Costos totales asociados a úlceras por presión y caídas en usuarios de los servicios clínicos de cirugía y medicina, en un establecimiento de alta complejidad, primer semestre del 2017 y primer semestre 2018, Chile / Total costs associated with pressure ulcers and falls in users of clinical surgery and medical services, in a highly complex establishment, first half of 2017 and first semester 2018, Chile

INTRODUCCIÓN: las actividades asistenciales relacionadas con la atención de pacientes en servicios clínicos tienen diferentes grados de riesgos para las personas que los reciben, el error en la atención sanitaria se denomina evento adverso y/o centinelas los que, según su gravedad, pueden llegar a causar la muerte de los usuarios. OBJETIVO: determinar los costos totales de úlceras por presión y caídas ocurridos en los usuarios de los servicios clínicos de cirugía y medicina en un establecimiento de alta complejidad durante el primer semestre del 2017 y primer semestre del 2018, en Chile. MÉTODO: estudio descriptivo retrospectivo. La ocurrencia de eventos relacionados a úlceras por presión y caídas son notificados a través del sistema informático Phoenix y son recepcionados por el Departamento de Calidad y Seguridad del Paciente del establecimiento, los datos económicos fueron proporcionados por el departamento de Finanzas. Los datos fueron procesados por programa computacional Excel. RESULTADOS: los costos totales asociado a úlceras por presión y caídas:Servicio de Cirugía, primer semestre del 2017:-Ulceras por presión $44.086.872 (U$ 57.557 dólares)-Caídas $39.630.517 (U$51.739 dólares)-Costo total $ 83.717.389 (U$109.297 dólares)Servicio de Medicina, primer semestre del 2017:-Úlceras por presión $22.654.894 (U$29.803 dólares)-Caídas $32.023.185 (U$41.807 dólares)-Costo total $ 54.678.079 (U$71.385 dólares)Servicio de Cirugía, primer semestre del 2018:-Ulceras por presión $76.979.440 (U$100.500 dólares)-Caídas $18.522.927 (U$24.182 dólares)-Costo total $ 95.502.367 (U$124.683 dólares)Servicio de Medicina, primer semestre del 2018:-Ulceras por presión $14.981.255 (U$19.558 dólares)-Caídas $55.258.625 (U$72.142 dólares)-Costo total $ 70.239.880 (U$91.701 dólares) CONCLUSIÓN: se logró levantar información actual sobre los recursos financieros y clínicos que determinan el impacto económico que generan los eventos adversos en los pacientes atendidos en un centro asistencial público. Es por esto, que el presente estudio, permitió cuantificar y evidenciar el impacto económico de dos eventos ocurridos en los servicios clínicos de un hospital de alta complejidad de Chile.

INTRODUCTION: healthcare activities related to the care of patients in clinical services, have different degrees of risks for the people who receive them, the error in health care is called an adverse event and / or sentinels which, depending on their severity, can arrive to cause the death of users. OBJECTIVE: to determine the total costs of pressure ulcers and falls that occurred in users of clinical services of surgery and medicine in a highly complex establishment during the first half of 2017 and the first half of 2018, in Chile. METHOD: retrospective descriptive study. The occurrence of events related to pressure ulcers and falls are notified through the Phoenix computer system and are received by the Department of Quality and Patient Safety of the establishment, the economic data were provided by the Department of Finance. The data were processed by Excel computer program. RESULTS: the total costs associated with pressure ulcers and falls:Surgery Service, first semester of 2017: -Pressure ulcers $ 44,086,872 (U$ 57,557)-Falls $ 39,630,517 (U$ 51,739) -Total cost$ 83,717,389 (U$ 109,297)Medicine Service, first semester of 2017: -Pressure ulcers $ 22,654,894 (U$29,803 dollars) -Falls $ 32,023,185 (U$41,807 dollars) -Total cost $ 54,678,079 (U$71,385 dollars)Surgery Service, first semester of 2018: -Pressure ulcers $ 76,979,440 (U$100,500 dollars) -Falls $ 18,522,927 (U$24,182 dollars) -Total cost $ 95,502,367 (U$124,683 dollars)Medicine Service, first semester of 2018: -Pressure ulcers $ 14,981,255 (U$19,558 dollars) -Falls $ 55,258,625 (U$72,142dollars) -Total cost $ 70,239,880 (U$91,701 dollars) CONCLUSIONS: it was possible to collect current information on financial and clinical resources that determine the economic impact generated by adverse events in patients treated in a public healthcare center. This is why the present study made it possible to quantify and demonstrate the economic impact of two events that occurred in the clinical services of a highly complex hospital in Chile.

