Characterization of the venom and external morphology of a natural hybrid between Crotalus atrox and Crotalus mictlantecuhtli.

Here we report, for the first time, a natural hybrid between Crotalus atrox and C. mictlantecuhtli based on intermediate characteristics of the external morphology and venom. Morphologically, the individual had characteristics of both parent species. The hybrid's venom exhibited an intermediate composition including the presence of crotoxin which has never been documented in C. atrox but is well documented in C. mictlantecuhtli. The hybrid's venom was highly toxic and showed an intermediate proteolytic activity between the parental species. The two Mexican antivenoms were able to neutralize the hybrid's venom's lethality.

Designing an Information and Communications Technology Tool With and for Victims of Violence and Their Case Managers in San Francisco: Human-Centered Design Study.

BACKGROUND: Violence is a public health problem. Hospital-based violence intervention programs such as the San Francisco Wraparound Project (WAP) have been shown to reduce future violent injury. The WAP model employs culturally competent case managers who recruit and enroll violently injured patients as clients. Client acceptance of the WAP intervention is variable, and program success depends on streamlined, timely communication and access to resources. High rates of smartphone usage in populations who are at risk for violent reinjury create an opportunity to design a tailored information and communications technology (ICT) tool to support hospital-based violence intervention programs. OBJECTIVE: Current evidence shows that ICT tools developed in the health care space may not be successful in engaging vulnerable populations. The goal of this study was to use human-centered design methodology to identify the unique communication needs of the clients and case managers at WAP to design a mobile ICT. METHODS: We conducted 15 semi-structured interviews with users: clients, their friends and families, case managers, and other stakeholders in violence intervention and prevention. We used a human-centered design and general inductive approach to thematic analysis to identify themes in the qualitative data, which were extrapolated to insight statements and then reframed into design opportunities. Wireframes of potential mobile ICT app screens were developed to depict these opportunities. RESULTS: Thematic analysis revealed four main insights that were characterized by the opposing needs of our users. (1) A successful relationship is both professional and personal. Clients need this around the clock, but case managers can only support this while on the clock. (2) Communications need to feel personal, but they do not always need to be personalized. (3) Healing is a journey of skill development and lifestyle changes that must be acknowledged, monitored, and rewarded. (4) Social networks need to provide peer support for healing rather than peer pressure to propagate violence. These insights resulted in the following associated design opportunities: (1) Maximize personal connection while controlling access, (2) allow case managers to personalize automated client interactions, (3) hold clients accountable to progress and reward achievements, and (4) build a connected, yet confidential community. CONCLUSIONS: Human-centered design enabled us to identify unique insights and design opportunities that may inform the design of a novel and tailored mobile ICT tool for the WAP community.

"You don't want anyone who hasn't been through anything telling you what to do, because how do they know?": Qualitative analysis of case managers in a hospital-based violence intervention program.

STATEMENT OF PURPOSE: Intentional violent injury is a leading cause of disability and death among young adults in the United States. Hospital-based violence intervention programs (HVIPs), which strive to prevent re-injury through intensive case management, have emerged as a successful and cost-effective strategy to address this issue. Despite the importance of strong therapeutic relationships between clients and their case managers, specific case manager behaviors and attributes that drive the formation of these relationships have not been elucidated. METHODS: A qualitative analysis with a modified grounded theory approach was conducted to gain insight into what clients perceive to be crucial to the formation of a strong client-case manager relationship. Twenty-four semi-structured interviews were conducted with prior clients of our hospital's HVIP. The interviews were analyzed using constant comparison method for recurrent themes. RESULTS: Several key themes emerged from the interviews. Clients emphasized that their case managers must: 1) understand and relate to their sociocultural contexts, 2) navigate the initial in-hospital meeting to successfully create connection, 3) exhibit true compassion and care, 4) serve as role models, 5) act as portals of opportunity, and 6) engender mutual respect and pride. CONCLUSIONS: This study identifies key behaviors of case managers that facilitate the formation of strong therapeutic relationships at the different stages of client recovery. This study's findings emphasize the importance of case managers being culturally aligned with and embedded in their clients' communities. This work can provide a roadmap for case managers to form optimally effective relationships with clients.

Accessing cryptic diversity in Neotropical rattlesnakes (Serpentes: Viperidae: Crotalus) with the description of two new species.

