Precision and accuracy of pre-surgical planning of non-cemented total hip replacement with calibrated digital images and acetates.

BACKGROUND: When approaching a joint replacement procedure, pre-surgical planning is essential to predict an accurate estimation of implant size and position. There are currently two methods to achieve it, analog and digital. The present study aims to demonstrate how the hybrid technique is accurate and precise for pre-surgical planning in a non-cemented total hip replacement. METHODS: Concordance-type study is used against a gold standard, as well as inter- and intra-observer consistency evaluation of two orthopedic surgeons and two orthopedic surgery residents. Accuracy was calculated with the intra-class correlation coefficient (ICC). Afterwards, the same calculation was done considering a margin of error with one size more and one less. RESULTS: Thirty-eight patients were included in the study: 19 women and 19 men. Twenty-two prostheses (57.89%) were right-sided and 16 were left (42.11%). Twelve prostheses (31.57%) were Stryker and 26 Johnson & Johnson (68.43%). Acetabular cup correlation compared with the gold standard was moderate: ICC reported 0.45 (95% CI, 0.15-0.76). When adjusted by ± 1 size, ICC was 0.48 (95% CI, 0.18-0.79). On the other hand, results from the femoral stem reported ICC 0.85 (95% CI, 0.07-0.98). When adjusted by ± 1 size, ICC was 0.86 (95% CI, 0.06-0.99). CONCLUSIONS: Hybrid templating is a reliable substitute for analog or digital planning. It is quick, inexpensive, accurate, and better results are observed in the femoral component regardless the level of expertise of the evaluator. LEVEL OF EVIDENCE: Grade IV.

Porfirias agudas: manifestaciones inespecíficas y manejo terapéutico inespecíficas y manejo terapéutico específico / Acute porphyrias: non-specific manifestations and specific therapeutic management specific therapeutic management

Revisión clínica, científica, teórica y documental teniendo como objetivo principal realizar una revisión sobre la porfiria aguda, su enfoque, diagnóstico y tratamiento. Se utilizó una metodología descriptiva, cualitativa y teórica que permitió la revisión bibliográfica de los estudios relacionados con la porfiria aguda, trastorno congénito poco frecuente que causa alteraciones en las enzimas de la biosíntesis del grupo hem. La importancia de esta patología radica en que se confunde con otras enfermedades debido al cuadro clínico complejo difícil de identificar, lo que ocasiona un diagnóstico tardío que puede comprometer la vida del paciente y por ello se conoce como enfermedad silenciosa. Como conclusión se recomienda mayor atención a los factores precipitantes de los ataques agudos por la elevada morbimortalidad, así como hacer un diagnóstico rápido y oportuno por medios cualitativos y cuantitativos solicitando PBG (porfobilinógeno) y ALA (ácido delta aminolevulínico).

This was a clinical, scientific, theoretical and documental review aimed to conduct a revision on the approach, diagnosis and treatment of acute porphyria. A descriptive, quantitative and theoretical methodology was used, allowing a bibliographic review of the studies on acute porphyria, an unusual congenital disorder characterized by the deficiency of specific enzymes involved in the heme group biosynthesis. This disease importance lies on being confused with other conditions due to its complex clinical manifestations leading to a delayed diagnosis which may become life-threatening thus it is known as a silent disease In conclusion, identifying the precipitating factors of acute attacks for its high morbidity and mortality, as well as achieving a rapid and timely diagnosis by using a quantitative or qualitative determination of PBG (porphobilinogen)) and ALA (delta-aminolevulinic acid) levels, deserve special attention.

Prevalence of diabetes and hypertension in Colombia: A systematic review / Prevalencias de diabetes e hipertensión en Colombia: Una revisión sistemática / Prevalência da diabetes e hipertensão na Colômbia: uma revisão sistemática

Abstract Objective: To conduct a systematic review determining the prevalence of diabetes and hypertension among the adult population in Colombia. Methodology: A structured search was carried out in the electronic databases PubMed, SciELO and ProQuest, including studies published in Spanish and English from January 2000 to June 2016. Results: Four studies in hypertension and 2 in diabetes were selected. The overall prevalence of hypertension in the 4 selected studies ranged from 13.4% (95% CI:11.5-15.2) to 70.4% (95% CI no reported). The overall prevalence of diabetes in the 2 selected studies were 8.1(95% CI:6.8-9.5) and 8.9% (95% CI no reported). Conclusion: This review provides limited but useful evidence about the prevalence of two major noncommunicable diseases in Colombia. The results enhance the need of improving surveillance systems of risk factors of these diseases and standardizing methodological procedures for the estimation of prevalence studies.

