Objetivo Comparar la actividad del Servicio de Urología de un Hospital Universitario Portugués durante el estado de alarma y el periodo equivalente del año anterior. Comparamos el número de consultas electivas y pruebas diagnósticas urológicas, el número y el tipo de cirugías electivas, así como las características demográficas de los pacientes y las principales causas de ingreso al Servicio de Urgencias (SU) de Urología durante los dos periodos mencionados. Materiales y métodos Los datos de 691 pacientes que acudieron a urgencias desde el 18 de marzo de 2020 hasta el 2 de mayo de 2020 -y del mismo periodo del año anterior- se recogieron del software medico institucional. Los datos recopilados fueron edad, sexo, fecha de visita al servicio de urgencias, derivación desde otros hospitales, color del triaje, causa del ingreso, diagnóstico al alta y la necesidad de cirugía de urgencia u hospitalización. Con la intención de identificar las asociaciones entre las variables demográficas y clínicas con el hecho de haber sido sometido a una cirugía de urgencia (variable), se aplicaron modelos de regresión logística. Resultados El análisis multivariante mostró asociación entre el sexo del paciente con el hecho de ser sometido a una cirugía, con una disminución del 65,6% en las probabilidades para el género masculino. El periodo (COVID versus sin-COVID) no mostró una asociación significativa con la cirugía. Conclusión Nuestro departamento experimentó una reducción importante en la actividad. También observamos una reducción de las causas urgentes para acudir a los servicios de urgencias considerados menos graves. El porcentaje de casos que requirieron cirugía de urgencia y hospitalización fue mayor durante el periodo COVID.
Objective To compare the activity the Urology Department of a Portuguese Academic Hospital during the state of emergency and the equivalent period at the previous year. We compared the number of elective consultations and diagnostic urologic examinations, number and type of elective surgeries, as well as patients’ demographic characteristics and main causes of presentation to Urology Emergency Department (ED) during the two mentioned periods. Materials and methods Data from 691 patients coming to emergency department were collected from institutional clinical software from March 18th 2020 to May 2nd 2020—and from the same period the previous year. Data collected were age, sex, day of the presentation to Emergency Department, referral from other hospitals, triage color, reason of admission, diagnosis of discharge, and the need for emergency surgery or hospitalization. In order to identify associations between demographic and clinical variables with having been submitted to an emergency surgery (outcome), logistic regression models were applied. Results Multivariable analysis showed an association of sex with being submitted to surgery, 65.6% decrease in the odds for the male gender. The period (COVID versus non-COVID) did not show a significant association with surgery. Conclusion Our department experienced an noticeable activity reduction. We also observe a reduction in urgent causes to attend the ED considered less serious. The percentage of cases requiring emergency surgery and hospitalization was higher during COVID-period.
Purpose Multidisciplinary team (MDT) conferences are currently the standard of care in cancer patients' management. Despite evidence supporting benefits to the majority of malignancies, a paucity of data exists examining the impact in urinary and male genital cancers. This study aims to evaluate the impact of MDT conferences in urologic cancer practice. Methods Clinical plans discussed in urologic MDT conferences in Centro Hospitalar Universitário de Lisboa Central between January 2019 and December 2019 were retrospectively analysed. Clinical plans were categorized as accepted, changed, rejected (cases that had to be re-presented to the MDT because of insufficient staging or administrative issues) or no plan. MDT conferences' impact was assessed according to type of consultation, referral medical specialty and primary tumour type. Results 710 clinical plans were discussed at the MDT conferences. 61.8% were accepted, 10.6% were changed, 16.5% were rejected and 11.1% of cases referred to MDT discussion had no defined clinical plan. First consultations had a higher rate of accepted clinical plans (63.4%) versus subsequent consultations (56.4%). Referrals by the urology specialty had the highest rate of acceptances (64.3%). On the stratification by primary tumour site, testicular cancer had the highest acceptance rate (70.3%), whereas bladder cancer had the lowest (47.8%). Conclusions MDT conferences had an important impact in the management of 38.2% of cases. Therefore, all patients with urologic malignancies should be referred to MDT review to ensure optimal clinical care.
