Mental health and psychosocial impact of the COVID-19 pandemic and social distancing measures among young adults in Bogotá, Colombia.

We sought to explore mental health and psychosocial impact among young people (18 to 24 years old) in Bogotá during the first months of the COVID-19 pandemic. Methods: We carried a cross sectional study using a web-based survey to assess mental health and personal impact among 18 to 24 years old living in Bogotá during the first 4 months of the 2020 COVID-19 pandemic lockdown. The depressive symptoms were measured with PHQ-8 and anxiety symptoms with (GAD-7). We also designed a questionnaire exploring changes in personal, family and social life. Results: Overall, 23% of the sample (n = 834) reported mild depressive symptoms (males 24% and females 23%); 29% reported moderate depressive symptoms (males 28%, females 30%); 22% moderate-severe symptoms (males 20%, females 23%) and 17% severe symptoms (males 15%, females 17%). Mild anxiety symptoms were reported by 29% of the sample (males 30%, females 29%); moderate anxiety symptoms by 29% (males 26%, females 30%); moderate-severe 18% (males 15%, females 20%) and severe anxiety by 6.0% (males 6.0% and females 6.0%). High symptoms of depression (PHQ-8 ≥ 10) were associated with being female, considering that the quarantine was stressful, having one member of the family losing their job, worsening of family relationships, decrease of physical activity and having a less nutritious diet. Having high anxiety symptoms (GAD-7 ≥ 10) were associated with sometimes not having enough money to buy food. Conclusions: The first months of the pandemic lockdown were associated with high depressive and anxiety symptoms among young persons living in Bogotá, Colombia. Increasing public health measures to provide support for young people is needed during lockdowns and it is necessary to further explore the long-term mental health impact due to personal, family and social changes brought by the COVID-19 pandemic.

Patterns of digital information and communication technology use among patients at primary health care centres in Colombia: Phase I of the DIADA project.

OBJECTIVE: Assess the prevalence and types of digital technology use, as well as the extent to which patients use the internet and mobile devises. Evaluate the socioeconomic characteristics of patients and the possible relation to patterns of technology use in Colombia. Understand the nature of patient technology use in primary care for finding medical information. METHODS: A survey was applied to adult patients who attended primary health care centers systems in 6 Colombian cities. The survey inquired about demographic characteristics, insurance, access to services, cell phone use, internet access, and the use of such technology to access health-related services and information. Data was collected and managed using REDCap. Summary statistics on each survey item were calculated and the differences between discrete variables were analyzed using chi-square. Multivariate analyses were performed using logistic regression analysis for binary dependent variables. RESULTS: A total of 1580 patients were surveyed across the six study sites. 93% of the patients reported they have a cell phone. Patients from urban healthcare centers showed a higher use of the Internet on their phone than less urban settings. Around half of the surveyed patients reported Internet use (49.7%). Among Internet users, 65% of participants use the Internet looking for health care information. Around one-third of patients use cellphones to arrange clinic visits. Around 24% of participants answered positively for both Whooley's questions. Of those who screened positive on the Whooley questions, 43% reported being moderately anxious, 47% reported being very anxious. 51% reported having moderate pain; 52% reported having severe pain. CONCLUSIONS: The patterns of technology use identified in this study are essential for developing future health interventions based on ICT. The design of ICT clinical interventions must take into account the cellphone payment plans, availability of internet connection, advantages, and disadvantages of messenger services, including SMS as a possible alternative to people who do not have smartphones.

Health-related quality of life and health literacy among adult primary care patients with subsidized or contributive health insurance in Colombia.

