ABSTRACT
BACKGROUND: In other countries, researchers have noticed diverse variations in the features of patients undergoing emergency surgery during the COVID-19 pandemic. In Mexico, there is not information about this issue. METHODS: Workers of the Mexican Government, who required emergency surgeries were studied by the general surgery service of a General Hospital administered by the Institute of Social Security and Services for State Workers Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), through the periods from March-August 2019 (non-exposed) and March-August 2020 (exposed). The analysis included: demographic data, laboratory information, post-operative diagnoses, symptoms' length, days of emergency stay, and post-operative stay. RESULTS: One hundred and ninety-three emergency surgeries were analyzed; 106 in 2019 and 87 in 2020 (a decrease of 18%). Throughout the pandemic, the number of days between the symptoms' onset and surgery was greater: 2019, 7.6 ± 4.6 days; 2020, 14 ± 6.7 days (p < 0.0001). In addition, cases of acute appendicitis decreased (2019-60.3%; 2020-42.5%), and those of acute calculous cholecystitis increased (2019-12.2%; 2020-24.1%). CONCLUSION: Through the COVID-19 pandemic, there were notable changes in the characteristics of Mexican Government's workers who warranted emergency surgery.
ANTECEDENTES: En otros países, han notado diversos cambios en las características de los pacientes sometidos a cirugía de emergencia durante la pandemia de COVID-19. En México no existe información sobre este tema. MÉTODO: Estudiamos a los trabajadores del gobierno mexicano que requirieron tratamiento quirúrgico de emergencia por el servicio de cirugía general de un Hospital General del Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE), durante los periodos de marzo-agosto de 2019 (no expuestos) y marzo-agosto de 2020 (expuestos). El análisis incluyó: datos demográficos, datos de laboratorio, diagnósticos postoperatorios, duración de los síntomas, días de estancia en emergencias y estadía postoperatoria. RESULTADOS: Se analizaron 193 cirugías de emergencia; 106 en 2019 y 87 en 2020 (una disminución del 18%). En la pandemia, el número de días entre el inicio de los síntomas y la cirugía fue mayor: 2019, 7.6 ± 4.6 días; 2020, 14 ± 6.7 días (p < 0.0001). Además, disminuyeron los casos de apendicitis aguda (2019-60,3%; 2020-42,5%) y aumentaron los de colecistitis litiásica aguda (2019-12,2%; 2020-24,1%). CONCLUSIÓN: Durante la pandemia de COVID-19, hubo cambios notables en las características de los trabajadores del gobierno mexicano que ameritaron cirugías de emergencia.
Subject(s)
COVID-19 , Humans , COVID-19/epidemiology , Pandemics , Retrospective Studies , Mexico/epidemiologyABSTRACT
RESUMEN Introducción. Se estima que los trastornos musculoesqueléticos constituyen la patología más frecuente que afecta la salud de los teletrabajadores, la productividad en las organizaciones y generan discapacidad. Objetivo. Determinar la prevalencia de los trastornos musculoesqueléticos y los factores de riesgo ergonómico de los docentes universitarios que dictan en la modalidad de teletrabajo en diferentes universidades de Lima, Perú. Método. Estudio transversal. Participaron 110 docentes a los que se les aplicó el cuestionario Nórdico de Kuorinka validado en el Perú. Resultados. La prevalencia de los trastornos musculoesqueléticos por segmento fue en el 100% (n=110) de la población encuestada. Se encontró con mayor frecuencia en la columna dorso-lumbar 67,2% (n=74) y en el cuello 64,5% (n=71), en menor porcentaje en el hombro 44,5% (n=49), muñeca/mano 38,2% (n=42) y en el codo/antebrazo 19,1% (n=21). Los docentes relacionaron estos trastornos musculoesqueléticos a posturas prolongadas en el rango de 26,8% - 50% y 12,5% -26,8% a largas jornadas laborales. El grupo etareo predominante fue de 41 a 50 años 39,1% (n=43) y de 31 a 40 años 28,2% (n=31). El 70,9% (n=78) fueron varones y 29,1% (n=32) mujeres. Conclusión. Existe una elevada prevalencia de trastornos musculoesqueléticos en los docentes universitarios estudiados, principalmente en la columna dorso-lumbar y cuello; y existe asociación de estos trastornos con factores de riesgo ergonómico como postura prolongada y largas jornadas laborales.
