Contribución de la radiología digital al mejoramiento de la calidad en el servicio de imagenología

Objective. This documentary study evaluates the optimal strategies of digital radiology (DR) in Radiology services in low and medium complexity hospitals in Colombia. Method. Exhaustive bibliographic review where the benefits were identified and compared with analog radiology, it was developed based on a sample of 32 scientific articles in different journals such as Dialnet, SciELO, Scopus, Springer Open, IOP Science. Result. X-ray imaging is a powerful and inexpensive technology that has been widely used in medical diagnosis. The technological importance of X-ray imaging has led to the rapid development of high performance X-ray detectors and associated imaging applications. Therefore, medical imaging services propose effective strategies in the functionality of digital radiology, factors that interfere with the computer system process. Conclusion. Taking into account the technical and fundamental advances of X-ray detectors, the emergence of computed radiography (CR) (DR) has led to technological evolution for obtaining digital X-ray images with more accurate and instantaneous information, while its separate reading mechanism suffers from technical limitations, such as high radiation dose and a non-dynamic image, this allows imaging service providers to be motivated to invest in adequate technology to generate a more optimal use of resources and the service is provided to the patient with high quality.Objetivo. El presente estudio documental evalúa las estrategias óptimas de la radiología digital (DR) en los servicios de Radiología en los hospitales de baja y mediana complejidad en Colombia. Método. Revisión bibliográfica exhaustiva donde se identificó los beneficios y se hizo comparación con la radiología análoga, se desarrolló basado en una muestra de 32 artículos científicos en diferentes revistas como Dialnet, SciELO, Scopus, Springer Open, IOP Science. Resultado. La imagen por rayos X es una tecnología poderosa y de bajo costo que se ha utilizado ampliamente en el diagnóstico médico. La importancia tecnológica de las imágenes de rayos X ha llevado al rápido desarrollo de detectores de rayos X de alto rendimiento y las aplicaciones de imágenes asociadas. Por lo tanto, los servicios de imágenes médicas proponen estrategias efectivas en la funcionalidad de la radiología digital, factores que interfieren con el proceso del sistema informático. Conclusión. Teniendo en cuenta los avances técnicos y fundamentales de los detectores de rayos X, el surgimiento de la radiografía computarizada (CR) (DR) ha llevado a la evolución tecnológica para la obtención de imágenes de rayos X digitales con información más precisa e instantánea, mientras que su mecanismode lectura separado adolece de limitaciones técnicas, como una alta dosis de radiación y una imagen no dinámica, esto permite a los prestadores de servicio de imagenología se motiven a invertir en una tecnología adecuada para generar un aprovechamiento más óptimo de los recursos y el servicio sea prestado al paciente con alta calidad

Gestión, emprendimiento e innovación: Conceptualización, desarrollos y perspectivas (1ª fase)

A esta propuesta le antecede el proyecto de investigación ‘Emprendimiento y Educación: Episteme, conceptualización, desarrollos y perspectivas desde las Ciencias Sociales 2019-2022’, el cual gene ró una importante producción basada en seis capítulos de libros, tres ponencias y la propuesta en proceso de aprobación externa de una Maestría en Gestión e Innovación – MGeI, junto a contactos y bases académicas, algunos de los que se canalizan en esta propuesta de investigación. El proyecto está orientado a fortalecer y profundizar en las áreas de conocimiento de gestión, emprendimiento e innovación. El propósito es conceptualizar, diseñar, formular e implementar iniciativas, es trategias, mecanismos, dinámicas, herramientas, modelos, rutas y alternativas de solución en atención a las organizaciones y sus demandas. Esto a partir de procesos en curso, como el apoyo en coordina ción con el Centro de Emprendimiento e Innovación de la Universidad Libre Bogotá (CEIDEUL) en los procesos de avance y desarrollo del Banco de Alimentos de Bogotá con sus organizaciones sociales aliadas. También el diseño e implementación del Laboratorio de Innovación Social LISBAB, la iniciativa de acciones para favorecer la competitividad de Faedpyme y el proyecto de Maestría en Gestión e Inno vación. Todo lo anterior respondiendo a las líneas de investigación dUniversidad Libre -- Facultad de Ciencias Económicas, Administrativas y Contables -- Administración de Empresa

