¿que factores favorecen el consumo de sustancias psicoactivas en los jóvenes y adolescentes del municipio?

Con el presente trabajo se pretende como estudiantes de Regencia en Farmacia establecer un estudio más profundo sobre la problemática que se viene presentando en nuestro país con respecto a las drogas licitas (alcohol, cigarrillos) e ilícitas como cocaína, marihuana, crack, etc., las cuales según informes de la policía se ha establecido que estas drogas ilícitas ya no están saliendo del país como exportador sino que se está convirtiendo o incrementando su consumo interno junto con otros medicamentos de control que son distribuidos por personas que no tienen conciencia, no les importa el daño que ocasionan a nivel personal, social y familiar. Esto nos deja ver un panorama alarmador y por lo tanto se debe crear conciencia sobre las negativas consecuencias que esto puede acarrear. De ahí la importancia de conocer a través de este tipo de encuestas quienes están cometiendo estas acciones y realizar análisis que conlleven a formular soluciones y acciones contundentes para erradicar este problema. Es hora de que entremos un poco en la verdadera realidad e inculquemos valores en nuestros hijos, entregando ejemplo de nosotros mismos y entrar en diálogo y hablarles desde edades muy tempranas acerca de estos temas, que son importantes su vida y desarrollo.In the present work is intended as Regency Pharmacy students establish a deeper study on the problem that is showing up in our country with respect to licit drugs (alcohol, cigarettes) and illicit drugs such as cocaine, marijuana, crack, etc.., which according to police reports have established that these illicit drugs are no longer leaving the country as an exporter but is becoming increasing domestic consumption or with other medications to control which are distributed by people who have no conscience, do not matter the damage done to personal, social and family life. This lets us see a picture alarmed and therefore should create awareness about the negative consequences this may entail. Hence the importance of learning through this type of survey who are committing these actions and analysis that lead to develop solutions and take decisive action to eradicate this problem. It's time we get a little on the true reality and instill values in our children, giving example of ourselves and enter into dialogue and to speak from an early age about these issues, which are important life and development

Importancia de la adherencia de la terapia antirretroviral como factor de éxito en pacientes con vih/sida

En el presente trabajo se tiene en cuenta la investigación cualitativa de los pacientes que en este momento de su vida padecen de VIH y están siendo tratados con terapia antirretrovial. Debemos tener en cuenta que la adherencia a la medicación antirretroviral es un elemento clave para que se pueda abordar con éxito el tratamiento. Una mala adherencia puede llevar a la aparición de resistencias y a la progresión de la infección por VIH con mayor rapidez. Sin olvidar que el primer régimen de tratamiento tiene más posibilidades de éxito a largo plazo, así que es muy importante tomar los fármacos correctamente desde el principio. Muchas personas descubren que la adherencia al tratamiento se hace más difícil con el tiempo. Es importante hablar con su médico sobre cualquier problema que tenga con el plan de tratamiento. Todo paciente con VIH avanzada debe recibir tratamiento antirretroviral y debe tener en cuenta algunas consideraciones especiales. Estos pacientes tienen infecciones oportunistas, síndrome de desgaste, demencia o enfermedades neoplásicas que precisan de un tratamientos o profilaxis que pueden interferir con el tratamiento antirretroviral, ya sea porque suman sus efectos tóxicos, o son incompatibles o porque el mismo enfermo esta 'discapacitado' para poderlos tomarlos correctamente.In this paper takes into account qualitative research patients at the moment of his life living with HIV and being treated with antirretrovial therapy. We should note that adherence to antiretroviral medication is a key element that can deal successfully with treatment. Poor adherence can lead to the emergence of resistance and the progression of HIV infection more quickly. Without forgetting that the first treatment regimen is more likely to succeed in the long term, so it is very important to take the drugs correctly from the beginning. Many people find adherence becomes more difficult with time. It is important to talk to your doctor about any problems you have with your treatment plan. All patients with advanced HIV should receive antiretroviral treatment and should take into account some special considerations. These patients have opportunistic infections, wasting syndrome, dementia or neoplastic diseases that require treatment or prophylaxis that may interfere with antiretroviral therapy, either because they add their toxic effects, or are incompatible or because the patient himself is 'disabled' to that they can be to take them correctl

