Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

INTRODUCTION: Breast cancer (BC) is the second most common in the world and the most frequent among women. The incidence varies between regions. In addition, BC is the fifth cause of cancer death worldwide, the most frequent in the least developed regions, and the second cause of death in the most developed regions and in South America. In Argentina, BC has the highest incidence and mortality rates in women. OBJECTIVES: To understand the reasons and consequences of delays as well as the strategies used by women in coping with barriers along the BC treatment process. METHODS: A cross-sectional descriptive study was performed using qualitative data collection technique. Semi-structured interviews were conducted among women with BC and recorded after informed consent. Atlas-ti (V.7.2) was used for data analysis. RESULTS: Barriers were identified at personal level (financial constraints, patient beliefs), at interpersonal level (job problems, family responsibility, physician-patient relationship), and at health system (health service organization, quality of medical care). CONCLUSIONS: The research provides evidence to understand the barriers faced by women diagnosed with BC and shows the opportunities for the implementation of the patient navigation strategy in order to reduce or mitigate delays in the care process.

El cáncer colorrectal (CCR) es el segundo cáncer más frecuente en Argentina, donde representa el 11,8% del total en ambos sexos. En la mayoría de los casos, el CCR se puede detectar en etapas tempranas mediante programas de tamizaje poblacional. En 2017 las autoridades sanitarias de Entre Ríos decidieron efectuar una prueba piloto en los departamentos de Paraná, Uruguay y Diamante. El objetivo del estudio fue identificar y describir las características socioeconómicas, de cobertura de salud y epidemiológicas del CCR de dichas localidades en el período 2007-2015, con el propósito de que sirva como insumo para los tomadores de decisiones en materia sanitaria. Se trató de un estudio descriptivo en base a fuentes secundarias. Los principales resultados del estudio indican que en términos epidemiológicos, la implementación de un tamizaje masivo para Paraná, Diamante e incluso Uruguay es pertinente, ya que los datos de mortalidad arrojan una situación crítica; en términos socioeconómicos, la provincia muestra una realidad compleja, que debe ser evaluada antes de la implementación de una prueba piloto debido a que las condiciones estructurales son poco favorables para este tipo de políticas de prevención, y en términos de cobertura de salud, se observa que la mayoría de la población entrerriana utiliza obras sociales, mientras que el programa de tamizaje masivo está enfocado exclusivamente al sistema público de salud.

NTRODUCTION: Many of the current emerging and reemerging diseases in humans are transmitted by animals. OBJECTIVES: To analyze knowledge, risk perception and behavior in relation to zoonoses in adults aged 18 and over. METHODS: A quantitative, cross-sectional and correlational study was conducted through a survey in the city of Córdoba in 2015. The sampling was random, multistage and stratified. Data analysis was descriptive and bivariate by Chi-square test. RESULTS: A total of 59% said they had domestic animals, and 94% answered that human beings can contract diseases through contact with animals. However, only 14% knew what zoonotic diseases are, and a small percentage was able to explain the way of transmission of the most common urban zoonoses. There was an association between sociodemographic variables and variables related to knowledge and risk perception of zoonotic diseases, as well as between knowledge and risk perception of zoonotic diseases and risk/prevention behaviors. CONCLUSIONS: Knowledge about zoonoses and risk perception have independent influence on risk/prevention behaviors. Future researches should deeply explore risk perception, in order to improve the impact of preventive actions

Las Enfermedades Crónicas no Transmisibles constituyen una de las principales causas de mortalidad en todo el mundo. A fin de contar con evidencia científica que permita mejorar la adopción, cobertura y eficacia de estrategias de prevención y control de estas enfermedades y sus factores de riesgo, y en el contexto de la implementación de la Cobertura Universal de Salud, el Ministerio de Salud y Desarrollo Social de la Nación (MSyDS) en conjunto con la Global Alliance for Chronic Diseases ha convocadoa para la presentación de proyectos de investigación en implementación, de entre dos y tres años de duración, por un monto de hasta $10.000.000, sobre estrategias para la prevención y control de hipertensión arterial, diabetes mellitus, tabaquismo y enfermedades cardio y cerebrovasculares, en poblaciones vulnerables de Argentina. En la primera fase de la convocatoria se recibieron 82 Notas Conceptuales, de las que 61 fueron rechazadas por requisitos administrativos o por no ajustarse al tipo de investigación requerida y 21 fueron enviadas para su revisión por un comité de evaluación externo. Luego de esta instancia, 12 de estas notas fueron seleccionadas para presentar propuestas completas que en enero de 2019 serán evaluadas por un comité evaluador conformado por representantes de la Global Alliance for Chronic Diseases y del MSyDS. Los proyectos que resulten ganadores comenzarán en abril de 2019.

