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1.
Rev. Bras. Saúde Mater. Infant. (Online) ; 21(2): 531-537, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1340655

ABSTRACT

Abstract Objectives: the aim of this study is to evaluate the impact of co-detection of Flu A and RSV using rapid immunochromatographic tests at the point of care, in pediatric patients under 2 years of age in a general hospital. Methods: a retrospective cohort study was conducted to analyze clinical outcomes in hospitalized infants with viral respiratory disease with positive results of rapid immunochromatographic test for RSV and/or Flu-A, from 2013 to 2018. A logistic regression model was adjusted to analyze predictors of orotracheal intubation during hospitalization. Results: we analyzed 220 cases: RSV (192), Flu-A (9), co-detection (19). Lethality rate was 1.8% (2 cases), and 88% (194) were under 1 year of age. Mean time of hospitalizations was higher in patients with co-detection. Variables significantly associated with orotracheal intubation were: younger age in months, comorbidities, RSV and Flu-A co-detection, and bacterial pneumonia during hospitalization. Conclusions: RSV and Flu-Aco-detection was associated with the least favorable clinical prognoses in this study. Rapid test diagnosis may provide important information at the point of care, because molecular panels are not widely accessible in general hospitals. Rapid diagnosis allows timely evaluation and treatment.


Resumo Objetivos: avaliar o impacto da codetecção de Influenza A (FluA) e Vírus Sincicial Respiratório (VSR) por meio de testes imunocromatográficos rápidos em tempo real, em pacientes menores de 2 anos em hospital público e universitário. Métodos: estudo de coorte retrospectivo foi conduzido para analisar os desfechos clínicos de crianças hospitalizadas com doença respiratória viral com resultados positivos do teste rápido imunocromatográfico para VSR e/ou FluA, de 2013 a 2018. Um modelo de regressão logística foi ajustado para analisar preditores de intubação orotraqueal durante a internação. Resultados: foram analisados 220 casos: RSV (192), FluA (9) eco-detecção (19). A letalidade foi de 1,8% (2 casos) e 88% (194) casos em menores de 1 ano. O tempo médio de internação foi maior nos pacientes com codetecção. As variáveis significativamente associadas à intubação orotraqueal foram: menor idade em meses, comorbidades, codetecção de VSR e Flu-A e pneumonia bacteriana durante a internação. Conclusões: codetecção VSR e FluA foi associada a prognósticos clínicos desfavoráveis. O teste rápido fornece informações importantes a beira-leito, pois os painéis moleculares não são amplamente acessíveis em hospitais públicos. O diagnóstico rápido permite a avaliação e tratamento oportunos.


Subject(s)
Humans , Child , Prognosis , Respiratory Syncytial Viruses/isolation & purification , Influenza, Human/diagnosis , Point-of-Care Testing/statistics & numerical data , Cohort Studies , Chromatography, Affinity/methods
2.
Afr. j. lab. med. (Online) ; 10(1): 1-6, 2021. Tables, figures
Article in English | AIM | ID: biblio-1291519

ABSTRACT

Background: Timely testing is a key determinant of management outcomes of coronavirus disease 2019 (COVID-19). Real-time reverse transcription polymerase chain reaction tests are currently the mainstay for COVID-19 testing. However, serological point-of-care tests (PoCTs) can be useful in identifying asymptomatic and recovered cases, as well as herd immunity. Objective: The aim of this study was to assess COVID-19 PoCTs in Kenya to support the emergency use authorisation of these tests. Methods: Between March 2020 and May 2020, 18 firms, of which 13 were from China, submitted their PoCTs to the national regulatory authority, the Pharmacy and Poison Board, who in turn forwarded them to the Kenya Medical Research Institute for pre-evaluation assessment. The tests were run with real-time reverse transcription polymerase chain reaction COVID-19-positive samples. Pre-COVID-19 plasma samples that were collected in June 2019were used as negative samples. The shelf lives of the PoCTs ranged from 6 to 24 months. Results: Only nine (50%) tests had sensitivities ≥ 40% (range: 40% ­ 60%) and the ability of these tests to detect IgM ranged from 0% to 50%. Many (7/18; 38.9%) of the kits had very weak IgM and IgG band intensities (range: 2­3). Conclusion: Serological-based PoCTs available in Kenya can only detect COVID-19 in up to 60% of the infected population.


Subject(s)
Humans , Point-of-Care Testing , COVID-19 Serological Testing , Sensitivity and Specificity , SARS-CoV-2
3.
Rev. enferm. UERJ ; 28: e50366, jan.-dez. 2020. graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1139121

ABSTRACT

RESUMO Objetivo discutir as evidências disponíveis sobre uso de ultrassonografia na implantação/manutenção de cateter venoso central de inserção periférica no neonato crítico. Método scoping review, baseada nas recomendações de especialistas do Joanna Briggs Institute. Para identificar a questão de investigação foi seguida a versão PCC - Population, Concept and Context. As buscas foram realizadas entre janeiro e março de 2020, em três bases dados e no Google Scholar. Resultados das 354 publicações encontradas resultou uma amostra de 15 artigos, publicados em diversos países, entre 2016 e 2020, em inglês e português. A maioria evidenciava uso da ultrasound point of care (POCUS) para escolha do sítio venoso ou localização da ponta do cateter. Conclusão são necessários mais estudos, investigando a efetividade da POCUS na inserção/manutenção de cateter epicutâneo em neonatos críticos, para basear sua adoção como padrão ouro nesta clientela. O manejo por enfermeiros ainda é incipiente.


RESUMEN Objetivo discutir la evidencia disponible sobre el uso de el ultrasonido en la inserción y mantenimiento de catéteres venosos centrales de inserción periférica en neonatos críticos. Método esta revisión de alcance se basó en recomendaciones de expertos del Instituto Joanna Briggs. Se utilizó el enfoque de población, concepto y contexto (PCC) para identificar la pregunta de investigación. El estudio se realizó entre enero y marzo de 2020 en tres bases de datos y Google Scholar. Resultados en las 354 publicaciones encontradas se obtuvo una muestra de 15 artículos publicados en varios países entre 2016 y 2020, en inglés y portugués. La mayoría mostró que se usaba el punto de atención de ultrasonido (POCUS) para elegir el sitio venoso o ubicar la punta del catéter. Conclusión se necesitan más estudios para investigar la efectividad de POCUS en la inserción y mantenimiento de catéteres epicutáneos en neonatos críticos, para respaldar su adopción como el estándar de oro en esta clientela. El manejo por parte de enfermeras es aún incipiente.


