-CoV-2 and potential drug targets. Currently, there are no proven effective therapies but remdesivir shows promise based on in vitro activity. Over 300 clinical trials are investigating potential treatments including repurposed drugs like chloroquine/hydroxychloroquine and lopinavir/ritonavir. The review summarizes the mechanisms and pharmacology of select proposed treatments and provides an overview of ongoing clinical trials.
El Colegio Médico Veterinario del Perú recomienda autorizar la venta de ivermectina de uso veterinario para tratar pacientes humanos con COVID-19, debido a la escasez del medicamento. También pide informar a la población sobre los riesgos de la automedicación y monitorear efectos entre la ivermectina y la hidroxicloroquina. Finalmente, ofrece la experiencia de los veterinarios para ayudar a combatir la pandemia.
Este documento presenta propuestas para enfrentar los efectos del COVID-19 en grupos vulnerables en el Perú. Introduce el contexto de nuevos escenarios sociales que surgirán debido a la pandemia y los cambios en la vida cotidiana. Luego, analiza siete grupos sociales clave que se verán afectados: trabajadores informales, migrantes venezolanos, mujeres, niños y jóvenes, población penitenciaria, pueblos indígenas y adultos mayores, con diagnósticos y recomendaciones de polí
1) This study analyzed clinical risk factors for death from COVID-19 using electronic health records from 17 million adults in England linked to COVID-19 death data. It found increased risks for males, older age, deprivation, uncontrolled diabetes, severe asthma, and various medical conditions.
2) Black and Asian people had higher risks of death from COVID-19 compared to white people, even after adjusting for clinical risk factors. Further research is needed to understand the drivers of this association.
3) Deprivation was also a major risk factor, with little of the excess risk explained by clinical risk factors. The findings support policies in the UK for protecting high-risk groups. The study represents the largest cohort analysis conducted on
This study evaluated the effectiveness of Ivermectin in treating COVID-19. It analyzed data from over 1,400 patients across 3 continents, comparing outcomes of patients who received Ivermectin to matched controls. It found lower mortality in the Ivermectin group (1.4% vs 8.5%), with a hazard ratio of 0.20. For patients requiring ventilation, mortality was also lower in the Ivermectin group (7.3% vs 21.3%). The study concludes Ivermectin is associated with improved survival in COVID-19 and randomized controlled trials are needed to confirm this.
This document discusses the ethical challenges of rationing scarce medical resources during the COVID-19 pandemic. It makes several key points:
1) The COVID-19 pandemic is likely to overwhelm healthcare systems and create shortages of resources like ICU beds, ventilators, and medical staff. Rationing will be necessary.
2) Ethical frameworks for rationing emphasize maximizing benefits, treating people equally, prioritizing the worst off, and rewarding those who can save others. However, no single value is sufficient.
3) The document recommends prioritizing those most likely to benefit from treatment, such as younger patients and those who can be saved with critical care. It also recommends prioritizing
This study examined the effects of hydroxychloroquine treatment on outcomes in 1376 patients hospitalized with COVID-19 at Columbia University Irving Medical Center in New York City. The primary outcome was a composite of intubation or death. 811 patients (58.9%) received hydroxychloroquine treatment. There was no significant association between hydroxychloroquine use and the primary outcome after adjusting for baseline differences, with a hazard ratio of 1.04 (95% CI, 0.82 to 1.32). Randomized controlled trials are still needed to determine if hydroxychloroquine provides any benefit for COVID-19.
This document summarizes evidence that SARS-CoV-2, the virus that causes COVID-19, may infect and damage neurological tissue. It finds that the brain expresses high levels of ACE2 receptors, which SARS-CoV-2 uses to enter cells. This raises the possibility that the virus could spread to and infect the brain. It also reviews cases that suggest neurological involvement in some COVID-19 patients. The document argues that more investigation is needed but that SARS-CoV-2 infection may contribute to COVID-19 morbidity and mortality through neurological tissue damage.
