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1.
BMJ Open ; 10(12): e037920, 2020 12 22.
Artículo en Inglés | MEDLINE | ID: mdl-33371014

RESUMEN

INTRODUCTION: Hypertension is a chronic disease with 31% worldwide prevalence in adults. It has been associated with non-adherence to therapeutic regime with a negative impact on the prognosis of the disease and healthcare-associated costs. So, it is necessary to identify effective interventions to improve adherence among the afflicted population. The objective of this protocol is to describe the methods for a systematic review that will evaluate the effect of individual interventions so as to improve adherence to the prescribed pharmacological treatment, as well as to prescribed diet and physical activity in adults with primary hypertension. METHODS AND ANALYSIS: A systematic search of studies will be conducted in PubMed/MEDLINE, BVS, CINAHL, Embase, Cochrane and Scopus databases. Randomised and non-randomised clinical studies conducted in human beings, published from 1 January 2009 to 13 December 2019, are to be included, in any language. Adherence to pharmacological treatment, diet and physical activity, measured by direct and indirect methods, will be the primary outcome. Two independent reviewers will select relevant studies and will extract the data following the Cochrane's Handbook for Systematic Reviews of Approach and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. Methodological quality will be evaluated using the risk-of-bias (RoB) 2 and Risk of Bias in Non-randomised Studies - of Interventions (ROBINS-I) tools. Risk of bias will also be evaluated, and if the criteria are met, a meta-analysis will be finally performed. ETHICS AND DISSEMINATION: Information to be analysed is of a grouped nature, and given that its sources are published studies, no ethics committee approval is required. Results will be published in scientific journals, and in conferences, seminars and symposiums. Copyrights will be addressed by giving due credit through bibliographic references. PROSPERO REGISTRATION NUMBER: CRD42020147655.

2.
Rev Soc Bras Med Trop ; 53: e20190477, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32049205

RESUMEN

INTRODUCTION: Benznidazole (BZL) and Nifurtimox (NFX) are the pharmacological treatment for acute phase Chagas Disease (CD); however, therapy resistance and residual mortality development remain important unresolved issues. Posaconazole (POS) has shown a trypanocidal effect in vivo and in vitro. Thus, this study aimed at comparing the T. Cruzi parasitic load-reducing effect of the combination of BZL+POS against that of monotherapy with either, during acute phase CD, in an experimental murine model. METHODS: Nineteen Wistar rats were randomly allocated to four groups and inoculated with the trypomastigotes of T. cruzi strain´s JChVcl1. The rats were administered anti-parasites from day 20-29 post-infection. The Pizzi and Brener method was used for parasitemia measurement. Longitudinal data analysis for the continuous outcome of repeated measures was performed using parasitemia as the outcome measured at days 20, 22, 24, 27, and 29 post-infection. RESULTS: All four groups had similar parasitic loads (p=0.143) prior to therapy initiation. Among the three treatment groups, the BZL+POS (n=5) group showed the highest mean parasitic load reduction (p=0.000) compared with the control group. Likewise, the BZL+POS group rats showed an earlier therapeutic effect and were the only ones without parasites in their myocardial samples. CONCLUSIONS: Treatment of acute phase CD with BZL+POS was more efficacious at parasitemia and myocardial injury reduction, compared with monotherapy with either.


Asunto(s)
Enfermedad de Chagas/tratamiento farmacológico , Nitroimidazoles/administración & dosificación , Parasitemia/tratamiento farmacológico , Triazoles/administración & dosificación , Tripanocidas/administración & dosificación , Enfermedad Aguda , Animales , ADN Protozoario , Modelos Animales de Enfermedad , Progresión de la Enfermedad , Quimioterapia Combinada , Carga de Parásitos , Ratas , Ratas Wistar
3.
Rev. Soc. Bras. Med. Trop ; 53: e20190477, 2020. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1057272

RESUMEN

Abstract INTRODUCTION: Benznidazole (BZL) and Nifurtimox (NFX) are the pharmacological treatment for acute phase Chagas Disease (CD); however, therapy resistance and residual mortality development remain important unresolved issues. Posaconazole (POS) has shown a trypanocidal effect in vivo and in vitro. Thus, this study aimed at comparing the T. Cruzi parasitic load-reducing effect of the combination of BZL+POS against that of monotherapy with either, during acute phase CD, in an experimental murine model. METHODS Nineteen Wistar rats were randomly allocated to four groups and inoculated with the trypomastigotes of T. cruzi strain´s JChVcl1. The rats were administered anti-parasites from day 20-29 post-infection. The Pizzi and Brener method was used for parasitemia measurement. Longitudinal data analysis for the continuous outcome of repeated measures was performed using parasitemia as the outcome measured at days 20, 22, 24, 27, and 29 post-infection. RESULTS All four groups had similar parasitic loads (p=0.143) prior to therapy initiation. Among the three treatment groups, the BZL+POS (n=5) group showed the highest mean parasitic load reduction (p=0.000) compared with the control group. Likewise, the BZL+POS group rats showed an earlier therapeutic effect and were the only ones without parasites in their myocardial samples. CONCLUSIONS: Treatment of acute phase CD with BZL+POS was more efficacious at parasitemia and myocardial injury reduction, compared with monotherapy with either.

