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  1. Article ; Online: COVID-19, a tale of two pandemics: novel coronavirus and fake news messaging.

    Atehortua, Nelson A / Patino, Stella

    Health promotion international

    2021  Volume 36, Issue 2, Page(s) 524–534

    Abstract: The emergence of COVID-19, caused by novel Coronavirus SARS-CoV-2, became a pandemic in just 10 weeks. Without effective medications or vaccines available, authorities turned toward mitigation measures such as use of face masks, school's closings, ... ...

    Abstract The emergence of COVID-19, caused by novel Coronavirus SARS-CoV-2, became a pandemic in just 10 weeks. Without effective medications or vaccines available, authorities turned toward mitigation measures such as use of face masks, school's closings, shelter-in-place, telework and social distancing. People found refuge on the internet and social media apps; however, there was a proliferation of instant messaging containing hoaxed, deliberate misleading information: fake news messaging (FNM). The aim of this study was to assess FNM through content analysis and to discriminate them in a proposed taxonomy structure. A sample of convenience of messages, memes, tweets or cartoons in several languages was selected from the most popular social media outlets, i.e. Facebook, WhatsApp, Twitter etc. More than 300 FNM were identified. Descriptive statistics were used for highlighting potential relationships between variables. Content analysis determined that FNM could be divided into Health- and non-health-related types. There are several sub-types considering, but not limited to, religious beliefs, politics, economy, nutrition, behaviors, prevention of the infection, the origin of the disease and conspiracy theories. The parallel FNM pandemic affected the response from an already debilitated public health system through the confusion created in the community and the erosion in the credibility of genuine media. Public health practitioners had to face people's unpredictable behaviors, panic, tensions with the communities and, in some cases, a hostile climate toward frontline workers. Public health practitioners must adjust ongoing and future health promotion and education interventions including plans to neutralize fake news messages.
    MeSH term(s) COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19/psychology ; Communicable Disease Control/methods ; Cross-Sectional Studies ; Health Behavior ; Health Communication/methods ; Health Communication/standards ; Humans ; Pandemics ; Politics ; Religion ; SARS-CoV-2 ; Social Media/standards
    Language English
    Publishing date 2021-01-15
    Publishing country England
    Document type Journal Article
    ZDB-ID 1027448-0
    ISSN 1460-2245 ; 0957-4824
    ISSN (online) 1460-2245
    ISSN 0957-4824
    DOI 10.1093/heapro/daaa140
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  2. Article: A method to measure clinical practice patterns of breast cancer genomic diagnostics in health systems.

    Atehortua, Nelson A / Issa, Amalia M

    Personalized medicine

    2012  Volume 9, Issue 6, Page(s) 585–592

    Abstract: Personalized genomic diagnostics, often in combination with targeted therapeutics, have become an important component of clinical oncologic practice over the last decade. However, there is a dearth of studies examining utilization of specific genomic ... ...

    Abstract Personalized genomic diagnostics, often in combination with targeted therapeutics, have become an important component of clinical oncologic practice over the last decade. However, there is a dearth of studies examining utilization of specific genomic diagnostics and their influence on clinical practice patterns in health systems. In order to begin to explore and understand the clinical utility of particular genomic diagnostics in current use, we developed an instrument to collect data on utilization and clinical practice patterns in health systems. We focused our efforts on gene-expression profiling (GEP) assays, particularly on a commonly used GEP in breast cancer: Oncotype DX
    Language English
    Publishing date 2012-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 2299146-3
    ISSN 1744-828X ; 1741-0541
    ISSN (online) 1744-828X
    ISSN 1741-0541
    DOI 10.2217/pme.12.72
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  3. Article ; Online: Cost-utility analysis of an implantable cardioverterdefibrillator for the treatment of patients with ischemic or non-ischemic New York Heart Association class II or III heart failure in Colombia

    Atehortúa, Sara / Senior, Juan Manuel / Castro, Paula / Ceballos, Mateo / Saldarriaga, Clara / Giraldo, Nelson / Mora, Guillermo

    Biomedica : revista del Instituto Nacional de Salud

    2019  Volume 39, Issue 3, Page(s) 502–512

    Abstract: Introduction: The use of an implantable cardioverter-defibrillator reduces the probability of sudden cardiac death in patients with heart failure.: Objective: To determine the cost-utility relationship of an implantable cardioverter-defibrillator ... ...

