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1.
Water Res ; 168: 115135, 2020 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-31622911

RESUMEN

Silica fouling during groundwater reverse osmosis (RO) treatment can have a significant impact on filtration performance. To better understand this phenomenon, the equilibrium kinetics of amorphous colloidal silica were studied at conditions relevant to RO of silica-rich alkaline groundwater. The impact of particle size was investigated using synthetic monodisperse silica nanoparticles. Bench scale experiments were conducted by monitoring dissolved silica concentration of aqueous suspensions of colloids of 100 and 300 nm diameter and pH 8.5 to 9.5. The equilibrium data was determined from existing established rate law equations. This study concluded that surface energy has a major impact on silica dissolution rate constant, particularly for colloidal silica. Observations of Ostwald ripening in bidisperse silica dispersions further confirmed these results, which indicate that dissolution and redeposition is responsible for the problematic silica fouling behaviour during RO treatment. 2D modelling based on inferred equilibrium data allows visualization of scale layer growth in agreement with cross-sectional scanning electron micrographs of autopsied membranes.


Asunto(s)
Agua Subterránea , Purificación del Agua , Coloides , Estudios Transversales , Membranas Artificiales , Ósmosis , Radio (Anatomía) , Dióxido de Silicio , Solubilidad
2.
Rev. cuba. angiol. cir. vasc ; 20(2): e385, jul.-dic. 2019. tab, graf
Artículo en Español | LILACS | ID: biblio-1003858

RESUMEN

Introducción: La coordinación entre niveles asistenciales centrada en las enfermedades frecuentes, graves y vulnerables, constituye un elemento esencial para incrementar la eficiencia del sistema sanitario con la ayuda del uso de instrumentos diagnósticos. Objetivo: Validar el Cuestionario de Edimburgo modificado para el diagnóstico de la claudicación arterial periférica en la atención primaria de salud. Métodos: Estudio de evaluación de instrumentos diagnósticos a través de un estudio explicativo observacional de corte transversal, en una muestra de 100 pacientes provenientes de la atención primaria de salud. El período de estudio fue el segundo semestre (julio-diciembre) de 2016. A todos los participantes se les realizó un examen físico vascular, se midieron los índices de presiones tobillo-brazo, se identificó la topografía de las lesiones arteriales de los miembros inferiores, se les aplicó el Cuestionario de Edimburgo modificado y se calculó su sensibilidad, especificidad, valores predictivos positivos y negativos y exactitud diagnóstica. Resultados: El examen físico vascular constató un predominio de la afección fémoro-poplítea (54,8 por ciento) seguido de la aorta-ilíaco (29,9 por ciento). Se obtuvo en la validación del Cuestionario una sensibilidad de 98 por ciento, una especificidad de 31,5 por ciento con alta probabilidad de tener falsos negativos. El valor predictivo positivo fue de 70 por ciento y el negativo de 92 por ciento. La exactitud de las pruebas diagnósticas fue de 73 por ciento, para cada prueba. Conclusiones: El uso del Cuestionario de Edimburgo modificado en la atención primaria de salud es de gran utilidad para establecer el diagnóstico clínico positivo de una claudicación intermitente por enfermedad arterial periférica(AU)


Introduction: Coordination between care levels centered in the severe, frequently and vulnerable diseases constitutes an essential element to increase the efficiency of the health system with the help of diagnostic means. Objective: To validate the modified Edinburgh Questionnaire for the diagnostic of arterial claudication in the primary health care. Methods: An assessment study of diagnostic instruments was done through of a cross-sectional, observational explicative study in a sample of 100 patients from primary health care. The study was conducted in the second semester (July-December) of 2016. A vascular physical exam was performed to all the participants where ankle- brachial pressure index was measured, the topography of the arterial occlusions of the lower limbs was identified, the modified Edinburgh Questionnaire was carried out; and the sensitivity, specificity, positive and negative predictive values and the diagnostic exactitude were calculated. Results: The vascular physical exam exhibited a predominant femoro-popliteal affectation (54,8 percent) followed of the aorta-iliac (29,9 percent). In the validation of the modified Edinburgh Questionnaire it was obtained a sensitivity of 98 percent and an specificity of 31,5 percent with high probabilities of false negative. The positive predictive value was 70 percent and the negative 92 percent. The exactitude of the diagnostic test was 73 percent for each test. Conclusions: The use of the modified Edinburgh Questionnaire in the primary health care is useful to establish the positive clinical diagnostic of an intermittent arterial claudication by Peripheral Arterial Disease(AU)