4.
Rev. Univ. Ind. Santander, Salud ; 51(4): 289-300, oct.-dic. 2019. tab
Artículo en Español | LILACS | ID: biblio-1092259

RESUMEN

Resumen Introducción: Las bombas de infusión inteligentes, constituyen una herramienta útil para la administración segura de medicamentos endovenosos dado que permiten prevenir potenciales eventos adversos. Objetivo: Evaluar la adherencia y los potenciales eventos adversos prevenidos, durante la administración de medicamentos endovenosos empleando bombas de infusión inteligentes. Metodología: Estudio observacional, realizado en cuatro unidades de cuidados intensivos usando datos del software Hospira MedNetTM. Un análisis descriptivo fue llevado a cabo junto con un análisis bivariado empleando una prueba U de Mann-Whitney, una prueba de Kruskal-Wallis y un test de Bonferroni para evaluar la adherencia y los potenciales eventos adversos prevenidos por año y servicio. Resultados: La adherencia fue del 74,0%, se presentaron 78.299 alertas de seguridad y se previnieron 4,54% (n=16.288) potenciales eventos adversos. Se encontraron diferencias entre el primer y segundo año en la adherencia [Mediana: 69,15 (Q1:64,2-Q3:75,5) Vs Mediana: 84,2(Q1:72,15-Q3:89,05), p<0.001], adherencia a la seguridad [Mediana: 87,1% (Q1:83,05-Q3:91,2) Vs Mediana: 94,05 (Q1:89,95-Q3:96,2), p<0.001] y las ediciones de alertas de limite relativo [Mediana:17,0 (Q1:8,5-Q3:24,5) Vs Mediana: 12,0 (Q1:7,0-Q3:17,5), p=0.013]. La solución salina, la norepinefrina, el lactato de ringer, la piperacilina-tazobactam, la nitroglicerina y la heparina presentaron el mayor número de alertas de seguridad. Conclusión: Se encontró una buena adherencia (uso de la farmacoteca) y adherencia a la seguridad (indicador de uso de la bomba), con una reducción de los potenciales eventos adversos; así el uso de bombas inteligentes podría contribuir en la prevención de potenciales errores durante la administración de medicamentos endovenosos en la unidad de cuidados intensivos.


Abstract Introduction: Smart infusion pumps have become a useful tool for the safe administration of intravenous medications, since they allow the prevention of potential adverse events. Objetive: To assess adherence and potential adverse events prevented during intravenous medication administration using smart infusion pumps. Methods: Observational study, conducted in four intensive care units using data from Hospira MedNetTM software. A descriptive analysis was carried out together with a bivariate analysis using a Mann-Whitney U test, a KruskalWallis test and a Bonferroni test to assess adherence and potential adverse events prevented by year and service. Results: Adherence was 74.0%, 78,299 safety alerts were presented and 4.54% (n = 16,288) potential adverse events were prevented. Differences were found between the first and second year in adherence [Median: 69.15 (Q1: 64.2-Q3:75.5) versus Median: 84.2 (Q1: 72.15-Q3: 89.05), p<0.001]. Likewise safety adherence [Median: 87.1% (Q1: 83.05-Q3: 91.2) versus Median: 94.05 (Q1: 89.95-Q3: 96.2), p<0.001] and the relative limit alert editions [Median: 17.0 (Q1: 8.5-Q3: 24.5) versus Median: 12.0 (Q1: 7.0-Q3: 17.5), p=0.013]. The saline solution, norepinephrine, ringer's lactate, piperacillin-tazobactam, nitroglycerin and heparin presented the highest number of safety alerts. Conclusions: Adequate adherence (use of the drug library) and safety adherence (indicator of pump use) were found, with a reduction in potential adverse events; thus, the use of smart pumps could contribute to the prevention of potential errors during the administration of intravenous medications in the intensive care unit.


