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1.
J Natl Cancer Inst Monogr ; 2024(66): 282-289, 2024 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-39108235

RESUMO

BACKGROUND: The benefits of cannabis in symptom management among cancer survivors are widely acknowledged; however, patterns of cannabis use by cancer stage at diagnosis are unknown. METHODS: Here, we examined the association between cancer stage at diagnosis and consideration of cannabis use since diagnosis. We analyzed cross-sectional survey data from 954 cancer survivors, weighted to be representative of a National Cancer Institute-Designated Comprehensive Cancer Center's patient population. We used survey-weighted multivariable logistic regression to examine the association between cancer stage at diagnosis (advanced [III/IV] versus non-advanced [I/II]) and consideration of cannabis use (yes versus no) since diagnosis. RESULTS: Sixty percent of the population was diagnosed with non-advanced stages of cancer, and 42% had considered using cannabis since diagnosis. The odds of consideration of cannabis use were 63% higher (odds ratio = 1.63, 95% confidence interval = 1.06 to 2.49) among cancer survivors diagnosed at stages III/IV than among those diagnosed at stages I/II. CONCLUSION: Cancer stage may be a predictor of consideration of cannabis use after diagnosis.


Assuntos
Sobreviventes de Câncer , Estadiamento de Neoplasias , Neoplasias , Humanos , Sobreviventes de Câncer/estatística & dados numéricos , Feminino , Masculino , Pessoa de Meia-Idade , Estudos Transversais , California/epidemiologia , Neoplasias/epidemiologia , Adulto , Idoso , Adulto Jovem
2.
Front Public Health ; 12: 1414361, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38962767

RESUMO

Introduction: Non-Hispanic Black (NHB) Americans have a higher incidence of colorectal cancer (CRC) and worse survival than non-Hispanic white (NHW) Americans, but the relative contributions of biological versus access to care remain poorly characterized. This study used two nationwide cohorts in different healthcare contexts to study health system effects on this disparity. Methods: We used data from the Surveillance, Epidemiology, and End Results (SEER) registry as well as the United States Veterans Health Administration (VA) to identify adults diagnosed with colorectal cancer between 2010 and 2020 who identified as non-Hispanic Black (NHB) or non-Hispanic white (NHW). Stratified survival analyses were performed using a primary endpoint of overall survival, and sensitivity analyses were performed using cancer-specific survival. Results: We identified 263,893 CRC patients in the SEER registry (36,662 (14%) NHB; 226,271 (86%) NHW) and 24,375 VA patients (4,860 (20%) NHB; 19,515 (80%) NHW). In the SEER registry, NHB patients had worse OS than NHW patients: median OS of 57 months (95% confidence interval (CI) 55-58) versus 72 months (95% CI 71-73) (hazard ratio (HR) 1.14, 95% CI 1.12-1.15, p = 0.001). In contrast, VA NHB median OS was 65 months (95% CI 62-69) versus NHW 69 months (95% CI 97-71) (HR 1.02, 95% CI 0.98-1.07, p = 0.375). There was significant interaction in the SEER registry between race and Medicare age eligibility (p < 0.001); NHB race had more effect in patients <65 years old (HR 1.44, 95% CI 1.39-1.49, p < 0.001) than in those ≥65 (HR 1.13, 95% CI 1.11-1.15, p < 0.001). In the VA, age stratification was not significant (p = 0.21). Discussion: Racial disparities in CRC survival in the general US population are significantly attenuated in Medicare-aged patients. This pattern is not present in the VA, suggesting that access to care may be an important component of racial disparities in this disease.


Assuntos
Negro ou Afro-Americano , Neoplasias Colorretais , Acessibilidade aos Serviços de Saúde , Disparidades em Assistência à Saúde , Programa de SEER , População Branca , Humanos , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/etnologia , Masculino , Feminino , Estados Unidos/epidemiologia , Idoso , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Pessoa de Meia-Idade , Disparidades em Assistência à Saúde/estatística & dados numéricos , Negro ou Afro-Americano/estatística & dados numéricos , População Branca/estatística & dados numéricos , Estudos de Coortes , Análise de Sobrevida , Idoso de 80 Anos ou mais , United States Department of Veterans Affairs/estatística & dados numéricos , Adulto
3.
Artigo em Inglês | MEDLINE | ID: mdl-39025254

