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1.

Epidemiología de la brucelosis caprina y ovina en la provincia de Formosa, Argentina./ [Epidemiology of caprine and ovine brucellosis in Formosa province, Argentina].

Russo, Ana M; Mancebo, Orlando A; Monzón, Carlos M; Gait, Juan J; Casco, Rubén D; Torioni de Echaide, Susana M
| Idioma(s): Español
An epidemiological study of brucellosis was carried out in 516 goats and mixed flocks (goat/sheep) from the three agro-ecological regions of Formosa province, Argentina. Serum samples from a total of 25401 goats and 2453 sheeps were analyzed using buffered plate agglutination test (BPAT) and complement fixation test (CFT). Bacteriological and PCR analyses on milk samples from goats in three flocks with a history of brucellosis and recent abortions were also performed. Brucellosis was detected in four of the nine departments of the province with an overall prevalence of 2% and an intra-flock prevalence ranging between 1% and 40%. The proportion of infected flocks was 3.6%, 12% and 36% for the eastern, central and western regions, respectively. Brucella melitensis bv. 1 was isolated efrom goats for the first time in the province. The expected fragments of 827bp from the omp2ab gene (Brucella spp.) and 731bp from the insert IS711 (B. melitensis) were amplified by PCR. Detection of antibodies by BPAT and FCT in sheep cohabiting with goats suggests that infections could have been caused by B. melitensis, posing an additional risk to public health. Control and eradication programs for brucellosis should consider mixed flocks as a single epidemiological unit. The results indicate that brucellosis by B. melitensis bv1 is highly endemic in the central and western regions of Formosa province.
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2.

Cuando la alegría entra al centro de salud: una experiencia de promoción de salud en Buenos Aires, Argentína/ When joy enters into the health center: an experience of health promotion in Buenos Aires, Argentina/ Quando a alegria entra no centro de saúde: uma experiência de promoção da saúde em Buenos Aires, Argentina

Bang, Claudia; Corín, Marcela; Stolkiner, Alicia
| Idioma(s): Español
Como parte de una investigación posdoctoral, el presente trabajo describe y analiza una experiencia de promoción y educación para la salud integral desarrollada por un Centro de Salud y Acción Comunitaria en una zona marginal urbana del sur de la Ciudad de Buenos Aires. Se trata de un estudio exploratorio-descriptivo que utiliza técnicas cualitativas para el trabajo de campo y análisis del material. En articulación con las dimensiones de la APS integral, se describe y analiza un dispositivo vincular, centrado en la interdisciplina y la articulación intersectorial como elementos clave de la organización de los cuidados en salud, con la inclusión de la dimensión intercultural y la participación comunitaria. Se incorporan actividades de promoción de salud integral centradas en el arte, creatividad y juego, constituyéndose en una experiencia resistencial al modelo biomédico de atención, con fuerte impacto subjetivo en los profesionales y la comunidad participante. As part of a postdoctoral research, this paper describes and analyzes an experience of promotion and education for comprehensive health, carried out by a Community Health Center in a slum of the City of Buenos Aires. This is an exploratory and descriptive study based on qualitative research methodologies in the fieldwork and also to examine the results. A linkage artifact is described and analyzed in the perspective of the dimensions of comprehensive PHC, focusing on the interdisciplinary and intersectoral articulation as key elements of the organization of health care, with the inclusion of the intercultural dimension and community participation. This experience incorporates health promotion activities focused on art, creativity and games, becoming an experience of resistance to the biomedical model of services, with a strong subjective impact on the professionals and the participant community. Como parte da pesquisa de pós-doutorado, o trabalho descreve e analisa uma experiência de promoção e educação para a saúde integral, desenvolvida por um Centro de Saúde e Ação Comunitária em uma zona marginal urbana do sul da Cidade de Buenos Aires. Trata-se de um estudo exploratório-descritivo, que utiliza técnicas qualitativas para o trabalho de campo e análise do material. Articulado com as dimensões da APS integral, descreve-se e se analisa um dispositivo vincular, centralizado na interdisciplina e na articulação intersetorial como elementos-chave da organização dos cuidados com a saúde, com a inclusão da dimensão intercultural e a participação comunitária. Incorporam-se atividades de promoção de saúde integral com o foco na arte, na criatividade e no jogo, constituindo uma experiência resistencial ao modelo biomédico de atenção, com forte impacto subjetivo nos profissionais e na comunidade participante.
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3.