Introducción: La cultura de seguridad del paciente implica un compromiso de pacientes y familiares, personal de salud, directivos y responsables de desarrollar e implementar las políticas sanitarias. Su fortalecimiento aumenta la seguridad de todos los involucrados en las prácticas con radiaciones ionizantes, minimizando los riesgos que atentan contra la salud individual, colectiva y ambiental. Objetivos: Introducir el concepto de cultura de seguridad del paciente aplicado a prácticas que utilizan radiaciones ionizantes en el ámbito de la salud pública. Método: Revisión bibliográfica para investigar las experiencias relacionadas con la cultura de seguridad en las prácticas médicas que utilizan fuentes de radiación ionizante, en sentido general. Resultados: Se precisaron los conceptos de cultura, cultura de seguridad y cultura de seguridad del paciente, enfatizando la necesidad de crear un ambiente propicio para reducir la probabilidad de incidentes y accidentes. Conclusiones: El compromiso con la seguridad del paciente y la cultura de seguridad del paciente debe estar lo suficientemente consolidado como para aceptar la responsabilidad y el desafío de garantizar que los pacientes estén y se sientan seguros. Las instituciones que realizan actividades con fuentes de radiación tienen la responsabilidad de alcanzar y sostener el más alto nivel de cultura de seguridad.

INTRODUCTION: Morbidity and epidemiology information from medical records of hospitalization (IEH) influences health statistics and decisions. In 2013, 71.8% (61 002) IEH were initially coded in six medical record departments of public hospitals and then controlled or recoded by the Department of Health Services Statistics (DESS) in the province of Tucumán. OBJECTIVES: To evaluate the degree of agreement in clinical coding of diseases and surgical procedures between DESS and public hospitals from September 2014 to June 2015. METHODS: A concordance study in clinical coding was carried out, including stratified random sampling with proportional allocation according to hospital production. The degree of agreement was estimated with the Kappa statistic (K). RESULTS: A total of 2255 IEH were evaluated; 60.39% (1362) contained a second diagnosis and 54.01% (1218) a coded surgical procedure. The degree of agreement for coding between DESS and hospitals was: K=0.74 in primary diagnosis; K=0.61 in second diagnosis; and K=0.75 in surgical procedures. CONCLUSIONS: The degree of agreement for clinical coding in the IEH was good.

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INTRODUCTION: Pesticides are a key factor of agricultural practices. OBJECTIVES: To describe the spatial distribution of pesticide exposure in Argentina and its association with cancer burden indicators, build global exposure indices, and validate individual exposure indices with biomarkers of effect in occupationally exposed subjects. METHODS: Two global indices were developed (pesticide exposure [PEI] and total environmental impact [TEII]), their spatial distribution was studied and, by means of a nationwide ecological study, the association with total, breast and prostate cancer mortality rates was estimated, using departments as level of spatial disaggregation (n=564). Two exposure indices, built with (individual) information of pesticide applicators in Córdoba, were validated using biomarkers (butyrylcholinesterase and genotoxicity). RESULTS: The Pampas have a PEI which is higher than national average as well as the highest TEII, corresponding to 2.4-D and chlorpyrifos. The increase in both exposure indices was associated to increases in the mortality rates due to cancer at the departmental level. Genotoxic damage in applicators was not associated to levels of exposure; what was associated was the reduction of butyrylcholinesterase activity. CONCLUSIONS: The instruments —indices— and results obtained provide valuable elements for the surveillance of pesticide exposure in Argentina.

INTRODUCTION: Bullying among students is a worrying phenomenon due to its frequency and severity. OBJECTIVES: To design and assess the feasibility of implementing a complex intervention aimed at reducing bullying situations. METHODS: A feasibility quasiexperimental before-and-after study with a historical control (year 2012) was conducted at five public schools in Bahía Blanca city. The acceptability, fidelity and limited efficacy were assessed (variation of the frequency of bullying and health related quality of life [HRQL] applied in 8-12 years-old children, at the beginning and end of 2014 school year). RESULTS: A complex intervention was designed, which combined theoretical, empirical and experiential evidence. Among the 35 teachers who responded the acceptability questionnaire, 70% referred that the intervention was applicable in their schools, 75% that it improved coexistence among children and 90% that they would implement it in the future. In 2014, 50% of the 534 included children referred that they did not participate in bullying situations through the school year (NP), 40% referred sporadic participation (16% at the beginning [PB] and 25% at the end [PE]) and 9% participated at the beginning and end of the year (PS). In 2012, the corresponding percentages were 55% (NP), 22% (PB), 10% (PE) and 13% (PS). HRQL showed no variation in 2014, while in 2012 it showed an improvement through the year. CONCLUSIONS: The complex intervention was feasible to apply and showed positive effects on intermediate results.