Estado de inactividad en adultos mayores de los barrios las mercedes y villa rosa en el municipio de Plato Magdalena

En el presente trabajo se realiza la formulación de un anteproyecto enfocado en los derechos humanos, de acuerdo a la idea planteada por la teoría del desarrollo humano, el cual resalta que el desarrollo de un país está en las personas, se escogió como población objeto a un grupo de adultos mayores del municipio de Plato en el departamento del Magdalena, específicamente de los barrio las Mercedes y Villa Rosa, con quienes se pretende reducir su estado de inactividad, alimentado por la crisis vital que atraviesan, la exclusión social a la cual son sometidos y el abandono por parte de los gobernantes de turno, por tanto se establecen acciones como: realizar convenio con institutos para que en su área de investigación incluyan la temática y sean ellos quienes se encarguen de la elaboración de diagnóstico y caracterización de la población de adulto mayor que orienten las políticas desde el nivel local, organización de huertas caseras administradas por el grupo, ejecutar talleres de elaboración de artículos de modisterías, tejidos, bordados y artesanales, organización y ejecución de talleres sobre emprendimiento, administración de recursos, manejo de contabilidad, técnicas de ahorro, liderados por el SENA, ofertar al mercado las frutas y verduras de las huertas caseras y productos artesanos, organizar en los distintos barrios tertulias dirigidas por un grupo de adultos mayores en donde tengan la oportunidad de expresar públicamente sus anécdotas con el objetivo de informar y formar a la comunidad en temas culturales y de historia del municipio específicamente y llevar a cabo talleres con los adultos mayores en donde se aborden temáticas como: autoestima, manejo de depresión, crisis vitales, higiene y autocuidado, adulto mayor y sociedad, adulto mayor y sociedad; encaminadas a disminuir el sedentarismo, promover la independencia económica y mitigar la presencia de problemas psicosociales en los adultos mayores a través de un esfuerzo interinstitucional

MEGARA anti-reflective coatings: theoretical and observed throughput estimations

MEGARA is the new integral field unit (IFU) and multi-object (MOS) spectrograph successfully commissioned at Gran Telescopio Canarias, in August 2017. MEGARA provides spectral resolutions R (fwhm) similar to 6000, 12000 and 20000, via volume phase holographic gratings, at very high efficiency in both IFU and MOS modes. In the case of MEGARA main optics and pupil elements optics, the surfaces in contact with air have an anti-reflective (AR) coatings to minimize the Fresnel losses at the interface glass-air. In this work we present the designs and calculation of the total throughput of the optical system based in the transmission measurements of the AR coated witness samples. The results reflect the benefits of having implemented customized AR coatings for the mean angle of incidence on each surface as the measured throughput was better than the requirements. We analyze the effects of the pupil elements AR coatings for each spectral configuration

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Battle of Postdisaster Response and Restoration

