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1.
Ann Ig ; 34(2): 109-121, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35088820

RESUMEN

Background: COVID-19 pandemic, with its dramatic impact on society, poses a challenge to Health Pro-motion and to its principles of empowerment, social cohesion and citizens' democratic participation in health policies. In this pressing emergency, public health strategies aimed at preventing the spread of the pandemic have been primarily oriented towards restrictive measures (travel restrictions, use of PPE) in absence of an adequate educational communication, aimed at increasing citizens' knowledge and skills in regard to the emergency context. Aim: To offer a perspective on the Italian situation, in terms of health literacy and life skills in the context of COVID-19 pandemic, aimed not only at identifying deficits, but particularly at determining opportuni-ties and resources (assets) - offered by the peculiar context of crisis - useful to provide citizens with the necessary tools to comprehend the criticalities linked with the emergency and to shape their behaviour to new requirements, in absence of external obligations, as well as to promote future participation of the population - both effective and informed - in a social and political context. Methods: A non-systematic review of literature on the subject of health literacy and social cohesion in emergency contexts has been supported by a qualitative assessment, based on the model of assets and on the Italian condition in the last trimester of 2020. Results: The scarce ability of the population to independently adequate habits and behaviour to new criti-calities required by the risk of infection - as well as the necessity to suspend their empowerment and capa-bility from government authorities to protect public health - has been firstly traced back to a widespread lack of literacy and life skills at a general population level. The current situation of crisis offers a peculiar opportunity of tools, circumstances and receptiveness to highlight such deficits, as well as an intervention on multiple fronts, in order to increase literacy and capability, both on an individual and on a community level, through inclusive and sustainable initiatives. Conclusion: A prevention strategy based on the critical understanding of risk and risk-related criticalities is the only one which can aspire to last over time, while offering an effective tool for the safeguarding of public health, along with an opportunity of being prepared to contrast future emergencies more effectively. The development of such strategies represents one of the most significant contributions Health Promotion can offer in the time of Coronavirus.


Asunto(s)
COVID-19 , Alfabetización en Salud , Humanos , Pandemias/prevención & control , SARS-CoV-2 , Cohesión Social
2.
Health Promot Int ; 35(2): 187-195, 2020 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-31219568

RESUMEN

Aaron Antonovsky advanced the concept of salutogenesis almost four decades ago (Antonovsky, Health, Stress and Coping. Jossey-Bass, San Francisco, CA, 1979; Unravelling the Mystery of Health. Jossey-Bass, San Francisco, CA, 1987). Salutogenesis posits that life experiences shape the sense of coherence (SOC) that helps to mobilize resources to cope with stressors and manage tension successfully (determining one's movement on the health Ease/Dis-ease continuum). Antonovsky considered the three-dimensional SOC (i.e. comprehensibility, manageability, meaningfulness) as the key answer to his question about the origin of health. The field of health promotion has adopted the concept of salutogenesis as reflected in the international Handbook of Salutogenesis (Mittelmark et al., The Handbook of Salutogenesis. Springer, New York, 2016). However, health promotion mostly builds on the more vague, general salutogenic orientation that implies the need to foster resources and capacities to promote health and wellbeing. To strengthen the knowledge base of salutogenesis, the Global Working Group on Salutogenesis (GWG-Sal) of the International Union of Health Promotion and Education produced the Handbook of Salutogenesis. During the creation of the handbook and the regular meetings of the GWG-Sal, the working group identified four key conceptual issues to be advanced: (i) the overall salutogenic model of health; (ii) the SOC concept; (iii) the design of salutogenic interventions and change processes in complex systems; (iv) the application of salutogenesis beyond health sector. For each of these areas, we first highlight Antonovsky's original contribution and then present suggestions for future development. These ideas will help guide GWG-Sal's work to strengthen salutogenesis as a theory base for health promotion.


