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1.
PLoS One ; 19(4): e0302293, 2024.
Article in English | MEDLINE | ID: mdl-38640122

ABSTRACT

Smoking is a worldwide epidemic and increased prices are one of the most cost-effective measures to reduce tobacco consumption. This article aims to estimate the price and income elasticity of cigarettes for different population groups in Ecuador. The National Survey of Urban and Rural Household Income and Expenditures (ENIGHUR) 2011-2012 was used, which has information on household cigarette consumption and its sociodemographic characteristics. Deaton's Almost Ideal Demand System, which decouples the effect of quality on the price of the good, was applied. The elasticities were calculated for several groups: urban/rural, income levels (tertiles), education level, sex and age ranges of the household head, and frequency of cigarette purchases in households. The estimated price elasticity nationwide is -0.89 and the income elasticity is 0.41, both statistically significant. Households headed by women (-2.22) are more sensitive to an increase in cigarette prices than those headed by men (-0.65) and households headed by people between 20 and 40 years of age (-2.32) have a higher price elasticity compared to country-level estimations. Differences within other groups are not statistically significant.


Subject(s)
Taxes , Tobacco Products , Male , Humans , Female , Ecuador/epidemiology , Commerce , Socioeconomic Factors , Elasticity
2.
Rev. cuba. med. mil ; 50(4)dic. 2021.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1408740

ABSTRACT

RESUMEN Introducción: La nefrolitotomía percutánea es la primera opción terapéutica para la litiasis renal coraliforme. Objetivo: Caracterizar a los pacientes con complicaciones de la nefrolitotomía percutánea para el tratamiento de la litiasis renal coraliforme. Método: Se estudió una serie de 191 pacientes, operados mediante nefrolitotomía percutánea. Variables estudiadas: tipo de litiasis coraliforme, posición para la técnica, condición de libre de litiasis después de la operación, presencia de complicaciones, momento, tipo y grado según clasificación de Clavien-Dindo. Se hallaron frecuencias absolutas, relativas y se utilizó el test de ji cuadrado para determinar asociación entre variables. Resultados: El 86,9 % tenía menos de 60 años, 67,0 % eran masculinos, 61,7 % presentaba comorbilidades. La litiasis coraliforme era parcial o total (30,3 % y 46,5 %, respectivamente). En 60,2 % afectaba el riñón izquierdo; 58,1 % se operaron en supino y 70,2 % quedaron libre de litiasis con la nefrolitotomía percutánea monoterapéutica. Ocurrieron complicaciones en 19,9 %; 16,2 % fueron postoperatorias, 14,1 % infecciosas, 7,8 % Clavien-Dindo I y 5,2 % IIIb. El tipo de litiasis y la posición de la nefrolitotomía percutánea no se asociaron con las complicaciones (p> 0,05). El grado de la complicación no se relacionó con el tipo de litiasis (p> 0,05). Conclusiones: Las complicaciones postoperatorias más frecuentes son las relacionadas con la infección y el sangrado; predominan ligeramente en los pacientes con litiasis coraliformes parcial, total y en los operados en supino; el grado Clavien-Dindo de las complicaciones, es mayor en las litiasis coraliformes más complejas.


ABSTRACT Introduction: Percutaneous nephrolithotomy is the first therapeutic option for staghorn kidney stones. Objective: To characterize patients with complications of percutaneous nephrolithotomy for the treatment of staghorn renal lithiasis. Method: A series of 191 patients, operated by percutaneous nephrolithotomy, was studied. Variables studied: type of staghorn lithiasis, position for the technique, stone-free condition after the operation, presence of complications, time, type and grade according to the Clavien-Dindo classification. Absolute and relative frequencies were found and the chi-square test was used to determine the association between variables. Results: 86.9 % were less than 60 years old, 67,0 % were male, 61,7 % had comorbidities. The staghorn lithiasis was partial or total (30,3 % and 46,5 %, respectively). In 60,2 % it affected the left kidney; 58.1 % underwent supine surgery and 70,2 % were stone free with monotherapeutic percutaneous nephrolithotomy. Complications occurred in 19,9 %; 16,2 % were postoperative, 14,1 % infectious, 7,8 % Clavien-Dindo I, and 5,2 % IIIb. The type of lithiasis and the position of the percutaneous nephrolithotomy were not associated with complications (p> 0,05). The degree of complication was not related to the type of lithiasis (p> 0,05). Conclusions: The most frequent postoperative complications are those related to infection and bleeding; they slightly predominate in patients with partial and total staghorn stones and in those operated on in the supine position; the Clavien-Dindo grade of complications is higher in the more complex staghorn stones.