[EN] The paper presents the results of the Battle of Postdisaster Response and Restoration (BPDRR) presented in a special session at the first International water distribution systems analysis & computing and control in the water industry (WDSA/CCWI) Joint Conference, held in Kingston, Ontario, Canada, in July 2018. The BPDRR problem focused on how to respond and restore water service after the occurrence of five earthquake scenarios that cause structural damage in a water distribution system. Participants were required to propose a prioritization schedule to fix the damages of each scenario while following restrictions on visibility/nonvisibility of damages. Each team/approach was evaluated against six performance criteria: (1) time without supply for hospital/firefighting, (2) rapidity of recovery, (3) resilience loss, (4) average time of no user service, (5) number of users without service for eight consecutive hours, and (6) water loss. Three main types of approaches were identified from the submissions: (1) general-purpose metaheuristic algorithms, (2) greedy algorithms, and (3) ranking-based prioritizations. All three approaches showed potential to solve the challenge efficiently. The results of the participants showed that for this network, the impact of a large-diameter pipe failure on the network is more significant than several smaller pipes failures. The location of isolation valves and the size of hydraulic segments influenced the resilience of the system during emergencies. On average, the interruptions to water supply (hospitals and firefighting) varied considerably among solutions and emergency scenarios, highlighting the importance of private water storage for emergencies. The effects of damages and repair work were more noticeable during the peak demand periods (morning and noontime) than during the low-flow periods; and tank storage helped to preserve functionality of the network in the first few hours after a simulated event. (C) 2020 American Society of Civil Engineers.Paez, D.; Filion, Y.; Castro-Gama, M.; Quintiliani, C.; Santopietro, S.; Sweetapple, C.; Meng, F.... (2020). Battle of Postdisaster Response and Restoration. Journal of Water Resources Planning and Management. 146(8):1-13. https://doi.org/10.1061/(ASCE)WR.1943-5452.0001239S1131468Balut A. R. Brodziak J. Bylka and P. Zakrzewski. 2018. “Battle of post-disaster response and restauration (BPDRR).” In Proc. 1st Int. WDSA/CCWI 2018 Joint Conf. 14. Kingston Canada: Open Journal Systems.Bibok A. 2018. “Near-optimal restoration scheduling of damaged drinking water distribution systems using machine learning.” In Proc. 1st Int. WDSA/CCWI 2018 Joint Conf. 14. 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Evaluating the ε-Domination Based Multi-Objective Evolutionary Algorithm for a Quick Computation of Pareto-Optimal Solutions. Evolutionary Computation, 13(4), 501-525. doi:10.1162/106365605774666895Deuerlein J. D. Gilbert E. Abraham and O. Piller. 2018. “A greedy scheduling of post-disaster response and restoration using pressure-driven models and graph segment analysis.” In Proc. 1st Int. WDSA/CCWI 2018 Joint Conf. 14. Kingston Canada: Open Journal Systems.Deuerlein, J. W. (2008). Decomposition Model of a General Water Supply Network Graph. Journal of Hydraulic Engineering, 134(6), 822-832. doi:10.1061/(asce)0733-9429(2008)134:6(822)Di Nardo, A., Di Natale, M., Giudicianni, C., Santonastaso, G. F., & Savic, D. (2018). Simplified Approach to Water Distribution System Management via Identification of a Primary Network. Journal of Water Resources Planning and Management, 144(2), 04017089. doi:10.1061/(asce)wr.1943-5452.0000885Eliades D. G. M. Kyriakou S. Vrachimis and M. M. Polycarpou. 2016. “EPANET-MATLAB toolkit: An open-source software for interfacing EPANET with MATLAB.” In Proc. 14th Int. Conf. on Computing and Control for the Water Industry (CCWI) 8. The Hague The Netherlands: International Water Conferences. https://doi.org/10.5281/zenodo.831493.Fragiadakis, M., Christodoulou, S. E., & Vamvatsikos, D. (2013). Reliability Assessment of Urban Water Distribution Networks Under Seismic Loads. Water Resources Management, 27(10), 3739-3764. doi:10.1007/s11269-013-0378-0Gilbert, D., Abraham, E., Montalvo, I., & Piller, O. (2017). Iterative Multistage Method for a Large Water Network Sectorization into DMAs under Multiple Design Objectives. Journal of Water Resources Planning and Management, 143(11), 04017067. doi:10.1061/(asce)wr.1943-5452.0000835Hill, D., Kerkez, B., Rasekh, A., Ostfeld, A., Minsker, B., & Banks, M. K. (2014). Sensing and Cyberinfrastructure for Smarter Water Management: The Promise and Challenge of Ubiquity. 