ABSTRACT Objective to discuss the available evidence on the use of ultrasound in insertion and maintenance of peripherally inserted central venous catheters in critical neonates. Method this scoping review was based on recommendations by experts from the Joanna Briggs Institute. The population, concept and context (PCC) approach was used to identify the research question. The study was carried out between January and March 2020 in three databases and Google Scholar. Results a sample of 15 articles published in several countries between 2016 and 2020, in English and Portuguese, was obtained in the 354 publications found. Most showed ultrasound point of care (POCUS) being used to choose the venous site or locate the catheter tip. Conclusion further studies are needed to investigate the effectiveness of POCUS in insertion and maintenance of epicutaneous catheters in critical neonates, to support its adoption as the gold standard in this clientele. Handling by nurses is still incipient.


Subject(s)
Humans , Infant, Newborn , Catheterization, Central Venous/instrumentation , Intensive Care Units, Neonatal , Intensive Care, Neonatal , Ultrasonography, Interventional/standards , Critical Care/methods , Point-of-Care Testing
4.
Rev. bras. anestesiol ; 70(3): 288-294, May-June 2020. graf
Article in English, Portuguese | LILACS | ID: biblio-1137173

ABSTRACT

Abstract The use of ultrasonography is well established in several anesthesia sub-specialties. Recently, there has been a major expansion of the POC (Point-Of-Care) ultrasound technique in intensive care, surgery, and emergency medicine, corroborating that USPOC in perioperative medicine has a much more comprehensive capability for both providing improved hemodynamic monitoring and early diagnosis of complications. The objective of the present article was to describe the use of a USPOC modality (focused cardiac US) that can be used for bedside assessment of unstable patients. Within a specific list of diagnoses, clinical treatment for a given situation can be tailored according to ultrasound findings, and by using binary and simple questions. Perioperative focused cardiac US use by the anesthesiologist has been related to lower rates of complications and mortality in high-risk patients.


Resumo O uso da ultrassonografia na prática anestésica já é bem estabelecido com a sua utilização em diversas subespecialidades. Recentemente, houve uma grande disseminação da técnica de ultrassonografia POC (point-of-care) nas áreas de medicina intensiva, cirurgia e medicina de urgência, confirmando que o seu uso em medicina perioperatória tem um potencial muito mais abrangente tanto para melhor monitorização hemodinâmica, como também para diagnóstico precoce de complicações. O objetivo deste artigo é descrever a utilização de uma modalidade de USPOC (ultrassom cardíaco focado) que pode ser utilizado à beira do leito com o objetivo de avaliar o paciente instável e, dentro de uma lista específica de diagnósticos, individualizar o tratamento clínico para determinada situação com base nos achados ultrassonográficos utilizando-se de questões de caráter binário e simples, sendo que o seu uso pelo anestesiologista no período perioperatório está relacionado a menores taxas de complicações e mortalidade em pacientes de alto risco.


Subject(s)
Humans , Echocardiography/methods , Point-of-Care Testing , Anesthesia
5.
Rev. bras. anestesiol ; 70(2): 125-133, Mar.-Apr. 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1137156

ABSTRACT

Abstract Background and objectives: The prediction of difficult laryngoscopy is based on tests that assess anatomic characteristics of face and neck. We aimed to identify the most accurate tests and propose a multivariate predictive model. Methods: This prospective observational study included 1134 patients. Thyromental Distance (TMD), Sternomental Distance (STMD), Ratio of Height-to-Thyromental Distance (R-H/TMD), Neck Circumference (NC), Ratio of Neck Circumference-to-Thyromental Distance (R-NC/TMD), Hyomental Distance with head in Neutral Position (HMD-NP) and at Maximal Extension (HMD-HE), Ratio of Hyomental Distance at Maximal head extension-to-hyomental distance in neutral position (R-HMD), Mallampati Class (MLC), Upper Lip Bite Test (ULBT), Mouth Opening (MO) and Head Extension (HE) were assessed preoperatively. A Cormack-Lehane Grade ≥ 3 was defined as Difficult Laryngoscopy. Sensitivity, specificity, positive and negative predictive values were assessed for all tests. Multivariate analysis with logistic regression was used to create the predictive models. Results: A model incorporating MLC, ULBT, HE, HMD-HE and R-NC/TMD showed high prognostic accuracy; x2(5) = 109.12, p < 0.001, AUC = 0.86, p < 0.001). Its sensitivity, specificity and negative predictive value were 82.3%, 74.8% and 97.4%, respectively. A second model including two measurements not requiring patient's cooperation (R-NC/TMD and HMD-HE) exhibited good prognostic performance; x2(2) = 63.5, p < 0.001, AUC = 0.77, p < 0.001. Among single tests, HE had the highest sensitivity (78.5%) and negative predictive value (96%). Conclusions: A five-variable model incorporating MLC, ULBT, HE, HMD-HE and R-NC/TMD showed satisfyingly high predictive value for difficult laryngoscopy. A model including R-NC/TMD and HMD-HE could be useful in incapable patients. The most accurate single predictor was HE.


Resumo Justificativa e objetivos: A previsão de laringoscopia difícil se baseia em testes que avaliam as características anatômicas da face e pescoço. Nosso objetivo foi identificar os testes mais precisos e propor modelo preditivo multivariado. Método: Estudo observacional prospectivo incluiu 1134 pacientes e avaliou no pré-operatório: Distância Tireomentoniana (DTM), Distância Esternomentoniana (DEM), razão Altura-Distância Tireomentoniana (A/DTM), Circunferência Cervical (CC), razão Circunferência Cervical-Distância Tireomentoniana (CC/DTM), Distância Hiomentoniana com a cabeça na Posição Neutra (DHM-PN) e em Extensão Máxima (DHM-EM), razão Distância Hiomentoniana com Cabeça em Extensão Máxima/Distância Hiomentoniana na posição Neutra (DHME/DHMN), Classe Mallampati (CML), Teste da Mordida do Lábio Superior (TMLS), Abertura da Boca (AB) e Extensão da Cabeça (EC). Grau Cormack-Lehane ≥ 3 foi definido como Laringoscopia Difícil. A sensibilidade, especificidade, valores preditivos positivo e negativo foram avaliados para todos os testes. A análise multivariada com regressão logística foi usada para criar modelos preditivos. Resultados: Um modelo incorporando CML, TMLS, EC, DHM-EM e CC/DTM demonstrou alta precisão prognóstica (x2(5) = 109,12, p < 0,001, AUC = 0,86, p < 0,001). A sensibilidade, especificidade e valor preditivo negativo foram 82,3%, 74,8% e 97,4%, respectivamente. Um segundo modelo incluindo duas medidas que não necessitavam da cooperação do paciente (CC/DTM e DHM-EM) demonstrou bom desempenho prognóstico (x2 (2) = 63,5; p < 0,001; AUC = 0,77, p < 0,001). Entre os testes individuais, EC teve a maior sensibilidade (78,5%) e valor preditivo negativo (96%). Conclusões: O modelo de cinco variáveis incorporando CML, TMLS, EC, DHM-EM e CC/DTM mostrou valor preditivo satisfatoriamente alto para laringoscopia difícil. Um modelo que incluísse CC/DTM e DHM-EM poderia ser útil em pacientes com incapacidade. O preditor individual mais preciso foi EC.


