A importância da persistência diagnóstica num caso suspeito de COVID-19 em contexto ocupacional

2020 ◽  
Vol 10 ◽  
pp. 1-10
Author(s):  
Alexandre Afonso ◽  
Luís Rodrigues ◽  
Vítor Pinheiro ◽  
Ricardo Silva ◽  
Joana Silva ◽  
...  
Keyword(s):  
Case Report ◽  
Disease Transmission ◽  
Molecular Detection ◽  
Health Care Systems ◽  
Scientific Evidence ◽  
Effective Control ◽  
Primary Role ◽  
Serological Tests ◽  
Care Systems ◽  
Screening And Identification

Introduction The SARS-CoV-2 pandemic has brought new and challenging problems to health care systems. More than ever, the screening and identification of disease transmission chains has proved to be extremely complex and important. The accurate diagnosis remains as a fundamental pillar of the screening, which is currently based on the molecular detection of SARS-CoV-2 in respiratory samples. This strategy may be insufficient for an effective control of the pandemic since the diagnostic performance of the molecular detection varies over time after exposure and is dependent on the sensitivity and specificity of the tests used. Case Report A case report of a healthcare professional with a clinical and epidemiological context (chronologically and geographically) highly suggestive of COVID-19 who, repeatedly, had a negative result in the molecular search for the disease agent. The maintenance of complaints and imperiousness to control secondary cases, motivated the more detailed study using serological tests of specific immunoglobulins for SARS-CoV-2 that proved to be reactive. Discussion/Conclusion The primary role of clinical suspicion in a pandemic scenario is highlighted and the need for careful interpretation of complementary diagnostic tests in the light of the evolution of scientific evidence. The intervention of the Occupational Health Service is also emphasized, both in terms of diagnosis and in monitoring the case in order to promote the health of the professional and to protect the remaining members of the healthcare staff and patients.

scholarly journals Tweets and Quacks: Network and Content Analyses of Providers of Non-Science-Based Anticancer Treatments and Their Supporters on Twitter

SAGE Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 215824402110030
Author(s):  
Anita Lavorgna ◽  
Leslie Carr
Keyword(s):  
Online Community ◽  
Health Care Systems ◽  
Scientific Evidence ◽  
Medical Treatments ◽  
Structural Relationships ◽  
Vulnerable Patients ◽  
The Social ◽  
Medical Discipline ◽  
Care Systems ◽  
English Speaking

Despite the consensus in the medical discipline that certain treatments lack scientific evidence and are worthless if not potentially dangerous, the promotion and selling of fake cures advertised as safe and effective has long plagued health care systems, praying on vulnerable patients and their loved ones. The web and social media are now playing a fundamental role in the propagation of non-science-based treatments and fraudulent medical claims, and in the rise of false health and lifestyle experts. This study combines criminological and computer science expertise to explore and critically analyze the Twitter presence of providers of non-science-based anticancer treatments and their active supporters in the English-speaking online community to investigate their structural relationships and to analyze the characteristics of the most popular actors. The features of the social network observed indicate that there is not a stable community of promoters and supporters of non-science-based medical treatments in the Twittersphere, suggesting the lack of a defined subculture and the presence of transient collectives rather than identifiable groups. Nonetheless, it is possible to observe dynamic conversational networks clustering around popular actors, tweets, and themes, prompting avenues for further research.

scholarly journals Journey of the Patient With Melanoma: Understanding Resource Use and Bridging the Gap Between Dermatologist, Surgeon, and Oncologist in Different Health Care Systems

2019 ◽  
pp. 1-8
Author(s):  
Cássia Rita Pereira da Veiga ◽  
Claudimar Pereira da Veiga ◽  
Ana Paula Drummond-Lage ◽  
Alberto Julius Alves Wainstein ◽  
Andreia Cristina de Melo
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Systems ◽  
Scientific Evidence ◽  
Health Resources ◽  
Medical Professionals ◽  
Public And Private ◽  
Patients With Cancer ◽  
Clinical Procedures ◽  
Care Systems

