South Health and Policy (Journal)
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Design and validation of a scale to assess user satisfaction with Primary Health Care
No full textIntroduction: Primary Health Care is key to user-centered care but faces challenges such as the lack of valid instruments to measure user satisfaction with the care received.Objective: to evaluate the psychometric properties of a scale designed to assess user satisfaction with health care.Methods: a methodological study for instrument validation was conducted in Pinar del Río in 2023, focusing on the validation of the SATUS-APS scale. Following its development, the instrument underwent expert validation and a pilot test, including exploratory and confirmatory factor analyses. Content and construct validity, as well as internal consistency, were analyzed.Results: the SATUS-APS scale showed high item-level content validity (.85–.94) and internal consistency (α=.83). Exploratory factor analysis identified six factors explaining 58.4% of the variance, with appropriate statistical fit (RMSEA=.045, CFI=.976), requiring modifications. The final model included 18 items, showing acceptable fit (CMIN/DF= 2.87, CFI=.976, TLI=.940, SRMR=.0471, RMSEA=.0404, p<.001) and excellent overall reliability (α=.968).Conclusions: the questionnaire demonstrated validity and reliability for measuring user satisfaction. Its structure was confirmed through factor analysis, and reliability coefficients were high across all dimensions. It is a useful tool for research and quality improvement in health services
Predicting Postoperative Complications in Glioblastoma Patients Using Machine Learning Models
No full textIntroduction: Glioblastoma multiforme (GBM) is the most aggressive primary brain tumor in adults. Despite advanced treatments, postoperative complications remain common and significantly impact patient outcomes. This study aims to predict such complications using machine learning (ML) models.Method: a retrospective analysis was conducted using GBM patient data from open-access sources (TCIA and Kaggle). Preoperative, intraoperative, and postoperative variables were collected. ML models including Logistic Regression, Random Forest, XGBoost, and Long Short-Term Memory (LSTM) were trained and evaluated using metrics such as AUROC, AUPRC, sensitivity, and specificity. Feature importance was assessed using SHAP values.Results: The study included 498 patients (median age: 55 years; 60 % male). Postoperative complications occurred in 30 % of patients, with infections (15 %), hemorrhage (10 %), and neurological deficits (18 %) being most common. LSTM outperformed other models (AUROC: 0.88; AUPRC: 0.64), especially in Grade IV tumors. Key predictors included low preoperative KPS, eloquent tumor location, subtotal resection, and ICU stay >5 days.Conclusions: ML models, especially deep learning (LSTM), effectively predicted postoperative complications in GBM patients. Their integration into clinical workflows may enhance risk stratification, surgical planning, and patient counseling
The diagnosis and treatment of SIBO in Latin America
No full textThe small intestine normally harboured a limited amount of bacteria, but in SIBO there was an abnormal proliferation of microorganisms, especially in the jejunum. This condition generated various symptoms such as abdominal distension, diarrhoea and malabsorption, which made it difficult to diagnose. The lactulose or glucose breath test has become established as a useful non-invasive technique for its detection, although its implementation in Latin America presented challenges related to access, standardisation and professional training. Appropriate treatment included antibiotics such as rifaximin, a specific diet and prokinetics to prevent relapses. Despite the progress made, obstacles persisted in the region that required further research and the strengthening of clinical guidelines
Excessive uterine bleeding in a patient with functional thrombopathy associated with chronic kidney disease. About a case
No full textWe report an adolescent with chronic kidney disease due to rapidly progressive glomerulonephritis undergoing hemodialysis treatment who presented excessive uterine bleeding. The anamnesis collected did not show a family history of hemorrhagic diathesis, however, during the pediatric age he had had a tendency to present ecchymosis in light and moderate traumas, occasional nocturnal epistaxis and prolonged bleeding after the loss of primary teeth, for which reason it was suspected. the possibility of a disorder of platelet function and aggregation. The coagulogram was normal, but the qualitative study of the platelets showed an aggregation disorder with ADP, epinephrine and collagen. No extrinsic factors dependent on the treatment of her underlying disease were verified that could potentially contribute to this platelet alteration and it was concluded that she was a patient with probably congenital thrombopathia, who, when added to the platelet toxicity typical of the uremic state, developed this hemorrhagic tendency. , which was controlled with transfusion of red blood cells and platelets associated with antifibrinolytic treatment. The relevance of this patient consists in showing how chronic kidney disease can contribute to the clinical expression of a hematological disease that had remained subclinical after childhood and the need to take this association into account when faced with the diagnostic problem of a hemorrhagic diathesis. in patients with this disorder.
