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1.
Lima; Perú. Ministerio de Salud; 20210500. 32 p. tab, ilus.
Monografía en Español | MINSAPERÚ | ID: biblio-1247470

RESUMEN

El documento contiene las acciones para fortalecer la vigilancia epidemiológica y de diagnóstico para la detección temprana, investigación epidemiológica y monitoreo de brotes y de conglomerados de casos de Síndrome de Guillain Barré.


Asunto(s)
Investigación , Brotes de Enfermedades , Técnicas de Laboratorio Clínico , Síndrome de Guillain-Barré , Diagnóstico , Monitoreo Epidemiológico
2.
Anal Chim Acta ; 1164: 338321, 2021 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-33992219

RESUMEN

In the past several decades, acoustic wave biosensors, as an emerging kind of biosensors, have been developed and widely used for the detection of mass, viscosity, conductivity and density. Varieties of applications have been explored such as medical diagnosis, drug screening, environmental monitoring, food analysis and biochemical assay. Among them, the detection of disease-related biomarkers based on acoustic sensors has aroused great research interest all over the world. In this review, the classification and characteristics of acoustic wave biosensors are briefly introduced. Then, some classical studies and recent advances in disease-related biomarker detection utilizing these biosensors are summarized and detailed, respectively. Here, the disease-related biomarkers mainly include antigens, small molecular proteins, cancer cells, viruses and VOCs. Finally, challenges and future trends of these typical acoustic wave biosensors are discussed. Compared with other reviews of acoustic wave sensors, this review highlights the great potential of typical acoustic wave biosensors for early disease screening and diagnosis compared with widely-used medical imaging. Moreover, they are integrated with other technologies for the design of multi-analyte, multi-parameter and intelligent devices, collecting more comprehensive information from biomarkers. This review provides a new perspective on the applications and optimization of acoustic wave biosensors to develop more reliable platforms for disease-related biomarker detection and disease diagnosis.


Asunto(s)
Técnicas Biosensibles , Enfermedad , Acústica , Biomarcadores , Diagnóstico , Humanos , Proteínas , Sonido
3.
An. Fac. Cienc. Méd. (Asunción) ; 54(1): 93-100, 20210000.
Artículo en Español | LILACS | ID: biblio-1178639

RESUMEN

El 15% de los individuos con DM2 presenta una úlcera en el pie y una fracción importante de ellos sufrirá en algún momento una amputación. Se realizó un estudio analítico, de corte trasversal retrospectivo de muestreo no probabilístico de casos consecutivos en pacientes con diagnóstico de pie diabético que acudieron al servicio de Urgencias del Hospital de Clínicas de San Lorenzo, en el periodo Enero ­ Diciembre del año 2019. Sobre un número total de 138 pacientes, se observa que el 51% recibió un manejo quirúrgico, con amputaciones de varios tipos. Se comparó el manejo instaurado en los pacientes, sea este quirúrgico o conservador según la presencia o no de ciertas comorbilidades, como edad mayor a 65 años, lugar de procedencia, glicemia capilar promedio del paciente e hipertensión arterial al ingreso; de estos existió una relación estadísticamente significativa (p<0,05) entre la necesidad de amputación y la glicemia capilar y la hipertensión arterial. El éxito de la intervención requiere un completo entendimiento de la patogénesis de las úlceras del pie diabético y una implementación rápida y estandarizada de un tratamiento efectivo. El manejo multidisciplinario puede lograr el salvataje de la extremidad, que conducirá a una mejor calidad de vida y sobrevida.


Among diabetic patients, 15% have a foot ulcer and a significant fraction of them will suffer an amputation at some point. An analytical, retrospective cross-sectional study of non-probabilistic sampling of consecutive cases was carried out in patients with a diagnosis of diabetic foot who attended the Emergency Service of the Clínicas Hospital in San Lorenzo, during January - December of the year 2019. In a total of 138 patients, the management established in the patients, whether surgical or. conservative, was compared according to certain comorbidities, such as age over 65 years, place of origin, average capillary glycemia and arterial hypertension on admission; Of these, there was a statistically significant relationship (p <0.05) between the need for amputation and capillary glycemia and arterial hypertension. Successful intervention requires a thorough understanding of the pathogenesis of diabetic foot ulcers and a rapid and standardized implementation of effective treatment. Multidisciplinary management can achieve limb salvage, leading to better quality of life and survival.


