ABSTRACT
COVID-19 has changed healthcare systems and imposed several restrictions on the delivery of pulmonary rehabilitation. To overcome this, telerehabilitation has emerged as a promising strategy. However, little is known about its effectiveness and safety. Aim(s): To present the preliminary results of the efficacy and safety of a pulmonary telerehabilitation program in a Portuguese hospital. Method(s): A pulmonary telerehabilitation program was made available by the hospital center in 2021. An initial face-toface assessment was performed in a multidisciplinary consultation. The program consisted of 3 weekly sessions and lasted 8 weeks, conducted by a rehabilitation nurse via videoconference. Patients received a kit consisting of a tensiometer, oximeter, cycle ergometer, elastic bands, and a Borg Scale. Result(s): From March 2021 to January 2022, 8 patients participated in the program. Improvements were observed in all variables evaluated: muscle strength of the lower limbs (range from19 Kg to 23 Kg) and upper limbs (range from 17 Kg to 19 Kg), 6 Minute Walk Test (range from 376.5 m to 403.5 m), Sit-to-Stand Test 1 Minute (range from 19 stands to 25 stands), Modified Medical Research Council (range from 2 to 3), COPD Assessment Test (range from 18 to 14), London Chest Activity of Daily Living (range from 25 to 19), Hospital Anxiety and Depression Scale (range from 16 to 12). There were no reports of adverse events. Conclusion(s): The threats and challenges posed by the COVID-19 pandemic present the opportunity to reorganize and improve the supply of rehabilitation care. Preliminary results from our program demonstrate that pulmonary telerehabilitation is an effective and safe alternative to traditional face-to-face intervention.
ABSTRACT
Emergency services worldwide have been exceeded in their capacities due to the SARS-CoV-2 pandemic, a generalized situation in countries with robust health systems and aggravated in lagging countries. As a result, focused computer solutions have been developed for self-diagnosis, triage, and follow-up of suspected and confirmed patients of SARS-CoV-2. But as it is a new disease, the symptoms evolve in a short time and the diagnostic protocols must be updated. The applications that integrate algorithms in their code to help sanitary processes need to be modified, recompiled, and published integrating these changes. This article presents a solution through the implementation of a neural network that only requires updating an external file without the need to modify whole applications. Copyright: © 2022 by the authors.
ABSTRACT
Emergency services worldwide have been overwhelmed in their capacities due to the SARS-CoV-2 pandemic, a generalized situation in countries with robust health systems and aggravated in lagging countries. As a solution, the Doctor 1847 application was developed between April and May 2020 in Tegucigalpa, Honduras, to perform self-diagnosis, triage, and follow-up of suspected and confirmed patients with SARS-CoV-2 infection, reducing health delays. With this software, the congestion of patients who come to a hospital emergency for considering having this disease was minimized;by making early use of this tool, the identification of signs and symptoms of danger that can lead to critical states that require access to emergency and specialized services. The risk to healthy patients, health and service personnel of being exposed to a real risk was also reduced. In a complementary way, a web interface was delivered with valuable data for decision-makers regarding controlling this pandemic, knowing the symptomatic behavior of this disease in the country. All of the above has been possible due to the cloud computing paradigm, taking advantage of its elastic and ubiquitous capacity;in conjunction with the capabilities of next-generation converged networks and intelligent mobile devices. Copyright: © 2022 by the authors.
