ABSTRACT
Establishing a robust One Health (OH) governance is essential for ensuring effective coordination and collaboration among human, animal, and environmental health sectors to prevent and address complex health challenges like zoonoses or antimicrobial resistance. This study conducted a mixed-methods environmental scan to assess to what extent Mexico displays a OH governance and identify opportunities for improvement. Through documentary analysis, the study mapped OH national-level governance elements: infrastructure, multi-level regulations, leadership, multi-coordination mechanisms (MCMs), and financial and OH-trained human resources. Key informant interviews provided insights into enablers, barriers, and recommendations to enhance a OH governance. Findings reveal that Mexico has sector-specific governance elements: institutions, surveillance systems and laboratories, laws, and policies. However, the absence of a OH governmental body poses a challenge. Identified barriers include implementation challenges, non-harmonised legal frameworks, and limited intersectoral information exchange. Enablers include formal and ad hoc MCMs, OH-oriented policies, and educational initiatives. Like other middle-income countries in the region, institutionalising a OH governance in Mexico, may require a OH-specific framework and governing body, infrastructure rearrangements, and policy harmonisation. Strengthening coordination mechanisms, training OH professionals, and ensuring data-sharing surveillance systems are essential steps toward successful implementation, with adequate funding being a relevant factor.
Subject(s)
One Health , Mexico , Humans , Interviews as Topic , Health Policy , AnimalsABSTRACT
BACKGROUND: Chagas disease is a globally important chronic systemic parasitic infection caused by Trypanosoma cruzi. AIM: To determine the prevalence of antibodies against T cruzi in pregnant women from the state of Morelos, México. METHODS: 1,620 sera from pregnant women were analyzed using two serological tests: ELISAc (native crude antigen) and ELISAr (recombinant, non-native antigen). Reactive samples were subsequently analyzed by indirect hemagglutination (IHA). Two detection approaches were used, in parallel (reactive samples by any method are positive) and serial (samples confirmed by IHA are positive). Sociodemographic and health factors associated with the presence of antibodies against T cruzi were evaluated using 95% odds ratios. RESULTS: A seroprevalence of 4.87% was obtained with parallel diagnosis and 0.43% in series. From the parallel results, the women who were attended at the general hospitals of Tetecala and Jojutla had respectively 2.2 and 2.0 times greater chance of presenting antibodies against T cruzi compared to the women who were attended at the General Hospital of Cuautla. CONCLUSION: The prevalence of antibodies against T cruzi in pregnant women from the state of Morelos fluctuated between 0.43 and 4.87%, depending on the antigen and the approach used. It is necessary to continue with the surveillance of the seroprevalence of antibodies against T cruzi in pregnant women from the state of Morelos, Mexico, using the techniques with the highest sensitivity and specificity available.
Subject(s)
Chagas Disease , Trypanosoma cruzi , Antibodies, Protozoan , Chagas Disease/diagnosis , Chagas Disease/epidemiology , Enzyme-Linked Immunosorbent Assay/methods , Female , Humans , Mexico/epidemiology , Pregnancy , Pregnant Women , Seroepidemiologic StudiesABSTRACT
INTRODUCCIÓN: La enfermedad de Chagas es una infección parasitaria crónica sistémica, de importancia global, causada por Trypanosoma cruzi. OBJETIVO: Determinar la prevalencia de anticuerpos contra T cruzi en mujeres embarazadas en el estado de Morelos, México. MATERIALES Y MÉTODOS: Se analizaron 1.620 sueros de mujeres embarazadas mediante dos pruebas serológicas: ELISAc (antígeno crudo nativo) y ELISAr (antígeno recombinante, no nativo). Las muestras reactivas se analizaron posteriormente mediante hemaglutinación indirecta (HAI). Se utilizaron dos enfoques de detección, en paralelo (son positivas las muestras reactivas por cualquier método) y en serie (son positivas las muestras confirmadas por HAI). Se evaluaron factores sociodemográficos y de salud asociados a la presencia de anticuerpos contra T. cruzi mediante razones de momios al 95%. RESULTADOS: Se obtuvo una seroprevalencia de 4,87% con el diagnóstico en paralelo y de 0,43% en serie. A partir de los resultados en paralelo las mujeres que fueron atendidas en los hospitales generales de Tetecala y Jojutla tuvieron, respectivamente, 2,2 y 2,0 veces mayor posibilidad de presentar anticuerpos contra T cruzi con respecto a las mujeres que fueron atendidas en el Hospital General de Cuautla. CONCLUSIÓN: La prevalencia de anticuerpos contra T cruzi en mujeres embarazadas en el estado de Morelos fluctuó entre 0,43 y 4,87%, según el antígeno y el abordaje utilizado. Es necesario continuar con la vigilancia de la seroprevalencia de anticuerpos contra T cruzi en mujeres embarazadas en el estado de Morelos, México, con las técnicas de mayor sensibilidad y especificidad disponibles.
