PANDEMIA COVID-19: INFORME DE EXPERIENCIA EN EL INSTITUTO COUTO MAIA (TELEICOM), SALVADOR, BAHIA, BRASIL

Relato de experiência de implementação de Teleatendimento do Instituto Couto Maia (TELEICOM) no atendimento de familiares e responsáveis dos pacientes internados com diagnóstico de covid-19 associados ou não a outras patologias em leitos de enfermarias e Unidades de Tratamento Intensivo (UTI) do Instituto Couto Maia. No período de Março a Setembro de 2020 os familiares e/ou responsáveis de todos os pacientes internados e acompanhados pelos médicos residentes ou plantonistas recebiam ligações telefônicas, diariamente, de 2 a 3 médicos de diversas especialidades com informações das situações clínicas dos mesmos. O ICOM disponibilizava computadores com o prontuário eletrônico, telefones e a colaboração do(a)s assistentes sociais, a fim de garantir a manutenção dos atendimentos destes familiares/responsáveis. O TELEICOM, no período de 01/04/2020 a 30/09/2020, realizou 12.101 ligações telefônicas. O perfil dos pacientes internados foi, em sua maioria, homens. O predomínio, nos recebimentos das chamadas telefônicas, foi de mulheres. Da cidade de Salvador vinham cerca de 74,5 % dos pacientes e demais do interior da Bahia ou outros estados. Nesses meses de experiência de teleatendimento, o TELEICOM tem se mostrado um recurso eficiente para atendimento de familiares/responsáveis com demandas, possibilitando o atendimento remoto com qualidade, de acordo com as avaliações positivas recebidas através da equipe multiprofissional e da ouvidoria deste hospital.Experience report of implementation of Teleservice at the Couto Maia Institute (TELEICOM) in the care of family members and guardians of hospitalized patients with a diagnosis of covid-19 associated or not with other pathologies in ward beds and Intensive Care Units (ICU) of the Couto Institute Mayan. From March to September 2020, family members and/or guardians of all hospitalized patients and accompanied by resident physicians or on-call physicians received daily phone calls from 2 to 3 physicians from different specialties with information on their clinical situations. ICOM provided computers with electronic medical records, telephones and the collaboration of social workers, in order to guarantee the maintenance of care for these family members/guardians. TELEICOM, from 04/01/2020 to 09/30/2020, made 12,101 telephone calls. The profile of hospitalized patients was mostly men. The predominance in receiving phone calls was women. About 74.5% of the patients came from the city of Salvador and others from the interior of Bahia or other states. In these months of teleservice experience, TELEICOM has proven to be an efficient resource for caring for family/guardians with demands, enabling quality remote care, according to the positive evaluations received by the multidisciplinary team and the ombudsman of this hospital.Informe de experiencia de implementación de Teleservicio en el Instituto Couto Maia (TELEICOM) en la atención de familiares y tutores de pacientes hospitalizados con diagnóstico de covid-19 asociado o no a otras patologías en camas de planta y Unidades de Cuidados Intensivos (UCI) del Instituto Couto Maya. De marzo a septiembre de 2020, familiares y/o tutores de todos los pacientes hospitalizados y acompañados de médicos residentes o de guardia recibieron llamadas telefónicas diarias de 2 a 3 médicos de diferentes especialidades con información sobre su situación clínica. El ICOM proporcionó computadoras con historia clínica electrónica, teléfonos y la colaboración de los trabajadores sociales, con el fin de garantizar el mantenimiento del cuidado de estos familiares/tutores. TELEICOM, del 01/04/2020 al 30/09/2020, realizó 12.101 llamadas telefónicas. El perfil de los pacientes hospitalizados fue mayoritariamente masculino. El predominio en la recepción de llamadas telefónicas fue el de mujeres. Alrededor del 74,5% de los pacientes procedían de la ciudad de Salvador y otros del interior de Bahía u otros estados. En estos meses de experiencia en teleservicio, TELEICOM ha demostrado ser un recurso eficiente para el cuidado de familiares/tutores con demandas, posibilitando una atención remota de calidad, según las valoraciones positivas recibidas por el equipo multidisciplinario y el ombudsman de este hospital

Puerperal brain cryptococcoma in an HIV-negative woman successfully treated with fluconazole: a case report

Cryptococcus spp. cerebral abscesses are uncommon in immunocompetent subjects. The recommended induction treatment is the administration of amphotericin B plus flucytosine combined with resection for lesions ≥3cm. In this paper, we describe an HIV-negative woman diagnosed with a large cryptococcoma in the immediate postpartum period. The lesion was not resected, and due to amphotericin B intolerance, she received an extended course of fluconazole monotherapy. There was no disease recurrence during the 4 years of follow-up. The abrupt onset of her symptoms following delivery suggests that she developed a postpartum immune reconstitution syndrome. This case also demonstrates that in specific situations fluconazole monotherapy can be attempted in immunocompetent patients with cryptococcoma