RESUMO

BACKGROUND & AIMS: Prevalence and severity of metabolic dysfunction-associated steatotic liver disease (MASLD) is reported to be higher in Hispanic adults in the United States (U.S.), although rates vary substantially across studies and have increased given the evolving obesity epidemic. This systematic review and meta-analysis quantifies MASLD disease burden and severity in contemporary cohorts to characterize health disparities experienced by adult Hispanic individuals in the U.S. METHODS: We searched the MEDLINE, Embase, and Cochrane databases per the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Studies from 2010 to December 2023 were included to capture data representative of current populations given the obesity epidemic. Studies from overlapping cohorts were excluded. Meta-analyses were conducted using random-effects models to estimate pooled prevalence and relative risk (RR) with 95% confidence intervals (CIs). RESULTS: We identified 22 studies, comprising 756,088 subjects, of which 62,072 were Hispanic. The pooled prevalence in U.S. Hispanic adults was 41% (95% CI, 30%-52%) for MASLD, 61% (95% CI, 39%-82%) for metabolic dysfunction-associated steatohepatitis (MASH), 27% (95% CI, 15%-39%) for MASH-associated advanced fibrosis (AF), and 5% (95% CI, 1%-8%) for MASH cirrhosis. Compared with non-Hispanic adults, Hispanic adults had a RR of 1.50 (95% CI, 1.32-1.69) for MASLD, 1.42 (95% CI, 1.04-1.93) for MASH, 1.37 (95% CI, 0.96-1.96) for MASH-associated AF, and 0.93 (95% CI, 0.49-1.77) for MASH cirrhosis. CONCLUSION: Health disparities for U.S. Hispanic adults continue to worsen with significantly higher relative risk of MASLD and MASH compared with non-Hispanic adults. Public health efforts to optimize screening and care delivery for the adult Hispanic population are urgently needed.

4.
Am Soc Clin Oncol Educ Book ; 44(3): e431272, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38843475

RESUMO

The worldwide cancer burden is growing, and populations residing in low- and middle-income countries (LMICs) are experiencing a disproportionate extent of this growth. Breast, colorectal, and cervical cancers are among the top 10 most frequently diagnosed malignancies, and they also account for a substantial degree of cancer mortality internationally. Effective screening strategies are available for all three of these cancers. Individuals from LMICs face substantial cost and access barriers to early detection programs, and late stage at diagnosis continues to be a major cause for cancer mortality in these communities. This chapter will review the epidemiology of breast, colorectal, and cervical cancers, and will explore prospects for improving global control through novel approaches to screening in cost-constrained environments.


Assuntos
Países em Desenvolvimento , Detecção Precoce de Câncer , Humanos , Detecção Precoce de Câncer/economia , Neoplasias/epidemiologia , Neoplasias/diagnóstico , Feminino , Programas de Rastreamento/economia , Programas de Rastreamento/métodos , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/diagnóstico , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/diagnóstico
5.
J Prim Care Community Health ; 15: 21501319241259684, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38864213

RESUMO

OBJECTIVE: To assess acceptability and feasibility of rapid at-home COVID-19 testing and reporting of test results among individuals seeking care at community health centers (CHCs) and their household members. METHODS: Participants were recruited from 2 Community Health Centers during a clinic visit or a community event. Over-the-counter COVID-19 tests were distributed to participants for self-testing and to offer testing to household members. Separate surveys were administered to collect baseline information on the study participant and to collect test results on the study participant and household members. We calculated the proportion of individuals who agreed to complete COVID home testing, those who reported test results, and the test positivity. For household members, we calculated the proportion who completed and reported results and the positivity rate. We assessed reasons for undergoing COVID-19 testing and the action taken by participants who reported positive tests. RESULTS: A total of 2189 individuals were approached by CHC staff for participation and 1013 (46.3%) agreed to participate. Among the 959 participants with complete sociodemographic data, 88% were Hispanic and 82.6% were female. The proportion providing test results was 36.2% and the test positivity was 4.2%. Among the 1927 test reports, 35.3% for the index participant and 64.4% were for household members. The largest proportion of test results were for index participants (35.3%) and the second largest was for the participant's children (32.1%), followed by parents (16.9%), and spouse/partner (13.2%). The 2 most common reasons for testing were symptoms (29%) and attending family gatherings (26%). Among test-positive individuals (n = 80), most (83.3%) noted that they isolated but only 16.3% called their provider and 1.3% visited a clinic. CONCLUSION: Our results show interest in at-home COVID-19 testing of multiple household members, as we headed into the endemic phase of the pandemic. However, reporting of test results was modest and among test-positive individuals, reporting results to a provider was very low. These results underscore the challenges with reporting and following guidelines among people undergoing home testing for COVID-19, which may have implications for future pandemics.