Asunto(s)
Humanos , Masculino , Femenino , Atención Primaria de Salud , Encuestas y Cuestionarios/normas , Estudios Transversales , Enfermedad Arterial Periférica/diagnóstico , Estudio Observacional , Claudicación Intermitente/diagnóstico
3.
Rev. cuba. angiol. cir. vasc ; 20(2)jul.-dic. 2019. tab, graf
Artículo en Español | LILACS | ID: biblio-1003859

RESUMEN

RESUMEN Introducción: la incorporación de la ecografía a los métodos diagnósticos de los aneurismas aórticos abdominales favorece su detección precoz. Objetivo: Describir las características de los pacientes a quienes se les detectó precozmente un aneurisma aórtico abdominal. Métodos: Estudio descriptivo de corte transversal en 243 pacientes pertenecientes al área de salud del Hospital Clinicoquirúrgico "General Freyre de Andrade", clasificados como población de riesgo (hombres > 50 años y mujeres > 60 años). El periodo de estudio: noviembre de 2016 a octubre de 2017. Resultados: Se realizó el diagnóstico de aneurisma aórtico abdominal en 2,1 % (n= 5); en estos pacientes prevaleció el grupo de edad de 70 a79 años (80 %) y el sexo masculino (60 %). Los factores de riesgo predominantes fueron el tabaquismo, la hipertensión arterial y la enfermedad arterial periférica, todos con igual porcentaje (100 %). El segmento aórtico más afectado fue el infrarrenal (100 %), los diámetros aórticos predominantes fueron: transversal (3-3,9 cm), longitudinal (5-10 cm) y antero-posterior (3-3,9 cm). La proteína C reactiva estuvo incrementada (mayor de 5 mg/L) en el 100 % de los casos. La claudicación intermitente fue la más frecuente. Conclusiones: A pesar de la baja prevalencia porcentual encontrada, destaca en todos los pacientes con aneurisma aórtico abdominal la presencia de factores de riesgo relevantes como es el tabaquismo, la hipertensión arterial y la enfermedad arterial periférica; incremento en la concentración de la proteína C reactiva, afectación en el segmento infrarrenal así como alto porcentaje con edades por encima de 70 años.


ABSTRACT Introduction: The incidence of abdominal aortic aneurysms in the population benefits from the incorporation of ultrasound to diagnostic methods due to the importance of their early detection. Objective: To describe the characteristics of patients who are early detected with an abdominal aortic aneurysm. Method: A descriptive, cross-sectional study was conducted in 243 patients belonging to the health area of "General Freyre de Andrade" Clinical- Surgical Hospital that were classified as a risk population (men > 50 years and women > 60 years). The study was conducted from November 2016 to October 2017. Results: The diagnosis of abdominal aortic aneurysm was performed in 2.1 % (n= 5); in these patients predominated the age group of 70 to 79 years (80 %), male sex (60 %) and white skin color (80 %). The predominant risk factors were smoking habit, arterial hypertension and peripheral arterial disease; all with equal percentage (100 %). The most affected aortic segment was the infrarenal (100 %), the predominant aortic diameters were: transversal (3-3.9 cm), longitudinal (5-10 cm) and anterior-posterior (3-3.9 cm). The C-reactive protein increased (greater than 5 mg/L) in 100 % of the cases. Intermittent claudication was the most frequent. Conclusions: Although the percentage prevalence of the disease was low, it was present in all the patients with abdominal aortic aneurysm, risk factors that are favorable to aneurysms, high concentrations of C-reactive protein, affectation in the infrarenal aortic segment, and high percentage of ages of more than 70 years.