PURPOSE New scientific evidence has led to modifications in the clinical practice of handling melanoma. In health care systems, there is currently a wide variety of clinical procedures to treat cancer, and the various routes have different effects on the survival of patients with cancer. Thus, this article aimed to evaluate the journey of patients with melanoma in the public and private health care systems in Brazil from the viewpoint of different medical professionals involved in the diagnosis and treatment of the disease. The study also considers the resources used for the complete delivery cycle of health care at different stages of the evolution of melanoma. METHODS We conducted a behavioral study by applying a questionnaire to a group of medical professionals. A nonprobabilistic sampling method for convenience was used, justified by the heterogeneous national incidence and the limited availability of medical professionals who diagnose and treat melanoma. RESULTS The questionnaire was answered by 138 doctors, including doctors from the Brazilian states with the highest concentration of medical specialists and regions with a higher melanoma incidence. The results of this study have the potential to enrich our understanding of the reality of Brazilian health care systems and, at the same time, allow us to discuss the multiple ways in which professionals from diverse specialist fields understand and explain decision making in health care. CONCLUSION Health care decision making is complex and, among other factors, depends on the diversity of available health resources and the knowledge of which treatments provide the greatest benefit to patients and greatest value to the system as a whole. This work can inform debates and reflection that are applicable not only in Brazil, but also in various other countries with similar realities.

scholarly journals Early evidence that social distancing and public health interventions flatten the COVID-19 curve in Italy

2020 ◽  
Author(s):  
Valentina Rotondi ◽  
Liliana Andriano ◽  
Jennifer Beam Dowd ◽  
Melinda C. Mills
Keyword(s):  
Health Care Systems ◽  
Scientific Evidence ◽  
Health Interventions ◽  
Infection Rates ◽  
Public Health Interventions ◽  
Social Distancing ◽  
Early Evidence ◽  
The World ◽  
Care Systems ◽  
Policy Measures

With the world experiencing one of the largest pandemics in one-hundred years, governments and policymakers are looking for scientific evidence to introduce rapid and effective policies. Here we provide evidence from two provinces in Italy with comparable early infection rates but different timing of mitigating policy measures. Lodi prohibited movement on February 23, 2020 and Bergamo 2 weeks later on March 8, before the entire lockdown of Italy on March 11. This comparison provides early evidence that rapid restriction of movement and social distancing measures may slow the transmission of the virus and “flatten the curve”, ultimately reducing pressure on health care systems

scholarly journals Changing Perspectives: Offloading a Patient With a Diabetic Foot Ulcer as Opposed to Offloading a Diabetic Foot Ulcer

2020 ◽  
pp. 193864002097562
Author(s):  
Katherine L. Samuelson ◽  
Chase T. Kiefer ◽  
Stephanie C. Wu ◽  
Ryan T. Crews
Keyword(s):  
Case Report ◽  
Diabetic Foot ◽  
Gold Standard ◽  
Health Care Systems ◽  
Foot Ulcer ◽  
Diabetic Foot Ulcer ◽  
Population Level ◽  
Patient Centered ◽  
Individual Patient Level ◽  
Care Systems

Diabetic foot ulcers (DFUs) represent a tremendous burden to health care systems. Offloading is one of the key tenants to healing DFU and knee-high irremovable offloading devices are considered the gold standard for offloading DFU. However, the gold standard is rarely utilized in clinical practice. Patients’ limited tolerance for such devices is one of a number of reasons that have been attributed to the lack of use of these devices. The practice of evidence-based medicine relies on shared decision making by pairing patients’ values and preferences with the best available evidence. The present case report reviews the process of a patient-centered approach to identify the best offloading option for a patient with DFU. In consultation with the patient, a series of modalities were evaluated for offloading 2 unilateral forefoot DFUs. It is suggested that optimizing DFU offloading outcomes at the population level will require concerted efforts to employ the best offloading solution at the individual patient level. Offloading modalities are necessitated to mitigate the physical stress imparted on DFU during the weightbearing activity that patients engage in. Success is likely to be maximized by maintaining a mind-set of treating individual patients with DFUs as opposed to simply treating DFUs. Levels of Evidence: Level V: Case report

scholarly journals Integrative Medicine in Hematology/Oncology: Benefits, Ethical Considerations, and Controversies

Hematology ◽  
2005 ◽  
Vol 2005 (1) ◽  
pp. 491-497 ◽  
Author(s):  
David S. Rosenthal ◽  
Elizabeth Dean-Clower
Keyword(s):  
Alternative Medicine ◽  
Integrative Medicine ◽  
Cancer Care ◽  
Complementary Therapies ◽  
Conventional Medicine ◽  
Health Care Systems ◽  
Scientific Evidence ◽  
Scientific Data ◽  
Fee For Service ◽  
Care Systems

