Comportamiento de algunos indicadores del Programa Materno Infantil en Campechuela durante los años 1980-2018 / Behavior of some indicators of the Maternal and Child Program in Campechuela during the years 1980-2018 / Comportamento de alguns indicadores do Programa Materno Infantil em Campechuela durante os anos 1980-2018

RESUMEN Introducción: el Programa Materno Infantil es un programa muy sensible en el sector de la salud ya que declara la atención integral tanto a la embarazada, a la madre, al niño y al adolescente. Las tasas de mortalidad fetal, en menores de un año y el bajo peso al nacer son indicadores que reflejan las condiciones de vida de la mujer; la morbilidad subyacente y la calidad de vida de una sociedad. Objetivo: determinar el comportamiento de estos dos indicadores en el municipio de Campechuela durante los años 1980 a 2018, período de 39 años. Métodos: se realizó un estudio observacional descriptivo, retrospectivo. El universo comprendió todos los nacimientos en Campechuela en los años de estudio, las muertes en menores de 1 año, las muertes fetales y el bajo peso al nacer. Se representaron los resultados expresados en frecuencias absolutas, frecuencias relativas y tasas. Mediante el empleo de las técnicas de la estadística descriptiva, Resultados: la natalidad ha disminuido a lo largo del período en estudio con variaciones en el tiempo, la tasa de mortalidad infantil ha tenido una disminución considerable, no siendo así, el bajo peso que han tenido fluctuaciones, y las defunciones fetales se ha comportado de forma desfavorable, los resultados permiten valorar que hay que intensificar aún más el control y seguimiento a este grupo priorizado, e incrementar las pesquisa de los factores de riesgo que conllevan a estos indicadores no favorables. Conclusiones: los indicadores del Programa Materno Infantil miden la calidad de vida de una nación, a pesar de todas las estrategias tomadas por el Ministerio de Salud Pública existen algunos resultados que hay que revertir como las muertes fetales, por lo que se requiere de más trabajo desde la Atención Primaria de Salud haciendo énfasis en la promoción y la prevención, trabajar con intención los protocolos de actuación en dicho programa.

ABSTRACT Introduction: the Maternal and Child Program is a very sensitive program in the health sector since it declares comprehensive care for pregnant women, mothers, children and adolescents. Fetal mortality rates in children under one year of age and low birth weight are indicators that reflect the living conditions of women; the underlying morbidity and quality of life of a society. Objective: to determine the behavior of these two indicators in the municipality of Campechuela during the years 1980 to 2018, a period of 39 years. Methods: a retrospective, descriptive, observational study was carried out. The universe included all the births in Campechuela in the study years, deaths in children under 1 year of age, fetal deaths and low birth weight. The results expressed in absolute frequencies, relative frequencies and rates were represented. Through the use of descriptive statistics techniques, Results: the birth rate has decreased throughout the period under study with variations over time, the infant mortality rate has had a considerable decrease, not being the case, the low weight that has fluctuated, and fetal deaths have behaved in a different way. In an unfavorable way, the results allow us to assess that it is necessary to further intensify the control and monitoring of this prioritized group, and to increase the investigation of the risk factors that lead to these unfavorable indicators. Conclusions: the indicators of the Maternal and Child Program measure the quality of life of a nation, despite all the strategies taken by the Ministry of Public Health there are some results that must be reversed, such as fetal deaths, so more work is required from Primary Health Care, emphasizing promotion and prevention, working with intention the protocols of action in said program.

