ABSTRACT
INTRODUCTION: The SARS-CoV-2 virus that causes the COVID-19 disease is transmitted through the inhalation of droplets or aerosols and inoculation via the oronasal or ocular routes, transforming the management of swallowing disorders into a challenge for healthcare teams, given their proximity to the aerodigestive tract and the high probability of aerosol generation during patient evaluation and treatment. AIM: To provide essential guidance for Latin American multidisciplinary teams, regarding the evaluation and treatment of oropharyngeal and esophageal dysphagia, at the different levels of healthcare. The position statement was formulated for the purpose of maintaining medical service continuity, in the context of a pandemic, and minimizing the propagation and infection risks of the virus. METHODS: Thirteen experts in swallowing disorders were summoned by the Latin American Dysphagia Society to formulate a series of clinical suggestions, based on available evidence and clinical experience, for the management of dysphagia, taking the characteristics of Latin American healthcare systems into account. RESULTS: The position statement of the Latin American Dysphagia Society provides a series of clinical suggestions directed at the multidisciplinary teams that manage patients with oropharyngeal and esophageal dysphagia. It presents guidelines for evaluation and treatment in different contexts, from hospitalization to home care. CONCLUSIONS: The present statement should be analyzed by each team or healthcare professional, to reduce the risk for COVID-19 infection and achieve the best therapeutic results, while at the same time, being mindful of the reality of each Latin American country.
Subject(s)
COVID-19 , Deglutition Disorders , Deglutition Disorders/epidemiology , Deglutition Disorders/therapy , Humans , Latin America/epidemiology , Pandemics , SARS-CoV-2ABSTRACT
INTRODUCTION: The SARS-CoV-2 virus that causes the COVID-19 disease is transmitted through the inhalation of droplets or aerosols and inoculation via the oronasal or ocular routes, transforming the management of swallowing disorders into a challenge for healthcare teams, given their proximity to the aerodigestive tract and the high probability of aerosol generation during patient evaluation and treatment. AIM: To provide essential guidance for Latin American multidisciplinary teams, regarding the evaluation and treatment of oropharyngeal and esophageal dysphagia, at the different levels of healthcare. The position statement was formulated for the purpose of maintaining medical service continuity, in the context of a pandemic, and minimizing the propagation and infection risks of the virus. METHODS: Thirteen experts in swallowing disorders were summoned by the Latin American Dysphagia Society to formulate a series of clinical suggestions, based on available evidence and clinical experience, for the management of dysphagia, taking the characteristics of Latin American healthcare systems into account. RESULTS: The position statement of the Latin American Dysphagia Society provides a series of clinical suggestions directed at the multidisciplinary teams that manage patients with oropharyngeal and esophageal dysphagia. It presents guidelines for evaluation and treatment in different contexts, from hospitalization to home care. CONCLUSIONS: The present statement should be analyzed by each team or healthcare professional, to reduce the risk for COVID-19 infection and achieve the best therapeutic results, while at the same time, being mindful of the reality of each Latin American country.
ABSTRACT
BACKGROUND: Patient satisfaction is a cognitive and emotional evaluation of the patient on the performance of health staff and is based on relevant aspects of their experience in health care. AIM: To determine the satisfaction level of patients after an endoscopic procedure in the gastrointestinal endoscopy service Specialty Hospital National Medical Center La Raza and to evaluate associated factors. MATERIAL AND METHODS: A modified and validated questionnaire was applied to assess patient satisfaction after an endoscopic procedure (mGHAA-9) in patients who underwent a gastroscopy or colonoscopy. Factors that influenced patient satisfaction were assessed. RESULTS: Two-hundred questionnaires were applied (response rate: 89.5%), in 62 men (34.6%) and 117 women (65.4%). Mean patient age was 51.3 years. The average score for the overall group was 30.9 (maximum score of 35). In the overall assessment of satisfaction patients reported 60.9% excellent, very good 29.6%, good 8.9% and 0.6% regular. Factors that influenced patient satisfaction were: waiting time for appointment (OR 3.104), explaining and answering questions (OR 2.961) and waiting time for performing the procedure (OR 2.408) Some factors did not influence on patient satisfaction: Sex: Male 58.1%, female 62.4% (p = 0.63), age 52 vs. 50 years (p = 0.48) and sedation 64.7% vs. 60.5% (p = 0.8) CONCLUSIONS: The level of satisfaction of patients undergoing a gastroscopy or colonoscopy is good. The factors that influence the satisfaction of these patients are related to communication between doctor and patient, and waiting time for the study.
Subject(s)
Endoscopy, Gastrointestinal , Patient Satisfaction , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Surveys and Questionnaires , Young AdultABSTRACT
BACKGROUND: There is a high prevalence of dyspepsia and obesity in Mexican population. A relationship between obesity and dyspeptic symptoms has been proposed. OBJECTIVE: To determine prevalence of dyspeptic symptoms in patients with normal weight, overweight and obesity. METHODS: Prospective study on consecutive patients who attend for medical assistance for any reason in a first level medical center. Weight, height, and body mass index (BMI) were measured. A validated questionnaire for dyspepsia was applied. RESULTS: Three-hundred and twenty patients were included (61.6% women, n = 197). The mean patient age was 37 ± 14.4 years old. Mean BMI was 26.68 with 42.2% of patients (n = 135) overweight, 35.6% (n = 114) with normal weight and 22.2% (n = 71) were obese. Compared to patients with normal weight and overweight the obesity group showed a higher prevalence of gastritis symptoms, pain, stomachache, heartburn, a worst quality of life, and a higher frequency of medication intake. Patients with overweight presented a higher score in quality of life and treatment compared with normal weight patients. CONCLUSIONS: Obese patients showed a higher prevalence of dyspeptic symptoms compared to normal weight and overweight patients.
Subject(s)
Dyspepsia/complications , Obesity/complications , Adult , Aged , Body Mass Index , Body Weight/physiology , Dyspepsia/epidemiology , Female , Humans , Male , Mexico/epidemiology , Middle Aged , Obesity/epidemiology , Overweight/complications , Prevalence , Prospective StudiesABSTRACT
BACKGROUND: There is a need to evaluate the process of quality improvement in health care services. AIMS: To determine quality indicators, frequencies into the registry of upper gastrointestinal endoscopies in a tertiary academic hospital in Mexico City. MATERIAL AND METHODS: A retrospective, observational and transversal study was performed in the Specialty Hospital Dr. Antonio Fraga Mouret IMSS between July 2007 and June 2008. Registry of several quality indicators for upper gastrointestinal endoscopy was sought. RESULTS: A total of 485 endoscopic reports were included. The reason for upper endoscopy was as follows: Barrett's esophagus 161, esophageal dilation 133, gastric ulcer 82, peptic ulcer 120, and upper gastrointestinal bleeding 130. The indicators evaluated were: Informed consent 91.3%, complete examination 97.7%, Barrett's esophagus measured and biopsy specimens taken 85.7% y 96.2% respectively. Biopsy specimens were taken in gastric ulcer 87.8%. Description and localization of upper gastrointestinal lesion 99.2%, ulcer haemostatic treatment 98.2%, and haemostasis documented 94.6%, proton pump inhibitors were recommended to patients undergone esophageal dilation and peptic ulcer 80.3% y 29.2% respectively. CONCLUSIONS: Registry frequencies of quality indicators were high for upper gastrointestinal bleeding, completeness of examination and Barrett's oesophagus. Pharmacological treatment recommendation in peptic disease is an area that has to be improved. It was not possible to establish either the indicator or only its register was omitted. Key words: Quality indicators, endoscopy, registries, gastroscopy, consent forms, Mexico.