BACKGROUND: Chagas disease is a globally important chronic systemic parasitic infection caused by Trypanosoma cruzi. AIM: To determine the prevalence of antibodies against T cruzi in pregnant women from the state of Morelos, México. METHODS: 1,620 sera from pregnant women were analyzed using two serological tests: ELISAc (native crude antigen) and ELISAr (recombinant, non-native antigen). Reactive samples were subsequently analyzed by indirect hemagglutination (IHA). Two detection approaches were used, in parallel (reactive samples by any method are positive) and serial (samples confirmed by IHA are positive). Sociodemographic and health factors associated with the presence of antibodies against T cruzi were evaluated using 95% odds ratios. RESULTS: A seroprevalence of 4.87% was obtained with parallel diagnosis and 0.43% in series. From the parallel results, the women who were attended at the general hospitals of Tetecala and Jojutla had respectively 2.2 and 2.0 times greater chance of presenting antibodies against T cruzi compared to the women who were attended at the General Hospital of Cuautla. CONCLUSION: The prevalence of antibodies against T cruzi in pregnant women from the state of Morelos fluctuated between 0.43 and 4.87%, depending on the antigen and the approach used. It is necessary to continue with the surveillance of the seroprevalence of antibodies against T cruzi in pregnant women from the state of Morelos, Mexico, using the techniques with the highest sensitivity and specificity available.
Subject(s)
Humans , Female , Pregnancy , Trypanosoma cruzi , Chagas Disease/diagnosis , Chagas Disease/epidemiology , Enzyme-Linked Immunosorbent Assay/methods , Antibodies, Protozoan , Seroepidemiologic Studies , Pregnant Women , Mexico/epidemiologyABSTRACT
The Lee Chronic Graft-versus-Host Disease (GVHD) Symptom Scale is a patient-reported instrument developed and validated in English to measure the symptoms and functional impact of cGVHD. This tool has not yet been validated in a Latin American population, however. The Brazil-Seattle Chronic GVHD Consortium conducted a multicenter study at 5 Brazilian institutions to validate the Lee cGVHD Symptom Scale in adults with cGVHD. Study objectives included the translation and validation of the instrument in Brazilian Portuguese and evaluation of the correlation with other quality of life (QoL) tools, including the Medical Outcomes Study Short Form 36 (SF-36) and Functional Assessment of Chronic Illness Therapy with Bone Marrow Transplant subscale (FACT-BMT). Translation and validation were done according to the American Association of Orthopedic Surgeons Outcome Committee guidelines. Spearman's correlation coefficient was used to measure construct validity. Reliability was assessed using Cronbach's α and intraclass correlation coefficients. Between April 2011 and August 2012, 47 patients with cGVHD based on the 2005 National Institutes of Health criteria (29 males [62%], 18 females [38%]; median age, 48 years; range, 23 to 69 years) were enrolled in this study. The reliability of the Lee cGVHD Symptom Scale was adequate (Cronbach's α = 0.62 to 0.83). The correlations between similar domains of the Lee cGVHD Symptom Scale, SF-36, and FACT-BMT were moderate to high. Our data indicate that the Brazilian Portuguese version of the Lee cGVHD Symptom Scale is valid and reliable and can be used in clinical trials of cGVHD in Brazil.
