Artificial Intelligence Starts the Big Bang of Modern Medicine and Surgery

Objective. To identify the areas of application and uses of artificial intelligence and expert systems in medicine, surgical procedures, and surgical specialties, classifying the degree of agreement in articles published between 2010 and 2019. Materials and Methods. The methodology consists of a relational database model and an entity-relationship model. To determine the quality of each article, the classification by degrees of agreement between “highly concordant”, “relatively concordant” or “not concordant” was created on our initiative. Results. A total of 146 articles were found, of which only 28 were highly concordant with the subject of interest. Conclusions. Artificial intelligence is the new research science that is revolutionizing the way of intervention in the different disciplines of the area of medicine

Costo de infección de vías urinarias asociada a sonda vesical en un hospital universitario de Santander, Colombia

Objetivo Estimar el exceso de costos de la infección de vías urinarias asociada al uso de catéter y las intervenciones clínicas que más influyen en los costos.Métodos Se realizó un estudio de cohortes pareadas por tiempo de aparición del evento nosocomial. Los expuestos fueron pacientes con infección de vías urinarias asociada a catéter, y los no expuestos, pacientes sin infección nosocomial, con diagnóstico de ingreso similar al expuesto. En las dos cohortes se evaluaron los costos directos de atención hospitalaria.Resultados El exceso de costo total de atención de una Infección de vías urinarias asociada a catéter fue de $2 460 168 pesos colombianos para 2009. El mayor porcentaje fue atribuido a los días de hospitalización en sala general con un 71,8$2 460 168,9 pesos (1 329 dólares de 2009)

The cost of connecting poor households to natural gas in colombia and its impact on health, 2007

Objective Assessing the cost of subsidizing access to household natural gas (HNG) and its impact on the health of about 35,000 poor households (socioeconomic strata 1 and 2) in Colombia, sponsored by a Global Partnership on Output-Based Aid (GPOBA) project. Methods The following studies were combined: an analysis of secondary data and analysis of databases provided by the Promigas foundation, demographic data from the 2005 DANE census and databases regarding Central Bank economic statistical series; an analysis of the burden of disease estimated from parameters identifi ed in previous studies; an analysis of the cost of the burden of illness and the estimated costs which were avoided by implementing the HNG connections program; and an analysis of the cost effectiveness of the program linking homes to HNG services. Results The OBA project led to about 4,000 to 5,000 cases of acute respiratory disease (ARD) and 1,200 to 2,300 outpatient cases of chronic obstructive pulmonary disease (COPD) being avoided during the study period; around 1,200 hospitalizations due to ARD and 500 due to COPD were also avoided. Forty-fi ve to 170 deaths (representing about 45,000 to 90,000 disability-adjusted life years (DALY)) were also avoided. The economic cost of the burden of disease arising from ARI and COPD in such scenario without HNG would have been between 10.7 and 23.6 million dollars, whilst HNG led to costs becoming reduced by about 32 %. Conclusions This study was a good estimator of the potential impact of the poorest and most vulnerable households gaining universal access to HNG

Costo de neumonía nosocomial no asociada a ventilación en el hospital universitario de santander, 2007-2009

Objetivo Estimar el exceso de costos asociado a neumonía nosocomial no asociada a ventilación mecánica y las intervenciones clínicas que más influyen en él.Métodos Se realizó un estudio de cohortes pareadas por tiempo de aparición del evento nosocomial. Los expuestos fueron pacientes con neumonía nosocomial y los no expuestos pacientes sin infección nosocomial, con diagnóstico de ingreso similar al expuesto. El principal resultado evaluado en las dos cohortes fueron los costos directos de atención hospitalaria.Resultados El exceso de costo total de atención de una neumonía nosocomial no asociada ventilación fue de $7 771 583,50 (4 200 dólares de 2009). Los días de hospitalización en unidad de cuidado intensivo correspondieron al 39$2 980 000), los antibióticos aportaron el 33,7 % (mediana $2 571 953,60), la hospitalización en sala general el 19$1 473 760), y las valoraciones diarias 4,9 % (mediana $379 937,90). Las demás variables contribuyeron más o menos 1$7 771 583,50 pesos (4 200,80 dólares de 2009)

Identificación de los conocimientos de calidad de la información de mortalidad en Bogotá