This document reviews potential pharmacologic treatments for COVID-19. It summarizes the virology of SARS-CoV-2 and potential drug targets. Currently, there are no proven effective therapies but remdesivir shows promise based on in vitro activity. Over 300 clinical trials are investigating potential treatments including repurposed drugs like chloroquine/hydroxychloroquine and lopinavir/ritonavir. The review summarizes the mechanisms and pharmacology of select proposed treatments and provides an overview of ongoing clinical trials.
This research letter summarizes a study investigating the environmental contamination of SARS-CoV-2 from symptomatic patients. Samples were collected from various surfaces in the rooms of 3 patients, as well as air samples and samples from healthcare workers' personal protective equipment (PPE). One patient's room tested positive for SARS-CoV-2 on 13 of 15 room surfaces and 3 of 5 toilet surfaces before routine cleaning, but all surfaces tested negative after cleaning. Air samples and most PPE samples were negative, except for one shoe sample. The findings suggest fomite and fecal-oral transmission of SARS-CoV-2 are possible, but current cleaning procedures are sufficient to decontaminate the environment.
This study analyzed 232 patients with COVID-19 admitted to hospitals in China between January 19th and March 6th. The study found that 21% of patients experienced diarrhea, with those patients more likely to have severe symptoms and require intensive care. As the outbreak progressed, a greater proportion of patients experienced diarrhea. This suggests that gastrointestinal symptoms may be more common with COVID-19 than initially reported, and patients with diarrhea appear to have worse outcomes.
This document provides recommendations for protecting healthcare workers from SARS-CoV-2 infection through proper use of respiratory devices and safety measures. It discusses:
1) The risk of transmission during various oxygen therapies and ventilation methods, finding CPAP via oronasal mask and NIV via helmet with tight seal have minimal dispersion.
2) Safety measures like handwashing, distancing, and masks to minimize contact/droplet transmission.
3) Precautions for aerosol-generating procedures in COVID-19 patients, including negative pressure rooms and appropriate PPE like N95 masks.
El documento ofrece recomendaciones para el manejo de la salud mental de los profesionales de la salud durante la pandemia de COVID-19. Señala que los profesionales de la salud enfrentan altos niveles de estrés y ansiedad debido a la alta demanda de atención, el riesgo de contagio y escasez de equipos de protección. Recomienda que los profesionales practiquen el autocuidado a través de una dieta saludable, ejercicio, descanso adecuado y actividades de relajación. Tamb
This document outlines the timeline of key events related to the COVID-19 pandemic from December 2019 to January 2020. It describes how Chinese health officials began investigating cases of viral pneumonia in Wuhan in December. By late December, doctors were warned about the new disease but were later reprimanded by police for spreading rumors. In early January, a seafood market was shut down and a new coronavirus was identified. The genetic sequence was shared internationally on January 12th, allowing diagnostic tests to be developed. The first cases outside of China were reported shortly after.
The document discusses how COVID-19 may attack hemoglobin and disrupt human heme metabolism. It finds that the ORF8 and spike proteins can bind to porphyrin, while orf1ab, ORF10, and ORF3a can coordinate to attack the heme on hemoglobin's beta chain. This releases iron to form porphyrin, reducing oxygen carrying capacity and causing lung inflammation. It also interferes with human heme pathways. Chloroquine may prevent these attacks and binding, relieving symptoms, though individual effectiveness may vary. Favipiravir may inhibit viral protein binding to porphyrins, preventing cell entry and free porphyrin capture.
This document provides guidance from Massachusetts General Hospital on potential treatment options for COVID-19, including both approved and experimental therapies. It recommends supportive care for mild cases but considers investigational antivirals like remdesivir for moderate or severe cases. It also outlines monitoring and treatment guidance for special populations, potential side effects of therapies, and criteria for considering treatments targeting cytokine release syndrome. The guidance is intended to be updated frequently as new data emerges on COVID-19 treatment.
