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Gene ; 723: 144120, 2020 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-31589964


PURPOSE: Matrix Gla protein (MGP) is a vitamin K-dependent, γ-carboxylated protein that was initially found to be a physiological inhibitor of ectopic calcifications affecting mainly cartilage and the vascular system. Mutations in the MGP gene were found to be responsible for a human pathology, the Keutel syndrome, characterized by abnormal calcifications in cartilage, lungs, brain and vascular system. MGP was recently implicated in tumorigenic processes such as angiogenesis and shown to be abnormally regulated in several tumors, including cervical, ovarian, urogenital and breast. This fact has triggered our interest in analyzing the expression of MGP and of its regulator, the transcription factor runt related transcription factor 2 (RUNX2), in colorectal cancer (CRC). METHODS: MGP and RUNX2 expression were analyzed in cancer and non-tumor biopsies samples from 33 CRC patients and 9 healthy controls by RT-qPCR. Consequently, statistical analyses were performed to evaluate the clinical-pathological significance of MGP and RUNX2 in CRC. MGP protein was also detected by immunohistochemical analysis. RESULTS: Showed an overall overexpression of MGP in the tumor mucosa of patients at mRNA level when compared to adjacent normal mucosa and healthy control tissues. In addition, analysis of the expression of RUNX2 mRNA demonstrated an overexpression in CRC tissue samples and a positive correlation with MGP expression (Pearson correlation coefficient 0.636; p ≤ 0.01) in tumor mucosa. However correlations between MGP gene expression and clinical-pathological characteristics, such as gender, age and pathology classification did not provide relevant information that may shed light towards the differences of MGP expression observed between normal and malignant tissue. CONCLUSIONS: We were able to associate the high levels of MGP mRNA expression with a worse prognosis and survival rate lower than five years. These results contributed to improve our understanding of the molecular mechanism underlying MGP deregulation in cancer.

Proteínas de Unión al Calcio/genética , Proteínas de Unión al Calcio/metabolismo , Neoplasias Colorrectales/patología , Subunidad alfa 1 del Factor de Unión al Sitio Principal/genética , Proteínas de la Matriz Extracelular/genética , Proteínas de la Matriz Extracelular/metabolismo , Regulación hacia Arriba , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias Colorrectales/genética , Neoplasias Colorrectales/metabolismo , Femenino , Regulación Neoplásica de la Expresión Génica , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Análisis de Supervivencia
Gene ; 722: 144057, 2020 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-31430519


OBJECTIVE: Fork head domain-containing transcription factor family (FOX), is comprised of >20 members. Members of FOX family have been implicated in a wide range of physiological and/or diseased conditions. Many of FOX members have been shown to be involved in tumorigenesis and progression. The potential roles in carcinogenesis of FOXN4, a member as one of the vast FOX family, remains relatively unknown. METHOD: Here, we explored the potential involvement of FOXN4 in breast cancer. RESULTS: First, observed that a higher FOXN4 was identified in the normal adjacent breast tissue as compared to that in the breast cancer samples; an increased FOXN4 level was associated with a better prognosis in patients with breast cancer. In addition, ectopically expression of FOXN4 led to the decreased cell proliferation, reduced colony formation and metastatic abilities (EMT, migration and invasion) in breast cancer cell lines. Furthermore, we showed the direct interaction between FOXN4 and TP53 and FOXN4 binding led to the increased activity of TP53. Silencing FOXN4 led to reduced TP53 and increased expression of Dll4, Notch and survivin, providing a link between FOXN4 and Notch signaling. Finally, we used patient-derived xenograft mouse model to demonstrate the tumor inhibitory effects of Notch-inhibitor, PF-3084014. We found that PF-3084014 treatment led to a significantly smaller tumor burden and higher survival ratio in patient-derived xenograft mice as compared to the vehicle. This tumor suppressive effect was accompanied by the increased expression of TP53, FOXN4 and decreased Dll4 and Notch. CONCLUSION: Collectively, our data strongly suggested the tumor suppressive roles of FOXN4 in breast tumorigenesis via the activation of TP53 while suppressing Notch signaling. Future studies are warranted to explore the clinical application of PF-3084104 (Notch inhibitor) for the treatment of breast cancer patients.

Neoplasias de la Mama/metabolismo , Factores de Transcripción Forkhead/metabolismo , Proteínas Supresoras de Tumor/metabolismo , Adulto , Animales , Neoplasias de la Mama/genética , Neoplasias de la Mama/patología , Carcinogénesis , Línea Celular Tumoral , Proliferación Celular , Femenino , Factores de Transcripción Forkhead/genética , Humanos , Péptidos y Proteínas de Señalización Intercelular/metabolismo , Neoplasias Mamarias Experimentales/tratamiento farmacológico , Neoplasias Mamarias Experimentales/genética , Neoplasias Mamarias Experimentales/metabolismo , Ratones , Metástasis de la Neoplasia , Pronóstico , Receptores Notch/antagonistas & inhibidores , Receptores Notch/metabolismo , Transducción de Señal , Tetrahidronaftalenos/uso terapéutico , Proteína p53 Supresora de Tumor/genética , Proteína p53 Supresora de Tumor/metabolismo , Proteínas Supresoras de Tumor/genética , Valina/análogos & derivados , Valina/uso terapéutico
Gene ; 722: 144098, 2020 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-31494241


This study evaluated the possible association between SNPs in cytokines coding genes, namely IL10, IL6 and IFNG, cytokines serum levels and clinical assessment' scores in patients with Rheumatoid Arthritis(RA). SNPs genotyping was performed in 126 RA patients and 177 healthy individuals with Taqman probes specific for IL10 -1082 (T>C, rs1800896);INFG -1616 (A>G, rs2069705) and IL6 -174 (G>C, rs1800795) variants,positioned in regulatory regions. Cytokine Bead Array (CBA) was used to measure cytokine levels. We found association between INFG -1616 G allele(p = 0.0210; OR = 1.605) and INFG -1616 GG genotype (p = 0.0268; OR =2.609) and RA susceptibility. We also observed association between IL10 -1082 TT genotype and high clinical disease activity index (CDAI) values (p = 0.026; OR = 1.906; 95% CI = 1.082 - 3.359), IL10 -1082 CC genotype and low CDAI values (p = 0.016; OR = 0.256) and INFG -1616 AA and high CDAI values (p = 0.025; OR = 2.919). IL10 -1082 CC also exhibited the lowest IL-10 levels than IL10 -1082 TT (p = 0.020) and IL10 -1082 TC (p = 0.032). Finally, we verified higher IL-6 value in the RA patients than healthy control group (p = 0.007) and an association between high IL-6 levels and increased CDAI (r = 0.4648, p = 0.0015); DAS 28 (r = 0.3933, p= 0.0091), presence of bone erosions (r = 0.3170, p = 0.0361), ESR levels(r = 0.3041, p = 0.0448) and IFN-γ levels (r = 0.3049, p = 0.0468).Altogether, we suggest that IL10 -1082 (T>C, rs1800896) and INFG -1616(A>G, rs2069705) polymorphisms as well as IL-6 levels alterations may play a role for prognostic and disease follow-up.

