Problemas de interés en Salud Pública en el Departamento del Amazonas

Problemas de interés en Salud Pública en el Departamento del AmazonasProblemas de interés en Salud Pública en el Departamento del AmazonasAmazon wor

Mental health institution in Colombia in 2025. Delphi Method

La incertidumbre de las instituciones psiquiátricas en Colombia tiene aspectos científicos, económicos, de mercado y regulatorios que dificultan la previsión de las decisiones para una atención adecuada, adaptada a las condiciones cambiantes de la prestación de salud. La investigación exploró cómo será la institución psiquiátrica en el año 2025, con metodología Delphi. Hallazgos: Existe gran incertidumbre de cómo adecuar la institución psiquiátrica en el futuro; de acuerdo con los cambios de legislación y las expectativas sociopolíticas en el momento del estudio. Se prevé la necesidad de educación del equipo profesional, mejoría en infraestructura e incremento de servicios, incluyendo consulta, hospitalización total y parcial, clínicas específicas y atención comunitaria. La institución ideal luce como un conjunto amplio de servicios desarrollados sobre la base de la prestación actual, asumiendo pacientes agudos y crónicos. El campo de acción de la clínica psiquiátrica se prevé continuará asumiendo la falta de desarrollo de la atención primaria y de dispositivos comunitarios.Uncertainty of psychiatric institutions in Colombia has scientific, economic, market and regulatory aspects that hinder the provision of decisions for adequate, efficient and effective care, facing the changing conditions of the provision of health services. The research explores how psychiatric institution will be in 2025. Materials and Methods: Delphi methodology, quantitative and qualitative analysis. Findings: There is great uncertainty about how to adapt the psychiatric institution in the future; according with changes in legislation and sociopolitical expectations at time of study. Education of professional team, improved infrastructure and increased services, including ambulatory ones, total and partial hospitalization, specific clinical and community care is expected. The ideal institution looks like a comprehensive set of services developed on the basis of the current provision, assuming acute and chronic patients. The scope of the psychiatric clinic is expected to continue assuming the lack of development of primary care and community facilitie

Caracterização dos registros de atendimento em uma instituição prestadora de serviços de saúde mental em Bogotá, 2001-2017

