ABSTRACT
Aim: The opinion of hemodialysis patients, professionals and family members is rarely considered in the design of a hemodialysis unit. Purpose: To know and compare the opinion and preferences of patients, family members and professionals regarding the design of a dialysis unit and the potential activities they believe should be carried out during the session in order to provide architects with real information for the construction of a dialysis center. Patients and Methods: Anonymous and voluntary survey in electronic format addressed to patients, relatives and professionals belonging to the 18 hemodialysis centers of the renal foundation and to ALCER and its different delegations, in relation to leisure activities to be carried out in the dialysis center and preferred design of the treatment room. The results obtained between the patient-family group and the professionals were compared. Results: We received 331 responses, of which 215 were from patients and family members (65%) and 116 (35%) from professionals. The most represented category among professionals was nursing (53%), followed by assistants (24%) and physicians (12.9%). A higher proportion of patients (66%) preferred rooms in groups of 10-12 patients as opposed to professionals who preferred open-plan rooms (p<0.001). The options that showed the most differences between patients and professionals were chatting with colleagues and intimacy (options most voted by patients/families), versus performing group activities and visibility (professionals). Conclusion: The professionals' view of patients' needs does not always coincide with the patients' perception. The inclusion of the perspective of people with kidney disease continues to be a pending issue in which we must improve both patient organizations and professionals, and the opinion of professionals and patients must be included in the design of a dialysis unit and the activities to be developed in it.
ABSTRACT
(1) Background: The impact of SARS-CoV-2 has been variable over the time course of the pandemic and in different populations. The aim was to analyze the impact of COVID-19 infection in a known population of hemodialysis (HD) patients and professionals in Spain at different times of the pandemic. (2) Methods: We conducted an observational, descriptive study with a follow-up from 3 March 2020 to 23 April 2022 (776 days), using in average of 414 professionals and 1381 patients from 18 HD units in Spain. The data from the positive PCR or the rapid antigen detection test (RADT) subject were analyzed and segmented into six periods (waves). (3) Results: Of 703 positive COVID-19 tests, 524 were HD patients (74.5%), and 179 were HD professionals (25.5%). Overall, 38% of staff and 43% of patients were affected. Differences were observed in regard to incidence (21% vs. 13%), mortality (3.5% vs. 0%), and symptomatology between the patients and professionals and throughout the pandemic. (4) Conclusions: COVID-19 severity varied during different pandemic waves, with a greater impact seen in the first wave. HD professionals and patients had similar infection rates, but patients had higher mortality rates. Community transmission was the primary route of infection.
ABSTRACT
BACKGROUND: The impact of the pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in low- and middle-income countries remains poorly understood. Our aim was to understand the characteristics and outcomes of PIMS-TS in Argentina. METHODS: This observational, prospective, and retrospective multicenter study enrolled patients younger than 18 years-old manifesting PIMS-TS, Kawasaki disease (KD) or Kawasaki shock syndrome (KSS) between March 2020 and May 2021. Patients were followed-up until hospital discharge or death (one case). The primary outcome was pediatric intensive care unit (PICU) admission. Multiple logistic regression was used to identify variables predicting PICU admission. RESULTS: Eighty-one percent, 82%, and 14% of the 176 enrolled patients fulfilled the suspect case criteria for PIMS-TS, KD, and KSS, respectively. Temporal association with SARS-CoV-2 was confirmed in 85% of the patients and 38% were admitted to the PICU. The more common clinical manifestations were fever, abdominal pain, rash, and conjunctival injection. Lymphopenia was more common among PICU-admitted patients (87% vs. 51%, p < 0.0001), who also showed a lower platelet count and higher plasmatic levels of inflammatory and cardiac markers. Mitral valve insufficiency, left ventricular wall motion alterations, pericardial effusion, and coronary artery alterations were observed in 30%, 30%, 19.8%, and 18.6% of the patients, respectively. Days to initiation of treatment, rash, lymphopenia, and low platelet count were significant independent contributions to PICU admission. CONCLUSION: Rates of severe outcomes of PIMS-TS in the present study agreed with those observed in high-income countries. Together with other published studies, this work helps clinicians to better understand this novel clinical entity.
Subject(s)
COVID-19 , Lymphopenia , Mucocutaneous Lymph Node Syndrome , Thrombocytopenia , Child , Humans , Adolescent , COVID-19/complications , SARS-CoV-2 , Argentina , Prospective Studies , Systemic Inflammatory Response Syndrome/complications , Mucocutaneous Lymph Node Syndrome/complications , Thrombocytopenia/complications , Lymphopenia/complicationsABSTRACT
[RESUMEN]: La transposición de grandes vasos es una cardiopatía congénita relativamente frecuente, con baja mortalidad y baja morbilidad si es intervenida quirúrgicamente en el periodo neonatal. Nuestro objetivo es presentar un caso clínico. Se trata de un recién nacido de 7 días de vida que fue derivado del Hospital Oñativia por sospecha de cardiopatía congénita por cianosis persistente. Fue evaluado clínicamente por el Servicio de Cardiología Infantil, se complementó la valoración con un Ecocardiograma transtorácico bidimensional Doppler color. Se realizó el diagnóstico de transposición de grandes vasos con comunicación interventricular muscular grande, aneurisma del septum interventricular y sospecha de anomalía coronaria con trayecto intramural. Fue operado a los 19 días de vida con técnica de switch arterial, cierre de comunicación interventricular, resección del aneurisma del septum y reimplante de las arterias coronarias. Evolucionó exitosamente sin defectos residuales significativos y con ritmo sinusal a su egreso hospitalario.
[ABSTRACT]: Transposition of the great arteries is a relatively frequent congenital heart disease, with low morbidity and mortality if surgery is performed in neonatal period. We aim to describe a case report: A 7 days old newborn was referred from Oñativia Hospital with suspected congenital heart disease due to persistent cyanosis. The child was clinically assessed by the pediatric cardiology department, supporting the evaluation with a transthoracic echocardiogram. A diagnosis of transposition of the great arteries with large ventricular septal defect, interventricular septum aneurysm and probable intramural coronary anomaly was made. An arterial switch procedure was performed at 19 days old, with closure of the ventricular septal defect, resection of the aneurysm of the ventricular septum and coronary arteries reimplantation. The patient evolved favorably, without significant residual defects and with sinus rhythm at the moment of the discharge.
Subject(s)
Transposition of Great Vessels , AneurysmABSTRACT
Tetralogy of Fallot is the most frequent cyanotic congenital heart disease. This is a case report of a pediatric patient who underwent her surgery with the monitorization of tranesopageal echocardiography
La tetralogía de Fallot es la cardiopatía congénita cianosante más frecuente. Se presenta un caso clínico de un paciente pediátrico que se monitorizó con ecocardiografía transesofágica intraoperatoria y se muestran las imágenes y los cambios en el manejo debido a la monitorización ecocardiográfica.