Asunto(s)
Predicción , Promoción de la Salud , Sentido de Coherencia , Estado de Salud , Humanos
3.
Ann Ig ; 30(3): 181-190, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29670987

RESUMEN

BACKGROUND: The Curitiba Statement of health promotion and equity is the main result of the World Conference on International Union for Health Promotion and Education (IUHPE - UIPES), held in May 2016 in Curitiba. The Curitiba Statement is the outcome of a participatory process, result of collaboration of all conference participants. The Curitiba Statement represents the continuity from Ottawa Charter for Health Promotion. This document remembers and asks to International Organizations, Governments, at all levels of the Institutions, the Health Sector, Citizens and Health Professionals and Researchers to change and eliminate all forms of discrimination and exclusion. STUDY DESIGN: Description of the translation and validation process. METHODS: The translation process from Spanish and English is based on the translation techniques enumerated by Fawcett in 1997: borrowing, calque, literal translation, transposition, modulation, reformulation, adaptation. RESULTS: The translation process produced some critical issues shifting from English to Italian: the most critical words and expressions correspond to the more significant ones of the Curitiba Statement, and these issues are reflected in research, politics and practice. In particular, we analyzed the translation of Inequity, Advocate, and Players, and then discussed their use in different expressions in the original text. CONCLUSION: Considering the Curitiba Statement's message has to be transversal, and it is addressed not only to Professionals but to all Citizens, researchers have made the choice of a clear translation for the Italian readers, not always similar to English form, but consistent and faithful in its content. To spread the culture and practice of Health Promotion, a deep attention in the translation of international documents could allow the propagation of ideas and strategies, from global to local.


Asunto(s)
Política de Salud , Promoción de la Salud/normas , Prejuicio/prevención & control , Justicia Social/normas , Salud Global , Disparidades en Atención de Salud , Humanos , Italia , Traducciones
4.
Ann Ig ; 23(1): 3-12, 2011.
Artículo en Italiano | MEDLINE | ID: mdl-21736002

RESUMEN

WHO stresses the importance of promoting balance diet among adolescents. The general practitioners are called at the forefront in the prevention of disorders related to eating habits. The present study describes a project to promote nutrition, created and run by general practitioners in the first classes of 20 secondary schools in seven municipalities, in the province of Carbonia-Iglesias (Italy), for a sample of 509 students (220 females and 289 males). The results also offer an expanded view of the eating habits of adolescents. The results show that adolescents do not give importance to the breakfast that is often not complete or is not consumed, and only 50% of respondents drink milk. The highest percentage of students consuming the first and second course (45-59%) at lunch and dinner consumption of protein was high ranging between 64 and 80% for lunch and dinner at 63 and 66%. That is evidenced by these results can be a valuable aid for future health promotion interventions.


Asunto(s)
Fenómenos Fisiológicos Nutricionales de los Adolescentes , Encuestas sobre Dietas , Conducta Alimentaria , Alimentos/estadística & datos numéricos , Médicos Generales , Estudiantes/estadística & datos numéricos , Adolescente , Índice de Masa Corporal , Conducta Cooperativa , Productos Lácteos/estadística & datos numéricos , Huevos/estadística & datos numéricos , Femenino , Frutas , Promoción de la Salud , Humanos , Italia/epidemiología , Masculino , Carne/estadística & datos numéricos , Obesidad/prevención & control , Sobrepeso/prevención & control , Población Rural/estadística & datos numéricos , Instituciones Académicas , Encuestas y Cuestionarios , Población Urbana/estadística & datos numéricos , Verduras
5.
Updates Surg ; 73(5): 1787-1793, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34100187

RESUMEN

To investigate the discrepancy between the distal resection margin (DRM) assessed by surgeons and pathologists, and the impact of neoadjuvant chemoradiotherapy (nCRT) on DRM. This study included 67 rectal cancer patients undergoing elective surgery. DRMs were assessed through four different techniques: in vivo subjective estimative, made by the surgeon before the rectal resection (by palpation and visual estimative); in vivo objective, measured with a ruler before the rectal transection; ex vivo objective, measured right after resection of the specimen; post-fixation objective measurement, conducted by the pathologist. The DRMs subjectively and objectively assessed by the surgeons were not significantly different (3.40 cm vs. 3.45 cm). There was a mean reduction in the length of DRMs of 35.6%, from 3.45 cm objectively measured by the surgeon to 2.20 cm measured by the pathologist. This difference was significant among patients that did not receive nCRT (3.90 cm vs. 2.30 cm, P < 0.001), but not among those who received nCRT (2.30 vs. 2.05 cm). Surgeons are accurate in assessing rectal cancer DRMs. There are significant differences between intraoperative measurements of DRMs and the final pathologic results. However, these differences are not seen when nCRT is used, a finding that may be useful when sphincter preservation is being considered.