    Title translation Análisis de costo-utilidad del desfibrilador cardioversor implantable para el tratamiento de pacientes colombianos con insuficiencia cardíaca isquémica o no isquémica de clase II o III según la New York Heart Association
    Abstract Introduction: The use of an implantable cardioverter-defibrillator reduces the probability of sudden cardiac death in patients with heart failure.
    Objective: To determine the cost-utility relationship of an implantable cardioverter-defibrillator compared to optimal pharmacological therapy for patients with ischemic or non-ischemic New York Heart Association class II or III (NYHA II-III) heart failure in Colombia.
    Materials and methods: We developed a Markov model including costs, effectiveness, and quality of life from the perspective of the Colombian health system. For the baseline case, we adopted a time horizon of 10 years and discount rates of 3% for costs and 3.5% for benefits. The transition probabilities were obtained from a systematic review of the literature. The outcome used was the quality-adjusted life years. We calculated the costs by consulting with the manufacturers of the device offered in the Colombian market and using national-level pricing manuals. We conducted probabilistic and deterministic sensitivity analyses.
    Results: In the base case, the incremental cost-effectiveness ratio for the implantable cardioverter-defibrillator was USD$ 13,187 per quality-adjusted life year gained. For a willingness-to-pay equivalent to three times the gross domestic product per capita as a reference (USD$ 19,139 in 2017), the device would be a cost-effective strategy for the Colombian health system. However, the result may change according to the time horizon, the probability of death, and the price of the device.
    Conclusions: The use of an implantable cardioverter-defibrillator for preventing sudden cardiac death in patients with heart failure would be a cost-effective strategy for Colombia. The results should be examined considering the uncertainty.
    MeSH term(s) Colombia ; Cost-Benefit Analysis ; Death, Sudden, Cardiac/prevention & control ; Decision Trees ; Defibrillators, Implantable/economics ; Heart Failure/classification ; Heart Failure/therapy ; Humans ; Meta-Analysis as Topic ; Middle Aged ; National Health Programs/economics ; Quality of Life ; Quality-Adjusted Life Years ; Systematic Reviews as Topic ; Time Factors
    Language Spanish
    Publishing date 2019-09-01
    Publishing country Colombia
    Document type Journal Article
    ZDB-ID 2059952-3
    ISSN 2590-7379 ; 0120-4157
    ISSN (online) 2590-7379
    ISSN 0120-4157
    DOI 10.7705/biomedica.4235
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  4. Article ; Online: Prenatal, Delivery and Postpartum Care Experiences among Black Women in Mississippi during COVID-19 Pandemic 2020–2021

    Praise Ebimaye Tangbe / Mary Shaw-Ridley / Gerri Cannon-Smith / Sheila McKinney / Nelson Atehortua / Russell Bennett

    Women, Vol 3, Iss 22, Pp 295-

    2023  Volume 309

    Abstract: The COVID-19 pandemic has presented challenges for countries to maintain high-quality, essential maternal health services, altering pregnancy experiences for women. This qualitative study aims to explore the impact of COVID-19 mitigation strategies on ... ...

    Abstract The COVID-19 pandemic has presented challenges for countries to maintain high-quality, essential maternal health services, altering pregnancy experiences for women. This qualitative study aims to explore the impact of COVID-19 mitigation strategies on self-reported prenatal, delivery, and postpartum care experiences among Black women in Mississippi. Postpartum Black women who gave birth between March 2020 and March 2021 were recruited from a Federally Qualified Health Clinic that serves three Mississippi counties. Using a semi-structured interview guide, 10 postpartum women were interviewed, and their responses were analyzed utilizing the thematic content analysis approach. Major themes identified were stress related to COVID-19, disruption of social life/support, disruption of expected healthcare services, uncertainty and fear about coronavirus, COVID-19 mitigation strategies, and associated poor maternal health outcome. COVID-19 mitigation strategies exacerbated normal maternity-related stress. Postpartum women reported increased anxiety, fear, frustration, emotional stress, and lack of social support resulting in what was described as depression and feelings of loneliness. The results of this qualitative study of 10 Black women who gave birth during COVID-19 suggest the importance of stress-informed care.
    Keywords pregnancy ; experiences ; concerns ; COVID-19 pregnancy script ; black women ; maternal mental health ; Medicine ; R ; Psychology ; BF1-990
    Language English
    Publishing date 2023-05-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Cost-utility analysis of an implantable cardioverterdefibrillator for the treatment of patients with ischemic or non-ischemic New York Heart Association class II or III heart failure in Colombia