Subject(s)
Humans , Male , Female , Adult , Aged , Models, Statistical , Point-of-Care Testing , Laryngoscopy , Multivariate Analysis , Predictive Value of Tests , Prospective Studies , Sensitivity and Specificity , Middle Aged
7.
Lima; Instituto Nacional de Salud; mar. 2020.
Non-conventional in Spanish | LILACS, BRISA | ID: biblio-1104220

ABSTRACT

ANTECEDENTES: Los coronavirus son una familia de virus causantes de enfermedades respiratorias, digestivas y del sistema nervioso en humanos y animales. En diciembre de 2019, se identificó en la provincia de Wuhan, China una cepa de coronavirus nunca antes encontrada en humanos, la cual recibió el nombre de SARS-CoV-2. La infección por SARS-CoV-2 se ha extendido a más de 100 países y fue declarada como pandemia por la Organización Mundial de la Salud. En nuestro país, se ha reportado 363 casos en trece regiones y un total de cinco fallecidos. La técnica molecular estándar para detectar SARSCoV-2 es la reacción en cadena de la polimerasa con transcriptasa inversa (RT-PCR). Sin embargo, se requieren incluir de modo complementario las pruebas rápidas que disminuyan el tiempo de espera entre la toma de muestras y la entrega de resultados, con la finalidad de descartar casos sospechosos, mejorar el pronóstico clínico y contener el contagio de la infección. El método basado en la detección de anticuerpos específicos como la IgG e IgM ha demostrado ser un método simple y de alta sensibilidad para realizar un diagnóstico rápido de varias enfermedades infecciosas. Sin embargo, se requiere examinar su precisión diagnóstica en el contexto de un virus nuevo como el SARS-CoV-2, con la finalidad de considerar la inclusión de este tipo de tecnología sanitaria en la intervención actual. OBJETIVO: Describir la evidencia científica disponible sobre la precisión diagnóstica de las pruebas rápidas de detección de anticuerpos para SARS-CoV-2. MÉTODO: Búsqueda sistemática en Medline, Cochrane Central Register of Controlled Trials (CENTRAL), LILACS y ClinicalTrials.gov. de estudios en idioma español o inglés publicados entre el 01 de diciembre de 2019 y el 21 de marzo de 2020, complementada con una búsqueda en Google Scholar y en la base de datos de dispositivos médicos de la Food and Drug Administration (FDA). RESULTADOS: Se seleccionaron 02 estudios desarrollados en China publicados en el año 2020 que compararon la precisión diagnóstica de pruebas rápidas para la detección de anticuerpos IgG e IgM contra el virus del SARS-CoV,-en comparación con RT-PCR como estándar de referencia. Principales hallazgos: Un estudio estimó valores de sensibilidad de 88,66% y de especificidad de 90,63% para la prueba de detección de anticuerpos combinados IGg/IgM para SARS-CoV-2, en comparación con RTPCR como estándar de referencia. La sensibilidad de detección de los anticuerpos combinados IGg/IgM fue mayor que la prueba individual de anticuerpos. En un subgrupo de siete pacientes se identificó una consistencia de 100% entre los resultados positivos y negativos de muestras obtenidas de punción digital, suero y plasma sanguíneo. El estudio restante estimó valores de sensibilidad de 87,3% y especificidad de 100% para la prueba de detección de anticuerpos combinados IGg/IgM para SARS-CoV-2, en comparación con RT-PCR como estándar de referencia. La sensibilidad de la prueba de anticuerpos combinados IGg/IgM fue mayor a la obtenida en pruebas individuales de IgG o IgM (82,5% y 44,4%, respectivamente). CONCLUSIONES: Comparado con RT-PCR, la prueba de detección de anticuerpos combinados IgG e IgM analizada en estos estudios, mostró buena sensibilidad (entre 87-88%) y especificidad (entre 90-100%) para el diagnóstico para SARS-CoV-2. Ambos estudios incluidos coinciden en observar una mayor precisión diagnóstica de la detección simultánea de IgG e IgM, respecto a la evaluación individual de anticuerpos. Un estudio determinó una consistencia de 100% entre los resultados positivos y negativos de muestras obtenidas mediante punción digital, suero y plasma sanguíneo. La utilidad del valor predictivo positivo y negativo calculado por los estudios (96-100% y 72-81%, respectivamente) es limitado, considerando que la prevalencia de la enfermedad en nuestro país es significativamente más baja a la reportada en los estudios (>60%) al encontrarnos en una fase inicial de la epidemia. Existen potenciales beneficios de la inclusión de este tipo de tecnología sanitaria en la intervención actual.(AU)


Subject(s)
Humans , Pneumonia, Viral/diagnosis , Coronavirus Infections/diagnosis , Diagnostic Techniques and Procedures/instrumentation , Point-of-Care Testing , Betacoronavirus/isolation & purification , Technology Assessment, Biomedical , Health Evaluation
8.
Rev. Esc. Enferm. USP ; 54: e03645, 2020. tab, graf
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1143709

ABSTRACT

RESUMO Objetivo Identificar os fatores relacionados ao processo de trabalho no que se refere à adesão das equipes de Atenção Primária ao teste rápido para HIV, sífilis, hepatites B e C durante o acompanhamento do pré-natal e a administração da penicilina benzatina na atenção primária à saúde. Método Estudo descritivo, exploratório, quantitativo, realizado entre os meses de julho e novembro de 2018, com profissionais das equipes da Estratégia de Saúde da Família do Seridó Norte-Rio-Grandense. Resultados Participaram do estudo 18 municípios, 94 Unidades Básicas de Saúde e 100 equipes de Estratégia de Saúde da Família. O enfermeiro era o principal envolvido no serviço de testagem, 93% das equipes entrevistadas ofereciam o teste na rotina do serviço. Dessas equipes, 97,8% realizavam a testagem no pré-natal, 51,6% disponibilizavam o teste para a gestante no início do terceiro trimestre e 57% ofereciam o teste rápido para os(as) parceiros(as) sexuais. A penicilina benzantina estava disponível em 87,1% das equipes, todavia, 49,5% não administravam a medicação na atenção primária. Conclusão O processo de testagem se mostrava fragilizado, pois, mesmo havendo disponibilidade do teste no pré-natal, as demais atividades interligadas ao processo de trabalho não ocorriam adequadamente.