Asunto(s)
Neoplasias del Recto , Cirujanos , Quimioradioterapia , Humanos , Márgenes de Escisión , Terapia Neoadyuvante , Patólogos , Neoplasias del Recto/cirugía , Resultado del Tratamiento
7.
J Prev Med Hyg ; 50(3): 191-5, 2009 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20411654

RESUMEN

UNLABELLED: OBJECTIVES. This study aims to assess the trend in initiation and cessation of smoking across successive birth cohorts, according to gender and education, in order to provide useful suggestion for tobacco control policy. STUDY DESIGN. The study is based on data from the "Health conditions and resort to sanitary services" survey carried out in Italy from October 2004 to September 2005 by the National Institute of Statistics. Through a multisampling procedure a sample representative of the entire national territory was selected. METHODS: In order to calculate trends in smoking initiation and cessation, data were stratified for birth cohorts, gender and education level, and analyzed through the life table method. RESULTS: The cumulative probability of smoking initiation, across subsequent generations, shows a downward trend followed by a plateau. This result highlights that there is not a shred of evidence to support the hypothesis of an anticipation in smoking initiation. The cumulative probability of quitting, across subsequent generations, follows an upward trend, highlighting the growing tendency of smokers to become an "early quitter", who give up within 30 years of age. CONCLUSION: Results suggest that the Italian antismoking approach, for the most part targeted at preventing the initiation of smoking emphasising the negative consequences, has an effect on the early smoking cessation. Health policies should reinforce the existing trend of "early quitting" through specific actions. In addition our results show that men with low education exhibit the higher probability of smoking initiation and the lower probability of early quitting, and therefore should be targeted with special attention.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Política de Salud , Promoción de la Salud , Cese del Hábito de Fumar/estadística & datos numéricos , Fumar/epidemiología , Adulto , Escolaridad , Femenino , Encuestas Epidemiológicas , Humanos , Italia/epidemiología , Masculino , Medición de Riesgo , Factores de Riesgo , Asunción de Riesgos , Factores Sexuales , Prevención del Hábito de Fumar , Mercadeo Social , Adulto Joven
8.
J Prev Med Hyg ; 60(4): E337-E342, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31967090

RESUMEN

BACKGROUND: High level of attendance by population is considered a proof of the efficacy in the screening programmes. Public health aims to increase people's attendance to cancer screening. The study aimed at assessing the level of knowledge and awareness about screening of citizens in Cagliari, from June to July 2016. METHODS: Recruitment took place near the atrium of the two main shopping centres of the city. The sample included 270 adults (138 men), 18-75 years old (mean age 46 years old). The information gathered from interviews were categorized by dichotomizing answers according to the knowledge and understanding of the discussed topics. Descriptive analysis was performed. The Chi-square test was used to assess gender and educational differences. RESULTS: Results show that population's knowledge of screening is limited. Although the word "screening" is known, only half of the people who declared to have heard of this word know about the aim of screening. Colorectal cancer screening is the least known. Men and people with lower education are less informed than women and those with high education level. CONCLUSION: In order to raise knowledge and awareness about cancer screening, special attention should be paid to communication and to the use of plain language. Future action should highlight the benefit of the screening procedure and thus contributing to spread the cancer prevention culture. Gender and socioeconomic inequalities must be taken into account when planning screening communication campaigns. General practitioner are highly trusted by people. They could play a decisive role to promote screening attendance.


Asunto(s)
Neoplasias de la Mama/diagnóstico , Neoplasias Colorrectales/diagnóstico , Detección Precoz del Cáncer , Conocimientos, Actitudes y Práctica en Salud , Neoplasias del Cuello Uterino/diagnóstico , Adolescente , Adulto , Anciano , Escolaridad , Femenino , Educación en Salud , Promoción de la Salud , Humanos , Italia , Masculino , Persona de Mediana Edad , Factores Sexuales , Adulto Joven
9.
J Epidemiol Community Health ; 61(2): 122-7, 2007 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-17234870

