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This study aimed to estimate the prevalence of alterations in self-perceived mental health during the COVID-19 pandemic and their associated factors in four Latin American countries. This is a cross-sectional study based on data collected from adults in 2021 through the Collaborative Response COVID-19 Survey by the MacDonnell Academy at Washington University in St. Louis (United States). The sample was composed of 8,125 individuals from Brazil, Colombia, Mexico, and Chile. A generalized linear model for a binary outcome variable with a logistic link and fixed country effects was used. There were 2,336 (28.75%) individuals who considered having suffered alterations in self-perceived mental health. Unemployed individuals (OR = 1.40; 95%CI: 1.24-1.58), those with bad/regular quality of life (OR = 5.03; 95%CI: 4.01-6.31), and those with high socioeconomic status (OR = 1.66; 95%CI: 1.41-1.96) had a higher risk of self-perceived mental health alterations than those with full-time employment, excellent quality, and low socioeconomic status. According to the fixed-effects model, Brazilians living in the country during the pandemic, who disagreed with their government's decisions (OR = 2.05; 95%CI: 1.74-2.42) and lacked trust in their government (OR = 2.10; 95%CI: 1.74-2.42) had a higher risk of having self-perceived mental health alterations. Nearly 30% of respondents indicated that the COVID-19 pandemic altered their self-perceived mental health. This outcome was associated with political, sociodemographic, and health risk factors. These findings should help policymakers develop post-pandemic community interventions.
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COVID-19 , Pueblos Sudamericanos , Adulto , Humanos , América Latina/epidemiología , Salud Mental , Calidad de Vida , Estudios Transversales , Pandemias , Brasil/epidemiología , AutoimagenRESUMEN
Abstract This study aimed to estimate the prevalence of alterations in self-perceived mental health during the COVID-19 pandemic and their associated factors in four Latin American countries. This is a cross-sectional study based on data collected from adults in 2021 through the Collaborative Response COVID-19 Survey by the MacDonnell Academy at Washington University in St. Louis (United States). The sample was composed of 8,125 individuals from Brazil, Colombia, Mexico, and Chile. A generalized linear model for a binary outcome variable with a logistic link and fixed country effects was used. There were 2,336 (28.75%) individuals who considered having suffered alterations in self-perceived mental health. Unemployed individuals (OR = 1.40; 95%CI: 1.24-1.58), those with bad/regular quality of life (OR = 5.03; 95%CI: 4.01-6.31), and those with high socioeconomic status (OR = 1.66; 95%CI: 1.41-1.96) had a higher risk of self-perceived mental health alterations than those with full-time employment, excellent quality, and low socioeconomic status. According to the fixed-effects model, Brazilians living in the country during the pandemic, who disagreed with their government's decisions (OR = 2.05; 95%CI: 1.74-2.42) and lacked trust in their government (OR = 2.10; 95%CI: 1.74-2.42) had a higher risk of having self-perceived mental health alterations. Nearly 30% of respondents indicated that the COVID-19 pandemic altered their self-perceived mental health. This outcome was associated with political, sociodemographic, and health risk factors. These findings should help policymakers develop post-pandemic community interventions.
Resumen Este estudio tuvo como objetivo estimar la prevalencia de alteraciones en la autopercepción de la salud mental durante la pandemia de COVID-19 y sus factores asociados en cuatro países de América Latina. Este es un estudio transversal de datos recopilados de adultos en el 2021 por medio de la investigación Respuesta Colaborativa a COVID-19 de la Academia McDonnell en la Universidad Washington en St. Louis (Estados Unidos). La muestra estuvo compuesta por 8.125 personas de Brasil, Colombia, México y Chile. El estudio utilizó un modelo lineal generalizado para una variable de desenlace binario con un enlace logístico y efectos fijos por país. En total, 2.336 (28,75%) personas consideraron que habían sufrido alteraciones en la autopercepción de la salud mental. Los desempleados (OR = 1,40; IC95%: 1,24-1,58), aquellos con calidad de vida mala/regular (OR = 5,03; IC95%: 4,01-6,31) y aquellos con alto nivel socioeconómico (OR = 1,66; IC95%: 1,41-1,96) presentaron mayor riesgo de alteraciones en la autopercepción de la salud mental que aquellos con empleo a tiempo completo, excelente calidad y bajo nivel socioeconómico. Según el modelo de efectos fijos, los brasileños que vivían en el país durante la pandemia y que no estuvieron de acuerdo con las decisiones del gobierno (OR = 2,05; IC95%: 1,74-2,42) y no confiaban en su gobierno (OR = 2,10; IC95%: 1,74-2,42) presentaron mayor riesgo de alteraciones en la autopercepción de la salud mental. Casi el 30% de los encuestados indicaron que la pandemia de COVID-19 alteró su autopercepción de la salud mental. Este desenlace se asoció con factores políticos, sociodemográficos y de riesgo a la salud. Estos hallazgos deben ayudar a los formuladores de políticas a desarrollar intervenciones comunitarias pospandémicas.
