Comportamiento epidemiológico de los factores de riesgo asociados a enfermedades crónicas no transmisibles en estudiantes universitarios

Describir el comportamiento epidemiológico de los factores de riesgo relacionados a enfermedades crónicas no transmisibles asociados a hipertrigliceridemia presentes en los estudiantes del primer año de la carrera de Médico y Cirujano de la Universidad de San Carlos de Guatemala. Estudio descriptivo transversal realizado en 1097 estudiantes, en los cuales se aplicó el cuestionario del método paso a paso para la vigilancia de factores de riesgo de enfermedades crónicas (STEPS) modificado. Se encontró 610 (56%) estudiantes sexo femenino, la media de edad fue de 19 años (±1.56); en relación a los factores de riesgo modificables: 219 (20%) consumen cigarrillo, 274 (25%) consumen alcohol nocivamente, 838 (76%) se alimentan de forma inadecuada, 887 (81%) no practica actividad física significativa; se identificó que 405 (37%) presentaron un índice cintura – cadera considerado de riesgo. En cuanto a los factores asociados a la presencia de hipertrigliceridemia: obesidad se identificó en 147 (13%) estudiantes (X2 de 104.98 y OR de 7), obesidad central en 204 (19%) (X2 de 55.74 y OR de 3), el sobrepeso en 330 (30%) (X2 de 53.4727 y OR de 3), presión arterial alta en 397 (36%) (X2 de 18.63 y OR de 2), y glucemia alterada en ayunas alta en 198 (18%) (X2 de 8.3 y OR de 2). La hipertrigliceridemia se presentó en 411 estudiantes (37%), siendo la edad más afectada la de 19 años. La mayoría de estudiantes estudiados es de sexo femenino. Existe una alta prevalencia de factores de riesgo modificables asociados a enfermedades crónicas no transmisibles, de estos se identificó que factores como obesidad, obesidad central, sobrepeso, presión arterial alta y glucemia alterada en ayunas alta tienen una significativa asociación al desarrollo de hipertrigliceridemia, con un aumento del riesgo de 7, 3, 3, 2 y 2, respectivamente

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Prevalencia de depresión en usuarios de los servicios ambulatorios de salud en el estado de Guanajuato

A depressão é um problema de saúde pública de proporções muito importantes. Para o ano 2020 será a segunda causa de anos de vida saudável perdido a escala mundial. Determinar a prevalência da depressão nos usuários dos serviços ambulatórios de primeiro nível de atenção do Instituto de Saúde Pública no Estado de Guanajuato, México. Método. Estudo realizado em uma amostra representativa e probabilística de 75 Unidades de Consulta Externa dos 46 municípios que existem no Estado, entre junho 2007 a abril de 2008. Resultados. No estudo participaram 421 pessoas das quais um 87% (368) eram mulheres. Se encontrou uma prevalência pontual global de 46.6% (IC 95% 41 - 51) nos assistentes à consulta. Segundo o grau de depressão (leve, moderada, severa) se identificou que a prevalência é próxima ao 0.15 (IC95% 0.12 [Windows-1252?]� 0.18) para cada tipo. Segundo o sexo, as mulheres tiveram prevalências similares na depressão leve e severa com um 0.16 (IC95% [Windows- 1252?]0.12�0.20). Conclusões. As prevalências entre gêneros encontradas são praticamente similares e as mais altas as reportadas em outros trabalhos mexicanos.La depresión es un problema de salud pública de proporciones muy importantes. Para el año 2020, será la segunda causa de años perdidos de vida saludable, a escala mundial. Objetivo: determinar la prevalencia de la depresión en los usuarios de los servicios ambulatorios de primer nivel de atención del Instituto de Salud Pública en el Estado de Guanajuato, México. Método: estudio realizado en una muestra representativa y probabilística de 75 Unidades de Consulta Externa de los 46 municipios que existen en el Estado, entre junio 2007 a abril de 2008. Resultados: en el estudio participaron 421 personas, de las cuales el 87% (368) eran mujeres. Se encontró una prevalencia de 46.6% (IC 95% 41-51) en los asistentes a la consulta. Según el grado de depresión (leve, moderada, severa), se identificó que la prevalencia es cercana al 0.15 (IC95% 0.12�0.18) para cada tipo. Según sexo, las mujeres tuvieron prevalencias similares en la depresión leve y severa con un 0.16 (IC95% 0.12�0.20). Conclusiones: las prevalencias encontradas entre géneros son prácticamente similares y más altas a las reportadas en otros trabajos mexicanos

Prevalência da depressão em usuários dos serviços ambulatórios de saúde no Estado de Guanajuato – México