Resumen Objetivo: Llevar a cabo una revisión sistemática de las prevalencias de diabetes e hipertensión en la población adulta colombiana. Metodología: Se llevó a cabo una búsqueda estructurada en las bases electrónicas PubMed, SciELO and ProQuest, la cual incluyó estudios publicados en español e inglés desde enero de 2000 a junio de 2016. Resultados: Cuatro estudios en hipertensión y 2 en diabetes fueron seleccionados. Las prevalencias generales de hipertensión tuvieron un rango de valores de 13,4% (IC95%:11,5-15,2) a 70,4% (no reportó el IC95%). Las prevalencias generales de diabetes en los 2 estudios fueron 8,1% (IC95%:6,8-9,5) y 8,9% (no reportó el IC95%). Conclusión: Esta revisión brinda evidencia limitada pero útil acerca de las prevalencias de dos enfermedades crónicas no-transmisibles en Colombia. Los resultados destacan la necesidad de mejorar los sistemas de vigilancia de factores de riesgo de estas enfermedades y estandarizar los procedimientos metodológicos para estimación de futuros estudios de prevalencia.

Resumo Objetivo: Efetuar uma revisão sistemática que determine a prevalência da diabetes e hipertensão na faixa etária adulta da Colômbia. Metodologia: se fez uma pesquisa estruturada nas bases de dados electrónicas PubMed, SciELO e ProQuest na qual se abrangeram os estudos publicados na língua espanhola e inglesa entre janeiro do 2000 e junho do 2016. Resultantes: se escolheram quatro estudos atinentes com a hipertensão e dois concernentes com a diabetes. A prevalência total da hipertensão nos quatro estudos escolhidos oscilou entre 13,4% (95% IC: 11,5-15,2) e 70,4% (95%, IC não reportado). No alusivo com a prevalência total da diabetes nos dois estudos escolhidos, o seu valor esteve entre 8,1% (95% IC: 6,8-9,5) e 8,9% (95%, IC não reportado). Conclusão: esta revisão fornece evidencia limitada porem útil no tocante com a prevalência de dois doenças não contagiantes de grande saliência na Colômbia. As resultantes acrescentam a necessidade de melhorar os sistemas da vigilância para os fatores de risco destas doenças e de padronizar os procedimentos metodológicos para a estimação dos estudos de prevalência.

Propuesta para la formación en Medicina Familiar y Comunitaria, desde la percepción, conceptualización y experiencia práctica de los enfoques de Salud Familiar / Proposal for training in Family and Community Medicine, from the perception, conceptualization and practical experience of Family Health approaches / Proposta de formação em Medicina Familiar e Comunitária, a partir da percepção, conceituação e experiência prática de abordagens de Saúde Familiar

Resumen La existencia de un Plan Decenal de Salud Pública para Colombia y la definición de una Política de Atención Integral en Salud concretaron un nuevo Modelo de Atención basado en la Atención Primaria de la Salud. Esto ubicó a la Salud Familiar y Comunitaria como núcleo fundamental y definió un rol al Médico y al Profesional Familiar y Comunitario, que dimensiona los procesos transdisciplinarios y la articulación de acciones individuales y colectivas, con esquemas pedagógicos holísticos transformadores. Este planteamiento generó un análisis y reflexión de la opinión de una muestra del 14,6% de los clasificados como Salubristas por el Observatorio Laboral del Ministerio de Educación quienes, con la respuesta a 13 preguntas enviadas por vía electrónica, libremente plantearon su percepción, conceptualización y experiencia práctica de los enfoques de Salud Familiar y Comunitaria. Con esta medición se definieron los contenidos básicos que se presentan en este documento con un nuevo enfoque transversal en el Pregrado y los Posgrados, de acuerdo con una propuesta pedagógica transformadora y con visión práctica, encontrándose aquí como destacable, la importante relación entre la educación y la salud integral; el concepto que en el 80% de las observaciones se expresó al denominar el poco compromiso de la comunidad y los profesionales de la salud con una "Cultura de la Salud Integralmente Concebida".