This research letter summarizes a study investigating the environmental contamination of SARS-CoV-2 from symptomatic patients. Samples were collected from various surfaces in the rooms of 3 patients, as well as air samples and samples from healthcare workers' personal protective equipment (PPE). One patient's room tested positive for SARS-CoV-2 on 13 of 15 room surfaces and 3 of 5 toilet surfaces before routine cleaning, but all surfaces tested negative after cleaning. Air samples and most PPE samples were negative, except for one shoe sample. The findings suggest fomite and fecal-oral transmission of SARS-CoV-2 are possible, but current cleaning procedures are sufficient to decontaminate the environment.
This document discusses the relationship between COVID-19 and diabetes based on clinical observations from China, Italy, and the United States. Emerging evidence shows that diabetes is a common comorbidity in patients with severe COVID-19 and may increase the risk of mortality. The document then reviews the pathogenesis and immune response to SARS-CoV-2 before discussing potential mechanisms by which diabetes could increase susceptibility to infection and severe disease. It concludes by highlighting areas for further investigation and management considerations for clinicians.
A 67-year-old woman presented with respiratory symptoms and was diagnosed with COVID-19. One week later, she presented with worsening symptoms and was found to have a large hemorrhagic pericardial effusion causing cardiac tamponade. She underwent pericardiocentesis, draining 800ml of fluid. After the procedure, she developed signs of takotsubo cardiomyopathy. The case report discusses the rare presentation of cardiac tamponade secondary to COVID-19 infection and the subsequent development of takotsubo cardiomyopathy.
A 58-year-old woman was admitted with COVID-19 symptoms and developed cardiogenic and septic shock. An echocardiogram showed findings consistent with takotsubo cardiomyopathy - also known as stress cardiomyopathy - with left ventricular dysfunction. Her left ventricular function improved over the next few days, supporting the diagnosis of reversible acute stress cardiomyopathy secondary to COVID-19. This is the first reported case of takotsubo cardiomyopathy associated with COVID-19 in the United States.
Este documento presenta predicciones sobre la evolución de casos confirmados de COVID-19 en el Perú. Se estima que la zona de contención se alcanzará entre el 8 y 15 de abril. Sin embargo, debido a limitaciones en las pruebas de detección, las cifras podrían ser mayores. El Perú tendría una trayectoria inferior a países como Brasil y Chile, y podría controlar la pandemia en un plazo similar al de China. Actualmente, el Perú tiene una baja tasa de letalidad en comparación internacional.
This document provides recommendations for managing acute myocardial infarction (AMI) during the COVID-19 pandemic. It addresses the varied clinical presentations of cardiovascular issues related to COVID-19 and recommends the appropriate use of personal protective equipment (PPE) by healthcare workers. For ST-elevation myocardial infarction (STEMI) patients, primary percutaneous coronary intervention (PCI) remains the standard at PCI-capable hospitals when it can be performed quickly by an expert team using PPE in a dedicated cardiac catheterization laboratory (CCL) room. Fibrinolysis may be considered at non-PCI hospitals or if primary PCI cannot be performed safely and quickly. The recommendations aim to ensure cardiovascular patients continue receiving timely care while protecting healthcare workers during the pandemic.
This study evaluated the effectiveness of ivermectin in treating COVID-19 patients. The study reviewed 280 hospitalized COVID-19 patients, 173 of whom received ivermectin and 107 received usual care. Patients who received ivermectin had a lower mortality rate compared to those who received usual care (15.0% vs 25.2%). Mortality was also lower in patients with severe disease who received ivermectin (38.8% vs 80.7%). After adjusting for potential confounding factors, ivermectin treatment remained significantly associated with lower mortality. The study concludes that ivermectin may be effective in treating COVID-19, especially in severe cases, but
El documento discute el potencial uso de tratamientos antivirales en casos leves de COVID-19. Señala que aunque actualmente no hay evidencia concluyente, estudios in vitro muestran que medicamentos como la cloroquina y la hidroxicloroquina tienen efecto antiviral contra el virus. También, las guías de varios países incluyen estos tratamientos. El documento argumenta que un tratamiento temprano en casos leves podría prevenir casos severos y que bajo un sistema estructurado, los centros de atención primaria en Perú podrían
Este documento resume la situación actual de COVID-19 en Perú. Se describe la propagación inicial del virus desde el primer caso importado en marzo hasta la transmisión comunitaria en la mayoría de las regiones a inicios de mayo. La mayoría de los casos se concentran en Lima y Callao, y la población adulta entre 30-59 años representa el 67% de los infectados. Los síntomas más comunes son tos, fiebre, malestar general y dolor de garganta.