    Sara Atehortúa / Juan Manuel Senior / Paula Castro / Mateo Ceballos / Clara Saldarriaga / Nelson Giraldo / Guillermo Mora

    Biomédica: revista del Instituto Nacional de Salud, Vol 39, Iss 3, Pp 502-

    2019  Volume 512

    Abstract: Introduction: The use of an implantable cardioverter-defibrillator reduces the probability of sudden cardiac death in patients with heart failure. Objective: To determine the cost-utility relationship of an implantable cardioverter-defibrillator compared ...

    Abstract Introduction: The use of an implantable cardioverter-defibrillator reduces the probability of sudden cardiac death in patients with heart failure. Objective: To determine the cost-utility relationship of an implantable cardioverter-defibrillator compared to optimal pharmacological therapy for patients with ischemic or non-ischemic New York Heart Association class II or III (NYHA II-III) heart failure in Colombia. Materials and methods: We developed a Markov model including costs, effectiveness, and quality of life from the perspective of the Colombian health system. For the baseline case, we adopted a time horizon of 10 years and discount rates of 3% for costs and 3.5% for benefits. The transition probabilities were obtained from a systematic review of the literature. The outcome used was the quality-adjusted life years. We calculated the costs by consulting with the manufacturers of the device offered in the Colombian market and using national-level pricing manuals. We conducted probabilistic and deterministic sensitivity analyses. Results: In the base case, the incremental cost-effectiveness ratio for the implantable cardioverter-defibrillator was USD$ 13,187 per quality-adjusted life year gained. For a willingness-to-pay equivalent to three times the gross domestic product per capita as a reference (USD$ 19,139 in 2017), the device would be a cost-effective strategy for the Colombian health system. However, the result may change according to the time horizon, the probability of death, and the price of the device. Conclusions: The use of an implantable cardioverter-defibrillator for preventing sudden cardiac death in patients with heart failure would be a cost-effective strategy for Colombia. The results should be examined considering the uncertainty.
    Keywords Heart failure ; defibrillators ; implantable ; death ; sudden ; cardiac ; cost-benefit analysis ; Colombia ; Medicine ; R ; Arctic medicine. Tropical medicine ; RC955-962
    Subject code 610
    Language English
    Publishing date 2019-09-01T00:00:00Z
    Publisher Instituto Nacional de Salud
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article: A national study of breast and colorectal cancer patients' decision-making for novel personalized medicine genomic diagnostics.

    Issa, Amalia M / Tufail, Waqas / Atehortua, Nelson / McKeever, John

    Personalized medicine

    2013  Volume 10, Issue 3, Page(s) 245–256

    Abstract: Aim: Molecular diagnostics are increasingly being used to help guide decision-making for personalized medical treatment of breast and colorectal cancer patients. The main aim of this study was to better understand and determine breast and colorectal ... ...

    Abstract Aim: Molecular diagnostics are increasingly being used to help guide decision-making for personalized medical treatment of breast and colorectal cancer patients. The main aim of this study was to better understand and determine breast and colorectal cancer patients' decision-making strategies and the trade-offs they make in deciding about characteristics of molecular genomic diagnostics for breast and colorectal cancer.
    Patients & methods: We surveyed a nationally representative sample of 300 breast and colorectal cancer patients using a previously developed web-administered instrument. Eligibility criteria included patients aged 18 years and older with either breast or colorectal cancer. We explored several attributes and attribute levels of molecular genomic diagnostics in 20 scenarios.
    Results: Our analysis revealed that both breast and colorectal cancer patients weighted the capability of molecular genomic diagnostics to determine the probability of treatment efficacy as being of greater importance than information provided to detect adverse events. The probability of either false-positive or -negative results was ranked highly as a potential barrier by both breast and colorectal patients. However, 78.6% of breast cancer patients ranked the possibility of a 'false-negative test result leading to undertreatment' higher than the 'chance of a false positive, which may lead to overtreatment' (68%). This finding contrasted with the views of colorectal cancer patients who ranked the chance of a false positive as being of greater concern than a false negative (72.8 vs 63%). Overall, cancer patients exhibited a high willingness to accept and pay for genomic diagnostic tests, especially among breast cancer patients. Cancer patients seek a test accuracy rate of 90% or higher. Breast and colorectal cancer patients' decisions about genomic diagnostics are influenced more by the probability of being cured than by avoiding potential severe adverse events.
    Conclusion: This study provides insights into the relative weight that breast and colorectal cancer patients place on various aspects of molecular genomic diagnostics, and the trade-offs they are willing to make among attributes of such tests.
    Language English
    Publishing date 2013-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 2299146-3
    ISSN 1744-828X ; 1741-0541
    ISSN (online) 1744-828X
    ISSN 1741-0541
    DOI 10.2217/pme.13.17
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  7. Article ; Online: Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels on 28-Day Mortality Among Patients With Septic Shock: The ANDROMEDA-SHOCK Randomized Clinical Trial.