Abstract The existence of a Decennial Public Health Plan for Colombia and the definition of a Comprehensive Health Care Policy concretized a new Model of Care based on Primary Health Care. This placed Family and Community Health as a fundamental nucleus and defined a role for the Family and Community Physician and Practitioner, who dimension the transdisciplinary processes and the articulation of individual and collective actions, with transformational holistic pedagogical schemes. This approach generated an analysis and reflection of the opinion of a sample of 14.6% of those classified as Salubristas by the Labor Observatory of the Ministry of Education who, with the answer to 13 questions sent electronically, freely raised their perception, conceptualization and practical experience of Family and Community Health approaches. With this measurement the basic contents that are presented in this document with a new transversal approach in the Undergraduate and Postgraduates were defined, according to a pedagogical proposal transforming and with practical vision, being here like remarkable, the important relation between the education and integral health; the concept that in 80% of the observations was expressed when denominating the little commitment of the community and the professionals of the health with an "Culture of the Health Integrally Conceived".

Resumo A existência de um Plano de Saúde Pública de dez anos para a Colômbia ea definição de uma Política Integral de Saúde resultou em um novo Modelo de Cuidados Baseado em Atenção Primária à Saúde. Isso colocou a Familia e a Saúde Comunitária como um núcleo fundamental e definiu um papel para o Médico e o Profissional Familiar e Comunitário, que dimensiona os processos transdisciplinares e a articulação de ações individuais e coletivas, com esquemas pedagógicos transformadores holísticos. Esta abordagem gerou uma análise e reflexão da opinião de uma amostra de 14,6% das classificadas como Salubristas pelo Observatório do Trabalho do Ministério da Educação que, com a resposta a 13 questões enviadas eletronicamente, aumentou livremente sua percepção, conceituação e experiência prática de abordagens de saúde familiar e comunitária. Com esta medida, os conteúdos básicos apresentados neste documento foram definidos com um novo foco transversal em Estudos de Graduação e Pós-Graduação, de acordo com uma proposta pedagógica transformadora e com uma visão prática, sendo aqui a relação notável entre educação e saúde abrangente; o conceito de que em 80% das observações foi expressado chamando o pequeno compromisso da comunidade e os profissionais de saúde com uma "Cultura de Saúde Integralmente Concebida".

Social conditions and urban environment associated with participation in the Ciclovia program among adults from Cali, Colombia.

The Ciclovia program (CP) has emerged as an effective initiative to promote active living in urban spaces in Latin America. This study assessed the association between social conditions, the urban environment and participation in the CP among adults living in the city of Cali, Colombia. A cross-sectional study was conducted in 2011 and 2012 among 719 adults aged 18 to 44. Urban environment measures were obtained using Geographic Information Systems. A multilevel logistic regression was used for the analysis. Slightly more than 7% of participants had participated in the CP in the previous four weekends. Being male and having a high school degree were positively associated with participation in the CP. Participation in the CP was positively associated with living in neighborhoods with Ciclovia lanes. In contrast, a negative association was found among those living in neighborhoods with a presence of traffic fatalities. This study provides new insights about a recreational program that has potential health benefits in a region marked by urban inequalities in terms of opportunities for physical activity.

Social conditions and urban environment associated with participation in the Ciclovia program among adults from Cali, Colombia / Condiciones sociales y ambientes urbanos asociados con la participación al programa de Ciclovía en adultos en Cali, Colombia / Condições sociais e ambientes urbanos associados à participação no programa Ciclovia entre adultos em Cali, Colômbia

Abstract The Ciclovia program (CP) has emerged as an effective initiative to promote active living in urban spaces in Latin America. This study assessed the association between social conditions, the urban environment and participation in the CP among adults living in the city of Cali, Colombia. A cross-sectional study was conducted in 2011 and 2012 among 719 adults aged 18 to 44. Urban environment measures were obtained using Geographic Information Systems. A multilevel logistic regression was used for the analysis. Slightly more than 7% of participants had participated in the CP in the previous four weekends. Being male and having a high school degree were positively associated with participation in the CP. Participation in the CP was positively associated with living in neighborhoods with Ciclovia lanes. In contrast, a negative association was found among those living in neighborhoods with a presence of traffic fatalities. This study provides new insights about a recreational program that has potential health benefits in a region marked by urban inequalities in terms of opportunities for physical activity.