ABSTRACT Introduction. It is estimated that musculoskeletal disorders are the most frequent pathology, affecting the health of teleworkers, productivity in organizations and generating disability. Objective. To determine the prevalence of musculoskeletal disorders and ergonomic risk factors of university professors who teach in the telework modality at different universities in Lima, Peru. Methods. Cross-sectional study. 110 teachers participated in the Kuorinka Nordic questionnaire validated in Peru. Results. The prevalence of musculoskeletal disorders by segment was 100% (n = 110) of the surveyed population. It was found more frequently in the dorso-lumbar spine 67,2% (n = 74) and in the neck 64,5% (n = 71), in a lower percentage in the shoulder 44,5% (n = 49), wrist / hand 38,2% (n = 42) and elbow / forearm 19,1% (n = 21). The teachers associated these musculoskeletal disorders with prolonged postures in the range of 26,8% - 50% and 12,5% - 26,8% with long working hours. The majority age group was 39,1% (n = 43) from 41 to 50 years and 28,2% (n = 31) from 31 to 40 years. 70,9% (n = 78) were men and 29,1% (n = 32) were women. Conclusion. There is a high prevalence of musculoskeletal disorders in university teachers, mainly in the dorsal-lumbar spine and neck; and there is an association of these disorders with ergonomic risk factors such as prolonged posture and long working hours.
ABSTRACT
INTRODUCTION: Postintensive care syndrome (PICS) is the physical, cognitive or psychiatric deterioration that appears after a critical illness and persists beyond hospital admission. The objective of this study was to describe the prevalence of PICS in the patients with coronavirus disease 2019 (COVID-19) admitted to the intensive care unit of the Consorcio Hospital General Universitario de Valencia. PATIENTS: They benefited from a standardized assessment, addressing health-related quality of life (EuroQol-5D-3L), a physical status (6 MWT, «test up and go¼ and hand dynamometer), a nutritional assessment (MUST and the Global Subjective Assessment), cognitive impairment (MoCA), mental health disorders (HADS and Davidson Trauma Scale) and pain (visual analogue scale and DN4). RESULTS: From March to June 2020, 59 patients with SARS-CoV-2 were admitted to our ICU. 29 of these were recruited for the study. The stay in the ICU and the mechanical ventilation time were long (24 days [IQR 12-36], and 18 days [IQR 7-31] respectively). The SOFA upon admission to the ICU was high (3 [IQR 3-5]). Tracheostomy was performed in 52% and pronation in 93%. 90% had some abnormal test. 20% had post-traumatic stress syndrome. CONCLUSIONS: We found that 9 out of 10 survivors of SARS-CoV-2 admitted had at least one PICS alteration at 4-6 weeks from discharge from the Hospital. Six out of 19 patients presented with two or more affected evaluated areas.
Subject(s)
COVID-19 , Critical Illness , COVID-19/epidemiology , COVID-19/therapy , Critical Care , Critical Illness/therapy , Humans , Intensive Care Units , Pilot Projects , Quality of Life , SARS-CoV-2ABSTRACT
Objective: This review aimed to provide an update on the characterization and impact of musculoskeletal pain in COVID-19 survivors. Methods: It is considered articles on subjects who had been recovered from COVID-19 infection after hospitalization (COVID-19 survivors) with secondary musculoskeletal pain. Results: Six articles (one editorial, one consensus statement, one letter to the editor, one case-control study, one cohort study and one review) showed the polyhedral effects of the SARS-CoV-2 on musculoskeletal pain. This short review was not able to clearly identify what the pathogenesis of musculoskeletal pain was in COVID-19 survivors. Conclusion: Preliminary data showed that widespread pain similar to the pattern compatible with pain of musculoskeletal origin could characterize symptoms after SARS-CoV-2 infection. Alternate :Objetivo: Esta revisión tuvo como objetivo proporcionar una actualización sobre la caracterización y el impacto del dolor musculoesquelético en los supervivientes de COVID-19. Métodos: Se consideraron artículos sobre sujetos que se recuperaron de la infección por COVID-19 tras la hospitalización (supervivientes de COVID-19) con dolor musculoesquelético secundario. Resultados: Seis artículos (un editorial, una declaración de consenso, una carta al editor, un estudio de casos y controles, un estudio de cohortes y una revisión) mostraron los efectos poliédricos del SARS-CoV-2 sobre el dolor musculoesquelético. Esta breve revisión no