Asunto(s)
Úlcera , Patogénesis Homeopática , Úlcera del Pie , Pie Diabético , Amputación , Hipertensión , Estudios Transversales , Diagnóstico
4.
Rev. Soc. Argent. Diabetes ; 55(1): 21-26, ene. - abr. 2021. graf
Artículo en Español | LILACS, BINACIS | ID: biblio-1248274

RESUMEN

Introducción: la diabetes mellitus (DM) es una enfermedad crónica no transmisible descripta desde la antigüedad en la cual se altera principalmente el metabolismo de los hidratos de carbono. Paraguay se enfrenta a un significativo déficit social en cuanto a los Objetivos del Desarrollo del Milenio. Los últimos datos sobre mortalidad son del año 2015, y la DM se ubica en segundo lugar como causa de muerte de la población general de 2013 a 2015. Objetivos: identificar los principales motivos de internación, y la distribución demográfica según sexo y edad de los pacientes diabéticos en el Servicio de Clínica Médica del Hospital Regional de Ciudad del Este, Paraguay, en el año 2016. Materiales y métodos: el estudio se realizó durante los meses de abril a octubre de 2018 en el Hospital Regional de Ciudad del Este. La población correspondió a todos los pacientes ingresados a la sala de internados del citado centro asistencial, en el período antes mencionado, con diagnóstico de DM corroborado por exámenes de laboratorio correspondientes. Se incluyeron todos los pacientes que cumplían con los criterios diagnósticos de DM: glicemia sérica igual o mayor a 126 mg/dl en ayunas, glicemia sérica mayor a 200 mg/dl en cualquier momento con síntomas clínicos de DM, y hemoglobina glicada>6,5%. Se excluyeron todos aquellos pacientes que no cumplían con dichos criterios. Resultados: se encontraron 245 pacientes con diagnóstico de DM de los cuales se incluyeron 241. La media de las edades de todos los pacientes fue de 59,92 años, la desviación estándar de 14,71, siendo la edad mínima de 15 años y la máxima de 90 años. Los pacientes que fueron admitidos por cuadros infecciosos fueron 126, lo que significó un 52% del total. Los pacientes ingresados por otras causas, que no fueran algún tipo de infección, fueron 115 pacientes lo que representó un 48%. Entre los pacientes ingresados por causas infecciosas y no infecciosas fueron discriminados otros subgrupos por sistemas afectados y etiologías. La principal causa de ingresos se encontró en las infecciones de piel y partes blandas con un total de 61 (25,3%), y fueron 43 (17,5%) los pacientes con infección del miembro inferior, de los cuales 22 (9,1%) presentaron pie diabético. Las causas menos frecuentes fueron las de los sistemas gastrointestinales, hematológicas y del sistema osteo artro-muscular, que contaron con un (0,4%) paciente cada una. Conclusiones: la principal causa de internación de personas diabéticas internadas en el Servicio de Clínica Médica en el año 2016 fue por infección de partes blancas con 61 pacientes (25,3%), y 43 (17,5%) de éstos por infección del miembro inferior y 22 (9,1%) por pie diabético. La determinación demográfica según sexo fue de 127 (53%) femenino y 114 (47%) masculino. La media de las edades de todos los pacientes fue de 59,92 años, la desviación estándar de 14,71, siendo la edad mínima de 15 años y la máxima de 90 años.


Introduction: diabetes mellitus is a chronic non-communicable disease described since ancient times, in which the metabolism of carbohydrates is mainly altered. Paraguay faces a significant social deficit regarding the Millennium Development Goals. The latest mortality data is from 2015, with diabetes mellitus in 2nd place as the cause of death of the general population from 2013 to 2015. Objectives: identify the main reasons for hospitalization, and the demographic distribution according to sex and age of diabetic patients in the Medical Clinic Service of the Regional Hospital of Ciudad del Este, Paraguay, in the year 2016. Materials and methods: the study was carried out during the months of April to October 2018, at the Regional Hospital of Ciudad del Este. The population corresponded to all patients admitted to the inpatient ward of the aforementioned healthcare center in the aforementioned period with a diagnosis of DM corroborated by corresponding laboratory tests. All patients who met the diagnostic criteria for diabetes were included: fasting serum glucose equal to or greater than 126 mg/dl, serum glucose greater than 200 mg/dl at any time with clinical symptoms of diabetes and glycated hemoglobin> 6.5 %. All those patients who did not meet these criteria were excluded. Results: 245 patients with a diagnosis of diabetes were found, of which 241 were included. The mean age of all patients was 59.92 years, the standard deviation was 14.71, with the minimum age being 15 years and the maximum age of 90 years. 126 patients were admitted for infectious conditions, which represented 52% of the total. The patients admitted for other causes, other than some type of infection, were 115 patients, which represented 48%. Among the patients admitted for infectious and non-infectious causes, other subgroups were discriminated by affected systems and etiologies. The main cause of admission was found in skin and soft tissue infections with a total of 61 (25.3%), and there were 43 (17.5%) patients with lower extremity infection, of which 22 (9,1%) had diabetic foot. The less frequent causes were those of the gastrointestinal, hematological and osteoarthro-muscular systems, which had 1 (0.4%) patient each. Conclusions: the main cause of hospitalization of diabetic patients admitted to the Medical Clinic Service of the Regional Hospital of Ciudad del Este in 2016 was due to infection of white parts with 61 patients (25.3%), of which 43 (17.5%) of these due to lower extremity infection and 22 (9%) were due to diabetic foot. The demographic determination according to sex was 127 (53%) female and 114 (47%) male. The mean ages of all patients was 59.92 years, the standard deviation of 14.71; being the minimum age of 15 years and the maximum of 90 years