Artritis Reumatoide/genética , Interferón gamma/genética , Interleucina-10/genética , Interleucina-6/genética , Polimorfismo de Nucleótido Simple , Adulto , Artritis Reumatoide/sangre , Artritis Reumatoide/diagnóstico , Femenino , Frecuencia de los Genes , Genotipo , Humanos , Interferón gamma/sangre , Interleucina-10/sangre , Interleucina-6/sangre , Masculino , Persona de Mediana Edad
Gene ; 722: 144127, 2020 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-31525397


Complement factor H (CFH) serves as a major down-regulator in the complement system, often utilized by bacterial pathogens to evade complement attack. Yet, little is currently known about the genetic correlation of CFH polymorphisms with sepsis due to various microbial infections. A case-control method (488 septic patients and 527 healthy individuals) was carried out in this study to investigate the genetic relationship between CFH polymorphisms (rs3753394 C/T, rs1065489 G/T and rs1061170 C/T) and susceptibility to sepsis caused by bacterial infections in Chinese Han populations. Our findings indicated that the frequency of rs3753394 CT/TT genotype in the septic patients with P. aeruginosa was significantly higher than that in the control individuals (P = 0.033, OR = 2.668, 95%CI = 1.072-6.334). The rs3753394 T allele frequency in the P. aeruginosa-infected patients was significantly increased, compared to that in the healthy controls (P = 0.014, OR = 1.68, 95%CI = 1.118-2.538). Moreover, these significant differences of rs3753394 genotype and allele frequencies remained after multiple testing corrections [P (corr.) = 0.033 for genotype; P (corr.) = 0.033 for allele]. The current study highlighted the significance of CFH polymorphism rs3753394 as a potential biomarker for targeting P. aeruginosa infection in critically ill patients.

Predisposición Genética a la Enfermedad , Infecciones por Pseudomonas/genética , Pseudomonas aeruginosa , Sepsis/genética , Adulto , Anciano , Grupo de Ascendencia Continental Asiática/genética , Estudios de Casos y Controles , China/etnología , Factor H de Complemento/genética , Frecuencia de los Genes , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Infecciones por Pseudomonas/diagnóstico , Infecciones por Pseudomonas/etnología , Sepsis/diagnóstico , Sepsis/etnología , Sepsis/microbiología
Einstein (Sao Paulo) ; 18: eAO4739, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31553355


OBJECTIVE: To use magnetic resonance imaging to assess the prevalence of foot and ankle ligament injuries and fractures associated with ankle sprain and not diagnosed by x-ray. METHODS: We included 180 consecutive patients with a history of ankle sprain, assessed at a primary care service in a 12-month period. Magnetic resonance imaging findings were recorded and described. RESULTS: Approximately 92% of patients had some type of injury shown on the magnetic resonance imaging. We found 379 ligament injuries, 9 osteochondral injuries, 19 tendinous injuries and 51 fractures. Only 14 magnetic resonance imaging tests (7.8%) did not show any sort of injury. We observed a positive relation between injuries of the lateral complex, syndesmosis and medial ligaments. However, there was a negative correlation between ankle ligament injuries and midfoot injuries. CONCLUSION: There was a high rate of injuries secondary to ankle sprains. We found correlation between lateral ligament injuries and syndesmosis and deltoid injuries. We did not observe a relation between deltoid and syndesmosis injuries or between lateral ligamentous and subtalar injuries. Similarly, no relation was found between ankle and midfoot injuries.

Traumatismos del Tobillo/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Adolescente , Adulto , Anciano , Traumatismos del Tobillo/diagnóstico por imagen , Brasil/epidemiología , Cartílago Articular/lesiones , Niño , Femenino , Humanos , Ligamentos Laterales del Tobillo/lesiones , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Prevalencia , Adulto Joven
Acta Neurochir Suppl ; 127: 179-183, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31407082


From 2013 to 2017, at the Burdenko Institute of Neurosurgery, intra-arterial verapamil for treatment of cerebral vasospasm following intracranial hemorrhage after aneurysm rupture was administered to 35 patients (total 75 procedures). The age is from 8 to 77 years. All ruptured aneurysms were treated: in 26 cases with open approach-clipping-and in 9 cases with endovascular occlusion. The procedure was carried out from 0 to 11 days after the operation. Severity of spasm was assessed by angiography and TCDU. Efficacy of the administration was assessed by TCDU 1 h after the procedure and by clinical evaluation of the patient's condition. The dose of verapamil was 15-50 mg (on average 40 mg) per procedure/per carotid pool and depended on the data of TCDU and clinical and radiological picture. The procedure was performed repeatedly (1-5 times) according to the indications and depending on the patient's condition, with an interval of 24 h. The procedure was effective as a preventive measure for care of patients in the initial stage of cerebral ischemia and was ineffective with a formed focus of ischemia. Endovascular administration of verapamil for treatment of cerebral vasospasm is a safe technique which positively affects the overall recovery of such patients.

Aneurisma Roto , Hemorragia Subaracnoidea , Vasodilatadores , Vasoespasmo Intracraneal , Verapamilo , Adolescente , Adulto , Anciano , Niño , Humanos , Persona de Mediana Edad , Hemorragia Subaracnoidea/tratamiento farmacológico , Hemorragia Subaracnoidea/prevención & control , Resultado del Tratamiento , Vasodilatadores/uso terapéutico , Vasoespasmo Intracraneal/tratamiento farmacológico , Verapamilo/uso terapéutico , Adulto Joven
Belo Horizonte; s.n; 20192803. 59 p. ilus, tab.
Tesis en Portugués | Coleciona SUS | ID: biblio-1016793