Asunto(s)
Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Proteína C-Reactiva/ultraestructura , Ultrasonografía/métodos , Aneurisma de la Aorta Abdominal/cirugía , Aneurisma de la Aorta Abdominal/diagnóstico por imagen , Epidemiología Descriptiva , Estudios Transversales , Factores de Riesgo
4.
Rev. Esc. Enferm. USP ; 53: e03509, Jan.-Dez. 2019. tab
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1020390

RESUMEN

RESUMO Objetivo Analisar o resultado do desempenho dos Núcleos Ampliados de Saúde da Família do estado de São Paulo, na dimensão Organização do Processo de Trabalho, na Avaliação do PMAQ-AB, segundo o Índice Paulista de Responsabilidade Social. Método Estudo transversal, descritivo, exploratório, com abordagem quantitativa, baseado nos dados do 2º ciclo do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica. Foram analisadas por frequência simples 149 equipes, de 47 municípios, distribuídas em cinco agrupamentos, de acordo com o Índice Paulista de Responsabilidade Social. Resultados As equipes do agrupamento quatro (municípios com baixa riqueza e indicadores sociais intermediários) alcançaram desempenho satisfatório e muito satisfatório (90,9%). As equipes dos municípios do agrupamento dois (alto índice de riqueza e indicadores sociais insatisfatórios) tiveram pior desempenho; as equipes do município de São Paulo obtiveram o maior percentual de desempenho satisfatório e muito satisfatório (95,8%). Conclusão As equipes do município de São Paulo (alto índice de riqueza e indicadores sociais insatisfatórios) e as equipes dos municípios do agrupamento quatro (baixa riqueza e indicadores sociais intermediários) foram as que alcançaram melhor desempenho.


RESUMEN Objetivo Analizar el resultado del desempeño de los Núcleos Ampliados de Salud de la Familia del Estado de São Paulo, en la dimensión Organización del Proceso de Trabajo, en la Evaluación del PMAQ-AB, según el Índice Paulista de Responsabilidad Social. Método Estudio transversal, descriptivo, exploratorio, con abordaje cuantitativo, basado en los datos del 2º ciclo del Programa Nacional de Mejoría del Acceso y la Calidad de la Atención Básica. Fueron analizadas por frecuencia simple 149 equipos, de 47 municipios, distribuidas en cinco agrupaciones, según el Índice Paulista de Responsabilidad Social. Resultados Los equipos de la agrupación cuatro (municipios con baja riqueza e indicadores sociales intermedios) alcanzaron desempeño satisfactorio y muy satisfactorio (90,9%). Los equipos de los municipios de la agrupación dos (alto índice de riqueza e indicadores sociales insatisfactorios) tuvieron peor desempeño; los equipos del municipio de São Paulo obtuvieron el mayor porcentual de desempeño satisfactorio y muy satisfactorio (95,8%). Conclusión Los equipos del municipio de São Paulo (alto índice de riqueza e indicadores sociales insatisfactorios) y los equipos de los municipios de la agrupación cuatro (baja riqueza e indicadores sociales intermedios) fueron las que alcanzaron mejor desempeño.


ABSTRACT Objective To analyze the performance of the Expanded Family Health Centers in the state of São Paulo in the Work Process Organization dimension in evaluating the PMAQ-AB , according to the Paulista Social Responsibility Index. A cross-sectional, descriptive, exploratory study with a quantitative approach based on data from the 2ndcycle of the National Program for Improving Access and Quality in Primary Care ( PMAQ-AB ). There were 149 teams from 47 municipalities distributed in five groups analyzed by simple frequency, according to the Paulista Social Responsibility Index. The teams from group four (municipalities of low wealth and intermediate social indicators) achieved satisfactory and very satisfactory performance (90.9%). The teams from the group two municipalities (high wealth index and unsatisfactory social indicators) had worse performance; the teams from the municipality of São Paulo obtained the highest percentage of satisfactory and very satisfactory performance (95.8%). Conclusion The teams from the municipality of São Paulo (high wealth index and unsatisfactory social indicators) and the teams from the municipalities of group four (low wealth and intermediate social indicators) were those that achieved better performance.


