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

Psicología de la liberación programa de prevención e intervención psicosocial a padres de familia, entidades públicas y privadas para la restitución de derechos de los niños, niñas y adolescentes en las Favelas de Rio de Janeiro, Brasil

A través de la fase diagnóstica se puede inferir que este proceso revela una grave vulneración de derechos. Estos menores enfrentan violencia, exclusión social y económica, falta de acceso a servicios básicos y educativos, y riesgos constantes en un entorno conflictivo. La precariedad de las condiciones de vida, la violencia doméstica y comunitaria, la exclusión educativa, y la falta de acceso a salud y protección social son problemas críticos. También hay una alta exposición a explotación laboral y actividades ilícitas debido a la falta de oportunidades. Por lo cual es urgente implementar intervenciones integrales y políticas públicas efectivas que protejan y promuevan el desarrollo y acceso a oportunidades de estos niños, con un enfoque en derechos humanos y equidad social.Through the diagnostic phase it can be inferred that this process reveals a serious violation of rights. These minors face violence, social and economic exclusion, lack of access to basic and educational services, and constant risks in a conflictive environment. The precariousness of living conditions, domestic and community violence, educational exclusion, and lack of access to health and social protection are critical problems. There is also a high exposure to labor exploitation and illicit activities due to lack of opportunities. Therefore, it is urgent to implement comprehensive interventions and effective public policies that protect and promote the development and access to opportunities of these children, with a focus on human rights and social equity.1. Titulo -- 2. Introducción -- 3. Diagnostico psicosocial -- 3.1 Referente contextual -- 3.1.1 Mapeo y localización -- 3.2. Técnicas de recolección de datos -- 3.2.1. Revisión bibliográfica -- 3.2.2 Observación -- 3.2.3 Árbol de problemas -- 3.3. Referente legal -- 3.4 Características socioculturales de la población beneficiaria -- 4. Planteamiento del problema -- 5. Justificación -- 6. Objetivos -- 6.1 Objetivo general -- 6.2 Objetivos específicos -- 7. Fundamentación teórica -- 7.1 Referente conceptual -- 7.2 Enfoque -- 7.2.1 Psicología social de la liberación -- 8 propuesta de intervención psicosocial -- 8.1 Diseño metodológico -- 8.3 Objeto de intervención -- 8.3.1 Objetivo general -- 8.3.2 Objetivo específicos -- 8.4 Metas -- 8.5 Sistema de evaluación -- 8.6 Monitoreo -- 8.7 Recursos -- 8.8 Presupuesto -- 8.9 Plan de acción -- 8.10 Cronograma -- 9. Conclusión -- 10. Referencia -- 11. AnexosPregradoPsicólog

Proteoma urinario en la enfermedad renal diabética. Estado del arte: Urinary proteome in diabetic kidney disease: state of the art

Diabetic kidney disease (DKD) is the main microvascular complication in patients with diabetes mellitus; it is an entity that generates a significant increase in mortality of cardiovascular origin in this group of patients, although its early diagnosis has a significant impact on the evolution to end-stage kidney disease and, therefore, on mortality. The detection of albuminuria in urine and the deterioration of the estimated glomerular filtration rate are the main diagnostic techniques that are used in clinical practice to establish the presence of DKD; however, they have limitations and therefore it is important to note that kidney damage is usually irreversible once they are present. Over the last few years, numerous studies have focused on the discovery of new biomarkers to detect DKD and this is where the urinary proteomics appears as a new tool, an emerging technology that allows the identification of proteins in a urine sample that strongly suggest the early presence of this disease. Likewise, the discovery of proteomic-based biomarkers represents a novel strategy to improve the diagnosis, prognosis, and treatment of diabetic nephropathy; however, proteomics-based approaches are not yet available in the majority of clinical chemistry laboratories.La enfermedad renal diabética (ERD) es la principal complicación microvascular de los pacientes con diabetes mellitus; esta es una entidad que genera un aumento significativo en la mortalidad de origen cardiovascular de este grupo de pacientes, aunque su diagnóstico temprano impacta de forma significativa en la evolución a enfermedad renal terminal y, por lo tanto, en la mortalidad. La detección de albuminuria en la orina y el deterioro de la tasa de filtración glomerular estimada son las principales técnicas diagnósticas que se utilizan en la práctica clínica para establecer la presencia de ERD; sin embargo, estas tienen limitaciones y por lo tanto es importante resaltar que el daño renal suele ser irreversible una vez están presentes. Durante los últimos años, numerosos estudios se han enfocado en detectar nuevos biomarcadores para detectar ERD y es aquí donde aparece como nueva herramienta la proteómica urinaria, una tecnología emergente que permite identificar en una muestra de orina proteínas que sugieren la presencia de esta enfermedad de manera temprana. Asimismo, el descubrimiento de biomarcadores basados en proteómicos representa una estrategia novedosa para mejorar el diagnóstico, pronóstico y tratamiento de la nefropatía diabética; sin embargo, los enfoques basados en la proteómica aún no están disponibles en la mayoría de los laboratorios de química clínic

Psicología en contexto: retos y desafíos para los investigadores

La investigación ha ocupado un lugar central en la Facultad de Psicología de la Universidad de San Buenaventura Cali. Desde su creación hasta la fecha, la Facultad ha asumido una perspectiva crítica de la disciplina, con la intención explícita de promover un ejercicio profesional reflexivo y ajustado a las necesidades y características de nuestro contexto colombiano. Se trata, por supuesto, de una tarea interminable que solo puede llevarse a cabo por los senderos del diálogo y la discusión. El Primer Encuentro Regional de Psicología se gestó con ese fin y este volumen condensa las ponencias presentadas en dicho encuentro, el 20 de septiembre del 2012. Los trabajos incluyen avances y resultados de investigación, así como ponencias de reflexión teórica. El evento contó con la participación de estudiantes y docentes, así como de algunas ONG de la región. También nos acompañaron como invitados internacionales, la profesora Amelia Haydée Imbriano (Argentina) y el profesor Jorge Juan Román (Cuba).Universidad de San buenaventura - Cal

I simposio Internacional sobre Investigación en la enseñanza de las ciencias

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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

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

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