RESUMO Introdução: o Programa Materno-Infantil é um programa muito sensível no setor saúde, pois declara o atendimento integral a gestantes, mães, crianças e adolescentes. As taxas de mortalidade fetal em menores de um ano e o baixo peso ao nascer são indicadores que refletem as condições de vida das mulheres; a morbidade subjacente e a qualidade de vida de uma sociedade. Objetivo: determinar o comportamento desses dois indicadores no município de Campechuela durante os anos de 1980 a 2018, um período de 39 anos. Métodos: foi realizado um estudo retrospectivo, descritivo e observacional. O universo incluiu todos os partos em Campechuela nos anos de estudo, óbitos em crianças menores de 1 ano, óbitos fetais e baixo peso ao nascer. Os resultados expressos em frequências absolutas, frequências relativas e taxas foram representados. Por meio do uso de técnicas de estatística descritiva, Resultados: a taxa de natalidade diminuiuao longo do período de estudo com variações ao longo do tempo, a taxa de mortalidade infantil diminuiu consideravelmente, não sendo o caso, o baixo peso que tem flutuado, e os óbitos fetais têm se comportado de forma diferente. De forma desfavorável, os resultados permitem avaliar que é necessário intensificar ainda mais o controle e monitoramento desse grupo priorizado, e aumentar a investigação dos fatores de risco que levam a esses indicadores desfavoráveis. Conclusões: os indicadores do Programa Materno Infantil medem a qualidade de vida de uma nação, apesar de todas as estratégias do Ministério da Saúde Pública existem alguns resultados que devem ser revertidos, como os óbitos fetais, por isso é necessário mais trabalho Atenção Primária à Saúde, com ênfase na promoção e prevenção, trabalhando intencionalmente os protocolos de ação desse programa.

Evaluation of dyslipidemia in normal and underweight diabetics patient and its association with BMI and gender

Objectives: To assess the frequency of dyslipidemia in type II diabetes mellitus in normal and underweight patients. Material and methods: This cross sectional study was conducted at Basic Health Unit, Manzabta District Okara. Total 218 type II diabetics having age 30-70 years either male or female, having BMI 15 to 24.99 were selected for this study. Five ml fasting blood sample was taken and sent to laboratory for lipid profile. Results: In present study total 218 type 2 diabetics were selected. Mean age of the patients was 48.33 ± 13.85 years, mean weight was 52.66 ± 8.63 Kg, mean height was 61.54 ± 2.46 inches and mean BMI was 22.73 ± 2.45. Out of 218 diabetics, dyslipidemia was noted in 152 (70%) patients.Total 163 (74.77%) patients were normal weight and 55 (25.23%) patients were under weight. Dyslipidemia was noted in 140 (85.9%) normal weight patients and 12 (21.8%) underweight patients. Significantly (P = 0.000) higher rate of dyslipidemia was noted in normal weight patients as compared to underweight patients. Conclusion: In present study, higher rate of dyslipidemia was noted in type II diabetics. There were not association of dyslipidemia with age and gender. But highly significant association of dyslipidemia with normal and underweight was noted.

Efectividad de intervención educativa en conocimientos de embarazadas sobre factores de riesgo maternos de bajo peso al nacer / Effectiveness of educational intervention in knowledge of pregnant women on maternal risk factors of under weight to be born

Introducción: el bajo peso al nacer guarda relación con la morbilidad, mortalidad y bienestar del binomio madre-hijo, el desconocimiento sobre sus factores de riesgo requiere de intervenciones educativas en las gestantes. Objetivo: evaluar la efectividad de intervención educativa en el nivel de conocimientos de embarazadas sobre factores de riesgo maternos de bajo peso al nacer. Métodos: estudio de intervención educativa con diseño preexperimental, con pre y post-test en gestantes del Policlínico Felipe Poey Aloy en Nueva Paz, Mayabeque, de abril 2013 hasta junio 2014. Universo de 32 gestantes con tiempo gestacional inferior a 26 semanas y factores maternos asociados, se aplicó un cuestionario inicial, se implementó la intervención y se evaluó su efectividad. Se utilizaron distribución de frecuencia absoluta y valor porcentual, la comparación de proporciones se realizó mediante medida de resumen para variables cualitativas. Se calculó la razón de las variables dependientes explicada por las diferencias entre los grupos. Resultados: el nivel de conocimientos sobre la edad óptima para el embarazo, el peso adecuado y la alimentación apropiada antes de la intervención eran insuficientes en 68,75 por ciento, 84,37 por ciento y 53,12 por ciento respectivamente, después de la intervención se elevó en 100 por ciento, 87,50 por ciento y 84,37 por ciento. Los conocimientos sobre las enfermedades maternas asociadas y los suplementos vitamínicos que se deben ingerir eran deficitarios en 59,37 por ciento y 62,50 por ciento elevándose en 68,75 por ciento y 90,62 por ciento en cada caso. Conclusiones: la intervención educativa fue efectiva en la modificación del nivel de conocimientos sobre factores de riesgo maternos de bajo peso al nacer de las embarazadas estudiadas(AU)