CONTEXT: Colombia passed Law 100 in 1993 with the goal of providing universal health care coverage, and by 2013, over 96% of the Colombian population had health insurance coverage. However, little is known about how health-related quality of life (HRQoL) and health literacy are related among those with the two most common types of health insurance coverage: subsidized (those with lower incomes) and contributory (those with higher incomes) coverage. OBJECTIVES AND METHODS: In the current exploratory investigation, data from adults visiting six primary care clinics in Colombia were analysed to examine the relationship between HRQoL (assessed as problems with mobility, self-care, completing usual activities, pain/discomfort, and anxiety/depression), demographics, the two health insurance types, and health literacy. Analyses also assessed whether, within insurance types, health literacy was related to HRQoL. RESULTS: Results showed that those with contributory health insurance coverage had greater health literacy than those with subsidized coverage, and this was accounted for by differences in education and socioeconomic status. HRQoL did not differ by insurance type. Although lower health literacy was related to worse HRQoL in the overall sample, in subgroup analyses lower health literacy significantly related to worse HRQoL only among those with subsidized health insurance coverage. CONCLUSION: Targeting skills which contribute to health literacy, such as interpreting medical information or filling out forms, may improve HRQoL, particularly in those with subsidized insurance coverage.

Ciencias de la implementación: de la evidencia a la práctica / Implementation science: from evidence to practice

Resumen La amplia gama de evidencias científicas que respaldan diversas intervenciones clínicas no son suficientes para que dichas intervenciones se utilicen en la práctica. De tal modo que la Medicina Basada en la Evidencia debe dar el paso hacia la Practica Basada en la Evidencia, a través de procesos de implementación que permitan desplegar y contextualizar intervenciones en salud respaldadas por la evidencia. Para tal fin se ha desarrollado la Ciencia de la implementación, la cual investiga los factores que influencian el uso efectivo y completo de las innovaciones científicas en la práctica, intentando maximizar los beneficios de las intervenciones en salud. Esta ciencia se define como el estudio de los métodos que promueven la incorporación sistemática de hallazgos de investigación en la rutina clínica, con el objetivo de mejorar la calidad y efectividad de los servicios e intervenciones en salud. El propósito de este artículo es introducir el concepto de Ciencia de la Implementación en relación con la epidemiología clínica y establecer las razones por las cuales existe una imperiosa necesidad de su desarrollo. Además, tiene el propósito de explicar el porqué de la necesidad de acelerar la aplicación efectiva de la Medicina Basada en Evidencia y definir los principales modelos que precisan el ámbito de trabajo de esta ciencia, incluyendo: las particularidades de los estudios de implementación, sus diferencias con los estudios clásicos de la epidemiología clínica, los modelos de implementación y evaluación, así como la definición de los desenlaces esperados en un estudio de implementación. (Acta Med Colomb 2018; 43: 207-216).

Abstract The wide range of scientific evidence supporting various clinical interventions is not sufficient for these interventions to be used in practice. For this reason, Evidence-Based Medicine must take the step towards Evidence-Based Practice, through implementation processes that allow deploying and contextualizing the health interventions supported by evidence. For this purpose, the Science of implementation has been developed, which investigates the factors that influence the effective and complete use of scientific innovations in practice, trying to maximize the benefits of health interventions. This science is defined as the study of methods that promote the systematic incorporation of research findings in the clinical routine, with the aim of improving the quality and effectiveness of health services and interventions. The purpose of this article is to introduce the concept of Implementation Science in relation to clinical epidemiology and establish the reasons by which there is an urgent need for its development. In addition, it has the purpose of explaining why the need to accelerate the effective application of Evidence-Based Medicine and define the main models that define the scope of work of this science, including: the particularities of implementation studies, their differences with the classic studies of clinical epidemiology, the implementation and evaluation models, as well as the definition of expected outcomes in an implementation study. (Acta Med Colomb 2018; 43: 207-216).

