Consenso colombiano de atención, diagnóstico y manejo de la infección por SARS-COV-2/COVID-19 en establecimientos de atención de la salud Recomendaciones basadas en consenso de expertos e informadas en la evidencia

The “Asociación Colombiana de Infectología” (ACIN) and the “Instituto de Evaluación de Nuevas Tecnologías de la Salud” (IETS) created a task force to develop recommendations for Covid 19 health care diagnosis, management and treatment informed, and based, on evidence. Theses reccomendations are addressed to the health personnel on the Colombian context of health services. © 2020 Asociacion Colombiana de Infectologia. All rights reserved

Polymorphism: an evaluation of the potential risk to the quality of drug products from the Farmácia Popular Rede Própria

Polymorphism in solids is a common phenomenon in drugs, which can lead to compromised quality due to changes in their physicochemical properties, particularly solubility, and, therefore, reduce bioavailability. Herein, a bibliographic survey was performed based on key issues and studies related to polymorphism in active pharmaceutical ingredient (APIs) present in medications from the Farmácia Popular Rede Própria. Polymorphism must be controlled to prevent possible ineffective therapy and/or improper dosage. Few mandatory tests for the identification and control of polymorphism in medications are currently available, which can result in serious public health concerns

Effectiveness of a digital application to improve stroke knowledge for kids

Introduction: Stroke is highly prevalent in Latin America and one of the leading causes of morbidity and mortality in the world. Educating children about stroke has been established as an effective method to detect symptoms early, reduce hospital visits, and raise awareness among adults. Objective: To analyze the effectiveness of a mobile application to improve knowledge and understanding of stroke among children. Method: We conducted a focus group session including 12 children in order to analyze the behavior of 6 questions previously validated by expert neurologists. Subsequently, 105 primary school students between the ages of 7 and 12 completed a questionnaire on stroke symptoms and how to contact the emergency services before and after using an application on stroke symptoms. Qualitative analyses and the Student t test were used to verify the existence of differences between pre- and post-intervention test results. Results: After a single 40-min working session with the application, between 50% and 67% of the children were able to identify the signs of stroke, and 96.2% knew the national emergency services telephone number. Statistical analysis revealed statistically significant differences before and after the intervention with the digital application (t = 19.54; p < 0.001) and intragroup differences in the post-intervention test results (t = 40.71; p < 0.001). Conclusion: Primary school children who used our digital application increased their knowledge, understanding, and learning of stroke symptoms. Resumen: Introducción: El ictus es muy prevalente en Latinoamérica y constituye una de las principales causas de morbimortalidad a nivel mundial. Se ha sugerido que enseñar a los niños a reconocer los primeros síntomas de ictus puede ayudar a reducir el número de ingresos por esta enfermedad y a concienciar a la población adulta. Objetivo: Analizar la efectividad de una aplicación móvil para aumentar el conocimiento del ictus en los niños. Método: Llevamos a cabo una sesión con un grupo focal de 12 niños para analizar el comportamiento de 6 preguntas previamente validadas por un grupo de neurólogos expertos. Posteriormente, administramos un cuestionario sobre síntomas de ictus y servicios de emergencias a 105 niños de entre 7 y 12 años en dos momentos diferentes: antes y después de usar la aplicación sobre síntomas de ictus. Se realizaron análisis cualitativos y se aplicó la prueba t de Student para confirmar la presencia de diferencias en las respuestas al cuestionario antes y después de la intervención. Resultados: Tras una única sesión de 40 minutos con la aplicación, entre el 50% y el 67% de los niños eran capaces de identificar los síntomas de ictus y el 96,2% se sabían el número de teléfono de emergencias. El análisis estadístico reveló diferencias estadísticamente significativas entre los resultados del cuestionario antes y después de la intervención (t = 19,54; P < 0,001), así como diferencias intragrupo en los resultados postintervención (t = 40,71; P < 0,001). Conclusión: Los niños que utilizaron nuestra aplicación acabaron sabiendo más sobre los síntomas de ictus y cómo actuar

Efectividad de una aplicación móvil para mejorar el conocimiento sobre los síntomas de ictus en una población pediátrica de Colombia