Introdução: As avaliações usando tecnologia estão presentes nas escolas em vários países, e seu uso se popularizou nas últimas duas décadas, sendo utilizadas no exame para licença médica nos Estados Unidos desde 1999. O potencial que as avaliações aprimoradas por tecnologia trazem para o mundo acadêmico foi o que motivou a realização deste estudo, e o conhecimento advindo de uma conferência específica sobre essas tecnologias trouxe o incentivo para persistir nessa linha de pesquisa. Método: Este estudo tem por objetivo comparar o estresse, a satisfação e o desempenho dos acadêmicos durante o primeiro semestre de 2018, ao realizarem provas escritas convencionais e provas no computador na disciplina de Ginecologia e Obstetrícia do curso de Medicina da Universidade José do Rosário Vellano, campus Alfenas. Foram avaliadas as turmas do décimo segundo período e sétimo período, totalizando uma amostra de 135 alunos. Tratou-se de um estudo experimental randomizado em que os alunos foram divididos em dois grupos para as avaliações e foram-lhes aplicados questionários pré-definidos e presenciais. Antes da prova, foram entregues aos alunos perguntas específicas para avaliar o estresse envolvido em sua realização. Ao término da prova, foram aplicadas as questões que avaliaram a satisfação com o tipo de prova realizada. Foram ainda registradas as notas obtidas nos dois tipos de avaliação. Cada aluno fez uma avaliação escrita convencional e uma avaliação via computador. Resultados: Os acadêmicos avaliados demonstraram maior estresse e menor satisfação com a prova no computador, comparando-a com a prova escrita convencional. O tipo de prova não esteve associado ao desempenho acadêmico. Conclusão: A falta de familiaridade e treinamento com a metodologia, antes da aplicação das avaliações, causou aumento no estresse nos acadêmicos envolvidos no presente estudo, o que interferiu na satisfação, ao fazer a prova usando tecnologia, embora não tenha havido diferença nos escores de desempenho. As informações coletadas serão utilizadas para reestruturação do formato dos testes oferecidos no departamento de Ginecologia e Obstetrícia da UNIFENAS, campus Alfenas, com o intuito de aprimorar a avaliação teórica que se realiza na Universidade.

Introduction: Evaluations using technology are present in schools in several countries and have become popular in the last two decades and have been used in the United States medical license examination since 1999. The potential that improved technology assessments bring to the academic world motivated the carrying out of this study, and the knowledge from a specific conference on these technologies brought the incentive to persist in this research line. Method: This study aims to compare the stress, satisfaction and performance of academics during the first semester of 2018, when conducting conventional written tests and computer tests in the course of Gynecology and Obstetrics of the medical program of the University of José do Rosário Vellano, Alfenas campus, a total sample of 135 students. It was a randomized experimental study in which the students were divided for the evaluations and pre-defined and class-based questionnaires were applied. Prior to the test, specific questions were given to students to assess the stress involved in their achievement. At the end of the test, the questions were answered to evaluate the satisfaction with the type of the test they took. Each student did a conventional written assessment and a computer assessment. Results: The evaluated students showed greater stress and less satisfaction with the computer-based test compared to the conventional written test, although there was no statistical difference in performance when comparing both. Conclusion: Lack of familiarity and training with the methodology prior to test application resulted an increase in students' stress in the present study, which interfered in the satisfaction with the test using technology, even though there was no difference in the performance scores. The collected information will be used to restructure the format of the tests offered in the Department of Gynecology and Obstetrics of UNIFENAS, Campus Alfenas, in order to improve the theoretical evaluation performed at the University.

Humanos , Masculino , Femenino , Adulto , Adulto Joven , Educación Médica , Estudiantes de Medicina , Computadores , Evaluación Educacional , Rendimiento Académico
Rev. Esc. Enferm. USP ; 53: e03464, Jan.-Dez. 2019.
Artículo en Español | LILACS, BDENF - Enfermería | ID: biblio-1020376


RESUMEN Objetivo Explorar la construcción social que sobre violencia obstétrica han elaborado mujeres Tének y Náhuatl de México. Método Estudio cualitativo-sociocrítico, mediante gupos focales se profundizó en las experiencias de parto de quienes vivieron un parto en el periodo 2015-2016. Resultados Participaron 57 mujeres. Mediante análisis de discurso se identificó que las participantes no poseen suficiente información sobre violencia obstétrica y/o derechos sexuales y reproductivos, lo que las imposibilita para asociar sus experiencias negativas al término legal "violencia obstétrica". Sus discursos corresponden en su mayoría a lo que desde el marco legal se ha denominado "violencia obstétrica", sin embargo, experiencias como el ayuno prolongado o el uso de tecnologías para la invasión de su intimidad fueron narradas como algo que conciben violento y que no se ha incorporado dentro del término legal. Conclusión Múltiples acciones que atentan contra los derechos humanos de las mujeres tienen lugar dentro de las salas de parto, la mayor parte no son identificadas por las usuarias, puesto que no han construido socialmente la imagen de la violencia obstétrica, ello no las hace menos susceptibles sin embargo, a sentirse agredidas y denigradas en sus partos.

RESUMO Objetivo Explorar a construção social que as mulheres Tének e Náhuatl do México elaboraram sobre a violência obstétrica. Método Estudo qualitativo-sociocrítico; por meio de grupos focais, houve um aprofundamento nas experiências de parto daquelas que passaram por um parto no período de 2015 a 2016. Resultados Participaram 57 mulheres. Mediante análise do discurso, foi identificado que as participantes não possuem informação suficiente sobre violência obstétrica e/ou direitos sexuais e reprodutivos, o que as impossibilita de associar suas experiências negativas ao termo legal "violência obstétrica". Seus discursos correspondem na sua maioria ao que, a partir do marco legal, foi denominado "violência obstétrica"; entretanto, experiências como jejum prolongado ou uso de tecnologias para a invasão da sua intimidade foram narradas como algo que concebem ser violento e que não foi incorporado ao termo legal. Conclusão Múltiplas ações que atentam contra os direitos humanos das mulheres têm lugar dentro das salas de parto, a maior parte não é identificada pelas usuárias, visto que não construíram socialmente a imagem da violência obstétrica, mas isso não as faz menos suscetíveis de sentir-se agredidas e denegridas nos seus partos.

ABSTRACT Objective To explore the social construction of obstetric violence developed by Tenek and Nahuatl women in Mexico. Method Qualitative, socio-critical study conducted through focal groups in which were deepened the childbirth experiences lived in the period 2015-2016. Results Participation of 57 women. Through discourse analysis, it was identified that participants do not have enough information about obstetric violence and/or sexual and reproductive rights. This makes the association of their negative experiences with the legal term "obstetric violence" impossible. Most of their speeches correspond to the legal denomination of "obstetric violence". Experiences like prolonged fasting or the use of technologies for invading their privacy were narrated like situations they perceive as violent, but have not been incorporated within the legal term. Conclusion Multiple actions against women's human rights take place within delivery rooms. Most remain unidentified by users, since they have not socially constructed the image of obstetric violence. However, that fact does not make them less susceptible to feel attacked and denigrated during their childbirth experiences.

Humanos , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Salas de Parto , Parto , Población Indígena , Violencia contra la Mujer , México , Grupos Focales , Investigación Cualitativa , Enfermería Obstétrica
Acta colomb. psicol ; 22(2): 53-69, July-Dec. 2019. tab
Artículo en Inglés | LILACS | ID: biblio-1019276


Abstract Different studies with university students show the presence of a negative image about the elderly and an absence of positive stereotypes regarding this age group. With the increase of the older population, these stereotypes must disappear in order to work with aged people without a negative view of them. The aim of this paper was to identify the existence of negative stereotypes towards old age in students who are pursuing health-related and not related university degree courses. A total of 262 students were assessed with the CENVE questionnaire. In order to find out whether there were differences between students with respect to negative stereotypes, an ANOVA and a post-hoc comparison test were carried out. Results were significant at the 5% level. These show evidence of the existence of negative stereotypes about old age in students pursuing university degrees related and not related to the field of health. ANOVAs showed differences in total CENVE (F3 259 = 3.574; p = 0.015; r2 = 0.040), Social Motivation dimension (F3259 = 3.697; p = 0.012; rf = 0.042), and Personality dimension (F3259 = 5.157; p = 0.002; r2 = 0.057). The post-hoc tests show the existence of differences in stereotypes depending on the course that is being studied, where the health related courses show the lower level of negative stereotypes.

