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4.
J Laryngol Otol ; 134(8): 680-683, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: covidwho-604803

RESUMEN

BACKGROUND: The coronavirus disease 2019 pandemic requires urgent modification to existing head and neck cancer diagnosis and management practices. A protocol was established that utilises risk stratification, early investigation prior to clinical review and a reduction in aerosol generating procedures to lessen the risk of coronavirus disease 2019 spread. METHODS: Two-week wait referrals were stratified into low, intermediate and high risk. Low risk patients were referred back to primary care with advice; intermediate and high risk patients underwent investigation. Clinical encounters and aerosol generating procedures were minimised. A combined diagnostic and therapeutic surgical approach was undertaken where possible. RESULTS: Forty-one patients were used to assess feasibility. Thirty-one per cent were low risk, 35 per cent were intermediate and 33 per cent were high risk. Thirty-three per cent were discharged with no imaging. CONCLUSION: Implementing this protocol reduces the future burden on tertiary services, by empowering primary care physicians to re-refer low risk patients. The protocol is applicable across the UK and avoids diagnostic delay.


Asunto(s)
Infecciones por Coronavirus/transmisión , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Neoplasias de Cabeza y Cuello/patología , Procedimientos Quirúrgicos Otorrinolaringológicos/estadística & datos numéricos , Neumonía Viral/transmisión , Aerosoles , Betacoronavirus/aislamiento & purificación , Biopsia con Aguja Fina/instrumentación , Protocolos Clínicos , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Diagnóstico Tardío/prevención & control , Estudios de Factibilidad , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Londres/epidemiología , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/virología , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Derivación y Consulta , Medición de Riesgo , Neoplasias de la Tiroides/diagnóstico por imagen , Neoplasias de la Tiroides/patología , Neoplasias de la Tiroides/cirugía , Ultrasonografía Intervencional/métodos
6.
Crit Care ; 24(1): 334, 2020 06 12.
Artículo en Inglés | MEDLINE | ID: covidwho-594759

RESUMEN

The handheld ultrasound demonstrates clinical and economic value in combating COVID-19 based on interviews with frontline ultrasound physician and cardiologist as well as a national expert in medical ultrasound.


Asunto(s)
Betacoronavirus , Computadoras de Mano/normas , Infecciones por Coronavirus/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Ultrasonografía Intervencional/instrumentación , Actitud del Personal de Salud , Infecciones por Coronavirus/terapia , Diagnóstico por Computador/instrumentación , Humanos , Pandemias , Neumonía Viral/terapia , Sistemas de Atención de Punto , Ultrasonografía Intervencional/métodos
9.
BMC Cardiovasc Disord ; 20(1): 314, 2020 Jul 01.
Artículo en Inglés | MEDLINE | ID: covidwho-620066

RESUMEN

BACKGROUND: Coronary artery aneurysm (CAA) is a potential cause of infarction. During the outbreak of coronavirus disease 2019 (COVID-19), home isolation and activity reduction can lead to hypercoagulability. Here, we report a case of sudden acute myocardial infarction caused by large CAA during the home isolation. CASE PRESENTATION: During the outbreak of coronavirus disease 2019 (COVID-19),a 16-year-old man with no cardiac history was admitted to CCU of Tang du hospital because of severe chest pain for 8 h. The patient reached the hospital its own, his electrocardiogram showed typical features of anterior wall infarction, echocardiography was performed and revealed local anterior wall dysfunction, but left ventricle ejection fraction was normal, initial high-sensitivity troponin level was 7.51 ng/mL (<1.0 ng/mL). The patient received loading dose of aspirin and clopidogrel bisulfate and a total occlusion of the LAD was observed in the emergency coronary angiography (CAG). After repeated aspiration of the thrombus, TIMI blood flow reached level 3. Coronary artery aneurysm was visualized in the last angiography. No stent was implanted. Intravascular ultrasound (IVUS) was performed and the diagnosis of coronary artery aneurysm was further confirmed. The patient was discharged with a better health condition. CONCLUSIONS: Coronary artery aneurysm is a potential reason of infarction, CAG and IVUS are valuable tools in diagnosis in such cases, during the outbreak of coronavirus disease 2019 (COVID-19), home isolation and activity reduction can lead to hypercoagulability, and activities at home should be increased in the high-risk patients.


Asunto(s)
Infarto de la Pared Anterior del Miocardio , Aneurisma Coronario , Angiografía Coronaria/métodos , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Trombectomía/métodos , Ultrasonografía Intervencional/métodos , Adolescente , Infarto de la Pared Anterior del Miocardio/diagnóstico , Infarto de la Pared Anterior del Miocardio/etiología , Infarto de la Pared Anterior del Miocardio/fisiopatología , Infarto de la Pared Anterior del Miocardio/cirugía , Betacoronavirus/aislamiento & purificación , China/epidemiología , Aneurisma Coronario/complicaciones , Aneurisma Coronario/diagnóstico por imagen , Ecocardiografía/métodos , Electrocardiografía/métodos , Humanos , Masculino , Pandemias , Medición de Riesgo , Factores de Riesgo , Resultado del Tratamiento
10.
J Cardiothorac Vasc Anesth ; 34(7): 1727-1732, 2020 07.
Artículo en Inglés | MEDLINE | ID: covidwho-45999

RESUMEN

The COVID-19 pandemic is spreading globally. COVID-19 has an effect on the systemic state, cardiopulmonary function and primary disease of patients undergoing surgery. COVID-19's high contagiousness makes anesthesia and intraoperative management more difficult. This expert consensus aims to comprehensively introduce the application of perioperative ultrasound in COVID-19 patients, including pulmonary ultrasound and anesthesia management, ultrasound and airway management, ultrasound-guided regional anesthesia and echocardiography for COVID-19 patients.


Asunto(s)
Anestesia/métodos , Betacoronavirus , Infecciones por Coronavirus/diagnóstico por imagen , Atención Perioperativa/métodos , Neumonía Viral/diagnóstico por imagen , Ultrasonografía/métodos , Manejo de la Vía Aérea/métodos , Anestesia de Conducción/métodos , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/diagnóstico por imagen , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/transmisión , Ecocardiografía/métodos , Hemodinámica , Humanos , Pulmón/diagnóstico por imagen , Enfermedades Pulmonares/diagnóstico por imagen , Enfermedades Pulmonares/microbiología , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/transmisión , Traqueotomía/métodos , Ultrasonografía Intervencional/métodos , Desconexión del Ventilador/métodos
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