Relatar vivência profissional de uma equipe multiprofissional em cuidados paliativos durante pandemia de Covid-19. Relato da experiência profissional, dos desafios enfrentados e estratégias implementadas por equipe multiprofissional em cuidados paliativos, durante pandemia de Covid-19 em hospital universitário do Estado do Rio de Janeiro. A diversidade das experiências e desafios relatados pelos profissionais destaca as estratégias implementadas para garantia da continuidade do cuidado ao paciente em cuidados paliativos, no contexto da pandemia. A implementação das ações do plano de contingências da instituição assegurou um cuidado com segurança para o paciente, familiares e profissional. O isolamento e distanciamento social impuseram a reorganização da dinâmica do atendimento. A reorganização das estratégias da assistência, possibilitou cumprir as regras de segurança impostas pela pandemia, afirmando paciente e família como centro do cuidado e mantendo como meta sua qualidade de vida. A diversidade das experiências reforça a singularidade do cuidar.Descritores: Cuidados Paliativos, Infecções por Coronavirus, Serviço Hospitalar de Oncologia, Equipe de Assistência ao Paciente. Palliative cancer care in the COVID-19 pandemic: experience reportAbstract: To report the professional experience of a multidisciplinary team in palliative care during the Covid-19 pandemic. Report of professional experience, challenges faced and strategies implemented by a multidisciplinary team in palliative care, during the Covid-19 pandemic in a university hospital in the State of Rio de Janeiro. The diversity of experiences and challenges reported by the professionals highlights the strategies implemented to guarantee the continuity of patient care in palliative care, in the context of the pandemic. The implementation of the institution's contingency plan actions ensured safe care for the patient, family and professional. The isolation and social distance imposed the reorganization of the service dynamics. The reorganization of care strategies made it possible to comply with the safety rules imposed by the pandemic, affirming the patient and family as the center of care and maintaining their quality of life as a goal. The diversity of experiences reinforces the uniqueness of care.Descriptors: Palliative Care, Coronavirus Infections, Oncology Service Hospital, Patient Care Team. Cuidados paliativos contra el cáncer en la pandemia de COVID-19: informe de experienciaResumen: Reportar la experiencia profesional de un equipo multidisciplinario en cuidados paliativos durante la pandemia Covid-19. Reporte de experiencia profesional, desafíos enfrentados y estrategias implementadas por un equipo multidisciplinario en cuidados paliativos, durante la pandemia Covid-19 en un hospital universitario del Estado de Rio de Janeiro. La diversidad de experiencias y desafíos reportados por los profesionales destaca las estrategias implementadas para garantizar la continuidad de la atención al paciente en cuidados paliativos, en el contexto de la pandemia. La implementación de las acciones del plan de contingencia de la institución garantizó una atención segura para el paciente, la familia y el profesional. El aislamiento y la distancia social impusieron la reorganización de la dinámica del servicio. La reorganización de las estrategias de atención permitió cumplir con las normas de seguridad impuestas por la pandemia, afirmando al paciente y su familia como centro de atención y manteniendo como meta su calidad de vida. La diversidad de experiencias refuerza la singularidad del cuidado.Descriptores: Cuidados Paliativos, Infecciones por Coronavirus, Servicio de Oncología en Hospital, Grupo de Atención al Paciente.
O presente artigo discorre sobre aplicação de uma avaliação pós ocupação (APO) na Praça Central em Carolina/MA. Esta praça, sendo um patrimônio histórico e cultural, sofreu intervenção por meio de uma obra no ano de 2022 e, deste modo, percebeu-se a necessidade de avaliar tal desempenho pós reforma. Foram realizados levantamentos e pesquisas de dados referente a praça e o seu processo de ocupação, bibliografado desde a década de 60, assim como a caracterização do seu entorno e os seus usuários. A metodologia utilizada para o desenvolvimento deste artigo partiu inicialmente pelo tema patrimônio cultural, praças ajardinadas, praças urbanas e avaliação pós-ocupação, em seguida foram aplicados métodos qualitativos por meio da APO e levantamentos de dados “in loco” para reconhecimento do ambiente de estudo. As análises de campo, mapeamentos, questionário de avaliação do ponto de vista dos usuários a respeito da praça possibilitaram uma reflexão acerca do desempenho de obras realizadas em espaços público que fazem parte de um patrimônio histórico gerando resultados para possíveis reformas e projetos futuros.
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