La depresión es un problema de salud pública de proporciones muy importantes. Para el año 2020, será la segunda causa de años perdidos de vida saludable, a escala mundial. Objetivo: determinar la prevalencia de la depresión en los usuarios de los servicios ambulatorios de primer nivel de atención del Instituto de Salud Pública en el Estado de Guanajuato, México. Método: estudio realizado en una muestra representativa y probabilística de 75 Unidades de Consulta Externa de los 46 municipios que existen en el Estado, entre junio 2007 a abril de 2008. Resultados: en el estudio participaron 421 personas, de las cuales el 87% (368) eran mujeres. Se encontró una prevalencia de 46.6% (IC 95% 41-51) en los asistentes a la consulta. Según el grado de depresión (leve, moderada, severa), se identificó que la prevalencia es cercana al 0.15 (IC95% 0.12–0.18) para cada tipo. Según sexo, las mujeres tuvieron prevalencias similares en la depresión leve y severa con un 0.16 (IC95% 0.12–0.20). Conclusiones: las prevalencias encontradas entre géneros son prácticamente similares y más altas a las reportadas en otros trabajos mexicanos.Depression is a significant public health problem. By 2020 it will be the second cause of years of healthy life lost in the world. The purpose of this study is to determine the prevalence of depression in users of ambulatory clinics of the Institute of Public Health in the state of Guanajuato, México. Method: The study was carried out between June 2007 and April 2008, with a representative and probablistic sample of 75 ambulatory clinics of the 46 municipalities in the state. Results. 421 persons took part in the study, of whom 87% (368) were women. An overall prevalence of 46.6% (IC 95% 41 - 51) was found in those who attended. It was determined that the prevalence is close to 0.15 (IC95% 0.12 [Windows-1252?]– 0.18) depending on the type of depression (light, moderate, severe). According to gender, women experienced similar prevalence of light and severe depression with 0.16 (IC95% [Windows-1252?]0.12–0.20). Conclusions. Prevalences found between genders are practically the same, and higher than those reported in other Mexican jobs.A depressão é um problema de saúde pública de proporções muito importantes. Para o ano 2020 será a segunda causa de anos de vida saudável perdido a escala mundial. Determinar a prevalência da depressão nos usuários dos serviços ambulatórios de primeiro nível de atenção do Instituto de Saúde Pública no Estado de Guanajuato, México. Método. Estudo realizado em uma amostra representativa e probabilística de 75 Unidades de Consulta Externa dos 46 municípios que existem no Estado, entre junho 2007 a abril de 2008. Resultados. No estudo participaram 421 pessoas das quais um 87% (368) eram mulheres. Se encontrou uma prevalência pontual global de 46.6% (IC 95% 41 - 51) nos assistentes à consulta. Segundo o grau de depressão (leve, moderada, severa) se identificou que a prevalência é próxima ao 0.15 (IC95% 0.12 [Windows-1252?]– 0.18) para cada tipo. Segundo o sexo, as mulheres tiveram prevalências similares na depressão leve e severa com um 0.16 (IC95% [Windows- 1252?]0.12–0.20). Conclusões. As prevalências entre gêneros encontradas são praticamente similares e as mais altas as reportadas em outros trabalhos mexicanos

Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p &lt; 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures

Impact of COVID-19 on Diagnostic Cardiac Procedural Volume in Oceania: The IAEA Non-Invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Objectives: The INCAPS COVID Oceania study aimed to assess the impact caused by the COVID-19 pandemic on cardiac procedure volume provided in the Oceania region. Methods: A retrospective survey was performed comparing procedure volumes within March 2019 (pre-COVID-19) with April 2020 (during first wave of COVID-19 pandemic). Sixty-three (63) health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, and 846 facilities outside of Oceania. The percentage change in procedure volume was measured between March 2019 and April 2020, compared by test type and by facility. Results: In Oceania, the total cardiac diagnostic procedure volume was reduced by 52.2% from March 2019 to April 2020, compared to a reduction of 75.9% seen in the rest of the world (p&lt;0.001). Within Oceania sites, this reduction varied significantly between procedure types, but not between types of health care facility. All procedure types (other than stress cardiac magnetic resonance [CMR] and positron emission tomography [PET]) saw significant reductions in volume over this time period (p&lt;0.001). In Oceania, transthoracic echocardiography (TTE) decreased by 51.6%, transoesophageal echocardiography (TOE) by 74.0%, and stress tests by 65% overall, which was more pronounced for stress electrocardiograph (ECG) (81.8%) and stress echocardiography (76.7%) compared to stress single-photon emission computerised tomography (SPECT) (44.3%). Invasive coronary angiography decreased by 36.7% in Oceania. Conclusion: A significant reduction in cardiac diagnostic procedure volume was seen across all facility types in Oceania and was likely a function of recommendations from cardiac societies and directives from government to minimise spread of COVID-19 amongst patients and staff. Longer term evaluation is important to assess for negative patient outcomes which may relate to deferral of usual models of care within cardiology

International Impact of COVID-19 on the Diagnosis of Heart Disease

Background: The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. Objectives: The study sought to assess COVID-19's impact on global cardiovascular diagnostic procedural volumes and safety practices. Methods: The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. Results: Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoracic echocardiography decreased by 59%, transesophageal echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p &lt; 0.001 for each procedure). In multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower–middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth. Conclusions: COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19–related changes in care delivery is warranted