RESUMEN
Patients on maintenance hemodialysis (MHD) are highly susceptible to SARS-CoV-2 and with high mortality rates due to Coronavirus disease 2019, mainly because of the older age in this group of patients, comorbidities, compromised immune status due to uremia, as well as inability to keep social isolation because of the necessity for regular physical presence in dialysis facility. Several retrospective studies of patients on MHD in Europe, America and Asia, show high susceptibility to SARS-CoV-2 in this group of patients with very high rates of critical course of the disease and high mortality rates, reaching more than 40% The aim of this retrospective observational study was to identify risk factors among patients on intermittent hemodialysis for infection with SARS-CoV-2 as well as predictors of severe COVID-19 and fatal outcome. Materials and methods. We analyzed 69 patients receiving intermittent dialysis in Aleksandrovska University Hospital - Hemodialysis Unit. 34 of them have been tested positive for SARS-CoV-2 in the period from September 2020 (when the first case of the disease was registered for our dialysis center) up to March 2022, and are compared with a control group of 35 dialysis-dependent patients without COVID-19. Data about comorbidities, main laboratory and radiologic findings, need of hospitalization and treatment in ICU, as well as data for conducted treatment, are collected from electronic medical records. To identify predictors of severe COVID and poor outcome we compared the group of survivors with the one of non-survivors. Results. There are no significant differences between patients on MHD with and without COVID-19 except higher frequency of COPD and hypoproteinemia in the positive group. Older age, female gender, history of smoking, lymphopenia with neutrophilia, treatment in ICU and need of mechanical ventilation, signs of malnutrition - hypoproteinemia and lower levels of serum creatinine, are risk factors for severe disease and fatal outcomes. Conclusions. The course of COVID infection in dialysis-dependent patients is severe and with high mortality rate, in line with other studies worldwide. Malnutrition is the main risk factor for COVID and also main predictor for poor outcomes.
RESUMEN
Artificial intelligence, digital health, telemedicine, portable sensors, virtual reality - these new technologies will completely change the way patients and doctors perceive healthcare. Digital health already has a huge impact on the way doctors work, it is very important what tasks it allows them to take on. There are many repetitive and monotonous tasks that most medical professionals do not like to do. Digital health solutions can make them better, faster and cheaper. These tasks usually do not require any creativity or empathy. The process of digital technologies entering healthcare is more complex than simply saying that artificial intelligence (AI) or robotics will take over medical work and activities. We live in unprecedented times. The new strain of coronavirus is spreading at an alarming rate, so much so that the World Health Organization (WHO) declared a pandemic on March 11. However, this strain of COVID-19, which is thought to have originated either by transfer from a non-human host or evolved into a pathogenic strain in the human population, is very real and causes suffering at every level of society. In particular, its virulent nature puts the elderly and the immunocompromised at higher risk. The development of the pandemic contributes to the widespread use of telemedicine. Prior to the pandemic, only 1 in 10 American patients used telemedicine services, according to a study by J.D. Power. But with COVID-19 the use of telehealth applications is increasing to 158% in the United States [3, 5]. The coronavirus pandemic has caused an explosive increase in the need for digital services, including those related to health and medicine. Many medical organizations (public and private) are starting to use telemedicine platforms and have announced the opening of free remote consultations between patients and doctors on COVID-19. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
RESUMEN
The relevance of the study is due to the increasing role of digital technologies in education. The abrupt shift of universities to distance learning during the COVID-19 pandemic has created new challenges. The purpose of this article is to analyze modern problems of traditional e-learning systems and identify the most effective digital technologies for improving the design system and implementing the content of professional educational programs at the university in the context of digitalization. Scientific articles in journals included in the Scopus database over the past five years, official websites of universities and their reports on the use of modern digital technologies were used as a statistical and empirical base for the study. Multiple comparative case studies and content analysis were applied. To solve the identified problems, such modern digital technologies and methods as cloud computing, adaptive design, big data, 3D printing, wearable technologies and gamification were proposed. The paper proposes an updated digital education system model at the university consisting of such elements as Instructors & Students, Master Courses, Content Delivery, Courses Collaboration, Progress Tracking, Assignments, Practices and Exams. The conclusions and recommendations formulated in this study can be used by different educational systems and universities.