3.
J Trop Med ; 2018: 4054501, 2018.
Article in English | MEDLINE | ID: mdl-30018645

ABSTRACT

Dengue, chikungunya, yellow fever, and Zika viruses transmitted by Aedes aegypti mosquitoes are major public health threats in the tropical and subtropical world. In México, construction of large tracts of "fraccionamientos" high density housing to accommodate population growth and urbanization has provided fertile ground for Ae. aegypti-transmitted viruses. We investigated the utility of pyrethroid-treated window curtains to reduce both the abundance of Ae. aegypti and to prevent dengue virus (DENV) transmission in fraccionamiento housing. Windows and doors of fraccionamiento homes in urban/suburban areas, where Ae. aegypti pyrethroid resistance associated with the Ile1016 knock down resistance (kdr) mutation in the voltage gated sodium channel gene was high, and in rural areas, where kdr resistance was low, were fitted with either insecticide-treated curtains (ITCs) or non-treated curtains (NTCs). The homes were monitored for mosquito abundance and DENV infection. ITCs reduced the indoor abundance of Ae. aegypti and the number of DENV-infected mosquitoes in homes in rural but not in urban/suburban study sites. The presence of non-treated screens also was associated with reduced numbers of mosquitoes in homes. "Super-infested" homes, yielding more than 50 mosquitoes, including DENV-infected mosquitoes, provide a significant public health risk to occupants, visitors, and people in neighboring homes.

4.
Rev Panam Salud Publica ; 41: e51, 2017 Jun 08.
Article in Spanish | MEDLINE | ID: mdl-28614471

ABSTRACT

OBJECTIVE: Analyze the proposal by the Ministry of Public Health to reform the public financing model in Ecuador with regard to pooling of funds and payment mechanisms. METHOD: A literature review was done of the financing model, the current legal framework, and the budgetary bases in Pubmed, SciELO, LILACS Ecuador, and regional LILACS using the key words health financing, health financing systems, capitation, pooling of funds, health system reform Ecuador, health system Ecuador, and health payment mechanisms. Books and other documents suggested by health systems experts were also included. RESULTS: Review of the financing model enabled identifying the historical segmentation of Ecuador's health system; out of this, the Ministry of Public Health conceived its proposal to reform the financing model. The Ministry's proposed solutions are pooling of funds and payment of services at the first level of care through payment per capita adjusted for socioeconomic and demographic risks. Progress made in reforming the financing model includes design of the proposals and their implementation mechanisms, and discussions with stakeholders. CONCLUSIONS: Implementation of these changes may produce improvements for the health system in efficiency, spreading of risks, incentives for meeting health objectives, as well as contribute to its sustainability and advance toward universal health coverage. Nevertheless, legal, political, and operational constraints are hampering their implementation.


Subject(s)
Financing, Government , Healthcare Financing , Ecuador , Health Care Reform
5.
Gene ; 627: 40-48, 2017 Sep 05.
Article in English | MEDLINE | ID: mdl-28600177