Assuntos
Teste para COVID-19 , COVID-19 , Centros Comunitários de Saúde , Humanos , Feminino , Masculino , COVID-19/epidemiologia , COVID-19/diagnóstico , Adulto , Centros Comunitários de Saúde/estatística & dados numéricos , Pessoa de Meia-Idade , Teste para COVID-19/métodos , Teste para COVID-19/estatística & dados numéricos , Autoteste , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Idoso , Adolescente , SARS-CoV-2 , Adulto Jovem , Estudos de Viabilidade , Criança
6.
Cancer ; 2024 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-38795024

RESUMO

BACKGROUND: Colorectal cancer (CRC) screening is underused, particularly among low-income and minoritized populations, for whom the coronavirus disease 2019 (COVID-19) pandemic has challenged progress in achieving equity. METHODS: A hub-and-spoke model was used. The hub was a nonacademic organization and the spokes were three community health center (CHC) systems overseeing numerous clinic sites. Via a cluster-randomized trial design, nine clinic sites were randomized to intervention and 16 clinic sites were randomized to usual care. Patient-level interventions included invitation letters, mailed fecal immunochemical tests (FITs), and call/text-based reminders. Year 1 intervention impact, which took place during the COVID-19 pandemic, was assessed as the proportion completing screening among individuals not up to date at baseline, which compared intervention and nonintervention clinics accounting for intraclinic cluster variation; confidence intervals (CIs) around differences not including 0 were interpreted as statistically significant. RESULTS: Among 26,736 patients who met eligibility criteria, approximately 58% were female, 55% were Hispanic individuals, and 44% were Spanish speaking. The proportion completing screening was 11.5 percentage points (ppts) (95% CI, 6.1-16.9 ppts) higher in intervention versus usual care clinics. Variation in differences between intervention and usual care clinics was observed by sex (12.6 ppts [95% CI, 7.2-18.0 ppts] for females; 8.8 ppts [95% CI, 4.7-13.9 ppts] for males) and by racial and ethnic group (13.8 ppts [95% CI, 7.0-20.6 ppts] for Hispanic individuals; 13.0 ppts [95% CI, 3.6-22.4 ppts] for Asian individuals; 11.3 ppts [95% CI, 5.8-16.8 ppts] for non-Hispanic White individuals; 6.1 ppts [95% CI, 0.8-10.4 ppts] for Black individuals). CONCLUSIONS: A regional mailed FIT intervention was effective for increasing CRC screening rates across CHC systems serving diverse, low-income populations.

7.
Int Psychogeriatr ; : 1-10, 2024 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-38186234

RESUMO

OBJECTIVE: To assess differences in psychosocial and mental health outcomes between older lesbian and bisexual women compared to heterosexual women. DESIGN: Cross sectional study. SETTING: The study was carried out in the California Teachers Study, a prospective cohort study. PARTICIPANTS: Self-identified heterosexual (n = 35,846), lesbian (n = 710), and bisexual (n = 253) women 50 years of age and older were enrolled. MEASUREMENTS: Validated questionnaires were used to measure social connection, overall happiness, and depression. Logistic regression modeling was used to estimate odds ratios (OR) and 95% confidence intervals (CI) comparing lesbian and bisexual women separately to heterosexual women in relation to psychosocial and mental health outcomes. RESULTS: After controlling for age and marital status, older bisexual women were significantly more likely to report lack of companionship (OR = 2.00; 95% CI, 1.30-3.12) and feeling left out (OR = 2.33; 95% CI, 1.36-3.97) compared to older heterosexual women. The odds of reporting feeling isolated from others was significantly higher in lesbian (OR = 1.56; 95% CI, 1.06-2.30) and bisexual women (OR = 2.30; 95% CI, 1.37-3.87) than in heterosexual women. The OR (95% CI) for reporting not being very happy overall was 1.96 (CI, 1.09-3.52) in bisexual women and 1.40 (0.92-2.14) in lesbian women compared to heterosexual women. The likelihood of reporting diagnosed depression was significantly higher in lesbian women (OR = 1.65; 95% CI, 1.38-1.97) and bisexual women (OR = 2.21; 95% CI, 1.67-2.93) compared to heterosexual women. CONCLUSION: Inclusion of lesbian and bisexual women in aging research is essential to understand their unique mental and other health needs, including those specific to bisexual women.

