The Hospital Metropolitano de Santiago (HOMS) is the largest hospital in the Dominican Republic and one of the most modern hospitals in Latin America and the Caribbean, with 300 doctor's offices, 400 beds, 16 operating rooms, a hotel, and other specialized units.HOMS not only takes care of the Dominicans’ health but also allows foreigners to have the opportunity to receive high quality health care at low prices in what is called "health tourism". HOMS has an investment of more than $80.0 million US dollars. HOMS will be looking to be accredited by the Join Commission of International Hospital Accreditation.
BACKGROUND:Preanesthesia consultation can be an effective tool for reducing anxiety scores in patients scheduled for elective surgery. Anxiety can cause perioperative complications. OBJECTIVE:was to determine the impact of preanesthesia consultation on anxiety scores. PATIENTS AND METHODS:A single-center, observational study was carried out, with a descriptive, cross-sectional design and primary source. The anxiety score assessed using the APAIS scale (Amsterdam Preoperative Anxiety and Information Scale) was evaluated in adult participants before and after the pre-anesthetic consultation during the period December 2024 to April 2025. Statistical analysis was performed using the Wilcoxon, McNemar and chi-square tests. A P value < 0.05 was considered significant. RESULTS:A total of 190 participants were interviewed, of whom 180 were ultimately analyzed; 76.7% were women, and the mean age was 41.6 years. The most frequent procedures were general surgery and gynecological procedures. 86.7% had previously received anaesthesia. The prevalence of pre-consultation anxiety was 68.3%, decreasing to 47.2% after the consultation (p = 0.001). All interviewees between the ages of 18 and 25 reported anxiety before the pre-anaesthesia consultation (p = 0.031). The anesthetic technique that generated the greatest fear was general anaesthesia (42.8%), with the most frequently reported cause being fear of death (15.6%). CONCLUSION:Preoperative anxiety is highly prevalent, and preanesthetic consultation could be an effective intervention to significantly reduce it.
Advances in the management of HIV and AIDS have shifted the primary health concerns for these patients from opportunistic infections to cardiovascular diseases. Although antiretroviral therapy (ART) has significantly improved survival, it has also been linked to complications such as dyslipidemia, hypertension, carbohydrate metabolism disorders, and coronary and peripheral artery disease. In the Dominican Republic, a middle-high-income country, healthcare practices for people living with HIV are generally not focused on preventing these comorbidities. Table 1. Patients demographics Cardiovascular risk factors 3 or more months after starting ARVs This cross-sectional study analyzed data from the HIV care program at a tertiary hospital in Santiago de los Caballeros, Dominican Republic. The aim was to identify and characterize dyslipidemia and its relationship with hypertension and diabetes mellitus. Lipid profiles, serum glucose levels, and blood pressure readings were compared before and at least three months after starting antiretroviral treatment to assess any significant changes.Correlation between gender and cardiovascular risk factors A total of 298 medical records were reviewed, with 82% of patients on an antiretroviral regimen consisting of Tenofovir/lamivudine + Dolutegravir. Hypertriglyceridemia was the most common form of dyslipidemia (33.2%), followed by hypercholesterolemia (26.5%). Hypertension was prevalent in 72.5% of patients, and 40.6% exhibited fasting hyperglycemia. Dyslipidemia was significantly associated with gender (p=0.03), but no statistically significant relationships were found between dyslipidemia, hypertension, and hyperglycemia. The high prevalence of hypertension and diabetes or pre-diabetes in the studied population highlights the need for preventive measures to address these chronic non-communicable diseases in HIV patients. It is crucial for healthcare providers to implement lifestyle modifications and consider medications that could slow the development of these complications. All Authors: No reported disclosures
Sepsis is a life-threatening condition caused by a dysregulated host response to infection, often leading to multiorgan failure and death. Mortality remains over 25%, making early diagnosis essential in critically ill patients. The need for reliable biomarkers readily available in low and middle income countries is of major interest. Pancreatic Stone Protein (PSP), produced in the pancreas and GI tract, has shown promise as a diagnostic and prognostic marker in sepsis, trauma, and inflammatory conditions. This study evaluated the role of PSP, procalcitonin (PCT), and C-reactive protein (CRP) as early predictors of sepsis in ICU patients at tertiary center in the Dominican Republic.Table 1.Demographic Factors and Comorbidities of Patients Admitted to the Intensive Care Unit (ICU) of the Hospital Metropolitano de Santiago (HOMS) During the Period September – December 2024Table 2.Results of Sepsis Biomarkers at Admission and During Follow-Up of Patients Admitted to the Intensive Care Unit (ICU) of the Hospital Metropolitano de Santiago (HOMS). This was a descriptive, observational, correlational study using secondary data from ICU patients at HOMS between September 1 and December 31, 2024. Of 343 screened records, 36 patients met inclusion criteria (no sepsis on admission). Data on demographics, biomarker levels (PSP, CRP, PCT), SOFA-based sepsis diagnosis, ICU length of stay (LOS), and mortality were analyzed using descriptive statistics, ANOVA, and Spearman correlation (p < 0.05).Figure 1.Results of PSP, C-Reactive Protein, and Procalcitonin Levels and Their Association with Length of Stay in the Intensive Care Unit (ICU) of the Hospital Metropolitano de Santiago (HOMS)Figure 2.Comparison of Average Levels of PSP, PCR, and PCT and Their Association with Sepsis in Patients Admitted to the Intensive Care Unit (ICU) of the Hospital Metropolitano de Santiago (HOMS) Among 36 patients, 66.7% were male, with a mean age of 47.2 years. Hypertension was the most common comorbidity (38.9%). PSP levels had a mean of 94.8 ng/mL and a wide range (10–667 ng/mL). CRP and PCT were near zero in most cases, limiting analysis. A strong correlation was found between CRP and PCT (ρ = 0.91, p = 0.0003), but PSP did not correlate with CRP (ρ = 0.15, p = 0.6103) or PCT (ρ = 0.18, p = 0.5382). No statistically significant differences were observed between septic and non-septic patients for any biomarker. Elevated CRP appeared to trend with longer ICU stays (∼10 days). No mortality was recorded during the study period. CRP and PCT showed strong correlation and may reflect similar inflammatory processes. PSP did not correlate with sepsis or other markers. Further research with larger samples is needed to evaluate PSP’s role in early sepsis diagnosis. All Authors: No reported disclosures
