Introduction: Preventing and fighting COVID-19 are of the utmost importance. In this context, the importance of using telemedicine tools has grown, including teleconsultations, epidemiological telemonitoring, remote diagnosis, support, and training of health professionals. Objective: This article aims to report the results of a distance-training course on SARS-CoV-2 and COVID-19. We analyze the course adherence, the students’ profile, pre, and post-test proficiency index and satisfaction with the course. Methods: This is a cross-sectional study that evaluated data from the course on SARS-CoV-2 and COVID-19. The data were analyzed in terms of distribution and comparisons of means and frequencies. A paired t-test was used to compare the pre and post-test grades. A p-value <0.05 was considered significant. Data were collected from the Moodle teaching platform, without identifying the participants. Results: From March 23 to May 14, the course was offered to 1,008 medical students and health care providers. Most were from the state of Minas Gerais, some from other Brazilian states, and Mozambique. The majority completed the course, with an 89.8% adherence. The evaluations related to the course, the tutors, the degree of satisfaction, and the security for the professional performance after the course obtained maximum scores. The comparison between the pre and post grades showed proficiency gain (p<0.0001). Conclusion: The course has contributed to the training of medical students and health professionals from Brazil and Mozambique. The organizing committee was able to prepare students and provide knowledge to professionals with difficulty to access good technical and evidence-based information. After the training, the students were selected to work on university projects aiming at supporting city halls, health departments, and the community.
Introdução: A Pandemia de COVID 19 trouxe, em curto espaço de tempo, um grande número de pacientes infectados com cerca de 20% deles evoluindo para a forma severa ou crítica da doença, com necessidade de internação hospitalar (WHO, 2021). A grande busca por serviços de saúde e o elevado número de mortes trouxe pressa à ciência para o descobrimento de possíveis medicamentos e ações terapêuticas que mitigassem as consequências danosas da pandemia. Objetivos: Assim, o presente estudo se presta a discutir, à luz das melhores evidências e recomendações, os principais fármacos analisados no tratamento da doença (dexametasona, tocilizumabe, remdesivir, imunoglobulina, ivermectina e hidroxicloroquina, entre outros), suas indicações (ou contraindicações) e formas de uso. Métodos: Será feita uma revisão ampla da literatura em bases de dados, de informações médicas e de artigos científicos, conhecidas da comunidade científica, como o Uptodate®, Dynamed®, Scielo®, PubMed®, Google Scholar®, entre outras, a fim de se compilar as melhores evidências e indicações para cada tratamento farmacológico, os descritores utilizados nas pesquisas foram “ fármaco em questão” AND “ treatment of COVID-19”. Resultados: Dentre as atuais recomendações: demonstrou-se benefício que superam possíveis riscos para o uso de Dexametasona em pacientes que precisem de suporte de oxigênio; o toxilizumab tem sua recomendação de uso com benefícios em pacientes que evoluem para o estado grave ou crítico, ou para aqueles que persistem com marcadores inflamatórios altos apesar da terapia com dexametasona; o redemsivir também demostrou seu maior benefício clínico em pacientes hospitalizados, sob oxigenoterapia de baixo fluxo; a associação bamlavizumab/etesevisumab demostrou possível benefício para pacientes com a forma leve da doença que apresentem condições de risco para desfecho clínico desfavorável. Dentre os outros fármacos, não indicação específica para seu uso, ou carecem de mais ensaios clínicos de qualidade. Conclusões: Foram encontradas recomendações formais de uso de alguns fármacos para o tratamento da COVID-19, como a Dexametasona, o Tocilizumab, Redemsivir e bamlavizumab/etesevisumab, enquanto outros carecem de estudos mais robustos para uso fora do contexto de ensaios clínicos.
Objective: Describe and analyze the knowledge of cardiologists on the prophylaxis of Rheumatic Fever (RF). Method: Application of questionnaire to cardiologists and cardiology residents March/2012 to December/2014. Results: The questionnaire was answered by 52 cardiologists 37 (71.8 %) specialists and 15 (28.9 %) cardiology residents. The average time for the formation of the group was 19.28 (±10.16) years, 39 (75 %) work in outpatient SUS, 34 (65%) in private practice. Of these 26 (50%) reported not having followed any cases of acute RF in the last year and 9 (17.3%) said they had not accompanied chronic RF cases last year. Among the 35 respondents (67.3%) report that they attended to most cases in the past and 37 (71.2 %) believe that there has been a decline in the disease. Although the majority, 47 (90.4 %) have knowledge about the last guideline of treatment and diagnosis of RF, the accuracy rate of all therapeutic options used in primary prophylaxis of these patients was 5 (9.6%) and secondary 7 (13.4 %), however 49 (94.2 %) made reference to benzathine penicillin as an option. Conclusions: The current study identified that, although RF is still an important clinical condition in our environment, the physicians interviewed did not show adequate knowledge on the subject, which could be related to poor patient adherence to RF prophylaxis. Greater attention should be devoted to continuing education on RF, which is a disease often neglected.
Chronic Obstructive Pulmonary Disease (COPD) is a lung disease, often associated with smoking. COPD patients have persistent, including urinary incontinence. Therefore, a research has the general objective of knowing the physiological mechanism of urinary incontinence associated with the pharmacological treatment of COPD. As a methodological process, this study is an integrative review that included randomized clinical trials, quasi-experimental intervention studies, cohort and case-control. The selection of studies was carried out in the databases PubMed, SciELO, Science Direct and BVS (Virtual Health Library), published between 2010 and July 2020, in Portuguese and English. Pharmacological classes SABA, LABA, SAMA, LAMA, ICS and iPDE4 were considered to investigate adverse effects and check for the presence of urinary symptoms caused by these drugs. In the results and discussion, 113 articles were identified with the investigated descriptors. After the article selection process, 14 studies resulted: PubMED (13); and Science Direct (1). The pharmacological class related to urinary incontinence identified in this study was that of anticholinergics / antimuscarinics. From this perspective, it can be considered that Urinary Incontinence has a low relationship with the adverse effects of drugs for the treatment of Chronic Obstructive Pulmonary Disease (COPD). However, as urinary incontinence is not considered a life-threatening problem, it is possible that it has not been included among the adverse events to be explored.
O objetivo desta pesquisa foi encontrar e avaliar a eficácia e a segurança do uso de plasma de pacientes recuperados para o tratamento de pacientes graves com COVID-19 (SARS-CoV-2), atraves de série de casos. A bsuca ocorreu nas bases de dados científicas como, Lilacs, MEDLINE, Google Academics, Scielo e Science Direct. Após a aplicação dos filtros para busca avançada, e do rastreamento por título, foi feito a leitura dos resumos pré-inclusos, depois avaliados na integra para extração de dados e síntese das informações e resultados. Ao final, três estudos observacionais do tipo série de casos foram incluídos. Os pacientes em estudo, estava usando madicamentos de forma paralela ao procedimento (ex.: antibioticios, antiviais e esteroides). Os pacientes, de forma geral, tiveram melhoras na maioria dos sintomas clinicos, como também, na diminuição dos títulos virais do SARS-CoV-2, nenhum evento adverso foi passivo de alerta. Conclue-se que as evidências encontradas neste trabalho são heterogênas e com bastante limitações, acerca de dose tranfundida, tempo de tratamento e critérios para elegir os pacientes, assim, devido as restrinções apresentadas, se faz necessiário realizações de ensaios clínicos com desenhos de estudo delineados, para certificar a segurança e efetividade do tratamento.
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