8.
Rev. Nutr. (Online) ; 31(6): 603-615, Nov.-Dec. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1041290

RESUMO

ABSTRACT Objective Food insecurity and child malnutrition are central topics in many food programs around the world; however, these indices do not diminish. The creation of strategies is necessary to increase the effectiveness of nutritional improvement programs. The objective of this research was to improve the nutritional quality of three local dishes included in the regular diet of the population by adding amaranth and to evaluate their acceptance by children from three communities in Tochimilco, Puebla, Mexico. Methods The study was carried out in three communities of "Tochimilco", Puebla, Mexico, in order to evaluate three local dishes: banana smoothie, beans and corn tortillas, which were chosen by mothers of the region in participative workshops on preparation of local dishes enriched with amaranth. Two sensory tests were applied: paired-comparison and hedonic scale to 208 and 210 children of preschool and scholar age, respectively. Results It was found that consumers showed similar preference for banana smoothie and beans enriched with amaranth compared to non-enriched dishes; while the amaranth enriched tortilla gained more preference in the different statistical tests and it was the dish with higher content of amino acids. Sensory attributes were similarly assessed and there were no significant differences among rural and urban communities and school year. Conclusion Children easily accept the addition of amaranth to the dishes they are accustomed to, as it does not change their food culture. It is possible to improve child nutrition by designing healthier dishes and incorporating them into the daily cooking of those who prepare the food.


RESUMO Objetivo A insegurança alimentar e a desnutrição infantil são temas centrais de muitos programas alimentares ao redor do mundo; no entanto, esses índices não diminuem. É preciso criar estratégias para aumentar a eficácia dos programas de desenvolvimento nutricional. A presente pesquisa teve como objetivo melhorar a qualidade nutricional de três pratos típicos da dieta normal da população local, adicionando amaranto às comidas típicas e avaliando a aceitação dele por crianças de três comunidades em Tochimilco, Puebla, México. Métodos O estudo foi realizado nas três comunidades para avaliar os três pratos típicos desta mesma região: vitamina de banana, feijão e as tortilhas de milho. Estas comidas foram escolhidas por mães da região em oficinas participativas de preparação de pratos locais enriquecidos com amaranto. Dois testes sensoriais foram aplicados: comparação pareada e escala hedônica para 208 e 210 crianças em idade pré-escolar e escolar, respectivamente. Resultados Verificou-se que os consumidores mostraram uma preferência semelhante pela vitamina de banana e feijão enriquecido com amaranto do que os mesmos não enriquecidos; enquanto a tortilha de milho enriquecida com amaranto ganhou mais preferência nos diferentes testes estatísticos e foi o prato com maior teor de aminoácidos. Os atributos sensoriais foram avaliados da mesma forma e não houve diferenças significativas entre as comunidades rurais e urbanas e as notas escolares. Conclusão As crianças aceitam facilmente a incorporação de amaranto nos pratos típicos da dieta delas, pois não repre-sentou nenhuma alteração da sua cultura alimentar. É possível melhorar a nutrição infantil, criando pratos mais saudáveis e incorporando-os na culinária cotidiana daqueles que preparam a comida.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Transtornos da Nutrição Infantil , Alimentos Fortificados , Criança , Pré-Escolar , Participação da Comunidade , Culinária , Amaranthus , México
9.
Rev. Esc. Enferm. USP ; 52: e03310, 2018. tab, graf
Artigo em Inglês, Espanhol | LILACS, BDENF - Enfermagem | ID: biblio-896671

RESUMO

RESUMEN Objetivo Evaluar el efecto de un programa, basado en juegos, sobre estudiantes de enfermería de la asignatura cuidados paliativos, midiendo el miedo a la muerte mediante la Escala Collett-Lester. El desafío es innovar, e integrar en el aula, teoría y experiencias cercanas al contexto de duelo. Método Estudio cuasi-experimental. Realizaron los cuestionarios 101 y 111 estudiantes, antes y después de la intervención de los juegos, respectivamente. Asignatura impartida en el primer semestre de tercer curso. Resultados Los estudiantes obtuvieron valores medios moderados en la variable "miedo a la muerte" (entre 14 y 19) para ambos momentos (pre y post). Hombres y mujeres aumentan estos valores de miedo en el post-test, a la vez que disminuyen su "percepción sobre preparación emocional", evidenciando el valor de los juegos, al exponer al estudiante a situaciones cercanas a las reales. Conclusión Consideramos que la herramienta didáctica de los juegos, aplicada en el contexto del aula, facilita que el estudiante pueda reconocer el miedo que genera la cercanía de la muerte, tanto en el enfermo y familia, como el propio.