Members of the Crotalus durissus species complex are widely distributed from Mexico to Argentina in areas with mainly seasonally dry tropical deciduous forest. Although four species (C. culminatus, C. durissus, C. simus and C. tzabcan) are currently recognized, species limits remain to be tested. Previous genetic studies suggest that C. durissus and C. simus may be paraphyletic and that at least one cryptic species may be present. We analyzed 2596 bp of DNA sequence data from three mitochondrial and one nuclear gene to infer phylogenetic relationships in the Neotropical rattlesnakes. We also examined museum and wild specimens as well as captive animals to analyze morphological characters. Our results suggest that the current taxonomy of the Crotalus durissus species complex does not reflect evolutionary history. We found strong support for five independent lineages within Crotalus simus (sensu lato), with genetic and morphological evidence for three previously recognized taxa and two new species, as well as three major lineages within C. durissus that each represent species hypothesis to be tested with additional evidence. We also found support to retain C. totonacus in the Crotalus molossus species complex. We suggest conservative taxonomic changes to the complex and related species, but more evidence is needed (e.g., morphology, ecology and venom composition) to clarify relationships among species.

Description of the male of Craugastor yucatanensis (Lynch, 1965) (Anura, Craugastoridae), its advertisement call, and additional data on females.

The male of Craugastor yucatanensis (Lynch, 1965) is described for the first time, as the original description was based on four females. The advertisement call is described and additional morphological data on females are presented. Also, information is provided on the sexual dimorphism and natural history of the species.

Endoparasites of Crotalus tzabcan (Serpentes: Viperidae), with a checklist in rattlesnakes.

The helminth and pentastomid fauna of 50 specimens of Crotalus tzabcan from the Yucatán Peninsula, Mexico is documented. The examination revealed the presence of three nematode species (Hastospiculum onchocercum, Hexametra boddaertii, and Travassosascaris araujoi), and one pentastomid (Porocephalus crotali). The threee nematode species had the same prevalence (2%), while the pentastomid had a higher prevalence (8%). The pentastomid P. crotali was the most abundant and intense parasite, although it was only found in four snake hosts. Crotalus tzabcan acts as definitive host for the adult helminths and pentastomids, with rodents as the probable intermediate hosts. This work represents the first systematic survey on the parasitic helminth and pentastomid fauna of C. tzabcan, and includes four new geographical records. Additionally, a checklist of helminths and pentastomids reported for Crotalus and Sistrurus is provided. To date, a total of 32 helminth and 7 pentastomid species have been recorded as parasites of rattlesnakes. Nematoda possessed the highest species richness. The genera with the highest number of host species were Mesocestoides and Hexametra, followed by Kalicephalus. The rattlesnake species with the highest number of reported parasites was C. durissus (18 nematodes and 2 pentastomids).

Ethnic Differences for Public Health Knowledge, Health Advocacy Skills, and Health Information Seeking Among High School Students: Community Agents of Change.

Although adult health advocacy programs have been examined in communities, little is known about integrated adolescent health advocacy programs in high schools. The purpose of this study was to examine the health advocacy program impact and ethnic differences among high school students. Using a cross-sectional study, high school students participating in the school-based program completed evaluation surveys. The program domains included upstream causes of health, community assets, and public health advocacy. Bivariate analyses were conducted to examine ethnic differences for public health knowledge, health advocacy skills, and health information seeking behaviors. Using thematic analysis, open-ended survey item responses were coded to identify themes for students' perceptions of community health. Non-Hispanic (n = 72) and Hispanic high school students (n = 182) in ten classes reported owning smartphones (95%) and laptops (76%). Most students (72%) reported seeking online health information. Non-Hispanic students reported significantly higher health advocacy skills for speaking with the class about health issues, identifying community services, or creating health awareness at school than Hispanic students. Non-Hispanic students were more likely to seek health information from fathers and television than Hispanic students. Hispanic students were more likely to seek health information from hospital or clinic staff than non-Hispanic students. Emergent themes included health advocacy skills, community awareness, and individual and community health changes. High schools benefit from integrating health advocacy programs into the core curriculum. Adolescents gain important skills to improve their individual health and engage in changing community health.

A decade of hospital-based violence intervention: Benefits and shortcomings.