Asunto(s)
Calidad de la Atención de Salud , Enfermería de Atención Primaria , Planificación en Salud , Grupo de Atención al Paciente , Evaluación en Salud , Estudios Transversales , Administración en Salud
5.
Rev. Esc. Enferm. USP ; 53: e03483, Jan.-Dez. 2019. tab
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1020374

RESUMEN

RESUMO Objetivo Mensurar as atitudes dos enfermeiros sobre o processo de enfermagem em hospital público de ensino. Método Estudo transversal e analítico, junto a enfermeiros de um hospital terciário. Foi aplicado um instrumento para a caracterização da amostra e o instrumento Posições sobre o Processo de Enfermagem, que mensura a atitude do enfermeiro em relação ao processo de enfermagem. São 20 itens a serem considerados, o valor mínimo possível é de 20, e o máximo, de 140. Os dados foram submetidos à estatística descritiva, e as variáveis de interesse, analisadas pelos testes Mann-Whitney, t de Student, Qui-quadrado, Kruskal-Wallis, coeficiente de correlação de Spearman e modelos de regressão múltipla hierárquicos, conforme apropriado. Resultados Em uma amostra de 226 enfermeiros, 80,5% (182) afirmaram realizar o processo de enfermagem diariamente. O escore médio do instrumento foi de 102,50 (DP=21,76). O item "rotineiro/criativo" apresentou escore mais baixo (3,54), enquanto "sem importância/importante" apresentou escore mais alto (5,81). Conclusão Os enfermeiros referiram ser favoráveis e apresentaram atitudes positivas quanto ao processo de enfermagem, além de considerarem-no importante, porém rotineiro, além de que afirmaram pouco ou nenhum contato com pesquisas, aulas e eventos sobre a temática.


RESUMEN Objetivo Mensurar las actitudes de los enfermeros acerca del proceso de enfermería en hospital público de enseñanza. Método Estudio transversal y analítico, con enfermeros de un hospital terciario. Fue aplicado un instrumento para la caracterización de la muestra y el instrumento Posiciones sobre el Proceso de Enfermería, que mensura la actitud del enfermero con respecto al proceso de enfermería. Son 20 puntos que considerarse, el valor mínimo posible es 20 y el máximo, 140. Los datos fueron sometidos a la estadística descriptiva, y las variables de interés, analizada por las pruebas Mann-Whitney, t de Student, Chi cuadrado, Kruskal-Wallis, coeficiente de correlación de Spearman y modelos de regresión múltiple jerárquicos, conforme apropiado. Resultados En una muestra de 226 enfermeros, el 80,5% (182) afirmaron realizar el proceso de enfermería a diario. El score medio del instrumento fue de 102,5 (DP=21,76). El punto "rutinero/creativo" presentó score más bajo (3,54), mientras que "sin importancia/importante" presentó score más alto (5,81). Conclusión Los enfermeros relataron ser favorables y presentaron actitudes positivas en cuanto al proceso de enfermería, además de considerarlo importante, pero rutinero. También afirmaron poco o ningún contacto con investigaciones, clases y eventos acerca de la temática.


ABSTRACT Objective To measure the attitudes of nurses on nursing process at a public teaching hospital. Method A cross-sectional and analytical study conducted with nurses at a tertiary hospital. It was applied an instrument to characterize sample, as well as the Positions on the Nursing Process instrument, which measures nurses' attitudes in relation to the nursing process. There are 20 items to be considered, in which the minimum possible value is 20 and the maximum of 140. The data were submitted to descriptive statistics and the variables of interest were analyzed by the Mann-Whitney, Student's t-test, Chi-square test, Kruskal-Wallis, Spearman's correlation coefficient and hierarchical multiple regression models, as appropriate. Results In a sample of 226 nurses, 80.5% (182) stated that they performed pdaily. The mean score of the instrument was 102.50 (SD = 21.76). The item "routine/creative" had a lower score (3.54), while "unimportant/important" had a higher score (5.81). Conclusion The nurses reported being in favor and presented positive attitudes about nursing process, in addition to considering it important, but routine, as well as affirming little or no contact with research, classes or events on the subject.