This document discusses policies on respiratory protection for healthcare workers during the COVID-19 pandemic. There is disagreement between health organizations like WHO, CDC, and ECDC on when masks or respirators should be used. Some recommend masks for routine care and respirators for high-risk procedures, while others recommend respirators for all patient contact. Individual countries also have varying policies. Due to shortages, extended use and reuse of masks and respirators has occurred, though evidence on their effectiveness is limited. Overall, the document examines inconsistencies in respiratory protection policies for healthcare workers globally during the COVID-19 outbreak.
El documento resume la evidencia sobre la asociación entre COVID-19 y enfermedad cardiovascular. Se reportó un grupo de pacientes con neumonía de origen desconocido en Wuhan, China en diciembre de 2019. En enero de 2020 se identificó el SARS-CoV-2 como la causa. A medida que aumentaron los casos, se observó que la enfermedad cardiovascular jugaba un papel fundamental en el desarrollo y pronóstico de la infección. Los factores de riesgo más importantes para mortalidad son la edad avanzada y las comorbilidades
1) Growing evidence indicates that hospitalized COVID-19 patients are at an increased risk of venous and arterial thrombosis. D-dimer levels at admission predict outcomes like ARDS, ICU admission, and mortality.
2) The working party on hemostasis proposes recommendations for thromboprophylaxis in COVID-19 patients, including use of low molecular weight heparin or unfractionated heparin based on renal function. Monitoring of lab values like D-dimers, platelets, and coagulation markers is also suggested.
3) Higher doses of anticoagulants or switching to intermediate or therapeutic doses should be considered for critically ill patients or those with signs of organ dysfunction. Monitoring for hepar
This research letter summarizes a study investigating the environmental contamination of SARS-CoV-2 from symptomatic patients. Samples were collected from various surfaces in the rooms of 3 patients, as well as air samples and samples from healthcare workers' personal protective equipment (PPE). One patient's room tested positive for SARS-CoV-2 on 13 of 15 room surfaces and 3 of 5 toilet surfaces before routine cleaning, but all surfaces tested negative after cleaning. Air samples and most PPE samples were negative, except for one shoe sample. The findings suggest fomite and fecal-oral transmission of SARS-CoV-2 are possible, but current cleaning procedures are sufficient to decontaminate the environment.
This study analyzed 232 patients with COVID-19 admitted to hospitals in China between January 19th and March 6th. The study found that 21% of patients experienced diarrhea, with those patients more likely to have severe symptoms and require intensive care. As the outbreak progressed, a greater proportion of patients experienced diarrhea. This suggests that gastrointestinal symptoms may be more common with COVID-19 than initially reported, and patients with diarrhea appear to have worse outcomes.
This document provides recommendations for protecting healthcare workers from SARS-CoV-2 infection through proper use of respiratory devices and safety measures. It discusses:
1) The risk of transmission during various oxygen therapies and ventilation methods, finding CPAP via oronasal mask and NIV via helmet with tight seal have minimal dispersion.
2) Safety measures like handwashing, distancing, and masks to minimize contact/droplet transmission.
3) Precautions for aerosol-generating procedures in COVID-19 patients, including negative pressure rooms and appropriate PPE like N95 masks.