Introduction: Low birth weight is related to morbidity, mortality and welfare of mothers and children, the lack of knowledge about their risk factors requires educational interventions in pregnant women. Objective: evaluating the effectiveness of educational intervention in the level of knowledge of pregnant women on maternal risk factors of underweight when being born. Methods: study of educational intervention with pre experimental pre-test post-test in pregnant Polyclinic Felipe Poey Aloy" in Nueva Paz, Mayabeque, from April 2013 to June 2014. Universe less than 32 pregnant women with gestational time design with and 26 weeks and associated maternal factors, an initial questionnaire was applied, the intervention was implemented and its effectiveness was evaluated. Distribution of absolute frequency and percentage value was used; the comparison of proportions was performed using summary measure for qualitative variables. The reason for the dependent variables explained by differences between groups was calculated. Results: the level of knowledge on the optimal age for pregnancy, the adequate weight and the nutrition adapted before intervention were insufficient in 68.75 percent, 84.37 percent and 53.12 percent respectively, after intervention rose in 100 percent, 87.50 percent and 84.37 percent. The knowledge on the maternal correlated diseases and the vitamin supplements that should be taken in were showing a deficit in 59.37 percent and 62.50 percent rising in 68.75 percent and 90.62 percent in each case. Conclusions: the educational intervention was effective in the modification of the level of knowledge on maternal risk factors of underweight to be born of the studi ed pregnant women(AU)

Algunas causales relacionadas con caídas en el hogar del adulto mayor / Some causes related to falls in the home of the elderly

Introducción: dentro de los grandes síndromes invalidantes en el adulto mayor se encuentran las caídas, las cuales son causa de atención y de estudio por el aumento de casos reportados. Objetivo: identificar algunas causales responsables en las caídas en el adulto mayor en el hogar. Métodos: se realizaron encuestas con el consentimiento informado, la población estuvo conformada por 1 903 adultos mayores de ambos sexos asistidos en consulta de fisiatría, y cuya muestra intencional lo conformaron 632 pacientes caídos en el hogar, constituyendo el 33,2 %. Resultados: hubo un predominio de caídas en el sexo femenino, por otra parte las fracturas de cadera fue la secuela que más predominó y sobre todo en el sexo femenino. Dentro de los factores extrínsecos, las caídas en baños peligrosos fueron las causantes más frecuentes y más del 50 % en los pacientes que no practican ninguna actividad física. Conclusiones: el trabajo realizado permitió identificar causales, constatar la atención del Sistema de Salud del área y desarrollar acciones para una mejor calidad de vida en el adulto mayor.

Introduction: low underweight when being born is the most important index to determine the possibilities of the newly born one to survive and to have a growth and normal development, one of the main current obstetric problems constitutes because it is related with more than 75 % of the perinatal morbimortality Objective: determiner the incidence and the main factors of risk associated to the first floor weight in San Antonio of the Bathrooms Method: he/she was carried out a retrospective descriptive observational study in the newly born ones with underweight when being born of the municipality of San Antonio of the Bathrooms, county Artemisia Cuba, the period of January to December of the 2013.El universe was constituted by 564 newly born alive and the sample for 29 with underweight when being born, it was identified prenatal factors that could constitute possible causes of the first floor weight. Results: the incidence of the first floor weight when being born in the year 2013 in San Antonio of the Bathrooms was of 5,9.El 58,62 % of the low pesos 37 of gestation they were born before the week. The most represented maternal age went from 20 to 34 years with 62, 06 %. The vaginal sepsis was present in 51, 80 % of the mothers with newly born under weight. Conclusions: the prematurity was the most frequent cause of newly born under weight when being born, the extreme ages of the reproductive life didn't constitute cause of underweight when being born, the vaginal sepsis and the arterial hypertension are outstanding factors of risk in the mothers with children under weight.