RESUMEN

OBJECTIVE: In Italy the law on industrial risk has emphasised the necessity of building a local information process to answer people's questions on safety and provide greater community participation in risk management. The aim of this research is to analyse the local population's ideas and expectations of a participatory approach in risk management in order to design a risk communication programme based on health promotion principles. DESIGN, SETTING AND PARTICIPANTS: The study was carry out in Portoscuso (Italy), an industrial district. A questionnaire was administrated through home interviews to 147 citizens. MAIN RESULTS: Six risk management styles were identified on the basis of citizens' trust in the different stakeholders. Additional parameters (importance of information, organisations they would trust to get information on industrial risks, preferred risk communication methodologies) were analysed according to the management styles. CONCLUSIONS: On the basis of these elements, a multi-approach strategy could be proposed. Each management style can have different roles. A programme of public forums could involve citizens with an interactive approach, interactive courses could involve citizens with a semi-participative approach, and leaflets and booklets could inform citizens oriented towards unidirectional communication. The participative process should always be open to new contributions from citizens who are not directly involved, and should allow for flexibility in the form and nature of partnership, as well as the details of implementation.


Asunto(s)
Actitud , Comunicación , Industrias , Salud Laboral , Accidentes de Trabajo/prevención & control , Adolescente , Adulto , Participación de la Comunidad , Femenino , Promoción de la Salud , Humanos , Italia , Masculino , Persona de Mediana Edad , Riesgo , Población Rural
10.
J Neurol ; 253(2): 208-13, 2006 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-16096810

RESUMEN

We examined the influence of alleles at the HLA loci, previously found to be associated with multiple sclerosis (MS) in Sardinia, on the clinical course of the disease in 835 relapsing (R) and 100 primary progressive (PP) patients. Multivariate analysis was carried out on predisposing 0301 or non-associated DPB1 alleles, susceptible or non-associated DRB1-DQB1 haplotypes, both predisposing and non-predisposing, and negatively and non-negatively associated D6S1683 alleles, taking interaction between them into account. Intra-patient analysis showed that the presence of the susceptible or protective D6S1683 allele interacting with predisposing DP 0301 modulated risk of PP disease. These findings suggest that a locus telomeric to HLA class I exerts an effect on alleles at the DPB1 locus in modulating disease course.


Asunto(s)
Cromosomas , Predisposición Genética a la Enfermedad , Antígenos HLA/genética , Esclerosis Múltiple/genética , Adolescente , Adulto , Anciano , Alelos , Niño , Intervalos de Confianza , Femenino , Frecuencia de los Genes , Genotipo , Antígenos HLA-DQ , Cadenas beta de HLA-DQ , Antígenos HLA-DR , Cadenas HLA-DRB1 , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Esclerosis Múltiple/clasificación , Análisis Multivariante , Oportunidad Relativa
11.
J Epidemiol Community Health ; 60(9): 799-803, 2006 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16905726

RESUMEN

STUDY OBJECTIVE: To assess how the prevalence of smokers in Italy from 1950 to 2000 has changed, in parallel with law development and the growing attention towards smoking prevention. DESIGN, SETTING, AND PARTICIPANTS: Historical data on smoking trends have been obtained using data collected in 2000 by the National Institute of Statistics. A correction coefficient is proposed to overcome the bias of differential mortality reported in other papers. The sample is made up of 102 261 people aged 15-69 years. MAIN RESULTS: A general downward trend is seen; there is a more pronounced decrease starting from 1975 to 1980. In both sexes the peak prevalence tends to decrease according to the birth cohort because of the earlier age in which they gave up. A partial exception to the decline of tobacco use in recent years may be made for the 15-19 year-old age group, which has remained stable since 1990. CONCLUSIONS: Although a comprehensive community programme against tobacco was not developed, the different prevention actions implemented in Italy have contributed to a change in attitude and behaviour. The effect of tobacco control strategies implemented in Italy until now is more evident in relation to the breaking of the smoking habit, which happens at an increasingly younger age, although it is not clear how much it is able to prevent people from starting smoking.