Resumo Este estudo teve como objetivo estimar a prevalência de alterações na autopercepção de saúde mental durante a pandemia de COVID-19 e seus fatores associados em quatro países da América Latina. Este é um estudo transversal de dados coletados de adultos em 2021 por meio da pesquisa Resposta Colaborativa à COVID-19 da Academia McDonnell na Universidade Washington em St. Louis (Estados Unidos). A amostra foi composta por 8.125 pessoas do Brasil, Colômbia, México e Chile. O estudo utilizou um modelo linear generalizado para uma variável de desfecho binário com uma conexão logística e efeitos fixos do país. No total, 2.336 (28,75%) pessoas consideraram ter sofrido alterações na autopercepção de saúde mental. Os desempregados (OR = 1,40; IC95%: 1,24-1,58), aqueles com qualidade de vida ruim/regular (OR = 5,03; IC95%: 4,01-6,31) e aqueles com alto nível socioeconômico (OR = 1,66; IC95%: 1,41-1,96) apresentaram maior risco de alterações na autopercepção de saúde mental do que aqueles com emprego em tempo integral, excelente qualidade e baixo nível socioeconômico. De acordo com o modelo de efeitos fixos, os brasileiros que viviam no país durante a pandemia, que discordavam das decisões do governo (OR = 2,05; IC95%: 1,74-2,42) e não confiavam em seu governo (OR = 2,10; IC95%: 1,74-2,42) apresentaram maior risco de alterações na autopercepção de saúde mental. Quase 30% dos entrevistados indicaram que a pandemia da COVID-19 alterou sua autopercepção de saúde mental. Esse desfecho estava associado a fatores políticos, sociodemográficos e de risco à saúde. Estes achados devem ajudar os formuladores de políticas a desenvolver intervenções comunitárias pós-pandemia.
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In response to the COVID-19 pandemic, the Chilean Congress approved three laws between July 2020 and April 2021 that allowed early withdrawals of pension funds without any eligibility constraints. In this paper, we use nationwide survey data to examine the factors associated with people's assessments about the suitability of these policies in the context of the pandemic, with a particular focus on trust and political ideology. We find that respondents that declare high levels of trust in Chile's pension system, financial system, and political institutions and actors tend to oppose early withdrawal policies. Similarly, respondents on the right of the political spectrum and those that voted for the incumbent president, who opposed this policy, also declare opposition to early withdrawals. Overall, our findings suggest that political attitudes and beliefs are associated with policy views on changes to Chile's pension-fund system and that support for early withdrawal policies may be driven by lack of confidence in institutions.
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PURPOSE: Staphylococcus aureus is one of the main causative agents of hospital-acquired (HA) infections. In Mexico, information about the characteristics of clinical S. aureus isolates is limited. Our aim was to characterize S. aureus strains obtained from blood cultures of paediatric patients treated in a tertiary care hospital. MATERIALS AND METHODS: We analysed 249 S. aureus isolates over the period from 2006 to 2019, and their resistance profiles were determined. The isolates were classified into methicillin-resistant S. aureus (MRSA) or methicillin-sensitive S. aureus (MSSA). Staphylococcal cassettes chromosome mec (SCCmec) were detected. Virulence genes (cna, clfA, clfB, eta, etb, fnbA, fnbB, hla, pvl, sec, and tsst) were amplified, and their clonal relationships were established by pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST) and clonal complex (CC) typing. We reviewed one hundred medical files to collect clinical information. RESULTS: Thirty-eight percent of the isolates were MRSA and showed an expanded profile of resistance to other non-beta-lactam antibiotics, while MSSA strains presented a reduced resistance profile. SCCmec-II was the most frequent element (86.3%). Eight virulence factors were detected in MSSA and six in MRSA. The pvl gene was detected in four MRSA-SCCmec-IV isolates (P≤0.0001). MRSA isolates were distributed among 14 clones and were classified into 15 sequence types (ST); the most frequent was ST1011 (17%). The most common CC in MRSA was CC5 (69%, P≤0.0001), and in MSSA, it was CC30 (30%, P≤0.0001). Eighty-seven percent of MRSA isolates were HA-MRSA, and 13% were community-acquired MRSA (CA-MRSA). Of 21 HA-MRSA isolates, 17 had SCCmec-II, while two CA-MRSA isolates had SCCmec-IV. Of MSSA isolates, 77% were derived from HA infections and 23% from CA infections. CONCLUSION: MSSA isolates had more virulence factors. MRSA isolates were resistant to more non-beta-lactam antibiotics, and those with SCCmec-IV expressed a greater variety of virulence factors. Most S. aureus isolates belonged to CC5.