RESUMEN Objetivo Identificar los factores relacionados con el proceso de trabajo relativo a la adhesión de los equipos de atención primaria a las pruebas rápidas de detección del VIH, la sífilis y la hepatitis B y C durante el seguimiento prenatal y la administración de penicilina benzatínica en la atención primaria de salud. Método Estudio descriptivo, exploratorio y cuantitativo, realizado entre julio y noviembre de 2018, con profesionales de la Estrategia de Salud Familiar de la región Seridó en el Río Grande do Norte. Resultados Participaran del estudio 18 municipios, 94 Unidades básicas de salud y 100 equipos de Estrategia de Salud Familiar. El enfermero fue el principal involucrado en el servicio de pruebas, el 93% de los equipos entrevistados ofrecieron la prueba en la rutina del servicio. De estos equipos, 97,8% realizó la prueba prenatal, 51,6% puso la prueba a disposición de la mujer embarazada al principio del tercer trimestre y el 57% ofreció la prueba rápida para parejas sexuales. El 87,1% de los equipos disponía de penicilina benzatina, pero el 49,5% no la administraba en la atención primaria. Conclusión El proceso de prueba se debilitó porque, aunque la prueba estaba disponible en el período prenatal, las demás actividades relacionadas con el proceso de trabajo no se desarrollaron adecuadamente.


ABSTRACT Objective To identify the factors related to the work process regarding the adherence of Primary Healthcare teams to the rapid test for HIV, syphilis, hepatitis B and C during prenatal care and administration of benzathine penicillin in primary healthcare. Method A descriptive, exploratory and quantitative study conducted between the months of July and November 2018, with professionals from the Family Health Strategy teams of the Seridó Norte-Rio-Grandense region in Rio Grande do Norte State, Brazil. Results There were 18 municipalities, 94 Basic Health Units and 100 Family Health Strategy teams which participated in the study. The nurse was the main person involved in the testing service, and 93% of the interviewed teams offered the test in the service routine. Of these teams, 97.8% underwent prenatal testing, 51.6% offered the test to the pregnant woman at the beginning of the third trimester, and 57% offered the rapid test to sexual partners. Benzantine penicillin was available in 87.1% of the teams; however, 49.5% did not administer the medication in primary healthcare. Conclusion The testing process proved to be fragile because even if the test was available in prenatal care, the other activities linked to the work process did not occur properly.


Subject(s)
Humans , Prenatal Care , Syphilis/prevention & control , HIV , National Health Strategies , Point-of-Care Testing , Hepatitis, Viral, Human/prevention & control , Health Personnel , Primary Care Nursing
10.
Afr. j. lab. med. (Online) ; 9(2): 1-8, 2020.
Article in English | AIM | ID: biblio-1257341

ABSTRACT

Background: Point-of-care testing (POCT) is defined as testing done near or at the site of patient care with the goal of providing rapid information and improving patient outcomes. Point-of-care testing has many advantages and some limitations which affect its use and implementation. Objective: The aim of the audit was to determine the current practices, staff attitudes and training provided to hospital clinical staff. Methods: The audit was conducted with the use of a questionnaire containing 30 questions. One hundred and sixty questionnaires were delivered to 55 sites at Tygerberg Academic Hospital in Cape Town, South Africa, from 21 June 2016 to 15 July 2016. A total of 68 questionnaires were completed and returned (42.5% response rate). Results: Most participants were nursing staff (62/68, 91%), and the rest were medical doctors (6/68, 9%). Most participants (66/68, 97%) performed glucose testing, 16/68 (24%) performed blood gas testing and 17/68 (25%) performed urine dipstick testing. Many participants (35/68, 51%) reported having had some formal training in one or more of the tests and 25/68 (37%) reported having never had any formal training in the respective tests. Many participants (46/68, 68%) reported that they never had formal assessment of competency in performing the respective tests. Conclusion: Participants indicated a lack of adequate training in POCT and, thus, limited knowledge of quality control measures. This audit gives an indication of the current state of the POCT programme at a Southand highlights areas where intervention is needed to improve patient care and management


Subject(s)
Clinical Audit , Knowledge , Point-of-Care Testing , South Africa , Tertiary Care Centers
11.
Article in English | AIM | ID: biblio-1258606

ABSTRACT

Introduction: The World Health Organization's (WHO) Basic Emergency Care Course (BEC) is a five day, inperson course covering basic assessment and life-saving interventions. We developed two novel adjuncts for the WHO BEC: a suite of clinical cases (BEC-Cases) to simulate patient care and a mobile phone application (BECApp) for reference. The purpose was to determine whether the use of these educational adjuncts in a flipped classroom approach improves knowledge acquisition and retention among healthcare workers in a low-resource setting. Methods: We conducted a prospective, cohort study from October 2017 through February 2018 at two district hospitals in the Pwani Region of Tanzania. Descriptive statistics, Fisher's exact t-tests, and Wilcoxon ranked-sum tests were used to examine whether the use of these adjuncts resulted in improved learner knowledge. Participants were enrolled based on location into two arms; Arm 1 received the BEC course and Arm 2 received the BEC-Cases and BEC-App in addition to the BEC course. Both Arms were tested before and after the BEC course, as well as a 7-month follow-up exam. All participants were invited to focus groups on the course and adjuncts. Results: A total of 24 participants were included, 12 (50%) of whom were followed to completion. Mean pre-test scores in Arm 1 (50%) were similar to Arm 2 (53%) (p=0.52). Both arms had improved test scores after the BEC Course Arm 1 (74%) and Arm 2 (87%), (p=0.03). At 7-month follow-up, though with significant participant loss to follow up, Arm 1 had a mean follow-up exam score of 66%, and Arm 2, 74%. Discussion: Implementation of flipped classroom educational adjuncts for the WHO BEC course is feasible and may improve healthcare worker learning in low resource settings. Our focus- group feedback suggest that the course and adjuncts are user friendly and culturally appropriate


Subject(s)
Educational Status , Emergency Medical Services/education , Point-of-Care Testing , Tanzania , World Health Organization
12.
Chinese Journal of Biotechnology ; (12): 1283-1292, 2020.
Article in Chinese | WPRIM | ID: wpr-826848

ABSTRACT

Point-of-care testing (POCT) is a test method performed on the sampling site or patient bedside. Accurate results can be achieved rapidly by the application of portable analytical instruments and compatible reagents. It has been widely used in the field of in vitro diagnosis (IVD). Paper-based microfluidics technology has great potential in developing POCT due to its advantages in low cost, simple operation, rapid detection, portable equipment, and unrestricted application conditions. In recent years, the development of paper-based microfluidic technology and its integration with various new technologies and methods have promoted the substantial development of POCT technology and methods. The classification and characteristic of the paper are summarized in this review. Paper-based microfluidic sample pretreatment methods, the flow control in the process of reaction and the signal detecting and analyzing methods for the testing results are introduced. The research progress of various kinds of microfluidic paper-based analytical devices (μPADs) toward POCT in recent years is reviewed. Finally, remaining problems and the future prospects in POCT application of paper-based microfluidics are discussed.