Asunto(s)
Humanos , Errores de Medicación , Bombas de Infusión , Administración de la Seguridad , Administración Intravenosa
5.
Rev. Fac. Med. (Bogotá) ; 67(2): 265-272, Apr.-June 2019. tab
Artículo en Español | LILACS-Express | LILACS | ID: biblio-1020405

RESUMEN

Resumen Introducción. La dieta es uno de los factores asociados al ataque cerebrovascular (ACV) con un impacto particular sobre las diferentes poblaciones. Objetivo. Evaluar la asociación entre el consumo de alimentos y el ACV isquémico en una muestra de pacientes adultos en Colombia. Materiales y métodos. Estudio de casos (n=357) y controles (n=348) con casos incidentes de ACV isquémico agudo. El consumo de alimentos fue evaluado mediante un cuestionario de frecuencia de consumo. Se calculó el odds ratio (OR) con sus respectivos intervalos de confianza (IC) del 95% mediante modelos de regresión logística. Resultados. Se identificaron 10 alimentos asociados con el ACV isquémico agudo. Según la escala propuesta (número de modelos con asociación significativa), un solo alimento se ubicó en la categoría de evidencia fuerte de asociación (gallina), cuatro en categoría débil (chocolate, harina de trigo, manteca, aguacate) y cinco en la categoría sospechosa (pollo con piel, pollo sin piel, arroz, arracacha, yuca). Conclusiones. El consumo de chocolate de mesa (preparado en leche con una composición de 70% azúcar y 30% cacao), aguacate y pollo sin piel podría sugerir un efecto protector, mientras la alta ingesta de harina de trigo, gallina, manteca, atún en agua, arroz, pollo con piel, arracacha y yuca podría aumentar el riesgo de presentar ACV isquémico agudo.


Abstract Introduction: Diet is one of the factors associated to stroke, with a particular impact on different populations. Objective: To assess the association between food intake and ischemic strokes in a sample of adult patients in Colombia. Materials and methods: Case (n=357) and controls (n=348) study, with incident cases of acute ischemic stroke. Food intake was assessed using a food frequency questionnaire. Odds ratios (OR) were calculated with their corresponding 95% confidence intervals (CI) using logistic regression models. Results: Ten foods associated with acute ischemic stroke were identified. According to the proposed scale (number of models with significant association), only one food was placed in the strong association category (hen), four in the weak association category (chocolate, wheat flour, lard, avocado) and five in the suspected association category (chicken with skin, skinless chicken, rice, arracacha, cassava). Conclusions: Consumption of drinking chocolate (prepared with milk and composed of 70% sugar and 30% cocoa), avocado, and skinless chicken may suggest a protective effect, while high intake of wheat flour, chicken, lard, canned tuna in water, rice, chicken with skin, arracacha and cassava may increase the risk of acute ischemic stroke.

6.
Hacia promoc. salud ; 21(1): 117-137, Jun. 2016. ilus, tab
Artículo en Español | LILACS | ID: biblio-953766

RESUMEN

OBJETIVO: realizar una síntesis del concepto de adherencia y describir los métodos empleados para medirla. METODOLOGÍA: artículo de revisión. Se realizó una búsqueda, selección y revisión de artículos originales y secundarios escritos en inglés o español, en las diferentes bases de datos: Scielo, Pubmed, Cinahl, Science@direct y Ovidsp; publicados entre 2004 y 2013. RESULTADOS: se seleccionaron 53 artículos, de los cuales 13 definían el concepto y la clasificación de los métodos, 32 fueron estudios de investigación que emplearon métodos indirectos, 17 combinaron métodos directos e indirectos y un estudio utilizó un método directo. CONCLUSIONES: se evidenció el uso de diferentes conceptos a la hora de definir la adherencia, sin que exista un consenso. Asimismo, para la medición se utilizaron diferentes técnicas, la más común fue el uso de métodos indirectos, seguidos de la combinación de directos e indirectos


OBJECTIVE: To carry out a synthesis of the concept of adherence and describe the methods used to measure it. METHODOLOGY: Review article. A search, selection and review of original and secondary articles published between 2004 and 2013, written in English or Spanish in different databases including Scielo, Pubmed, Cinahl, Science@direct and Ovidsp which were was carried out. RESULTS: A total of 53 articles were selected, 13 of which defined the concept and classification of methods; 32 were research studies that used indirect methods, 17 combined direct and indirect methods and one study used a direct method. CONCLUSIONS: The use of different concepts defining adherence, without a consensus was evident. Also, different techniques were used for measurement being the most widely used indirect methods, followed by the combination of direct and indirect methods