The Mediating Role of Impulsivity in the Relationship Between Suicidal Behavior and Early Traumatic Experiences in Depressed Subjects

Background: Depressed patients with early traumatic experiences may represent a clinically and biologically distinct subtype, with worse clinical outcomes and greater risk of suicide. Since early traumatic experiences alter development of systems that regulate the stress response, increasing sensitivity to stress and mood disorders later in life, certain personality features may influence coping strategies, putting individuals with depression and a history of early traumatic experiences at greater risk of suicidal behavior.Objective: To determine whether impulsivity mediates the relationship between early traumatic experiences and suicidal behavior in patients with major depressive disorder (MDD).Methods: The total sample consists of 190 patients [mean age (SD) = 53.71 (10.37); females: 66.3%], with current MDD (DSM-5 criteria). The Childhood Trauma Questionnaire-Short Form (CTQ-SF), the List of Threatening Experiences (LTE), and the Barratt Impulsiveness Scale-11 (BIS-11) were used to assess childhood and adulthood adverse life events and impulsivity, respectively. We developed mediation models by bootstrap sampling methods.Results: Eighty-one (42.6%) patients had a history of previous suicide attempts (SA). CTQ-SF-Total and BIS-11-Total scores were significantly higher in MDD patients with previous SA. Correlation analyses revealed significant correlations between the CTQ-SF-Total and BIS-11-Total, CTQ-SF-Total and HDRS-Total, and BIS-11-Total and HDRS-Total scores. Regression models found that CTQ-SF-Total, BIS-11-Total, and HDRS-Total scores were associated with SA. Mediation analyses further revealed the association between CTQ-SF-Total and SA was mediated by the indirect effect of the BIS-11-Total score (b = 0.007, 95% CI = 0.001, 0.015), after statistically controlling for sex, the HDRS-Total, and the LTE-Total.Discussion: Data suggest that impulsivity could mediate the influence of childhood trauma on suicidal behavior. This will help understand the role of risk factors in suicidal behavior and aid in the development of prevention interventions focused on modifiable mediators when risk factors are non-modifiable.2020-2

HTLV-1 infection in solid organ transplant donors and recipients in Spain

HTLV-1 infection is a neglected disease, despite infecting 10-15 million people worldwide and severe illnesses develop in 10% of carriers lifelong. Acknowledging a greater risk for developing HTLV-1 associated illnesses due to immunosuppression, screening is being widely considered in the transplantation setting. Herein, we report the experience with universal HTLV testing of donors and recipients of solid organ transplants in a survey conducted in Spain. All hospitals belonging to the Spanish HTLV network were invited to participate in the study. Briefly, HTLV antibody screening was performed retrospectively in all specimens collected from solid organ donors and recipients attended since the year 2008. A total of 5751 individuals were tested for HTLV antibodies at 8 sites. Donors represented 2312 (42.2%), of whom 17 (0.3%) were living kidney donors. The remaining 3439 (59.8%) were recipients. Spaniards represented nearly 80%. Overall, 9 individuals (0.16%) were initially reactive for HTLV antibodies. Six were donors and 3 were recipients. Using confirmatory tests, HTLV-1 could be confirmed in only two donors, one Spaniard and another from Colombia. Both kidneys of the Spaniard were inadvertently transplanted. Subacute myelopathy developed within 1 year in one recipient. The second recipient seroconverted for HTLV-1 but the kidney had to be removed soon due to rejection. Immunosuppression was stopped and 3 years later the patient remains in dialysis but otherwise asymptomatic. The rate of HTLV-1 is low but not negligible in donors/recipients of solid organ transplants in Spain. Universal HTLV screening should be recommended in all donor and recipients of solid organ transplantation in Spain. Evidence is overwhelming for very high virus transmission and increased risk along with the rapid development of subacute myelopathy