Prevalencia y factores asociados a conductas de riesgo alimentario en población indígena de Colombia / Prevalence of risky eating behaviors and associated factors in indigenous population in Colombia

Resumen La información sobre conductas alimentarias de riesgo (CAR) entre indígenas latinoamericanos es escasa. El objetivo de este estudio fue estimar la prevalencia de CAR en población indígena de Colombia, así como identificar factibles factores de riesgo sociodemo-gráficos e individuales. De la Encuesta Nacional de Salud Mental se retomaron los registros de 493 indígenas adultos (Medad =29.5 años, DE =7.39), hombres y mujeres. Las CAR evaluadas fueron: dieta restrictiva, malestar al comer, atracón y vómito autoinducido. El 19.5% de los participantes reportaron presentar al menos una CAR, y aquellas con mayor prevalencia fueron la dieta (8.5-9.6%) y el atracón (6.1%). Ninguno de los factores sociodemográficos evaluados se asoció a la presencia de CAR; por el contrario, de entre los factores individuales, la presencia de trastorno afectivo mostró ser un factible factor de riesgo de estas conductas. Las CAR no son infrecuentes en la población indígena adulta colombiana, e incluso su prevalencia puede duplicar la documentada en población general. Este estudio pretende aportar al escaso conocimiento existente sobre el tópico en poblaciones indígenas. Hallazgos que, ya sea a mediano o largo plazo, deberán incidir en el planteamiento de políticas de salud públicas acordes a las minorías indígenas presentes en Latinoamérica.

Abstract Data on risky eating behaviors (REB) in Latin American ethnic groups is scarce. The aim of this study was to determine the prevalence of REB in adult indigenous from Colombia, as well as to identify feasible sociodemographic and individual risk factors. A total of 493 records of adult indigenous men and women (Mage = 29.5 years, SD = 7.39) were retrieved from the National Survey of Mental Health. The REB assessed were: restrictive dieting, eating discomfort, binge-eating and self-induced vomiting. Participants (19.5%) reported having at least one REB, being restrictive dieting (8.5-9.6%) and binge eating (6.1%) those with higher prevalence. None of the sociodemographic factors evaluated was associated with the presence of REB, on the contrary, among the individual factors, the presence of affective disorder showed to be a feasible risk factor for these behaviors. The REB are common in the indigenous population in Colombia, even its prevalence may double the one reported in general population. This study aims to contribute to the scarce existing knowledge about the topic in indigenous populations. Findings that, whether in the medium or long term, should influence the approach of public health policies according to the indigenous minorities in Latin America.

Modalidades de atención para el paciente adulto con diagnóstico de esquizofrenia en fase aguda y de mantenimiento / Types of Care for Adult Patients Diagnosed With Acute and Maintenance Phase Schizophrenia

Objetivos: Ayudar al clínico en la toma de decisiones sobre las modalidades de atención disponibles para el adulto con diagnóstico de esquizofrenia. Determinar cuáles son las modalidades de atención que se asocian a mejores desenlaces en personas adultas con diagnóstico de esquizofrenia. Método: Se elaboró una guía de práctica clínica bajo los lineamientos de la Guía Metodológica del Ministerio de Salud y Protección Social para identificar, sintetizar, evaluar la evidencia y formular recomendaciones respecto al manejo y seguimiento de los pacientes adultos con diagnóstico de esquizofrenia. Se adoptó y actualizó la evidencia de la guía NICE 82, que contestaba la pregunta acá planteada. Se presentó la evidencia y su graduación al grupo desarrollador de la guía (GDG) para la formulación de las recomendaciones siguiendo la metodología propuesta por el abordaje GRADE. Resultados: Se revisaron siete metaanálisis para la formulación de las recomendaciones de esta pregunta. Los pacientes que estuvieron en la modalidad de tratamiento asertivo comunitario presentaron un menor riesgo de nuevas hospitalizaciones. Para la modalidad de atención de manejo intensivo de caso se encontraron resultados concluyentes que favorecen a la intervención para rehospitalizaciones a mediano plazo, funcionamiento social y satisfacción con los servicios. Los equipos de resolución de crisis favorecen a esta frente al cuidado estándar en los desenlaces de rehospitalizaciones, funcionamiento social y satisfacción con el servicio. Conclusión: La utilización de diferentes modalidades de atención conlleva a la necesidad de ofrecer un abordaje integral a los pacientes. La evidencia muestra beneficios para la mayoría de los desenlaces estudiados sin encontrarse riesgos para la integridad o la salud de los pacientes. En esta evaluación se recomienda utilizar modalidades de prestación de servicios de salud que tengan una base comunitaria y que cuenten con un grupo multidisciplinario. No se recomienda usar la modalidad hospital día en la fase aguda de la esquizofrenia en adultos.