Resumo Diversos estudos sobre estereótipos com estudantes universitários mostram que as pessoas idosas são percebidas mais frequentemente a partir de uma imagem negativa do que com estereótipos positivos. Levando em consideração o crescente aumento da população idosa na atualidade e como o fim de trabalhar com pessoas mais velhas a partir de uma visão positiva de si mesmos, é preciso que esses estereótipos desapareçam. O objetivo deste trabalho foi determinar se existem estereótipos negativos com respeito à velhice em estudantes de cursos universitários relacionados e não relacionados com o campo da saúde. No total, 262 estudantes foram avaliados com o questionário CENVE e, para saber se existiam diferenças de estereótipos negativos entre os estudantes de acordo com sua habilitação, foi realizada uma análise ANOVA, além de comparações post hoc. Os resultados foram significativos com um nível de 5% e evidenciaram a existência de estereótipos negativos com respeito à velhice em estudantes de habilitações universitárias relacionadas e não relacionadas com o campo da saúde. Os ANOVA mostraram diferenças para o CENVE total (F3259 = 3.574; p = .015; n2 = .040), para a dimensão de motivação social (F3259 = 3.697; p = .012; n2 = .042) e para a dimensão de personalidade (F3259 = 5.157; p = .002; n2 = .057). As provas post hoc mostraram a existência de diferenças no grau de estereótipos negativos de acordo com as habilitações em curso, sendo que as habilitações de saúde mostraram menor grau em comparação com as demais.

Resumen Diversos estudios sobre estereotipos con estudiantes universitarios muestran que las personas mayores son percibidas más desde una imagen negativa que con estereotipos positivos. Teniendo en cuenta el creciente aumento de la población mayor en la actualidad, y con el fin de trabajar con personas mayores desde una visión positiva de sí mismos, es necesario que estos estereotipos desaparezcan. El objetivo de este trabajo fue determinar si existen estereotipos negativos hacia la vejez en estudiantes de carreras universitarias relacionadas y no relacionadas con el campo de la salud. En total, se evaluó a 262 estudiantes con el cuestionario CENVE, y, para saber si existían diferencias de estereotipos negativos entre los estudiantes según su titulación, se realizó un análisis ANOVA, además de comparaciones post hoc. Los resultados fueron significativos al nivel del 5 % y evidenciaron la existencia de estereotipos negativos hacia la vejez en estudiantes de títulos universitarios relacionados y no relacionados con el campo de la salud. Los ANOVA mostraron diferencias para el CENVE total (F3259 = 3.574; p = .015; η 2 = .040), para la dimensión de motivación social (F3259 = 3.697; p = .012; η2 = .042) y para la dimensión de personalidad (F3259 = 5.157; p = .002; η 2 = .057). Las pruebas post hoc mostraron la existencia de diferencias en el grado de estereotipos negativos según las titulaciones en curso, donde las titulaciones sanitarias mostraron menor grado en comparación con las demás.

Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Ageísmo
Acta colomb. psicol ; 22(2): 148-177, July-Dec. 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1019280


Abstract The objective of the present study was to design, validate and obtain the reliability of the Maternal Attitudes Towards Overweight and Childhood Obesity Scale. The validation of this instrument was carried out in four stages: a) Study 1: Exploratory, with N= 95 mothers and grandmothers aged 20 to 46 years (M age = 32.43, SD = 7.9) which used the semantic networks technique to inquire about the psychological meaning of overweight and obesity; b) Study 2: Content Validity, where 33 items were written and the content validity was obtained through five judges; c) Study 3: First Validation, which included 346 mothers aged 18 to 62 (M age = 33.08, SD = 6.8) with preschool children; 11 items were obtained distributed in three factors denominated: negative attitude (α = .72), meaning (α = .63) and importance (α = .56), with α = .77 of the total scale and an explained variance of 54.50%; d) Study 4: Second Validation, in which 369 mothers and grandmothers (3 %) aged between17 and 63 years (M age = 32.43, SD = 7.9) participated. The final scale was two-dimensional, composed of 11 items with an α =.85 and an explained variance of 46%, which evaluates the negative attitudes perceived towards obesity and its consequences.

Resumo O objetivo do presente estudo foi desenhar e validar a Escala de atitudes maternas com respeito ao sobrepeso e à obesidade infantil. Em particular, a validação consistiu de quatro etapas: (a) um estudo exploratório (Estudo 1) com 95 mães e avós de 20 a 46 anos (M idade = 32.43, DP = 7.9), no qual se utilizou a técnica de redes semânticas para conhecer o significado psicológico do sobrepeso e da obesidade; (b) um estudo de validade de conteúdo (Estudo 2), no qual 33 reativos foram escritos e a validade de conteúdo foi obtida por meio do conceito de cinco juizes; (c) um estudo para uma primeira validação (Estudo 3) com 346 mães de 18 a 62 anos (M idade = 33.08, DP = 6.8) com filhos em idade pré-escolar, com a qual foram obtidos 11 reativos distribuidos em três fatores, denominados atitude negativa (α = .72), significado (α = .63) e importância (α = .56), com um α = .77 na escala total e uma variância explicada de 54,50%, e (d) um estudo para uma segunda validação (Estudo 4), no qual participaram 369 mães e avós (3 %) de 17 a 63 anos (M idade = 32.43, DE = 7.9). Como resultado, a escala foi bidimensional, composta por 11 reativos, com um α = .85 e uma variância explicada de 46%, que avalia as atitudes negativas percebidas com respeito à obesidade e suas consequências.

Resumen El objetivo del presente estudio fue diseñar y validar la escala de actitudes maternas hacia el sobrepeso y la obesidad infantil. En particular, la validación consistió en cuatro etapas: (a) un estudio exploratorio (Estudio 1) con 95 madres y abuelas de 20 a 46 años (M edad = 32.43, DE = 7.9), en el que se utilizó la técnica de redes semánticas para conocer el significado psicológico del sobrepeso y la obesidad; (b) un estudio de validez de contenido (Estudio 2), en el que se redactaron 33 reactivos, y la validez de contenido se obtuvo mediante el concepto de cinco jueces; (c) un estudio para una primera validación (Estudio 3) con 346 madres de 18 a 62 años (M edad = 33.08, DE = 6.8), con hijos en edad preescolar, con el cual se obtuvieron 11 reactivos distribuidos en tres factores, denominados actitud negativa (α = .72), significado (α = .63) e importancia (α = .56), con un α = .77 en la escala total y una varianza explicada del 54.50 %; y (d) un estudio para una segunda validación (Estudio 4), en el que participaron 369 madres y abuelas (3 %) de 17 a 63 años (M edad = 32.43, DE = 7.9). Como resultado, la escala fue bidimensional, compuesta por 11 reactivos, con un α = .85 y una varianza explicada del 46 %, que evalúa las actitudes negativas percibidas hacia la obesidad y las consecuencias de esta.