El documento ofrece recomendaciones para el manejo de la salud mental de los profesionales de la salud durante la pandemia de COVID-19. Señala que los profesionales de la salud enfrentan altos niveles de estrés y ansiedad debido a la alta demanda de atención, el riesgo de contagio y escasez de equipos de protección. Recomienda que los profesionales practiquen el autocuidado a través de una dieta saludable, ejercicio, descanso adecuado y actividades de relajación. Tamb
This document outlines the timeline of key events related to the COVID-19 pandemic from December 2019 to January 2020. It describes how Chinese health officials began investigating cases of viral pneumonia in Wuhan in December. By late December, doctors were warned about the new disease but were later reprimanded by police for spreading rumors. In early January, a seafood market was shut down and a new coronavirus was identified. The genetic sequence was shared internationally on January 12th, allowing diagnostic tests to be developed. The first cases outside of China were reported shortly after.
The document discusses how COVID-19 may attack hemoglobin and disrupt human heme metabolism. It finds that the ORF8 and spike proteins can bind to porphyrin, while orf1ab, ORF10, and ORF3a can coordinate to attack the heme on hemoglobin's beta chain. This releases iron to form porphyrin, reducing oxygen carrying capacity and causing lung inflammation. It also interferes with human heme pathways. Chloroquine may prevent these attacks and binding, relieving symptoms, though individual effectiveness may vary. Favipiravir may inhibit viral protein binding to porphyrins, preventing cell entry and free porphyrin capture.
This document provides guidance from Massachusetts General Hospital on potential treatment options for COVID-19, including both approved and experimental therapies. It recommends supportive care for mild cases but considers investigational antivirals like remdesivir for moderate or severe cases. It also outlines monitoring and treatment guidance for special populations, potential side effects of therapies, and criteria for considering treatments targeting cytokine release syndrome. The guidance is intended to be updated frequently as new data emerges on COVID-19 treatment.
This research letter summarizes a study investigating the environmental contamination of SARS-CoV-2 from symptomatic patients. Samples were collected from various surfaces in the rooms of 3 patients, as well as air samples and samples from healthcare workers' personal protective equipment (PPE). One patient's room tested positive for SARS-CoV-2 on 13 of 15 room surfaces and 3 of 5 toilet surfaces before routine cleaning, but all surfaces tested negative after cleaning. Air samples and most PPE samples were negative, except for one shoe sample. The findings suggest fomite and fecal-oral transmission of SARS-CoV-2 are possible, but current cleaning procedures are sufficient to decontaminate the environment.
This document discusses the relationship between COVID-19 and diabetes based on clinical observations from China, Italy, and the United States. Emerging evidence shows that diabetes is a common comorbidity in patients with severe COVID-19 and may increase the risk of mortality. The document then reviews the pathogenesis and immune response to SARS-CoV-2 before discussing potential mechanisms by which diabetes could increase susceptibility to infection and severe disease. It concludes by highlighting areas for further investigation and management considerations for clinicians.
A 67-year-old woman presented with respiratory symptoms and was diagnosed with COVID-19. One week later, she presented with worsening symptoms and was found to have a large hemorrhagic pericardial effusion causing cardiac tamponade. She underwent pericardiocentesis, draining 800ml of fluid. After the procedure, she developed signs of takotsubo cardiomyopathy. The case report discusses the rare presentation of cardiac tamponade secondary to COVID-19 infection and the subsequent development of takotsubo cardiomyopathy.
A 58-year-old woman was admitted with COVID-19 symptoms and developed cardiogenic and septic shock. An echocardiogram showed findings consistent with takotsubo cardiomyopathy - also known as stress cardiomyopathy - with left ventricular dysfunction. Her left ventricular function improved over the next few days, supporting the diagnosis of reversible acute stress cardiomyopathy secondary to COVID-19. This is the first reported case of takotsubo cardiomyopathy associated with COVID-19 in the United States.
Este documento presenta predicciones sobre la evolución de casos confirmados de COVID-19 en el Perú. Se estima que la zona de contención se alcanzará entre el 8 y 15 de abril. Sin embargo, debido a limitaciones en las pruebas de detección, las cifras podrían ser mayores. El Perú tendría una trayectoria inferior a países como Brasil y Chile, y podría controlar la pandemia en un plazo similar al de China. Actualmente, el Perú tiene una baja tasa de letalidad en comparación internacional.