Introduction: The comprehensive approach to mental health is one of the country’s public health challenges, as the Colombian population has deteriorated in this area over the past twenty years, according to the CONPES Document 3992, 2020. Objective: To characterize the individual mental health service delivery records at a service provider institution in Bogota, Colombia, between 2001 and 2017. Methods: Descriptive cross-sectional study. Individual service delivery records were used as a source of information, and the International Classification of Diseases (ICD-10) was considered. Total mental health RIPS by interdisciplinary team: general practitioner, psychiatrist, nurse, psychologist, social worker, and occupational therapist. Results: A total of 2,360,295 individual mental health service delivery records from the selected institution were analyzed. According to the records, the average age of the patients was 47 years, and females predominated with 52.5% of the patients. Inpatient (49.82%), outpatient (43.42%), emergency room (4.54%), and day hospital (0.39%) services were used. The highest number of records (64.47 %) were found among the 18-59 years age group, followed by the 60+ year age group (28.50 %) and those under 18 years of age (7.03 %). The main diagnostic groups were psychotic disorder (33.38%), depression (15.39%), and anxiety (13.71%). Conclusions: Women are the main users of the service (52.5%). Hospitalization is the service most frequently used (49.82%). Adults between the ages of 18 and 59 use the services the most (64.47%). There has been a progressive increase in the number of attendances. Severe schizophrenia and bipolar mental disorders are the most treated (33.38%), followed by depression and anxiety (29%). General medical conditions were present in 10.95% of attendances.Introducción: el abordaje integral de la salud mental es uno de los retos del país en salud pública, dado que la población colombiana ha presentado un deterioro en ese aspecto en los últimos veinte años de acuerdo con el documento CONPES 3992 del 2020. Objetivo: Caracterizar los registros individuales de prestación de servicios en atención de salud mental en una institución prestadora de servicios en Bogotá, Colombia, entre el 2001 y el 2017. Métodos: estudio descriptivo trasversal. Se usaron los registros individuales de prestación de servicios como fuente de información y se tuvo en cuenta clasificación internacional de enfermedades (CIE-10) En total de registros RIPS en salud mental, por equipo interdisciplinario: médico general, médico psiquiatra, enfermería, psicología, trabajo social y terapia ocupacional. Resultados: se analizaron 2.360.295 registros individuales de prestación de servicios en salud mental de la institución seleccionada. Según los registros, el promedio de edad de las personas atendidas era de 47 años y predominó el sexo femenino con el 52,5 %. Los servicios utilizados fueron hospitalización (49,82 %), consulta externa (43,42 %), urgencias (4,54 %) y hospital de día (0,39 %). El mayor número de registros (64,47 %) se presentó en el grupo entre los 18 y 59 años de edad; seguido del grupo de 60 años o más (28,50 %) y de menores de 18 años (7,03 %). Los grupos de diagnóstico principales fueron trastorno psicótico con el 33,38 %, depresión con el 15,39 % y ansiedad con el 13,71 %. Conclusiones: Son las mujeres quienes más utilizan el servicio (52.5%). Es la hospitalización el servicio más utilizado (49.82%). Son los adultos entre 18 y 59 años quienes más utilizan los servicios (64.47%). Se observa un progresivo incremento en el número de atenciones. Los trastornos mentales severos esquizofrenia y bipolar son los más atendidos (33.38%) seguidos de trastornos de depresión y ansiedad (29%). Las enfermedades medicas generales se presentaron en el (10.95%) de las atenciones.Introdução: a abordagem integral da saúde mental é um dos desafios do país em saúde pública, visto que a população colombiana tem apresentado uma deterioração neste aspecto nos últimos vinte anos de acordo com o documento Conpes 3992 de 2020. Objetivo: Caracterizar os registros individuais de prestação de serviços em saúde mental em uma instituição prestadora de serviços em Bogotá, Colômbia, entre 2001 e 2017. Métodos: estudo descritivo transversal. Usaram-se os registros individuais de prestação de serviços como fonte de informação e considerou-se a classificação internacional de doenças (CID-10). No total de registros RIPS em saúde mental, por equipe interdisciplinar: clínico geral, psiquiatra, enfermagem, psicologia, serviço social e terapia ocupacional. Resultados: Foram analisados ​​2.360.295 prontuários individuais de prestação de serviço de saúde mental da instituição selecionada. De acordo com os registros, a média de idade das pessoas atendidas foi de 47 anos e o sexo feminino predominou com 52,5%. Os serviços utilizados foram internação (49,82%), ambulatorial (43,42%), emergência (4,54%) e hospital-dia (0,39%). O maior número de registros (64,47%) foi apresentado no grupo entre 18 e 59 anos; seguido pelo grupo de 60 anos ou mais (28,50%) e os menores de 18 anos (7,03%). Os principais grupos diagnósticos foram transtorno psicótico com 33,38%, depressão com 15,39% e ansiedade com 13,71%. Conclusões: As mulheres são as que mais utilizam o serviço (52,5%). A internação é o serviço mais utilizado (49,82%). Os adultos entre 18 e 59 anos são os que mais utilizam os serviços (64,47%). Observa-se um aumento progressivo no número de atenções. Os transtornos mentais graves esquizofrenia e bipolaridade são os mais atendidos (33,38%) seguidos de depressão e transtornos de ansiedade (29%). Doenças médicas gerais estiveram presentes em (10,95%) dos atendimentos.

Uso de e-mental health para el seguimiento posterapia de pacientes con depresión en Colombia