Humanos , Femenino , Adulto , Persona de Mediana Edad , Adulto Joven , Sobrepeso , Madres , Obesidad
Acta colomb. psicol ; 22(2): 194-217, July-Dec. 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1019282


Abstract The purpose of this study was to analyze the divergences in perception of parental practices, positive behavior and problems between parents and children. The participants, parents and adolescents, collaborated voluntarily and were examined in the following dyads: 248 fathers-sons, 241fathers-daughters, 237 mothers-sons, and 241 mothers-daughters. The psychometric instruments used were the Strengths and Difficulties Scale and the Parental Practices Scale for mothers and fathers. To achieve the main objective, correlation analysis, path analysis and differences of means with related samples were performed. The results showed correlations, from moderate to low, between parental practices, problems and prosocial behavior. In addition, different predictive factors of the children's behaviors were obtained, according to the sex of the parents and the parental practices they implemented. Finally, there were divergences between reports of parental practices, prosocial behavior and problems between parents and their children. Therefore, it is concluded that parental behavior is oriented according to the sexual role of their children, which involves social desirability.

Resumo O presente estudo teve como finalidade analisar as divergências na percepção das práticas parentais, no comportamento positivo e nas problemáticas entre pais e filhos. Os participantes, pais e adolescentes, colaboraram de maneira voluntária e foram avaliados nas seguintes díades: 248 pais-filhos, 241 pais-filhas, 237 mães-filhos e 241 mães-filhas. Os instrumentos utilizados foram a Escala de Capacidades e Dificuldades e a Escala de Práticas Parentais para mães e pais. Para alcançar o objetivo principal, realizaram-se análises de correlação, análises de caminhos e diferenças de médias com amostras relacionadas. Os resultados mostraram correlações - de moderadas a baixas - entre as práticas parentais, os problemas e a conduta pró-social, além de diferentes fatores preditivos das condutas dos filhos a partir do gênero dos pais e das práticas parentais exercidas. Houve divergências entre os relatórios de práticas parentais, conduta pró-social e problemas entre os pais e seus filhos. Conclui-se que a conduta parental é orientada de acordo com o gênero dos filhos, o que implica certa desejabilidade social relacionada com seu papel como homens ou como mulheres.

Resumen El presente estudio tuvo como finalidad analizar las divergencias en la percepción de las prácticas parentales, el comportamiento positivo y las problemáticas entre padres e hijos. Los participantes, padres y adolescentes, colaboraron de manera voluntaria y se evaluaron en las siguientes díadas: 248 padres-hijos, 241 padres-hijas, 237 madres-hijos, y 241 madres-hijas. Los instrumentos utilizados fueron la Escala de Capacidades y Dificultades y la Escala de Prácticas Parentales para madres y padres. Para lograr el objetivo principal se realizaron análisis de correlación, análisis de senderos y diferencias de medias con muestras relacionadas. Los resultados mostraron correlaciones -de moderadas a bajas- entre las prácticas parentales, los problemas y la conducta prosocial, además de diferentes factores predictores de las conductas de los hijos a partir del sexo de los padres y las prácticas parentales ejercidas. Se presentaron divergencias entre los reportes de prácticas parentales, conducta prosocial y problemas entre los padres y sus hijos. Se concluye que la conducta parental se orienta según el sexo de los hijos, lo cual implica cierta deseabilidad social relacionada con su rol como hombres o como mujeres.

Humanos , Masculino , Femenino , Adulto , Adulto Joven , Relaciones Padres-Hijo , Conducta , Familia , Comunicación
Acta colomb. psicol ; 22(2): 267-291, July-Dec. 2019. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1019285


Abstract The aim of this research was to analyze the shaping of the meaning of the academic profession in 160 scholars, from public and private universities in four Colombian cities. The instrument QPW-5 (Questionnaire on Quality of Work life in Human Service Organizations) was applied. It was composed of 173 items distributed in five scales: Working Conditions, Perceived Workload, General Working Well-being, Maslach Burnout Inventory and Engagement, and five key words that define the work experience. This study was carried out following a quantitative approach, a non - experimental design with a cross-sectional descriptive correlation. A correlational analysis and Principal Component Analysis were performed to establish the pattern of the dimensions evaluated. The teachers surveyed showed general tendencies to shape their meaning of the academic profession in an ambivalent manner in a positive and negative pole, where the presence of fragmented working conditions that denote exhaustion, cynicism and collateral effects, as well as a new configuration of academic professionalism are highlighted. It is pointed out that the temporality of the contractual relationship is naturalized as a condition of precarious working conditions, placing a focus on the psychosocial risks of university teachers.

Resumo Enquadrada no contexto das transformações do trabalho acadêmico, em especial com a explosão do capitalismo acadêmico, e situada nas organizações universitárias, a presente pesquisa teve como objetivo analisar a configuração da percepção da profissão acadêmica em 160 professores universitários pertencentes a universidades públicas e privadas de cinco cidades colombianas. Este estudo foi quantitativo, não experimental, transversal e descritivo. Aplicou-se o instrumento QPW-5 -questionário sobre a qualidade da vida laboral em organizações de serviços humanos, composto por 173 itens que medem as escalas de condições de trabalho e bem-estar laboral geral-, o inventário de Burnout de Maslach e um questionário de Engagement, além de uma parte qualitativa com cinco palavras-chave que definem a experiência de trabalhar. Realizou-se uma análise correlacionai e uma análise de componentes principais para estabelecer o padrão das dimensões avaliadas. Como resultado, descobriu-se que os docentes participantes evidenciaram tendências gerais para configurar uma percepção da profissão acadêmica de forma ambivalente, em um polo positivo e negativo, no qual se destaca a presença de condições de trabalho fragmentadas que denotam esgotamento, cinismo e efeitos colaterais, bem como uma nova configuração do profissionalismo acadêmico. Além disso, indica-se que a temporalidade do vínculo contratual é naturalizada como condições de trabalho precárias que chamam a atenção para os riscos psicossociais dos docentes universitários.