Plan gallego de hospitalización a domicilio. Estrategia HADO 2019-2023

Documento estratéxico que pretende potenciar e consolidar a hospitalización a domicilio como un modelo asistencial do Servizo Galego de Saúde e garantir o seu desenvolvemento nos próximos seis anos, establecendo criterios homoxéneos de atención coa finalidade de normalizar os modelos asistenciais, carteira de servizos e fluxos de traballo para asegurar una asistencia sanitaria de calidadeDocumento estratégico que pretende potenciar y consolidar la hospitalización a domicilio como un modelo asistencial del Servicio Gallego de Salud y garantizar su desarrollo en los próximos seis años, estableciendo criterios homogéneos de atención con la finalidad de normalizar los modelos asistenciales, cartera de servicios y flujos de trabajo para asegurar una asistencia sanitaria de calida

Effectiveness, safety/tolerability of OBV/PTV/r ± DSV in patients with HCV genotype 1 or 4 with/without HIV-1 co-infection, chronic kidney disease (CKD) stage IIIb-V and dialysis in Spanish clinical practice - Vie-KinD study

Limited data are available on the effectiveness and tolerability of direct-acting antivirals (DAAs) therapies in the real world for HCV-infected patients with comorbidities. This study aimed to describe the effectiveness of OBV/PTV/r ± DSV (3D/2D regimen) with or without ribavirin (RBV) in HCV or HCV/HIV co-infected patients with GT1/GT4 and CKD (IIIb-V stages), including those under hemodialysis and peritoneal dialysis in routine clinical practice in Spain in 2015.Non-interventional, retrospective, multicenter data collection study in 31 Spanish sites. Socio-demographic, clinical variables, study treatment characteristics, effectiveness and tolerability data were collected from medical records.Data from 135 patients with a mean age (SD) of 58.3 (11.4) years were analyzed: 92.6% GT1 (81.6% GT1b and 17.6% GT1a) and 7.4% GT4, 14 (10.4%) HIV/HCV co-infected, 19.0% with fibrosis F3 and 28.1% F4 by FibroScan®, 52.6% were previously treated with pegIFN and RBV. 11.1%, 14.8% and 74.1% of patients had CKD stage IIIb, IV and V respectively. 68.9% of patients were on hemodialysis; 8.9% on peritoneal dialysis and 38.5% had history of renal transplant. A total of 125 (96.2%) of 135 patients were treated with 3D, 10 (7.4%) with 2D and 30.4% received RBV. The overall intention-to-treat (ITT) sustained virologic response at week 12 (SVR12) was 92.6% (125/135) and the overall modified-ITT (mITT) SVR12 was 99.2% (125/126). The SVR12 rates (ITT) per sub-groups were: HCV mono-infected (91.7%), HCV/HIV co-infected (100%), GT1 (92.0%), GT4 (100%), CKD stage IIIb (86.7%), stage IV (95%) and stage V (93%). Among the 10 non-SVR there was only 1 virologic failure (0.7%); 4 patients had missing data due lost to follow up (3.0%) and 5 patients discontinued 3D/2D regimen (3.7%): 4 due to severe adverse events (including 3 deaths) and 1 patient´s decision.These results have shown that 3D/2D regimens are effective and tolerable in patients with advanced CKD including those in dialysis with GT 1 or 4 chronic HCV mono-infection and HIV/HCV coinfection in a real-life cohort. The overall SVR12 rates were 92.6% (ITT) and 99.2% (mITT) without clinically relevant changes in eGFR until 12 weeks post-treatment. These results are consistent with those reported in clinical trials