Modeling phytoplankton community in reservoirs. A comparison between taxonomic and functional groups-based models.

Di Maggio, Jimena; Fernández, Carolina; Parodi, Elisa R; Diaz, M Soledad; Estrada, Vanina
| Idioma(s): Inglés
In this paper we address the formulation of two mechanistic water quality models that differ in the way the phytoplankton community is described. We carry out parameter estimation subject to differential-algebraic constraints and validation for each model and comparison between models performance. The first approach aggregates phytoplankton species based on their phylogenetic characteristics (Taxonomic group model) and the second one, on their morpho-functional properties following Reynolds' classification (Functional group model). The latter approach takes into account tolerance and sensitivity to environmental conditions. The constrained parameter estimation problems are formulated within an equation oriented framework, with a maximum likelihood objective function. The study site is Paso de las Piedras Reservoir (Argentina), which supplies water for consumption for 450,000 population. Numerical results show that phytoplankton morpho-functional groups more closely represent each species growth requirements within the group. Each model performance is quantitatively assessed by three diagnostic measures. Parameter estimation results for seasonal dynamics of the phytoplankton community and main biogeochemical variables for a one-year time horizon are presented and compared for both models, showing the functional group model enhanced performance. Finally, we explore increasing nutrient loading scenarios and predict their effect on phytoplankton dynamics throughout a one-year time horizon.
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4.

Conocimientos de salud bucodental en relación con el nivel socioeconómico en adultos de la ciudad de Corrientes, Argentina/ Oral health knowledge in relation to socio-economic level in adults from Corrientes city, Argentina/ Conhecimentos de saúde bucal em relação ao nível socioeconômico em adultos dacidade de Corrientes, Argentina

Silvina Dho, María
| Idioma(s): Español
OBJETIVO: analizar los conocimientos de salud bucodental y su relación con el nivel socioeconómico en individuos adultos. METODOLOGIA: se realizó un estudio transversal. A través de una encuesta domiciliaria se recolectó información referente a las variables de estudio. Se determinó el tamaño de la muestra estableciéndose un nivel de confianza del 95% (381 individuos) para la generalización de los resultados. Se aplicó un diseño muestral aleatorio simple para la selección de las viviendas a encuestar, que se complementó con un muestreo no probabilístico por cuotas para la selección de los individuos a entrevistar. RESULTADOS : Los individuos adultos de la Ciudad de Corrientes presentan en general un nivel de conocimientos de salud bucodental aceptable, pues en una escala de 0 a 28 puntos utilizada para valorar los conocimientos, se registró un mínimo de 15 puntos. Los individuos de NSE bajo presentan un nivel de conocimientos de salud bucodental similar a los individuos de NSE medio-alto/alto. Las personas de NSE medio-bajo presentaron un nivel significativamente menor de conocimientos de salud bucodental. CONCLUSION: Estos resultados deberían contemplarse en el diseño estrategias de intervención que incidan en los determinantes socioculturales del proceso salud-enfermedad. OBJECTIVE: to analyze the knowledge of oral health and its relationship with the socioeconomic status in adults. Methodology: a cross-sectional study was carried out. Information on sociodemographic and oral health knowledge was collected through a household survey using the technique of direct observation by the "face to face" interviewer. The sample size was determined by establishing a confidence level of 95% for the generalization of results (381 individuals). Simple random sampling design was used for the selection of households to be surveyed, which was supplemented with a non-probability sampling procedure for selecting individuals to be interviewed, based on data provided by the 2010 census. We used a SPSS 21.0 program for the analysis of data. RESULTS : the adults of the city of Corrientes have an acceptable level of knowledge of oral health. The scale of 0-28 points used to measure knowledge, checked a minimum of 15 points. Individuals of low socioeconomic status have a similar level of knowledge about oral health than those of medium-high/high status. People of medium-low status had a significantly lower level of knowledge about oral health. CONCLUSION: these results should be considered in the design of intervention strategies that affect the social and cultural determinants of the health-disease process. Objetivo: analisar os conhecimentos de saúde bucal e sua relação com o nível socioeconômico em indivíduos adultos. Metodologia: realizou-se um estudo transversal. Através de um questionário domiciliário foram coletadas informações referentes às variáveis do estudo. Foi determinado o tamanho da amostra estabelecendo-se um nível de confiança de 95% (381 indivíduos) para a generalização dos resultados. Aplicouse um desenho amostral aleatório simples para a seleção de domicílios a pesquisar, que se complementou com uma amostragem não probabilística por quotas para a seleção dos indivíduos a entrevistar. Resultados : os indivíduos adultos da Cidade de Corrientes apresentam em geral um nível de conhecimentos de saúde dental aceitável, pois em uma escala de 0 a 28 pontos utilizada para avaliar os conhecimentos, registrou-se um mínimo de 15 pontos. Os indivíduos de NSE baixo apresentam um nível de conhecimentos de saúde dental similar aos indivíduos de NSE médio-alto/alto. As pessoas de NSE médio - baixo apresentaram um nível significativamente menor de conhecimentos de saúde dental. Conclusão: estes resultados deveriam ser considerados no desenho de estratégias de intervenção que afetam os determinantes socioculturais do processo saúde-doença.
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6.