Subject(s)
Diagnostic Tests, Routine , Methods , Humans , Microfluidic Analytical Techniques , Paper , Point-of-Care Testing
13.
Audiol., Commun. res ; 25: e2388, 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1142385

ABSTRACT

RESUMO Objetivo Estimar a prevalência e fatores de risco para disfagia orofaríngea em indivíduos idosos hospitalizados por fraturas traumato-ortopédicas. Métodos Foram coletados dados sociodemográficos, incluindo comorbidades clínicas, autopercepção do desempenho de deglutição (Eating Assessment Tool) e identificação de risco nutricional (Mini Avaliação Nutricional). Para avaliar o sistema estomatognático e a deglutição, foram utilizados os protocolos Avaliação Miofuncional para Pessoas Idosas e o Volume Viscosity Swallow Test, compilados para composição do desfecho a partir da Functional Oral Intake Scale (FOIS). Resultados O estudo evidenciou que 58% dos indivíduos apresentaram restrições de consistências alimentares devido à disfagia orofaríngea (FOIS ≤ 6). Observou-se, também, risco de diminuição funcional entre aqueles com idade maior ou igual a 70 anos, com piores condições dentárias, diminuição da funcionalidade global, doenças neurológicas associadas e com percepção de alterações na deglutição. Conclusão Houve prevalência de disfagia orofaríngea em seis a cada dez indivíduos, sendo a fragilidade, idade avançada, múltiplas doenças e condições orais deficitárias os fatores de risco para a alteração, fatores estes que devem ser identificados para a prevenção de aspiração alimentar.


ABSTRACT Purpose To estimate the prevalence of and risk factors for oropharyngeal dysphagia in older adults hospitalized for orthopedic trauma fractures. Methods Sociodemographic data, clinical comorbidities, auto-perception of swallowing performance (Eating Assessment Tool) and identification of nutritional risk (Mini Nutritional Assessment) were collected. In order to evaluate the stomatognathic system and swallowing, the Orofacial Myofunctional Evaluation Protocol for older people and the Volume Viscosity Swallow Test protocols were used to assess the outcome through the Functional Oral Intake Scale (FOIS). Results 58% individuals presented dietary consistency restrictions due to oropharyngeal dysphagia (FOIS ≤ 6). A risk for functional decrease was observed among patients 70 years or older, with worse dental conditions, global functionality decreased, neurologic disorders and self-perception of swallowing changes. Conclusion The study observed a prevalence of oropharyngeal dysphagia in six out of ten individuals. Frailty, advanced age, multiple comorbidities and deficient oral conditions are risk factors that should be identified in order to prevent food aspiration.


Subject(s)
Humans , Aged , Bone Plates , Deglutition Disorders/epidemiology , Risk Factors , Hospitalization , Socioeconomic Factors , Stomatognathic System , Myofunctional Therapy , Point-of-Care Testing
14.
Acta bioquím. clín. latinoam ; 53(4): 539-543, dic. 2019. graf
Article in Spanish | LILACS | ID: biblio-1124031

ABSTRACT

La certeza del valor de la relación internacional normalizada (RIN), ensayo para controlar la anticoagulación con dicumarínicos, en pacientes con anticoagulante lúpico positivo (AL) es desconocida especialmente para los dispositivos al lado del paciente (POCT). El objetivo de este trabajo fue investigar si existe correlación entre el valor del RIN obtenido por el método tradicional y el obtenido con un dispositivo portátil en pacientes con AL positivo. Se estudiaron 35 pacientes anticoagulados por enfermedad tromboembólica con diagnóstico de AL positivo persistente a los que se les determinó al mismo tiempo el RIN por el método tradicional y con CoaguChek durante 4 controles consecutivos. El rango del RIN fue 1,9 a 5,60 y el RIN-POCT estuvo entre 2,0 y 4,92. La comparación del RIN vs RIN-POCT mostró r=0,98, pendiente: 1,56 (0,98-1,12) y una ordenada al origen de -0,088 (-0,282-0,007). El sesgo fue 2,1%. Para un nivel del RIN menor de 3,5 (n=136 controles) la diferencia del RIN promedio fue de 0,17 con un rango de 0,01-0,56. Un paciente, con triple positividad, mostró una diferencia entre ambos métodos mayor de 0,4 en dos controles. Para un RIN mayor de 4,5 el grado de concordancia fue menor pero no tiene implicancia clínica. Los resultados del RIN obtenidos por CoaguChek en los pacientes estudiados con AL positivo son útiles para la práctica clínica. Los datos obtenidos demuestran que hay una buena correlación entre el RIN tradicional y el CoaguChek. Por la gran diversidad de los equipos POCT los resultados no son extrapolables a otros dispositivos. Dada la heterogeneidad de los anticuerpos antifosfolípidos, es recomendable probar en cada paciente si hay una buena concordancia entre el RIN tradicional y el RIN-POCT.


The certainty of the value of the international normalized relation (INR) assay to control dicoumarin anticoagulation in patients with positive lupus anticoagulant (LA) is unknown especially for the point of care testing (POCT). The aim of this work was to investigate if there was a correlation between the INR values obtained by the traditional method and those obtained with a POCT in patients with positive LA. The population under study were 35 patients anticoagulated by thromboembolic disease with a persistent positive LA, whose INR was determined at the same time by the traditional method and with CoaguChek during 4 consecutive controls. The INR range was 1.9 to 5.60 and the RIN-POCT was between 2.0-4.92. The comparison of INR vs. INR - POCT showed r=0.98, slope: 1.56 (0.98-1.12) and ordered to the origin -0.088 (-0.282-0.007). The bias was 2.1%. For an INR level lower than 3.5 (n=136 controls) the average INR difference was 0.17 with a range of 0.01-0.56. One patient, with triple positivity showed a difference between both methods greater than 0.4. in two controls. For INR greater than 4.5, the degree of concordance is lower but has no clinical implications. The data obtained show that there is a good correlation between the traditional INR and the CoaguChek. The results of INR obtained by CoaguChek in patients studied with positive LA are useful for clinical practice. Due to the large diversity of POCT, the results cannot be extrapolated to other devices. Given the heterogeneity of antiphospholipid antibodies, it is advisable to test in each patient whether there is a good agreement between the traditional INR and INR-POCT.


