HANY SIMON JUNIOR

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2
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Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina

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Assunto: Emergency department ×

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  • article 9 Citação(ões) na Scopus
    Fast, cheap and feasible: Implementation of pediatric telemedicine in a public hospital during the Covid-19 pandemic
    (2022) SEVERINI, Rafael da Silva Giannasi; OLIVEIRA, Pedro Carpini de; COUTO, Thomaz Bittencourt; SIMON JUNIOR, Hany; ANDRADE, Anarella Penha Meirelles de; NANBU, Danilo Yamamoto; FARHAT, Sylvia C. L.; SCHVARTSMAN, Claudio
    Objective: In Brazil, telemedicine was allowed as an exception during the coronavirus disease (COVID-19) pandemic. Despite its recognized value and availability, telemedicine is not universally used, suggesting that some barriers prevent its adoption and acceptance within the community. This study aims to describe the implementation of a low-cost telemedicine service in a pediatric hospital in Brazil. Method: Retrospective descriptive study reporting the first three months (April to June 2020) of the experience of implementing a low-cost telemedicine emergency care program in a public tertiary hospital. The service was available to patients up to 18 years of age enrolled in this hospital. A tool for assessing the severity of the patient was developed, the aim of standardizing the procedure, while maintaining quality and safety. Guardian's satisfaction was assessed with a questionnaire sent after teleconsultations. Results: 255 teleconsultations were carried out with 140 different patients. Of the total consultations, 182 were from 99 patients that had performed the Real-Time Polymerase Chain Reaction (RT-PCR) test for the new coronavirus (SARS-Cov-2) or had direct contact with a person known to be positive for COVID-19. Only 26 (14%) were referred to an in-person consultation. No deaths, adverse events or delayed diagnosis were recorded. 86% of the patients who answered the satisfaction questionnaire were satisfied and 92% would use telemedicine again. Conclusion: This study presents an innovative implementation of a telemedicine program in a public and exclusively pediatric tertiary service, serving as a reference for future implementation in other public services in Brazil and developing countries. (C) 2022 Sociedade Brasileira de Pediatria.
  • article 29 Citação(ões) na Scopus
    Multisystem inflammatory syndrome associated with COVID-19 from the pediatric emergency physician's point of view
    (2021) SIMON JUNIOR, Hany; SAKANO, Tania Miyuki Shimoda; RODRIGUES, Regina Maria; EISENCRAFT, Adriana Pasmanik; CARVALHO, Vitor Emanoel Lemos de; SCHVARTSMAN, Claudio; REIS, Amelia Gorete Afonso da Costa
    Objective: Multisystem inflammatory syndrome in children (MIS -C) associated with coronavirus disease (COVID-19) is a rare and challenging diagnosis requiring early treatment. The diagnostic criteria involve clinical, laboratory, and complementary tests. This review aims to draw pediatrician attention to this diagnosis, suggesting early treatment strategies, and proposing a pediatric emergency care flowchart. Sources: The PubMed/MEDLINE/WHO COVID-19 databases were reviewed for original and review articles, systematic reviews, meta -analyses, case series, and recommendations from medical societies and health organizations published through July 3, 2020. The reference lists of the selected articles were manually searched to identify any additional articles. Summary of the findings: COVID-19 infection is less severe in children than in adults, but can present as MIS -C, even in patients without comorbidities. There is evidence of an exacerbated inflammatory response with potential systemic injury, and it may present with aspects similar to those of Kawasaki disease, toxic shock syndrome, and macrophage activation syndrome. MIS -C can develop weeks after COVID-19 infection, suggesting an immunomediated cause. The mostfrequent clinical manifestations include fever, gastrointestinal symptoms, rash, mucous membrane changes, and cardiac dysfunction. Elevated inflammatory markers, lymphopenia, and coagulopathy are common laboratory findings. Supportive treatment and early immunomodulation can control the intense inflammatory response and reduce complications and mortality. Conclusions: MIS -C associated with COVID-19 is serious, rare, and potentially fatal. The emergency department pediatrician must recognize and treat it early using immunomodulatory strategies to reduce systemic injury. Further studies are needed to identify the disease pathogenesis and establish the most appropriate treatment. (C) 2020 Sociedade Brasileira de Pediatria.