Experiencia del programa mi escuela saludable/ Experience of my healthy school program

González, Verónica Beatriz; Antún, María Cecilia; Casagrande Soria, María Laura; Di Paola, Melina; Eisenberg, María Paula; Escasany, María; Ferrari, María Florencia; Yomal, Alejandro
| Idioma(s): Español
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7.

Efectos del peso al nacer en la salud de los niños durante el primer año de vida en la ciudad de Santa Fe, Argentina/ Effects of birth weight on the health of children during the first year of life in the city of Santa Fe, Argentina

Radosevich, Ainelen Liliana
| Idioma(s): Español
Introducción: El peso al nacer es reconocido por su influencia en el crecimiento y desarrollo del niño durante su primer año de vida. Objetivos: Evaluar la asociación del peso al nacer, las características socioeconómicas, de la madre, de la gestación y del proceso de atención con la salud de los niños durante el primer año de vida. Métodos: Estudio de cohorte no concurrente de 407 niños, 194 nacidos con bajo peso (BP) y 213 con peso normal (PN), en Santa Fe, Argentina en el 2013. Se evaluó el efecto de variables socioeconómicas, de la madre, de la gestación y del proceso de atención sobre 3 desenlaces en la salud del niño: la ocurrencia de enfermedades, el estado nutricional (EN) al año de edad y la fluctuación del estado nutricional según las consultas postnatales (FEN). La ocurrencia de enfermedades se evaluó mediante dos abordajes: ocurrencia de alguna enfermedad y luego según tipo de enfermedad, sean eventos graves (respiratórias del tracto inferior y neumonía) y menos graves (respiratorias del tracto superior y diarreas). (...) Conclusiones: Los factores asociados a la ocurrencia de enfermedades y estado nutricional inadecuado son prevenibles con atención prenatal y postnatal adecuada, oportuna y sostenida en el tiempo. Los resultados hallados han demostrado la importancia de la vigilancia de la salud los nuestros niños, como así también cómo políticas preventivas pueden traducirse en resultados positivos sobre su salud. Esta información es de amplia utilidad e importancia que podrían contribuir a las actuales acciones de vigilancia y control de la salud de niños. Introduction: Birth weight is widely recognized for its effects on child growth and development, mainly in the first year of life. Objective: The aim of this study was to evaluate the association between birth weight, socioeconomic, pregnancy, health attention and maternal factors from health outcomes in the first year of life. Methods: We conducted a cohort study including 407 newborns, 194 of them were born with low birth weight (LBW) and 213 with normal weight (NW), in Santa Fe, Argentina, in 2013. We analyzed the effects of several factors (socioeconomic, maternal, pregnancy and health attention) in three health outcomes during the first year of life: morbidity incidence, nutritional status (NS) and weight fluctuation (WF). Morbidity incidence was evaluated using two different approaches: incidence of any morbidity and according to the severity of the event. Lower respiratory events and pneumonia were considered severe and upper respiratory events and diarrhea were less severe. NS was measured using the Body Mass Index (BMI) at one year old and the WF was measured considering the date of different postnatal care visits until one year old, in other words, recovery or worsening of nutritional status. (...) Inappropriate maternal health care during pregnancy was inversely associated with a positive fluctuation (recovery of nutritional status) in infants NS (HR=0.56; 0,38-0,81). Conclusions: The risk factors we have found for infants' morbidity and inadequate nutritional status during the first year of life can be prevented with opportune, sustained and adequate prenatal and postnatal health care. Our results have shown the importance of health surveillance in children´s health and also how preventive policies could benefits children´s health. This information provides relevant and useful evidence for Public Health, in order to improve attention and surveillance on children's health.
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8.