Puerperal brain cryptococcoma in an HIV-negative woman

Submitted by Ana Maria Fiscina Sampaio ([email protected]) on 2014-06-04T18:57:23Z No. of bitstreams: 1 Hagan JE Puerperal brain....pdf: 1140839 bytes, checksum: 3c06df73ae5d23f154cfd27b464cbab1 (MD5)Made available in DSpace on 2014-06-04T18:57:23Z (GMT). No. of bitstreams: 1 Hagan JE Puerperal brain....pdf: 1140839 bytes, checksum: 3c06df73ae5d23f154cfd27b464cbab1 (MD5) Previous issue date: 2014Yale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, CT, USA / Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilHospital Couto Maia. Secretaria de Saúde do Estado da Bahia. Salvador, BA, Brasil / Universidade Federal da Bahia. Faculdade de Medicina da Bahia. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilHospital Couto Maia. Secretaria de Saúde do Estado da Bahia. Salvador, BA, BrasilYale School of Public Health. Department of Epidemiology of Microbial Diseases. New Haven, CT, USA / Fundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisa Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, BrasilCryptococcus spp. cerebral abscesses are uncommon in immunocompetent subjects. The recommended induction treatment is the administration of amphotericin B plus fl ucytosine combined with resection for lesions ≥3cm. In this paper, we describe an HIV-negative woman diagnosed with a large cryptococcoma in the immediate postpartum period. The lesion was not resected, and due to amphotericin B intolerance, she received an extended course of fl uconazole monotherapy. There was no disease recurrence during the 4 years of follow-up. The abrupt onset of her symptoms following delivery suggests that she developed a postpartum immune reconstitution syndrome. This case also demonstrates that in specifi c situations fl uconazole monotherapy can be attempted in immunocompetent patients with cryptococcom

Síndrome de Guillain-Barré e outras manifestações neurológicas possivelmente relacionadas à infecção pelo vírus Zika em municípios da Bahia, 2015

Resumo Objetivo: descrever os casos notificados de síndrome de Guillain-Barré (SGB) e outras manifestações neurológicas com histórico de infecção por dengue, chikungunya ou Zika, na Região Metropolitana de Salvador e no município de Feira de Santana, Brasil. Métodos: estudo descritivo com dados de investigação conduzida pela vigilância epidemiológica, de março a agosto de 2015; para confirmar as manifestações neurológicas, considerou-se o registro de diagnóstico médico, e para infecção prévia, utilizaram-se critérios clínicos e laboratoriais. Resultados: dos 138 casos suspeitos investigados, 57 relataram quadro infeccioso até 31 dias antes dos sintomas neurológicos - 30 prováveis de infecção por Zika, 13 por dengue, 8 por chikungunya e 6 inconclusivos -; SGB foi a condição neurológica mais frequente (n=46); houve predomínio do sexo masculino (n=32), e a mediana de idade foi de 44 anos. Conclusão: a maioria dos casos relatou quadro clínico compatível com doença aguda pelo vírus Zika, que precedeu a ocorrência dos sintomas neurológicos

Cognitive dysfunction in chronic Chagas disease cardiomyopathy

Abstract Chagas disease (CD) remains a major cause of stroke in developing countries, but cognitive repercussion of CD has not been well studied. Objective: To compare the frequency and pattern of cognitive dysfunction in patients with CD cardiomyopathy (CDC) and other cardiomyopathies (OC). Methods: We studied 37 patients with CDC and 42 patients with OC with similar age, educational level and cardiac systolic function. Cognitive tests were applied to both groups by a single examiner blinded to CD status. Logistic regression multivariable models were constructed to ascertain predictors of cognitive dysfunction for each test. Results: Cognitive dysfunction was detected in 9 (24%) CDC patients and 6 (14%) OC patients by Mini Mental State Exam (MMSE) corrected for educational level. Independent predictors of abnormal MMSE (p <0.05) included stroke history (OR=5.51; 95% CI=1.27-24.01) and digoxin use (OR=0.23, 95% CI=0.06-0.89), while CD showed a trend toward statistical significance (OR=4.63; 95% CI=0.87-24.73, p =0.07). Delayed recall of Rey's Complex Figure Test was significantly worse in CD patients, where this remained a significant predictor in the multivariable analysis (OR=4.67; 95% CI=1.23-17.68). Conclusions: Cognitive dysfunction is frequent in Chagas disease and should be considered as an outcome measure in Chagas disease studies