Asunto(s)
Cese del Hábito de Fumar/estadística & datos numéricos , Fumar/tendencias , Adolescente , Adulto , Anciano , Actitud Frente a la Salud , Estudios de Cohortes , Femenino , Conductas Relacionadas con la Salud , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Fumar/epidemiología
12.
Transplant Proc ; 37(1): 308-11, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-15808627

RESUMEN

The University of Wisconsin (UW) solution is the most commonly used preservation solution. However, a new preservation solution-IGL-1-contains an inversion of K and Na concentrations and substitution of polyethylene glycol for hydroxyethyl starch in the UW solution. The present study is the first clinical experience on the outcome of kidneys preserved in IGL-1 solution. From June 2003 to June 2004, 119 cadaveric kidneys were retrieved and stored in IGL-1 solutions; among the 119 organs, this study includes 37 IGL-1-preserved kidneys that were locally transplanted versus 33 kidneys stored in University of Wisconsin (UW) solution that were also locally transplanted. The groups were comparable with regard to donor and recipient characteristics. Renal function outcome was evaluated by comparing delayed graft function (DGF) rates, the evolution of serum creatinine, daily urine output, and creatinine clearance. Biopsies were performed after reperfusion to evaluate apoptosis. The incidence of DGF was 5.71% among IGL-1 kidneys and 13.79% among UW kidneys. Creatinine values were significantly lower among the IGL-1 group from 2 to 14 days postoperative and at 1 month. Daily urinary output did not show any significant differences between the two groups. IGL-1 kidneys had a superior creatinine clearance during the first 15 postoperative days compared to UW kidneys. Kidneys preserved in IGL-1 solution showed fewer apoptotic cells compared to kidneys preserved in UW solution. This preliminary report suggests a superiority of IGL-1 for the immediate outcome of transplanted kidneys.


Asunto(s)
Trasplante de Riñón/fisiología , Riñón , Soluciones Preservantes de Órganos , Adenosina , Adulto , Alopurinol , Cadáver , Femenino , Glutatión , Humanos , Insulina , Masculino , Polietilenglicoles , Potasio , Rafinosa , Sodio , Donantes de Tejidos , Resultado del Tratamiento
13.
Neurology ; 58(2): 283-8, 2002 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-11805258

RESUMEN

OBJECTIVE: To estimate the presence of familial aggregation and determine the contribution of genetic factors to familial clustering of MS in patients coming from Sardinia, a Mediterranean island considered a genetically homogeneous, isolated area having high disease incidence and prevalence. METHODS: Recurrence risk in siblings of 901 Sardinian patients and factors influencing risk (patient and sibling sex, patient age at onset, sibling birth cohort, and presence of affected relatives other than siblings) were examined. The presence of distant familial relationships among patients was evaluated by tracing the extended pedigrees of all patients with MS born in one Sardinian village. RESULTS: Twenty-three brothers and 36 sisters of the 2,971 siblings were affected with MS. Recurrence risk was greater in siblings of index patients with onset age less than 30 years (p < 0.01, increased risk 2.33 times) and having a relative with MS other than a sibling or parent (p < 0.01, increased risk 2.90 times). Pedigree analysis of patients from the village of L. showed that all 11 patients descended from 3 pairs of ancestors, whereas no cases occurred in the remaining 2,346 inhabitants. In descendants from the 3 couples, MS prevalence was dramatically greater than the regional average and 1.5 times greater than that observed in siblings of affected cases. CONCLUSIONS: Data from this study indicate that MS familial aggregation in Sardinians is influenced by genetic factors and that founder effect and the isolation of Sardinia can be considered causes of the enrichment of "etiologic" MS genes.


Asunto(s)
Efecto Fundador , Predisposición Genética a la Enfermedad , Tablas de Vida , Esclerosis Múltiple/genética , Adulto , Femenino , Humanos , Italia , Masculino , Esclerosis Múltiple/etiología , Núcleo Familiar , Linaje
14.
Thromb Haemost ; 83(1): 49-53, 2000 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-10669154