Objectives: To assist the clinician in making decisions about the types of care available for adults with schizophrenia. To determine which are the modalities of treatment associated with better outcomes in adults with schizophrenia. Methods: A clinical practice guideline was elaborated under the parameters of the Methodological Guide of the Ministerio de Salud y Protección Social to identify, synthesize and evaluate the evidence and make recommendations about the treatment and follow-up of adult patients with schizophrenia. The evidence of NICE guide 82 was adopted and updated. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. Results: Patients who were in Assertive community treatment had a lower risk of new hospitalizations. For the intensive case management, the results favored this intervention in the outcomes: medium term readmissions, social functioning and satisfaction with services. The crisis resolution teamswas associated with better outcomes on outcomes of readmissions, social functioning and service satisfaction in comparison with standard care. Conclusion: The use of different modalities of care leads to the need of a comprehensive approach to patients to reduce the overall disability associated with the disease. Evidence shows overall benefit for most outcomes studied without encountering hazards for health of patients. This evaluation is recommended to use the professional ways of providing health services that are community-based and have a multidisciplinary group. It is not recommended the modality "day hospital" during the acute phase of schizophrenia in adults.

Prevención y tratamiento de los efectos adversos agudos más frecuentes por el uso de antipsicóticos en pacientes adultos con diagnóstico de esquizofrenia / Prevention and Treatment of Common Acute Adverse Effects With Antipsychotic Use in Adults With Schizophrenia Diagnosis

Objetivo: Determinar las estrategias más adecuadas para la prevención y tratamiento de los efectos adversos agudos más frecuentes con el uso de Antipsicóticos. Método: Se elaboró una guía de práctica clínica bajo los lineamientos de la Guía Metodológica del Ministerio de Salud y Protección Social para identificar, sintetizar, evaluar la evidencia y formular recomendaciones respecto al manejo y seguimiento de los pacientes adultos con diagnóstico de esquizofrenia. Se realizó una búsqueda sistemática de la literatura de novo. Se presentó la evidencia y su graduación al grupo desarrollador de la guía (GDG) para la formulación de las recomendaciones siguiendo la metodología propuesta por el abordaje GRADE. Resultados: Resultados: Las intervenciones no farmacológicas tales como los consejos nutricionales por nutricionista, el ejercicio y la psicoterapia son efectivas para prevenir la ganancia de peso con el uso de antipsicóticos (disminución de peso en kg DM -3.05 [-4.16, -1.94]). La estrategia de cambio de antipsicótico fue efectiva para demostrar disminución de peso e IMC con el paso de olanzapina a aripiprazol (disminución del peso en kg DM -3.21 [-9.03; -2.61]). El uso de betabloqueadores comparado con placebo, usando como desenlace la reducción del 50% de los síntomas de acatisia, no mostró ser efectivo en la reducción de la acatisia inducida por antipsicóticos con un RR de 1.4 (0.59, 1.83). Conclusión: En esta evaluación se recomienda realizar acompan˜ amiento psicoterapéutico y por nutrición para el manejo del sobrepeso en pacientes en tratamiento farmacológico. En caso de que estas alternativas no sean efectivas se sugiere cambiar el antipsicótico a uno con menor riesgo de presentar incremento de peso o considerar el inicio de metformina. Para el manejo de acatisia inducida por medicamentos se recomienda la disminución de la dosis del medicamento y la adición de benzodiacepinas tipo lorazepam. No se recomienda el uso de betabloqueadores.