Indicadores del bajo peso al nacer en el área de salud del Policlínico Docente "José Martí Pérez" durante un quinquenio / Low birth weight indicators in the health area from "José Martí Pérez" Teaching Polyclinic during a five-year period

Se realizó un estudio descriptivo de los 252 nacidos con bajo peso pertenecientes al área de salud del Policlínico Docente "José Martí Pérez" de Santiago de Cuba, durante el quinquenio 2007-2011, a fin de caracterizarles y determinar cómo se manifestó el bajo peso al nacer en ellos. Se incluyeron las variables: índices de bajo peso al nacer, peso al nacer, distribución y fallecidos según sus formas clínicas, mortalidad del nacido con peso menor de 2 000 g y su supervivencia, causa del nacimiento pretérmino e indicaciones médicas. En la serie el índice de bajo peso aumentó de 6,9 en 2007 a 7,1 en el 2011, predominó como forma clínica el crecimiento intrauterino retardado, la preeclampsia grave fue el diagnóstico médico más frecuente y el mayor número de fallecidos correspondió al grupo con peso menor de 2 000 g. De igual manera, se logró un incremento en la supervivencia de estos recién nacidos, en directa relación con la mejoría ostensible de los indicadores en el período.

A descriptive study of the 252 underweight newborns belonging to the health area from "José Martí Pérez" Teaching Polyclinic in Santiago de Cuba was carried out during the five year period 2007-2011, in order to characterize them and to determine how the low birth weight was shown in them. The variables: low birth weight indexes, birth weight, distribution and deaths according to their clinical forms, mortality of the newborn with weight lower than 2 000 g and their survival, causes of the preterm birth and medical indications were included. In the series the underweight index increased from 6.9 in 2007 to 7.1 in 2011. Delay intrauterine growth prevailed as clinical form, severe preeclampsia was the most frequent medical diagnosis and the highest number of deaths corresponded to the group with weight under 2 000 g. In the same way, an increment in the survival of these newborns was achieved, in direct relation to the ostensible improvement of the indicators in the period.

Body mass index among patient with chronic obstructive pulmonary diseases.

Body mass index (BMI) is one of the important parameter to assess functional status of patients with Chronic Obstructive Pulmonary Disease (COPD). The aim of present study was to assess the prevalence of underweight among clinically stable COPD patients and relationship of BMI with increasing severity of COPD. COPD was defined as a subject who had post-bronchodilator FEV1/FVC < lower limit of normal, age more than 40 years and either current or ex smoker. Spirometry data of 7412 subjects were retrospectively analyzed and 1269 COPD patients and 1202 bronchial asthma patients were identified. The severity of airflow obstruction was classified as per GOLD guideline. The BMI of each patient was calculated from weight and height. The BMI of COPD patients were compared with bronchial asthma. The average BMI of COPD patients and bronchial asthma patients were 20.2±4.3 kg/m2 and 23.2±5.4 kg/m2 respectively. Overall, 38 % COPD patients were underweight (BMI<18.5 kg/m2) and irrespective of severity of the disease, proportion of underweight COPD patient was significantly more as compared to bronchial asthma patients (P<0.001). The mean BMI also reduces significantly with progression of COPD severity.

Perception of weight and weight management practices among students of a tertiary institution in south west Nigeria.

The study focuses on young adults’ perception of their weight and their management of perceived weight problems. Participants (N = 200) were medical and pharmacy undergraduates in a tertiary institution. Their weights, heights, hip to waist ratio and hip circumference were measured. A questionnaire was administered to assess their weight perception and examine self management of their perceived weight problems. More than half (65.5%) of students surveyed were within normal BMI weight range, but there was a significant difference between actual weight and perception of weight. The actual prevalence of weight problems (underweight, overweight and obese) was 34.5% and drug use in weight management was also low (9%). The females were more concerned about losing extra weight than males. They used Xenical® (orlistat), Green world® (chitosan and pro-slim tea), Xenadrine® ( green tea, caffeine and capsaicin) and Lipo6® fat burner pills, which are all weight loss drugs. From the study, it can be concluded that this population has relatively healthy weight, as more respondents have normal weight than underweight, overweight and obese students. However, there was significant distortion in weight perception.