Factores que Afectan la Duración de los Tratamientos de Ortodoncia en un Servicio Público de Salud / Factors that Affect the Duration of Orthodontic Treatment in Public Health Services

RESUMEN: La duración de los tratamientos de ortodoncia siempre ha sido una de las mayores preocupaciones, tanto en los pacientes como en los Ortodoncistas. El proposito de esta investigacion fue determinar la magnitud de las inasistencias a los controles por parte de los pacientes y como estas y otras variables, influyen en la duración de los tratamientos de Ortodoncia en el Centro de Salud Familiar (CESFAM) Dr. Victor Manuel Fernandez, Servicio de Salud de Concepcion, Chile. Se realizo un estudio descriptivo, de tipo transversal, retrospectivo, en el que se utilizaron las fichas clínicas de todos los pacientes que fueron dados de alta por los Ortodoncistas del CESFAM Dr. V. M. F. durante el año 2017. La tabulación se realizó en Microsoft Excel y el análisis estadístico se hizo en InfoStat 17. Se incluyeron 246 pacientes, con una edad de ingreso promedio de 13,6 años. La maloclusion predominante fue la Clase I de Angle (71 %). Estos pacientes tuvieron una duracion de tratamiento promedio de 33,9 meses. Se concluyó que a mayor cantidad de inasistencias, el tratamiento de ortodoncia tuvo una duración mayor.

ABSTRACT: The duration of orthodontic treatments has always been one of the biggest concerns, both in patients and for orthodontists. The purpose of this investigation was to determine the magnitude of the absences to the controls of the patients and how they influence the duration of the orthodontic treatments in the CESFAM Dr. Victor Manuel Fernandez, Concepcion, Chile. A descriptive, cross-sectional, retrospective study was carried out, in which the clinical records of all patients discharged by the Orthodontists of CESFAM Dr. V.M.F. during the year 2017 were analyzed. The tabulation was performed in Microsoft Excel and the statistical analysis was carried out in InfoStat 17. In total, 246 patients were included, with an average age of admission of 13.6 years. The predominant malocclusion was Class I of Angle (71 %). These patients had an average treatment duration of 33.9 months. It was further concluded that the length of orthodontic treatment, was also affected by the increased number of times patients failed to show for treatment.

Biobanco do Hospital de Clínicas de Porto Alegre: aspectos técnicos, éticos, jurídicos e sociais / Hospital de Clínicas de Porto Alegre biobank: technical, ethical, legal and social issues

As atividades de pesquisa em saúde cada vez mais necessitam do armazenamento de materiais biológicos em biorepositórios e em biobancos. O estabelecimento de políticas institucionais para lidar com aspectos técnicos, éticos, legais e sociais é imprescindível para garantir a sua adequação. O Hospital de Clínicas de Porto Alegre está com um projeto de desenvolvimento em execução para propiciar que estas atividades sejam harmônicas e integradas.

Health research increasingly requires the storage of biological samples in biorepositories and in biobanks. The establishment of institutional policies to deal with technical, ethical, legal and social issues is essential to ensure the adequacy of these activities. Hospital Clínicas de Porto Alegre has a development project to bring harmony and integration to these activities.