Objective: To determine the most adequate strategies for the prevention and treatment of the acute adverse effects of the use of antipsychotics. Methods: A clinical practice guideline was elaborated under the parameters of the Methodological Guide of the Ministerio de Salud y Protección Social to identify, synthesize and evaluate the evidence and make recommendations about the treatment and follow-up of adult patients with schizophrenia. A systematic literature search was carried out. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. Results: The non-pharmacological interventions such as nutritional counseling by a nutritionist, exercise and psychotherapy are effective in preventing weight gain with the use of antipsychotics. (Kg Weight reduction in DM of −3.05 (−4.16, −1.94)). The antipsychotic change from olanzapine to aripiprazole showed weight loss and decreased BMI (decreased weight in KG DM −3.21 (−9.03, −2.61). The use of beta blockers was ineffective in reducing akathisia induced by antipsychotic; using as outcome the 50% reduction of symptoms of akathisia comparing beta-blockers with placebo RR was 1.4 (0.59, 1.83). Conclusion: It is recommended to make psychotherapeutic accompaniment and nutrition management of overweight for patients with weight gain. If these alternatives are ineffective is suggested to change the antipsychotic or consider starting metformin. For the management of drug-induced akathisia it is recommended to decrease the dose of the drug and the addition of lorazepam. It is recommended using 5 mg biperiden IM or trihexyphenidyl 5 mg orally in case of secondary acute dystonia and for the treatment of antipsychotic-induced parkinsonism to decrease the dose of antipsychotic or consider using 2 -4 mg/day of biperiden or diphenhydramine 50 mg once daily.

[Prevention and Treatment of Common Acute Adverse Effects With Antipsychotic Use in Adults With Schizophrenia Diagnosis]. / Prevención y tratamiento de los efectos adversos agudos más frecuentes por el uso de antipsicóticos en pacientes adultos con diagnóstico de esquizofrenia.

OBJECTIVE: To determine the most adequate strategies for the prevention and treatment of the acute adverse effects of the use of antipsychotics. METHODS: A clinical practice guideline was elaborated under the parameters of the Methodological Guide of the Ministerio de Salud y Protección Social to identify, synthesize and evaluate the evidence and make recommendations about the treatment and follow-up of adult patients with schizophrenia. A systematic literature search was carried out. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. RESULTS: The non-pharmacological interventions such as nutritional counseling by a nutritionist, exercise and psychotherapy are effective in preventing weight gain with the use of antipsychotics. (Kg Weight reduction in DM of -3.05 (-4.16, -1.94)). The antipsychotic change from olanzapine to aripiprazole showed weight loss and decreased BMI (decreased weight in KG DM -3.21 (-9.03, -2.61). The use of beta blockers was ineffective in reducing akathisia induced by antipsychotic; using as outcome the 50% reduction of symptoms of akathisia comparing beta-blockers with placebo RR was 1.4 (0.59, 1.83). CONCLUSION: It is recommended to make psychotherapeutic accompaniment and nutrition management of overweight for patients with weight gain. If these alternatives are ineffective is suggested to change the antipsychotic or consider starting metformin. For the management of drug-induced akathisia it is recommended to decrease the dose of the drug and the addition of lorazepam. It is recommended using 5mg biperiden IM or trihexyphenidyl 5mg orally in case of secondary acute dystonia and for the treatment of antipsychotic-induced parkinsonism to decrease the dose of antipsychotic or consider using 2 - 4mg/day of biperiden or diphenhydramine 50mg once daily.

[Types of Care for Adult Patients Diagnosed With Acute and Maintenance Phase Schizophrenia]. / Modalidades de atención para el paciente adulto con diagnóstico de esquizofrenia en fase aguda y de mantenimiento.