    Hernández, Glenn / Ospina-Tascón, Gustavo A / Damiani, Lucas Petri / Estenssoro, Elisa / Dubin, Arnaldo / Hurtado, Javier / Friedman, Gilberto / Castro, Ricardo / Alegría, Leyla / Teboul, Jean-Louis / Cecconi, Maurizio / Ferri, Giorgio / Jibaja, Manuel / Pairumani, Ronald / Fernández, Paula / Barahona, Diego / Granda-Luna, Vladimir / Cavalcanti, Alexandre Biasi / Bakker, Jan /
    Ospina-Tascón, Gustavo / Petri Damiani, Lucas / Rodriguez, Nicolás / Holger, Patricia / Soto, Natalia / Pozo, Mario / Cook, Deborah / Vincent, Jean-Louis / Rhodes, Andrew / Kavanagh, Bryan P / Dellinger, Phil / Rietdijk, Wim / Carpio, David / Pavéz, Nicolás / Henriquez, Elizabeth / Bravo, Sebastian / Valenzuela, Emilio Daniel / Vera, Magdalena / Dreyse, Jorge / Oviedo, Vanessa / Cid, Maria Alicia / Larroulet, Macarena / Petruska, Edward / Sarabia, Claudio / Gallardo, David / Sanchez, Juan Eduardo / González, Hugo / Arancibia, José Miguel / Muñoz, Alex / Ramirez, Germán / Aravena, Florencia / Aquevedo, Andrés / Zambrano, Fabián / Bozinovic, Milan / Valle, Felipe / Ramirez, Manuel / Rossel, Victor / Muñoz, Pilar / Ceballos, Carolina / Esveile, Christian / Carmona, Cristian / Candia, Eva / Mendoza, Daniela / Sanchez, Aída / Ponce, Daniela / Lastra, Jaime / Nahuelpán, Bárbara / Fasce, Fabrizio / Luengo, Cecilia / Medel, Nicolas / Cortés, Cesar / Campassi, Luz / Rubatto, Paolo / Horna, Nahime / Furche, Mariano / Pendino, Juan Carlos / Bettini, Lisandro / Lovesio, Carlos / González, María Cecilia / Rodruguez, Jésica / Canales, Héctor / Caminos, Francisco / Galletti, Cayetano / Minoldo, Estefanía / Aramburu, Maria Jose / Olmos, Daniela / Nin, Nicolás / Tenzi, Jordán / Quiroga, Carlos / Lacuesta, Pablo / Gaudín, Agustín / Pais, Richard / Silvestre, Ana / Olivera, Germán / Rieppi, Gloria / Berrutti, Dolores / Ochoa, Marcelo / Cobos, Paul / Vintimilla, Fernando / Ramirez, Vanessa / Tobar, Milton / García, Fernanda / Picoita, Fabricio / Remache, Nelson / Granda, Vladimir / Paredes, Fernando / Barzallo, Eduardo / Garcés, Paul / Guerrero, Fausto / Salazar, Santiago / Torres, German / Tana, Cristian / Calahorrano, José / Solis, Freddy / Torres, Pedro / Herrera, Luís / Ornes, Antonio / Peréz, Verónica / Delgado, Glenda / López, Alexei / Espinosa, Eliana / Moreira, José / Salcedo, Blanca / Villacres, Ivonne / Suing, Jhonny / Lopez, Marco / Gomez, Luis / Toctaquiza, Guillermo / Cadena Zapata, Mario / Orazabal, Milton Alonso / Pardo Espejo, Ruben / Jimenez, Jorge / Calderón, Alexander / Paredes, Gustavo / Barberán, José Luis / Moya, Tatiana / Atehortua, Horacio / Sabogal, Rodolfo / Ortiz, Guillermo / Lara, Antonio / Sanchez, Fabio / Hernán Portilla, Alvaro / Dávila, Humberto / Mora, Jorge Antonio / Calderón, Luis Eduardo / Alvarez, Ingrid / Escobar, Elena / Bejarano, Alejandro / Bustamante, Luis Alfonso / Aldana, José Luis

