Caracterización clínico-epidemiológica de pacientes con cardiopatía hipertensiva

Fundamento: las enfermedades crónicas, como la hipertensión arterial, constituyen en la actualidad uno de los mayores retos que enfrentan los sistemas de salud en todo el mundo. Objetivo: caracterizar clínica y epidemiológicamente a los pacientes con cardiopatía hipertensiva ingresados en el Servicio de Medicina Interna del Hospital General Docente Guillermo Domínguez López de Las Tunas. Métodos: se realizó un estudio descriptivo y transversal, en pacientes ingresados con cardiopatía hipertensiva en el Servicio de Medicina Interna del Hospital General Docente Guillermo Domínguez López del municipio Puerto Padre, provincia Las Tunas, de junio de 2019 a junio de 2021. El universo estuvo conformado por la totalidad de los pacientes con el diagnóstico de dicha entidad. Se incluyeron las siguientes variables: edad, sexo, color de la piel, factores de riesgo, grados de la hipertensión arterial, tiempo de evolución de la hipertensión arterial, tipos y complicaciones de la cardiopatía hipertensiva. Se utilizó estadística descriptiva. Resultados: se encontró predominio de pacientes del sexo masculino (56,6 %) y del grupo etáreo entre 60 y 69 años (35,1 %). El tabaquismo se manifestó (35,9 %) como factor de riesgo más prevalente. Predominó la correlación entre el tipo lV y el grado lll (15,9 %). Así como el tipo lV en hipertensos de más de treinta años de evolución (42,7 %). La enfermedad cerebrovascular (33,2 %) y la insuficiencia cardíaca (25,5 %) predominaron como complicaciones. Conclusiones: los pacientes hipertensos del sexo masculino, con más de sesenta años y fumadores son propensos a desarrollar cardiopatía hipertensiva, acompañándose de otras enfermedades cardiovasculares, como complicaciones.

Background: chronic diseases, such as arterial hypertension, currently constitute one of the greatest challenges facing health systems throughout the world. Objective: to clinically and epidemiologically characterize patients with hypertensive heart disease admitted to the Internal Medicine Service of the Guillermo Domínguez López General Teaching Hospital in Las Tunas. Methods: a descriptive and cross-sectional study was carried out in patients admitted with hypertensive heart disease in the Internal Medicine Service of the Guillermo Domínguez López General Teaching Hospital in the municipality of Puerto Padre, Las Tunas province, from June 2019 to June 2021. The universe was made up of all the patients with the diagnosis of said entity. The following variables were included: age, sex, skin color, risk factors, degrees of arterial hypertension, time of evolution of arterial hypertension, types and complications of hypertensive heart disease. Descriptive statistics were used. Results: there was a predominance of male patients (56.6 %) and the age group between 60 and 69 years (35.1 %). Smoking (35.9 %) as the most prevalent risk factor. The correlation between type IV and grade III (15.9 %) predominated. As well as type IV in hypertensive patients with more than thirty years of evolution (42.7 %). Cerebrovascular disease (33.2 %) and heart failure (25.5 %) predominated as complications. Conclusions: it was concluded that male hypertensive patients, over sixty years old and smokers are prone to developing hypertensive heart disease, accompanied by other cardiovascular diseases, as complications.

Caracterización de pacientes hipertensos en un centro de aislamiento para la COVID-19 / Characterization of Hypertensive Patients in an Isolation Center for COVID-19

RESUMEN Fundamento: una de las enfermedades más frecuentes en pacientes con COVID-19 es la hipertensión. También es la que se presenta en más pacientes con complicaciones graves y su posterior fallecimiento. Es además la patología crónica que más se muestra en pacientes ingresados en centros de aislamiento por contactos de casos positivos a la COVID-19. Objetivo: caracterizar a los pacientes contactos de casos positivos de COVID-19 con hipertensión ingresados en uno de los centros de aislamiento de la Universidad de Ciencias Médicas de Cienfuegos entre enero y abril del 2021. Métodos: se realizó un estudio de tipo descriptivo, transversal y prospectivo. El universo estuvo conformado por 275 pacientes, todos mayores de 18 años, con sospecha de COVID-19 ingresados con diagnóstico de hipertensión durante el período comprendido entre enero y abril de 2021, en uno de los centros de aislamiento de la Universidad de Ciencias Médicas de la provincia Cienfuegos. Las variables estudiadas fueron: edad, sexo, color de la piel, procedencia, tiempo de evolución de la hipertensión, patologías asociadas y comportamiento de las cifras de tensión arterial durante el ingreso. Los resultados se presentan en frecuencias absolutas y relativas, a través de tablas y gráficos estadísticos, empleando medias, medianas y porcentajes. Resultados: predominaron los mayores de 60 años y del sexo femenino, aquellos que presentaron más de 10 años de evolución de la hipertensión arterial y con diabetes mellitus como patología asociada. Durante la estancia en el hospital un menor número de hipertensos presentó cifras elevadas de tensión arterial. Conclusiones: continúa siendo la hipertensión la comorbilidad más frecuente vinculada a la mortalidad por el virus en los mayores de 60 años y del sexo femenino.