A certeza do valor da razão internacional normalizada (RIN ou IIN), ensaio que controla a anticoagulação com dicumarínicos, em pacientes com anticoagulante lúpico positivo (AL) é desconhecida especialmente para os dispositivos de teste do tipo point-of-care (POCT). Este trabalho teve como objetivo pesquisar se existe correlação entre o valor de RIN obtido pelo método tradicional e aquele obtido com um dispositivo portátil em pacientes com AL positivo. Foram estudados 35 pacientes anticoagulados por doença tromboembólica com diagnóstico de AL positivo persistente aos quais lhes determinaram, ao mesmo tempo, a RIN pelo método tradicional e com CoaguChek durante 4 controles consecutivos. O intervalo de RIN foi de 1,9 a 5,60 e o de RIN-POCT ficou entre 2,0 e 4,92. A comparação de RIN vs RIN-POCT mostrou r=0,98, pendente: 1,56 (0,98-1,12) e uma ordenada à origem de -0,088 (-0,282-0,007). O viés foi 2,1%. Para um nível de RIN menor a 3,5 (n=136 controles) a diferença de RIN em média foi de 0,17 com um intervalo de 0,01-0,56. Um paciente, com tríplice positividade, mostrou uma diferença entre ambos os métodos maior a 0,4 em dois controles. Para um RIN de mais de 4,5, o grau de concordância foi menor, mas não tem consequências clínicas. Nos pacientes estudados com AL positivo, os resultados da RIN obtidos por CoaguChek são úteis para a prática clínica. Os dados obtidos demonstram que existe uma boa correlação entre a RIN tradicional e o CoaguChek. Devido à grande diversidade dos equipamentos POCT, os resultados não são extrapoláveis a outros dispositivos. É recomendável, visto a heterogeneidade dos anticorpos antifosfolípídes, provar em cada paciente a existência de uma boa concordância entre a RIN tradicional e a RIN-POCT.


Subject(s)
Lupus Coagulation Inhibitor/analysis , Antibodies, Antiphospholipid , Antibodies , Anticoagulants , Time , Work , Bias , Disease , Lupus Coagulation Inhibitor , International Normalized Ratio , Diagnosis , Equipment and Supplies , Point-of-Care Testing , Methods
15.
Rev. bras. ter. intensiva ; 31(3): 354-360, jul.-set. 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1042575

ABSTRACT

RESUMO Objetivo: Avaliar a concordância entre médicos intensivistas que receberam treinamento semelhante para utilização do ultrassom pulmonar à beira do leito, na identificação das linhas B pulmonares visualizadas em tempo real, a fim de verificar a reprodutibilidade do método. Métodos: Foram analisados 67 pacientes que apresentaram alguma piora ventilatória identificada nas últimas 12 horas da realização do ultrassom pulmonar, no período de novembro de 2016 a março de 2017, estando todos internados em um centro de terapia intensiva de um hospital privado de Belo Horizonte (MG). Os ultrassons pulmonares foram realizados por três profissionais diferentes, denominados A, B e C, sendo o intervalo de tempo entre cada ultrassom pulmonar menor que 3 horas. As zonas torácicas visualizadas foram apenas as anteriores e laterais, sendo definidas como zonas anteriores (1) direita e esquerda (Z1D e Z1E, respectivamente), delimitadas pela clavícula, esterno, linha horizontal perpendicular ao processo xifoide e linha axilar anterior; e zonas laterais (2) direita e esquerda (Z2D e Z2E, respectivamente), abrangendo a área entre linha axilar anterior e posterior lateralmente, tendo como limite inferior a mesma linha horizontal correspondente à altura do processo xifoide. Uma zona pulmonar era considerada positiva para linhas B, quando houvesse visualização de três ou mais dessas linhas, caracterizando possível síndrome interstício-alveolar. Por meio do valor Kappa, avaliamos a concordância dentre as quatro zonas, conforme execução de cada dupla de profissional (AB, AC e BC). Resultados: Cerca de 80% das áreas visualizadas tiveram concordância classificada como moderada a substancial, com Kappa variando de 0,41 - 079 (p < 0,05; IC95%). Os maiores graus de concordância ocorreram nas zonas superiores Z1D e Z1E entre os subgrupos AC e BC, com Kappa em torno de 0,65 (p < 0,001). Já a Z2E apresentou uma das menores concordâncias, com Kappa de 0,36. Conclusão: A possível limitação do ultrassom pulmonar quanto ao efeito examinador-dependente não se mostrou presente neste trabalho, sugerindo boa reprodutibilidade dessa modalidade diagnóstica à beira do leito.


ABSTRACT Objective: To evaluate the agreement between intensive care physicians with similar training in the use of bedside lung ultrasonography in identifying pulmonary B lines, visualized in real time, to verify the reproducibility of the method. Methods: A total of 67 patients with some ventilatory deterioration identified within 12 hours after a pulmonary ultrasonography in the period from November 2016 to March 2017 were analyzed, and all were admitted to an intensive care unit of a private hospital in Belo Horizonte, Minas Gerais. The lung ultrasonographies were performed by three different professionals, termed A, B and C, and the time interval between each lung ultrasonography was less than 3 hours. The only visualized chest zones were the anterior and lateral, defined as right and left anterior (1) zones (Z1R and Z1L, respectively), which were delimited by the clavicle, the sternum and the horizontal line perpendicular to the xiphoid process and anterior axillary line. The right and left lateral (2) zones (Z2R and Z2L, respectively) covered the lateral area between the anterior and posterior axillary lines, with the lower limit being the same horizontal line corresponding to the height of the xiphoid process. A lung zone was considered positive for B lines upon visualization of three or more of these lines, suggesting the presence of alveolar-interstitial syndrome. Using the Kappa value, we evaluated the agreement among the four zones according to the execution of each pair of professionals (AB, AC and BC). Results: Approximately 80% of the areas that were visualized showed a moderate to substantial agreement, with the Kappa values ranging from 0.41 - 079 (p < 0.05; 95% CI). The highest levels of agreement occurred in the upper zones Z1R and Z1L between subgroups AC and BC, with a Kappa of approximately 0.65 (p < 0.001). In turn, Z2L showed one of the lowest agreements, with a Kappa of 0.36. Conclusion: The possible limitation of an examiner-dependent effect on lung ultrasounds was not found in this study, suggesting the good reproducibility of this diagnostic modality at the bedside.


Subject(s)
Humans , Male , Female , Aged , Critical Care/standards , Point-of-Care Testing , Lung/diagnostic imaging , Observer Variation , Cross-Sectional Studies , Reproducibility of Results , Ultrasonography , Forms as Topic
16.
Infectio ; 23(3): 259-265, July-Sept. 2019. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1002160

ABSTRACT

Resumen Objetivo: Se considera que el diagnóstico del dengue es fundamentalmente clínico; sin embargo, las pruebas rápidas basadas en la detección de IgM o NS1/IgM están siendo utilizadas en los servicios de salud. Este estudio determinó la contribución de las pruebas rápidas al diagnóstico de dengue en un área endémica antes de la introducción del virus zika. Metodología: Diseño de corte transversal de pruebas diagnósticas realizado a partir del análisis secundario de un estudio previo en 14 instituciones de salud del Valle del Cauca. Se obtuvo información de 632 participantes con resultados de prueba rápida, diagnóstico clínico y pruebas de referencia ELISA NS1, ELISA IgM y RT-PCR. Se compararon la sensibilidad, especificidad, valores predictivos y razones de verosimilitud del uso solo, en serie, y paralelo de los componentes NS1, IgM, NS1/IgM de la prueba rápida y el diagnóstico clínico con las pruebas Q de Cochran y McNemar para datos pareados. Resultados: La sensibilidad del diagnóstico clínico (61,4% IC95% 56%-66,7%) fue superior a la de las pruebas rápidas (37% IC95% 29,6%-44,7%) (P Conclusión: El diagnóstico clínico tiene una mayor sensibilidad que las pruebas rápidas, pero por si solo no es suficiente para confirmar o descartar dengue. Un resultado positivo en pruebas rápidas en pacientes con diagnóstico clínico de dengue es útil para confirmarlo, pero un resultado negativo no lo descarta.