Tendencias de la mortalidad por lesiones de tránsito en Argentina, 2002-2012/ Trends in mortality from traffic injuries in Argentina, 2002-2012

Ramírez, Félix Alejandro
| Idioma(s): Español
Introducción: Según la Organización Mundial de la Salud, las lesiones por el tránsito ocupan los primeros lugares entre las causas de muerte y es la primera entre los jóvenes de 15 a 29 años. El objetivo del estudio fue describir el perfil epidemiológico de las víctimas, evaluar la tendencia de la mortalidad por lesiones de tránsito (LT) y su asociación con el parque automotor y motovehícular en Argentina entre 2002 y 2012. Materiales y Métodos: Estudio ecológico con datos oficiales de mortalidad (codificados según CIE-10) y de parque automotor y motovehicular para el período2002-2012. La mortalidad por lesiones no intencionales inespecíficas fueron redistribuidas entre las no intencionales según la metodología de Global Burden of Disease. Se calcularon tasas brutas y ajustadas. Se realizaron modelos Poisson conefectos aleatorios para explorar asociaciones entre las variables en estudio. Resultados: Se estimó un aumento del número de muertes del 67 por ciento por el método de la redistribución. Se calculó para Argentina una tasa de mortalidad por lesiones de tránsito para el periodo de 13,1 por 100.000 habitantes. Las tasas de mortalidad por lesiones entre ocupantes de autos aumentaron de 8,8 a 11,1 por 100.000 habitantes durante el periodo de estudio. Los varones motociclistas presentaron un marcado aumento de la tasa de mortalidad, las regiones Noroeste y Noreste presentaron los mayores incrementos de 5 a 15 muertes por 100.000 habitantes del 2002 al 2012. La tendencia en peatones y ciclistas fue en descenso. Al realizar los modelos de Poisson con efectos mixtos se observo que el riesgo fue mayor en los jóvenes varones motociclistas de lassiete regiones de Argentina, con un riesgo de 1,88 por ciento (IC 95 por ciento 1.79-1.97) para el país. Conclusión: Se observaron grandes diferencias regionales, por tipo de usuario de la vía pública, por sexo y por edad, sustento para la implementación de políticas para revertirlas tendencias actuales. Introduction: According to the World Health Organization, traffic injuries rank first among causes of death, especially in young people aged 15 to 29 years. The aim of the study was to describe the epidemiological profile of the victims, to assess the trend of mortality associated with traffic injuries (TI) and its association with the number of carsand motorcycles, in Argentina between 2002 and 2012. Methods: Ecological study based on official mortality data (coded according to ICD-10) and the number of cars and motorcycles, for the period 2002-2012. Mortality from un specified unintentional injuries was redistributed, according to the methodology of Global Burden of Disease. Crude and adjusted rates were calculated. Poisson models were developed to explore associations between the variables. Results: By the redistribution method, it was estimated an increase of 67 percent in death sassociated to traffic injury. The mortality rate was 13.1 per 100,000 inhabitants for the period. Mortality rate among occupants of cars increased from 8.8 to 11.1 per 100,000 in habitants during the period. Male Motorcyclists showed a marked increase in the mortality rate; the Northwest and Northeast regions registered the highest growth from 5to 15 deaths per 100,000 from 2002 to 2012. The mortality in pedestrians and cyclists showed a declining trend. By performing Poisson models, it was observed a higher inyoung men motorcyclists, in the different seven regions of Argentina, with a risk of 1.88 percent (95 percent CI 1.79-1.97) for the all country. Conclusion: There were regional differences considering sex, age and type of vehicle. This information could support policy implementation, in order to reverse current trends.
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9.