Asunto(s)
Humanos , Actitud del Personal de Salud , Atención de Enfermería , Proceso de Enfermería , Estudios Transversales , Hospitales de Enseñanza
6.
Rev. Esc. Enferm. USP ; 53: e03508, Jan.-Dez. 2019. tab, graf
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1020384

RESUMEN

RESUMO Objetivo Avaliar a estrutura e a adesão às medidas de precauções-padrão e específicas dos profissionais de saúde em Unidade de Terapia Intensiva de hospital de ensino, no Distrito Federal. Método Estudo descritivo, transversal e prospectivo. Utilizou-se de questionário estruturado mediante observações que registraram as práticas dos profissionais com Equipamentos de Proteção Individual e indicações de precauções. Foi aplicado o teste Qui-quadrado, e calculado o p-valor . Resultados Participaram do estudo 52 profissionais, e foram observados 445 procedimentos assistenciais em 36 sessões de auditoria. A média da taxa de adesão ao uso de equipamentos foi de 72,72%, sendo 94,91% às luvas, 91,43% ao avental, 80% à máscara e 24,56% aos óculos de proteção. Quando não havia indicação e não foi utilizado o Equipamento de Proteção Individual, a média da taxa foi de 68,01%, sendo 30,77% em relação às luvas, 87,58% ao avental, 57,58% à máscara, e 96,13% aos óculos. As precauções de contato foram indicadas desnecessariamente em 35% dos pacientes. Conclusão Verificou-se boa adesão ao uso de luvas, avental e máscara, baixa adesão ao uso de óculos de proteção e uso desnecessário de máscaras e precauções de contato admissionais.


RESUMEN Objetivo Evaluar la estructura y la adhesión a las medidas de precauciones estándar y específicas de los profesionales sanitarios en Unidad de Cuidados Intensivos de hospital de enseñanza, en el Distrito Federal. Método Estudio descriptivo, transversal y prospectivo. Se utilizó un cuestionario estructurado mediante observaciones que registraron las prácticas de los profesionales con Equipos de Protección Individual e indicaciones de precauciones. Se aplicó la prueba de Chi cuadrado y se calculó el p-valor. Resultados Participaron en el estudio 52 profesionales y se observaron 445 procedimientos asistenciales en 36 sesiones de auditoría. El promedio de la tasa de adhesión al uso de equipos fue del 72,72%, siendo el 94,91% a los guantes, el 91,43% al delantal, el 80% a la mascarilla y el 24,56% a los anteojos de protección. Cuando no había indicación y no fue utilizado el Equipo de Protección Individual, el promedio de la tasa fue del 68,01%, siendo el 30,77% con relación a los guantes, el 87,58% al delantal, el 57,58% a la mascarilla y el 96,13% a los anteojos. Las precauciones de contacto fueron indicadas innecesariamente al 35% de los pacientes. Conclusión Se verificó buena adhesión al uso de guantes, delantal y mascarilla, baja adhesión al uso de anteojos de protección y uso innecesario de mascarillas y precauciones de contacto de ingreso.


ABSTRACT Objective To evaluate the structure and adherence to the standardized and specific precautionary measures of health professionals in the Intensive Care Unit of a teaching hospital in the Federal District of Brazil. Method A descriptive, cross-sectional and prospective study. A structured questionnaire was used via observations which recorded the practices of professionals with Individual Protection Equipment and indications of precautions. The chi-square test was applied, and the p-value was calculated. Results A total of 52 professionals participated in the study, and 445 care procedures were observed in 36 audit sessions. The average adhesion rate for equipment use was 72.72%, with 94.91% for gloves, 91.43% for aprons, 80% for masks and 24.56% for safety glasses. When there was no indication and no personal protective equipment was used, the average rate was 68.01%, with 30.77% for gloves, 87.58% for aprons, 57.58% for masks, and 96.13% for safety glasses. Contact precautions were unnecessarily indicated for 35% of patients. Conclusion Good adherence to using gloves, aprons and masks were observed, but there was poor adherence to using safety glasses and unnecessary use of masks and admission contact precautions.


Asunto(s)
Humanos , Práctica Profesional , Precauciones Universales , Control de Infecciones , Personal de Salud , Unidades de Cuidados Intensivos , Estudios Transversales , Estudios Prospectivos , Seguridad del Paciente , Hospitales de Enseñanza
7.
Rev. Esc. Enferm. USP ; 53: e03470, Jan.-Dez. 2019. tab
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1020385

