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1
Las infecciones del sitio quirúrgico (ISQ) constituyen una de las Infecciones Asociadas al Cuidado de la Salud (IACS) más frecuentes que ponen en riesgo a los pacientes llevando muchas veces al fracaso del procedimiento quirúrgico. Con una incidencia mucho mayor en países de medianos y bajos ing
...
resos, representa un desafío de la práctica médica cotidiana que compromete la salud y la seguridad de los pacientes. La indicación de profilaxis primaria con antibióticos en relación a los procedimientos invasivos, tiene como objetivo disminuir la incidencia de infecciones con la consecuente disminución de la morbimortalidad debiendo utilizarse únicamente en aquellos procedimientos en los que hay evidencia de efectividad. Cabe destacar que la indicación inadecuada, tiene potenciales efectos adversos tales como infecciones por Clostridium difficile, emergencia de resistencia
bacteriana, reacciones adversas a drogas e incremento de los costos en salud.
La profilaxis antibiótica como complemento de una buena técnica quirúrgica, es una medida costo efectiva de prevención de las ISQ representando alrededor del 30% de la indicación de antibióticos entre los pacientes hospitalizados. Dado que en algunos estudios el uso inapropiado de antibióticos se ve reflejado en el 40 al
80% de las indicaciones médicas, desde la Comisión de Infecciones Asociadas al Cuidado de la Salud y Seguridad del Paciente de SADI hemos realizado una actualización de la evidencia disponible. Este documento es una acción complementaria al consenso “Prevención de Infección del Sitio Quirúrgico” realizado entre SADI y el Instituto Nacional de Epidemiología “J. Jara” durante el Congreso de SADI 2015.
La posibilidad de contar con una guía actualizada de profilaxis quirúrgica adaptada a nuestro medio, constituye una herramienta de uso cotidiano por parte de los profesionales del equipo quirúrgico que permite la optimización de la utilización de fármacos restringiendo así la emergencia y diseminación de la resistencia bacteriana. Sin duda esperamos que pueda ser de utilidad para el equipo de salud.
more
Climate change is a major risk to good development outcomes, and the World Bank Group is committed to playing an important role in helping countries integrate climate action into their core development agendas. The World Bank Group is committed to supporting client countries to invest in and build a
...
low-carbon, climate-resilient future, helping them to be better prepared to adapt to current and future climate impacts.
more
La Profilaxis Post-Exposición para el VIH (PEP) constituye una herramienta de prevención que consiste en el uso de medicamentos antiretrovirales para reducir el riesgo de infección luego de situaciones de potencial exposición del virus. Su incorporación está recomendada por la Organización Mu
...
ndial de la Salud en el marco de una estrategia de Prevención Combinada1,2. Cuando se inicia dentro de las 72 horas del episodio de potencial exposición al VIH, la PEP reduce en forma significativa el riesgo de transmisión, por lo que su uso se indica en exposiciones ocupacionales y no ocupacionales esporádicas. En la actualidad, una combinación de 3 drogas antirretrovirales durante 28 días es el esquema estándar empleado como PEP2.
A través de la Dirección de Sida, ETS, Hepatitis y TBC, se distribuye la medicación
necesaria para que la PEP esté disponible en efectores del sistema público de salud cuando está clínicamente indicada.
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Resumen para Equipos de Salud Edición 2021-2022
Las presentes recomendaciones se encuentran dirigidas a los miembros del equipo de salud que asisten niñas, niños y adolescentes (NNyA) que viven con VIH. También se dirigen a los responsables jurisdiccionales que participan en el proceso de gesti
...
ón de acceso a tratamientos antiretrovirales recomendados. El objetivo es brindar directrices para optimizar el cuidado y tratamiento antiretroviral de NNyA, con opciones más seguras y eficaces, basadas en la mejor evidencia disponible.
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Therapeutics for Ebola virus disease
recommended
The WHO Ebola Virus Disease (EVD) Clinical management: living guidance contains the Organization’s most up-to-date recommendations for the clinical management of people with EVD. Providing guidance that is comprehensive and holistic for the optimal care of patients with EVD throughout their il
...
lness is important.
The living guidance is available in both pdf format (via the ‘Download’ button) and via an online platform in both French and English, and is updated regularly as new evidence emerges.
This first version of the Clinical management for EVD living guidance contains four new recommendations regarding use of therapeutics for EVD, this includes two strong recommendations for the use of monoclonal antibody therapies. This new living guideline is written to accompany the optimized supportive care (oSoC) for EVD standard operating procedures (5, 6). The living guideline aims to summarize high quality evidence for EVD therapeutics and make recommendations for their use.
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Traitements contre la maladie à virus Ebola
recommended
Cette première version des orientations evolutives relatives a la prise en charge clinique de la MVE contient quatre nouvelles recommandations concernant l’utilisation de traitements contre la MVE, y compris deux recommandations fortes en faveur de l’utilisation de thérapies à base d’antico
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rps monoclonaux. Ce nouveau document est rédigé en vue d’accompagner des soins de support optimisés (oSoC) pour les procédures opérationnelles standards appliquees a la MVE (5, 6). Les orientations evolutives presentent des preuves de haute qualité concernant l’efficacite des traitements contre la MVE et les recommandations de l’OMS relatives leur utilisation.