RESUMEN

The aims of this study were to investigate on the general adhesion of the patients to oral anticoagulant therapy, and particularly on the quality of life of our patients, the doctor-patient relationship and the Centre-patient relationship. For this purpose we administered a questionnaire containing 17 main questions each with a maximum of 4 secondary questions. The questionnaire was administered to two groups of 127 and 137 oral anticoagulated patients (127 males and 137 females, mean age 55 +/- 19 years), followed at two Anticoagulation Clinics, in two Italian cities, Cagliari (Sardinia) and Padua (North East Italy). The cities differed in the number of patients monitored and the management modalities of anticoagulation. The results show that oral anticoagulant therapy does not limit the life-style of the patients. Only 11% of the patients complain of limitations to their daily life. Fifty-two percent believe their health has improved, and 87% are not afraid of negative consequences. The doctor-patient relationship is considered very important by 96% of patients. Seventy-eight percent refer to the Anticoagulation Clinic also for other health problems, 93% consider it important to be assessed by the doctor at the Anticoagulation Clinic, while 83% believe the doctor should always hand out the results personally. We conclude that in general oral anticoagulant therapy is accepted by the majority of patients, in spite of the need for periodic monitoring. The doctor-patient relationship should be taken into account, even in the case of a monitored, computer-assisted method of dose-adjustment.


Asunto(s)
Anticoagulantes/administración & dosificación , Relaciones Médico-Paciente , Calidad de Vida , Tromboembolia/prevención & control , Tromboembolia/psicología , Administración Oral , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios
15.
Intensive Care Med ; 22(9): 947-53, 1996 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-8905431

RESUMEN

OBJECTIVE: To determine survival and changes in quality of life (QOL) after hospital discharge in patients who had stayed in an intensive care unit (ICU). DESIGN: Prospective study by direct interviews during ICU stay and 6 months after hospital discharge. SETTING: Surgical-medical ICU. PATIENTS AND METHODS: We interviewed cooperative, adult patients admitted consecutively to the ICU for more than 24 h, living near the hospital, who gave informed consent. The following QOL domains were investigated: residence, physical activity, social life, perceived QOL, oral communication and functional limitation. RESULTS: One-year survival was 82.4% (predicted 84%). Mortality was 36.3% after urgent neoplastic surgery, 19.4% for medical admissions and 4.9% after non-neoplastic surgery. Of 160 patients studied, eight cases, older and already deteriorated at the first interview, could not respond to the perceived QOL item after ICU discharge. In the other 152 patients, physical activity was reduced in 31% (usually slightly), social life had worsened in 32% and functional limitation increased in 30%. The perceived QOL did not change. CONCLUSIONS: After hospital discharge, the survival of ICU-admitted patients is comparable to that of the general population and not related to ICU treatments. Most patients maintain their physical activity and social status at the preadmission level. Any worsening, if present, is slight and does not influence perceived QOL.


Asunto(s)
Cuidados Críticos/psicología , Calidad de Vida , Actividades Cotidianas , Anciano , Actitud Frente a la Salud , Cuidados Críticos/normas , Femenino , Hospitales con más de 500 Camas , Hospitales de Enseñanza , Humanos , Relaciones Interpersonales , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Estudios Prospectivos , Encuestas y Cuestionarios , Análisis de Supervivencia
16.
Am J Trop Med Hyg ; 63(3-4): 192-8, 2000.
Artículo en Inglés | MEDLINE | ID: mdl-11388514

RESUMEN

The distribution of Hepatitis GB-C/HG (GB-C/HG) and TT viruses (TTV) infections was investigated in selected populations from Gabon using Polymerase Chain Reaction (PCR) and Enzyme Linked Immunosorbent Assay (ELISA) for anti-Envelop 2 (anti-E2) GBV-C/HGV antibodies. Among pregnant women, 29 of 229 (12.6%) were Hepatitis GB virus-C and Hepatitis G virus (GBV-C/HGV) RNA positive (+) and 32 of 81 (39.5%) anti-E2 + versus 8 of 39 (20.5%) TTV DNA +. Among sickle cell anemia patients, 9.7% (3/31) were GBV-C/HGV RNA + versus 22.5% (7/31) TTV DNA +. For tuberculosis patients, the figures were 11.5% (4/35) and 0%. A study of hepatocellular carcinoma cases (n = 27) versus controls (n = 66) did not show significant differences for GBV-C/HGV RNA (10.7% versus 12.1%) and TTV DNA (44.4% versus 30.3%). According to phylogenetic analysis, the 15 GBV-C/HGV strains investigated clustered in group 1, the most common in sub-Saharan Africa whereas TTV sequences (n = 4) mostly clustered in genotypes G1 and one close to genotype G3. In the Gabonese populations investigated, GBV-C/HGV and TTV infections were highly endemic. These data are consistent with the low pathogenicity of these agents.