Asunto(s)
Humanos , Diabetes Mellitus , Pie Diabético , Diagnóstico , Hospitalización
6.
Rev. SOBECC ; 26(1): 60-67, 31-03-2021.
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1223950

RESUMEN

Objetivo: Identificar a ocorrência e os fatores de risco determinantes para o desenvolvimento do diagnóstico de enfermagem risco de hipotermia perioperatória. Método: Revisão integrativa, usando o acrônimo PIO (pacientes, intervenção, outcomes/desfecho), em que P=pacientes adultos e idosos; I=cirurgias eletivas; O=fatores de risco associados à hipotermia perioperatória. A revisão foi conduzida e reportada com base no Check-list Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), seguindo-se as sete etapas propostas pelo método PRISMA. Resultados: A busca gerou 854 artigos, sendo retirados os duplicados e os sem relevância. Após aplicação dos critérios de exclusão, 13 artigos foram submetidos à análise final. Índice de massa corporal baixo, idade avançada e tempo cirúrgico prolongado foram os fatores mais relacionados ao desenvolvimento de hipotermia nos pacientes cirúrgicos. O manejo da hipotermia colabora para diminuição dos riscos de eventos adversos cardíacos, complicações infecciosas, sangramentos e traz maior conforto para o paciente. Conclusão: O enfermeiro precisa agir antes do quadro hipotérmico se instalar, reconhecendo os fatores de risco inerentes ao paciente e identificando quais tecnologias do cuidado aplicar.


Objective: To identify the occurrence and the risk factors that determine the development of the nursing diagnosis 'risk for perioperative hypothermia'. Method: Integrative review, using the acronym PIO (patients, intervention, outcomes), in which P=adult and older adults; I=elective surgeries; O=risk factors associated with perioperative hypothermia. The review was conducted and reported based on the Check-list Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA), following the seven steps proposed by the PRISMA method. Results: The search generated 854 articles, excluding duplicates and non-relevant titles. After applying the exclusion criteria, 13 articles were submitted to the final analysis. Low body mass index, advanced age and prolonged surgical time were the factors most related to the development of hypothermia in surgical patients. The management of hypothermia helps to reduce the risk of adverse cardiac events, infectious complications, and bleeding, besides bringing greater comfort to patients. Conclusion: Nurses need to act before the hypothermic condition sets in, recognizing the risk factors inherent to each patient and identifying which care technologies to apply.


Objetivo: Identificar la ocurrencia y los factores de riesgo que determinan el desarrollo del Diagnóstico de Enfermería Riesgo de Hipotermia Perioperatoria. Método: Revisión integrativa, utilizando el acrónimo PIO (Pacientes, Intervención, Outcomes/Resultado), donde P=pacientes adultos y ancianos; I=cirugías electivas; O=factores de riesgo asociados a hipotermia perioperatoria. La revisión se llevó a cabo y se informó utilizando los elementos de informe preferidos de la lista de verificación para revisiones sistemáticas y metaanálisis (Check-list Preferred Reporting Items for Systematic Reviews and Meta-Analyses ­ PRISMA), siguiendo los siete pasos propuestos por el método PRISMA. Resultados: La búsqueda generó 854 artículos, eliminando los duplicados y los no relevantes. Tras aplicar los criterios de exclusión, se sometieron 13 artículos al análisis final. El bajo índice de masa corporal, la edad avanzada y el tiempo quirúrgico prolongado fueron los factores más relacionados con el desarrollo de hipotermia en los pacientes quirúrgicos. El manejo de la hipotermia ayuda a reducir los riesgos de eventos cardíacos adversos, complicaciones infecciosas, hemorragias y brinda mayor comodidad al paciente. Conclusión: La enfermera debe actuar antes de que se presente la condición hipotérmica, reconociendo los factores de riesgo inherentes al paciente e identificando qué tecnologías de atención aplicar.


Asunto(s)
Humanos , Cirugía General , Enfermería Perioperatoria , Hipotermia , Diagnóstico , Infecciones , Cuidados Intraoperatorios
7.
RECIIS (Online) ; 15(1): 122-135, jan.-mar. 2021. tab
Artículo en Español | LILACS | ID: biblio-1177108

RESUMEN

Identificar los factores relacionados al conocimiento del estado actual de la enfermedad en mujeres con cáncer de mama y factores sociodemográficos, diagnóstico, tratamiento y atención del cáncer de mama en instituciones oncológicas, Cartagena-Colombia. Estudio descriptivo transversal; participaron 211 mujeres con cáncer de mama, mediante una encuesta estructurada. El Odd Ratio (OR) fueron calculados usando SPSS versión 23.0. Se encontró una asociación estadística entre la práctica del autoexamen de mama con el poseer estudios de educación superior y pertenecer al nivel contributivo; además, una mujer menor de 50 años con diagnostico confirmado de cáncer y que tenga un nivel educativo superior entró con una acción de tutela. Se identificaron lagunas derivadas de la estratificación social, segmentación geográfica y acceso a mecanismos de información telefónica. Por lo tanto, las condiciones de vulnerabilidad bajo nivel educativo y pobreza marcan diferencias y denotan oportunidades perdidas para la detección, atención y tratamiento.