Abstract Integrative Medicine (IM), a newly emerging field, has evolved from Complementary and Alternative Medicine (CAM). CAM refers to diverse medical and health care systems, practices, and products that are not presently considered part of conventional medicine and generally have limited scientific evidence. In the US, CAM is a multi-billion dollar, unregulated industry with potential benefits and risks to consumers, including cancer patients, who are high utilizers of complementary therapies. Patients’ CAM use often is unsupervised by physicians, yet patients need the advice and guidance of their hematologists/oncologists as part of total cancer care. Ethical and legal issues physicians need to address include inquiring about and educating patients regarding potential interactions (e.g., drug-herb, radiation-antioxidant) or product contaminants, while discussing other therapies that may alleviate symptoms and/or improve quality of life. Administratively, CAM offerings in medical settings require relevant policies and procedures, such as properly credentialing practitioners and providing financial assistance counseling for those who cannot afford fee-for-service. Unlike “Alternative Medicine,” the goal of IM is to combine mainstream medical therapies and CAM therapies (e.g., acupuncture, meditation, music therapy) that have some high-quality scientific evidence of safety and effectiveness. The Society for Integrative Oncology (SIO), a new international organization of oncology professionals studying and integrating effective complementary therapies in cancer care, serves as a forum for presenting scientific data on these therapies while emphasizing the importance of developing infrastructure that promotes IM principles and practices. The ultimate goal is to develop multidisciplinary expertise and therapeutic synergy between conventional and complementary therapies.

scholarly journals Public Health Perspectives of Preeclampsia in Developing Countries: Implication for Health System Strengthening

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Kayode O. Osungbade ◽  
Olusimbo K. Ige
Keyword(s):  
Public Health ◽  
Developing Countries ◽  
Health System ◽  
Calcium Supplementation ◽  
Health Care Systems ◽  
Health System Strengthening ◽  
Effective Control ◽  
Cochrane Database ◽  
Prophylactic Measures ◽  
Care Systems

Objectives. Review of public health perspectives of preeclampsia in developing countries and implications for health system strengthening.Methods. Literature from Pubmed (MEDLINE), AJOL, Google Scholar, and Cochrane database were reviewed.Results. The prevalence of preeclampsia in developing countries ranges from 1.8% to 16.7%. Many challenges exist in the prediction, prevention, and management of preeclampsia. Promising prophylactic measures like low-dose aspirin and calcium supplementation need further evidence before recommendation for use in developing countries. Treatment remains prenatal care, timely diagnosis, proper management, and timely delivery. Prevailing household, community, and health system factors limiting effective control of preeclampsia in these countries were identified, and strategies to strengthen health systems were highlighted.Conclusion. Overcoming the prevailing challenges in the control of preeclampsia in developing countries hinges on the ability of health care systems to identify and manage women at high risk.

scholarly journals Prospective Study of the Performance of Parent-Collected Nasal and Saliva Swab Samples, Compared with Nurse-Collected Swab Samples, for the Molecular Detection of Respiratory Microorganisms

2021 ◽  
Author(s):  
Claire A. Woodall ◽  
Hannah V. Thornton ◽  
Emma C. Anderson ◽  
Suzanne M. Ingle ◽  
Peter Muir ◽  
...  
Keyword(s):  
Health Care ◽  
Health Professional ◽  
Prospective Study ◽  
Community Health ◽  
Molecular Detection ◽  
Health Care Systems ◽  
Community Health Care ◽  
Swab Sample ◽  
Care Systems

RTIs are ubiquitous among children. Diagnosis involves a swab sample being taken by a health professional, which places a considerable burden on community health care systems, given the number of cases involved.

scholarly journals Study on Periplaneta americana (Blattodea: Blattidae) Fungal Infections in Hospital Sewer System, Esfahan City, Iran, 2017

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Maryam Khodabandeh ◽  
Leila Shirani-Bidabadi ◽  
Mahboobe Madani ◽  
Alireza Zahraei-Ramazani
Keyword(s):  
Aspergillus Niger ◽  
Disease Transmission ◽  
Periplaneta Americana ◽  
Fungal Infections ◽  
Health Care Systems ◽  
Candida Krusei ◽  
The Body ◽  
American Cockroach ◽  
Hospital Environments ◽  
Care Systems