INTRODUCTION: Initial analyses of hospital-based violence intervention programs (VIPs) have demonstrated decreased violent injury recidivism. Long-term VIP performance has not been assessed. Violence intervention program quality improvement requires evaluation to identify shortcomings and client subpopulations warranting additional resources. We evaluated our case manager-based VIPs to identify modifiable risk factors that most impact violent injury recidivism and determine subpopulations that need modification of targeted services. METHODS: Data on demographic variables, socioeconomic factors, needs, and injury recidivism from 2005 to 2014 were collected through our VIP database. Possible client needs included housing, education, employment, court advocacy, driver's license obtainment, and "other." Case managers assessed needs as "not needed," "identified (unmet)," and "met." χ And nonparametric tests were used to identify factors associated with recidivism reduction. RESULTS: Over the 10-year period, 466 clients were enrolled in VIP. During the program period, the violent reinjury rate was 4%, as compared with a historical control of 8% from 2000 to 2004. Women had lower rates of reinjury than men (3% vs 13%, respectively, p = 0.023). Blacks had the lowest recidivism (2%, p < 0.0001), whereas a higher rate (11%) was observed among Latinos. Although a minority of clients (5%), 100% of white clients were reinjured. Mental health services (51%), victim-of-crime compensation (48%), employment (36%), and housing (30%) were the most frequently identified needs. Expressing the need for education was significantly associated with likelihood of reinjury, an effect that was completely reversed when the need was met. CONCLUSION: This evaluation of a VIP demonstrates sustained recidivism reduction and success in addressing client needs from a traditionally underserved population. Efforts to identify and address root causes of Latino and white client reinjury should be increased. Violence intervention program prioritization of housing needs may reduce future reinjury. This study demonstrating sustainable success underscores the importance of increased integration of VIP into trauma centers nationally. LEVEL OF EVIDENCE: Therapeutic study, level III.

[Risk factors associated to the epidemic outbreak of dengue virus infection.] / Factores de riesgo en la epidemia de dengue en Querétaro.

Objective: to identify the risk factors associated to the epidemic of dengue virus infections occurred at Queretaro, Mexico. Methods: a case-control study was carried out on 49 cases and 49 controls. The data included: age, sex, residency, schooling, occupation, clinical data, sources infected with Aedes aegypti, travelling, source of waters, and protection to water recipients. The protection to door and windows was investigated. χ2 test and odds ratio were estimated. Results: the age group of 20-39 years was the most affected and women predominated. The Satellite area contributed with 38 cases (77.1 %). The absence of mosquito nettings on windows had an OR = 1.8, and ignorance of preventive activities had an OR = 2.8, while the use of insecticides (OR = 0.30) and mosquito repellents (OR = 0.54) were protective factors. Conclusions: the epidemic outbreak in Queretaro confirmed that Aedes aegypti has adapted to greater heights. This fact should alert to the sanitary authorities to face the possibility of an epidemic outbreak with great affectation among population.

Objetivo: identificar los factores de riesgo relacionados con la epidemia de dengue clásico ocurrida en 2011 en Querétaro, México. Métodos: estudio de pacientes con dengue y 49 controles de las mismas localidades. Se registró edad, sexo, lugar de residencia, escolaridad, ocupación, cuadro clínico, viajes a zonas endémicas, abasto de agua y protección de los recipientes donde se almacena, presencia de recipientes para el desarrollo del vector, recolección de basura, aseo de patios, uso de mosquiteros e insecticidas y conocimiento de las medidas preventivas. Fueron calculadas la χ2 y la razón de momios. Resultados: el grupo etario más afectado fue el de 20 a 39 años, con predom inio del sexo femenino. El área de Satélite aportó 38 casos (77.1 %). Como factores de riesgo se identificó la ausencia de mosquiteros en ventanas (RM = 1.8) y el desconocimiento de las medidas de prevención (RM = 2.8). Como factores protectores se identificó el uso de insecticidas (RM = 0.30) y de repelentes (RM = 0.54). Conclusiones: el brote epidémico en Querétaro confirma que el Aedes aegypti se ha adaptado a vivir en zonas con mayor altura. Este hecho aunado a la falta de preparación y desconocimiento de las medidas de prevención fueron los factores de riesgo más importantes.