ABSTRACT Background: one of the most frequent diseases in patients with COVID-19 is hypertension. It is also the one that occurs in more patients with serious complications and subsequent death. It is also the chronic pathology that is most commonly seen in patients admitted to isolation centers due to contacts of positive cases of COVID-19. Objective: to characterize the contact patients of COVID-19 positive cases with hypertension admitted to one of The Cienfuegos University of Medical Sciences isolation centers between January and April 2021. Methods: a descriptive, cross-sectional and prospective study was carried out. The studied universe was 275 patients suspected of having COVID-19 admitted during the study period, all over 18 years of age with a diagnosis of hypertension during the period between January and April 2021, in one of the Cienfuegos Medical Sciences University isolation centers. The variables studied were: age, sex, skin color, origin, evolution time of hypertension, associated pathologies and behavior of blood pressure figures during admission. The results are presented in absolute and relative frequencies, through tables and statistical graphs, using means, medians and percentages. Results: those older than 60 years old and female prevailed, as well as those who presented more than 10 years of arterial hypertension evolution and with diabetes mellitus as an associated pathology. During the hospital stay, a smaller number of hypertensive patients presented high blood pressure. Conclusions: the most frequent linked comorbidity keeps on being the hypertension to the mortality for the virus in the elders of 60 years and of the female sex.

Desigualdad en la distribución de médicos en el Perú / Inequality in the Distribution of Doctors in Peru

Introducción: Los determinantes sociales de la salud explican la mayor parte de las inequidades sanitarias, y el sistema sanitario es uno de ellos. Objetivo: Determinar la desigualdad en la distribución de médicos destinados a la atención de afiliados al Seguro Integral de Salud en el Perú. Métodos: Se realizó un estudio transversal analítico con datos de la Dirección General de Gestión y Desarrollo de Recursos Humanos del Ministerio de Salud y del Seguro Integral de Salud del año 2015. Ica fue usada como territorio referente por tener el menor porcentaje de población pobre en el Perú. Resultados: La densidad de médicos en establecimientos del primer nivel de atención fue de 8,22 x 10 000 asegurados; en el cuartil superior se ubicaron Moquegua, Tacna, Arequipa, Ica, Madre de Dios, Apurímac y Huancavelica. En el segundo nivel de atención, el Perú registró 1,85 médicos especialistas x 10 000 asegurados; Ica ostentaba la tasa más alta (10,28). Conclusiones: Existe desigualdad en la distribución de los médicos destinados a la atención de la población afiliada al Seguro Integral de Salud por lo que se deben rediseñar y reorientar políticas de recursos humanos que incentiven el aumento de la densidad de médicos en los territorios de mayor pobreza(AU)

Introduction: The health social determinants explain most of the health inequities, and the health system is one of them. Objective: To determine the inequality in the distribution of doctors assigned to the care of members of the Comprehensive Health Insurance in Peru. Methods: An analytical cross-sectional study was carried out with data from the General Directorate of Human Resources Management and Development of the Ministry of Health and Comprehensive Health Insurance in 2015. Ica was used as a reference territory for having the lowest percentage of poor population in Peru. Results: The density of physicians in first-level care facilities was 8.22 x 10 000 insured; Moquegua, Tacna, Arequipa, Ica, Madre de Dios, Apurímac and Huancavelica were located in the upper quartile. At the second level of care, Peru registered 1.85 specialist doctors x 10,000 insured; Ica had the highest rate (10.28). Conclusions: There is inequality in the distribution of doctors assigned to the care of the population affiliated with the Comprehensive Health Insurance, so it is necessary to redesign and redirect human resource policies that encourage an increase in the density of doctors in the poorest territories(AU)

La medicina tradicional herbolaria en los sistemas de salud convencionales / The traditional herbalist medicine in the conventional health systems

RESUMEN La medicina tradicional herbolaria desde su evolución hasta la contemporaneidad ha sido objeto de uso para la medicina convencional. Por eso el objetivo del trabajo es describir el comportamiento de la medicina tradicional herbolaria en los sistemas de salud convencionales. Se realizó la búsqueda y análisis documental de numerosas fuentes sobre la temática pertenecientes a las bases de datos SciELO Cuba, SciELO Regional, Science Direct, Clinical Key, Cumed, Lilacslo. Se concluye que la actualidad social registra manifestaciones alentadoras en el campo de la aceptación de la herbolaria como medicina complementaria por el equipo de salud y un renovado interés en el ámbito mundial por estudiar los efectos que tienen las plantas sobre la salud.

ABSTRACT The traditional herbalist medicine from its evolution to the contemporaneity has been an object use for the conventional medicine. That's why the objective of the work is to describe the behavior of the traditional herbalist medicine in the conventional health systems. A search and documentary analysis of numerous sources on the subject-matter belonging to the databases SciELO Cuba, SciELO Regional, Science Direct, Clinical Key, Cumed, Lilacslo was carried out. It is concluded that the social actuality registers encouraging declarations in the field of the acceptance of the herbalist as complementary medicine for the team of health and a renewed interest in the world ambience to study the effects that have the plants on the health.

