This content is from the Advance Chapters of the NEW Where There Is No Doctor. You can download this chapter in Bangla, English, Haitian Kreyol, Lao, Nepali, Spanish, and Swahili
Las guías para la prevención de Infecciones del Sitio Quirúrgico (ISQ) resumen las medidas basadas en la evidencia que han demostrado disminuir su incidencia y mejorar la calidad asistencial de los pacientes sometidos a cirugía. La última revisión local fue realizada en el año 2009, en el mar...co del consenso intersociedades INE - SADI - ADECI.
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This document outlines PAHO’s regional priorities for the year 2023 to sustain and scale up health emergency and humanitarian assistance in the Americas, with a focus on five priority countries currently facing a prolonged humanitarian crisis and recovering from recent acute emergencies: Colombia,... El Salvador, Guatemala, Haiti, and Venezuela (Bolivarian Republic of). These goals align with and build on the World Health Organization’s Global Health Emergency Appeal for 2023, its principles, priorities, and strategies.
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Colombia is characterized by a fragile and prolonged humanitarian context marked by recurrent multi-hazards affecting its territories and combined with severe structural and systemic challenges within the health system. Recent shocks, including the
COVID-19 pandemic, growing violence within the Col...ombian territories and along the border with Venezuela (Bolivarian Republic of), and repetitive hydro-meteorological disasters over the last 12 months aggravate such chronic challenges.
In 2022, the number of people in need of humanitarian assistance increased by 300 000 due to deteriorating indicators of maternal and child mortality, pregnancy in adolescent girls, human immunodeficiency virus (HIV), suicides, sexually transmitted
infections (STIs), gender-based and sexual violence, and communicable diseases. increasing population trends, primarily due to mass migration movements and the persistence of armed conflicts, create access barriers to essential health services, mobility restrictions, and forced displacement, further impacting the health, lives, and well-being of populations in vulnerable situations. In many territories, geographical distance to health facilities and attacks against medical missions hinder providing appropriate healthcare.
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The recurrence of severe climate events combined with economic, social, and institutional fragilities leave El Salvador in an utterly critical humanitarian situation and highly vulnerable. Located in a disaster-prone subregion, El Salvador is among the 20 countries at the highest risk of disasters w...orldwide. The successive hydrometeorological hazards that impacted El Salvador over the past two years include tropical storms Amanda and Cristóbal and hurricanes Eta, Iota, and,
more recently, Julia. These storms profoundly affected the lives and livelihoods of almost 900 000 people and significantly disrupted health services, especially at the first level of care. In addition, the country’s exposure to earthquakes, floods, and droughts is also constant. Infrastructural and institutional limitations to deal with emergencies and
low capacity to respond to adverse events are an additional challenge, which leaves the population—particularly the most vulnerable—at even higher risk.
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The Bolivarian Republic of Venezuela has been facing a prolonged socio-political and economic situation that has profoundly and negatively impacted social and health indicators. The COVID-19 pandemic further aggravated the humanitarian context in the
country, which stretched the limits of an alread...y weakened national health system. Violence and social conflicts, hyperinflation, constant political tensions, the persistence of migratory movements, and intensification of climate threats and natural hazards
have worsened the living conditions and health status of populations in vulnerable situations, including women, children, and indigenous people. A large influx of returnees back to Venezuela (Bolivarian Republic of) marked the first
two years of the pandemic. However, the country’s continued deteriorating political, socio-economic, and human rights situation resulted in renewed increased migration of Venezuelans in 2022. The profile of Venezuelan migrants has progressively changed
over the years, from single men in search of better economic opportunities to families with women and children in situations of extreme vulnerability. The increasingly irregular and unsafe journeys of those migrants are constantly putting their lives at high risk
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Recovery from COVID-19 has been challenging in Guatemala. As a result of the prolonged socio-economic impact of the pandemic, the average poverty rate nationwide has increased by almost 5%. This rise in the poverty level further exacerbates preexisting vulnerabilities and erodes the limited safety n...ets available to vulnerable populations. Year after year, recurrent disasters and humanitarian crises aggravate the historic social gaps that result in high levels of vulnerability, multidimensional poverty, and overall deprivation of essential services among hundreds of thousands of Guatemalans. According to the World Risk Report 2020, Guatemala is the tenth country with the highest level of exposure to disaster worldwide. Globally, it ranks 28th regarding vulnerability according to the 2021 INFORM’s risk index and 62nd in the Global Climate Risk Index 2021.
In 2020, Guatemala faced a record-breaking and devastating hurricane season with extreme rainfall, catastrophic winds, and deadly landslides, from which the country has not yet recovered. Unfortunately, recurrent extreme weather events, such as Hurricane Julia that hit Central America in early October 2022, progressively but deeply eroded a weak health infrastructure and local health systems.