Base de datos de instrumentos de evaluación de salud mental y psiquiatría / Database of assessment tools for mental health and psychiatry

La investigación en salud mental requiere de instrumentos de evaluación de probada validez y confiabilidad y que cuenten con normas de interpretación ajustadas a la población local. Esta información debe ser accesible al investigador, de manera rápida y oportuna. Objetivo. El estudio, de tipo documental, identifica los instrumentos de evaluación de salud mental adaptados y creados en la ciudad de Lima, registrándolos en una base de datos, y analiza la producción encontrada. Método: Se revisaron, entre los meses de mayo y setiembre 2004, diferentes fuentes de investigación publicadas desde 1990 en adelante, tales como tesis, revistas, monografías y libros, en diversas instituciones de Lima: universidades, hospitales, institutos, asociaciones, organismos, públicos y organismos no gubernamentales, realizándose 1148 registros de instrumentos a través de una ficha de análisis. Se creó la base de datos en el programa Access con los registros depurados. Resultados: Se obtuvo una base de instrumentos de salud mental con 1051 registros, encontrándose que el 32 por ciento de los registros correspondía a instrumentos creados; el 23 por ciento, a instrumentos adaptados, y el resto, 45 por ciento, a aplicaciones de instrumentos. Estos registros se refieren a más de 703 instrumentos diferentes. El tema sobre el que existe mayor número de registros es la personalidad, seguida de funciones cognoscitivas y familia. El 88 por ciento de los registros se obtuvo en universidades, y el 75 por ciento, en tesis.

Digital video recording and archiving in ophthalmic surgery.

Currently most ophthalmic operating rooms are equipped with an analog video recording system [analog Charge Couple Device camera for video grabbing and a Video Cassette Recorder for recording)]. We discuss the various advantages of a digital video capture device, its archiving capabilities and our experience during the transition from analog to digital video recording and archiving. The basic terminology and concepts related to analog and digital video, along with the choice of hardware, software and formats for archiving are discussed.

The GATO gene annotation tool for research laboratories

Large-scale genome projects have generated a rapidly increasing number of DNA sequences. Therefore, development of computational methods to rapidly analyze these sequences is essential for progress in genomic research. Here we present an automatic annotation system for preliminary analysis of DNA sequences. The gene annotation tool (GATO) is a Bioinformatics pipeline designed to facilitate routine functional annotation and easy access to annotated genes. It was designed in view of the frequent need of genomic researchers to access data pertaining to a common set of genes. In the GATO system, annotation is generated by querying some of the Web-accessible resources and the information is stored in a local database, which keeps a record of all previous annotation results. GATO may be accessed from everywhere through the internet or may be run locally if a large number of sequences are going to be annotated. It is implemented in PHP and Perl and may be run on any suitable Web server. Usually, installation and application of annotation systems require experience and are time consuming, but GATO is simple and practical, allowing anyone with basic skills in informatics to access it without any special training. GATO can be downloaded at [http://mariwork.iq.usp.br/gato/]. Minimum computer free space required is 2 MB.

Modelo de gerenciamento da manutenção de equipamentos de radiologia convencional / Maintenance management model for conventional radiology equipments

Foi elaborado um modelo de gerenciamento da manutenção dos equipamentos convencionais de raios X no Hospital Universitário Clementino Fraga Filho. O modelo foi implementado em várias etapas, que incluíram visitas a centros hospitalares que gerenciam seus equipamentos, linha de colaboração com a Fundação Oswaldo Cruz para realização de cursos e treinamento de técnicos de eletrônica do hospital, montagem de uma esquemateca dos equipamentos em uso, criação de um programa de gerenciamento utilizando um banco de dados na plataforma Microsoft Windows 98-Access, levantamento operacional e condições de funcionamento dos equipamentos. A criação de uma nova rotina nas manutenções vai ao encontro das necessidades de reduzir o tempo de atendimento, custos, e de melhoria na qualidade da imagem em um serviço de radiodiagnóstico, atendendo também às exigências da Portaria 453/98 do Ministério da Saúde.

We developed a management model for maintenance of hospital radiological X-ray equipment. The model was implemented in several steps including visits to other hospitals where equipment management is also done, collaboration work with "Fundação Oswaldo Cruz" for the realization of courses and a training program for the hospital electronic technicians, organization of a small library with the schemes of the radiological equipment in use at "Hospital Universitário Clementino Fraga Filho", Rio de Janeiro, Brazil, development of a management software using a database from Access (Microsoft Windows) and evaluation of the performance of the radiological equipment. The implementation of a new routine for equipment maintenance fulfils the need for reducing repair delay and costs, improving image quality in radiodiagnosis services, and complying with resolution 453/98 of the Brazilian Ministry of Health.