Polifarmacia en Chile: una investigación descriptiva / Polipharmacy in Chile: a descriptive research

La polifarmacia es un término que, si bien no existe un consenso, se considerará como el uso concomitante de cinco o más medicamentos ya sean recetados o no por un profesional. Con respecto a ésta, se ha visto que se ha acrecentado en los últimos años tanto en Chile como en el mundo. En la presente investigación descriptiva se realizó un análisis de la Encuesta Nacional de Salud de Chile (ENS) 2016-17 y se comparó con los resultados obtenidos en la Encuesta Nacional de Salud 2009-10 y con la Encuesta sobre Salud, Envejecimiento y Jubilación Europea para de esta forma realizar un recuento objetivo sobre el aumento de esta condición en Chile. Al caracterizar a los grupos más afectados, se vio que en Chile la mayor prevalencia se daba en población adulta mayor sobre 65 años, mujeres y personas con escolaridad menor a 8 años cursados. Esto da cuenta del nivel del problema y la necesidad de una visión médica holística para el especial abordaje de la multimorbilidad, pues la polifarmacia trae consigo a su vez riesgos para la salud como lo son el aumento de las reacciones adversas e interacciones medicamentosas, riesgo de hospitalización, mayor deterioro del estado funcional, incremento de alteraciones cognitivas y mayores costos monetarios para el sistema de salud.

Polypharmacy is a term that, although there is no official definition, is understood as the concomitant use of five or more medications, regardless of whether they are prescribed by a professional. Regarding this phenomenon, an increase can be observed in recent years both in Chile and on a global level. This present descriptive research draws on an analysis of the National Health Survey (ENS) from 2016-17 and a comparison with the National Survey of Health from 2009-10 and with Survey of Health, Ageing and Retirement in Europe in order to carry out an objective count on the increase of this phenomenon. When characterizing the most affected groups, this paper shows that in Chile the highest prevalence can be found in the older adult population over 65 years of age, women and people with less than 8 years of schooling. These results reveal the dimension of the issue, and the need for a holistic medical vision to pay particular attention to multiple morbidities since polypharmacy brings with it health risks such as increased adverse reactions and drug interactions, risk of hospitalization, further deterioration of functional status, increase in cognitive alterations and higher monetary costs for the health system

Effect of Neuromuscular Electrical Stimulation on the Duration of Mechanical Ventilation.

BACKGROUND: It has been proposed that neuromuscular or functional electrical stimulation may have effects on respiratory muscles through its systemic effects, similar to those produced by exercise training. However, its impact on the duration of invasive mechanical ventilation has not been adequately defined. We sought to evaluate the effect of neuromuscular or functional electrical stimulation on the duration of invasive mechanical ventilation in critically ill subjects. METHODS: We systematically searched 3 databases up to August 2019 (ie, CENTRAL, MEDLINE, and EMBASE) as well as other resources to identify randomized controlled trials (RCTs) that evaluated the effects of neuromuscular or functional electrical stimulation compared to usual care/rehabilitation or placebo of neuromuscular or functional electrical stimulation on the duration of invasive mechanical ventilation. RESULTS: After reviewing 1,200 single records, 12 RCTs (N = 530 subjects) fulfilled our eligibility criteria. Three studies included only subjects with COPD (n = 106 subjects), whereas the rest considered subjects with different diseases. The most frequently stimulated muscle group was the quadriceps. Neuromuscular or functional electrical stimulation may decrease the duration of invasive mechanical ventilation (mean difference = -2.68 d, 95% CI -4.35 to -1.02, I2 = 50%, P = .002; 10 RCTs; low quality of evidence), and we are uncertain whether this effect may be more pronounced in subjects with COPD (mean difference = -2.90 d, 95% CI -4.58 to -1.23, I2 = 9%, P < .001; 3 RCTs; very low quality of evidence). CONCLUSIONS: Neuromuscular or functional electrical stimulation may slightly reduce the duration of invasive mechanical ventilation; we are uncertain whether these results are found in subjects with COPD compared to subjects receiving usual care or placebo, and the quality of the body of evidence is low to very low. More RCTs are needed with a larger number of subjects, with more homogeneous diseases and basal conditions, and especially with a more adequate methodological design.

[Suicide in lesbian, gay, bisexual and trans populations: systematic review of a decade of research (2004-2014)]. / Suicidio en poblaciones lesbiana, gay, bisexual y trans: revisión sistemática de una década de investigación (2004-2014).

UNLABELLED: Lesbian, gay, bisexual and trans (LGBT) populations have a high prevalence of suicide behaviors. AIM: To review the literature on suicide among LGBT populations. MATERIAL AND METHODS: A systematic review of the scientific literature published between 2004 and 2014 on suicidality among LGBT people was conducted. Forty-five articles were selected for a thematic analysis. RESULTS: The research on suicide among LGBT people has increased during the last decade. The vast majority of studies have been conducted in the U.S. and other English speaking countries. At the same time, in a great part, these studies have been published in journals specializing in mental health and public health of sexual minorities. In general, they provide a significant foundation on protective and risk factors for suicide as well as their epidemiology. CONCLUSIONS: The focus of research on suicide among LGBT populations is mainly exploratory. More attention on these at-risk groups is required from the suicide research community in order to provide useful evidence for prevention and development of focalized and effective interventions.

Suicidio en poblaciones lesbiana, gay, bisexual y trans: revisión sistemática de una década de investigación (2004-2014) / Suicide in lesbian, gay, bisexual and trans populations: systematic review of a decade of research (2004-2014)

Lesbian, gay, bisexual and trans (LGBT) populations have a high prevalence of suicide behaviors. Aim: To review the literature on suicide among LGBT populations. Material and Methods: A systematic review of the scientific literature published between 2004 and 2014 on suicidality among LGBT people was conducted. Forty-five articles were selected for a thematic analysis. Results: The research on suicide among LGBT people has increased during the last decade. The vast majority of studies have been conducted in the U.S. and other English speaking countries. At the same time, in a great part, these studies have been published in journals specializing in mental health and public health of sexual minorities. In general, they provide a significant foundation on protective and risk factors for suicide as well as their epidemiology. Conclusions: The focus of research on suicide among LGBT populations is mainly exploratory. More attention on these at-risk groups is required from the suicide research community in order to provide useful evidence for prevention and development of focalized and effective interventions.