pudo identificar claramente cuál era la patogénesis del dolor musculoesquelético en los supervivientes del COVID-19. Conclusión: Los datos preliminares mostraron que el dolor generalizado similar al patrón compatible con el dolor de origen musculoesquelético podría caracterizar los síntomas después de la infección por SARS-CoV-2.Alternate :Objetivo: Esta revisão teve como objetivo fornecer uma atualização sobre a caracterização e o impacto da dor musculoesquelética em sobreviventes de COVID-19. Métodos: São considerados artigos sobre sujeitos que se recuperaram da infecção por COVID-19 após internação (sobreviventes de COVID-19) com dor musculoesquelética secundária. Resultados: Seis artigos (um editorial, uma declaração de consenso, uma carta ao editor, um estudo de caso-controle, um estudo de coorte e uma revisão) mostraram os efeitos poliédricos do SARS-CoV-2 na dor musculoesquelética. Esta breve revisão não foi capaz de identificar claramente qual era a patogênese da dor musculoesquelética em sobreviventes de COVID-19. Conclusão: Dados preliminares mostraram que dor generalizada semelhante ao padrão compatível com dor de origem musculoesquelética pode caracterizar sintomas após infecção por SARS-CoV-2.
ABSTRACT
INTRODUCTION: Chronic pain is one of the most prevalent pathologies in the world. Treatment with neurostimulators is carried out in the most extreme cases and requires a large investment of resources. In these times of the COVID19 pandemic, we present a comprehensive solution for monitoring this kind of patient, this solution includes the development of a mobile application and a support center for remote monitoring (SCRM). MATERIAL AND METHODOLOGY: The project was developed according to the scientific evidence in the following phases: (1) Approval in a multidisciplinary clinical committee of implants for chronic pain, (2) Setting up a group of experts, (3) Protocol adaptation for the follow-up of patients with chronic pain to the Smartphone environment, (4) Technology platform adaptation to the clinical protocol (technological environment and workflow between the hospital and the SCRM), and (5) Quality evaluation by survey (quantitative and qualitative) of a small series of patients. RESULTS: The application was evaluated by asking for user opinions about design and usefulness with the first implanted patients. Some minor adjustments were made concerning downloadable material and screen color and text. CONCLUSIONS: Developing a comprehensive solution should be based on scientific principles and in accordance with established protocols. A support center ensures greater adherence for follow-up and better patient care.
Subject(s)
COVID-19 , Chronic Pain , Mobile Applications , Telemedicine , Humans , Telemedicine/methods , Chronic Pain/therapyABSTRACT
SARS-CoV-2 infection has evolved into a pandemic and a Public Health Emergency of International Importance that has forced health organizations at the global, regional and local levels to adopt a series of measures to address to COVID-19 and try to reduce its impact, not only in the social sphere but also in the health sphere, modifying the guidelines for action in the health services. Within these recommendations that include the Pain Treatment Units, patients with suspected or confirmed SARS-CoV-2 infection may be waiting for medical consult or interventional procedures for the management of chronic pain refractory to other therapies. A series of guidelines aimed at reducing the risk of infection of health personnel, other patients and the community are included in this manuscript.
Subject(s)
COVID-19 , Chronic Pain , Chronic Pain/epidemiology , Humans , Pain Management , Pandemics , SARS-CoV-2ABSTRACT
In this paper I discuss Jungian psychological work of the trauma and loss experienced in reaction to COVID-19 with a man who represents a clinical composite. The issues of precarity, a concept used by the philosopher Judith Butler, are combined with the notions of lack and absence of French psychoanalyst André Green. The psychological and societal situation of precarity aroused the man's childhood issues that were long repressed. The loneliness, isolation and death from COVID-19 mirrored his personal and the collective responses to the disaster from this global pandemic. He felt on the edge of collapse as what he knew of his world crashed and he found himself unable to cope. The subsequent Jungian work taking place through the virtual computer screen was taxing and restorative simultaneously for both analyst and analysand.
