Browsing by Author "Nieto Calvache, Alejandro Solo"
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Item Cumplimiento de la política pública de salud sexual y reproductiva masculina en IPS de los municipios de Palmira y Candelaria en el periodo comprendido de 2015-2017(Universidad Santiago de Cali, 2018) Calvache Morales, Alba Lucia; Castaño Cortes, Carlos Deyver; Nieto Calvache, Alejandro Solo; Cruz Aguilar, Pedro LeónEl gobierno colombiano ha planteado diversas políticas públicas en materia de salud, en un esfuerzo por responder oportunamente a las necesidades que emergen en la población. En el caso de las patologías de cáncer del aparato reproductor masculino (próstata, pene y testículo) se ha observado empíricamente la impresión de pobre cumplimiento por parte de las IPS, dando la sensación de que la política tiene un escaso desarrollo. El presente trabajo analiza el cumplimiento de la política de salud sexual y reproductiva masculina (cáncer de próstata, pene y testículo) en IPSs de la ciudad de Palmira y Candelaria para el período 2015-2017, a través de triangulación de investigación cualitativa de fuentes bibliográficas, entrevistas a actores fundamentales en la PSSRM, y entrevistas a pacientes de las patologías bajo estudio, para identificar el nivel de conocimiento de las políticas, actitudes y prácticas frente a dicha política, y determinar el control estatal a los indicadores de cobertura y cumplimiento de las mismas.Item Training facilitated by interinstitutional collaboration and telemedicine: an alternative for improving results in the placenta accreta spectrum(2021) Nieto Calvache, Albaro José; Palacios Jaraquemada, José Miguel; Vergara Galliadi, Lina María; Nieto Calvache, Alejandro Solo; Zambrano, Maria Andrea; Burgos Luna, Juan ManuelPlacenta accreta spectrum is a severe condition that requires trained, interdisciplinary group intervention. However, achieving the level of training that is required is difficult without academic programs or hospitals dedicated to teaching the necessary skills to deal with placenta accreta spectrum. We describe an interinstitutional collaboration process focused on improving placenta accreta spectrum treatment, which is facilitated by telemedicine. Lastly, we propose a replicable model for other centers. This was a retrospective, descriptive study that included placenta accreta spectrum patients treated over a 10-year period in a low-middle income country hospital (local hospital). We evaluated the clinical results and impact of interinstitutional collaboration with a placenta accreta spectrum expert group at another low-middle income country hospital. Virtual strategies of continuous communication between the local hospital and expert group were used, such as telemedicine, teleradiology, and telepresence during surgeries. A total of 89 placenta accreta spectrum patients were included. We observed a progressive improvement in the clinical outcomes (intraoperative bleeding, transfusion frequency, postoperative length of stay, and frequency of complications) as the fixed interdisciplinary group at the local hospital gained experience by treating more cases. Interinstitutional collaboration (through telemedicine and remote supervision) and placenta accreta spectrum team formation were the 2 factors associated with the best outcomes in the most recent years of observation. Thus, ongoing placenta accreta spectrum team training, facilitated by interinstitutional collaboration and telemedicine, is a valid strategy for improving the clinical outcomes in placenta accreta spectrum.Item The usefulness of inter-institutional collaboration (teleconsultation, eHealth) in the management of placenta accreta(Taylor and Francis Ltd, 2020-03-22) Nieto Calvache, Álbaro José; López Girón, Maria Camila; Nieto Calvache, Alejandro SoloIntroduction: The availability of interdisciplinary groups trained in morbidly adherent placenta (MAP) is limited. Telemedicine can be a useful strategy to bring patients affected by MAP to institutions specialized in its management. We sought to assess how useful an informal teleconsultation is for MAP cases among users who contacted a reference center for this pathology in a low middle-income country. Methodology: Likert-type surveys were conducted among specialist physicians who carried out teleconsultation with a MAP experienced institution, for assessing how useful the remote assistance was. Results: In 15-month period, 21 teleconsultations associated with MAP were recorded. Teleconsultation was considered “very useful” by 100% of obstetricians. Among the physicians, 90.5% said they would “definitely use the service again” if they had a new case of MAP and 85.7% said that they would “always recommend” the service to other groups of specialists. Conclusion: Teleconsultation in MAP cases is perceived by service users as a useful tool in the management of affected patients. In a context with few specialized centers in the management of this condition, telemedicine must be taken into account when designing comprehensive care strategies for this rare and highly morbid disease.