Resumen El programa de Ciclovía (PC) ha surgido como una iniciativa efectiva para promover actividad física en el contexto urbano de América Latina. Este estudio evaluó la asociación entre las condiciones sociales, el ambiente urbano y la participación en el PC en adultos que vivían en Cali, Colombia. Se llevó a cabo un estudio transversal en 2011 y 2012 en 719 adultos de 18 a 44 años. Se obtuvieron medidas del ambiente urbano utilizando Sistemas de Información Geográfica. Un poco más del 7% de las personas participaron en el PC en los últimos 4 fines de semana. Ser hombre y tener un nivel de escolaridad de secundaria se asoció positivamente con la participación en el PC. Así mismo, se encontró una asociación positiva con residir en barrios con existencia de corredores con este programa. Por el contrario, la existencia de muertes por accidentes de tránsito fue negativamente asociada. Este estudio brinda nuevos conocimientos acerca de un programa recreativo que tiene beneficios potenciales para la salud, en una región marcada por desigualdades urbanas relacionadas con actividad física.

Resumo O programa Ciclovia (PC) surgiu como uma iniciativa eficaz para promover a atividade física no contexto urbano da América Latina. Este estudo avaliou a associação entre as condições sociais, o ambiente urbano e participação no PC em adultos que vivem em Cali, Colômbia. Um estudo transversal foi realizado em 2011 e 2012, em 719 adultos com idades entre 18 e 44 anos. Medidas do ambiente urbano utilizando SIG foram obtidos. Pouco mais de 7% das pessoas participaram do PC nos últimos quatro finais de semana. Ser do sexo masculino e ter um nível de ensino médio foi positivamente associado com a participação no PC. Da mesma forma, uma associação positiva com residência em bairros com corredores existência desse programa foi encontrada. Pelo contrário , a existência de mortes no trânsito foi negativamente associado . Este estudo fornece novos conhecimentos sobre um programa de lazer que tem benefícios de saúde potenciais em uma região marcada por desigualdades urbanas em atividade física.

Perceived neighborhood environment and physical activity in 11 countries: do associations differ by country?

BACKGROUND: Increasing empirical evidence supports associations between neighborhood environments and physical activity. However, since most studies were conducted in a single country, particularly western countries, the generalizability of associations in an international setting is not well understood. The current study examined whether associations between perceived attributes of neighborhood environments and physical activity differed by country. METHODS: Population representative samples from 11 countries on five continents were surveyed using comparable methodologies and measurement instruments. Neighborhood environment × country interactions were tested in logistic regression models with meeting physical activity recommendations as the outcome, adjusted for demographic characteristics. Country-specific associations were reported. RESULTS: Significant neighborhood environment attribute × country interactions implied some differences across countries in the association of each neighborhood attribute with meeting physical activity recommendations. Across the 11 countries, land-use mix and sidewalks had the most consistent associations with physical activity. Access to public transit, bicycle facilities, and low-cost recreation facilities had some associations with physical activity, but with less consistency across countries. There was little evidence supporting the associations of residential density and crime-related safety with physical activity in most countries. CONCLUSION: There is evidence of generalizability for the associations of land use mix, and presence of sidewalks with physical activity. Associations of other neighborhood characteristics with physical activity tended to differ by country. Future studies should include objective measures of neighborhood environments, compare psychometric properties of reports across countries, and use better specified models to further understand the similarities and differences in associations across countries.

Patterns of neighborhood environment attributes related to physical activity across 11 countries: a latent class analysis.