ABSTRACT

Sudden death in a child is a devastating event with important medical implications for surviving relatives. Because it may be the first manifestation of unknown inherited cardiac disease, molecular autopsy can be helpful to determine the cause of death and identify at risk family members. The aim of the study was to perform a molecular autopsy in a seven year-old girl with sudden unexplained death, to find evidence supporting the possible pathogenicity of mutations identified in inherited cardiac disease genes, and to clinically and genetically assess first-degree relatives. DNA from the index case was extracted from umbilical cord cells stored at birth, and DNA of first-degree relatives from blood samples. Targeted sequencing was performed using a Haloplex design including 81 cardiogenes. Possible functional consequences of the mutations were analyzed using protein modeling and structural mobility analyses. The child was compound heterozygous for KCNQ1 variants p.Ala300Thr and p.Pro535Thr. Ala300Thr is known to cause long QT syndrome in the homozygous state, while Pro535Thr is novel and of unknown clinical significance. The father and sibling were Ala300Thr heterozygous, and had normal QTc intervals at rest and during exercise. The asymptomatic mother was heterozygous for Pro535Thr, and showed borderline QTc at rest, but prolonged QTc during exercise. Protein modeling predicted that Ala300Thr alters the mobility profile of the Kv7.1 tetramer and Thr535 disrupts a calmodulin-binding site, probably causing co-assembly or trafficking defects of the mutant monomer. Altogether, the evidence strongly suggests that this child was affected with a recessive form of Romano Ward syndrome.


Subject(s)
Death, Sudden, Cardiac , KCNQ1 Potassium Channel/chemistry , KCNQ1 Potassium Channel/genetics , Romano-Ward Syndrome/genetics , Child , DNA Mutational Analysis , Female , Heterozygote , Humans , Models, Molecular , Pedigree , Point Mutation , Romano-Ward Syndrome/physiopathology
6.
Article in Spanish | PAHO-IRIS | ID: phr-34056

ABSTRACT

Objetivo. El objetivo de este artículo es analizar la propuesta planteada por el Ministerio de Salud Pública para la reforma del modelo de financiamiento público en Ecuador referente a mancomunación de fondos y mecanismos de pago. Método. Se realizó una revisión documental sobre el modelo de financiamiento, el marco legal vigente y las bases presupuestarias por medio de Pubmed, Scielo, LILACS Ecuador y LILACS regional utilizando como palabras clave financiamiento de la salud, sistemas de financiamiento en salud, capitación, mancomunación de fondos, reforma de salud Ecuador, sistema de salud Ecuador y mecanismos de pago en salud. Se incluyeron, además, libros y otros documentos referidos por expertos en sistemas de salud. Resultados. La revisión del modelo de financiamiento permitió identificar la segmentación histórica del sistema de salud ecuatoriano, a partir de la cual nace la propuesta del Ministerio de Salud Pública para reformar el modelo de financiamiento. El Ministerio ha planteado como soluciones la mancomunación de fondos y el pago de servicios en el primer nivel de atención mediante una cápita ajustada por riesgos socioeconómicos y demográficos. Los avances en la reforma del modelo de financiamiento incluyen el diseño de los planteamientos, sus mecanismos de implementación y el debate con los actores. Conclusiones. La implementación de estas modificaciones puede generar mejoras para el sistema de salud en la eficiencia, dispersión de riesgos, incentivos para el cumplimiento de objetivos sanitarios, así como contribuir a su sostenibilidad y avanzar hacia la cobertura universal de salud. No obstante, existen limitaciones legales, políticas y operativas que dificultan su implantación.


Objective. Analyze the proposal by the Ministry of Public Health to reform the public financing model in Ecuador with regard to pooling of funds and payment mechanisms. Method. A literature review was done of the financing model, the current legal framework, and the budgetary bases in Pubmed, SciELO, LILACS Ecuador, and regional LILACS using the key words health financing, health financing systems, capitation, pooling of funds, health system reform Ecuador, health system Ecuador, and health payment mechanisms. Books and other documents suggested by health systems experts were also included. Results. Review of the financing model enabled identifying the historical segmentation of Ecuador’s health system; out of this, the Ministry of Public Health conceived its proposal to reform the financing model. The Ministry’s proposed solutions are pooling of funds and payment of services at the first level of care through payment per capita adjusted for socioeconomic and demographic risks. Progress made in reforming the financing model includes design of the proposals and their implementation mechanisms, and discussions with stakeholders. Conclusions. Implementation of these changes may produce improvements for the health system in efficiency, spreading of risks, incentives for meeting health objectives, as well as contribute to its sustainability and advance toward universal health coverage. Nevertheless, legal, political, and operational constraints are hampering their implementation.