OBJECTIVES: To assist the clinician in making decisions about the types of care available for adults with schizophrenia. To determine which are the modalities of treatment associated with better outcomes in adults with schizophrenia. METHODS: A clinical practice guideline was elaborated under the parameters of the Methodological Guide of the Ministerio de Salud y Protección Social to identify, synthesize and evaluate the evidence and make recommendations about the treatment and follow-up of adult patients with schizophrenia. The evidence of NICE guide 82 was adopted and updated. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. RESULTS: Patients who were in Assertive community treatment had a lower risk of new hospitalizations. For the intensive case management, the results favored this intervention in the outcomes: medium term readmissions, social functioning and satisfaction with services. The crisis resolution teams was associated with better outcomes on outcomes of readmissions, social functioning and service satisfaction in comparison with standard care. CONCLUSION: The use of different modalities of care leads to the need of a comprehensive approach to patients to reduce the overall disability associated with the disease. Evidence shows overall benefit for most outcomes studied without encountering hazards for health of patients. This evaluation is recommended to use the professional ways of providing health services that are community-based and have a multidisciplinary group. It is not recommended the modality "day hospital" during the acute phase of schizophrenia in adults.

Factores de riesgo para ideación suicida en pacientes con trastorno depresivo en Colombia / Risk Factors for Suicidal Ideation in Patients with Depressive Disorders in Colombia

Introducción: La ideación suicida es un factor de mal pronóstico en depresión por el riesgo de intento de suicidio y suicidio consumado; sin embargo, es un aspecto que no ha sido estudiado lo suficiente en la población colombiana. Es importante conocer factores asociados para desarrollar estrategias adecuadas de tratamiento. Objetivo: Identificar factores de riesgo para la ideación suicida en pacientes con diagnóstico de trastorno depresivo mayor entre los 18 y 65 años, en 5 ciudades de Colombia. Método: Se empleó la información de 295 pacientes con diagnóstico de trastorno depresivo mayor que participaron en el Estudio de Carga Económica de la Depresión en Colombia. La asociación de variables clínicas y psicosociales con la ideación suicida se evaluó por medio de modelos multinivel. Resultados: El sexo femenino fue un factor asociado con un menor riesgo de ideación suicida. Los factores asociados con ideación suicida incluyen desempleo, consumo de cigarrillo y de alcohol en los últimos 30 días, percepción de la salud mental como regular o mala, diagnóstico de depresión doble, tratamiento intrahospitalario, bajos ingresos y haber sufrido una gran crisis financiera en los últimos 2 años. Conclusiones: La ideación suicida es altamente prevalente en pacientes con trastorno depresivo mayor. Dentro de los factores de riesgo para ideación suicida se identifican elementos clínico como psicosocial que deben ser abordados con especial cuidado en pacientes con este diagnóstico al momento de hacer una evaluación de riesgo.

Introduction: Suicidal ideation is a poor prognostic factor in patients with depression, due to the risk of suicide attempt or completed suicide. However, it is a relatively unexplored aspect in the Colombian population. It is important to identify the associated factors in order to develop appropriate treatment strategies. Objective: To identify risk factors for suicidal ideation in patients with major depressive disorder between 18 and 65 years in 5 Colombian cities. Methods: Data from 295 patients diagnosed with major depressive disorder were used from the Study of the Economic Burden of Depression in Colombia. The association between the clinical and psychosocial variables with the presence of suicidal ideation was assessed using two-level hierarchical models. Results: Female sex was a factor associated with a lower risk of suicidal ideation. Factors associated with the presence of suicidal ideation include unemployment, smoking and alcohol use in the past 30 days, mental health perceived as fair or poor, diagnosis of double depression, inpatient treatment, low income, unemployment, and a major financial crisis in the last 2 years. Conclusions: Suicidal ideation is highly prevalent in patients with major depressive disorder. Risk factors associated with both the clinical and psychosocial domain must be carefully evaluated during risk assessment of patients with this diagnosis.