Subject(s)
Graft vs Host Disease/diagnosis , Severity of Illness Index , Adult , Aged , Brazil , Chronic Disease , Cross-Cultural Comparison , Female , Humans , Language , Male , Middle Aged , Quality of Life , Statistics, Nonparametric , Young AdultABSTRACT
OBJECTIVE: To perform a function evaluation of patients before and after hematopoietic stem cell transplantation. METHODS: From November 2008 to November 2010, 29 female (58%) and 21 male patients (42%) with median age of 48 years (range: 24-67) were enrolled in this study. Data collection was performed before and after autologous or allogeneic hematopoietic stem cell transplantation. Evaluation instruments included the 2-minute walking test to evaluate gait performance with assessment of the oxygen saturation, heart rate and Borg Scale before and after the test; grip strength for strength evaluation, Schober Test for spine mobility testing and maximum and adapted activity scores of the Human Activity Profile questionnaire to test functionality in daily activities. RESULTS: Fifty patients were evaluated at baseline; six did not undergo hematopoietic stem cell transplantation (three died, one refused and two were excluded). Thus 44/50 (88% - 21 allogeneic and 23 autologous) transplantations were performed. Only 33 of the 44 patients (75%) performed evaluations after transplantation (nine died and two were excluded). Of the patients who performed both evaluations, significantly lower values were found in the evaluation after transplantation for the 2-minute walking test (p-value = 0.004), grip strength of both right and left hands (p-value = 0.004 and p-value < 0.0001, respectively), the Schober Test, and maximum and adapted activity scores (p-value < 0.0001). The heart rate was higher (p-value = 0.01) before the 2-minute walking test and oxygen saturation was higher (p-value = 0.02) after. CONCLUSION: Statistical differences indicate functional impairment after transplantation showing physical losses in this population.
Subject(s)
Humans , Female , Pacemaker, Artificial/standards , Pacemaker, Artificial , Electrocardiography , VectorcardiographyABSTRACT
En este manual se esbozan técnicas, procedimientos, recomendaciones y normas que por regla general, constituyen buenas practicas sanitarias y de fabricacionen la industria, el almacenamiento, el transporte y el expendio de alimentos.(au)
Subject(s)
Humans , Male , Female , Food Hygiene , Food Inspection/methods , Food Inspection/standards , Food Inspection/trends , Bolivia , Pest Control , TransportationABSTRACT
El presente manual tiene por objeto facilitar un instrumento didacti con los conocimientos básicos para que los inspectores junto a otros profesionales del campo de la inocuidad alimentaria asi como maestros y líderes comunitarios, coayuben en la educacion de los manipuladores de toda la cadena alimentaria.(au)
Subject(s)
Humans , Male , Female , Food , Food Analysis , Food Contamination , Food Inspection , Food Quality , Bolivia , Food Handling , Food Hygiene , Food Parasitology , Food Quality StandardsABSTRACT
Only rarely do myxomas originate from the mitral valve. This is the report of a 49-year-old woman presenting with congestive heart failure. The diagnosis of an intracardiac tumor involving the anterior cuspid of the mitral valve was mode by transesophageal echocardiography. The patient underwent surgery for tumor resection and plasty of the valve was made with reconstruction and preservation of the valve. The diagnosis of myxoma was confirmed by histology. This is the 23rd case of myxoma of the mitral valve reported in the literature.