Abstract Objective: Dengue diagnosis is considered to be mainly clinical; however, rapid tests that detect IgM or NS1/IgM are being used in health services. This study assessed the contribution of rapid tests to dengue diagnosis in an endemic area before the emergence of zika virus in Colombia. Methods: Cross-sectional study of diagnostic tests based on a secondary analysis of a previous study in 14 health care institutions in Valle del Cauca department. Results of dengue rapid test, clinical diagnosis, and reference tests ELISA NS1, ELISA IgM, and RT-PCR were obtained for 632 participants. The sensitivity, specificity, predictive values and likelihood ratios of the use alone, serial and parallel combinations of NS1, IgM, NS1/IgM of the rapid test and clinical diagnosis were compared using Cochran´s Q and MacNemar tests for paired data. Results: The sensitivity of clinical diagnosis (61.4% 95%IC 56-66.7) was higher than the sensitivity of rapid tests (37% 95% IC 29.6-44.7) (P<0.001). The serial used of NS1/IgM rapid test when clinical diagnosis was negative increased the sensitivity to 79.5% and, the serial use when clinical diagnosis was positive increased the specificity (from 66.3% to 98.7%). However, the latter decreased the sensitivity to 32.2%. While all negative likelihood ratios (LR-) were close to 1, the serial use of rapid tests when clinical diagnosis was positive had LR+ higher than 10. Conclusion: The clinical diagnosis is more sensitive than rapid tests, but by itself does not confirm or rule out dengue. A positive result in rapid tests is useful to confirm dengue but a negative result does not rule it out.


Subject(s)
Humans , Male , Female , Dengue , Dengue/diagnosis , Zika Virus , Sensitivity and Specificity , Viral Nonstructural Proteins/analysis , Colombia , Clinical Laboratory Techniques , Point-of-Care Testing
17.
REME rev. min. enferm ; 23: e-1173, jan.2019.
Article in Portuguese | LILACS, BDENF | ID: biblio-1005450

ABSTRACT

Objetivo: apreender o conteúdo e a estrutura das representações sociais de profissionais de saúde sobre o teste rápido para detecção de infecções sexualmente transmissíveis em um município baiano. Método: pesquisa qualitativa fundamentada na teoria das representações sociais, em sua abordagem estrutural, realizado em 12 unidades básicas de saúde. Participaram 37 trabalhadores de saúde de nível superior. A coleta de dados foi realizada por meio de um roteiro que comportou questões relacionadas à caracterização profissional, acrescido da expressão indutora teste rápido. O corpus foi organizado e processado com auxílio do software Ensemble de programm espermettant lanalyse des evocations. Resultados: os possíveis elementos constituintes do núcleo central da representação desses trabalhadores, em ordem direta, foram representados pelo termo HIV e, em substituição, por medo, HIV, doenças e agilidade. Os sentidos atribuídos ao teste rápido, revelados no núcleo central, mostram discrepância ­ considerando a ordem direta e a substituição ­ entre as representações e, em certa medida, as caracterizam como representações distintas.(AU)


Objective: to understand the content and structure of social representations for health professionals about the rapid test for the detection of sexually transmitted infections in a municipality in Bahia. Method: qualitative research based on the theory of social representations, in its structural approach, carried out in 12 basic health units. 37 higher-level health workers participated. Data collection was performed through a script that included questions related to the professional characterization, plus the inductive expression rapid test. The corpus was organized and processed with the help of the software Ensemble de Programm Espermettant Lanalyse des Evocations. Results: the possible constituent elements of the central core of the representation for these workers, in direct order, were represented by the term HIV and, instead, by fear, HIV, diseases and agility. The senses attributed to the fast test, disclosed in the central core, show discrepancy ­ considering the direct order and the substitution ­ among the representations and, in a certain measure, they characterize them as distinct representations.(AU)


Objetivo: analizar el contenido y la estructura de las representaciones sociales de profesionales de salud sobre la prueba rápida para detectar infecciones de transmisión sexual en un municipio de Bahía. Método: investigación cualitativa basada en la teoría de las representaciones sociales, en su enfoque estructural, realizado en 12 unidades básicas de salud. Participaron 37 trabajadores de salud de nivel superior. La recogida de datos fue realizada por medio de un cuestionario con preguntas...(AU)


Subject(s)
Humans , Primary Health Care , Occupational Risks , Health Personnel , Point-of-Care Testing
18.
Arq. neuropsiquiatr ; 77(1): 33-38, Jan. 2019. tab, graf
Article in English | LILACS | ID: biblio-983871

ABSTRACT

ABSTRACT Objective: To determine the sensitivity and specificity of peripheral and respiratory muscle strength tests in diagnosing critical illness polyneuromyopathy (CIPNM), compared with an electrophysiological examination. Methods: Fifty septic patients who required mechanical ventilation for at least five days, and without a previous history of muscle weakness, were included. Peripheral muscle strength was assessed using the Medical Research Council (MRC) score, handgrip strength by dynamometry, and respiratory muscle strength with maximum respiratory pressures. Diagnosis of CIPNM was either confirmed or rejected by an electrophysiological examination. Receiver operating characteristic curve analysis was performed to determine the cut-off values with the best sensitivity (SN) and specificity (SP) of the studied variables in the presence or absence of CIPNM. Results: Patients with CIPNM were older, more critical (APACHE IV/SAPS 3), had a longer hospitalization, required mechanical ventilation for longer, and had a higher rate of intensive care unit readmission. Cutoff values identified CIPNM patients using MRC scores, dynamometry according to sex, maximal expiratory and inspiratory pressures, as well as being confirmed by the electrophysiological examination, with good sensitivity and specificity: < 40 (SN: 0.893; SP: 0.955); < 7 kg (SN: 1; SP: 0.909) for men, < 4 kg (SN: 0.882; SP: 1) for women; < 34 cmH2O (SN: 0.808; SP: 0.909) and > −40 cmH2O (SN: 0.846; SP: 0.909), respectively. Conclusion: The MRC score, dynamometry or maximum respiratory pressures can be used to identify patients with CIPNM at the intensive care bedside assessment. The healthcare professional can choose any of the methods studied to evaluate the patient, based on his experience and the resource available.