RESUMEN

RESUMO Objetivo Avaliar a frequência e as razões da omissão do cuidado de enfermagem e verificar se as razões de omissão diferem entre categorias profissionais. Método Estudo quantitativo e transversal realizado nas unidades de internação adulto de hospital público de uma instituição de ensino. A coleta de dados foi realizada no período de fevereiro a abril de 2017, por meio de uma ficha de caracterização pessoal e profissional e pelo instrumento MISSCARE-BRASIL. Resultados Participaram do estudo 58 profissionais de enfermagem responsáveis pela assistência direta ao paciente, dos quais 74,1% relataram pelo menos uma atividade de enfermagem omitida no turno de trabalho. As principais razões atribuídas à omissão do cuidado foram o dimensionamento inadequado dos profissionais, as situações de urgência com os pacientes durante o turno de trabalho e a não disponibilidade de medicamentos, materiais ou equipamentos quando necessário. Conclusão A maioria dos cuidados foi "sempre" ou "frequentemente" realizada, e as razões atribuídas para a omissão do cuidado estão relacionadas aos recursos laborais, materiais e estilo de gestão. Os enfermeiros diferem dos técnicos quanto às razões para a não realização dos cuidados.


RESUMEN Objetivo Evaluar la frecuencia y las razones de la omisión del cuidado de enfermería y verificar si las razones de omisión difieren entre categorías profesionales. Método Estudio cuantitativo y transversal llevado a cabo en las unidades de hospitalización de adultos de un hospital público de un centro de enseñanza. La recolección de datos fue realizada en el período de febrero a abril de 2017, mediante una ficha de caracterización personal y profesional y por el instrumento MISSCARE-BRASIL. Resultados Participaron en el estudio 58 profesionales de enfermería responsables de la asistencia directa al paciente, de los que el 74,1% relataron por lo menos una actividad de enfermería omitida en el turno de trabajo. Las principales razones atribuidas a la omisión del cuidado fueron el dimensionamiento inadecuado de los profesionales, las situaciones de urgencias con los pacientes durante el turno de trabajo y la no disponibilidad de fármacos, materiales o equipos cuando necesario. Conclusión La mayoría de los cuidados fue "siempre" o "a menudo" realizada, y las razones atribuidas para la omisión del cuidado están relacionadas con los recursos laborales, materiales y estilo de gestión. Los enfermeros difieren de los técnicos en cuanto a las razones para la no realización de los cuidados.


ABSTRACT Objective To evaluate the frequency and reasons for missed nursing care and to verify whether the reasons for omission differ between professional categories. Method A quantitative and cross-sectional study carried out in the adult hospitalization units of a public hospital of a teaching institution. Data collection was performed from February to April 2017, through a personal and professional characterization form and the MISSCARE-BRASIL instrument. Results Fifty-eight (58) nursing professionals responsible for direct patient care participated in the study, of which 74.1% reported at least one missed nursing care activity during the work shift. The main reasons attributed to missed care situations were an inadequate amount of professionals, urgent situations with the patients during the work shift, and the non-availability of medicine, materials or equipment when necessary. Conclusion Most care was "always" or "often" performed, and the reasons given for missed care are related to work resources, materials, and management style. Nurses differ from the technicians as to the reasons for not performing care.


Asunto(s)
Humanos , Evaluación del Resultado de la Atención al Paciente , Atención de Enfermería , Evaluación en Salud , Estudios Transversales , Seguridad del Paciente
8.
BMJ ; 367: l5873, 2019 10 31.
Artículo en Inglés | MEDLINE | ID: mdl-31672760

RESUMEN

OBJECTIVE: To determine the global capacity (availability, accessibility, quality, and affordability) to deliver kidney replacement therapy (dialysis and transplantation) and conservative kidney management. DESIGN: International cross sectional survey. SETTING: International Society of Nephrology (ISN) survey of 182 countries from July to September 2018. PARTICIPANTS: Key stakeholders identified by ISN's national and regional leaders. MAIN OUTCOME MEASURES: Markers of national capacity to deliver core components of kidney replacement therapy and conservative kidney management. RESULTS: Responses were received from 160 (87.9%) of 182 countries, comprising 97.8% (7338.5 million of 7501.3 million) of the world's population. A wide variation was found in capacity and structures for kidney replacement therapy and conservative kidney management-namely, funding mechanisms, health workforce, service delivery, and available technologies. Information on the prevalence of treated end stage kidney disease was available in 91 (42%) of 218 countries worldwide. Estimates varied more than 800-fold from 4 to 3392 per million population. Rwanda was the only low income country to report data on the prevalence of treated disease; 5 (<10%) of 53 African countries reported these data. Of 159 countries, 102 (64%) provided public funding for kidney replacement therapy. Sixty eight (43%) of 159 countries charged no fees at the point of care delivery and 34 (21%) made some charge. Haemodialysis was reported as available in 156 (100%) of 156 countries, peritoneal dialysis in 119 (76%) of 156 countries, and kidney transplantation in 114 (74%) of 155 countries. Dialysis and kidney transplantation were available to more than 50% of patients in only 108 (70%) and 45 (29%) of 154 countries that offered these services, respectively. Conservative kidney management was available in 124 (81%) of 154 countries. Worldwide, the median number of nephrologists was 9.96 per million population, which varied with income level. CONCLUSIONS: These comprehensive data show the capacity of countries (including low income countries) to provide optimal care for patients with end stage kidney disease. They demonstrate substantial variability in the burden of such disease and capacity for kidney replacement therapy and conservative kidney management, which have implications for policy.


