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BACKGROUND: There is a lack of consensus regarding the optimal method of assessing health-related quality of life (HR-QOL) among patients with metastatic renal cell carcinoma (mRCC). This study explored the perceived relevance of items that make up the Functional Assessment of Cancer Therapy Kidney Symptom Index-19 (FKSI-19), as judged by patients with mRCC. METHODS: This was a multinational cross-sectional survey. Eligible patients responded to a questionnaire composed of 18 items that assessed the perceived relevance of each item in the FKSI-19 questionnaire. Open-ended questions assessed additional issues deemed relevant by patients. Responses were grouped as relevant (scores 2-5) or nonrelevant (score 1). Descriptive statistics were collated, and open-ended questions were analyzed and categorized into descriptive categories. Spearman correlation statistics were used to test the association between relevance and clinical characteristics. RESULTS: A total of 151 patients were included (gender: 78.1 M, 21.9F; median age: 64; treatment: 38.4 immunotherapy, 29.8 targeted therapy, 13.9 immuno-TKI combination therapy) in the study. The most relevant questions evaluated fatigue (77.5), lack of energy (72.2), and worry that their condition will get worse (71.5). Most patients rated blood in urine (15.2), fevers (16.6), and lack of appetite (23.2) as least relevant. Qualitative analysis of open-ended questions revealed several themes, including emotional and physical symptoms, ability to live independently, effectiveness of treatment, family, spirituality, and financial toxicity. CONCLUSION: There is a need to refine widely used HR-QOL measures that are employed among patients diagnosed with mRCC treated with contemporary therapies. Guidance was provided for the inclusion of more relevant items to patients' cancer journey.

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ABSTRACT Purpose: To assess the perception of Latin American ophthalmology practitioners regarding coronavirus disease 2019 (COVID-19) exposure risk, knowledge about personal protection measures, and prioritization of patients. Methods: Self-administered voluntary anonymous survey (Google Drive forms) was distributed via text message to ophthalmology practitioners from May 01 to May 05, 2020. Results: Three hundred seventy-one practitioners (45% response rate) comprising 118 (27.6%) residents, 111 (40.5%) ophthalmologists, and 142 (32.8%) sub-specialists completed the survey. Among them, 106 (32.6%) thought that they were at a high risk of acquiring COVID-19 during the course of work. Furthermore, 273 (69.1%) believed that the current guidelines were insufficient to identify COVID-19 patients. The survey also revealed that 265 (59.5%) were not trained to use personal protective equipment (PPE), and even with its correct use, 341 (91.5%) still felt that they were at risk of acquiring COVID-19. Moreover, 80% of the respondents were of the view that staff members were not knowledgeable about national protocols for attending COVID-19 patients. However, only 9 (2%) considered changing their profession to ameliorate COVID-19 contagion risk. Conclusion: This survey has revealed the issues faced by ophthalmology practitioners in Latin America during their routine practice. These concerns and anxiety about COVID- 19 pandemic seem to be the same worldwide. It is important to reinforce the confidence of ophthalmology practitioners on current guidelines for attending COVID-19 patients. It is also necessary to conduct training programs on PPE usage and ensure that PPE items are available at all times to enhance the quality of care and minimize the spread of the disease.

