Implementation of a clinical guideline for detection of gestational diabetes in primary care

Background: Gestational diabetes (GD) impacts maternal and fetal morbidity. In 2012, the World Diabetes Foundation provided financing project in Barranquilla (Colombia), aimed to implement a clinical guide for the diagnosis and treatment of this condition. Aim: To estimate the adherence of the guide in primary care centers. Material and Methods: A Cross-sectional study of pregnant women suspected of having gestational diabetes. Pregnant women were classified according to the week of admission to the prenatal control program: < week 24 or later. Women with a fasting blood glucose over 92 mg/dL and under 126 mg/dL or with some positive result to the oral glucose tolerance test were included. Results: Nine percent (1,887 women) of 21,699 registries of pregnant women, were at risk for gestational diabetes. Of these, 1,880 registries with complete data were analyzed. Sixty nine entered the program at less than 24 weeks of pregnancy and 71% had had a fasting blood glucose measured in the first control. In 69.2% of these women, criteria for gestational diabetes was met. A glucose tolerance test was suggested to women with a blood glucose below 92 mg/dl. Among 72% of the latter, the glucose tolerance test met the criteria for gestational diabetes. Among the 498 women who entered the program after 24 weeks of gestation, 68% met the criteria for gestational diabetes with the fasting blood glucose levels. In 90 women, a glucose tolerance test was performed and 80% met the criteria for gestational diabetes. Conclusions: An adequate adherence to guidelines favors the detection of pregnant women with gestational diabetes

Incidences and Causes of Surgery Cancellation in a University Hospital in Barranquilla, Colombia, in 2016

Introducción: La cirugía es todo procedimiento realizado en quirófano que permite el tratamiento oportuno a patologías y traumatismos; en Colombia un indicador de calidad para el Sistema de Información de salud es la proporción de cancelación de cirugía programada. Materiales y método: Diseñamos un estudio observacional retrospectivo, seleccionando todos los pacientes programados en la Institución Hospitalaria en el periodo de 1 enero 2016 a 31 diciembre de 2016. Un total de 3207 pacientes programados. Se analizaron las cancelaciones en factores atribuibles al paciente, institución y orden médica. Resultados: De los 3207 procedimientos programados 1739 (54,2%) fueron hombres y 1468 (45,8%) mujeres, se programaron procedimientos quirúrgicos entre 6 meses y 116 años de edad, con un promedio de 38 años. Del total de programaciones 244 (7,6%) sufrieron cancelación de la cirugía, los meses con el menor y mayor incidencia de cancelación fue de agosto y noviembre con 9 (3,7%) y 36 (14,8%) respectivamente. La tasa de cancelación por especialidades medico quirúrgicas de manera independiente oscila entre 1 (0,4%) de las especialidades de ginecología oncológica, maxilofacial, urología y 85 (34,8%) de ortopedia. Las causas de cancelación se clasificaron en atribuibles a la institución 93 casos (38,1%), al usuario 99 (40,6) y por orden médica 52 (21,3%). Conclusiones: El 41% de las cancelaciones podrían haber sido evitadas. Recomendamos seguimiento continuo a los pacientes programados, además divulgación de estos estudios a profesionales para el empoderamiento de las responsabilidades y la necesidad de educación a los usuarios que serán intervenidos.ABSTRACT: Introduction: Surgery is any procedure performed in the operating room that allows timely treatment of pathologies and injuries; in Colombia, an indicator of the quality of the information system is the proportion of scheduled surgery cancellations. Materials and method: We designed a retrospective observational study, selecting all patients scheduled for surgery at the hospital institution from January 1, 2016 to December 31, 2016. A total of 3207 patients were included. We analyzed cases of surgery cancellations because of factors attributable to the patient, institution, and medical order. Results: Of the 3207 scheduled procedures, 1739 (54.2%) were men and 1468 (45.8%) were women. Surgical procedures were scheduled for patients aged between 6 months and 116 years, with an average age of 38 years. Of the scheduled procedures, 244 (7.6%) surgeries were cancelled. The months with the lowest and highest incidences of surgery cancellation were August and November, with 9 (3.7%) and 36 (14.8%) cancellations, respectively. The cancellation rate for surgical specialties independently ranged from 1 (0.4%) for gynecology specialties of oncology, maxillofacial, and urology and 85 (34.8%) for orthopedics. As the causes of cancellation, 93 (38.1%) were attributable to the institution, 99 (40.6) to patients, and 52 (21.3%) to medical orders. Conclusions: In total, 41% of cancellations could have been avoided. We recommend continuous monitoring of scheduled patients, as well as the dissemination of our findings to professionals for the empowerment of responsibilities and the need for education for patients undergoing intervention

Factors Attributable to Cardiovascular Diseases in the Elderly Population of the Campo Alegre Resettlement, Tierralta, Córdoba

Background: cardiovascular diseases are the leading cause of death worldwide, each year more people die from one of these diseases than from any other cause. Objective: to identify the risk factors for the development of cardiovascular diseases in the Campo Alegre resettlement, Tierra Alta, Córdoba during 2020-2021. Methods: a descriptive study was carried out in which adults over 60 years of age residing in the resettlement were included. The variables studied were: age and sex, marital status, socioeconomic status, educational level, work status, household or personal income, health history and healthy lifestyle conditions such as high blood pressure, type 2 diabetes mellitus, physical activity , healthy eating and daily food ration, weight control, drug dependence, medical control and hypercholesterolemia. They were given a survey focused on knowing the risks exposed to cardiovascular disease. The data was stored in Excel and analyzed in SPSS Statistics 26. Results: minimum ages (60 years) and maximum ages (76 years and over) were obtained. It was possible to show that arterial hypertension prevailed in the population for both sexes, the educational level is related to the educational level of the population, a greater number of cases was found in the population without studies. Conclusions: the frequency of risk factors for cardiovascular diseases present in the population warns about the need to develop health promotion and disease prevention plans in this area of the municipality of Tierralta, Córdoba, since it has been shown that this entails to consequences in the quality of life of the elderly population

Implementation of a clinical guideline for detection of gestational diabetes in primary care

Background: Gestational diabetes (GD) impacts maternal and fetal morbidity. In 2012, the World Diabetes Foundation provided financing project in Barranquilla (Colombia), aimed to implement a clinical guide for the diagnosis and treatment of this condition. Aim: To estimate the adherence of the guide in primary care centers. Material and Methods: A Cross-sectional study of pregnant women suspected of having gestational diabetes. Pregnant women were classified according to the week of admission to the prenatal control program: < week 24 or later. Women with a fasting blood glucose over 92 mg/dL and under 126 mg/dL or with some positive result to the oral glucose tolerance test were included. Results: Nine percent (1,887 women) of 21,699 registries of pregnant women, were at risk for gestational diabetes. Of these, 1,880 registries with complete data were analyzed. Sixty nine entered the program at less than 24 weeks of pregnancy and 71% had had a fasting blood glucose measured in the first control. In 69.2% of these women, criteria for gestational diabetes was met. A glucose tolerance test was suggested to women with a blood glucose below 92 mg/dl. Among 72% of the latter, the glucose tolerance test met the criteria for gestational diabetes. Among the 498 women who entered the program after 24 weeks of gestation, 68% met the criteria for gestational diabetes with the fasting blood glucose levels. In 90 women, a glucose tolerance test was performed and 80% met the criteria for gestational diabetes. Conclusions: An adequate adherence to guidelines favors the detection of pregnant women with gestational diabetes