Médicos en el Ejército Libertador / Doctors in the Liberation Army

Se realizó una revisión bibliográfica para connotar algunos oficiales médicos presentes en las contiendas del ejército libertador en las tres guerras por la independencia del siglo XIX. Se citan 52 médicos que intervinieron en los distintos cuerpos del ejército libertador así como 4 enfermeras no graduadas que tuvieron acciones de sanidad dentro del ejército con el grado de Capitán. Del total 33 fueron Coroneles, 3 tenientes coroneles, 14 Generales de Brigadas y dos Mayores Generales, dos de los cuales eran nacidos en otros países, y varios cumplieron dentro del ejército funciones no relacionadas con la sanidad. Después de instaurada la República, 32 de ellos ocuparon cargos públicos, e incluso la presidencia de la república; solo cuatro murieron en combate y cinco dedicaron esfuerzos a la docencia en tiempo de paz. Se ubican por cuerpos del ejército y se plasman datos más relevantes de los mismos (AU)

A literature review was carried out to know some medical officers present in the liberation army battles in three wars for independence of the nineteenth century. 52 doctors that participated in various Liberation Army force are arrange and four not graduate nurses who had health actions within the army with the Captain rank. From the total 33 were colonels, three lieutenant colonels, 14 brigadier general and two Major Generals that the last two men were born in other countries, and they did several functions unrelated to health. After the Republic were established 32 of them held public office, and even the president of the Republic, only four were killed in action and five dedicated efforts to teaching in peacetime. They are located by army corps and relevant data are mentioned (AU)

Diagnóstico del daño neurológico en recién nacido pretérmino mediante ecografía transfontanelar / Diagnosis of neurological damage in preterm infants using cranial ultrasound

Se realizó un estudio observacional descriptivo con el objetivo de determinar el daño neurológico en recién nacido pretérmino, mediante la ecografía transfontanelar, en el Hospital Provincial Dr. Antonio Luaces Iraola de Ciego de Ávila, en el período de tiempo comprendido desde septiembre de 2009 hasta septiembre del 2011. La muestra estuvo integrada por el total de pacientes nacidos pretérmino en ese periodo que presentaron alteraciones neurológicas diagnosticadas por ecografía. Predominó el sexo masculino y la edad gestacional de 30 a 34 semanas, donde los partos distócicos fueron los más frecuentes, el 40 por ciento de los neonatos se encontraban ligeramente deprimidos al realizar el puntaje de Apgar. Como principal daño neurológico se presentó la hemorragia intraventricular, seguido de la leucomalacia periventricular (AU)

A descriptive observational study was carried out in order to determine the neurological damage in preterm newborn by cranial ultrasound, in the Provincial Teaching Hospital Dr. Antonio Luaces Iraola in Ciego de Avila, from September 2009 to September 2011. The sample consisted of the total of newborn preterm patients in that period that presented neurological alterations diagnosed by ultrasound. Predominating masculine sex corresponding to gestacional age 30-34 weeks, where dystocic childbirth were the most frequent, 40 percent of neonates were depressed when making the apgar score. As main neurological damage the intraventricular hemorrhage appeared, followed by periventricular leukomalacia (AU)

Comportamiento ecográfico de la cirrosis hepática en Ciego de Ávila durante el año 2011 / Ultrasonographic behavior of cirrhosis in Ciego de Ávila during 2011

Se realizó un estudio observacional analítico transversal con el objetivo de determinar el comportamiento ecográfico de la cirrosis hepática en pacientes atendidos en el Hospital Provincial Docente “Dr. Antonio Luaces Iraola” durante el período de enero a diciembre del año 2011. El universo de estudio estuvo integrado por los pacientes que acudieron al Servicio de Gastroenterología con sospecha de cirrosis hepática. La muestra quedó conformada por 47 casos según criterios de inclusión, a estos se les realizó ecografía y para corroborarlo se realizó un diagnostico clínico-patológico final como prueba de oro. La técnica de obtención de la información fue la encuesta. Predominó en el estudio el sexo masculino y los mayores de 60 años, el consumo de alcohol como factor predisponente. En los hallazgos ecográficos predominó hígado de tamaño normal y heterogéneo, con macronódulos; la mayoría de los casos no tenían signos de hipertensión portal, fue de gran valor el cálculo de los cocientes de Harbin y Hess; solamente 7 casos no resultaron positivos de acuerdo a la ecografía. Se obtuvo una sensibilidad y especificidad alta así como el valor predictivo positivo. El índice de validez o proporción correcta de aciertos fue de 0,91 (AU)