OBJETIVO: Realizar uma síntese do conceito de aderência e descrever os métodos empregados para medir-la METODOLOGIA: artigo de revisão. Realizou se uma busca, seleção e revisão de artigos originais e secundários escritos em inglês ou espanhol, nas diferentes bases de dados: Scielo, Pubmed, Cinahl, Science@direct e Ovidsp; publicados entre 2004 e 2013. RESULTADOS: Selecionaram se 53 artigos, dos quais 13 definiam o conceito e a classificação dos métodos, 32 foram estudos de pesquisa que empregaram métodos indiretos, 17 misturaram métodos diretos e indiretos e um estudo utilizou um método direto. CONCLUSÕES: Evidenciou se o uso de diferentes conceitos à hora de definir a aderência, sem que exista um consenso. Assim mesmo, para a medição se utilizaram diferentes técnicas, a mais comum foi o uso de métodos indiretos, seguidos da combinação de diretos e indiretos


Asunto(s)
Humanos , Terapéutica , Enfermedad Crónica , Cumplimiento de la Medicación , Métodos , Evaluación en Enfermería
7.
Rev. cienc. cuidad ; 10(2): 11-21, 2013.
Artículo en Español | LILACS, BDENF - Enfermería, COLNAL | ID: biblio-906830

RESUMEN

Objetivo: gestionar la creación y puesta en marcha de una red de apoyo intersectorial, cuyo fin es brindar soporte y contribuir a la solución de la problemática de las familias. Materiales y Métodos: estudio descriptivo, llevado a cabo en 42 familias, 15 líderes comunitarios y representantes de 8 instituciones y 11 trabajadores del centro de salud de un barrio de estratos 1 y 2 de la ciudad de Bucaramanga. Se aplicó un formato de valoración por dominios de la Asociación Norteamericana de Diagnósticos de Enfermería (NANDA) para identificar la problemática de las familias. El procesamiento de los datos, se realizó en Excel mediante la obtención de frecuencias y promedios para su posterior análisis. Resultados: se logró la creación y puesta en marcha de la red de apoyo, conformada por ocho instituciones del sector,con la cual se abordaron problemáticas como: inasistencia a programas de promoción y prevención, drogadicción, violencia intrafamiliar, embarazos en adolescentes. Conclusiones: la articulación interinstitucional y la conformación de redes de apoyo logran mejores efectos a nivel económico, social, espiritual, físico y psicológico, contribuyendo a la salud familiar. Asimismo, contribuye al desarrollo personal, profesional, liderazgo y construcción del conocimiento, propios de enfermería familiar como eje de abordaje en la salud pública.


Goal: To manage the creation and implementation of a network of cross sector support, which aims to provide support and contribute to the solution of the problems of families. Materials and Methods: A descriptive study was conducted in 42 families, 15 community leaders and representatives of eight institutions and 11 health center workers in a district of 1 and 2 statuses in the city of Bucaramanga. It was used the Format for valuation domains of the American Association of Nursing Diagnoses (NANDA) to identify the problems of families. The data processing was performed in Excel by obtaining frequencies and averages for further analysis. Results: Absence from promotion and prevention programs, drug addiction, domestic violence, teen pregnancy: the creation and implementation of the support network, consisting of eight institutions in the sector, which addressed issues as was achieved. Conclusions: interagency coordination and the creation of support networks achieve better effects in economic, social, spiritual, physical and psychological level, contributing to family health. It also contributes to personal, professional, leadership and knowledge. building, typical of family nursing as axis approach to public health.


Objetivo: Gerenciar a criação e implementação de uma rede de apoio intersetorial, que visa dar apoio e contribuir para a solução dos problemas das famílias. Materiais e Métodos: Estudo descritivo, realizado em 42 famílias, 15 líderes comunitários e representantes de oito instituições e 11 trabalhadores de centros de saúde no distrito de níveis 1 e 2, na cidade de Bucaramanga. Formato foi utilizada para domínios de avaliação da Associação Americana de Diagnósticos de Enfermagem (NANDA) para identificar os problemas das famílias. O processamento dos dados foi realizada no Excel através da obtenção de freqüências e médias para análise posterior. Resultados: Ausência de programas de promoção e prevenção, toxicodependência, violência doméstica, gravidez na adolescência: a criação e implementação da rede de apoio, constituída por oito instituições do setor, que abordou temas como foi conseguido. Conclusões: a coordenação interinstitucional ea criação de redes de apoio alcançar melhores efeitos em nível econômico, social, espiritual, física e psicológica, contribuindo para a saúde da família. Também contribui para a pessoal, profissional, liderança e construção do conhecimento, típico de enfermagem de família como eixo abordagem à saúde pública.


Asunto(s)
Apoyo Social , Organización y Administración , Atención Primaria de Salud , Enfermería
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