Introduction: Stroke is highly prevalent in Latin America and one of the leading causes of morbidity and mortality in the world. Educating children about stroke has been established as an effective method to detect symptoms early, reduce hospital visits, and raise awareness among adults. Objective: To analyze the effectiveness of a mobile application to improve knowledge and understanding of stroke among children. Method: We conducted a focus group session including 12 children in order to analyze the behavior of 6 questions previously validated by expert neurologists. Subsequently, 105 primary school students between the ages of 7 and 12 completed a questionnaire on stroke symptoms and how to contact the emergency services before and after using an application on stroke symptoms. Qualitative analyses and the Student t test were used to verify the existence of differences between pre- and post-intervention test results. Results: After a single 40-min working session with the application, between 50% and 67% of the children were able to identify the signs of stroke, and 96.2% knew the national emergency services telephone number. Statistical analysis revealed statistically significant differences before and after the intervention with the digital application (t = 19.54; p < 0.001) and intragroup differences in the post-intervention test results (t = 40.71; p < 0.001). Conclusion: Primary school children who used our digital application increased their knowledge, understanding, and learning of stroke symptoms.Introducción: El ictus es muy prevalente en Latinoamérica y constituye una de las principales causas de morbimortalidad a nivel mundial. Se ha sugerido que ensenar ˜ a los niños a reconocer los primeros síntomas de ictus puede ayudar a reducir el número de ingresos por esta enfermedad y a concienciar a la población adulta. Objetivo: Analizar la efectividad de una aplicación móvil para aumentar el conocimiento del ictus en los niños. Método: Llevamos a cabo una sesión con un grupo focal de 12 niños para analizar el comportamiento de 6 preguntas previamente validadas por un grupo de neurólogos expertos. Posteriormente, administramos un cuestionario sobre síntomas de ictus y servicios de emergencias a 105 niños de entre 7 y 12 años ˜ en dos momentos diferentes: antes y después de usar la aplicación sobre síntomas de ictus. Se realizaron análisis cualitativos y se aplicó la prueba t de Student para confirmar la presencia de diferencias en las respuestas al cuestionario antes y después de la intervención. Resultados: Tras una única sesión de 40 minutos con la aplicación, entre el 50% y el 67% de los niños eran capaces de identificar los síntomas de ictus y el 96,2% se sabían el número de teléfono de emergencias. El análisis estadístico reveló diferencias estadísticamente significativas entre los resultados del cuestionario antes y después de la intervención (t = 19,54; P < 0,001), así como diferencias intragrupo en los resultados postintervención (t = 40,71; P < 0,001). Conclusión: Los niños que utilizaron nuestra aplicación acabaron sabiendo más sobre los síntomas de ictus y cómo actuar

Avaliação de desempenho de serviços de saúde Evaluation of the performance of health services

A partir da literatura recente (até 1988) a respeito da avaliação de serviços de saúde em geral e do desempenho hospitalar em particular, destacam-se os diferentes aspectos conceituais e metodológicos envolvidos, começando pelas primeiras tentativas no seio do Colégio Americano de Cirurgiões, passando pela criação e evolução da Comissão Conjunta de Acreditação de Hospitais americana, até os esforços e elaborações conceituais e metodológicas mais recentes. São destacados a metodologia dos grupos diagnósticos homogêneos ("diagnosis related groups" ou "DRGs") e os indicadores de gravidade ("severity of illness"). É comentada a evolução desse incipiente campo de conhecimento e de prática no ambiente nacional. São comentadas as origens do recente interesse internacional a respeito do problema, ou seja, o aumento generalizado de custos dos serviços de saúde, crescente aumento de demandas judiciais em alguns países e ainda o acentuado incremento de complexidade dos atos em muitas especialidades. Destacam-se as fontes de informação correntemente utilizadas no processo, ou seja, a observação direta (estudos caso/controle), os prontuários médicos e os instrumentos-resumo, freqüentemente utilizados para remuneração do atendimento. Mencionam-se as profundas influências na prática de saúde que o processo de avaliação tem introduzido, particularmente a padronização de procedimentos, o estadiamento de agravos, os estudos de trajetória, os relacionados a situações traçadoras ("tracers") e a alternativa que mais tem influenciado a prática de situações complexas de saúde, que são os protocolos diagnóstico-terapêutico s já amplamente utilizados em algumas áreas como a do tratamento de câncer, inclusive no Brasil.<br>Recent literature (up to 1988) on health service assessment in general and especially on hospital service assessment is reviewed, with special attention to its conceptual and methodological aspects. The history of this process is also examined, from the first attempts by the American College of Surgeons, through the Joint Commission for Hospital Accreditation activities up to more recent efforts. The Diagnosis Related Group methodology is commented especially, as well as its more recent complement, the severity of illness inidicators. Progress made in this field is briefly examined as in the light of the Brazilian situation. The origins of the growing international concern with this field are enumerated: soaring costs of health services; the recent growth in the number of medical malpractice suits; and the sharp increase in the complexity of health services. The sources of information used in the process, such as immediate observation (case-control type studies), medical records, and summary instruments already in use for payment or financial control purposes, are commented on. Mention is made of the deep influences of the assessment process on practice as in the case of the standardization of practices and procedures, staging of the pathological processes, trajectory-type studies; the utilization of tracer situations, and, finally, the most influencial on practice of all these assessment instruments: the diagnosis and treatment protocols, already in wide use in some medical fields such as cancer treatment even in developing countries

Consenso colombiano de atención, diagnóstico y manejo de la infección por SARS-COV-2/COVID-19 en establecimientos de atención de la salud Recomendaciones basadas en consenso de expertos e informadas en la evidencia

The “Asociación Colombiana de Infectología” (ACIN) and the “Instituto de Evaluación de Nuevas Tecnologías de la Salud” (IETS) created a task force to develop recommendations for Covid 19 health care diagnosis, management and treatment informed, and based, on evidence. Theses reccomendations are addressed to the health personnel on the Colombian context of health services. © 2020 Asociacion Colombiana de Infectologia. All rights reserved