BACKGROUND: Neighborhood environment studies of physical activity (PA) have been mainly single-country focused. The International Prevalence Study (IPS) presented a rare opportunity to examine neighborhood features across countries. The purpose of this analysis was to: 1) detect international neighborhood typologies based on participants' response patterns to an environment survey and 2) to estimate associations between neighborhood environment patterns and PA. METHODS: A Latent Class Analysis (LCA) was conducted on pooled IPS adults (N=11,541) aged 18 to 64 years old (mean=37.5±12.8 yrs; 55.6% women) from 11 countries including Belgium, Brazil, Canada, Colombia, Hong Kong, Japan, Lithuania, New Zealand, Norway, Sweden, and the U.S. This subset used the Physical Activity Neighborhood Environment Survey (PANES) that briefly assessed 7 attributes within 10-15 minutes walk of participants' residences, including residential density, access to shops/services, recreational facilities, public transit facilities, presence of sidewalks and bike paths, and personal safety. LCA derived meaningful subgroups from participants' response patterns to PANES items, and participants were assigned to neighborhood types. The validated short-form International Physical Activity Questionnaire (IPAQ) measured likelihood of meeting the 150 minutes/week PA guideline. To validate derived classes, meeting the guideline either by walking or total PA was regressed on neighborhood types using a weighted generalized linear regression model, adjusting for gender, age and country. RESULTS: A 5-subgroup solution fitted the dataset and was interpretable. Neighborhood types were labeled, "Overall Activity Supportive (52% of sample)", "High Walkable and Unsafe with Few Recreation Facilities (16%)", "Safe with Active Transport Facilities (12%)", "Transit and Shops Dense with Few Amenities (15%)", and "Safe but Activity Unsupportive (5%)". Country representation differed by type (e.g., U.S. disproportionally represented "Safe but Activity Unsupportive"). Compared to the Safe but Activity Unsupportive, two types showed greater odds of meeting PA guideline for walking outcome (High Walkable and Unsafe with Few Recreation Facilities, OR=2.26 (95% CI 1.18-4.31); Overall Activity Supportive, OR=1.90 (95% CI 1.13-3.21). Significant but smaller odds ratios were also found for total PA. CONCLUSIONS: Meaningful neighborhood patterns generalized across countries and explained practical differences in PA. These observational results support WHO/UN recommendations for programs and policies targeted to improve features of the neighborhood environment for PA.

Time spent traveling in motor vehicles and its association with overweight and abdominal obesity in Colombian adults who do not own a car.

OBJECTIVE: This study examined associations between time spent traveling in motor vehicles per week (TSTMV) and BMI and abdominal obesity (AO) among Colombian adults residing in urban areas who do not own car. METHOD: Secondary data analysis of the 2005 National Nutrition Survey of Colombia was conducted. TSTMV was assessed using the long International Physical Activity Questionnaire. Body composition was measured in 7900 adults. Polytomous and binary logistic regressions were conducted, stratified by gender and adjusted for confounders, including physical activity (PA). RESULTS: Forty-two percent of participants were either overweight or obese according to their BMI, and 22.4% had AO. Males in the middle (10 to 149 min) and highest (>150 min) TSTMV tertiles were more likely to be overweight (POR=1.58, 95% CI=1.13-2.21 and POR=1.55, 95% CI=1.12-2.15 respectively, p-trend=0.012), obese (POR=2.39, 95% CI=1.43-3.99 and POR=1.93, 95% CI=1.22-3.08 respectively, p trend=0.019) and to have AO (POR=1.81, 95% CI=1.18-2.78 and POR=1.73, 95% CI=1.18-2.54 respectively, p-trend=0.009). Associations were not significant in females. CONCLUSIONS: TSTMV was positively associated with overweight and AO in adult Colombian males even after adjusting for PA. These findings highlight the potential deleterious health effects of sedentary behaviors such as prolonged traveling time, independently of having met PA recommendations.

Leisure-time physical activity among women in a neighbourhood in Bogotá, Colombia: prevalence and socio-demographic correlates

O estudo mediu a prevalência de exercício físico em mulheres de 18 a 69 anos de idade e identificou correlatos sociais no bairro de Santa Fé, em Bogotá, Colômbia. Os níveis de atividade física foram calculados por meio de um estudo populacional com uma amostra de 1.045 mulheres. Um modelo de regressão logística identificou fatores associados com sedentarismo. De acordo com os resultados, 79,1 por cento das mulheres foram classificadas como inativas; 15,7 por cento relataram atividade física irregular e apenas 5,2 por cento praticavam exercícios físicos regularmente. Após o ajuste das covariáveis, a inatividade física estava associada com a falta de participação em atividades dominicais de lazer e com a falta de planos para perder peso. Os resultados do estudo demonstram a alta proporção de mulheres fisicamente inativas numa comunidade de baixa renda de Bogotá. Estratégias de intervenção devem ser desenvolvidas para reforçar os exercícios físicos promovidos nas áreas de lazer reservadas aos domingos pelo governo municipal de Bogotá.