RESUMO Objetivos: Avaliar a percepção do risco de exposição da Doença de Coronavírus 2019 (COVID-19), conhecimento sobre medidas de proteção pessoal entre os profissionais de oftalmologia latino-americanos e priorização de pacientes com Covid-19. Métodos: Pesquisa anônima voluntária autoadministrada (formulários do Google Drive) distribuída por mensagem de texto para profissionais de oftalmologia em 1º a 5 de maio de 2020. Resultados: Trezentos e setenta e um profissionais completaram a pesquisa (taxa de resposta de 45%), composta por 118 residentes (27,6%), 111 oftalmologistas (40,5%) e 142 subespecialistas (32,8%). 106 profissionais (32,6%) sentiram-se em alto risco de adquirir o COVID-19 no trabalho. 273 (69,1%) acreditavam que as diretrizes atuais não são suficientes para identificar os pacientes com COVID-19. 265 (59,5%) não tinham treinamento para usar os equipamentos de proteção individual (EPI) e, mesmo com seu uso correto, 341 (91,5%) ainda se sentiram em risco de adquirir COVID-19. 80% consideraram que a equipe de trabalho não tem conhecimento de protocolos nacionais para o atendimento aos pacientes com COVID-19. Apenas 9 dos profissionais (2%) consideraram mudar a profissão para minimizar o risco de contágio por COVID-19. Conclusão: Esta pesquisa mostra a escassez de pessoal e treinamento específico que os praticantes de oftalmologia na América Latina enfrentam em sua prática diária. Essas preocupações e ansiedade parecem ser as mesmas em todo o mundo com a pandemia de COVID- 19. É importante reforçar a confiança dos profissionais de oftalmologia nas diretrizes atuais de atendimento ao paciente com COVID-19 e também disponibilizar programas de treinamento sobre o uso de EPI e também itens de EPI disponíveis em todos os momentos para garantir a qualidade do atendimento e a disseminação mínima da doença.

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Background The Diagnosis Related Groups (DRG) constitute a method of classifying hospital discharges. Aim To report its development and implementation in a Chilean University Hospital and global results of 10 years Material and Methods We included 231,600 discharges from 2007 to 2016. In the development we considered the physical plant, clinical record flow, progressively incorporated human resources and computer equipment for coding and analysis to obtain results. The parameters used were: average stay, average DRG weight, mean of diagnosis and codified procedures, behavior of upper outliers, hospital mortality, distribution by severity and its relationship with other variables. Results The global complexity index was 0.9929. The average of diagnoses coded was 4.35 and of procedures was 7.21. The average stay was 4.56 days, with a downward trend. The top outliers corresponded to 2.25%, with stable hospital days and average DRG weight. The median of hospital mortality was 1.65% with a tendency to decrease and stable DRG mean weight. Seventy two percent had a grade 1 severity, with low median hospital stay. They occupied 40% of bed days. Nine percent had a grade 3 severity with high median hospital stay and accounting for 31.5% of bed days. Conclusions DRG methodology is a valuable information tool for decision making and result assessment in hospital management.

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INTRODUCTION: National Survey of Mental Health (ENSM) in 2015 in Colombia asks, among other conditions, about alcohol consumption in people 12-17 years old, and 18 and older. Data were presented by age and region, with no cross-references to other categories of mental health problems, disorders, access to services, and health status. OBJECTIVE: To assess alcohol consumption in Colombia, taking into account sociodemographic and clinical screening categories included. METHODS: Secondary database analysis, sample size: 15,231 people from 13,200 households of five regions (Atlantic, Bogotá, Central, Eastern, and Pacific), with an age range from 12 to 96 years. AUDIT and AUDIT-C were used and stratified according to score and other variables included in the survey analysis. RESULTS: The high-risk drinking category was observed in 2.7% of children studied, with the highest percentage of drinking risk lying in the range of 18 to 44 years, with a clear majority of men. CONCLUSIONS: The study finds that a positive AUDIT-C in adults is associated with a higher percentage of non-anxiety, less anxiety problems, and traumatic events and traumatic events related to armed conflict. This requires further studies. Adults with positive AUDIT-C have a greater perception of well-being, but also a higher percentage of households in poverty. The study of individual, social, family and environmental factors in specific populations should be developed in order to make more appropriate interventions.

