COMVC-19: A Program to protect healthcare workers' mental health during the COVID-19 Pandemic. What we have learned

OBJECTIVE: In 2020, the COVID-19 pandemic brought a work and stress overload to healthcare workers, increasing their vulnerability to mental health impairments. In response, the authors created the COMVC-19 program. The program offered preventive actions and mental health treatment for the 22,000 workers of The Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP). This paper aims to describe its implementation and share what we have learned from this experience. METHODS: Workers were able to easily access the program through a 24/7 hotline. Additionally, a mobile phone app that screened for signs and symptoms of emotional distress and offered psychoeducation and/or referral to treatment was made available. Data from both these sources as well as any subsequent psychiatric evaluations were collected. RESULTS: The first 20 weeks of our project revealed that most participants were female, and part of the nursing staff working directly with COVID-19 patients. The most frequently reported symptoms were: anxiety, depression and sleep disturbances. The most common diagnoses were Adjustment, Anxiety, and Mood disorders. CONCLUSIONS: Implementing a mental health program in a multimodal intervention was feasible in a major quaternary public hospital. Our data also suggests that preventive actions should primarily be aimed at anxiety and depression symptoms, with a particular focus on the nursing staff.

Estado atual da cirurgia de revascularização do miocárdio / Coronary artery bypass graft: state of the art

A doença aterosclerótica cardiovascular é a maior causa de morte tanto no Brasilquanto nos países desenvolvidos, sendo, portanto, um assunto de relevância tanto para profissionais da área de saúde quanto para a população geral. Apresentamos, então, as formasde tratamento da doença, principalmente no enfoque cirúrgico, com a revascularização do miocárdio. Para tanto, iniciamos com um pequeno histórico que nos mostra como se chegouà operação como conhecemos hoje. Discutimos as técnicas atualmente empregadas neste tipo de operação e quando ela é feita com ou sem circulação extra-corpórea; quais são ospacientes com indicação para esse tipo de tratamento e o que se espera dos resultados, quais as perspectivas desse procedimento; e como a prática de cirurgias minimamente invasivas ea utilização da robótica auxiliam o cirurgião. Por fim, contextualizamos dois procedimentos novos: a revascularização percutânea, que ainda apresenta resultados incertos a longo prazo e a neoangiogênese, que é um procedimento em fase de estudo.

The atherosclerotic cardiovascular disease is the greatest cause of death in Brazil as much as in the developed world. Therefore, it’s a relevant issue for health professionals and for general population. So, we present the treatments for the disease, focusing the surgery, with revascularization of the myocardium. Then, we start with a short report that shows how the operation achieves its actual state, the techniques currently applied in this kind of operationand when it’s done with or without extracorporeal circulation; who the patients for this treatment are and what results we can expect; the perspectives for this procedure, such as the practiceof minimally invasive surgeries and the utilization of robotics to help the surgeon. At last, we contextualize two new procedures: the percutaneous revascularization, that still shows uncertain long-term results, and the neoangiogenesis, which still is in study phase.