ABSTRACT
BACKGROUND AND AIMS: Haemodialysis (HD) patients tend to be old, have weakened immune systems and suffer from multiple comorbidities, making them particularly prone to infections and death by the Coronavirus disease 2019 (COVID-19). Global vaccination against SARS-CoV2 has been underway, but long-term data in dialysis patients are still scant. We aimed to study the seroconversion with the Pfizer BNT162b2 vaccine in HD patients of 5 Dialysis Centres after the first 2 doses and monitor the immune responses and clinical data during the following 7 months. We also investigated the security of the vaccine. METHOD: We included 404 patients on chronic HD. All patients received 2 shots of the Pfizer BNT162b2 vaccine, separated by 21 days. Serologic tests were run using Quant II IgG anti-Spike SARS-CoV-2 assay by Abbott. Blood was drawn 21 days after the first dose (D22), 21 days after the second dose (D43), 3 and 6 months after the first dose (M3 and M6, respectively). We asked the patients to answer written questionaries about the symptoms reported during the 7 days after each vaccination. RESULTS: 60.6% of our patients were male and the median age was 70 years (min 19, max 97). 26 patients (6.4%) had previously been infected with COVID-19. 6 of them (23.1%) needed hospitalization. At 7 months follow-up, there were 3 new cases and 1 death (the one who died had negative antibody counts at M3). Maximum response to the vaccine was seen at D43, with 97.3% of the patients showing positive antibody titers. At 6 months, 91.5% still had positive antibodies. As is reported in Table 1, the following patients had higher antibody titers at D43 and M6: patients with COVID-19 before the first vaccine, younger patients, patients with higher albumin levels, patients on HDF versus HD. Patients on HDF had higher titers at all moments during the 6 months (Figure 1). Patients with cancer without antineoplasic treatment in the last 6 months showed lower rates of seroconversion at D43: OR: 0.117 [95% confidence interval (95% CI) 0.016-0.863]} and M6 (OR: 0.203, 95% CI 0.049-0.842]. Patients whose levels of C-reactive protein was ≤ 2.8 mg/dL had more probability of seroconversion at D43 (OR: 7.840, 95% CI 1.839-33.419;P < 0.005) as well as those with a higher (better) Karnofsky scale (OR 1.062, 95% CI 1.016-1.110). 43.4% of the patients reported at least one side effect after the first shot and 64.6% after the second shot. A total of 69.1% had at least one-side effect on the first or second shot. All the reported reactions were mild and transitory. CONCLUSION: Patients on HD respond surprisingly well to anti-COVID-19 vaccination and present only mild side effects. Further studies should analyze the impact of HDF on immune responses, since our work suggests that this type of dialysis may have a positive and protective long-term role on this population.
ABSTRACT
In many different contexts, the encounter between two or more individuals opens a window in which information can be exchanged. Considering Mobile Ad hoc Networks (MANETs) scenarios, encounters - also called contacts - are used to transfer data between nodes (the users). In more recent cases, tracing contacts between individuals has shown to be a strong strategy in mapping the transmission of contagious diseases, such as COVID-19. However, sharing contact data can impose threats to the safety of participants regarding their social and mobility behavior. As an example, we can infer acquaintances, as well as home and work locations. This work presents a strategy to anonymize contact tracing data by utilizing mix-zones, a well-defined concept to anonymize data in a given region. Called social mix-zones, it considers the number of contacts happening in a location, producing anonymized data and protecting the personal integrity of the individuals. We validate the proposal using two real contact tracing data, showing that social mix-zones can cover a large portion of contacts, reducing the risk of malicious location attacks. © 2021 ACM.
ABSTRACT
IntroductionThe confinement associated with COVID-19 pandemic was an experience with significant physical and mental health implications, including higher stress levels, decreased sleep quality, pain symptoms and changes in lifestyle behaviours.ObjectivesThe main goal of this study was to analyze the relationship between stress and health variables (sleep, health symptoms, health perception, and lifestyle behaviours) in a Portuguese university during COVID-19 home confinement.MethodsA cross-sectional online survey design was conducted. A sample of 263 Portuguese workers (64.3% females), with mean age of 48.3 years (sd=8.9), filled in the PSS10, answering questions concerning health symptoms (perceived health, pain symptoms and fatigue), lifestyle behaviours (sleep and eating habits, use of alcohol and tobacco) during COVID-19 home confinement. A descriptive statistical analysis, a Pearson correlation analyses and the t Student test, for independent samples, were performed.ResultsThe results showed significant correlations between stress and perceived health (r=-.404;p<.0001), arms pain (r=.212;p=.002), legs pain (r=.201;p=.003), back pain (r=.219;p=.001), headache (r=.289;p<.0001) and fatigue (r=.295;p<.0001). Concerning lifestyle behaviours, the results showed significant correlations between stress and sleep (r=-.552;p<.0001) and stress is significantly higher (p<.0001) in individuals who have changed their eating habits.ConclusionsDuring the COVID-19 home confinement, higher stress levels are associated with a worse perception of health, more pain symptoms (legs, arms, back, headache), worse sleep quality and more fatigue. Moreover, the individuals with higher levels of stress have changed their eating habits. Lastly, health promotion interventions are needed in order to minimize the impact of home confinement in health.