Asunto(s)
Anticuerpos Antivirales/sangre , Infecciones por Virus ADN/epidemiología , Flaviviridae/inmunología , Hepatitis Viral Humana/epidemiología , ARN Viral/sangre , Torque teno virus/inmunología , Adulto , Anemia de Células Falciformes/virología , Transfusión Sanguínea , Carcinoma Hepatocelular/virología , Estudios de Casos y Controles , Preescolar , Ensayo de Inmunoadsorción Enzimática , Femenino , Flaviviridae/clasificación , Flaviviridae/genética , Gabón/epidemiología , Humanos , Neoplasias Hepáticas/virología , Masculino , Filogenia , Reacción en Cadena de la Polimerasa , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/virología , Prevalencia , Torque teno virus/clasificación , Torque teno virus/genética , Tuberculosis Pulmonar/virología , Proteínas del Envoltorio Viral/inmunología
17.
Drug Alcohol Depend ; 48(2): 119-26, 1997 Nov 25.
Artículo en Inglés | MEDLINE | ID: mdl-9363411

RESUMEN

The purpose of this study was to investigate the influence of the severity of concomitant psychiatric symptomatology on some selected measures of methadone maintenance treatment efficacy in a comprehensive methadone maintenance treatment program (MMTP). The cohort studied included 267 patients who entered a maintenance program in the years 1991-92. Two groups of patients differing in the severity of psychiatric symptomatology were obtained on the bases of the referral to the psychiatrist and the ascertainment of a current disorder. These two groups were compared for retention in treatment, urine tests positive for morphine while in treatment and methadone dose during an observation period of 2 years. The outcome of the study suggests that on these outcome parameters, patients on MMTP who are more psychiatrically ill can perform as well as the other patients.


Asunto(s)
Metadona/uso terapéutico , Narcóticos/uso terapéutico , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/rehabilitación , Adulto , Terapia Combinada , Trastorno Depresivo/complicaciones , Femenino , Humanos , Masculino , Escalas de Valoración Psiquiátrica , Psicoterapia , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Trastornos Relacionados con Sustancias/complicaciones
18.
Clin Lung Cancer ; 1(4): 277-85; discussion 286, 2000 May.
Artículo en Inglés | MEDLINE | ID: mdl-14733632

RESUMEN

Laser ablation (LA) is currently used in our institute as palliative treatment for endobronchial nonresectable or recurrent lung cancer. The objective of this study was to assess the impact of LA on the quality of life (QOL) in a large group of patients with endobronchial obstructions due to nonresectable or re-current lung cancer. Evaluation was based on Eastern Cooperative Oncology Group performance status (ECOG PS) for the "objective" assessment of QOL and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 version 1.0 (EORTC QLQ-C30(v1)) for the "subjective" assessment of QOL. From May 1994 to June 1997, 133 LAs were performed using neodymium: yttrium-aluminum garnet (Nd:YAG) laser at low power settings (< 30W) on 89 evaluable patients (Male/Female 78/11, mean age 63.5/62.8 years, range 42-82/47-73). The QOL was evaluated by ECOG PS and QLQ-C30(v1) at baseline (3 days before LA), t1 (7 days after LA), and t2 (1 month after LA). The objective tumor response was evaluated at t2. The objective tumor response to LA intervention was "excellent," ie, complete response (CR), in 33 (24.8%) patients and "fair," ie, partial response (PR), in 97 (72.9%) patients, with an overall response rate (ORR) of 97.7%. A highly significant decrease in high score (ECOG PS 3-4) was registered from baseline to t1 and from t1 to t2. However, at the same time a significant increase of low score (ECOG PS 0-2) was observed. The comparison of patient QOL assessment by QLQ-C30(v1) at different times during the study was also made; the functioning scales, the global QOL scale, and the symptom scales/items showed a highly significant improvement at t1 compared to baseline (P < 0.001), whereas only global QOL improved at t2 compared to t1. A comparison of baseline ECOG PS scale with QLQ-C30(v1) scale revealed a strong relationship between PS and the symptom "fatigue." Our study demonstrates that dramatic clinical improvement obtained by an effective though palliative treatment such as LA improves QOL based on both physician-rated (PS) and mostly self-rated (QLQ-C30(v1)) assessment.