Identificar fatores relacionados ao conhecimento do estado atual da doença em mulheres com câncer de mama e fatores sociodemográficos, diagnóstico, tratamento e cuidado do câncer de mama em instituições oncológicas, Cartagena-Colômbia. Estudo descritivo transversal; 211 mulheres com câncer de mama participaram através de uma pesquisa estruturada. Foi encontrada uma associação estatística entre a prática do auto-exame das mamas e o fato de ter uma educação superior e pertencer ao nível contributivo; além disso, uma mulher com menos de 50 anos de idade com diagnóstico confirmado de câncer e com um nível de educação superior entrou com uma ação de tutela. São identificadas as lacunas derivadas da estratificação social, segmentação geográfica e acesso a mecanismos de informação telefônica. Portanto, as condições de vulnerabilidade, baixo nível educacional e pobreza marcam diferenças e denotam a perda de oportunidades de detecção, cuidado e tratamento.


To identify factors related to knowledge of the current state of the disease in women with breast cancer and sociodemographic factors, diagnosis, treatment and care of breast cancer in oncological institutions, Cartagena-Colombia. Cross-sectional descriptive study; 211 women with breast cancer participated through a structured survey. A statistical association was found between the practices of breast self-examination and having a higher education and belonging to the contributory level; in addition, a woman under 50 years old with a confirmed diagnosis of cancer and with a higher education level uses guardianship action by right. Gaps derived from social stratification, geographical, health system segmentation and access to telephone information mechanisms are identified. Therefore, the conditions of vulnerability, low educational level and poverty mark differences and denote lost opportunities for detection, care and treatment.


Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Terapéutica , Neoplasias de la Mama , Conocimiento , Diagnóstico , Empatía , Demografía , Epidemiología Descriptiva , Salud de la Mujer
8.
Iatreia ; 34(1): 71-77, ene.-mar. 2021. tab, graf
Artículo en Español | LILACS | ID: biblio-1154360

RESUMEN

RESUMEN La amiloidosis laríngea es un desorden infrecuente con síntomas inespecíficos que dificultan su diagnóstico. A través de la descripción y análisis de tres casos valorados en el Hospital Universitario San Ignacio, Bogotá buscamos ampliar el conocimiento en esta patología y comparar nuestros hallazgos con los descritos en la literatura. Se realizó una búsqueda retrospectiva de pacientes con diagnóstico de amiloidosis laríngea en los últimos cinco años en nuestra institución, obteniendo un total de 3 pacientes que cumplieron con nuestros criterios de selección. El síntoma más frecuente en estos pacientes fue la disfonía. La principal presentación encontrada fue de tipo sistémica, contrario a lo reportado en la literatura. Se realizó una remodelación de la vía aérea mediante microcirugía laríngea con láser de dióxido de carbono, obteniendo resultados clínicos satisfactorios. Es importante realizar más estudios del tema en nuestro país, teniendo en consideración el número reducido de casos debido a su baja prevalencia.


SUMMARY Laryngeal amyloidosis in an infrequent disorder, with nonspecific symptoms that difficult the diagnosis and without a consensus for its treatment. Through the description, analysis and comparison of three cases of laryngeal amyloidosis at the Hospital Universitario San Ignacio Bogotá, we seek to expand the knowledge in this pathology and compare it with what is described in the literature. We made a retrospective research of patients with a diagnosis of laryngeal amyloidosis in the last five years in our institution, obtaining a final sample of 3 cases that met the inclusion criteria. The most frequent symptom was dysphonia, the most frequent presentation was systemic, contrary to what was reported in the literature. Airway remodeling was performed using laryngeal microsurgery with carbon dioxide laser, obtaining good clinical results. We con-sider important to carry out more studies on the subject in our country.


Asunto(s)
Humanos , Amiloidosis , Diagnóstico
9.
Clin Interv Aging ; 16: 325-333, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33654389