Resumen Enmarcada en el contexto de las transformaciones del trabajo académico, en especial con la irrupción del capitalismo académico, y situada en las organizaciones universitarias, la presente investigación tuvo como objetivo analizar la configuración del sentido de la profesión académica en 160 profesores universitarios pertenecientes a universidades públicas y privadas de cinco ciudades colombianas. Este estudio fue cuantitativo, no experimental, transversal y descriptivo. Se aplicó el instrumento QPW-5 -cuestionario sobre la calidad de vida laboral en organizaciones de servicios humanos, compuesto por 173 ítems que miden las escalas de condiciones de trabajo y bienestar laboral general-, el inventario de Burnout de Maslach, y un cuestionario de engagement, además de una parte cualitativa con cinco palabras clave que definen la experiencia de trabajar. Se realizó un análisis correlacional y un análisis de componentes principales para establecer el patrón de las dimensiones evaluadas. Como resultados, se encontró que los docentes encuestados evidenciaron tendencias generales a configurar un sentido de la profesión académica de forma ambivalente, en un polo positivo y negativo, donde se destaca la presencia de condiciones de trabajo fragmentadas que denotan agotamiento, cinismo y efectos colaterales, así como una nueva configuración del profesionalismo académico. Además de esto, se señala que la temporalidad del vínculo contractual se naturaliza como condiciones de trabajo precarias que colocan como foco de atención a los riesgos psicosociales de los docentes universitarios.

Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Condiciones de Trabajo , Docentes , Estrés Laboral
Acta colomb. psicol ; 22(2): 319-341, July-Dec. 2019. tab
Artículo en Inglés | LILACS | ID: biblio-1019287


Abstract The objective of the present study was to analyze the psychometric properties (evidences of validity and reliability) of the ENCAO in employees of a private company of the hydrocarbon sector in Metropolitan Lima. A sample of 384 participants was evaluated, of whom 64 % were women and 36% men, aged between 19 and 56 years (M = 29.57 years, SD = 7.33). As evidences of validity related to the internal structure, an exploratory factorial analysis (EFA) and a confirmatory factorial analysis (CFA) were carried out, resulting in a structure of four related factors (Organizational Learning and Culture, Social Learning, Group Learning and Strategic Individual Learning) with the 21 items on the scale that explained 60.33 % of the total variance and with adequate goodness of fit indexes (x 2 = 371.6, x 2/df = 2.03, CFI = .99, RMSEA = .041). As a source of external validity, moderate correlations (between .31 and .46) were obtained with the variable Job Satisfaction. The Cronbach alpha coefficients of the four factors obtained ranged between .60 and .84. It is concluded that the ENCAO and its derived scores are a valid and reliable measure to measure organizational learning in the evaluated labor sector.

Resumo O objetivo do presente estudo foi analisar as propriedades psicométricas (evidências de validade e confiabilidade) da ENCAO em trabalhadores de uma empresa privada do setor de hidrocarbonetos na região metropolitana de Lima, no Peru. Para isso, avaliou-se uma amostra de 384 participantes, 64 % mulheres e 36 % homens, com idades compreendidas entre 19 e 56 anos (M= 29.57 anos, DP = 7.33). Como evidências de validade relacionada à estrutura interna, realizou-se uma análise fatorial exploratória (AFE) e uma análise fatorial confirmatória (AFC) com as quais foi encontrada uma estrutura de quatro fatores relacionados (formação e cultura organizacional, aprendizagem social, aprendizagem grupal e aprendizagem estratégica individual) com os 21 itens da escala, os quais explicaram o 60.33 % da variância total e obtiveram adequados índices de bondade de ajuste (x 2 = 371.66; x 2 /gl = 2.03; CFI = .99; RMSEA = .041). Como fonte de validade externa foram obtidas correlações moderadas (entre .31 e .46) com a variável satisfação laboral. Os coeficientes alfa de Cronbach dos quatro fatores oscilaram entre .60 e .84. Conclui-se que a ENCAO e suas pontuações derivadas são uma medida válida e fiável para medir a aprendizagem organizacional no setor laboral avaliado.

Resumen El objetivo del presente estudio fue analizar las propiedades psicométricas (evidencias de validez y confiabilidad) de la ENCAO en trabajadores de una empresa privada del sector de hidrocarburos en Lima Metropolitana. Para esto, se evaluó a una muestra de 384 participantes, 64 % mujeres y 36 % hombres, con edades entre los 19 y los 56 años (M= 29.57 años, DE = 7.33). Como evidencias de validez de la estructura interna del instrumento, se realizó un análisis factorial exploratorio (AFE) y un análisis factorial confirmatorio (AFC), donde se encontró una estructura de cuatro factores relacionados (formación y cultura organizacional, aprendizaje social, aprendizaje grupal y aprendizaje estratégico individual) con los 21 ítems de la escala, los cuales explicaron el 60.33 % de la varianza total y obtuvieron adecuados índices de bondad de ajuste (x 2 = 371.66; x 2 /gl = 2.03; CFI = .99; RMSEA = .041). Como fuente de validez externa se obtuvieron correlaciones moderadas (entre .31 y .46) con la variable satisfacción laboral. Los coeficientes alfa de Cronbach de los cuatro factores oscilaron entre .60 y .84. Se concluye que la ENCAO y sus puntuaciones derivadas son una medida válida y fiable para medir el aprendizaje organizacional en el sector laboral evaluado.

Humanos , Masculino , Femenino , Adulto , Sociedades , Reproducibilidad de los Resultados , Análisis Factorial
Rev. Esc. Enferm. USP ; 53: e03491, Jan.-Dez. 2019. graf
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1020389


RESUMO Objetivo Relatar as experiências educativas das mães ou cuidadoras de crianças com microcefalia, desenvolvidas por equipe acadêmica na temática da promoção da saúde dessas crianças. Método Trata-se de relato de experiência vivenciado por alunos do curso de graduação em enfermagem, discentes e docentes do programa de Pós-Graduação em Saúde e Ambiente da Universidade Tiradentes sobre intervenções educativas realizadas em três unidades de referência no atendimento à criança com microcefalia no estado de Sergipe. A amostra do estudo foi de conveniência. Resultados Participaram da pesquisa 70 mães ou cuidadoras principais de crianças com diagnóstico confirmado de microcefalia, durante os meses de setembro a dezembro. Os eixos temáticos-teóricos selecionados para descrever as atividades foram promoção da alimentação saudável, importância do vínculo mãe e filho e estimulação precoce de crianças com microcefalia. Conclusão A experiência relatada demostrou a importância das estratégias educativas na promoção da saúde de crianças com microcefalia, proporcionando capacitação adicional às mães/cuidadoras para que estas ofereçam um cuidado holístico e humanizado a essas crianças.

RESUMEN Objetivo Relatar las experiencias educativas de las madres o cuidadoras de niños con microcefalia, desarrolladas por equipo académico en la temática de la promoción de la salud de esos niños. Método Se trata de relato de experiencia vivida por alumnos de la carrera universitaria de enfermería, discentes y docentes del programa de Posgrado en Salud y Ambiente de la Universidad Tiradentes acerca de intervenciones educativas realizadas en tres unidades de referencia en la atención al niño con microcefalia en el Estado de Sergipe. La muestra del estudio fue de conveniencia. Resultados Participaron en la investigación 70 madres o cuidadoras principales de niños con diagnóstico de microcefalia, durante los meses de septiembre a diciembre. Los ejes temáticos-teóricos seleccionados para describir las actividades fueron promoción de la alimentación sana, importancia del vínculo madre e hijo y estimulación precoz de niños con microcefalia. Conclusión La experiencia relatada demostró la importancia de las estrategias educativas en la promoción de la salud de niños con microcefalia, proporcionando capacitación adicional a las madres/cuidadoras a fin de que estas proporcionen un cuidado holístico y humanizado a esos niños.