19.
Oncol Rep ; 5(1): 273-80, 1998.
Artículo en Inglés | MEDLINE | ID: mdl-9458381

RESUMEN

A phase III, single-institution, open, prospective, randomized, parallel study was carried out on head and neck cancer patients to compare a combination of low-dose (20 mg q.i.d.) oral metoclopramide (M) + i.m. Dexamethasone (D) with an oral 5-HT3-Receptor Antagonist (5-HT3-RA) alone in the prevention of high-dose (HD > or = 80 mg/m2) cisplatin-induced delayed emesis. 51 consecutive patients, all but two with advanced stage of disease, were treated for a total of 198 chemotherapic cycles: 23 patients entered Group A (5-HT3-RA) receiving a total of 108 cycles, 28 patients entered Group B (M + D) receiving a total of 90 cycles. The treatment groups were well matched for age, sex (almost all patients were males), ECOG PSR, stage of disease and alcohol intake. The efficacy of M + D was significantly higher than that of 5-HT3-RA in achieving complete protection (CR 88.9% vs 72.2%, chi2 9.9, p = 0.002) and major efficacy (ME: CR + MR) (94.5% vs 85.2%, chi2 5.6, p = 0.02). Generally, for both treatments (5-HT3-RA and M + D) a good control of delayed emesis was achieved in patients who had complete protection on acute emesis. A good control of acute emesis had a highly positive predictive value of delayed emesis for both treatments without significant difference between them (CR 85% for M + D and 82% for 5-HT3-RA; ME 88% for M + D and 92% for 5-HT3-RA). The failure (F) on acute emesis had a significantly higher negative predictive value of delayed emesis for M + D (98%) than 5-HT3-RA (67%). Our study is, to our knowledge, the first comparing M + D vs one 5-HT3-RA alone in the prevention of HD cisplatin-induced delayed emesis in a properly designed clinical trial. Our results show that M + D are more effective than 5-HT3-RA alone in the prevention of HD cisplatin induced delayed emesis, whereas 5-HT3-RA may be the treatment of choice in patients who had acute vomiting. Our study demonstrated not only the persistence of antiemetic efficacy but also increasing efficacy, during subsequent courses. Our results confirm that protection from acute emesis plays a major role in the appearance and control of delayed emesis.


Asunto(s)
Antieméticos/uso terapéutico , Cisplatino/efectos adversos , Dexametasona/uso terapéutico , Neoplasias de Cabeza y Cuello/tratamiento farmacológico , Metoclopramida/uso terapéutico , Receptores de Serotonina/fisiología , Antagonistas de la Serotonina/uso terapéutico , Administración Oral , Adulto , Anciano , Antieméticos/administración & dosificación , Dexametasona/administración & dosificación , Femenino , Granisetrón/administración & dosificación , Granisetrón/uso terapéutico , Neoplasias de Cabeza y Cuello/patología , Humanos , Indoles/administración & dosificación , Indoles/uso terapéutico , Inyecciones Intramusculares , Masculino , Metoclopramida/administración & dosificación , Persona de Mediana Edad , Estadificación de Neoplasias , Ondansetrón/administración & dosificación , Ondansetrón/uso terapéutico , Estudios Prospectivos , Receptores de Serotonina 5-HT3 , Antagonistas de la Serotonina/administración & dosificación , Tropisetrón , Vómitos/inducido químicamente , Vómitos/prevención & control
20.
Physiol Behav ; 34(5): 671-5, 1985 May.
Artículo en Inglés | MEDLINE | ID: mdl-4034705

RESUMEN

The effects of the oral administration of thyroid hormones on the hippocampal glial cells in fasting or fed adult rats were studied. The hormone treatment and/or fasting were done during two periods of five days interpolated by ten days without any hormone treatment or fasting. Prominent histological changes and increased number of glial cells were observed in the hippocampus of rats when the thyroid hormone administration was associated with fasting.


Asunto(s)
Ayuno , Hipocampo/efectos de los fármacos , Neuroglía/efectos de los fármacos , Tiroxina/farmacología , Triyodotironina/farmacología , Animales , Barrera Hematoencefálica , Recuento de Células , Oligodendroglía/efectos de los fármacos , Ratas , Ratas Endogámicas
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