Subject(s)
Humans , Female , Middle Aged , Heart Neoplasms/diagnosis , Mitral Valve , Myxoma/diagnosis , Heart Failure , Heart Neoplasms/surgery , Myxoma/surgeryABSTRACT
Objetivo - Verificar-se as características adaptativas do ventrículo esquerdo (VE), também, estão presentes em indivíduos < 70 anos, com estenose valvar aórtica grave (EA). Métodos - Estudamos 40 pacientes consecutivos,<70 anos de idade, com EA, sem doença arterial coronariana, encaminhados à cirurgia, sendo 22 homens e 18 mulheres, (idade de 49,8+14,3 anos). Foram coligidos os sintomas cardíacos, presença de hipertensão arterial sistêmica (HAS), classe funcional de acordo com a NYHA e a etiologia do EA. Ao Dopplerecocardiograma foram estudados as dimensões cavitárias, a fração de ejeção (FE) e fração de encurtamento cavitário (FEC), massa (MS) e espessura diastólica relativa (EDR) do VE. Resultados - Quatorze homens e 11 mulheres estavam em CF III/IV (p=0,70). A freqüência de sintomas foi igual em ambos os sexos. Havia mais mulheres com HAS do que nos homens (10 contra 2, p=0,0044). As mulheres apresentaram menor índice de diâmetro diastólico final do VE (32,1+6,5 x 36,5+5,3 mm/m2, p=0,027), de diâmetro sistólico final (19,9+5,9 x 26,5+6,4mm/m2, p=0,0022) e MS (211,4+71,1 x 270,9+74,9g/m2, p=0,017) A FE (66,2+13,4 x 52,0+14,6 por cento, p=0,0032), FEC (37,6+10,7 x 27,9+9,6 por cento, p=0,0046) e EDR (0,58+0,22 x 0,44+0,09), p=0,0095) eram significativamente maiores nas mulheres. Conclusão - É o sexo e não a idade dos pacientes que influi na resposta adaptativa do VE à EA.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aortic Valve Stenosis/physiopathology , Ventricular Function, Left/physiology , Heart Ventricles/anatomy & histology , Sex FactorsABSTRACT
Se realizó un trabajo de correlación entre el diagnóstico clínico, el diagnóstico por complementarios (rayos X simple, TAC y mielografía) y los hallazgos transoperatorios de 100 pacientes operados por hernia discal lumbar en el Servicio de Ortopedia del Hospital General Docente "Comandante Pinares" de San Cristóbal, en el período decenal entre 1985 y 1994 (ambos inclusive). Se comprobó una alta correlación entre el diagnóstico clínico y el diagnóstico transoperatorio, una correlación adecuada entre el diagnóstico por TAC y mielografía, y también una correlación menos confiable por radiografía simple; asimismo se comprobó que los resultados finales del tratamiento quirúrgico en nuestra casuística sólo son totalmente alentadores en 1 de cada 2 pacientes, lo que reafirma el concepto de operar únicamente a pacientes en los que haya fracasado el tratamiento incruento.
The correlation existing between the clinical diagnosis, the diagnosis by complementary tests (simple X-ray, CAT and myelography) and the transoperative findings of 100 patients operated on of lumbar disc herniation at the Orthopedics Service of the "Comandante Pinares" General Teaching Hospital, in San Cristóbal, from 1985 to 1994 (including both), is apporached in this paper. It was found a high correlation between the clinical diagnosis and the transoperative diagnosis, and adequate correlation between the diagnosis by CAT and myelography, and a less reliable correlation by simple X-ray. It was also proved that the final results of the surgical treatment in our casuistics are completely encouraging in only 1 out of 2 patients, which reaffirms the concept of operating on just when the bloodless treatment fails.
Un travail de corrélation entre le diagnostic clinique, le diagnostic par complémentaires (rayons X simple, TAC et myélographie) et les trouvailles trans-opératoires de 100 patients opérés, dû à une hernie lombo-discale, dans le Service d´orthopédie de l´hôpital général universitaire "Comandante Pinares" de San Cristóbal, a étéréalisé entre 1985 et 1994 (tous les deux ans y compris). La hautecorrélation entre le diagnostic clinique et le diagnostic trans-opératoire, une corrélation adéquate entre le diagnostic par TAC et par myélographie, et aussi une corrélation moins fiable par radiographie simple sont été constatées; de même qu´on a vérifié que les résultats finals du traitement chirurgical dans notre experience ne sont que tout à fait encourageants en 1 patient sur 2, réaffirmant le concept de n´opérer que des patients chez lesquels le traitement non sanglant ait échoué.