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Resumen Introducción: Introducción: La Encuesta Nacional de Salud Mental (ENSM) de 2015 indagó en Colombia, entre otros asuntos, sobre el de consumo de alcohol de las personas entre 12 y 17 años y de 18 y más años. Se presentaron los datos según edad y región, sin realizar cruces con otras variables de salud mental, problemas, trastornos, acceso a servicios, estados de salud y su valoración. Objetivo: Evaluar la prevalencia del consumo de alcohol en la población colombiana de edad ≥ 12 años teniendo en cuenta las variables sociodemográficas y el cribado clínico. Métodos: Análisis secundario de base de datos de la ENSM 2015; constituyeron la muestra 15.231 personas de 12 a 96 años de 13.200 hogares de cinco regiones del país (Atlántica, Bogotá, Central, Oriental y Pacífica). Se usó el Alcohol and Use Disorder Identification Test, corto y completo (AUDIT y AUDIT-C), con análisis estratificado según puntuación y otras variables incluidas en la encuesta. Resultados: El 2,7% de los menores estudiados entran en la categoría de bebedor de riesgo. El mayor porcentaje de bebedores de riesgo se ubica en la franja de 18 a 44 años, con clara mayoría de varones. Conclusiones: El estudio encuentra que un AUDIT-C positivo en mayores de edad se asocia con mayor porcentaje de no presentar síntomas ansiedad y menos problemas de ansiedad, eventos traumáticos y eventos traumáticos por conflicto armado reportados. Esto requiere más estudios. Las personas adultas con AUDIT-C positivo tienen mayor percepción de bienestar, aunque también se halla mayor porcentaje de hogares en estado de pobreza. El estudio de factores individuales, sociales, familiares y ambientales en poblaciones específicas se debe desarrollar para realizar intervenciones más adecuadas.

Abstract Introduction: National Survey of Mental Health (ENSM) in 2015 in Colombia asks, among other conditions, about alcohol consumption in people 12-17 years old, and 18 and older. Data were presented by age and region, with no cross-references to other categories of mental health problems, disorders, access to services, and health status. Objective: To assess alcohol consumption in Colombia, taking into account sociodemographic and clinical screening categories included. Methods: Secondary database analysis, sample size: 15,231 people from 13,200 households of five regions (Atlantic, Bogotá, Central, Eastern, and Pacific), with an age range from 12 to 96 years. AUDIT and AUDIT-C were used and stratified according to score and other variables included in the survey analysis. Results: The high-risk drinking category was observed in 2.7% of children studied, with the highest percentage of drinking risk lying in the range of 18 to 44 years, with a clear majority of men. Conclusions: The study finds that a positive AUDIT-C in adults is associated with a higher percentage of non-anxiety, less anxiety problems, and traumatic events and traumatic events related to armed conflict. This requires further studies. Adults with positive AUDIT-C have a greater perception of well-being, but also a higher percentage of households in poverty. The study of individual, social, family and environmental factors in specific populations should be developed in order to make more appropriate interventions.

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OBJECTIVE: : Recognizing reasons for prehospital delay after symptoms of acute coronary syndrome (ACS) is established in developed countries yet evidence from Latin America is limited. We aimed to assess ACS symptom recognition, health care-seeking behavior, and confidence in local health care facilities to take care of ACS by gender in a sample of Peruvians. METHODS: : A community-based interview survey in a peri-urban area in Lima, Peru. The 24-item study instrument included vignettes and questions assessing identification of urgent and emergent ACS symptoms, anticipated help-seeking behaviors, and confidence in local health care facilities. RESULTS: : In the study population (90 people; 45.6% men; mean age, 43.5 years), women were 4 times less likely to correctly attribute symptoms of chest pain to the heart (OR = 0.23; 95% CI: 0.063-0.87; P = 0.03). Women were much more likely to respond that a man would "Seek help" (OR = 4.54; 95% CI: 1.21-16.90; P = 0.024) and that "Yes," a woman would be less likely to seek help for chest pain symptoms (OR = 3.26; 95% CI: 1.13-9.41 P = 0.029) after adjusting for age, education level, age at migration, and history of chest pain. Women were less likely than men to think that their local Health Care Post would help them if they had a heart attack (2.1% vs. 14.6%; P = 0.04), and only 18.7% of women believed that their local emergency room would help them. CONCLUSIONS: : Our findings suggest women are less likely to seek help for chest pain and women and men in a peri-urban area in Peru are not confident in their local health care facility to treat urgent or emergent ACS symptoms.

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