Antimicrobial resistence of Escherichia coli in urinary tract infections
No full textUrinary tract infection (UTI) is a microbial invasion of the urinary tract that overwhelms the host\u27s defense mechanisms. UTIs are a common cause of consultations and hospitalizations worldwide at all ages, with the impact on kidney function varying depending on associated risk factors and age. The increasing use of antimicrobials has resulted in increased resistance among microorganisms. A narrative literature review was conducted that included various texts, articles, and printed and digital materials related to urinary tract infections caused by Escherichia coli (E. coli) and their resistance patterns. The aim was to analyze the literature that supports the growing antimicrobial resistance of E. coli in urinary tract infections. The study concluded that antimicrobial resistance is an issue that globally affects public health and has been increasing. E. coli has specifically developed special resistance to fluoroquinolones and carbapenems, a situation of increasing concern. Faced with this global emergency, we must work together to mitigate the situation. Otherwise, the outlook for the near future will be very bleak if this health threat continues to be ignored
Characterization ok risk factor associated with oral cancer in Guane region. Pinar del Río. Cuba
No full textIntroduction: Head and neck cancer is a group of neoplasms that share a similar anatomical origin, most of which originate from the mucosa that covers the epithelium of the upper digestive airways. The term oral cancer includes: cancer of the lips, oral cavity, oropharynx and salivary glands. Methods: A descriptive, analytical and observational study was conducted. The study universe was made up of patients over 15 years of age from the 25th Medical officer of the “Manuel Piti Fajardo” Main Emergency Polyclinic, in Guane, Pinar del Río, Cuba; with the aim of screening the risk factors associated with the appearance of oral cancer. Results: Of 1038 individuals surveyed, the male sex was the most prevalent with 60.3%, 58 individuals were found with precancerous lesions. The age group over 60 years was the most affected by lesions in the oral cavity. Smoking was the risk factor with the highest incidence with 19.5% of those studied. Subprosthetic stomatitis was the most prevalent lesion with 3.7%; followed by leukoplakia. The hard palate was the most affected anatomical location with 7% of affected individuals. Conclusions: The predominant sex presenting lesions was male. The age group 60 years and older was the most affected by presenting lesions. Smoking was the most common risk factor. Subprosthetic stomatitis predominated as a lesion. The hard palate was anatomically the most affected region.
The cuckoo of serologies: the HIV test Why do people avoid getting tested for HIV?