Background. American cockroaches contaminated with pathogens inside hospital manholes can be one of the major problems that health care systems face. Objectives. The aim of this study was to investigate the fungal infections of American cockroaches in the Esfahan hospital sewage network. The principle goal of the study was about the roaches as a vector of fungi and other pathogens. Method. The type of study was descriptive-analytical. A total of 55 American cockroach specimens from the manhole walls of the sewerage system of 7 large hospitals were captured. Samples were taken from the surface of the body, digestive tract, and haemocoel of cockroaches. The specimens were then cultured on Sabouraud dextrose agar separately, and fungi were identified according to the macroscopic and microscopic characteristics. Results. All cockroaches collected from hospitals were infected with fungi. Among the 24 (13 infected and 11 noninfected) (44%) female cockroaches and 31 (18 infected and 13 noninfected) (56%) male cockroaches, it was identified that 40.00% was infected with Aspergillus niger, 3.64% with Rhizopus, 7.27% with Penicillium, and 5.45% with Mucor. 6 cockroaches had no yeast contamination. 17 (30.91%) cockroaches were contaminated with Candida glabrata, 23 (41.82%) cockroaches were contaminated with Candida krusei, and 22 (40%) cockroaches were contaminated with other yeast species. The results of this study showed that Candida krusei had the highest prevalence among the isolated fungi with 35.37% of the digestive system and Aspergillus niger with 70.97% of the surface of the cockroach body. Conclusion. The results emphasized the role played by cockroaches as potential pathogenic vectors in hospital environments. Therefore, suitable management is needed for controlling this insect to prevent disease transmission in hospitals.

scholarly journals Strategies and practical examples

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
T Schmitt
Keyword(s):  
Health Systems ◽  
Policy Development ◽  
Policy Making ◽  
Health Care Systems ◽  
Scientific Evidence ◽  
Scientific Information ◽  
Real Life ◽  
Policy Makers ◽  
Care Systems ◽  
Public Health Practitioners

Abstract Various tools and mechanisms can help to increase the use of scientific evidence in policy development by making policymakers appreciate, understand and incorporate such scientific information into policy decisions. As part of this process, it is crucial that researchers and public health practitioners acquire the ability to translate their knowledge and become skilled on communicating the evidence effectively. The European Observatory on Health Systems and Policies supports and promotes evidence-based health policy-making through comprehensive and rigorous analysis of the dynamics of health-care systems in Europe. It engages directly with policy-makers and experts, and works in partnership with research centers, governments and international organizations to analyze health systems and policy trends. In this presentation, concrete strategies will be given for advocating scientific evidence. The focus will lie particularly on the process of real-life applications of evidence-informed policy-making. By this way, it will help the participants to analyze to whom they are targeting, what are their interests and how to communicate scientific information to a decision-maker effectively based on specific examples from the European Observatory on Health Systems and Policies.

scholarly journals Nurse practitioner and physician assistant students' knowledge, attitudes, and perspectives of chiropractic

2016 ◽  
Vol 30 (2) ◽  
pp. 114-120 ◽  
Author(s):  
Briana S. Bowden ◽  
Lisa Ball
Keyword(s):  
Health Care ◽  
Nurse Practitioner ◽  
Interprofessional Collaboration ◽  
Multinomial Logistic Regression ◽  
Physician Assistant ◽  
Health Care Systems ◽  
Scientific Evidence ◽  
Graduate Studies ◽  
Logistic Regression Models ◽  
Care Systems

Objective: The purpose of this study was to assess nurse practitioner (NP) and physician assistant (PA) students' views of chiropractic. As the role of these providers progresses in primary care settings, providers' views and knowledge of chiropractic will impact interprofessional collaboration and patient outcomes. Understanding how NP and PA students perceive chiropractic may be beneficial in building integrative health care systems. Methods: This descriptive quantitative pilot study utilized a 56-item survey to examine attitudes, knowledge, and perspectives of NP and PA students in their 2nd year of graduate studies. Frequencies and binomial and multinomial logistic regression models were used to examine responses to survey totals. Results: Ninety-two (97%) students completed the survey. There were conflicting results as to whether participants viewed chiropractic as mainstream or alternative. The majority of participants indicated lack of awareness regarding current scientific evidence for chiropractic and indicated a positive interest in learning more about the profession. Students who reported prior experience with chiropractic had higher attitude-positive responses compared to those without experience. Participants were found to have substantial knowledge deficits in relation to chiropractic treatments and scope of practice. Conclusion: The results of this study emphasize the need for increased integrative initiatives and chiropractic exposure in NP and PA education to enhance future interprofessional collaboration in health care.

Sign in / Sign up

Export Citation Format

Share Document