ABSTRACT
Se realizó un estudio de 126 pacientes con osteoartrtis de la rodilla, diagnosticados en el Servicio de Ortopedia y Traumatología del Hospital General Docente "Comandante Pinares" de San Cristóbal, Pinar del Río, a los que se les realizaron infiltraciones intraarticulares con ozono una vez por semana como único tratamimento. Entre los resultados obtenidos después de aplicar el patrón evaluativo previamente diseñado, se encontró que se obtuvo mejoría clínica subjetiva en el 81,7 porciento de los casos, con un promedio de 4 infiltraciones, suficientes para resolver los problemas de la mayoría de los pacientes y con ausencia total de complicaciones, lo que hace un método valedero en la solución de este problema de salud. Se destaca el ahorro sustancial de medicamentos deficitarios, que son sustituidos por el gas cuyo costo es ínfimo, así como la satisfacción de la población al ver sus síntomas mediante un proceder sencillo (AU)
Subject(s)
Osteoarthritis/therapy , Ozone/therapeutic use , Knee Injuries/therapyABSTRACT
Se realizó un estudio de 126 pacientes con osteoartrtis de la rodilla, diagnosticados en el Servicio de Ortopedia y Traumatología del Hospital General Docente "Comandante Pinares" de San Cristóbal, Pinar del Río, a los que se les realizaron infiltraciones intraarticulares con ozono una vez por semana como único tratamimento. Entre los resultados obtenidos después de aplicar el patrón evaluativo previamente diseñado, se encontró que se obtuvo mejoría clínica subjetiva en el 81,7 porciento de los casos, con un promedio de 4 infiltraciones, suficientes para resolver los problemas de la mayoría de los pacientes y con ausencia total de complicaciones, lo que hace un método valedero en la solución de este problema de salud. Se destaca el ahorro sustancial de medicamentos deficitarios, que son sustituidos por el gas cuyo costo es ínfimo, así como la satisfacción de la población al ver sus síntomas mediante un proceder sencillo
Subject(s)
Knee Injuries/therapy , Osteoarthritis/therapy , Ozone/therapeutic useABSTRACT
El presente manual sobre el control y vigilancia de enfermedades transmitidas por medio de los alimentos, es un esfuerzo que se realiza en pos de una educación en salud, para promocionar y prevenir la salud d la población, ya que estas enfermedades se producen principalmente a causa de la pobreza
Subject(s)
Disease Outbreaks/prevention & control , Infection Control/trends , Health Education/trends , Foodborne Diseases/epidemiology , Bolivia , Disease Outbreaks , Health Education , Foodborne Diseases , Epidemiological Monitoring , Food and Nutritional Surveillance , Health SurveillanceABSTRACT
El presente manual sobre el control y vigilancia de enfermedades transmitidas por medio de los alimentos, es un esfuerzo que se realiza en pos de una educación en salud, para promocionar y prevenir la salud d la población, ya que estas enfermedades se producen principalmente a causa de la pobreza
Subject(s)
Disease Outbreaks/prevention & control , Infection Control/trends , Health Education/trends , Foodborne Diseases/epidemiology , Bolivia , Disease Outbreaks , Health Education , Foodborne Diseases , Epidemiological Monitoring , Food and Nutritional Surveillance , Health SurveillanceABSTRACT
Se realizó un estudio retrospectivo con el objetivo de establecer la frecuencia de enfermedades inflamatorias pélvica en el Hospital Dr. Luis E. Aybar, Santo Domingo, República Dominicana, en el período 1-1-1989-31-12-1992, teniendo como fuente de datos los expedientes de 450 pacientes ingresados por causas ginecológicas de los cuales 20 fueron diagnosticados con enfermedad inflamatoria pélvica (E.I.P. para un 4.4//) el grupo etáreo más afectado fue el comprendido entre 30-39 años (40//), la población más afectada fueron las primigestas (45//), el grado de evoluci'on predominante el agudo (55//), el procedimiento diagnóstico más utilizado fue el cultivo (65//), el microorganismo más frecuente fue la Clamyhia Trachomatis (35//), la laparoscopia se hizo en 1 caso (5//) y en ningún caso se hizo biopsia
Subject(s)