RESUMEN

We describe our challenge in diagnosing an unusual and rapidly progressing case of pulmonary pleomorphic carcinoma (PPC)-a rare, poorly differentiated, or undifferentiated non-small-cell carcinoma that can metastasize locally or distantly and has a poor prognosis. Our patient was an elderly man with a one-month history of abdominal pain, anorexia, and weight loss, diagnosed with atrophic gastritis via endoscopy, and treated medically without improvement. A week later, this patient developed pain in the head, neck, and shoulder area, and further examination revealed a thickening of his left neck and shoulder, with no palpable lymph nodes. Computed tomography (CT) of the neck, chest, and abdomen led us to believe that we might be dealing with primary sarcoma of the neck since no lung mass was evident. Further investigation could not be performed because the patient's status deteriorated rapidly. An autopsy revealed that soft tissue in the left neck and the mesentery was invaded by poorly differentiated polymorphic malignant cells, which were also seen in the lung lesion. Immunohistochemically, these malignant cells were all positive for AE1/AE3, CAM5.2, TTF-1, Napsin-A, and Vimentin. The cells were also positive for programmed death-ligand 1 staining with a low level of tumor proportion score (over 1%). The final diagnosis was PPC with metastases to soft tissues in the left neck and the mesentery. A review of previous case reports of PPC revealed that soft tissue is an uncommon site for metastasis, and that our CT findings were rather unusual. We hereby present our case and review of published case reports, with the hope that an awareness of the heterogeneous features of PPC could prompt timely biopsy and histological diagnosis.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Neoplasias de Cabeza y Cuello , Neoplasias Pulmonares , Pulmón/patología , Neoplasias Peritoneales , Anciano de 80 o más Años , Antígeno B7-H1/análisis , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Carcinoma de Pulmón de Células no Pequeñas/inmunología , Carcinoma de Pulmón de Células no Pequeñas/patología , Deterioro Clínico , Diagnóstico , Diagnóstico Diferencial , Resultado Fatal , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/secundario , Humanos , Inmunohistoquímica , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/inmunología , Neoplasias Pulmonares/patología , Masculino , Mesenterio/patología , Cuello/diagnóstico por imagen , Neoplasias Peritoneales/patología , Neoplasias Peritoneales/secundario , Tomografía Computarizada por Rayos X/métodos
10.
BMC Health Serv Res ; 21(1): 150, 2021 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-33588848

RESUMEN

BACKGROUND: Despite health centres being the first point of contact of care, there are challenges faced in providing care to patients at this level. In Malawi, service provision barriers reported at this level included long waiting times, high numbers of patients and erratic consultation systems which lead to mis-diagnosis and delayed referrals. Proper case management at this level of care is critical to prevent severe disease and deaths in children. We aimed to adopt Emergency, Triage, Assessment and Treatment algorithm (ETAT) to improve ability to identify severe illness in children at primary health centre (PHC) through comparison with secondary level diagnoses. METHODS: We implemented ETAT mobile Health (mHealth) at eight urban PHCs in Blantyre, Malawi between April 2017 and September 2018. Health workers and support staff were trained in mHealth ETAT. Stabilisation rooms were established and equipped with emergency equipment. All PHCs used an electronic tracking system to triage and track sick children on referral to secondary care, facilitated by a unique barcode. Support staff at PHC triaged sick children using ETAT Emergency (E), Priority (P) and Queue (Q) symptoms and clinician gave clinical diagnosis. The secondary level diagnosis was considered as a gold standard. We used statistical computing software R (v3.5.1) and used exact 95% binomial confidence intervals when estimating diagnosis agreement proportions. RESULTS: Eight-five percentage of all cases where assigned to E (9.0%) and P (75.5%) groups. Pneumonia was the most common PHC level diagnosis across all three triage groups (E, P, Q). The PHC level diagnosis of trauma was the most commonly confirmed diagnosis at secondary level facility (85.0%), while a PHC diagnosis of pneumonia was least likely to be confirmed at secondary level (39.6%). The secondary level diagnosis least likely to have been identified at PHC level was bronchiolitis 3 (5.2%). The majority of bronchiolitis cases (n = 50; (86.2%) were classified as pneumonia at the PHC level facility. CONCLUSIONS: Implementing a sustainable and consistent ETAT approach with stabilisation and treatment capacity at PHC level reinforce staff capacity to diagnose and has the potential to reduce other health system costs through fewer, timely and appropriate referrals.


Asunto(s)
Servicio de Urgencia en Hospital , Atención Primaria de Salud , Triaje , Instituciones de Atención Ambulatoria , Niño , Preescolar , Diagnóstico , Femenino , Humanos , Lactante , Recién Nacido , Malaui/epidemiología , Masculino , Población Urbana
11.
San Salvador; MINSAL; feb. 04, 2021. 18 p. ilus, graf.
No convencional en Español | LILACS | ID: biblio-1177209

RESUMEN

La Unidad de servicios de apoyo diagnostico tiene la finalidad de elaborar y actualizar la normativa técnica para la prestación de los servicios de apoyo diagnóstico: Laboratorio Clínico, Banco de Sangre, Patología, Imagenología y Rayos X, que contribuyen con el plan terapéutico del paciente en cualquiera de los establecimientos de salud de los tres niveles de atención del MINSAL. En este sentido y a fin de establecer la herramienta administrativa que sirva de guía para el desarrollo de las funciones de dicha Unidad, se ha elaborado el presente Manual que describe la estructura organizativa, objetivos, funciones y relaciones de trabajo que orientan y delimitan el campo de acción de los diferentes elementos que intervienen en esa Unidad


The Diagnostic Support Services Unit has the purpose of developing and updating the technical regulations for the provision of diagnostic support services: Clinical Laboratory, Blood Bank, Pathology, Imaging and X-rays, which contribute to the therapeutic plan of the patient in any of the health establishments of the three levels of MINSAL care. In this sense and in order to establish the administrative tool that serves as a guide for the development of the functions of said Unit, this Manual has been prepared that describes the organizational structure, objectives, functions and work relationships that guide and delimit the field of action of the different elements that intervene in that Unit