ABSTARCT: Use of E-Mental Health for monitoring depressive patients in Colombia Depressive disorders affect people of all ages, they reduce the quality of life and are recurrent. The most recent reports of the Ministry of Health and Social Protection establish between 12,1 and 13,1 % the prevalence of depression in the Colombian population. In recent years, the field of e-mental health has expanded rapidly and interventions based on communication and information technologies are being suggested as means to complement conventional mental health services. In this context, the research had as purpose to evaluate in Colombia the feasibility and acceptability of the technological intervention called “Apoyo, Seguimiento y Control de Enfermedades a partir de Sistemas Operativos –ASCENSO”. A purposive sample of patients discharged from psychotherapeutic treatments was selected. The HPQ-9 was applied, the ASCENSO platform was implemented, and finally, semi-structured interviews were conducted with study participants. The results show a favorable opinion of the patients that participated, the difficulties of the mental health institutions to join a project like this and a sensible lack of e-mental health programs in Colombia.RESUMEN: Los trastornos depresivos afectan a personas de todas las edades, reducen la calidad de vida y son recurrentes. Los informes más recientes del Ministerio de Salud y Protección Social establecen entre 12,1 y 13,1 % la prevalencia de la depresión en la población colombiana. En los últimos años, el campo del e-mental health se ha expandido rápidamente y las intervenciones basadas en las tecnologías de información y comunicación (TIC) se sugieren cada vez más como medio para complementar la atención convencional de la salud mental. En este contexto, la investigación tuvo como propósito evaluar en Colombia la factibilidad de uso y aceptabilidad de la estrategia de intervención tecnológica “Apoyo, Seguimiento y Control de Enfermedades a partir de Sistemas Operativos – ASCENSO”. Fue seleccionada una muestra intencional de pacientes dados de alta de tratamientos psicoterapéuticos. Se aplicó el HPQ-9, se implementó la plataforma ASCENSO y se realizaron entrevistas semiestructuradas a los participantes. Los resultados señalan la opinión favorable que manifestaron los pacientes que se beneficiaron del proceso, las dificultades de las instituciones de salud mental para vincularse a estos proyectos y una sensible ausencia de programas e-mental health en Colombia

Guías colombianas de electrofisiología no invasiva

Los métodos diagnósticos no invasivos son el pilar inicial del estudio de cualquier paciente con una patología en particular, de ahí que sean los exámenes más solicitados y constituyan una importante carga en costos para un sistema de salud.Q4Guías1-12

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

Search for Physics beyond the Standard Model in Events with Overlapping Photons and Jets

Results are reported from a search for new particles that decay into a photon and two gluons, in events with jets. Novel jet substructure techniques are developed that allow photons to be identified in an environment densely populated with hadrons. The analyzed proton-proton collision data were collected by the CMS experiment at the LHC, in 2016 at root s = 13 TeV, and correspond to an integrated luminosity of 35.9 fb(-1). The spectra of total transverse hadronic energy of candidate events are examined for deviations from the standard model predictions. No statistically significant excess is observed over the expected background. The first cross section limits on new physics processes resulting in such events are set. The results are interpreted as upper limits on the rate of gluino pair production, utilizing a simplified stealth supersymmetry model. The excluded gluino masses extend up to 1.7 TeV, for a neutralino mass of 200 GeV and exceed previous mass constraints set by analyses targeting events with isolated photons.Peer reviewe

Measurement of the top quark forward-backward production asymmetry and the anomalous chromoelectric and chromomagnetic moments in pp collisions at √s = 13 TeV

Abstract The parton-level top quark (t) forward-backward asymmetry and the anomalous chromoelectric (d̂ t) and chromomagnetic (μ̂ t) moments have been measured using LHC pp collisions at a center-of-mass energy of 13 TeV, collected in the CMS detector in a data sample corresponding to an integrated luminosity of 35.9 fb−1. The linearized variable AFB(1) is used to approximate the asymmetry. Candidate t t ¯ events decaying to a muon or electron and jets in final states with low and high Lorentz boosts are selected and reconstructed using a fit of the kinematic distributions of the decay products to those expected for t t ¯ final states. The values found for the parameters are AFB(1)=0.048−0.087+0.095(stat)−0.029+0.020(syst),μ̂t=−0.024−0.009+0.013(stat)−0.011+0.016(syst), and a limit is placed on the magnitude of | d̂ t| &lt; 0.03 at 95% confidence level. [Figure not available: see fulltext.

Measurement of the Jet Mass Distribution and Top Quark Mass in Hadronic Decays of Boosted Top Quarks in pp Collisions at root s=13 TeV

A measurement is reported of the jet mass distribution in hadronic decays of boosted top quarks produced in pp collisions at root s = 13 TeV. The data were collected with the CMS detector at the LHC and correspond to an integrated luminosity of 35.9 fb(-1). The measurement is performed in the lepton + jets channel of t (t) over bar events, where the lepton is an electron or muon. The products of the hadronic top quark decay t -> bW -> bq (q) over bar' are reconstructed as a single jet with transverse momentum larger than 400 GeV. The t (t) over bar cross section as a function of the jet mass is unfolded at the particle level and used to extract a value of the top quark mass of 172.6 +/- 2.5 GeV. A novel jet reconstruction technique is used for the first time at the LHC, which improves the precision by a factor of 3 relative to an earlier measurement. This highlights the potential of measurements using boosted top quarks, where the new technique will enable future precision measurements.Peer reviewe