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B. 1967. “Some methods for classification and analysis of multivariate observations.” In Vol. 1 of Proc. 5th Berkeley Symp. on Mathematical Statistics and Probability 281–297. Berkeley: University of California Press.Mahmoud, H. A., Kapelan, Z., & Savić, D. (2018). Real-Time Operational Response Methodology for Reducing Failure Impacts in Water Distribution Systems. Journal of Water Resources Planning and Management, 144(7), 04018029. doi:10.1061/(asce)wr.1943-5452.0000956Meng, F., Fu, G., Farmani, R., Sweetapple, C., & Butler, D. (2018). Topological attributes of network resilience: A study in water distribution systems. Water Research, 143, 376-386. doi:10.1016/j.watres.2018.06.048Ostfeld, A., Uber, J. G., Salomons, E., Berry, J. W., Hart, W. E., Phillips, C. A., … Walski, T. (2008). The Battle of the Water Sensor Networks (BWSN): A Design Challenge for Engineers and Algorithms. Journal of Water Resources Planning and Management, 134(6), 556-568. doi:10.1061/(asce)0733-9496(2008)134:6(556)Paez D. Y. Filion and M. Hulley. 2018a. “Battle of post-disaster response and restoration (BPDRR)—Problem description and rules.” Accessed June 14 2019. https://www.queensu.ca/wdsa-ccwi2018/problem-description-and-files.Paez, D., Suribabu, C. R., & Filion, Y. (2018). Method for Extended Period Simulation of Water Distribution Networks with Pressure Driven Demands. Water Resources Management, 32(8), 2837-2846. doi:10.1007/s11269-018-1961-1Salcedo C. A. Aguilar P. Cuero S. Gonzalez S. Muñoz J. Pérez A. Posada J. Robles and K. Vargas. 2018. “Determination of the hydraulic restoration capacity of b-city involving a multi-criteria decision support model.” In Proc. 1st Int. WDSA/CCWI 2018 Joint Conf. 14. Kingston Canada: Open Journal Systems.Santonastaso G. F. E. Creaco A. Di Nardo and M. Di Natale. 2018. “Post-disaster response and restauration of B-town network based on primary network.” In Vol. 1 of Proc. 1st Int. WDSA/CCWI 2018 Joint Conf. Kingston Canada: Open Journal Systems.Sophocleous S. E. Nikoloudi H. A. Mahmoud K. Woodward and M. Romano. 2018. “Simulation-based framework for the restoration of earthquake-damaged water distribution networks using a genetic algorithm.” In Proc. 1st Int. WDSA/CCWI 2018 Joint Conf. 14. Kingston Canada: Open Journal Systems.Sweetapple C. F. Meng R. Farmani G. Fu and D. Butler. 2018. “A heuristic approach to water network post-disaster response and restoration.” In Proc. 1st Int. WDSA/CCWI 2018 Joint Conf. 14. Kingston Canada: Open Journal Systems.Tabucchi, T., Davidson, R., & Brink, S. (2010). Simulation of post-earthquake water supply system restoration. Civil Engineering and Environmental Systems, 27(4), 263-279. doi:10.1080/10286600902862615Taormina, R., Galelli, S., Tippenhauer, N. O., Salomons, E., Ostfeld, A., Eliades, D. G., … Ohar, Z. (2018). Battle of the Attack Detection Algorithms: Disclosing Cyber Attacks on Water Distribution Networks. Journal of Water Resources Planning and Management, 144(8), 04018048. doi:10.1061/(asce)wr.1943-5452.0000969Walski, T. M. (1993). Water distribution valve topology for reliability analysis. Reliability Engineering & System Safety, 42(1), 21-27. doi:10.1016/0951-8320(93)90051-yWang, Y., Au, S.-K., & Fu, Q. (2010). Seismic Risk Assessment and Mitigation of Water Supply Systems. Earthquake Spectra, 26(1), 257-274. doi:10.1193/1.3276900Yoo, D. G., Kang, D., & Kim, J. H. (2016). Optimal design of water supply networks for enhancing seismic reliability. Reliability Engineering & System Safety, 146, 79-88. doi:10.1016/j.ress.2015.10.001Zhang Q. F. Zheng K. Diao B. Ulanicki and Y. Huang. 2018. “Solving the battle of post-disaster response and restauration (BPDRR) problem with the aid of multi-phase optimization framework.” In Proc. 1st Int. WDSA/CCWI 2018 Joint Conf. 14. Kingston Canada: Open Journal Systems

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Global Retinoblastoma Presentation and Analysis by National Income Level.

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

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