Asunto(s)
Servicios Básicos de Salud , Manuales como Asunto , Rayos X , Bancos de Sangre , Diagnóstico , Laboratorios
12.
Anal Chem ; 93(4): 2652-2659, 2021 02 02.
Artículo en Inglés | MEDLINE | ID: mdl-33464828

RESUMEN

Periventricular white matter hyperintensities (pvWMHs) are a neurological feature detected with magnetic resonance imaging that are clinically associated with an increased risk of stroke and dementia. pvWMHs represent white matter lesions characterized by regions of myelin and axon rarefaction and as such likely involve changes in lipid composition; however, these alterations remain unknown. Lipids are critical in determining cell function and survival. Perturbations in lipid expression have previously been associated with neurological disorders. Matrix-assisted laser desorption/ionization (MALDI) imaging mass spectrometry (IMS) is an emerging technique for untargeted, high-throughput investigation of lipid expression and spatial distribution in situ; however, the use of MALDI IMS has been previously been limited by the need for non-embedded, non-fixed, fresh-frozen samples. In the current study, we demonstrate the novel use of MALDI IMS to distinguish regional lipid abnormalities that correlate with magnetic resonance imaging (MRI) defined pvWMHs within ammonium formate washed, formalin-fixed human archival samples. MALDI IMS scans were conducted in positive or negative ion detection mode on tissues sublimated with 2,5-dihydroxybenzoic acid or 1,5-diaminonaphthalene matrices, respectively. Using a broad, untargeted approach to lipid analysis, we consistently detected 116 lipid ion species in 21 tissue blocks from 11 different post-mortem formalin-fixed human brains. Comparing the monoisotopic mass peaks of these lipid ions elucidated significant differences in lipid expression between pvWMHs and NAWM for 31 lipid ion species. Expanding our understanding of alterations in lipid composition will provide greater knowledge of molecular mechanisms underpinning ischemic white matter lesions and provides the potential for novel therapeutic interventions targeting lipid composition abnormalities.


Asunto(s)
Encéfalo/patología , Lípidos/química , Imagen por Resonancia Magnética , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción/métodos , Sustancia Blanca/patología , Diagnóstico , Humanos , Sustancia Blanca/metabolismo
13.
J Med Internet Res ; 23(2): e22841, 2021 02 23.
Artículo en Inglés | MEDLINE | ID: mdl-33493130

RESUMEN

BACKGROUND: Misdiagnosis, arbitrary charges, annoying queues, and clinic waiting times among others are long-standing phenomena in the medical industry across the world. These factors can contribute to patient anxiety about misdiagnosis by clinicians. However, with the increasing growth in use of big data in biomedical and health care communities, the performance of artificial intelligence (Al) techniques of diagnosis is improving and can help avoid medical practice errors, including under the current circumstance of COVID-19. OBJECTIVE: This study aims to visualize and measure patients' heterogeneous preferences from various angles of AI diagnosis versus clinicians in the context of the COVID-19 epidemic in China. We also aim to illustrate the different decision-making factors of the latent class of a discrete choice experiment (DCE) and prospects for the application of AI techniques in judgment and management during the pandemic of SARS-CoV-2 and in the future. METHODS: A DCE approach was the main analysis method applied in this paper. Attributes from different dimensions were hypothesized: diagnostic method, outpatient waiting time, diagnosis time, accuracy, follow-up after diagnosis, and diagnostic expense. After that, a questionnaire is formed. With collected data from the DCE questionnaire, we apply Sawtooth software to construct a generalized multinomial logit (GMNL) model, mixed logit model, and latent class model with the data sets. Moreover, we calculate the variables' coefficients, standard error, P value, and odds ratio (OR) and form a utility report to present the importance and weighted percentage of attributes. RESULTS: A total of 55.8% of the respondents (428 out of 767) opted for AI diagnosis regardless of the description of the clinicians. In the GMNL model, we found that people prefer the 100% accuracy level the most (OR 4.548, 95% CI 4.048-5.110, P<.001). For the latent class model, the most acceptable model consists of 3 latent classes of respondents. The attributes with the most substantial effects and highest percentage weights are the accuracy (39.29% in general) and expense of diagnosis (21.69% in general), especially the preferences for the diagnosis "accuracy" attribute, which is constant across classes. For class 1 and class 3, people prefer the AI + clinicians method (class 1: OR 1.247, 95% CI 1.036-1.463, P<.001; class 3: OR 1.958, 95% CI 1.769-2.167, P<.001). For class 2, people prefer the AI method (OR 1.546, 95% CI 0.883-2.707, P=.37). The OR of levels of attributes increases with the increase of accuracy across all classes. CONCLUSIONS: Latent class analysis was prominent and useful in quantifying preferences for attributes of diagnosis choice. People's preferences for the "accuracy" and "diagnostic expenses" attributes are palpable. AI will have a potential market. However, accuracy and diagnosis expenses need to be taken into consideration.