Subject(s)
Health Services Coverage , Ecuador , Health Care Reform , Financing, Government , Financing, Government , Capitation Fee , Health Care Reform , Health Services Coverage
7.
Trop Med Int Health ; 19(10): 1267-75, 2014 Oct.
Article in English | MEDLINE | ID: mdl-25040259

ABSTRACT

OBJECTIVES: To evaluate the household use of insecticide consumer products to kill mosquitoes and other insect pests, as well as the expenditures for using these products, in a dengue-endemic area of México. METHODS: A questionnaire was administered to 441 households in Mérida City and other communities in Yucatán to assess household use of insecticide consumer products. RESULTS: A total of 86.6% of surveyed households took action to kill insect pests with consumer products. The most commonly used product types were insecticide aerosol spray cans (73.6%), electric plug-in insecticide emitters (37.4%) and mosquito coils (28.3%). Mosquitoes were targeted by 89.7% of households using insecticide aerosol spray cans and >99% of households using electric plug-in insecticide emitters or mosquito coils. Products were used daily or every 2 days in most of the households for insecticide aerosol spray cans (61.4%), electric plug-in insecticide emitters (76.2%) and mosquito coils (82.1%). For all products used to kill insect pests, the median annual estimated expenditure per household that took action was 408 Mexican pesos ($MXN), which corresponded to approximately 31 $US. These numbers are suggestive of an annual market in excess of 75 million $MXN (>5.7 million $US) for Mérida City alone. CONCLUSION: Mosquitoes threaten human health and are major nuisances in homes in the study area in México. Households were found to have taken vigorous action to kill mosquitoes and other insect pests and spent substantial amounts of money on insecticide consumer products.


Subject(s)
Culicidae , Dengue , Family Characteristics , Health Expenditures , Insect Vectors , Insecticides , Mosquito Control/methods , Animals , Dengue/prevention & control , Endemic Diseases , Female , Humans , Insecticides/economics , Male , Mexico , Mosquito Control/economics , Surveys and Questionnaires
8.
Salud Publica Mex ; 52(1): 61-9, 2010.
Article in Spanish | MEDLINE | ID: mdl-20464255

ABSTRACT

OBJECTIVE: To analyze experiences of heterosexual Mexican people living with HIV (PLWHA) related to the exercise of their sexual and reproductive rights. MATERIAL AND METHODS: Qualitative study based on 40 in-depth interviews with PLWHA in four Mexican States. RESULTS: Lack of support and counseling limits the exercise of sexual and reproductive rights by PLWHA, especially women. Principal limitations include feelings of frustration and confusion, fear of re-infection, scanty information, lack of power to negotiate condom use, social stigma and discrimination, and limited access to services and adequate technologies. CONCLUSION: To increase awareness and exercise of rights by PLWHA it is necessary to: improve sexual education; promote processes of cultural change to combat gender inequality and stigma and discrimination; and provide timely and scientific information about HIV prevention.


Subject(s)
HIV Infections/psychology , Health Knowledge, Attitudes, Practice , Heterosexuality/psychology , Human Rights , Sexual Behavior , Adult , Confusion , Educational Status , Fear , Female , Frustration , HIV Infections/prevention & control , Humans , Male , Mexico , Middle Aged , Prejudice , Reproduction , Safe Sex , Sexual Partners/psychology
9.
Salud pública Méx ; 52(1): 61-69, ene.-feb. 2010. tab
Article in Spanish | LILACS | ID: lil-554364