[Risk Factors for Suicidal Ideation in Patients with Depressive Disorders in Colombia]. / Factores de riesgo para ideación suicida en pacientes con trastorno depresivo en Colombia.

INTRODUCTION: Suicidal ideation is a poor prognostic factor in patients with depression, due to the risk of suicide attempt or completed suicide. However, it is a relatively unexplored aspect in the Colombian population. It is important to identify the associated factors in order to develop appropriate treatment strategies. OBJECTIVE: To identify risk factors for suicidal ideation in patients with major depressive disorder between 18 and 65 years in 5 Colombian cities. METHODS: Data from 295 patients diagnosed with major depressive disorder were used from the Study of the Economic Burden of Depression in Colombia. The association between the clinical and psychosocial variables with the presence of suicidal ideation was assessed using two-level hierarchical models. RESULTS: Female sex was a factor associated with a lower risk of suicidal ideation. Factors associated with the presence of suicidal ideation include unemployment, smoking and alcohol use in the past 30 days, mental health perceived as fair or poor, diagnosis of double depression, inpatient treatment, low income, unemployment, and a major financial crisis in the last 2 years. CONCLUSIONS: Suicidal ideation is highly prevalent in patients with major depressive disorder. Risk factors associated with both the clinical and psychosocial domain must be carefully evaluated during risk assessment of patients with this diagnosis.

Prevalencia del consumo de sustancias psicoactivas en pacientes no psiquiátricos que consultan un servicio de urgencias en Bogotá / Prevalence of Psychoactive Substance Use in Non-Psychiatric Patients Seen at an Emergency Department in Bogotá

Introducción: El consumo de sustancias psicoactivas (SPA) es un problema mundial de Salud pública. Los consumidores suelen utilizar los servicios de urgencias, más que los no Consumidores. Objetivo: Determinar la prevalencia de consumo de seis sustancias psicoactivas en personas entre 18 y 65 años, que acudieron al servicio de urgencias de un hospital Universitario en Bogotá e identificar sus características demográficas. Método: Estudio De corte transversal, con muestreo estratificado por grupos de edad y sexo de pacientes Adultos que acudieron al servicio de urgencias por patologías no psiquiátricas, a quienes Se les aplicó un instrumento que indagaba datos demográficos, médicos, farmacológicos y Toxicológicos. Luego se realizó un análisis toxicológico con el Breath Scan Test, para la detección de alcohol a partir de la exhalación de aire, y el Screeners KO, para la detección en orina de cannabinoides, cocaína, benzodiacepinas, anfetaminas y opiáceos, en las últimas Seis horas. Resultados: Se realizó el análisis en 473 personas. La prevalencia de consumo De cualquier sustancia fue de 7,8%. La sustancia más detectada fue opiáceos, seguida por Alcohol, cannabis, cocaína, benzodiacepinas y anfetaminas. El reporte verbal de consumon las últimas seis horas sólo fue veraz para alcohol. Conclusiones: La prevalencia de Consumo de SPA en la población general de urgencias es alta. De acuerdo con los Resultados, ocho de cada cien personas que consultan a urgencias han consumido alguna SPA en las últimas seis horas...

Introduction: Psychoactive substance abuse is a world public health problem. Drug users tend to use emergency services more than non-users. Objective: To determine the prevalence and demographic characteristics of the use of six substances in people between the ages of 18 and 65, seen at the emergency department of a teaching hospital in Bogotá. Method: Cross sectional study with stratified sampling by age and gender groups of adult patients who were seen at the emergency department (ED). Data collected included demographic, medical, pharmacological, and toxicological information. Toxicological analysis was performed with Scan Breath Test to detect alcohol and KO Screeners to screen urine for use of cannabinoids, cocaine, enzodiazepines, amphetamines, and opiates in the last six hours. Results: Analyses were performed in 473 patients. The prevalence of any substance was 7.8%. The substance most frequently detected was opiates, followed by alcohol, cannabis, cocaine, benzodiazepines, and amphetamines. Conclusions: The prevalence of psychoactive drug use in the general population of the ED is high. According to these results, 8 of out of 100 people who use emergency services have used a psychoactive Substance in the last six hours. The prevalence of self-report was very low compared with The positive results of the toxicology tests...