A cross-sectional analytical observacional study was carried out with the objective to determine the ultrasonographic behavior of cirrhosis, in patients attended at Dr. Antonio Luaces Iraola Provincial General Teaching Hospital of Ciego de Ávila during January to December 2011. The study universe was integrated by the patients who went to Gastroenterology Service with suspicion of cirrhosis. The study universe was integrated by patients who went to astroenterology Service with cirrhosis suspicion.The sample was conformed by 47 cases according to inclusion criteria, to these ultrasound was carried out to them and to corroborate it an end clinical pathologycal diagnose was done as a test of gold. The obtaining technique of the information was the survey. In the study masculine sex and adults aged over 60 predominated, the alcohol consumption like predisposing factor. In the ultrasonographic finding, liver of normal and heterogenous size predominated,with macronodules; most of the cases did not have portal hypertension signs, the calculation of Harbin and Hess quotients was the great value; only 7 cases were not positive according to the ultrasound.A sensitivity and high specificity was obtained as well as positive predictive value. The index of validity or correct proportion of successes was 0,91 (AU)

Comportamiento ecográfico de la cirrosis hepática en Ciego de Ávila durante el año 2011 / Ultrasonographic behavior of cirrhosis in Ciego de Ávila during 2011

Se realizó un estudio observacional analítico transversal con el objetivo de determinar el comportamiento ecográfico de la cirrosis hepática en pacientes atendidos en el Hospital Provincial Docente “Dr. Antonio Luaces Iraola” durante el período de enero a diciembre del año 2011. El universo de estudio estuvo integrado por los pacientes que acudieron al Servicio de Gastroenterología con sospecha de cirrosis hepática. La muestra quedó conformada por 47 casos según criterios de inclusión, a estos se les realizó ecografía y para corroborarlo se realizó un diagnostico clínico-patológico final como prueba de oro. La técnica de obtención de la información fue la encuesta. Predominó en el estudio el sexo masculino y los mayores de 60 años, el consumo de alcohol como factor predisponente. En los hallazgos ecográficos predominó hígado de tamaño normal y heterogéneo, con macronódulos; la mayoría de los casos no tenían signos de hipertensión portal, fue de gran valor el cálculo de los cocientes de Harbin y Hess; solamente 7 casos no resultaron positivos de acuerdo a la ecografía. Se obtuvo una sensibilidad y especificidad alta así como el valor predictivo positivo. El índice de validez o proporción correcta de aciertos fue de 0,91.

A cross-sectional analytical observacional study was carried out with the objective to determine the ultrasonographic behavior of cirrhosis, in patients attended at Dr. Antonio Luaces Iraola Provincial General Teaching Hospital of Ciego de Ávila during January to December 2011. The study universe was integrated by the patients who went to Gastroenterology Service with suspicion of cirrhosis. The study universe was integrated by patients who went to astroenterology Service with cirrhosis suspicion.The sample was conformed by 47 cases according to inclusion criteria, to these ultrasound was carried out to them and to corroborate it an end clinical pathologycal diagnose was done as a test of gold. The obtaining technique of the information was the survey. In the study masculine sex and adults aged over 60 predominated, the alcohol consumption like predisposing factor. In the ultrasonographic finding, liver of normal and heterogenous size predominated,with macronodules; most of the cases did not have portal hypertension signs, the calculation of Harbin and Hess quotients was the great value; only 7 cases were not positive according to the ultrasound.A sensitivity and high specificity was obtained as well as positive predictive value. The index of validity or correct proportion of successes was 0,91.