Asunto(s)
Inteligencia Artificial , Diagnóstico , Prioridad del Paciente , Médicos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , China , Conducta de Elección , Técnicas y Procedimientos Diagnósticos/economía , Femenino , Gastos en Salud , Humanos , Análisis de Clases Latentes , Modelos Logísticos , Masculino , Persona de Mediana Edad , Pandemias , Encuestas y Cuestionarios , Factores de Tiempo , Adulto Joven
14.
Nat Protoc ; 16(2): 1276-1296, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33462443

RESUMEN

RNA sequencing (RNA-seq) has emerged as a powerful approach to discover disease-causing gene regulatory defects in individuals affected by genetically undiagnosed rare disorders. Pioneering studies have shown that RNA-seq could increase the diagnosis rates over DNA sequencing alone by 8-36%, depending on the disease entity and tissue probed. To accelerate adoption of RNA-seq by human genetics centers, detailed analysis protocols are now needed. We present a step-by-step protocol that details how to robustly detect aberrant expression levels, aberrant splicing and mono-allelic expression in RNA-seq data using dedicated statistical methods. We describe how to generate and assess quality control plots and interpret the analysis results. The protocol is based on the detection of RNA outliers pipeline (DROP), a modular computational workflow that integrates all the analysis steps, can leverage parallel computing infrastructures and generates browsable web page reports.


Asunto(s)
Secuencia de Bases/genética , Expresión Génica/genética , Análisis de Secuencia de ARN/métodos , Diagnóstico , Técnicas y Procedimientos Diagnósticos , Enfermedad/genética , Perfilación de la Expresión Génica/métodos , Secuenciación de Nucleótidos de Alto Rendimiento/métodos , Humanos , ARN/genética , Programas Informáticos , Flujo de Trabajo
16.
Rev. cienc. cuidad ; 18(2): 43-54, 2021.
Artículo en Español | LILACS, BDENF - Enfermería, COLNAL | ID: biblio-1247481

RESUMEN

Objetivos: el objetivo de este proyecto de investigación se basó en identificar los factores aso-ciados a la estancia hospitalaria prolongada, en una institución de mediana y alta complejidad de Medellín. Materiales y métodos: se realizó un estudio analítico, cuantitativo, de corte transversal, con una selección aleatoria simple de pacientes registrados en el consolidado de estancia hospitalaria prolongada en la institución objeto de estudio, donde (n =291) pacientes. Para el análisis bivariado se utilizó x2 cuadrado en SPSS, los valores P arrojados fueron evaluados con un nivel de confianza del 95% y un margen de error del 5%, con un nivel de significancia o de valor alfa de 0.05 de los 291 registros analizados. Resultados: se encontró asociación estadísticamente significativa entre estancia hospitalaria prolongada y atención domiciliaria (p= 0,028), con procedimientos (p= 0.046) y ayudas diagnósticas (p= 0,38). Conclusiones: La estancia hospitalaria de un paciente, no solo depende de su condición clíni-ca, sino de una interrelación con otros actores en su atención como la institución, el prestador y la red de servicios.


Objectives: The objective of this research project was to identify associated factors of ex-tended hospital stay, in a medium and high-complexity health care institution in Medellin. Materials and methods: An analytic, quantitative, cross-sectional study was made, with a simple random sample of patients (n=291) from the consolidate records of extended hospital stay in the institutions subject of study. For the bivariate analysis, the x2 squared was used in SPSS, the P values generated were evaluated with a confidence level of 95% and a margin of error of 5%, with a significant value or alpha value of 0.05 from the 291 records analyzed. Results: A significant statistical association was found between prolonged hospital stay and home care (p= 0,028), with procedures (p= 0.046) and diagnostic aids (p= 0.38). Conclu-sions: The hospital stay of a patient, does not only depend on their clinical condition, but also on the correlation with other care actors such as the institution, provider, and service network


Objetivo: Identificar os fatores associados à estância hospitalar prologada numa instituição de mediana e alta complexidade de Medellín. Materiais e métodos: Estudo analítico, quantita-tivo, transversal, com uma seleção aleatória simples de 291 pacientes registrados no consol-idado de estância hospitalar prolongada numa instituição de saúde. Para a análise bivariada usou-se o X 2 em SPSS, os valores p obtidos foram avaliados com um nível de confiança do 95% e uma margem de erro do 5%, considerando significativos de alfa de 0,05. Resultados: Encontrou-se associação significativa entre a estância hospitalar prolongada e a assistência domiciliar (p=0,028), com procedimentos (p=0,046) e ajudas diagnosticas (p=0,038). Con-clusões: A estância hospitalar de um paciente não só depende da sua condição clínica, e sim da interação com outros atores no seu atendimento como a instituição, o prestador e rede de serviços.