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OBJECTIVES: Staphylococcus epidermidis can cause prosthetic joint infections. Strategies to differentiate between healthy skin and prosthetic joint infections isolates are relatively ineffective, which makes necessary to search for new differential biomarkers. Staphylococcus epidermidis has eleven surface proteins, denoted as Ses proteins. In this work, ses genes are used as biomarkers to differentiate between prosthetic joint infections and healthy skin isolates. METHODS: All prosthetic joint infections (n = 51) and healthy skin (n = 51) isolates were genotyped by pulsed-field gel electrophoresis. icaA, embp, sesA-I, and sdrF genes were determined by PCR. The phenotypic data included biofilm production and antibiotic resistance. RESULTS: 10 pulsed-field gel electrophoresis profiles were identified: four profiles were exclusive of prosthetic joint infections isolates, three profiles presented a higher proportion in prosthetic joint infections isolates and three profiles presented a higher proportion in healthy skin isolates. sesA, sesB, sesC, sesD, sesE, sesG, and sesH genes were more prevalent in healthy skin isolates than in prosthetic joint infections isolates (p < .05). Prosthetic joint infections isolates were more resistant to oxacillin (78%), ciprofloxacin (60%), levofloxacin (60%), and moxifloxacin (57%). The principal coordinate analysis and a discriminant analysis found that prosthetic joint infections isolates had as discriminant biomarker the biofilm formation, the icaA gene, oxacillin, ciprofloxacin, levofloxacin, moxifloxacin, and gentamicin resistance. In contrast, the healthy skin isolates had as discriminant biomarkers the embp, sesA, sesB, sesC, sesD, sesE, sesG, and sesH genes. CONCLUSIONS: These data suggest that ses genes can be considered biomarkers to differentiate between S. epidermidis commensal and prosthetic joint infections clinical.
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Genes Bacterianos , Infecciones Relacionadas con Prótesis/diagnóstico , Infecciones Relacionadas con Prótesis/microbiología , Infecciones Estafilocócicas/microbiología , Staphylococcus epidermidis/genética , Simbiosis , Adulto , Anciano , Anciano de 80 o más Años , Antibacterianos/farmacología , Artritis Infecciosa/microbiología , Biopelículas/crecimiento & desarrollo , Biomarcadores/análisis , Femenino , Marcadores Genéticos , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Piel/microbiología , Staphylococcus epidermidis/patogenicidad , Adulto JovenRESUMEN
BACKGROUND: Odontogenic cutaneous fistulas arise as a sequel of bacterial invasion of the dental pulp, become necrotic, and infection spreads into the periradicular area resulting in dissection and breakthrough to form sinus tracts that drain towards the skin. The objective of this study was to investigate the clinical and epidemiologic characteristics of patients diagnosed with odontogenic cutaneous fistulas. METHODS: A retrospective study was done between January 2001 and December 2011. Cases were included with a clinical and radiological diagnosis of odontogenic cutaneous fistulas. The variables investigated were frequency, gender, age, localization, morphology, time of evolution, and referral clinical diagnosis. Data were analyzed using descriptive statistical methods. RESULTS: During an 11-year period, 75 cases were found. Female gender predominated with 53% of the cases, and the mean age was 45 ± 26 years. The most frequent location was the mandible angle, in 36% of the cases, and the most common morphology was a nodule, in 52%. The mean time of evolution was 8 ± 11 months. The referral clinical diagnosis was odontogenic cutaneous fistulas in 51% of the cases. CONCLUSIONS: Our results are similar to those previously published-the diagnosis was suspected in only half of the cases. We consider it important that odontogenic cutaneous fistulas be included among the differential diagnosis of cutaneous facial lesions to avoid delaying appropriate treatment.