ABSTRACT Objective To report the educational experiences of mothers or caregivers of children with microcephaly, as developed by an academic team with the theme of promoting these children's health. Method This is an experience report by undergraduate nursing students and Health and Environment Post-Graduation students and professors of Tiradentes University on educational interventions carried out in three reference units for the care of children with microcephaly in the state of Sergipe. The study sample was taken by convenience. Results A total of 70 mothers or primary caregivers of children with a confirmed diagnosis of microcephaly during the months of September to December participated in the study. The thematic-theoretical axes selected to describe the activities were promotion of healthy eating, importance of the mother and child bond, and early stimulation of children with microcephaly. Conclusion The experience reported demonstrates the importance of educational strategies in promoting the health of children with microcephaly, providing additional training to mothers/caregivers to provide holistic and humanized care to these children.

Humanos , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Educación en Salud , Cuidadores , Promoción de la Salud , Microcefalia/terapia , Madres , Entrevista , Enfermería de la Familia , Investigación Cualitativa
Rev. Esc. Enferm. USP ; 53: e03466, Jan.-Dez. 2019.
Artículo en Inglés, Español | LILACS, BDENF - Enfermería | ID: biblio-1020391


RESUMEN Objetivo Describir la experiencia del cuidado familiar a la mujer con cáncer de mama durante el tratamiento, desde la perspectiva de los cuidadores en el contexto mexicano. Método Estudio cualitativo fenomenológico. Fueron realizadas entrevistas en profundidad con cuidadores de mujeres sobrevivientes de cáncer de mama seleccionados mediante muestreo intencional, acumulativo y secuencial. Se llevó a cabo un análisis de contenido convencional. Resultados Participaron siete cuidadores. Los cuidadores refieren sus experiencias positivas y negativas al asumir su rol de cuidadores informales en el contexto familiar. Sobre la fortaleza de la reciprocidad del cuidado y su recompensa, prevalecen los momentos críticos, los sentimientos negativos y la falta de recursos de apoyo durante la experiencia. Ello permite entender el vínculo del cuidado informal para potenciarlo con estrategias de afrontamiento y orientación especifica por parte del personal de enfermería. Conclusión Los participantes experimentaron una transformación en su identidad como cuidadores y al ser conscientes de su experiencia, fueron capaces de describir sus cualidades lo que incrementa sus estrategias de afrontamiento tanto de la enfermedad como de los desafíos del cuidado.

RESUMO Objetivo Descrever a experiência do cuidado familiar com a mulher com câncer de mama durante o tratamento, do ponto de vista dos cuidadores no contexto mexicano. Método Estudo qualitativo fenomenológico. Foram realizadas entrevistas em profundidade com cuidadores de mulheres sobreviventes ao câncer de mama selecionados por meio de amostragem intencional, acumulativa e sequencial. Foi realizada uma análise de conteúdo convencional. Resultados Participaram sete cuidadores. Os cuidadores relatam suas experiências positivas e negativas ao assumir seu papel de cuidadores informais no contexto familiar. Sobre a força da reciprocidade do cuidado e sua recompensa, prevalecem os momentos críticos, os sentimentos negativos e a falta de recursos de apoio durante a experiência. Isso permite entender o vínculo do cuidado informal para potencializá-lo com estratégias de enfrentamento e orientação específica por parte do pessoal de enfermagem. Conclusão Os participantes experimentaram uma transformação na sua identidade como cuidadores e, ao ser conscientes da sua experiência, foram capazes de descrever suas qualidades, o que aumenta suas estratégias de enfrentamento tanto da doença quanto dos desafios do cuidado.

ABSTRACT Objective To describe the experience of family care to women with breast cancer during treatment from the perspective of caregivers in the Mexican context. Method Qualitative phenomenological study. In-depth interviews were conducted with caregivers of women who survived breast cancer. Participants were selected by intentional, cumulative and sequential sampling. A conventional content analysis was performed. Results Participation of seven caregivers, who reported their positive and negative experiences when assuming their role as informal caregivers in the family context. On the strength of the reciprocity of care and its reward, prevailed critical moments, negative feelings, and lack of support resources during the experience. This enables the understanding of the informal care bond in order to enhance it with coping strategies and specific guidance from the nursing staff. Conclusion Participants experienced a transformation in their identity as caregivers and by being aware of their experience, they could describe their qualities, which increased their coping strategies with the disease and the care challenges.

Humanos , Femenino , Adulto , Persona de Mediana Edad , Anciano , Neoplasias de la Mama/terapia , Familia , Cuidadores/psicología , Enfermería Oncológica , Entrevista , Investigación Cualitativa
MMWR Morb Mortal Wkly Rep ; 68(43): 967-973, 2019 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-31671083


Among the 47,600 opioid-involved overdose deaths in the United States in 2017, 59.8% (28,466) involved synthetic opioids (1). Since 2013, synthetic opioids, particularly illicitly manufactured fentanyl (IMF), including fentanyl analogs, have been fueling the U.S. overdose epidemic (1,2). Although initially mixed with heroin, IMF is increasingly being found in supplies of cocaine, methamphetamine, and counterfeit prescription pills, which increases the number of populations at risk for an opioid-involved overdose (3,4). With the proliferation of IMF, opioid-involved overdose deaths have increased among minority populations including non-Hispanic blacks (blacks) and Hispanics, groups that have historically had low opioid-involved overdose death rates (5). In addition, metropolitan areas have experienced sharp increases in drug and opioid-involved overdose deaths since 2013 (6,7). This study analyzed changes in overdose death rates involving any opioid and synthetic opioids among persons aged ≥18 years during 2015-2017, by age and race/ethnicity across metropolitan areas. Nearly all racial/ethnic groups and age groups experienced increases in opioid-involved and synthetic opioid-involved overdose death rates, particularly blacks aged 45-54 years (from 19.3 to 41.9 per 100,000) and 55-64 years (from 21.8 to 42.7) in large central metro areas and non-Hispanic whites (whites) aged 25-34 years (from 36.9 to 58.3) in large fringe metro areas. Comprehensive and culturally tailored interventions are needed to address the rise in drug overdose deaths in all populations, including prevention strategies that address the risk factors for substance use across each racial/ethnic group, public health messaging to increase awareness about synthetic opioids in the drug supply, expansion of naloxone distribution for overdose reversal, and increased access to medication-assisted treatment.