RESUMO Objetivo: Determinar a sensibilidade (SN) e especificidade (SP) dos testes de força muscular periférica e respiratória no diagnóstico da Polineuromiopatia do Doente Crítico (PNDC) em comparação com o estudo eletrofisiológico. Métodos: Foram incluídos 50 pacientes sépticos, em ventilação mecânica (VM) durante pelo menos cinco dias e sem história prévia de fraqueza muscular. A força muscular foi avaliada utilizando o escore Medical Research Council (MRC), a força de preensão palmar e as pressões respiratórias máximas. O diagnóstico de PNDC foi confirmado ou excluído pelo estudo eletrofisiológico. A análise da curva ROC foi realizada para determinar os valores de corte com a melhor SN e SP. Resultados: Os pacientes com PNDC eram mais velhos, mais graves, tiveram hospitalização mais longa, necessitaram de VM por mais tempo e apresentaram maior taxa de readmissão na Unidade de Terapia Intensiva. Os valores de corte identificaram os pacientes com PNDC usando o MRC, a dinamometria de acordo com o sexo, as pressões expiratórias e inspiratórias máximas, também confirmado pelo estudo eletrofisiológico, com boa sensibilidade e especificidade: < 40 (SN: 0.893; SP: 0.955), < 7 kg (SN: 1; SP: 0,909) para homens, < 4 kg (SN: 0,882; SP: 1) para mulheres, <34 cmH2O (SN: 0,808; SP: 0,909) e > −40 cmH2O (SN: 0,846; SP: 0,909), respectivamente. Conclusão: Tanto o MRC, a dinamometria quanto as pressões respiratórias máximas podem ser usadas para identificar pacientes com PNDC na avaliação à beira do leito, podendo o profissional de saúde escolher qualquer um dos métodos baseado em sua experiência e no recurso disponível.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Polyneuropathies/diagnosis , Polyneuropathies/physiopathology , Critical Illness , Sepsis/physiopathology , Reference Values , Respiratory Muscles/physiopathology , Prospective Studies , Reproducibility of Results , Sensitivity and Specificity , Statistics, Nonparametric , APACHE , Electromyography/methods , Muscle Strength/physiology , Muscle Strength Dynamometer , Point-of-Care Testing , Maximal Respiratory Pressures , Intensive Care Units
19.
Clinics ; 74: e1087, 2019. tab
Article in English | LILACS | ID: biblio-1039539

ABSTRACT

OBJECTIVES: The benefits of implementing point-of-care ultrasound (POCUS) in the emergency department are well established. Ideally, physicians should be taught POCUS during medical school. Several different courses have been designed for that purpose and have yielded good results. However, medical students need specifically designed courses that address the main objectives of knowledge acquisition and retention. Despite that, there is limited evidence to support knowledge retention, especially in the mid-term. The purpose of this study is to evaluate short- and mid-term knowledge retention after a student-aimed ultrasound course. METHODS: Medical students participating in a medical student trauma symposium (SIMPALT) in 2017 were included. Their profiles and baseline ultrasound knowledge were assessed by a precourse questionnaire (PRT). The same questionnaire was used one week (1POT) and three months (3POT) after the course. RESULTS: Most of the participants were 1st- to 4th- year medical students. None had prior ultrasound knowledge. They reported costs as the major barrier (65%) to enrollment in an ultrasound course. A comparison between the PRT and 1POT results showed a statistically significant difference (p<0.02), while no difference was found between 1POT and 3POT (p>0.09). CONCLUSION: Our findings support the use of a tailored ultrasound course for medical students. Knowledge acquisition and mid-term retention may be achieved by this specific population.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Retention, Psychology , Students, Medical/psychology , Ultrasonography/methods , Knowledge , Education, Medical, Undergraduate/methods , Point-of-Care Testing , Prospective Studies , Surveys and Questionnaires , Educational Measurement
20.
HU rev ; 45(1): 98-103, 2019.
Article in Portuguese | LILACS | ID: biblio-1048672

ABSTRACT

Introdução: O termo ultrassonografia a beira do leito ou point of care (POCUS) tem sido utilizado para descrever o uso de ultrassons portáteis pelo médico quando do atendimento ao paciente. A POCUS está cada vez mais sendo integrada a prática médica como extensão do exame físico tradicional. Objetivo: Apresentar a experiência da implementação do ensino da POCUS no currículo de graduação da Faculdade de Medicina da UFJF. Relato de experiência: São descritos o processo e as condições de implementação da disciplina Ecografia Clínica (EC) I com os alunos do quarto período do curso de medicina da UFJF. Resultados: Na avaliação cognitiva (AC) com opções de múltipla escolha, 88% dos estudantes obtiveram notas iguais ou superiores 80 pontos. Na AC de associação de imagens, o resultado foi ainda melhor, com 96% dos discentes obtendo notas iguais ou superiores a 80 pontos (nenhum aluno obteve nota inferior a 60 pontos). No OSCE, o aproveitamento igual ou superior a 80 pontos foi alcançado por 92% dos alunos. A avaliação de satisfação com a disciplina EC I (escala do tipo Likert) pelos estudantes revelou que a maioria absoluta deles considera que a ultrassonografia melhorou a sua educação médica, melhorou a qualidade do seu exame físico e deveria ser mais inserida no currículo médico. Conclusão: A inserção da ultrassonografia no ensino de graduação em medicina é pedagogicamente adequada e aprovada pelos estudantes.


Introduction: The term bedside ultrasound (POCUS) has been used to describe the use of portable ultrasounds by the physician when providing patient care. POCUS is increasingly being integrated in medical practice as an extension of the traditional physical examination. Objective: To report the experience of the implementation of the teaching POCUS in the undergraduate curriculum of the Faculty of Medicine of UFJF. Experience report: The process and the conditions for the implementation of the discipline Clinical Ultrasound I with the students of the fourth period of the UFJF medical course are described. Results and discussion: In the cognitive assessment (CA) with multiple choice options, 88% of students scored 80 points or higher. In the CA using image association, the result was even better, reaching 96% of students with grades equal to or greater than 80 points (no student scored below 60 points). In the OSCE, achievement equal to or greater than 80 points was achieved by 92% of the students. Satisfaction assessment with the discipline clinical ultrasound I (Likert scale) by medical students revealed that the absolute majority of them consider that ultrasound has improved their medical education, improved the quality of their physical examination and should be more inserted in the medical curriculum doctor. Conclusion: The insertion of the ultrasonography in the teaching of graduation in medicine is pedagogically adequate and approved by the students.


Subject(s)
Humans , Male , Female , Patients , Schools, Medical , Students, Medical , Ultrasonography , Point-of-Care Systems , Research Report , Point-of-Care Testing , Academic Performance
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