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Fístula Cutánea/patología , Fístula Dental/patología , Diente , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Fístula Cutánea/epidemiología , Fístula Dental/epidemiología , Cara , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Tiempo , Adulto JovenRESUMEN
La acantosis nigricans es un síndrome que afecta tanto la piel como las mucosas que se caracteriza por lesiones papilomatosas en mucosa bucal y alteraciones pigmentadas de la piel. Puede encontrarse con o sin asociación a neoplasia maligna, generalmente adenocarcinoma gástrico. Las manifestaciones bucales de este padecimiento, son más comunes cuando se encuentra asociada a neoplasia maligna y, se caracterizan por proliferaciones papilomatosas en labio, encías y lengua. El tratamiento es sintomático y al tratar la neoplasia subyacente se pueden llegar a resolver las lesiones de piel y de la boca. En el presente trabajo se describe un caso clínico asociado a adenocarcinoma de endometrio, destacando las manifestaciones bucales de la lesión de importancia para el estomatólogo de práctica general para que después de sea enviado al servicio correspondiente.
The acantosis nigricans is a syndrome that affects both the skin and the mucousas ones that are characterized by papilomatosus injuries in mucousae of the mouth and pigmented alterations of the skin. It can be with or without association to malignant neoplasia,, generally adenocarcinoma gastric. The mouth manifestations of this suffering, are more common when it is associated to malignant neoplasia and, are characterized by polilomatosus proliferations in lip, gums and tongue. The treatment is symptomatic and on having treated the neoplasia there can manage to be solved the injuries of skin and of the mouth. In the present work a clinical case is described, emphasizing the mouth manifestations of the injury of importance for the dentist for a good channeling of patiently and suitable attention.
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Humanos , Femenino , Anciano , Acantosis Nigricans/diagnóstico , Acantosis Nigricans/etiología , Adenocarcinoma/complicaciones , Adenocarcinoma/etiología , Papiloma/patología , OdontologíaRESUMEN
Es de gran importancia que el odontólogo esté entrenado en la detección temprana de cualquier lesión de la cavidad bucal, más aun cuando se trata de una lesión pre-maligna o maligna. El odontólogo es el primer profesional de la salud que entra en contacto con la cavidad bucal del paciente y por lo tanto el encargado de preservar la salud de la misma, no solo de los órganos dentarios si no de todos los tejidos que componen el aparato estomatognático. En el presente caso se muestra un paciente masculino de 72 años de edad que acude al Instituto Dermatológico de Jalisco Dr. José Barba Rubio con una lesión exofítica ulcerada de aproximadamente cinco años de evolución localizada en piel de mejilla, se realiza excisión quirúrgica, el estudio histopatológico diagnostica carcinoma de células escamosas bien diferenciado originado en cavidad bucal que posteriormente invade tejido blando y piel. Se remite al Instituto Jalisciense de Cancerología para continuar el tratamiento.
It is important, the dentist should be prepared in early detection of any lesion of the oral cavity, specially, if there is a premalignant lesion. The dentist is the health professional that first has contact with the mouth of the patient. Therefore preserving the health of dental organs and all tissues of the mouth. The case we report, is a 72 year old male who presented at the dermatological institute of Jalisco, Dr. Jose Barba Rubio, with an ulcerated exophytic lesion of approximately five years of development, surgical excision is performed, the histopathological diagnosis of squamous cell carcinoma, well differentiated originated in the oral cavity, the latter invading soft tissue and skin. The patient was referred to the Instituto Jalisciense de Cancerología, to continue treatment.
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Humanos , Masculino , Anciano , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patología , Neoplasias de la Boca/diagnóstico , Neoplasias de la Boca/patología , Pronóstico , Factores de TiempoRESUMEN
We report a rare case of intravascular papillary endothelial hyperplasia (IPEH) of the oral mucosa. This neoplasm, known as Masson's tumor, is an unusual vascular lesion of proliferating endothelial cells. It is usually confined to the lumen of preexisting vessels or vascular malformations. The principal significance of IPEH is its microscopic resemblance to angiosarcoma and possible misdiagnosis as such. Achieving a correct diagnosis is essential to avoid subjecting a patient to unnecessarily aggressive therapy. For this reason, awareness of this lesion is very important for dermatologists and dentists. In this article, we discuss the clinical features, histopathological characteristics, and management of IPEH and review the pertinent literature.
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