Analgésicos Opioides/envenenamiento , Grupos de Población Continentales/estadística & datos numéricos , Sobredosis de Droga/etnología , Sobredosis de Droga/mortalidad , Grupos Étnicos/estadística & datos numéricos , Drogas Sintéticas/envenenamiento , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Afroamericanos/estadística & datos numéricos , Distribución por Edad , Anciano , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Hispanoamericanos/estadística & datos numéricos , Humanos , Persona de Mediana Edad , Estados Unidos/epidemiología , Adulto Joven
MMWR Morb Mortal Wkly Rep ; 68(43): 985-989, 2019 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-31671085


CDC, the Food and Drug Administration, state and local health departments, and other public health and clinical stakeholders are investigating a national outbreak of electronic-cigarette (e-cigarette), or vaping, product use-associated lung injury (EVALI) (1). As of October 22, 2019, 49 states, the District of Columbia (DC), and the U.S. Virgin Islands have reported 1,604 cases of EVALI to CDC, including 34 (2.1%) EVALI-associated deaths in 24 states. Based on data collected as of October 15, 2019, this report updates data on patient characteristics and substances used in e-cigarette, or vaping, products (2) and describes characteristics of EVALI-associated deaths. The median age of EVALI patients who survived was 23 years, and the median age of EVALI patients who died was 45 years. Among 867 (54%) EVALI patients with available data on use of specific e-cigarette, or vaping, products in the 3 months preceding symptom onset, 86% reported any use of tetrahydrocannabinol (THC)-containing products, 64% reported any use of nicotine-containing products, and 52% reported use of both. Exclusive use of THC-containing products was reported by 34% of patients and exclusive use of nicotine-containing products by 11%, and for 2% of patients, no use of either THC- or nicotine-containing products was reported. Among 19 EVALI patients who died and for whom substance use data were available, 84% reported any use of THC-containing products, including 63% who reported exclusive use of THC-containing products; 37% reported any use of nicotine-containing products, including 16% who reported exclusive use of nicotine-containing products. To date, no single compound or ingredient used in e-cigarette, or vaping, products has emerged as the cause of EVALI, and there might be more than one cause. Because most patients reported using THC-containing products before symptom onset, CDC recommends that persons should not use e-cigarette, or vaping, products that contain THC. In addition, because the specific compound or ingredient causing lung injury is not yet known, and while the investigation continues, persons should consider refraining from the use of all e-cigarette, or vaping, products.

Brotes de Enfermedades , Sistemas Electrónicos de Liberación de Nicotina , Lesión Pulmonar/epidemiología , Vapeo/efectos adversos , Adolescente , Adulto , Anciano , Centers for Disease Control and Prevention (U.S.) , Dronabinol/toxicidad , Femenino , Humanos , Lesión Pulmonar/mortalidad , Masculino , Persona de Mediana Edad , Estados Unidos/epidemiología , Adulto Joven
Ann R Coll Surg Engl ; 101(8): e172-e177, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31672034


Intragastric balloons have been used as an invasive non-surgical treatment for obesity for over 30 years. Within the last 37 years, we have found only 27 cases reported in the literature of intestinal obstruction caused by a migrated intragastric balloon. We report the laparoscopic management of such a case and make observations from similar case presentations published in the literature. A 26-year-old woman had an intragastric balloon placed endoscopically for weight control 13 months previously. She presented to the emergency department with a four-day history of intermittent abdominal cramps and vomiting. Contrast enhanced computed tomography confirmed the presence of the intragastric balloon within the small bowel. At laparoscopic retrieval, the deflated intragastric balloon was found impacted in the terminal ileum approximately 15 cm from the ileocaecal valve. The balloon was retrieved by enterotomy and primary closure of the ileum without event. The risk of balloon deflation and subsequent migration increases over time but several published cases demonstrate that this complication can occur within six months of insertion. The initial approach to the treatment of migrated intragastric balloons causing small bowel obstruction should be determined by the location of impaction, severity of obstruction and the available skill set of the attending radiologist, endoscopist and/or surgeon. Balloons causing obstruction in the duodenum are likely amenable to endoscopic retrieval whereas impaction within the jejunum or ileum could be managed by percutaneous needle aspiration (in selected cases), endoscopy (double-balloon enteroscopy), laparoscopy or open surgery.

Migración de Cuerpo Extraño/cirugía , Balón Gástrico/efectos adversos , Enfermedades del Íleon/cirugía , Obstrucción Intestinal/cirugía , Laparoscopía/métodos , Adulto , Femenino , Migración de Cuerpo Extraño/diagnóstico por imagen , Migración de Cuerpo Extraño/etiología , Humanos , Enfermedades del Íleon/diagnóstico por imagen , Enfermedades del Íleon/etiología , Obstrucción Intestinal/diagnóstico por imagen , Obstrucción Intestinal/etiología , Obesidad/cirugía , Tomografía Computarizada por Rayos X
MMWR Morb Mortal Wkly Rep ; 68(44): 993-998, 2019 Nov 08.
Artículo en Inglés | MEDLINE | ID: mdl-31697655


Lung and bronchus (lung) cancer is the leading cause of cancer death in the United States (1). In 2016, 148,869 lung cancer deaths were reported.* Most lung cancers can be attributed to modifiable exposures, such as tobacco use, secondhand smoke, radon, and asbestos (1). Exposure to lung cancer risk factors vary over time and by characteristics such as sex, age, and nonmetropolitan or metropolitan residence that might affect lung cancer rates (1,2). A recent report found that lung cancer incidence rates were higher and decreased more slowly in nonmetropolitan counties than in metropolitan counties (3). To examine whether lung cancer incidence trends among nonmetropolitan and metropolitan counties differed by age and sex, CDC analyzed data from U.S. Cancer Statistics during 2007-2016, the most recent years for which data are available. During the 10-year study period, lung cancer incidence rates were stable among females aged <35, 45-64, and ≥75 years in nonmetropolitan counties, were stable among females aged <35 years in metropolitan counties, and decreased in all other groups. Overall, among males, lung cancer incidence rates decreased from 99 to 82 per 100,000 in nonmetropolitan areas and from 83 to 63 in metropolitan areas; among females, lung cancer incidence rates decreased from 61 to 58 in nonmetropolitan areas and from 57 to 50 in metropolitan areas. A comprehensive approach to lung cancer prevention and control includes such population-based strategies as screening for tobacco dependence, promoting tobacco cessation, implementing comprehensive smoke-free laws, testing all homes for radon and using proven methods to lower high radon levels, and reducing exposure to lung carcinogens such as asbestos (1). Increasing the implementation of these strategies, particularly among persons living in nonmetropolitan counties, might help to reduce disparities in the decline of lung cancer incidence.

Disparidades en el Estado de Salud , Neoplasias Pulmonares/epidemiología , Población Rural/estadística & datos numéricos , Población Urbana/estadística & datos numéricos , Adulto , Anciano , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Factores de Riesgo , Estados Unidos/epidemiología