Análisis espacial de factores socioeconómicos, de servicios de salud y de mortalidad por cáncer de mama, Argentina, 2009-2011/ Spatial analysis of socioeconomic factors, health care and mortality from breast cancer, Argentina, 2009-2011

Perinetti, Andrea
| Idioma(s): Español
Introducción: La mortalidad por cáncer de mama es mayor en países con mayores ingresos donde también hay mayor supervivencia debido al acceso para la detección temprana y tratamiento oportuno. Argentina presenta altas tasas de mortalidad por cáncer de mama. Material y Métodos: estudio ecológico con análisis espacial de indicadores demográficos, socio-económicos, muertes mal definidas y servicios de salud por departamentos. Se describieron los flujos origen-destino de los egresos hospitalarios del sector público. Se calculó la razón estandarizada de mortalidad y tasa bayesiana (año 2009-2011). Utilizando modelos condicionales de autoregresión espacial se ajustaron 3 modelos donde la variable dependiente fue tasa bruta de mortalidad (modelo 1), razón estandarizada de mortalidad (modelo 2) y tasa bayesiana de mortalidad (modelo 3) Resultados: Las regiones del norte presentaron peores indicadores socioeconómicos, menor cobertura de mamografía y menor disponibilidad de servicios de salud. Los egresos hospitalarios presentaron poca migración entre provincias. En el modelo 1 y 2 la mortalidad se relacionó directamente con mejores indicadores socioeconómicos, mayor cobertura de mamografía, e inversamente con muertes mal definidas. En el modelo 1 las regiones de Cuyo y Noreste tuvieron mayor mortalidad; en el modelo 2 la Patagonia presentó menor mortalidad. En el modelo 3 hubo relación directa de la mortalidad con mejores indicadores socioeconómicos y fue menor en las regiones Noreste, Noroeste y Patagonia. No se observó relación con variables de disponibilidad de servicios en ningún modelo. Discusión: al igual que en otros países se observó mayor mortalidad en regiones con mejor nivel socioeconómico. Sin embargo se evidenció asociación inversa de la mortalidad con muertes mal definidas y menor edad de mortalidad en regiones con mayor pobreza y menor disponibilidad de servicios lo que sugiere la presencia de barreras para la accesibilidad y menor sobrevida en las regiones más pobres. Conclusiones: Es necesario profundizar el uso de metodologías de análisis espacial complejo para estudiar mejor los determinantes socioeconómicos y el acceso a los servicios. Esto es imprescindible para evaluar la equidad del sistema de salud y el impacto que las políticas sanitarias tienen en los distintos escenarios y contextos de nuestro país. Introduction: Breast cancer mortality is higher in higher income countries where there is also greater survival. Argentina has high rates of mortality from breast cancer. Material and methods: ecological study. Spatial analysis at department level of demographic and socio-economic indicators, ill-defined deaths and health services was performed. Origin-destination flows of hospital discharges in the public sector were described. Standardized mortality rate and bayesian mortality rate (year 2009-2011) was calculated. Using conditional spatial autoregression three models were adjusted. Dependent variables were raw mortality rate (model 1), standardized mortality rate (model 2) and bayesian mortality rate (model 3). Results: In the Northern regions worse socioeconomic indicators, lower mammography coverage and reduced health services availability were found. Hospital discharges showed little migration between provinces. In model 1 and 2 mortality was directly related to better socioeconomic indicators, greater coverage of mammography, and inversely with ill-defined deaths. In model 1 Cuyo and Northeastern regions had higher mortality. Model 2 showed a lower mortality in Patagonia region. Model 3 presented a direct relationship between mortality and better socioeconomic indicators and it was lower in the Northeast, Northwest and Patagonia regions. No relation to variables of availability of services in any pattern was observed. Discussion: As in other countries increased mortality was observed in regions with higher socioeconomic status. However it was observed inverse association of mortality with ill defined mortality causes in addition to mortality at younger ages in regions with greater poverty and fewer services, suggesting the presence of barriers to accessibility and lower survival in the poorest regions. Conclusions: It is necessary to deepen the use of complex spatial analysis methodologies to better study socioeconomic determinants and access to services. This is imperative to assess the equity of the health system and the impact that health policies have in different scenarios and contexts of our country.
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10.