Relationships of Mental Disorders and Weight Status in the Korean Adult Population

The purpose of this study was to evaluate the associations between weight status and mental disorders, including depressive disorder, anxiety disorder and alcohol use disorder. A total of nationally representative 6,510 subjects aged 18-64 yr was interviewed in face-to-face household survey. Response rate was 81.7%. Mental disorders were diagnosed using the Korean version of the Composite International Diagnostic Interview (K-CIDI). The subjects reported their heights and weights. After adjusting for age and gender, the lifetime diagnosis of depressive disorder had a significant association with only the underweight group (odds ratio [OR], 1.68, 95% confidence interval [CI], 1.19-2.38). The association between underweight and depressive disorder was the strongest for subjects with a high education level (OR, 1.75, 95% CI, 1.2-2.56), subjects with a married/cohabiting status (OR, 1.94, 95% CI, 1.17-3.22) and smokers (OR, 2.58, 95% CI, 1.33-4.98). There was no significant association between obesity and depressive disorder in Korea. But there was a significant association between the underweight group and depressive disorder. The relationship between obesity and mental disorder in a Korean population was different from that in a Western population. These results suggest that the differences of traditional cultures and races might have an important effect on the associations between the weight status and mental disorders.

A STUDY ON THE BLOOD CONSTITUENTS AND PHYSICAL FITNESS OF UNDER-WEIGHT ELEMENTARY SCHOOLBOYS / 体力科学

The present study was done to elucidate the medical problems and physical fitness of under-weight elementary schoolboys. Eighty nine volunteers, ranging in age from 9 to 12 yrs, were divided into five groups based on the grade of obesity, expressed as % of the standard, taking into account height, age and sex.<BR>The mean grade of obesity for under-weight boys was -12 %, and this group was defined as the experimental group (group I; n=15) . The group III, which contained 23 boys of grade 0 %, and the group V made of 13 boys of grade +33.5 % was defined as the normal control and obese control, respectively.<BR>The measurement of blood pressure, EKG recording, and blood sampling were done in the state of fasting before and after exercise. The exercise was a step test of 5 min duration with a temp of 1 step per 2 seconds, jumping over a bench 25 cm high for 9 years old boys, and 33 cm high for boys of 10 to 12 years. The step test score (PFI) and recovery rate of heart rate (RR (HR) ) were calculated from the EKG. The test battery of physical fitness performance was also done on another experimental day.<BR>The serum levels of total cholesterol (TC), triglyceride (TG), total protein (TP) and hemoglobin (Hgb) were lower in experimental group (EG) than in control groups (CG) . The cholesterol-HDL/TC ratio was conversely higher in EG than in CG. There were no significant differences in the other biochemical measurements between the five groups.<BR>Any abnormal EKG was not recorded before and after exercise throughout the subjects. The frequency of hypertension (above the 135/80 mmHg) was 10.2 % at pre-exercise time. But, none of the boys in EG was found to be hypertensive.<BR>The PFI and physical fitness performance test score showed no differences between EG and group III, however, the score of group V was inferior to that of EG and/or group III. The RR (HR) in EG and over-weight group was lower compared to that for the average-weight boys.<BR>Almost all components in blood measured were elevated after exercise in all the groups. The finding of the highest interest of the exercise-induced elevations of blood constituent levels was an increase in WBC measured as an indicator of stress. The magnitude of increase in WBC (ΔWBC) was higher in EG and the over-weight group than in the average-weight group. In normal subjects, ΔWBC was generally proportional to the work intensity, which, in the present exercise, depended upon the stature and body weight, because the height of bench, tempo and duration of exercise were same for all groups. The work intensity in EG was presumed milder, becasue the mean stature was slightly taller and bodyweight was less heavy compared to those in control groups. But, the greater increase of WBC in EG was observed in spite of a lighter work intensity. According to the Selye's literature, the particular WBC reaction to exercise in the under-weight boys was interpreted as a over-reaction to stress in the state of malnutrition.<BR>From some biochemical parametors, the leaner subjects were assumed to be in a slight malnutrition. And also a later recovery of HR and over-reaction to exercise stress were shown in the under-weight boys group.<BR>It is emphasized that the malnutrition resulting from excessive effort for preventing obesity was unfavourable for children in the growing stage for their healthy growth and development.