RESUMO Objetivo Avaliar o efeito de um programa, baseado em jogos, sobre estudantes de enfermagem da disciplina cuidados paliativos, medindo o medo da morte por meio da Escala Collett-Lester. O desafio é inovar e integrar, na sala de aula, teoria e experiências próximas ao contexto do luto. Método Estudo quase-experimental. Realizaram os questionários 101 e 11 estudantes, antes e depois da intervenção dos jogos, respectivamente. Disciplina ministrada no primeiro semestre do terceiro ano. Resultados Os estudantes obtiveram valores médios moderados na variável "medo da morte" (entre 14 e 19) para os dois momentos (pré e pós). Homens e mulheres aumentam esses valores de medo no pós-teste, ao mesmo tempo que diminuem sua "percepção sobre preparo emocional", evidenciando-se o valor dos jogos ao expor o estudante a situações próximas às reais. Conclusões Consideramos que a ferramenta didática dos jogos, aplicada no contexto da sala de aula, fornece ao estudante a oportunidade de reconhecer o medo que a proximidade da morte gera, tanto no doente e na família, quanto nele próprio.


ABSTRACT Objective To evaluate the effect of a games-based intervention on palliative care nursing students' scores on the Collett-Lester Fear of Death Scale. The challenge was to innovate and integrate grief-related theory and experiences into the classroom. Method Quasi-experimental study. Before and after the games-based intervention, 101 and 111 students completed the questionnaires, respectively. The intervention was performed in the context of a palliative care class taught during the first semester of the third year of the nursing programme. Results The students obtained moderate mean scores on the variable fear of death (between 14 and 19) at both time points (pre- and post-intervention). Both men and women indicated a heightened sense of fear post-intervention and a decrease in self-perceived emotional preparedness, which support the value of the games for exposing the student to situations that closely approximated reality. Conclusion The use of games as a didactic tool in the classroom context helped the students recognize the fear generated by proximity to death in the patient and family and in the student him- or herself.


Assuntos
Humanos , Masculino , Feminino , Estudantes de Enfermagem , Morte , Educação em Enfermagem , Medo , Jogos Experimentais , Cuidados Paliativos , Espanha , Bacharelado em Enfermagem
10.
Rev. méd. (La Paz) ; 21(2): 18-24, 2015. ilus
Artigo em Espanhol | LILACS | ID: lil-785630

RESUMO

OBJETIVOS: Correlacionar el grado de funcionalidad renal de acuerdo a la clasificación de K-DOQUI con el control glucémico a través del porcentaje de hemoglobina glucosilada y de glucosa sérica, en adultos mayores diabéticos del módulo de diabetes, y comparar los resultados con los pacientes no diabéticos del módulo Gerontológico. MATERIAL Y MÉTODOS: Se incluyeron dos grupos: El primero conformado por diabéticos del módulo de diabetes, y el segundo por no diabéticos del módulo de gerontología. Muestreo no probabilístico por conveniencia en adultos mayores de 60 años y más, se aplicó ficha de identificación, se envió al laboratorio para toma de productos, y se determinó funcionalidad renal en función del Grado K-Doqui. Se utilizaron pruebas de U de Mann Whitney, t de student para muestras independientes, Chi cuadrada y correlación de Spearman, nivel de significancia 0.05, programa estadístico SPSS v 18. RESULTADOS: El total fue de 240 pacientes, Para funcionalidad renal; nueve pacientes del módulo de diabetes presentaron estadio 4, por seis del módulo gerontológico. (p=0.455). Para el control glucémico por hemoglobina glucosilada, el promedio para el módulo de diabetes 6.8%, y para módulo gerontológico 6.2%, (p=0.000). Al asociar función renal y control glicémico por hemoglobina gucosilada, se obtuvo asociación directa con significancia estadística para el módulo de diabetes (p=0.002), mientras que para el módulo gerontológico no se presentó dicha asociación (p=0.118). CONCLUSIONES: A diferencia del grupo control, para el grupo de diabéticos se obtuvo asociación directa entre control glicémico y daño renal, aunque su correlación fue baja.


