ABSTRACT
Objective: To assess the impacts of measures to face COVID-19 on total knee arthroplasty procedures in the country, based on data provided by the SUS Information and Informatics Department (DATASUS). Methods: Cross-sectional study of secondary data in the public domain, available on the website of the Department of Information and Informatics of SUS (DATASUS), containing information about hospital admissions in the SUS. Results: Brazil suffered a 51.82% decrease, on average, in the performance of total knee arthroplasty by the Unified Health System (SUS) in 2020, due to measures to face COVID-19. The analysis by region offers more details on this reduction in the number of procedures. In the Northeast, the decrease was on average 48.02%, whereas in the Center-West it was 65.61%. Southeast, North, and South registered an average decrease of 49.38%, 51.81%, and 55.06%, respectively. Conclusion: COVID-19 impacted the realization of TKA in Brazil, with greater and lesser levels of decline observed in different Brazilian regions. In the Southeast region, for example, the states of São Paulo and Minas Gerais were the most affected, mainly due to the large population concentration, as well as Paraná, which has high numbers of procedures and a sharp decrease in 2020. Level of Evidence III, Retrospective Comparative Study.
ABSTRACT
Objective: To assess the impacts of measures to face COVID-19 on total knee arthroplasty procedures in the country, based on data provided by the SUS Information and Informatics Department (DATASUS). Methods: Cross-sectional study of secondary data in the public domain, available on the website of the Department of Information and Informatics of SUS (DATASUS), containing information about hospital admissions in the SUS. Results: Brazil suffered a 51.82% decrease, on average, in the performance of total knee arthroplasty by the Unified Health System (SUS) in 2020, due to measures to face COVID-19. The analysis by region offers more details on this reduction in the number of procedures. In the Northeast, the decrease was on average 48.02%, whereas in the Center-West it was 65.61%. Southeast, North, and South registered an average decrease of 49.38%, 51.81%, and 55.06%, respectively. Conclusion: COVID-19 impacted the realization of TKA in Brazil, with greater and lesser levels of decline observed in different Brazilian regions. In the Southeast region, for example, the states of São Paulo and Minas Gerais were the most affected, mainly due to the large population concentration, as well as Paraná, which has high numbers of procedures and a sharp decrease in 2020. Level of Evidence III, Retrospective Comparative Study.
Objetivo: Avaliar os impactos das medidas de combate à COVID-19 nos procedimentos de artroplastia total do joelho (ATJ) no país, com base nos dados fornecidos pelo Departamento de Informações e Informática do Sistema Único de Saúde (SUS). Métodos: Estudo transversal realizado com dados secundários de domínio público, disponíveis no site do Departamento de Informações e Informática do SUS (DATASUS), contendo informações sobre as internações hospitalares realizadas no SUS. Resultados: O Brasil sofreu uma queda de 51,82%, em média, na realização da artroplastia total do joelho pelo SUS em 2020, decorrente das medidas de combate à COVID-19. A análise por região oferece mais detalhes dessa redução no número de procedimentos. Na região Nordeste, a queda foi, em média, de 48,02%, enquanto no Centro-Oeste foi de 65,61%. Sudeste, Norte e Sul registraram queda, em média, de 49,38%, 51,81% e 55,06%, respectivamente. Conclusão: A COVID-19 impactou a realização de ATJ no Brasil, com níveis de maior e menor declínio observados nas diferentes regiões brasileiras. Na região Sudeste, por exemplo, os estados de São Paulo e Minas Gerais foram os mais afetados, devido principalmente à grande concentração populacional, assim como o Paraná, que apresenta números altos de procedimentos realizados e forte queda em 2020. Nível de Evidência III, Estudo Retrospectivo Comparativo.
ABSTRACT
This study aimed to evaluate the experience of tracheostomy in COVID-19 patients in a Southern Europe tertiary hospital. Retrospective observational study in tracheostomized patients from April 1, 2020 to February 28, 2021. Data related to tracheostomy were evaluated in patients with and without COVID-19, including infections in healthcare professionals involved in patient care. Forty-two tracheostomies were performed in COVID-19 patients aged 68.4 ± 11.1 years, predominantly men (71%) and caucasians (81%). They had at least 1 comorbidity (93%), on average 3. The most frequent were heart disease (71%), age > 65 years (67%) diabetes (40%) and obesity (33%). The greater number of comorbidities was associated with the lesser probability of the patient's recovery (p = .001). Age (p = .047) and renal failure (p = .013) were associated with higher mortality. Patients were tracheostomized by prolonged endo-tracheal intubation (50%), pneumonia (33%) and extubation failure (10%). Ventilation time before the tracheostomy (22.9 ± 6.5 days) was higher than ventilation time after the tracheostomy (7.1 ± 15.1 days) (p < 0.001). No differences were found in ventilation time (p = 0.094) and tracheostomy time (p = 0.514) in the different indications. There were 3 minor complications (7.1%), 25 discharges (60%) and 11 deaths (26%). During the same period 49 tracheostomies were performed in patients without COVID-19, with a homogeneous gender and age distribution, 31% without comorbidities, with an average of 1 comorbidity per patient and higher mortality (43%). Tracheostomy in COVID-19 patients proved to be a safe procedure for both patients and healthcare professionals and improves the clinical outcome of patients with severe infection. The 21-day procedure timing seems adequate. Comorbidities played an essential role in patient´s recovery. Age and renal failure are associated with a worse vital prognosis.
ABSTRACT
The COVID-19 pandemic has detrimentally affected people’s lives and the economies of many countries, causing disruption in the health, education, transport, and other sectors. Several countries have implemented sanitary barriers at airports, bus and train stations, company gates, and other shared spaces to detect patients with viral symptoms in an effort to contain the spread of the disease. As fever is one of the most recurrent disease symptoms, the demand for devices that measure skin (body surface) temperature has increased. The thermal imaging camera, also known as a thermal imager, is one such device used to measure temperature. It employs a technology known as infrared thermography and is a noninvasive, fast, and objective tool. This study employed machine learning transfer using You Only Look Once (YOLO) to detect the hottest temperatures in the regions of interest (ROIs) of the human face in thermographic images, allowing the identification of a febrile state in humans. The algorithms detect areas of interest in the thermographic images, such as the eyes, forehead, and ears, before analyzing the temperatures in these regions. The developed software achieved excellent performance in detecting the established areas of interest, adequately indicating the maximum temperature within each region of interest, and correctly choosing the maximum temperature among them.