Errores en la fase analítica y su repercusión en los resultados de las pruebas diagnósticas en los pacientes con COVID -19.

The Coronavirus is structured by non-segmented positive-sense RNAs that belong to the Coronaviridae family and the Nidovirales order, and are widely distributed in humans and other mammals, causing multiple conditions ranging from influenza to death. As the number of people infected with COVID-19 continues to rise around the world and healthcare systems are increasingly strained, it is clear that laboratories play an essential role, contributing to patient diagnosis as well as recovery. epidemiological and surveillance. This study was based on the analytical phase, with the aim of identifying the percentage of errors and specifying possible strategies to minimize these determinants, which will be of great benefit to patients. The present study of qualitative design and systematic review, carried out the bibliographic search in various scientific databases such as: Scielo, Elsevier, Science Direct, Redalyc, Dialnet, Medigraphic, Google Scholar, PubMed, among others. The MeSH terms were used: "errors", "phase", "analytics", "tests", "diagnosis", "covid-19". Boolean operators "and" and "or" were used. The interest was to search for information jointly and separately. The results within the analysis focused on the analytical phase, giving an error rate of 13%, which occurs due to cross contamination between samples, low concentrations of antibodies and uncalibrated equipment. Concluding that a quality management system should be applied based on the Six Sigma methodology.El Coronavirus está estructurado por ARN sentido positivo no segmentados que pertenecen a la familia Coronaviridae y al orden Nidovirales, y se distribuyen ampliamente en humanos y otros mamíferos, originando múltiples afecciones que van desde una gripe hasta la muerte. A medida que el número de personas infectadas con COVID-19 continúa aumentando en todo el mundo y los sistemas de salud se exigen cada vez más, está claro que los laboratorios desempeñan un papel esencial, contribuyendo al diagnóstico del paciente, así como a la recuperación epidemiológica y vigilancia. Este estudio se basó en la fase analítica, con los objetivos de identificar cuál es el porcentaje de errores y especificar estrategias posibles donde permitan minimizar estos determinantes mismos que servirán de gran beneficio para los pacientes.  El presente estudio es de diseño cualitativo de tipo revisión sistemática, ya que se realizó la búsqueda bibliográfica de diversas fuentes científicas. Se realizó una búsqueda bibliográfica en las bases de datos científicas Scielo, Elsevier, Science Direct, Redalyc, Dialnet, Medigraphic, Google académico, PubMed, entre otras. Utilizaron los términos MeSH: “errores”, “fase”, “analítica”, “pruebas”, “diagnóstico”, “covid-19”. Se emplearon operadores booleanos “and” u “or” el interés fue buscar información de manera conjunta y separada. Los resultados dentro del análisis se enfocaron en la fase analítica dando un porcentaje de error del 13% cometidos que acontecen por la contaminación cruzada entre muestras, bajas concentraciones de anticuerpos y equipos no calibrados, recomendando que se debe aplicar un sistema de gestión de calidad a partir de la metodología Seis Sigmas

Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

Background: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19\ub78 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6\ub76 and 2\ub74 per cent respectively before, but 23\ub77 and 5\ub73 per cent, during the pandemic (both P < 0\ub7001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2