RESUMENLa medicina centrada en la persona (MCP) es un movimiento programático mundial liderado por el International College of Person Centered Medicine. Su ingreso en Latinoamérica es reciente. Reclama el empleo de la investigación científica como instrumento para generar la mejor evidencia clínica, y el humanismo como esencia de la medicina en bien de la humanidad. Su propuesta no es solo combatir la enfermedad, sino, también, promover el despliegue de los potenciales saludables del ser humano hacia el logro de su bienestar y desarrollo integral. Aunque el humanismo de la medicina en Latinoamérica ha sido característica distintiva de su práctica, se aprecia en épocas actuales una preocupante reducción de su influencia en la atención de salud por factores diversos. El presente artículo compendia perspectivas latinoamericanas de cuatro países. Se cotejan necesidades y experiencias y describen respuestas que vienen generándose frente a la influencia deshumanizadora de la tecnología y del manejo de la salud como bien de consumo. LATIN AMERICAN PERSPECTIVES ON PERSON-CENTERED MEDICINE ABSTRACT Person-centered medicine (PCM) is a programmatic global initiative led by the International College of Person-CenteredMedicine. It has recently emerged in Latin America. It requires the use of scientific research as an instrument to generate the best clinical evidence, and humanism as the essence of medicine to help mankind. It is focused on not only combatting disease but also promoting the display of healthy human being potentials towards achieving well-being and comprehensive growth. Although the humanism of medicine in Latin America has been a distinctive characteristic of its practice, now, there is a worrying decline in its impact on healthcare. This article summarizes the Latin American perspective from four countries. Needs and experiences are compared and responses that arise in view of the dehumanizing influence of technology and health management as a consumption good are described. Medicine -Health Care Systems--Medical Education -Health Research -Public Health in Latin America (Source: DeCS BIREME). Key words: Person Centered INTRODUCCCIÓNJuan Enrique Mezzich y sus colaboradores del International College of Person Centered Medicine, han descrito los ocho principios de la medicina centrada en la persona (MCP) (1) : compromiso ético, marco holístico, sensibilidad y respuesta cultural; foco comunicativo y relacional; individualización del programa de atención clínica; establecer una base común entre clínicos, paciente y familia para el entendimiento y la acción; organización de servicios integrados y centrados en las personas y la comunidad; educación médica e investigación científica en salud centradas en la persona. A esta perspectiva general se suman aspectos particulares ligados a la realidad de cada país. A continuación, se presentan algunas reflexiones sobre la MCP desde la perspectiva de cuatro países latinoamericanos.
Introduction. The complex problem of COVID-19 and the possibilities of responding through innovative general health strategies have been raised. The development of innovative health strategies was stimulated by the 1978 Alma Ata Declaration on Primary Health Care and by related perspectives around the 2018 Astana Conference. To this may be added the contributions of the International College and the Latin American Network of Person Centered Medicine toward the exploration and formulation of innovative concepts and strategies of health focused on persons.Objectives: (1) Ontological clarification of the concept of health and of the strategies and tactics for health actions; (2) Delineation of and assessment of multifactorial support for promising general health strategies focused on persons; and (3) Elucidation of the relevance of such strategies to respond to the demands of the COVID-19 pandemic.Methods: (a) Analysis and reflection on health concepts and strategies by a multidisciplinary authors group; (b) Selective review of the international and Latin American literature on health systems and the pandemic, displayed, and analyzed tabular and narratively.Results1. Ontological concepts corresponding to the meaning and functions of health and of specific general strategies and tactics to restore and promote health were formulated.2. A general health strategy was outlined based on an analysis of the process of building promising health constructs emerging from conferences and international declarations in recent years. Then, early and contemporary historical considerations, as well as contextual perspectives (Social Determinants of Health, the Sustainable Development Goals, and the Essential Functions of Public Health) were identified as supporting the specific elements of the persons-centered mutual and integral healthcare strategy.3. The relevance of the essential concept of health and the elements of the examined general health strategy was ascertained positively to respond to the demands of the current pandemic.Discussion: The value, implications, and limitations of the results obtained were discussed in the light of COVID-19 and future pandemics. Emerging recommendations on desirable next steps were also presented.Conclusions: The contributions of this study include the ontological clarification of the concept of person-centered health and the strategies and tactics for health actions, as well as the historical and contemporary multifactorial substantiation of the general health strategy involving Integral and Mutual Health Care Oriented to the Well-being of all Persons, particularly in the face of the demands of the COVID-19 pandemic.
Background: The World Health Organization declared a worldwide Coronavirus (COVID-19) pandemic on March 11, 2020. In Uruguay, unlike most countries, a mandatory confinement was not declared. On the contrary, an extensive education and prevention campaign was carried out associated with measures to reduce social mobility, such as prohibiting meetings and closing bars.Objectives: The aim of the present study was to evaluate the COVID-19 pandemic in Uruguay and its repercussion on the clinical evolution of the two most common surgical pathologies: acute appendicitis (AA) and acute cholecystitis (AC).Methods: A retrospective comparative cohort study was performed at the Emergency Department of the University Hospital “Hospital de Clinicas Manuel Quintela,” the most important tertiary referral hospital in the city of Montevideo, capital of Uruguay. Two cohorts were identified: 13th of March 2019 to 13th of June 2019 [Pre-Covid period (PCP)] and the same period in 2020 [Pandemic Covid period (PCVP)]. Demographic and clinical data were analyzed.Results: A total of 118 cases were registered in 2019 and 109 in 2020. There were 43 cases (36.4%) of acute appendicitis in the pre-Covid period and 42 cases (36.5%) in Pandemic Covid period (p = 0.745). Acute cholecystitis cases differed significantly between cohorts, with a raise of cases in the Pandemic Covid period (14 vs 25) (p = 0.027). The surgical approach (Laparoscopy vs Open) did not change significantly (p = 0.207). A significant increase in complicated cases (AA + AC) was found during the pandemic (PCP 57 cases vs PCVP 67 cases) (p < 0.001). The sub-analysis of AA and AC showed a significant increase in AA’s complicated cases during PCVP (14 vs 25; p < 0.001) and no significant changes in the AC group (p = 0.99).Conclusion: An increase of complicated cases of AA was observed with maintenance of the number of consultations that might be explained by the excellent pre-hospital care system and absence of lock-down measures. The results are contradictory in some aspects, which calls for a deeper analysis, comparing different realities and longer periods of time in order to be able to draw conclusions that are representative for the Coronavirus pandemic in Uruguay.
From December 18 to 20, 2020, in the city of Montevideo, Uruguay, the 8th International Congress, 6th Latin American Conference, and 2nd Uruguayan Meeting of Person-Centered Medicine were held in virtual mode.Organized by the Latin American Network of Person-Centered Medicine, the International College of Person Centered Medicine and the PAHO/WHO representation of Uruguay, it was sponsored by the Peruvian Association of Person-Centered Medicine, the Latin American Association of Academies of Medicine, Spain and Portugal (ALANAM) and the National University of San Marcos.The program consisted of four general sessions, including the Opening and the Closing, as well as two Interdisciplinary and Multistage Forums that included four Plenary Sessions.The spectrum of speakers summoned covered countries from four continents: (America, Europe, Asia, and Oceania).
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