Factores influyentes en el bajo peso al nacer en el área salud Camilo Cienfuegos de Chambas, 2007-2008 / Factors influencing low birth weight in the health area Camilo Cienfuegos Chambas, 2007-2008

Se realizó un estudio observacional analítico retrospectivo de casos y controles para conocer los principales factores de riesgo que influyen en el bajo peso al nacer en el área de salud Camilo Cienfuegos del municipio Chambas en el periodo comprendido entre los años 2007 y 2008. La edad materna, el nivel de escolaridad, los hábitos tóxicos como el fumar y el consumo de alcohol, la hipertensión arterial, la sepsis vaginal y las condiciones económicas no favorables resultaron tener una asociación significativa con este fenómeno. Predominaron los partos pretérmino, también en relación con el nacimiento de un niño de bajo peso(AU)

A retrospective observational and analytical case-control study was conducted to ascertain the main risk factors that influence low birth weight in the health area Camilo Cienfuegos from Chambas municipality in the period between 2007 and 2008. Maternal age, educational level, toxic habits such as smoking and alcohol consumption, hypertension, vaginal sepsis, and unfavorable economic conditions were having a significant association with this phenomenon. The preterm deliveries were predominant, also in connection with low weight babies birth(AU)

Factores influyentes en el bajo peso al nacer en el área salud Camilo Cienfuegos de Chambas, 2007-2008 / Factors influencing low birth weight in the health area Camilo Cienfuegos Chambas, 2007-2008

Se realizó un estudio observacional analítico retrospectivo de casos y controles para conocer los principales factores de riesgo que influyen en el bajo peso al nacer en el área de salud Camilo Cienfuegos del municipio Chambas en el periodo comprendido entre los años 2007 y 2008. La edad materna, el nivel de escolaridad, los hábitos tóxicos como el fumar y el consumo de alcohol, la hipertensión arterial, la sepsis vaginal y las condiciones económicas no favorables resultaron tener una asociación significativa con este fenómeno. Predominaron los partos pretérmino, también en relación con el nacimiento de un niño de bajo peso

A retrospective observational and analytical case-control study was conducted to ascertain the main risk factors that influence low birth weight in the health area Camilo Cienfuegos from Chambas municipality in the period between 2007 and 2008. Maternal age, educational level, toxic habits such as smoking and alcohol consumption, hypertension, vaginal sepsis, and unfavorable economic conditions were having a significant association with this phenomenon. The preterm deliveries were predominant, also in connection with low weight babies birth

Intervención educativa para elevar el nivel de conocimientos sobre depresión en familiares de adultos mayores diagnosticados con esta patología / Educational intervention to raise the knowledge level about depression in elderly relatives diagnosed with this disease

Se realizó un estudio pre-experimental con el objetivo determinar la efectividad de un Programa de intervención educativa en el nivel de conocimientos sobre depresión en el adulto mayor, en familias con adultos mayores diagnosticados con este problema en el Consultorio del Médico de Familia No. 3 del área de salud Camilo Cienfuegos, de junio del 2008 a mayo del 2009, en Chambas. El universo del estudio lo conformaron familiares de 175 adultos mayores que representan el total de ancianos del consultorio. La muestra la integraron familiares de 32 ancianos diagnosticados con trastornos afectivos, seleccionados en correspondencia con cada adulto mayor, previa discusión de la necesidad de la intervención educativa y de la aprobación del trabajo por la familia; se les aplicó un cuestionario que midió su nivel de conocimientos antes y después de la intervención educativa, sobre cambios generales en el adulto mayor, trastornos del equilibrio y marcha, cambios en los aspectos mentales y signos de demencia, trastornos afectivos y su prevención y transferencia al especialista. Los resultados muestran diferencias significativas entre las medias obtenidas por los familiares, antes y después de la intervención educativa. Se observaron niveles altos de conocimiento después de ejecutado el programa de intervención educativa, lo que demuestra la efectividad del mismo(AU)

A pre-experimental study was carried out with the aim of determine the effectiveness of an educational intervention program on knowledge level about depression in older adults, in families with older adults diagnosed with this problem in the Family Doctor's office number 3 of the health area Camilo Cienfuegos, from June 2008 to May 2009, Chambas. The study universe consisted of 175 elderly family members representing the total elderly´s office. The sample consisted of 32 elderly family members diagnosed with affective disorders, selected in correspondence with each older adult, preliminary discussion of the need for educational intervention and approval of work by the family, they answered a questionnaire that measured their level of knowledge before and after the educational intervention on general changes in the elderly, balance and gait disorders, changes in mental aspects and signs of dementia, affective disorders and their prevention and transfer to a specialist. The results show significant differences between the means obtained by relatives before and after the educational intervention. It was observed high levels of knowledge after executing the educational intervention program, demonstrating its effectiveness(AU)

[Style and quality of life in patients with type 2 diabetes]. / Estilo y calidad de vida de pacientes con diabetes mellitus tipo 2.