Asunto(s)
Salud Global/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Fallo Renal Crónico/terapia , Nefrología/estadística & datos numéricos , Terapia de Reemplazo Renal/estadística & datos numéricos , Estudios Transversales , Países en Desarrollo/estadística & datos numéricos , Humanos
9.
J Water Health ; 17(5): 826-836, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31638032

RESUMEN

There is a global concern regarding the occurrences of harmful algal blooms (HABs) and their effects on human health. Lake Victoria (LV) has been reported to face eutrophication challenges, resulting in an increase of bloom-forming cyanobacteria. This study is aimed at understanding the association of HABs and health risks at Ukerewe Island. A cross-sectional study conducted on 432 study subjects and water samples for cyanobacteria species identification were collected at LV shores. The results reveal that concentrations of cyanobacteria cells are beyond (WHO) acceptable limits; species of Microcystis aeruginosa range from 90,361.63 to 3,032.031.65 cells/mL and Anabaena spp. range from 13,310.00 to 4,814,702 cells/mL. Water usage indicates that 31% use lake water, 53% well water and 16% treated supplied pipe water. Vomiting and throat irritation was highly reported by lake water users as compared to wells and pipe water (P < 0.001). Gastrointestinal illness (GI) was significantly elevated among lake water users as compared to pipe and well water users (P < 0.001). Visible blooms in lake water were associated with GI, skin irritation and vomiting as compared to water without visible blooms (P < 0.001). The concentration of cyanobacteria blooms poses greater risks when water is used without treatment.


Asunto(s)
Floraciones de Algas Nocivas , Lagos/microbiología , Microcystis , Estudios Transversales , Humanos , Tanzanía
10.
Artículo en Inglés | MEDLINE | ID: mdl-31618373

RESUMEN

Santa Catarina is a Brazilian State that has reported the lowest prevalence of human T-cell lymphotropic viruses (HTLV-1/2) in blood donors (0.04%). Although it presents ports, airports and roads that facilitate the entrance and dissemination of new infectious agents, no information exists concerning the HTLV-1/2 infections in HIV/AIDS patients. This study searched for HTLV-1/2 antibodies in plasma samples of 625 HIV/AIDS patients from the municipality of Tubarao (Southern Santa Catarina), and disclosed 1.1% of positivity (0.48% HTLV-1, 0.48% HTLV-2 and 0.16% untypeable HTLV), and a positive correlation with the male sex (OR 4.16) and intravenous drug use (OR 35.18). Although the percentage of 1.1% appears to be low, it is 27.5 times higher than the percentage detected in blood donors. Since HTLV-1 and HTLV-2 are circulating in HIV-infected individuals in Southern Santa Catarina, and these retroviruses could cause a differently impact on the HIV/AIDS outcomes, the surveillance of HTLV-1/2 is necessary, and it could support public health policies in preventing the transmission and dissemination of these viruses in this State.