This document provides recommendations for managing acute myocardial infarction (AMI) during the COVID-19 pandemic. It addresses the varied clinical presentations of cardiovascular issues related to COVID-19 and recommends the appropriate use of personal protective equipment (PPE) by healthcare workers. For ST-elevation myocardial infarction (STEMI) patients, primary percutaneous coronary intervention (PCI) remains the standard at PCI-capable hospitals when it can be performed quickly by an expert team using PPE in a dedicated cardiac catheterization laboratory (CCL) room. Fibrinolysis may be considered at non-PCI hospitals or if primary PCI cannot be performed safely and quickly. The recommendations aim to ensure cardiovascular patients continue receiving timely care while protecting healthcare workers during the pandemic.
This study evaluated the effectiveness of ivermectin in treating COVID-19 patients. The study reviewed 280 hospitalized COVID-19 patients, 173 of whom received ivermectin and 107 received usual care. Patients who received ivermectin had a lower mortality rate compared to those who received usual care (15.0% vs 25.2%). Mortality was also lower in patients with severe disease who received ivermectin (38.8% vs 80.7%). After adjusting for potential confounding factors, ivermectin treatment remained significantly associated with lower mortality. The study concludes that ivermectin may be effective in treating COVID-19, especially in severe cases, but
El documento discute el potencial uso de tratamientos antivirales en casos leves de COVID-19. Señala que aunque actualmente no hay evidencia concluyente, estudios in vitro muestran que medicamentos como la cloroquina y la hidroxicloroquina tienen efecto antiviral contra el virus. También, las guías de varios países incluyen estos tratamientos. El documento argumenta que un tratamiento temprano en casos leves podría prevenir casos severos y que bajo un sistema estructurado, los centros de atención primaria en Perú podrían
Este documento resume la situación actual de COVID-19 en Perú. Se describe la propagación inicial del virus desde el primer caso importado en marzo hasta la transmisión comunitaria en la mayoría de las regiones a inicios de mayo. La mayoría de los casos se concentran en Lima y Callao, y la población adulta entre 30-59 años representa el 67% de los infectados. Los síntomas más comunes son tos, fiebre, malestar general y dolor de garganta.
This document discusses policies on respiratory protection for healthcare workers during the COVID-19 pandemic. There is disagreement between health organizations like WHO, CDC, and ECDC on when masks or respirators should be used. Some recommend masks for routine care and respirators for high-risk procedures, while others recommend respirators for all patient contact. Individual countries also have varying policies. Due to shortages, extended use and reuse of masks and respirators has occurred, though evidence on their effectiveness is limited. Overall, the document examines inconsistencies in respiratory protection policies for healthcare workers globally during the COVID-19 outbreak.
El documento resume la evidencia sobre la asociación entre COVID-19 y enfermedad cardiovascular. Se reportó un grupo de pacientes con neumonía de origen desconocido en Wuhan, China en diciembre de 2019. En enero de 2020 se identificó el SARS-CoV-2 como la causa. A medida que aumentaron los casos, se observó que la enfermedad cardiovascular jugaba un papel fundamental en el desarrollo y pronóstico de la infección. Los factores de riesgo más importantes para mortalidad son la edad avanzada y las comorbilidades
1) Growing evidence indicates that hospitalized COVID-19 patients are at an increased risk of venous and arterial thrombosis. D-dimer levels at admission predict outcomes like ARDS, ICU admission, and mortality.
2) The working party on hemostasis proposes recommendations for thromboprophylaxis in COVID-19 patients, including use of low molecular weight heparin or unfractionated heparin based on renal function. Monitoring of lab values like D-dimers, platelets, and coagulation markers is also suggested.