BACKGROUND: Diabetes mellitus type 2 (DM2) is the main cause of morbi-mortality, and disability in our country. The life style (LS) is the pattern of conduct that can or cannot affect the health; LS influences on the DM2 incidence and affects the quality of life of the diabetic patient. The purpose was to evaluate the quality and LS in patients with DM2. METHODS: A cross-sectional study in 150 patients with DM2 was carried out. The quality and LS were measured. RESULTS: The sample aged 53.5±6.6 years, 72.7% aged 50 to 59 years; 45.3% were women; an average of 8±2.08 years in the disease's evolution was found. The 84% belonged to a supporting group, 8.7% were in SODHI groups and 7.3% to other group. The affected domains of LS were physical activity (48.1%), Self-esteem (57.8%), Self-perception (68.3%), Diet (68.7%) and attachment to the treatment (73.5%). The most affected domains of quality of life were physical, social relations and environmental. Spirituality and believes obtained greater qualifications. CONCLUSIONS: There was little adhesion to support groups. It is necessary to improve life styles on physical activity, self-esteem, diet and attachment to the treatment.

Intervención educativa para elevar el nivel de conocimientos sobre depresión en familiares de adultos mayores diagnosticados con esta patología / Educational intervention to raise the knowledge level about depression in elderly relatives diagnosed with this disease

Se realizó un estudio pre-experimental con el objetivo determinar la efectividad de un Programa de intervención educativa en el nivel de conocimientos sobre depresión en el adulto mayor, en familias con adultos mayores diagnosticados con este problema en el Consultorio del Médico de Familia No. 3 del área de salud Camilo Cienfuegos, de junio del 2008 a mayo del 2009, en Chambas. El universo del estudio lo conformaron familiares de 175 adultos mayores que representan el total de ancianos del consultorio. La muestra la integraron familiares de 32 ancianos diagnosticados con trastornos afectivos, seleccionados en correspondencia con cada adulto mayor, previa discusión de la necesidad de la intervención educativa y de la aprobación del trabajo por la familia; se les aplicó un cuestionario que midió su nivel de conocimientos antes y después de la intervención educativa, sobre cambios generales en el adulto mayor, trastornos del equilibrio y marcha, cambios en los aspectos mentales y signos de demencia, trastornos afectivos y su prevención y transferencia al especialista. Los resultados muestran diferencias significativas entre las medias obtenidas por los familiares, antes y después de la intervención educativa. Se observaron niveles altos de conocimiento después de ejecutado el programa de intervención educativa, lo que demuestra la efectividad del mismo.

A pre-experimental study was carried out with the aim of determine the effectiveness of an educational intervention program on knowledge level about depression in older adults, in families with older adults diagnosed with this problem in the Family Doctor's office number 3 of the health area Camilo Cienfuegos, from June 2008 to May 2009, Chambas. The study universe consisted of 175 elderly family members representing the total elderly´s office. The sample consisted of 32 elderly family members diagnosed with affective disorders, selected in correspondence with each older adult, preliminary discussion of the need for educational intervention and approval of work by the family, they answered a questionnaire that measured their level of knowledge before and after the educational intervention on general changes in the elderly, balance and gait disorders, changes in mental aspects and signs of dementia, affective disorders and their prevention and transfer to a specialist. The results show significant differences between the means obtained by relatives before and after the educational intervention. It was observed high levels of knowledge after executing the educational intervention program, demonstrating its effectiveness.