Cobertura efectiva de las intervenciones en salud de América Latina y el Caribe: métrica para evaluar los sistemas de salud / Effective coverage of health interventions in Latin America and the Caribbean: metrics for the assessment of health systems performance

OBJETIVO: Medir la cobertura efectiva para once intervenciones de salud en nueve países de América Latina utilizando las encuestas de demografía y salud o registros administrativos que abarcan la salud infantil, de la mujer y el adulto. MATERIAL Y MÉTODOS: Se seleccionaron las intervenciones y se armonizaron definiciones y métodos de cálculo de acuerdo con la información disponible para lograr la comparabilidad entre países. RESULTADOS: Chile es el país con mejores indicadores de coberturas crudas y efectivas, seguido por México y Colombia, y existen brechas importantes entre regiones, departamentos o estados. CONCLUSIONES: La métrica de cobertura efectiva es un indicador sensible que relaciona la necesidad de las intervenciones en salud, su utilización y calidad, lo que permite valorar los programas de salud al aportar datos precisos de dónde y a quién deben dirigirse los recursos y esfuerzos nacionales para que los países alcancen los propósitos y metas planteados.

OBJECTIVE: To measure effective coverage for ll health interventions in Latin America including the children's, women's and adult health, as part of program evaluation. MATERIAL AND METHODS: Interventions were selected; the definitions and calculation methods were harmonized according to the information available to ensure comparability between countries. RESULTS: Chile has better indicators of crude and effective coverage followed by Mexico and Colombia.There are significant gaps between regions, counties or states. CONCLUSIONS: The health metric on effective coverage is a sensitive indicator that links three important aspects: Coverage of health interventions, use of health services, and access to such services. Effective coverage is a good tool to evaluate health programs performance, and also provides data of where and to whom the system should address national efforts and resources to achieve the purposes and goals set.

Caracterização geográfica, epidemiológica e da organização dos serviços de saúde na tríplice fronteira Brasil-Colômbia-Peru / Geographic characterization, epidemiology and of organization of health services in the triple border between Brazil and Colombia-Peru

Esta tese trata da análise do sistema de saúde e da organização da assistência no contexto da fronteira entre o Brasil, a Colômbia e o Peru. Partindo da delimitação geográfica e da caracterização sócio-demográfica e epidemiológica da região, procedeu-se a uma análise dos sistemas locais de saúde e da oferta de serviços à população que habita ou circula pela área de fronteira. Bases de dados oficiais foram utilizadas na coleta de dados secundários e questionários aplicados junto a gestores de unidades de saúde de dezesseis localidades fronteiriças serviram para avaliar os fatores limitantes da oferta e as estratégias de superação adotadas. Constatou-se que as reformas sanitárias implementadas nos três países, com propósito de reduzir iniqüidades, melhorar o uso eficiente dos recursos e aumentar a qualidade dos serviços, provocaram impactos de tal ordem na configuração dos sistemas locais de saúde que atualmente dificultam a integração da rede de serviços fronteiriços. Apesar das intensas relações trans-fronteiriças e do contexto internacional que demarca a formação de novos blocos econômicos e a cooperação entre nações soberanas, as diferenças dos modelos de gestão e as desigualdades regionais no interior de cada espaço nacional representam obstáculos à implementação de uma assistência integrada à saúde, estruturada a partir das necessidades regionais. Foi observado uma insuficiência e inadequação da infraestrutura de assistência, combinando um quadro de escassez e concentração de diversos serviços, notadamente os de maior complexidade. As características da oferta são analisadas considerando a perspectiva de articulação das autoridades sanitárias e a promoção de ações conjuntas visando a descentralização da rede e a criação de um sistema único de saúde da fronteira. Conclui-se que, para esta finalidade, um ponto de partida seria a unificação das ações de primeiro e segundo níveis de atenção, que nos três países já são de responsabilidade do setor público...

This thesis deals with the analysis of the health system and the organization of the assistance in the context of the border among Brazil, Colombia and Peru. Considering the geographicdelimitation, the socio-demographic and epidemiological characterization of the region, it was made an analysis of the local systems of health and the services supply to the population that inhabits or circulates around the border area. Official databases were used in secondary data collection and questionnaires together the managers of health units of sixteen border localities served to assess the limiting factors of supply and overrun strategies adopted. It was verified that the sanitary reforms implemented by the three countries with the intention to reduce iniquities, improve the efficient use of the resources and increase the quality of the services, provoked such impacts in the configuration of the local systems of health that actuallydifficult the net integration of border services. Despite of the intense relations across the border and the international context that demarcates a new formation of economic blocks andthe cooperation among sovereign nations, the regional differences of management models and the inequalities within each national space represent obstacles for the implementation of an integrated assistance of health, wich was structured based on regional needs. It was observed as well an insufficiency and inadequacy of the assistance infrastructure, combining a scarcityand concentration of diverse services, particularly those of higer complexity. The supply features were analyzed according to the perspective of an articulation of the sanitary authorities and the promotion of joint actions seeking the decentralization of the net and the creation of a single border health system...