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For the past years, Haiti has been engulfed in a socioeconomic, political, and humanitarian crisis that has reached critical levels since mid-September 2022 with the intensification of gang violence and social unrest. The widespread insecurity and
political instability have drastically affected the... country’s access to essential goods and services, including food, water, and health. The current fuel supply crisis has affected the water and electricity supply to the population, health centers, and hospitals. Due to problems of insecurity and violence, patients and health personnel have difficulty accessing hospitals and health services.
In parallel, the public health system and international partners face limited response capacity due to reduced international personnel in Haiti, logistics issues, and difficulties in importing supplies. Indeed insecurity, roadblocks, and lockdowns are affecting the importation of internationally procured goods, which may slow the arrival of essential lifesaving supplies to support cholera response efforts. This scenario is particularly problematic, as cholera recently resurfaced in early October.
Armed gangs now control over 60% of the metropolitan area of Port-au-Prince, affecting at least 1.5 million people, and have expanded their influence outside of the capital city, interrupting vital humanitarian programs in most of the national territory,
including COVID-19 vaccination campaigns.
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The Lancet Regional Health, July 19, 2022 DOI:https://doi.org/10.1016/j.lana.2022.100319
El siguiente manual se continuará actualizando, de ser necesario, a medida que se disponga de nueva información.
The crisis caused by the COVID-19 pandemic exacerbated preexisting structural economic inequalities, and had a disproportionate impact on informal workers, especially on women and young people, who lost jobs and income. The situation was even more difficult for single-parent households led by women,... who also had to endure more housework and care tasks. As shown by various research studies, the asymmetric distribution of care tasks, taken up by women, is an inequality factor.
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Acessed on 15.08.2022
Estudio sobre los efectos en la salud mental de personas gestantes por COVID-19
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Accessed on 15.08.2022
La farmacovigilancia es una herramienta que permite la detección, evaluación, conocimiento y prevención de efectos adversos y/o inesperados de los medicamentos que se prescriben. También facilita la detección de fallas de respuesta terapéutica por deficiencias de calid...ad.
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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.
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Diagnóstico y tratamiento de sífilis recomendaciones para los equipos de salud.
El siguiente documento es elaborado por el Programa Nacional de Control de Cáncer de Mama (PNCM) para la gestión de las diferentes acciones involucradas en la
estrategia de Navegación de Pacientes en Cáncer de Mama.
Se busca poder generar una herramienta para la gestión cotidiana de los/las ...navegadores/as que sirva como guía en la consideración de sus intervenciones, de los tiempos de atención y del abordaje de todo el continuo de cuidado de las personas a las cuales realizan seguimiento.
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Objetivos:
- Reforzar la importancia del informe anatomopatológico en el manejo del cáncer
de mama, como elemento fundamental para la toma de decisiones.
- Estandarizar los procedimientos de las técnicas anatomopatológicas a nivel
nacional.
- Establecer los factores pronósticos morfoló...gicos, inmunohistoquímicos y
moleculares validados actualmente.
- Establecer un protocolo de informe anatomopatológico completo, reproducible y
estandarizado, orientado a contribuir en el manejo clínico y en la elaboración de
bases de datos.
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Objetivo general: Delinear las recomendaciones para la atención médica de niños, adolescentes y adultos infectados por el T. cruzi, en cualquiera de sus fases y formas clínicas. Se espera de esta forma optimizar el uso de recursos y mejorar la calidad de atención de los pacientes, con el fin de... aumentar el número de personas diagnosticadas, controladas y tratadas, y contribuir a disminuir la morbimortalidad y la transmisión de la Enfermedad de Chagas en Argentina.
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la Clasificación tabular de problemas de salud es la herramienta primordial para la codificación, pero el Indice alfabético es un complemento que facilita la búsqueda. De todas maneras siempre será necesario consultar la Clasificación tabular y sus
notas.
El pediatra es el médico de cabecera de los niños pequeños y es el primero en ser consultado por las familias. Los padres esperan que el pediatra no solo sea un experto en atender al niño durante una enfermedad, sino que también lo sea en temas
vinculados al desarrollo. Las alteraciones del d...esarrollo son motivo frecuente de consulta en el ámbito pediátrico. La identificación temprana, el diagnóstico y el seguimiento de estos pacientes constituyen un verdadero desafío para los
médicos pediatras.Esta guía ofrece recomendaciones para la vigilancia del desarrollo, la pesquisa, la evaluación y el seguimiento de pacientes con
retrasos y discapacidades del desarrollo.
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