Factores de riesgo cardiovascular en la localidad de Santa Fe de la ciudad de Bogotá. Resultados obtenidos en el área demostrativa Carmen / Cardiovascular risk factors in the locality of Santa Fe in the city of Bogotá. Results obtained in the demonstration area Carmen

Objetivo Determinar la prevalencia y características sociodemográficas asociadas de factores de riesgo cardiovascular en las población de 15 a 69 años de la localidad de Santa Fe, Distrito Capital de Bogotá, área demostrativa Carmen (Conjunto de Acciones para la Reducción Multifactorial de las Enfermedades no Transmisibles). Metodología Se determinó la prevalencia de factores de riesgo cardiovascular de tipo comportamental y biológico por medio de una muestra probabilística, multietápica a 2.002 individuos residentes en la localidad. La aplicación de un modelo de regresión logística permitió identificar los factores asociados con tener dos o más factores de riesgo. Resultados Los porcentajes de participación en los individuos seleccionados en la muestra para indicadores de comportamiento y biológicos, fueron del 97,8 y 52,4%, respectivamente. Con respecto a los factores de riesgo de comportamiento, el 65,8% de las personas eran inactivas físicamente en tiempo libre, 37,4% habían consumido más de 5 tragos de licor en los últimos 30 días y el 26,9% eran fumadores actuales. En factores de riesgo biológicos, el 20,4% eran hipercolesterolémicos, 16,7% tenían cifras tensionales elevadas y el 43,3% tenían sobrepeso u obesidad. Después del ajuste de covariables, la edad y el nivel de escolaridad tuvieron una asociación directa con la presencia de dos o más factores de riesgo. Conclusión Este estudio evidencia las altas prevalencias de factores de riesgo cardiovasculares de tipo comportamental y biológico en la localidad de Santa Fe. Si se tiene en cuenta el enfoque planteado en los Programas Carmen lo encontrado en ésta área demostrativa destaca la prioridad que debe tener el tema en la agenda pública de la ciudad.

Objective To determine the prevalence and associated sociodemographic characteristics of cardiovascular risk factors in the population aged 15 to 69 years in the locality of Santa Fe, Capital District of Bogota, demonstration area Carmen (Set of Actions for the Multifactorial Reduction of Noncommunicable Diseases). Methodology The prevalence of behavioral and biological cardiovascular risk factors was determined by means of a probabilistic, multistage sample of 2,002 individuals residing in the locality. The application of a logistic regression model made it possible to identify the factors associated with having two or more risk factors. Results The participation percentages in the individuals selected in the sample for behavioral and biological indicators were 97.8% and 52.4%, respectively. With respect to the behavioral risk factors, 65.8% of the individuals were physically inactive in their free time, 37.4% had consumed more than 5 drinks of liquor in the last 30 days and 26.9% were current smokers. In biological risk factors, 20.4% were hypercholesterolemic, 16.7% had elevated blood pressure and 43.3% were overweight or obese. After adjustment for covariates, age and level of schooling had a direct association with the presence of two or more risk factors. Conclusion This study evidences the high prevalences of behavioral and biological cardiovascular risk factors in the Santa Fe locality. If the approach proposed in the Carmen Programs is taken into account, what was found in this demonstration area highlights the priority that the subject should have in the public agenda of the city.

Intervenciones comunitarias para la promoción de hábitos alimentarios saludables: resultados de una revisión sistemática / Community interventions to promote healthy nutritional habits: results of a systematic review

Objetivo: identificar elementos técnicos de intervenciones comunitarias en hábitos alimentarios, susceptibles de ser implementados en el contexto de ciudades latinoamericanas. Metodología: se realizó una revisión sistemática de los estudios publicados desde 1990, enfatizando en la descripción del proceso y la evaluación de la efectividad de las intervenciones. Resultados: de 25 experiencias revisadas, 23 abordaron exclusivamente intervenciones en hábitos alimentarios y 3 restantes las combinaron con actividad física. Las teorías y modelos de comportamiento utilizadas para fundamentarlas fueron: teoría de influencias sociales (7), teoría cognitiva social (6), modelo transteórico (1), la combinación de la teoría cognitiva social y el modelo transteórico (3) y otras aproximaciones teóricas (3); cinco estudios no determinaron la teoría o modelo. Conclusiones: las intervenciones que lograron obtener un mayor efecto contaban con enfoque integral, definición clara de los objetivos, caracterización adecuada del problema, y participación de la comunidad en el diseño y definición de una etapa de mantenimiento. Se destaca la importancia de validar intervenciones en el contexto de los países latinoamericanos.