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first issued 18 August 2022
Latin America and the Caribbean is characterized by a matrix of social inequality whose axes —such as
socioeconomic stratum, gender, stage in the life cycle, ethnicity and race, territory, disability, and immigration
status— create multiple, often concurrent, situations of exclusion and discri
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mination. The coronavirus
disease (COVID-19) pandemic has exacerbated wide social gaps and it is no coincidence that Latin America
and the Caribbean is one of the regions in which the health and socioeconomic impacts of the pandemic have
been the most severe, which shows that the costs of inequality are unsustainable
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This profile is part of a series of Climate Risk Country Profiles developed by the World Bank Group (WBG). The country profile synthesizes most relevant data and information on climate change, disaster risk reduction, and adaptation actions and policies at the country level. The country profile seri
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es are designed as a quick reference source for development practitioners to better integrate climate resilience in development planning and policy making. This effort is managed and led by Veronique Morin (Senior Climate Change Specialist, WBG) and Ana E. Bucher (Senior Climate Change Specialist, WBG)
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Enfermedad de chagas
Rosas, F.; Vanegas, D.; Cobrales, M.
Sociedad Colombiana de Cardiología y cirugía cardiovascular
(2012)
C2
Durante muchos años, la enfermedad de Chagas ha sido una entidad olvidada en nuestro medio, pese a que Colombia posee las condiciones apropiadas para que esta infección se desarrolle y se perpetúe en el tiempo.
Esto se refleja en el poco conocimiento de la enfermedad y en la existencia de muchos
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individuos que sufren una pérdida significativa de su calidad y esperanza de vida, así como en costos importantes para el sistema de salud.
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For patients on HFNO with persistent hypoxaemia or respiratory distress:
• Check the equipment: inspect the exterior of the machine, the tubing (circuit), the prong for any sign of mechanical damage, confirm it fits and the filters are in place. Ensure the settings are appropriate and flow is max
...
imized.
• Check the oxygen source: there is sufficient oxygen available and flowing through the device. If FiO2 > 50% of oxygen is needed, the device must have a blender.
• Check there is no obstruction with secretions: patients with COVID-19 may have very thick secretions which may block small and large airways and cause sudden respiratory deterioration.
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WHO recommends prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support.
Hypoxaemic respiratory failure in ARDS commonly re
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sults from intrapulmonary ventilation-perfusion mismatch or shunt and usually requires mechanical ventilation.
At any time, if there are urgent or emergent indications for intubation, do not delay.
WHO suggests that hospitalized patients with severe or critical COVID-19 with acute hypoxaemic respiratory failure that do not require emergent intubation be treated with HFNO, or CPAP or NIV (BiPAP) rather than standard oxygen therapy.
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For patients on NIPPV or HFNO with persistent hypoxaemia or respiratory distress:
• Check the equipment: inspect the exterior of the machine, the tubing (circuit), the mask for any sign of mechanical damage, confirm it fits securely without leak (if CPAP/BiPAP) and the filters are in place. Ensur
...
e the settings are appropriate and flow is maximized.
• Check the oxygen source: there is sufficient oxygen available and flowing through the device. If FiO2 > 50% of oxygen is needed, the ventilator must have a blender.
• Check there is no obstruction with secretions: patients with COVID-19 may have very thick secretions which may block small and large airways and cause sudden respiratory deterioration.
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Peru − Progress in health and sciences in 200 years of independence
Carrillo-Larco; R.M.; Guzman-Vilca, W. C.; Leon-Velarde, F.; et al.
The Lancet Regional Health - Americas
(2021)
CC
Peru celebrates 200 years of independence in 2021. Over this period of independent life, and despite the turbulent socio-political scenarios, from internal armed conflict to economic crisis to political instability over the last 40 years, Peru has experienced major changes on its epidemiological and
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population health profile. Major advancements in maternal and child health as well as in communicable diseases have been achieved in recent decades, and today
Peru faces an increasing burden of non-communicable diseases including mental health conditions. In terms of the configuration of the public health system, Peru has also strived to secure country-wide optimal health care, struggling in particular to improve primary health care and intercultural services.
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Climate change is a major risk to good development outcomes, and the World Bank Group is committed to playing an important role in helping countries integrate climate action into their core development agendas. The World Bank Group is committed to supporting client countries to invest in and build a
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low-carbon, climate-resilient future, helping them to be better prepared to adapt to current and future climate impacts
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This profile is part of a series of Climate Risk Country Profiles developed by the World Bank Group (WBG). The country profile
synthesizes most relevant data and information on climate change, disaster risk reduction, and adaptation actions and policies
at the country level. The country profile se
...
ries are designed as a quick reference source for development practitioners to better
integrate climate resilience in development planning and policy making.
more
Brazil‘s Social Policy Response to Covid-19: Healthcare and Poverty Alleviation
Massard da Fonseca, E.; Arantes Beatriz, L. B.; Portella, C.
Global Dynamics of Social Policy; Deutsche Forschungsgemeinschaft
(2022)
CC
During the pandemic, Brazil has provided its citizens with support in the areas of long-term care and disability, the labor market, social assistance, education, and pensions. This report focuses on two social policy areas, health-care and family benefits (including labor policies), as these were th
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e most crucial social policies implemented in Brazil during the Covid-19 pandemic in terms of the resources allocated and the magnitude of social impact. Brazil’s relatively generous social policies were uncoordinated with public health interventions, which contributed to poor compliance with these public health interventions. This suggests that social policy initiatives alone are insufficient in mitigating the social consequences of the pandemic. They need to be accompanied by and coordinated with public health measures, including regulations on testing, social distancing and mask wearing.
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Core Indicators 2019: Health Trends in the Americas starts with a demographic overview of the Americas to demonstrate how the Region has changed over 25 years. These key demographic indicators provide valuable context to better understand the population’s characteristics and their impact on health
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. Brief narratives accompany the graphics to highlight important information.
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