OBJECTIVE: To correlate the renal functionality degree according to K-DOQUI classification with the glycemic control through the percentage of glycated hemoglobin and serum glucose, in elder diabetic from the diabetes module and to compare it with the non-diabetic patients from the gerontological module. MATERIAL AND METHODS: Two groups were included, the first one consisting of diabetics from the diabetes module, the second one of non-diabetics from the gerontological module. No probabilistic of convenience sample in adults over 60 years, an identification card was applied, it was sent to the clinic's laboratory for taking products and determine the renal functionality based on the patients K-DOQUI degree. U Man Whitney, t Student for independent samples, Square Xi, and Spearman correlation were used. Significance level 0.05 Statistical Program SPSS 18 V. RESULTS: 240 total patients. For renal functionality 9 patients from the diabetes module presented stage 4, by 6 patients from the gerontological module (p=0.455). For glycemic control of glycated hemoglobin the average for diabetes module was 6.8%, and 6.2% for gerontological module (p=0.000). While associating the renal function and glycemic control of glycated hemoglobin, a direct association was obtained, with a statistical significance for the diabetes module (p=0.002). For the gerontological module there was no association (p=0.118). CONCLUSIONS: Unlike the control group, for the non-diabetic group a direct association between glycemic control and kidney failure was obtained, though its correlation was low.


Assuntos
Humanos , Índice Glicêmico , Testes de Função Renal , Hemoglobinas Glicadas
11.
Rev. cuba. endocrinol ; 25(2): 57-65, Mayo.-ago. 2014.
Artigo em Espanhol | LILACS, CUMED | ID: lil-727591

RESUMO

Objetivos: determinar la prevalencia de infección de vías urinarias, la sensibilidad antimicrobiana y los factores de riesgo asociados en pacientes con diabetes mellitus tipo 2. Métodos: estudio descriptivo, transversal y prospectivo, a 300 pacientes con diagnóstico de diabetes mellitus tipo 2, seleccionados mediante muestreo no probabilístico. Se aplicó ficha de identificación, y se realizó diagnóstico clínico y microbiológico de infección de vías urinarias. El análisis estadístico se realizó a través de razón de momios, intervalos de confianza y chi cuadrado, con el programa estadístico SPSS versión 17. Resultados: el porcentaje total de infección de vías urinarias fue de 17 por ciento, y se presentó 12,5 por ciento de bacteriuria asintomática y 38,4 por ciento de bacteriuria sintomática (p= 0,000; OR= 4,38; IC 95 por ciento 2,09-8,99). Se obtuvo una prevalencia de infección de vías urinarias de 6,5 por ciento para hombres y 22,8 por ciento para mujeres (p= 0,000; OR= 4,22; IC 95 por ciento 1,78-11,51). Escherichia coli se aisló en 68,6 por ciento, seguido de Klebsiella spp. en 13,7 por ciento. En relación con la sensibilidad a los antibióticos, E. coli presentó 74,3 por ciento de resistencia a la ciprofloxacina y 68,6 por ciento a la ampicilina. Conclusiones: E. coli y Klebsiella spp. fueron las bacterias de mayor prevalencia, con porcentajes altos de resistencia a la ampicilina y la cefalosporina, 2 de los antimicrobianos mayormente utilizados en estos procesos. De los factores de riesgo analizados, solo el sexo se asoció a infección de vías urinarias en el paciente diabético(AU)


Objectives: to determine the prevalence of urinary tract infection, antimicrobial resistance and associated risk factors in type 2 diabetes mellitus patients. Methods: prospective, descriptive and cross-sectional study conducted in 300 patients diagnosed with type 2 diabetes mellitus and selected by non-probabilistic sampling. The identification card was used and the clinical and microbiological diagnosis of urinary tract infection was performed. The statistical analysis used the SPSS statistical program version 17 through the odds ratio, the confidence intervals and the chi square test. Results: total percentage of urinary tract infection was 17 percent, asymptomatic bacteriuria reached 12.5 percent and symptomatic 38.4 percent (p= 0.000; OR= 4.38; IC 95 percent 2.09-8.99). The prevalence of urinary tract infection was 6.5 percent for men and 22.8 percent for women (p= 0.000; OR= 4.22; IC 95 percent 1.78-11.51). Escherichia coli was isolated in 68.6 percent of cases, followed by Klebsiella spp. in 13.7 percent. Regarding the antimicrobial resistance, E. coli exhibited 74.3 percent resistance to ciprofloxacin and 68.6 percent to ampicillin. Conclusions: E. coli and Klebsiella spp. were the preponderant bacteria with high percentages of resistance to ampicillin and to cephalosporin, two of the mostly used antimicrobials to control these processes. Sex was the only risk factor associated to urinary tract infection in the diabetic patient(AU)