Objetivo Identificar los conocimientos del personal que participaba en la producción y el uso de la información de mortalidad sobre la calidad de la misma, durante el año 2010.Métodos Estudio descriptivo que aplicó encuesta semi-estructurada, auto-administrada a 130 funcionarios que participaban en la producción y uso de estadísticas de mortalidad. Sobre los conocimientos de calidad de la información de mortalidad, se indagaron aspectos que daban cuenta de fiabilidad, características, calificación, explicación a la calificación dada y propuesta para mejorar. Se calcularon frecuencias y distribuciones porcentuales. Resultados El 76,2 % de los encuestados identificaron cobertura y contenido como aspectos que daban cuenta de la fiabilidad de la información de mortalidad. Las principales características de calidad de la información reconocidas fueron veracidad, 80,8 %; completitud, 76,2 %; precisión, 75,4 %; oportunidad, 74,6 %; y validez, 73,8 %. El 55,4 % de los participantes calificó la calidad como regular y el 6,2 % como mala. Sensibilización, procesos formativos y evaluativos fueron algunas de las propuestas mencionadas para el mejoramiento de la calidad. Conclusiones Los hallazgos sugieren que existe falta de conocimientos sobre la calidad de la información de mortalidad. Se hace necesario corregir esa falta de conocimientos poniendo en práctica las propuestas de mejoramiento realizada por los encuestados. Se recomendó que las distintas propuestas que se pongan en marcha, sean seguidas y evaluadas para conocer el impacto que ellas producen.Objective Identify the workers knowledge involved in the production and usage, about the quality of mortality information in Bogotá during 2006.Methods We conducted a descriptive study using a self-administered and semi-structured questionnaire in 130 functionaries who participated in the mortality data production and use. The instruments inquired into the reliability, characteristics, qualification, reasons for that qualification and improvement proposals. We calculated frequencies and percentage distributions.Results 76.2 % of respondents identified coverage and content as the aspects that best indicated reliability of mortality information. The main quality characteristics of the information recognized were veracity, 80.8 %; completeness, 76.2 %; accuracy, 75.4 %; opportunity, 74.6 %; and validity, 73.8 %. 55.4 % of participants rated the quality as fair and 6.2 % as poor. Some of the proposals for the quality improvement were awareness, training and evaluation processes.Conclusions The findings suggest that there is still a lack of knowledge about the quality of mortality information in people involved in its production and use. It is necessary to correct this lack of knowledge by implementing the proposals to improve the quality of mortality data made by respondents. It is recommended that the various proposals that were exposed are monitored and evaluated to determine the impact they produce

Budgetary impact analysis of preexposure prophylaxis (prep) strategy for the prevention of hiv in Colombia, 2019-2021

We aimed to estimate the budgetary impact of a PrEP strategy for the prevention and control of HIV in men who have sex with men (MSM) and transgender women (TGW) in Colombia. We adapted a budgetary impact model developed by Fundación Oswaldo Fiocruz, Brazil. Modelling was performed from the third-payer perspective over a 3-year period. Epidemiological and cost inputs were extracted from literature reviews and Colombian data. Two scenarios were simulated: 1. No PrEP scenario; and, 2. New scenario: MSM and TGW would have access to a PrEP program, which potentially reduce the HIV cases. Costs include the sum of PrEP program costs for MSM and TGW, and the treatment costs of cases that will occur in the 3-years of implementation. The new scenario was modelled at different risk and PrEP program coverage levels. Budget impact analysis (BIA) was calculated as the difference between the two scenarios. Cost were reported in Colombian pesos (COP). At a PrEP coverage of 80% and an incidence of 4.5 per 100 person-year would be avoid 4,057, 4,315 and 4,383 HIV cases in MSM for years 1, 2 and 3, respectively. The BIA was COP$47 billion for year 1; COP$20 billion for the second, and for the third year the PrEP program would save COP$11 billion. In TGW, at a PrEP coverage of 80$3.3 billion, COP$-2.1 billion and COP$-8.1 billion, respectively. PrEP strategy should focus on small fractions of the population at high risk, such as those addressed in our study. Our results suggest that PrEP program would avoid cases and save costs for the Colombian health system

Direct medical costs related to COVID-19 in Colombia

We studied 113 patients hospitalized by COVID-19, 51.3% men. On average, the hospital length of stay for COVID-19 hospitalized patient was 7,3 (± 6,2) days with a median cost of $1,688 (IQR 788-2,523). In women, the median direct medical cost of hospitalization was$1,328 (IQR $463-$2,098), while in men was 1.4 times greater. Being 60 years of age or older triggers hospitalization costs almost twice as high as those under this age ($1,813 vs.$2,994), and when the cost is compared by type of hospitalization, this difference is more than three times (ICU: 4,118; general ward: $1,312)

Enhancing interventions for prevention-of-mother-to-child- transmission (PMTCT) of hepatitis B virus (HBV)

Prevention of mother to child transmission (PMTCT) of hepatitis B virus (HBV) infection is a cornerstone of interventions to support progress towards elimination goals for viral hepatitis. Current guidelines recommend maternal screening, antiviral therapy during the third trimester of high-risk pregnancies, universal and timely HBV birth-dose vaccine, and post-exposure prophylaxis with hepatitis B immunoglobulin (HBIG) for selected neonates. However, serological and molecular diagnostic testing, treatment and HBV vaccination are not consistently deployed, particularly in many high endemicity settings, and models predict that global targets for reduction in paediatric incidence will not be met by 2030. In this article, we briefly summarise the evidence for current practice and use this as a basis to discuss areas in which PMTCT implementation can potentially be enhanced. By reducing health inequities, enhancing pragmatic use of resources, filling data gaps, developing advocacy and education, and seeking consistent investment from multilateral agencies, significant advances can be made to further reduce vertical transmission events, with wide health, societal and economic benefits