Gastritis: relación directa en la producción del cáncer gástrico / Gastritis: direct relationship in the production of gastric cancer

Hemos realizado esta revisión bibliográfica con la finalidad de definir y encasillar algunos conceptos acerca de esta enfermedad, que es muy frecuente en nuestra población, totalmente curable en manos de un médico experto, pero cuyas recaídas se presentan a menudo. Es necesario aclarar que la población en general confunde los términos gastritis, colitis nerviosa, etc., con cualquier sintomatología del abdomen se distorsionan estos conceptos. Se conoce como gastritis a la inflamación de la mucosa gástrica debido a la presencia de acidez. Puede ser aguda o crónica, con daño epitelial y vascular; es notable incluso su evolución y gran incidencia de cáncer gástrico debido a la presencia de esta patología...

Pie diabético: estudio clínico, epidemiológico y estadístico de casos en el Hospital Docente de la Policía Nacional Guayaquil-2 / Diabetic foot: clinical study, statistical epidemiologist and of cases in the Educational Hospital of the National Police Guayaquil-2

Realizamos un estudio bioestadístico de todos los pacientes que acudieron al Hospital de la Policía Nacional Guayaquil-2, que tenían Diagnóstico Pie Diabético. El objetivo de nuestro estudio, fue el obtener datos clínicos, epidemiológicos y socio culturales de esta patología, así como contribuir a buscar las causas y consecuencias, determinar sus características clínico-epidemiológicas, para así resaltar una patología que afecta física y emocionalmente a la diversidad de pacientes inmersos en esta enfermedad. Los resultados observados fueron, que el sexo masculino predominaba en un 70 por ciento, la edad tuvo su mayor incidencia entre los 45 y 50 años. El 71 por ciento de los pacientes eran hipertensos, en un 57 por ciento presentaban obesidad...

Cáncer de pene: reporte de un caso / Cancer of penis: report of a case

El cáncer de pene constituye el 2 por ciento de todos los cánceres urogenitales y en su mayoría son carcinomas epidermoides. Se diseminan por vía linfática, a las cadenas femorales e ilíacas. Son fácilmente visibles mediante la exploración física, debido a que son lesiones macroscópicas. Presentamos el caso de un hombre de raza negra de 59 años, al que se le diagnosticó carcinoma verrucoso del pene, y se le realizó posteriormente penectomía y linfadenectomía bilateral. Se concluye que el tratamiento se aplica de acuerdo al estadio del carcinoma teniendo en cuenta que el carcinoma verrucoso no es mortal ni diseminado y que en el caso presentado se obtuvo un buen pronóstico de vida, al realizar el tratamiento mencionado.

Medicion de la mortalidad por medio de una red de atencion primaria en salud / Mortality measuring through a primary health care network

Este trabajo plantea el subregistro y la discordancia de causas de defuncion en las muertes totales de un ano (1985-1986) del Valle del Cauca (Colombia) al comparar los sistemas rutinarios DANE de recoleccion y analisis de la estadistica de mortalidad (316 defunciones) con los que se generan al usar una red de atencion primaria extramural (355 defunciones) coordinada con agentes voluntarios y autoridades educativas y sanitarias. Se encontraron diferenciales estadisticamente significantes del subregistro segun edad, sitio de residencia y mes de la defuncion. Se destaca un gradiente en descenso de subregistro segun edad y la desaparicion del subregistro despues de 9 meses de la observacion con el caso de la red primaria. El subregistro encontrado en un ano de la observacion fue de 11%. Hubo discordancias en las causas basicas de defuncion principalmente en difuntos con diagnosticos relacionados con el sistema cardiovascular y casi una ausencia en difuntos con diagnosticos relacionados con cancer. Se observo una proporcion de causas discordantes de 26.6%. Se observo la capacidad de captacion de las defunciones por parte de las redes de atencion primaria (extramurales) y las bondades del conocimiento dia a dia de las defunciones en las instituciones de salud para la toma de decisiones tanto para aspectos educativos, administrativos y de mejoramiento de los servicios de salud