Assuntos
Humanos , Masculino , Feminino , Infecções Urinárias/epidemiologia , Fatores de Risco , Diabetes Mellitus Tipo 2/diagnóstico , Bacteriúria/microbiologia , Infecções Urinárias/microbiologia , Epidemiologia Descritiva , Estudos Transversais , Interpretação Estatística de Dados , Estudos Prospectivos
12.
Arch. Inst. Cardiol. Méx ; 64(5): 439-44, sept.-oct. 1994. tab, ilus
Artigo em Espanhol | LILACS | ID: lil-188126

RESUMO

La mayoría de los especímenes biológicos para microscopía electrónica de barrido (MEB) carecen de conductividad eléctrica, requiriendo un recubrimiento con elementos conductores, para prevenirles del daño con el haz electrónico. En el presente trabajo, se combina el uso de la técnica Osmio-Tiocarbohidrazida-Osmio (OTO) con Peldri II y con hexametildisilazan (HMDS) como procedimientos alternativos para examinar miocardio por MEB. Examinamos el miocardio de ratas, fracturado y preparado para MEB. El corazón fue perfudido con bufffer de cacodilato y con glutaraldehido al 2.5 por ciento en el mismo buffer. Los fragmentos de tejido fueron removidos y fijados en inmersión por dos horas. El primer grupo se procesó con la técnica de rutina, tomándolo como control, el segundo grupo con la técnica OTO-PELDRI II y el tercero con OTO-HMDS. Todas las muestras fueron examinadas con un microscopio electrónico de barrido. Ambas técnicas permiten observar el micardio y sus elementos subcelulares como el núcleo, miofibrillas, mitocondrias. Sin embargo, la técnica OTO-PELDRI II permite conservar muy bien la estructura del miocardio, como sucede con la técnica de rutina. Los procedimientos descritos aquí, ofrecen alternativas en la preparación para mejorar el detalle en los especímenes biológicos para MEB.


Assuntos
Ratos , Animais , Terapias Complementares , Microscopia Eletrônica de Varredura/métodos , Miocárdio/citologia , Miocárdio/ultraestrutura , Ratos Wistar/embriologia
13.
Rev. cuba. enferm ; 5(3): 192-202, sept.-dic. 1989. tab
Artigo em Espanhol | LILACS, BDENF - Enfermagem | ID: lil-78388

RESUMO

Se realizó un estudio para demostrar la influencia que tienen determinados factores relacionados con la madre y el niño en la aparición de la anemia ferritiva mediante la aplicación de una encuesta a 50 madres de niños menores de 1 año diagnosticados con esta enfermedad y que son atendidos en el Hospital Provincial Pediátrico Docente "José Luis Miranda" de Villa Clara. Los datos se procesaron por tabulación manual y se presentaron en tablas estadísticas. Entre los antecedentes màs frecuentes se encuentran: la madre que durante el embarazo presentó anemia (50%) y el parto pretérmino (32%). Están presentes también la anemia en el período de recién nacido (26%), así como una inadecuada ablactaciòn (60%). En estos 2 últimos aspectos es donde màs incide la labor de enfermería, encaminada a lograr una correcta lactancia materna y ablactación del niño en el primer año de vida


Assuntos
Recém-Nascido , Lactente , Humanos , Masculino , Feminino , Anemia Hipocrômica/etiologia
14.
Recurso educacional aberto em Português | CVSP - Brasil | ID: cfc-181483

RESUMO

Maria Elena Martinez falou da educação a distância numa perspectiva intercultural. Na opinião da professora, é fundamental estabelecer o diálogo entre os diferentes saberes para construir um conhecimento integrado. "É preciso lidar e aprender a trabalhar com a interculturalidade, e o ensino a distância nos oferece ferramentas para construção de novas linguagens. Essa modalidade cria oportunidades de aprendizagem no nível coletivo e individual", afirmou. O arquivo está disponível para audição e/ou download por meio do ícone ao lado.

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