3) Higher doses of anticoagulants or switching to intermediate or therapeutic doses should be considered for critically ill patients or those with signs of organ dysfunction. Monitoring for hepar
El manejo inicial del paciente politraumatizado implica el conocimiento y puesta en práctica de una metodología sistemática de valoración y tratamiento, con el fin de lograr dos objetivos principales: 1) La detección y solución inmediata de los procesos que pueden acabar con la vida del paciente en muy corto espacio de tiempo. 2) El desarrollo de una sistemática de evaluación pormenorizada que evite que alguna lesión pueda pasar desapercibida. Aceptando el método universal desarrollado por el Advanced Trauma Life Support (ATLS).Es aquel que pre- senta lesiones a consecuencia de un trauma- tismo que afectan a dos o más órganos o bien aquel que presenta al menos una lesión que pone en peligro su vida. El politraumatismo es la principal causa de muerte e incapacidad en niños mayores de un año.El trauma se ha convertido en una pandemia que tiene un severo impacto socio económico para la sociedad, la alta tasa de morbi mortalidad y sobre todo las secuelas muchas veces permanentes con alto costo, obliga a los gobiernos a enfrentar esta patología en forma multisectorial, buscando la disminución de los daños a través de múltiples estrategias, en lo que se refiere a los sistemas de salud, éstos deben de contar con una adecuada organización y todos los procesos asistenciales para un adecuado resultado en la atención del paciente politraumatizado, por tanto el equipo de salud debe de estar preparado para ello, buscando la continua capacitación y actualización en el manejo inicial del paciente politraumatizado ya que según las estadísticas en la primera hora de sucedido el evento existe una alta mortalidad, asociada ésta a que un 25% de ellas ocurre debido a un manejo inadecuado. Palabras clave: Heridas y traumatismos, lesiones, traumatismo múltiple
Entre los grandes titulares que se esgrimen sobre la sanidad, siempre se demanda su carácter universal, su óptima calidad y el ámbito público de prestación de los servicios, temas de extrema importancia que son objeto de amplios debates, pero, ¿qué hay detrás del otro tema demandado: la gratuidad? Este es el asunto que se trae a discusión y análisis en este momento.
La asistencia sanitaria no es gratuita y nunca podrá serlo. No se debe de confundir el desembolso inmediato que tendría que hacer el paciente para ser atendido con su aportación mediante impuestos a los fondos estatales que son dedicados a este menester.
La sanidad es una actividad que requiere cuantiosos recursos y crece de forma continua, acompañando a la evolución de la economía social, y como cualquier actividad de servicios, requiere dotaciones de personal, instalaciones, equipos tecnológicos y una organización que provea de una logística eficiente y de alta calidad.
El tratamiento de este problema, generalmente es discutido en los despachos de la Administración como un asunto de reparto y gestión de los presupuestos, buscando que la calidad asistencial sea la mejor posible. Pero analizar el tema en este exclusivo entorno, impide tener una visión completa, simplemente porque la asistencia sanitaria, en principio, es un asunto con dos actores principales: el médico y el paciente. El análisis, pues, debe de realizarse contemplando sus respectivas circunstancias y perspectivas.
OBJETIVO DEL SEMINARIO:
El seminario es experimental, al ser el primero, si respondemos a las expectativas de los asistentes programaremos varias sesiones en la próxima temporada.
Las características que debe recoger un seminario de un par de horas que trate sobre la importancia de la economía y la asistencia sanitaria, es quizás demasiado ambicioso, pero planteado como ensayo piloto para diseñar un programa de información futuro no solo sobre la economía sanitaria y su impacto asistencial, sino también sobre todos aquellos aspectos y circunstancias que rodean la asistencia sanitaria, puede resultar muy instructivo.
INFORMACION SOBRE EL PONENTE
Luis Núñez Martín es especialista en Radiofísica Hospitlaria., Física Medica y Protección Radiológica. Ha sido Jefe de Servicio en el Hospital Puerta de Hierro en Majadahonda (jubilado) y es Profesor Honorario del Departamento de Medicina de la UAM.