Dans cet article je discute le travail psychologique Jungien sur le traumatisme et la perte dont fait l'expérience un patient en réaction au COVID-19, patient qui représente un composite clinique. Les questions en lien avec la précarité, un concept utilisé par la philosophe Judith Butler, sont combinées avec les notions de manque et d'absence chez le psychanalyste français André Green. La situation psychologique et sociale de précarité a activé les problèmes de l'enfance de cet homme, réprimés depuis longtemps. La solitude, l'isolement et la mort liés au COVID-19 ont fait miroir avec ses réponses personnelles et les réponses collectives au désastre de cette pandémie globale. Il se sentit à la limite de l'effondrement alors que ce qu'il connaissait de son monde s'écroulait et il se trouva dans l'incapacité de faire face. Le travail Jungien qui s'ensuivit, au moyen de l'écran virtuel de l'ordinateur fut éprouvant et réparateur pour l'analysant et l'analyste simultanément.
En el presente trabajo, describo el trabajo psicológico Junguiano, con un hombre que representa un compuesto clínico, acerca del trauma y la pérdida experimentada en reacción al COVID-19. Cuestiones de precariedad, un concepto utilizado por la filósofa Judith Butler, son combinadas con las nociones de falta y ausencia del psicoanalista francés André Green. La situación psicológica y social de precariedad activa temas infantiles del individuo, hasta entonces reprimidos. La soledad, aislamiento y muerte del COVID-19 espejó la suya personal y las respuestas colectivas al desastre de esta pandemia global. Él se encontró en el borde del colapso debido a que lo que él conocía del mundo se quebró, y se encontró imposibilitado de hacer algo con esto. El trabajo Junguiano subsiguiente que tuvo lugar a través de la pantalla virtual de la computadora fue arduo y restaurador simultáneamente para ambos, analista y analizando.
Subject(s)
Adverse Childhood Experiences , COVID-19 , Jungian Theory , Loneliness , Psychoanalytic Therapy , Psychological Trauma/therapy , Adult , Ego , Humans , Male , Telecommunications , TelemedicineABSTRACT
SARS-CoV-2 infection has evolved into a pandemic and a Public Health Emergency of International Importance that has forced health organizations at the global, regional and local levels to adopt a series of measures to address to COVID-19 and try to reduce its impact, not only in the social sphere but also in the health sphere, modifying the guidelines for action in the health services. Within these recommendations that include the Pain Treatment Units, patients with suspected or confirmed SARS-CoV-2 infection may be waiting for medical consult or interventional procedures for the management of chronic pain refractory to other therapies. A series of guidelines aimed at reducing the risk of infection of health personnel, other patients and the community are included in this manuscript.
ABSTRACT
Se presenta el caso clínico de una paciente femenino de 38 años de edad, vista en emergencia en un hospital de New York, que consulta por dolor abdominal, fiebre y astenia. Los estudios complementarios muestran linfopenia y leve alteración de transaminasas. Por TAC abdominopelvica, se visualiza imágenes en bases pulmonares, de tipo reticulonodular. Se le tomó muestra para COVID-19. Fue manejada en emergencias con hidratación parenteral, antipireticos, se le indica antibióticos por via oral y se instruye medidas sociales de aislamiento. Dos días después, consulta nuevamente, confirmadose COVID-19 positivo. Es seguida de manera ambulatoria, una semana después con buena evolución clínica. Adicionalmente se muestra una revisión clínica y explicación fisiopatológica del compromiso del tubo digestivo por el virus y la forma atípica de presentación con dolor abdominal
The clinical case of a 38-year-old female patient, seen in an emergency room in a New York hospital, who consults for abdominal pain, fever and fatigue is presented. Complementary studies show lymphopenia and slight alteration of transaminases. Abdominopelvic CT scan visualizes images in the lung bases, reticulonodular type. A sample was taken for COVID-19. She was managed in emergencies with parenteral hydration, antipyretics, oral antibiotics are indicated and social isolation measures are instructed. Two days later, it cost again, confirming positive COVID-19. It is followed on an outpatient basis, one week later with good clinical evolution. Additionally, a clinical review and pathophysiological explanation of the involvement of the digestive tract by the virus and the atypical form of presentation with abdominal pain are shown