Prevalencia del trastorno depresivo en pacientes que consultan un servicio de urgencias en Bogotá / Prevalence of depressive disorder among emergency department patients in Bogotá

Introducción: Por su alta prevalencia, la depresión se considera un problema de salud mundial. Es importante conocer la prevalencia de este trastorno en los pacientes que acuden a servicios de urgencia en Bogotá. Objetivo: Calcular la prevalencia de síntomas depresivos en la última semana y determinar las características demográficas de personas entre los 18 y 65 años de edad que acuden por patologías no psiquiátricas al servicio de urgencias de un hospital universitario en Bogotá. Método: Estudio de corte transversal de pacientes adultos que asisten al servicio de urgencias de un hospital universitario. La información recopilada incluye datos demográficos, motivo de consulta, diagnóstico y aplicación de la escala del centro de estudios epidemiológicos para depresión (CES-D). Resultados: Se obtuvo una muestra de 470 pacientes que acudieron al servicio de urgencias con una prevalencia de síntomas depresivos en la última semana, del 27,7%. La presencia de sintomatología depresiva se vio asociada con sexo femenino, bajo nivel educativo, acudir en horario de la tarde al servicio de urgencias y diagnóstico de alguna enfermedad del sistema nervioso central. Conclusiones: Se describe por primera vez en Bogotá la prevalencia de síntomas depresivos en la población que acude a los servicios de urgencias de un hospital general. Son necesarios más estudios para dilucidar factores de riesgo asociados a este trastorno en la población que acude a servicios de urgencias...

Background: Depression is a public health problem worldwide due to its high prevalence. In emergency departments it is often underdetected and undertreated. It is important to be informed about the prevalence of this disorder in emergency departments in Bogotá. Objective: To determine the prevalence of clinically significant depressive symptoms in the last week among adult patients visiting the emergency department (ED) with non-psychiatric complaints, in a teaching hospital in Bogotá. Method: Cross-sectional study in adult patients who visit the ED. Data collected included socio-demographical data, chief complaint, diagnosis, and results of the Center for Epidemiologic Studies Depression Scale (CES-D). Results: Of the 470 patients visiting the ED, 27.7% had clinically significant depressive symptoms. The presence of depressive symptoms was associated with female sex, low education level, visits to the ED in the afternoon, and the diagnosis of a central nervous system disease. Conclusions: This study identified a high frequency of clinically significant depressive symptoms among ED patients in Bogotá. More studies are needed to determine risk factors associated to this disorder in this kind of population...

Telemedicina: historia, aplicaciones y nuevas herramientas en el aprendizaje / Telemedicine: history, uses and new learning tools

En la actualidad las intervenciones en salud ya sean de tipo diagnóstico o terapéutico no son distribuidas equitativamente, por lo cual garantizar la prestación de servicios de salud representa un reto incesante para muchos programas en diferentes países; sin embargo, gracias a los avances tecnológicos en telecomunicación y procesos de imágenes, es ahora posible ofrecer varios servicios de salud a un mayor número de la población a distancia con un buen nivel de calidad; esto se define como telemedicina...

Introduction: Currently, health care interventions either diagnostic or therapeutic, are not distributed evenly across the globe, therefore ensuring the provision of health services represents a constant challenge for many health care programs in different countries, however, thanks to the advances in telecommunication and imaging processing, it is now possible to offer a variety of health care services to a greater number of people at a distance with a good level of quality, this concept is currently defined as telemedicine...