Pesticide exposure and health conditions of terrestrial pesticide applicators in Córdoba Province, Argentina/ Exposición a plaguicidas y condiciones de salud de agroaplicadores terrestres de la Provincia de Córdoba, Argentina/ Exposição aos agrotóxicos e condições de saúde dos aplicadores de pesticidas da Província de Córdoba, Argentina

Butinof, Mariana; Stimolo, María Inés; Machado, Ana Lia; Blanco, Marcelo; Lantieri, María Josefina; Díaz, María del Pilar; Fernandez, Ricardo Antorio; Franchini, Germán
| Idioma(s): Inglés
Agricultural workers represent a population that is highly vulnerable to the toxic effects of pesticide exposure. This cross sectional study aimed to describe the health conditions of terrestrial pesticide applicators in Córdoba Province, Argentina, their work practices and socio-demographic characteristics, by means of a standardized self-administered questionnaire (n = 880). A descriptive analysis reported a high prevalence of occasional or frequent symptoms: 47.4% had symptoms of irritation, 35.5% fatigue, 40.4% headache and 27.6% nervousness or depression. Using logistic regression models, risk and protective factors were found for symptoms of irritation, medical consultation and hospitalization. Among the occupational exposure variables, marital status, length of time in the job, low level of protection with regard to the use of personal protective equipment, combined use of different pesticides and the application of the insecticide endosulfan, were associated with a higher frequency of reported symptoms and higher consultation rates and hospitalization. Los trabajadores agrícolas son una población altamente vulnerable a los efectos tóxicos de la exposición a plaguicidas. Con el objetivo de describir las condiciones de salud de agroaplicadores terrestres de plaguicidas de la Provincia de Córdoba, Argentina, sus prácticas laborales y características sociodemográficas, se realizó un estudio transversal, mediante cuestionario (n = 880). Un análisis descriptivo reportó alta prevalencia de sintomatología ocasional o frecuente: 47,4% síntomas irritativos, 35,5% cansancio, 40,4% cefalea y 27,6% ansiedad o depresión. Mediante modelos logísticos se detectaron factores protectores y de riesgo que explican la presencia de síntomas irritativos, la consulta médica y la hospitalización. El estado civil, la antigüedad en la tarea, el nivel de protección considerando uso de equipo de protección personal, la exposición múltiple a plaguicidas y la aplicación del insecticida endosulfán, se asociaron a mayor frecuencia de reporte de síntomas, consultas médicas y hospitalizaciones por causas relacionadas con la exposición a plaguicidas. Os trabalhadores agrícolas são uma população altamente vulnerável aos efeitos tóxicos da exposição a pesticidas. Este estudo transversal teve o objetivo de descrever as condições de saúde de aplicadores terrestres de pesticidas da Província de Córdoba, Argentina, suas práticas de trabalho e características sociodemográficas, por meio de um questionário padronizado autoadministrado (n = 880). A análise descritiva relatou alta prevalência de sintomas ocasionais ou frequentes: 47,4% sintomas irritativos, 35,5% fadiga, 40,4% dor de cabeça e 27,6% ansiedade ou depressão. Mediante modelos logísticos foram detectados os fatores protetores e do risco que explicam a presença de sintomas irritativos, consulta médica e hospitalização. O estado civil, anos de trabalho, o nível de proteção considerando o uso de equipamentos de proteção individual, a exposição a vários pesticidas e aplicação do inseticida endosulfan, foram associados com maior frequência de sintomas, consultas médicas e hospitalização por causas relacionadas à exposição ao agrotóxico.
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