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Gaceta Medica de Caracas ; 130(2):429-438, 2022.
Article in Spanish | Scopus | ID: covidwho-1989124


In March 2022, two years have passed since the declaration of a pandemic by COVID-19. Millions of people affected, and deceased have been the result of this ongoing story that has evolved from a global risk to a catastrophe for humanity. COVID-19 has led to reconsidering ethical and legal aspects that should be clear. In these times of globalization and sustainable development, it laid bare the pre-existing moral weakness. Public health remains distant from its center: the person, who is now more vulnerable and influenced by an infodemic that alters their ability to decide on their well-being and that of those around them. The old and current problems are derived from individualism versus collectivism for human rights. The use of unproven interventions outside the scope of research, almost on free will;a prioritization in the allocation of scarce resources that continues to seek a way to decide who yes and who no. Finally, the race to achieve a vaccine has changed the curve of this pandemic but has not shown fairness in its application. The dignity of the human person, their fundamental rights, and the common good must be the three elements of evaluation for bioethics, leading us to deliberation, responsibility, and prudence in decisions for each situation that shows human vulnerability increased in these times of COVID-19. © 2022 Academia Nacional de Medicina. All rights reserved.

Multiple Sclerosis Journal ; 27(3 SUPPL):17, 2021.
Article in English | EMBASE | ID: covidwho-1582622


Background: Since the Covid-19 pandemic started, it has been necessary to adapt our clinical practice to limit physical contact. We have established a virtual/presential rehabilitation program (VPR) in patients with EDSS ≤6.5. Methods: Our aim was to compare the effectiveness of the VPR with the previous face-to-face rehabilitation program (PR). Retrospective data were obtained from all patients with an EDSS≤6.5 who were admitted between September and December of 2019 and 2020. All patients were attended 3 times per week for 4 months. In the 2019 group the sessions were PR based, whereas in the 2020 group patients received a VPR, with one face-to-face session plus 2 virtual sessions. Outcomes (obtained pre and post rehabilitation programs) compared between VPR and PR groups were: 10MWT, Tinnetti Test (TT) and Berg Balance Scale (BBS). A minimally clinical significant difference was established for each test: 20% for 10MWT, 3 points for BBS and 1 point for TT. Results: One hundred and forty people were included in the groups VPR (n=80) / PR (N=60). For VPR and PR groups, mean age was 51.45y (SD10.71) / 54.65y (SD11.19) and mean EDSS 4.62 (SD1.45) / 4.64 (SD1.46). All clinical outcomes demonstrated statistically significant improvements pre-post intervention in both groups. Comparing VPR vs PR scores, test didn't show differences using a U of Mann-Whitney for independent samples: BBS 54.2%/44.1% (p =0.27);10MWT 36.7%/22.0% (p =0.13) and TT 40.7%/37.3% (p =0.72). Conclusions: No differences were observed in the effectiveness of VPR versus PR in any of the tests. The VPR program could be a useful tool for patients with an EDSS≤6.5, as the VPR provides a series of subjective benefits (ease of occupational and family life, reduction of fatigue caused by long journeys) while maintaining effectiveness. Further studies with improved designs are warranted to confirm these findings.