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1.
Contact Dermatitis ; 86(SUPPL 1):48-49, 2022.
Article in English | EMBASE | ID: covidwho-1927571

ABSTRACT

Background: Delayed local reactions due to mRNA vaccines or COVID arm have been reported. COVID arm commonly presents as an itchy and painful erythematous plaque with swelling and is characterized by a delayed onset of 7 to 10 days after vaccination. New excipients used in mRNA vaccines (polyethylene glycol (PEG)-2000, tromethamol and 1,2-distearoyl-sn-glicero-3-phosphocholine) have increased the awareness about their role in such cutaneous adverse reactions. Objectives: To define the excipient accountability in COVID arm through specific skin provocation testing. Methods: Health workers of a tertiary level hospital suffering COVID arm were patch, skin prick (SP) and intradermal (ID) tested with PEG-400, PEG-2000, tromethamol and 3-phosphocholine at different concentrations (0.001%, 0.01%, 0.1% and 1%). Positive long standing ID reactions were biopsied. Results: Eleven patients were included. Patch tests were always negative. PEG-2000 presented positive SP at 1% (4 patients) and 0.1% (1 patient). PEG-2000 ID was positive at 1% (10 patients), 0.1% (7 patients) and 0.01% (6 patients). Three showed long standing positive reactions to ID of PEG-2000 on day 2, whose biopsies depicted perivascular lymphocytes, occasional eosinophils and dermal edema. In addition, 6 patients reacted to PEG-400, all of which also reacted to PEG-2000. SP and ID for the other excipients were negative. Conclusions: The presence of immediate and delayed reactions to PEG-2000 in patients. with COVID arm poses a challenge on whether PEG-2000 acts as a delayed sensitizer or. these infrequent reactions are irritative.

3.
Radiotherapy and Oncology ; 161:S1248-S1249, 2021.
Article in English | EMBASE | ID: covidwho-1492825

ABSTRACT

Purpose or Objective: Cancer diagnostics and surgery have been disrupted by the response of health care services to the coronavirus disease pandemic. With the COVID-19 irruption in 2020, some radiotherapy treatments were omitted, delayed, changed intent or shifted to a hypofractionated scheme. The purpose of this study is to investigate the effect, direct or indirect, that COVID-19 has had on radiotherapy treatments in comparison with previous years. Materials and Methods: All treatments from 2018 (1521), 2019 (1498) and 2020 (1613) were analysed. Treatments were separated into two categories regarding treatment intent: curative or palliative. Moreover curative treatments were classified by site or pathology: H&N, lung, rectum, prostate, breast, central nervous system (CNS), gynaecological, SBRT and other sites. Percentage of hypofractionated treatments per year (for those with curative intent) was also taken into account. Results: Regarding treatment intent, we have found that the number of palliative treatments was similar to previous years: 38% in 2020, 37 % in 2018 and 35% in 2019. Figure I shows the percentage of hypofractionated treatments. During 2020 there were 10% hypofractionated treatments more than 2019, which is more than a threefold increase compared to the growth between 2018 and 2019 (3%). (Figure Presented) Conclusion: On one side, reasons related directly or indirectly with COVID-19 do not had an effect on the treatment intent in our department: similar number of palliative treatments was reported during 2020. On the other side, the use of hypofractionated schemes was accelerated during the pandemic, following national and international recommendations. This has allowed reducing treatment time bringing more comfort to the patients. To resume, it is difficult to assess whether the pandemic had a negative effect on cancer treatments based on treatment intent. Deeper analysis of cancer staging could reveal a different result related to collateral damage to the pandemic.

7.
Actas Dermo-Sifiliograficas ; 2020.
Article in English, Spanish | EMBASE | ID: covidwho-956848

ABSTRACT

Teledermatology has facilitated specialist care during the crisis caused by the coronavirus disease 2019 pandemic, eliminating unnecessary office visits and the possible exposure of patients or dermatologists. However, teledermatology brings forward certain ethical and medicolegal questions. A medical consultation in which the patient is not physically present is still a medical act, to which all the usual ethical and medicolegal considerations and consequences apply. The patient's right to autonomy and privacy, confidentiality, and data protection must be guaranteed. The patient must agree to remote consultation by giving informed consent, for which a safeguard clause should be included. Well-defined practice guidelines and uniform legislation are required to preserve the highest level of safety for transferred data. Adequate training is also needed to prevent circumstances involving what might be termed “telemalpractice.”

8.
Actas Dermosifiliogr (Engl Ed) ; 111(10): 815-821, 2020 Dec.
Article in English, Spanish | MEDLINE | ID: covidwho-758464

ABSTRACT

Teledermatology has facilitated specialist care during the crisis caused by the coronavirus disease 2019 pandemic, eliminating unnecessary office visits and the possible exposure of patients or dermatologists. However, teledermatology brings forward certain ethical and medicolegal questions. A medical consultation in which the patient is not physically present is still a medical act, to which all the usual ethical and medicolegal considerations and consequences apply. The patient's right to autonomy and privacy, confidentiality, and data protection must be guaranteed. The patient must agree to remote consultation by giving informed consent, for which a safeguard clause should be included. Well-defined practice guidelines and uniform legislation are required to preserve the highest level of safety for transferred data. Adequate training is also needed to prevent circumstances involving what might be termed «telemalpractice¼.


Subject(s)
COVID-19/epidemiology , Pandemics , SARS-CoV-2 , Telemedicine , Checklist , Confidentiality , Delivery of Health Care/legislation & jurisprudence , Dermatology/ethics , Dermatology/legislation & jurisprudence , Dermatology/methods , Evidence-Based Medicine , Humans , Informed Consent , Malpractice , Patient Acceptance of Health Care , Personal Autonomy , Spain/epidemiology , Telemedicine/ethics , Telemedicine/legislation & jurisprudence , Telemedicine/methods
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