No full textBackground: so many people don’t know they might have HIV, they avoid the possibility of having a diagnosis right in time, maybe because they don’t realize they got exposed to the virus or just chose to ignore the chance of having it. Even though science advances faster as we get older, and laboratories present more possibilities of treatment, people still avoid certain healthcare methods such as Elisa’s test for HIV. In this article we do a revision of the most common universal barriers that complicate people to get tested for HIV. Material and methods: SCIelo, pubmed, google academic. Bibliographic revision type. Results: From the research conducted in very few countries, we have found that social stigma continues to prevail and prevents those at risk of testing positive for HIV from getting tested. Negative experiences and fear of a healthcare system that is not compassionate towards those who have it contribute to this. Conclusion: The social stigma remains just as strong as when HIV was first publicized without a clear understanding of how the disease evolved. Now, with so much knowledge from the healthcare system, ignorance and fear of learning about HIV, its diagnosis, and the possibility of treatment continue to prevail
Impact of diclofenac use on the incidence and severity of ischemic colitis: A systematic rewiew
No full textIntroduction: Ischemic colitis is inflammation of the colon caused by decreased blood flow, being the most frequent form of intestinal ischemia. Symptoms can be mild to severe complications such as intestinal perforation. Diclofenac, a non-steroidal anti-inflammatory drug (NSAID), which is commonly used, has been associated with various gastrointestinal complications. Currently, several studies have suggested a possible relationship between diclofenac use and ischemic colitis. Objective: To evaluate the impact of diclofenac use on the incidence and severity of ischemic colitis through a systematic review of the available scientific literature. Materials and Methods: An exhaustive search of databases such as Pudmed and Scielo was performed to identify relevant studies that analyzed the relationship between diclofenac use and ischemic colitis, using the following terms: “Colitis”; “Ischemia”; “Diclofenac”; “Colon”; “Anti-Inflammatory Agents, Non- Steroidal”. Observational studies, clinical trials and case reports were included. Data were extracted and analyzed to assess the incidence and severity of ischemic colitis in patients treated with diclofenac. Results: The articles reviewed indicate a significant relationship between the use of diclofenac and the appearance of ischemic colitis. Bielsa Martín et al. (2006) presented specific cases of acute colitis induced by diclofenac. Gleeson and Davis (2003), together with Sierra Gabarda et al. (2022) found a correlation between the use of NSAIDs and the recent diagnosis of ischemic colitis. The proposed mechanisms involve inhibition of prostaglandin synthesis, which affects intestinal mucosal integrity and blood perfusionConclusion: This systematic review emphasizes the significant impact of diclofenac on the incidence and severity of ischemic colitis. It is recommended that clinicians cautiously evaluate the need to prescribe diclofenac, considering therapeutic alternatives with less risk and monitoring those patients with risk factors. In addition, further research is needed to confirm a conclusive causal relationship and to develop preventive and therapeutic strategies to help reduce the risks associated with diclofenac use
Impact of Mental Health on Patients with Psoriasis
No full textIntroduction: Psoriasis is a chronic, systemic, immune-mediated dermatological disease of the skin that significantly affects patients\u27 quality of life. The mental health of these patients is frequently compromised due to the clinical manifestations of the lesions and the stigmatizing nature of the disease.Material and methods: A review was carried out of 15 articles obtained from Google Scholar and SciELO. The selected studies address various aspects of the relationship between psoriasis and mental health, including depression and anxiety affecting quality of life. Results: Of a total of 15 articles reviewed, the results indicate a high prevalence of mental disorders, such as depression and anxiety, in patients with psoriasis, highlighting the importance of comprehensive interventions that address both physical and mental health.Conclusion: Mental health is a critical component in the management of psoriasis. Health professionals should consider continuous multidisciplinary mental health work in these patients to provide comprehensive treatment. Interdisciplinary collaboration between dermatologists and mental health professionals is essential to improve outcomes in patients with psoriasis
Attention Deficit Hyperactivity Disorder: Late diagnosis and its psychosocial and functional consequences
No full textIntroduction: Attention Deficit Hyperactivity Disorder (ADHD) has traditionally been diagnosed in childhood, but in recent years an increase in adult diagnoses was observed. Lack of knowledge, confusion with other disorders and the absence of obvious symptoms hindered its early detection. Late diagnosis generated negative impacts on the emotional, professional, social and sexual life of those affected.Methods: An observational and descriptive study was conducted, based on an online survey applied to adults with late diagnosis of ADHD. The questionnaire included 28 questions distributed in variables such as diagnosis, relationships, academic, emotional and sexual life. The sample consisted of 13 participants from Brazil and Argentina, and the data were analyzed quantitatively and qualitatively.Results: 38.5% were diagnosed after the age of 18 years. Some 76.9% presented academic difficulties and 61.5% had problems in completing their studies. In the work environment, 46.2% reported difficulties related to disorganization and distraction. Likewise, 69.2% reported problems in personal relationships and 61.5% in self-esteem. More than half experienced alterations in their sexual life. 61.5% stated that the treatment improved their quality of life, although some did not agree for economic reasons.Conclusion: Late diagnosis of ADHD had a significant impact on multiple areas of adult life. It was concluded that greater awareness, early diagnosis and access to comprehensive treatment are essential to improve the quality of life of these individuals