Universidad y conducta suicida: respuestas y propuestas institucionales, Bogotá 2004-2014

Objetivo Analizar las respuestas institucionales frente a la conducta suicida de estudiantes de cinco universidades de Bogotá y su relación con los lineamientos de la Política Nacional de Salud Mental, de la Atención Primaria Integral en Salud y los planes establecidos para su abordaje y, a partir de estos, formular recomendaciones para la acción.Métodos Estudio cualitativo de tipo exploratorio-descriptivo basado en la consulta a la memoria de 66 agentes universitarios quienes aportaron acerca del hecho suicida y sus características, y sobre las respuestas y propuestas institucionales asumidas en cinco universidades de Bogotá. Se utilizaron entrevistas semiestructuradas.Resultados Las universidades participantes presentan comprensiones heterónomas frente al fenómeno del suicidio y mecanismos de atención diferentes principalmente direccionados al apoyo administrativo y a la prevención de contagio del comportamiento suicida.Conclusiones Los suicidios consumados de estudiantes le han servido a las universidades para reflexionar sobre esta problemática y a partir de ello se ha hecho más visible el problema de la deshumanización en la formación, el papel del bienestar universitario y los servicios de salud. Emerge con fuerza el tema de la conveniencia de las redes de trabajo interinstitucional e intersectorial, la psicoeducación, la corresponsabilidad, así como la activa participación de los jóvenes en la discusión y formulación de enfoques y programas orientados hacia su bienestar.Objective To analyze the institutional responses and actions towards suicidal behavior of students from five universities in Bogotá, and their relation with the National Mental HealthPolicy (NMHP), the Comprehensive Primary Health Care Guidelines (APS), and the plans established for approaching this issue, to finally make suggestions based on them.Methods Qualitative, exploratory-descriptive study based on the experiences of 66 university workers, who provided inputs on suicide and its characteristics; this study is alsogrounded on the institutional response of five universities in Bogotá. Semi-structured interviews were also used.Results Participating universities have a heteronomous understanding of the phenomenon of suicide, as well as different attention mechanisms, which are mainly directed to administrative support and the prevention of suicidal behavior contagion.Conclusion The consummate suicides of students have served the universities to reflect upon this problem, which has made more visible the problem of dehumanization in training, and the role of university well-being and health services.The appropriateness of inter-institutional and intersectoral networks, psychoeducation, co-responsibility, and the active participation of young people in the discussion and formulation of welfare-oriented approaches and programs are strong aspects that arise from this reflection

Subcutaneous anti-COVID-19 hyperimmune immunoglobulin for prevention of disease in asymptomatic individuals with SARS-CoV-2 infection: a double-blind, placebo-controlled, randomised clinical trialResearch in context

Summary: Background: Anti-COVID-19 hyperimmune immunoglobulin (hIG) can provide standardized and controlled antibody content. Data from controlled clinical trials using hIG for the prevention or treatment of COVID-19 outpatients have not been reported. We assessed the safety and efficacy of subcutaneous anti-COVID-19 hyperimmune immunoglobulin 20% (C19-IG20%) compared to placebo in preventing development of symptomatic COVID-19 in asymptomatic individuals with SARS-CoV-2 infection. Methods: We did a multicentre, randomized, double-blind, placebo-controlled trial, in asymptomatic unvaccinated adults (≥18 years of age) with confirmed SARS-CoV-2 infection within 5 days between April 28 and December 27, 2021. Participants were randomly assigned (1:1:1) to receive a blinded subcutaneous infusion of 10 mL with 1 g or 2 g of C19-IG20%, or an equivalent volume of saline as placebo. The primary endpoint was the proportion of participants who remained asymptomatic through day 14 after infusion. Secondary endpoints included the proportion of individuals who required oxygen supplementation, any medically attended visit, hospitalisation, or ICU, and viral load reduction and viral clearance in nasopharyngeal swabs. Safety was assessed as the proportion of patients with adverse events. The trial was terminated early due to a lack of potential benefit in the target population in a planned interim analysis conducted in December 2021. ClinicalTrials.gov registry: NCT04847141. Findings: 461 individuals (mean age 39.6 years [SD 12.8]) were randomized and received the intervention within a mean of 3.1 (SD 1.27) days from a positive SARS-CoV-2 test. In the prespecified modified intention-to-treat analysis that included only participants who received a subcutaneous infusion, the primary outcome occurred in 59.9% (91/152) of participants receiving 1 g C19-IG20%, 64.7% (99/153) receiving 2 g, and 63.5% (99/156) receiving placebo (difference in proportions 1 g C19-IG20% vs. placebo, −3.6%; 95% CI -14.6% to 7.3%, p = 0.53; 2 g C19-IG20% vs placebo, 1.1%; −9.6% to 11.9%, p = 0.85). None of the secondary clinical efficacy endpoints or virological endpoints were significantly different between study groups. Adverse event rate was similar between groups, and no severe or life-threatening adverse events related to investigational product infusion were reported. Interpretation: Our findings suggested that administration of subcutaneous human hyperimmune immunoglobulin C19-IG20% to asymptomatic individuals with SARS-CoV-2 infection was safe but did not prevent development of symptomatic COVID-19. Funding: Grifols

International Nosocomial Infection Control Consortiu (INICC) report, data summary of 43 countries for 2007-2012. Device-associated module

We report the results of an International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2007-December 2012 in 503 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study using the Centers for Disease Control and Prevention's (CDC) U.S. National Healthcare Safety Network (NHSN) definitions for device-associated health care–associated infection (DA-HAI), we collected prospective data from 605,310 patients hospitalized in the INICC's ICUs for an aggregate of 3,338,396 days. Although device utilization in the INICC's ICUs was similar to that reported from ICUs in the U.S. in the CDC's NHSN, rates of device-associated nosocomial infection were higher in the ICUs of the INICC hospitals: the pooled rate of central line–associated bloodstream infection in the INICC's ICUs, 4.9 per 1,000 central line days, is nearly 5-fold higher than the 0.9 per 1,000 central line days reported from comparable U.S. ICUs. The overall rate of ventilator-associated pneumonia was also higher (16.8 vs 1.1 per 1,000 ventilator days) as was the rate of catheter-associated urinary tract infection (5.5 vs 1.3 per 1,000 catheter days). Frequencies of resistance of Pseudomonas isolates to amikacin (42.8% vs 10%) and imipenem (42.4% vs 26.1%) and Klebsiella pneumoniae isolates to ceftazidime (71.2% vs 28.8%) and imipenem (19.6% vs 12.8%) were also higher in the INICC's ICUs compared with the ICUs of the CDC's NHSN