Humans , Female , Adolescent , Adult , Pelvic Inflammatory Disease/epidemiology , Retrospective StudiesABSTRACT
PURPOSE--To study the short and long-term follow-up of patients with left main coronary artery disease (LMCAD) and age over 65 years, by comparing the results with patients under 65 years-old. METHODS--Twenty-two patients with LMCAD and mean age of 69 +/- 3.5 years (group I) were underwent isolated coronary artery bypass grafting (CABG) and compared to 31 patients with LMCAD, mean age of 54 +/- 7 years (group II), who also underwent isolated CABG. The life-table Kaplan-Meyer method was used to estimate the post-operative survival. The chi-square and Student "t" test were used when necessary. RESULTS--Despite higher operative mortality in group I (9.1 x 3.2), the difference was statistically not significant. The operative morbidity was similar in both groups. Actuarial survival at 4 years was 85 in group I and 95 in group II. Actuarial survival free of cardiac events was 69 in group II and 75 in group II. CONCLUSION--The CABG is well tolerated and had low morbidity and acceptable mortality in old patients with LMCAD. The long-term survival in these patients was very similar to the younger patients.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Coronary Disease , Myocardial Revascularization , Follow-Up Studies , Actuarial Analysis , Survival Analysis , Age Factors , Myocardial Revascularization/adverse effectsABSTRACT
Patients with alchoholic hepatic cirrhosis have a higher predisposition to acquiring infections than healthy individuals, suggesting an alteration in the immune system. They also exhibit an important decrease in certain plasmatic constituents such as zinc, albumin, and transferrin which are involved in the normal immune response. The blastoid transformation of lymphocites stimulated in vitro with phytohemaglutinin M and P in patients with alcoholic hepatic cirrhosis was studied and the results were correlated with the plasmatic constitutents aforementioned. The rate of blastoid transformation was significantly lower (p<.001) in these patients when compared to the control group, but did not correlate directly with the concentration of zinc, albumin, transferrin or circulating globulins. Patients' plasma significantly inhibited the response of normal cells to stimulation with phytohemaglutinin and Concanavalin A; nevertheless, the blastoid transformation of lymphocytes in these patients was not restored to normal levels when incubated with control plasma
Subject(s)
Humans , Male , Female , Adult , Liver Cirrhosis/complications , Immune System/physiopathology , Interleukin-2/pharmacokinetics , Interleukin-2/physiologyABSTRACT
Foram estudados treze pacientes portadores de marcapasso artificial tipo VVI com resposta de freqüência (Medtronic Activitrax 8400). O protocolo de estudo constou de uma gravaçäo de Holter de 24h para observaçäo do funcionamento dos geradores e das freqüências de estimulaçäo atingidas durante atividades físicas espontâneas dos pacientes. Estas foram reproduzidas no laboratório de ecocardiografia, com os pacientes sentados e fazendo movimentos com as pernas, simulando o ato de andar e correr. Nestas circunstâncias determinou-se os volumes sistólicos e débitos cardíacos os geradores atingiam freqüências de estimulaçäo de 70, 90, 100 ñ 5 ppm através de curvas integralizadas de fluxo aórtico, usando-se um doppler pulsátil (Aloka SSD 730). Os volumes foram calculados nos ciclos näo precedidos de ondas P, para avaliar-se os efeitos das variaçöes de freqüência sem contribuiçäo da contraçäo atrial. Os resultados nas médias dos grupos foram para os volumes sistólicos de 38,0 ñ 15,0 ml com 70 ppm; 40,0 ñ 15,0 ml com 90 ppm e 42,0 ñ17,0 ml com 100 ppm. As diferenças das médias näo foram estatisticamente significativas. Os débitos cardíacos foram de 2660 ñ 350,0 ml com 70 ppm; 3580 ñ 480,0 ml com 90 ppm; 4176 ñ 58,0 ml com 100 ppm. Houve um acréscimo de 34% de 70 para 90 ppm, de 16% de 90 para 100 ppm e de 56% de 70 para 100 ppm. As diferenças das médias foram estatisticamente sibnificativas (p < 0,01)...