Contribución de los factores genéticos y ambientales en el desarrollo de la hipertensión arterial en estudios de gemelos en el municipio Chambas / Genetic and environmental factors contribution in hypertension development in studies of twins from Chambas town

Se realizó un estudio observacional analítico transversal, en el municipio Chambas, de Febrero a Abril del 2007 para describir el comportamiento clínico, epidemiológico y genealógico de la Hipertensión Arterial, identificando la contribución de factores genéticos y ambientales en el origen de la enfermedad. El universo incluyó 41 parejas de gemelos. La muestra quedó constituida por 33, donde al menos un miembro del par padecía Hipertensión Arterial, 16 monocigóticos y 17 dicigóticos. La mayor proporción de monocigóticos concordaron para la hipertensión arterial. En ambos tipos de cigocidad predominó el grupo de 45-55 años y 65 años y más, la raza blanca; la edad de debut promedio de la enfermedad fue antes de los 50 años, destacándose el sexo masculino. Entre los factores de riesgo se destaca el sedentarismo, dieta rica en sal y tabaquismo. Predominaron los gemelos con familiares de primer grado afectados. La concordancia para monocigóticos fue de 38 por ciento, en dicigóticos 18 por ciento. Se concluye que mientras mayor es la proporción de genes compartidos en común, mayor es la probabilidad de desarrollar la hipertensión arterial, además de la importancia de los factores de riesgo no genéticos para desarrollar esta enfermedad (AU)

A cross-sectional observational study was carried out, in Chambas municipality, from February to April 2007 for describing the clinical, epidemiological and genealogical Hypertension behavior, identifying the contribution of genetic and environmental factors in the disease origin. The universe included 41 pairs of twins. The sample was composed of 33, where at least one member of pair suffered hypertension, 16 monozygotic and 17 dizygotic twins. Largest proportion of monozygotic agreed to hypertension. In both types of zygosity dominated 45 - 55 years and 65 years and older, white race; the average age of illness onset was before 50 years, particularly males. Among the risk factors highlighted a sedentary lifestyle, high-salt diet and smoking. Twins prevailed with first-degree relatives affected. The monozygotic concordance is 38 percent, 18 percent in dizygotic and the monozygotic probed was 54 percent and 30 percent dizygotic, 48 percent heritability. It concludes that the higher the proportion of genes shared in common, the greater is the likelihood of developing hypertension, and the importance of non-genetic risk factors for developing this disease (AU)

Contribución de los factores genéticos y ambientales en el desarrollo de la hipertensión arterial en estudios de gemelos en el municipio Chambas / Genetic and environmental factors contribution in hypertension development in studies of twins from Chambas town

Se realizó un estudio observacional analítico transversal, en el municipio Chambas, de Febrero a Abril del 2007 para describir el comportamiento clínico, epidemiológico y genealógico de la Hipertensión Arterial, identificando la contribución de factores genéticos y ambientales en el origen de la enfermedad. El universo incluyó 41 parejas de gemelos. La muestra quedó constituida por 33, donde al menos un miembro del par padecía Hipertensión Arterial, 16 monocigóticos y 17 dicigóticos. La mayor proporción de monocigóticos concordaron para la hipertensión arterial. En ambos tipos de cigocidad predominó el grupo de 45-55 años y 65 años y más, la raza blanca; la edad de debut promedio de la enfermedad fue antes de los 50 años, destacándose el sexo masculino. Entre los factores de riesgo se destaca el sedentarismo, dieta rica en sal y tabaquismo. Predominaron los gemelos con familiares de primer grado afectados. La concordancia para monocigóticos fue de 38 por ciento, en dicigóticos 18 por ciento. Se concluye que mientras mayor es la proporción de genes compartidos en común, mayor es la probabilidad de desarrollar la hipertensión arterial, además de la importancia de los factores de riesgo no genéticos para desarrollar esta enfermedad.

A cross-sectional observational study was carried out, in Chambas municipality, from February to April 2007 for describing the clinical, epidemiological and genealogical Hypertension behavior, identifying the contribution of genetic and environmental factors in the disease origin. The universe included 41 pairs of twins. The sample was composed of 33, where at least one member of pair suffered hypertension, 16 monozygotic and 17 dizygotic twins. Largest proportion of monozygotic agreed to hypertension. In both types of zygosity dominated 45 - 55 years and 65 years and older, white race; the average age of illness onset was before 50 years, particularly males. Among the risk factors highlighted a sedentary lifestyle, high-salt diet and smoking. Twins prevailed with first-degree relatives affected. The monozygotic concordance is 38 percent, 18 percent in dizygotic and the monozygotic probed was 54 percent and 30 percent dizygotic, 48 percent heritability. It concludes that the higher the proportion of genes shared in common, the greater is the likelihood of developing hypertension, and the importance of non-genetic risk factors for developing this disease.