Asunto(s)
Hospitalización , Procedimientos Quirúrgicos Operativos , Diagnóstico , Visita Domiciliaria
17.
Acta odontol. Colomb. (En linea) ; 11(1): 71-82, 2021. ilus, tab
Artículo en Español | LILACS, COLNAL | ID: biblio-1152199

RESUMEN

Objetivo: describir las aplicaciones de la teleodontología para la atención de pacientes durante y posterior a la pandemia de la COVID-19. Método: la búsqueda de artículos sobre teleodontología se realizó en las bases de datos PubMed, EMBASE, EBSCO, SCOPUS, ClinicalKey y LILACS, para identificar estudios publicados en inglés, español y portugués; se incluyeron estudios que contenían las palabras claves teleodontología y COVID-19, publicados desde enero a diciembre de 2020 y que estuvieran completos. La calidad de los artículos se evaluó según las directrices PRISMA-P. Resultados: se identificaron 49 artículos y se incluyeron 14 para la evaluación. De estos estudios, dos eran descriptivos (test de diagnóstico), seis eran estudios descriptivos de corte transversal, cinco eran pruebas pilotos; se identificó, además, un estudio de diseño retrospectivo. Se presenta la teleodontología como alternativa para diagnósticos y tratamientos de enfermedades bucales en tiempos de pandemia, mediante uso de dispositivos móviles, teleorientación y fotografías. La mayoría de los estudios presentaron un riesgo de sesgo de moderado a alto. Conclusión: la teleodontología es una herramienta tecnológica remota para apoyar la orientación, educación y tratamiento, que permite consolidar información de manera sincrónica y asincrónica sin la necesidad del contacto directo entre odontólogo y paciente.


Objective: to describe the applications of teleodontology for patient care during and after the COVID-19 pandemic. Method: the search for articles on teleodontology was carried out in the PubMed, EMBASE, EBSCO, SCOPUS, ClinicalKey and LILACS databases to identify studies published in English, Spanish and Portuguese; Studies that contained the keywords teleodontology and COVID-19, published from January to December 2020 and that were complete, were included. The quality of the articles was evaluated according to the PRISMA-P guidelines. Results: 49 articles were identified and 14 were included for evaluation. Of these studies, two were descriptive (diagnostic tests), six were descriptive cross-sectional studies, five were pilot tests; In addition, a retrospective design study was identified. Teleodontology is presented as an alternative for diagnosing and treating oral diseases in times of pandemic, through the use of mobile devices, remote orientation and photographs. Most of the studies were at moderate to high risk of bias. Conclusion: teleodontology is the remote tool to support remote guidance, education and treatment through technology, allowing the consolidation of information synchronously and asynchronously without the need for direct contact between dentist and patient


Asunto(s)
Humanos , Infecciones por Coronavirus , Teleodontología , Telemedicina , Consulta Remota , Diagnóstico , Promoción de la Salud
19.
Rev. am. med. respir ; 20(4): 288-290, dic 2020.
Artículo en Español | LILACS, BINACIS | ID: biblio-1150704

RESUMEN

Roberto Koch, en 1882 demuestra la etiología de la TB y años después (1890) propone en el 10° Congreso Internacional de Medicina de Berlín la tuberculina como un "remedio" para la enfermedad. No funcionó, pero nos legó la denominada posteriormente tuberculina bruta o antigua (OT, old tuberculin) que se usó durante años como diagnóstico de infección por Mycobacterium tuberculosis y fue reemplazada por el Derivado Proteico Purificado (PPD) desarrollado por Florencia Seibert en 1934. La técnica de aplicación intradérmica de Mantoux (1908), sigue aún vigente


Asunto(s)
Tuberculina , Tuberculosis , Preparaciones Farmacéuticas , Diagnóstico
20.
Diagn. tratamento ; 25(4): 152-155, 20201200. fig, tab
Artículo en Portugués | LILACS | ID: biblio-1146913

RESUMEN

Contexto: Escorbuto tem sido identificado, modernamente, com certa frequência devido ao aumento de fatores de riscos como neoplasias, bypass gástrico, quadros infecciosos, uso crônico de diuréticos, doenças neuropsiquiátricas, alcoolismo, dieta inadequada e progressivo envelhecimento populacional, com mais idosos morando sozinhos. Relato de caso: Apresentamos o caso de paciente pós-bariátrica, sexo feminino, 43 anos, cardiopata grave sob longa internação em uso de altas doses de diuréticos e drogas vasoativas, que desenvolveu púrpuras e equimoses espontâneas nos membros inferiores e no abdome. O tratamento com vitamina C endovenosa levou à melhora clínica das lesões e da condição hemodinâmica em três semanas. Discussão: O escorbuto se manifesta de forma insidiosa e pouco específica em pacientes com comorbidades crônicas. Alterações hemorrágicas (petéquias, equimoses, sangramento gengival), edema articular, fadiga, anorexia, anemia, xerose, e susceptibilidade a infecções, devem levar à suspeita clínica em pacientes de risco. Conclusão: Os clínicos devem estar atentos ao diagnóstico do escorbuto moderno, especialmente, em pacientes bariátricos.


Asunto(s)
Humanos , Femenino , Adulto , Escorbuto , Dermoscopía , Diagnóstico , Cirugía Bariátrica , Cardiopatías
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