ABSTRACT

OBJETIVO: Analizar experiencias relacionadas con el ejercicio de los derechos sexuales y reproductivos de personas heterosexuales que viven con VIH (PVVIH) en México. MATERIAL Y MÉTODOS: Estudio cualitativo donde se realizaron 40 entrevistas en profundidad a PVVIH en cuatro estados del país. Resultados. Vivir con VIH sin apoyo ni consejería limita el ejercicio de los derechos sexuales y reproductivos, especialmente en las mujeres. Las principales limitantes son sentimientos de frustración, falta de claridad en la información, temor a la reinfección, falta de poder para negociar el uso del condón, estigma, discriminación y falta de acceso a servicios y tecnología adecuados. CONCLUSIÓN: Para una mayor conciencia y ejercicio de los derechos de las PVVIH se necesita promover la educación sexual, cambios culturales que combatan la desigualdad de género, el estigma y la discriminación, e información oportuna y científica sobre prevención del VIH.


OBJECTIVE: To analyze experiences of heterosexual Mexican people living with HIV (PLWHA) related to the exercise of their sexual and reproductive rights. MATERIAL AND METHODS: Qualitative study based on 40 in-depth interviews with PLWHA in four Mexican States. RESULTS: Lack of support and counseling limits the exercise of sexual and reproductive rights by PLWHA, especially women. Principal limitations include feelings of frustration and confusion, fear of re-infection, scanty information, lack of power to negotiate condom use, social stigma and discrimination, and limited access to services and adequate technologies. CONCLUSION: To increase awareness and exercise of rights by PLWHA it is necessary to: improve sexual education; promote processes of cultural change to combat gender inequality and stigma and discrimination; and provide timely and scientific information about HIV prevention.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , HIV Infections/psychology , Health Knowledge, Attitudes, Practice , Heterosexuality/psychology , Human Rights , Sexual Behavior , Confusion , Educational Status , Fear , Frustration , HIV Infections/prevention & control , Mexico , Prejudice , Reproduction , Safe Sex , Sexual Partners/psychology
10.
Braz. j. microbiol ; Braz. j. microbiol;40(3): 563-568, Sept. 2009.
Article in English | LILACS | ID: lil-522476

ABSTRACT

The present study aimed to evaluate the ability for biotransformation of the Diels-Alder adduct tricyclo[6.2.1.0(2,7)]undeca-4,9-dien-3,6-dione (1) and two synthetic derivatives by the saprobe fungus Mucor ramosissimus Samutsevitsch. Products from oxidation, isomerization and, regioselective and enantioselective reduction were achieved.


Neste trabalho avaliou-se a capacidade de biotransformação do aduto de Diels-Alder triciclo[6.2.1.0(2-7)]undeca-4,9-dien-3,6-diona (1) e dois derivados sintéticos pelo fungo sapróbio Mucor ramosissimus Samutsevitsch. Produtos de oxidação, isomerização e redução regiosseletiva e enantiosseletiva foram obtidos.

11.
Braz J Microbiol ; 40(3): 563-8, 2009 Jul.
Article in English | MEDLINE | ID: mdl-24031400

ABSTRACT

The present study aimed to evaluate the ability for biotransformation of the Diels-Alder adduct tricyclo[6.2.1.0(2,7)]undeca-4,9-dien-3,6-dione (1) and two synthetic derivatives by the saprobe fungus Mucor ramosissimus Samutsevitsch. Products from oxidation, isomerization and, regioselective and enantioselective reduction were achieved.

12.
Article in English | VETINDEX | ID: vti-444421

ABSTRACT

The present study aimed to evaluate the ability for biotransformation of the Diels-Alder adduct tricyclo[6.2.1.0(2,7)]undeca-4,9-dien-3,6-dione (1) and two synthetic derivatives by the saprobe fungus Mucor ramosissimus Samutsevitsch. Products from oxidation, isomerization and, regioselective and enantioselective reduction were achieved.


Neste trabalho avaliou-se a capacidade de biotransformação do aduto de Diels-Alder triciclo[6.2.1.0(2-7)]undeca-4,9-dien-3,6-diona (1) e dois derivados sintéticos pelo fungo sapróbio Mucor ramosissimus Samutsevitsch. Produtos de oxidação, isomerização e redução regiosseletiva e enantiosseletiva foram obtidos.

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