    JAMA

    2019  Volume 321, Issue 7, Page(s) 654–664

    Abstract: Importance: Abnormal peripheral perfusion after septic shock resuscitation has been associated with organ dysfunction and mortality. The potential role of the clinical assessment of peripheral perfusion as a target during resuscitation in early septic ... ...

    Abstract Importance: Abnormal peripheral perfusion after septic shock resuscitation has been associated with organ dysfunction and mortality. The potential role of the clinical assessment of peripheral perfusion as a target during resuscitation in early septic shock has not been established.
    Objective: To determine if a peripheral perfusion-targeted resuscitation during early septic shock in adults is more effective than a lactate level-targeted resuscitation for reducing mortality.
    Design, setting, and participants: Multicenter, randomized trial conducted at 28 intensive care units in 5 countries. Four-hundred twenty-four patients with septic shock were included between March 2017 and March 2018. The last date of follow-up was June 12, 2018.
    Interventions: Patients were randomized to a step-by-step resuscitation protocol aimed at either normalizing capillary refill time (n = 212) or normalizing or decreasing lactate levels at rates greater than 20% per 2 hours (n = 212), during an 8-hour intervention period.
    Main outcomes and measures: The primary outcome was all-cause mortality at 28 days. Secondary outcomes were organ dysfunction at 72 hours after randomization, as assessed by Sequential Organ Failure Assessment (SOFA) score (range, 0 [best] to 24 [worst]); death within 90 days; mechanical ventilation-, renal replacement therapy-, and vasopressor-free days within 28 days; intensive care unit and hospital length of stay.
    Results: Among 424 patients randomized (mean age, 63 years; 226 [53%] women), 416 (98%) completed the trial. By day 28, 74 patients (34.9%) in the peripheral perfusion group and 92 patients (43.4%) in the lactate group had died (hazard ratio, 0.75 [95% CI, 0.55 to 1.02]; P = .06; risk difference, -8.5% [95% CI, -18.2% to 1.2%]). Peripheral perfusion-targeted resuscitation was associated with less organ dysfunction at 72 hours (mean SOFA score, 5.6 [SD, 4.3] vs 6.6 [SD, 4.7]; mean difference, -1.00 [95% CI, -1.97 to -0.02]; P = .045). There were no significant differences in the other 6 secondary outcomes. No protocol-related serious adverse reactions were confirmed.
    Conclusions and relevance: Among patients with septic shock, a resuscitation strategy targeting normalization of capillary refill time, compared with a strategy targeting serum lactate levels, did not reduce all-cause 28-day mortality.
    Trial registration: ClinicalTrials.gov Identifier: NCT03078712.
    MeSH term(s) Aged ; Capillaries/physiopathology ; Cause of Death ; Female ; Fluid Therapy/methods ; Hemodynamics ; Humans ; Intensive Care Units ; Kaplan-Meier Estimate ; Lactic Acid/blood ; Male ; Middle Aged ; Organ Dysfunction Scores ; Proportional Hazards Models ; Renal Replacement Therapy ; Respiration, Artificial ; Resuscitation/methods ; Shock, Septic/blood ; Shock, Septic/mortality ; Shock, Septic/physiopathology ; Shock, Septic/therapy ; Vasoconstrictor Agents/therapeutic use
    Chemical Substances Vasoconstrictor Agents ; Lactic Acid (33X04XA5AT)
    Language English
    Publishing date 2019-02-27
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Multicenter Study ; Randomized Controlled Trial
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.2019.0071
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