Asunto(s)
Anticuerpos Antivirales/sangre , Infecciones por VIH/epidemiología , Infecciones por HTLV-I/epidemiología , Infecciones por HTLV-II/epidemiología , Virus Linfotrópico T Tipo 1 Humano/inmunología , Virus Linfotrópico T Tipo 2 Humano/inmunología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Estudios Transversales , Monitoreo Epidemiológico , Femenino , Infecciones por VIH/complicaciones , Infecciones por HTLV-I/complicaciones , Infecciones por HTLV-I/diagnóstico , Infecciones por HTLV-II/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Adulto Joven
11.
Codas ; 31(6): e20180029, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31644709

RESUMEN

PURPOSE: To compare clinical characteristics of tinnitus and interference in quality of life in individuals with and without associated hearing loss, as well as to discuss the association of quantitative measurements and qualitative instruments. METHODS: A quantitative, cross-sectional and comparative study approved by the Research Ethics Committee (No. 973.314/CAEE: 41634815.3.0000.0106) was carried out. The responses of the psychoacoustic assessment of tinnitus (intensity, frequency, minimum masking level and loudness discomfort level for pure tone and speech), as well as the Tinnitus Handicap Inventory (THI) questionnaire, and the visual analogue scale (VAS) were compared between 15 patients with tinnitus and peripheral hearing loss (group I) and 16 adults with normal hearing (group II). RESULTS: The mean VAS and THI scores obtained in GI were 5.1 (+1.5) and 42.3 (+18), and in GII, 5.7 (+2.6) and 32.7 (+25), respectively. This result suggests moderate GI annoyance and moderate/mild GII annoyance (p>0.005). There was a positive and moderate correlation between THI and VAS only in GII. In the psychoacoustic evaluation, significant differences were observed between the groups regarding the measurement of loudness (*p=0.013) and the minimum masking level (*p=0.001). CONCLUSION: There was no direct influence of the presence of hearing loss in relation to the impact of tinnitus. The differences found between the groups regarding the psychoacoustics measures can be justified by the presence of cochlear damage. The objective measurement of tinnitus, regardless of the presence or absence of peripheral hearing loss, is an important instrument to be used along with self-evaluation measures.


Asunto(s)
Audiometría/métodos , Pérdida Auditiva/complicaciones , Acúfeno/complicaciones , Adulto , Factores de Edad , Estudios Transversales , Femenino , Pérdida Auditiva/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Psicoacústica , Calidad de Vida , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Acúfeno/diagnóstico , Escala Visual Analógica , Adulto Joven
12.
Codas ; 31(6): e20180266, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31644711

RESUMEN

PURPOSE: To identify the prevalence of fear of public speaking and verify its association with sociodemographic variables, self-perception of voice, speech, and oral communication skills in public. METHODS: A cross-sectional and analytical study with 1,124 university students was carried out. An online questionnaire addressed was performed, considering factors as sociodemographic characteristics; fear of speaking; Scale for Self-Assessment When Speaking in Public (SSPS), self-perception of the voice, the ability to grasp, and keep the listener's attention and influence another. RESULTS: The fear of public speaking was prevalent in undergraduate students. There was an association of the fear of speaking with the vocal self-perception, with the ability to capture and keep the listener's attention and to influence another with their communication. Individuals who have the ability to capture and maintain the attention of the interlocutor are more likely to be afraid of public speaking than the undergraduate students who perceive themselves as having the ability to influence the listener with their communication. CONCLUSION: The more communicative skills and more persuasive the individual perceives his or her self, the less likely he or she is to be affected by the fear of speaking.


Asunto(s)
Miedo/psicología , Habla , Estudiantes/psicología , Universidades/estadística & datos numéricos , Adolescente , Adulto , Percepción Auditiva , Brasil , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Comunicación Persuasiva , Prevalencia , Autoinforme , Voz , Adulto Joven
13.
Codas ; 31(5): e20180217, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31644717

RESUMEN

PURPOSE: To compare the ability to recognize sentences in silence and in noise in monolingual normal-hearing Brazilian Portuguese speakers, and bilingual speakers of Brazilian Portuguese and German, and bilingual speakers of Brazilian Portuguese and Italian, as well as to analyze the influence of age of second language acquisition on the performance of bilinguals. METHODS: 87 normal-hearing individuals aged between 18 and 55 years participated of this research. They were categorized into: Control Group, composed by 30 monolingual Brazilian Portuguese speakers; German Research Group, 31 simultaneous bilingual native speakers of Portuguese and speakers of German as a second language and; Italian Research Group, consisting of 26 successive bilinguals, native speakers of Portuguese and speakers of Italian as a second language. The Sentence List Test in Brazilian Portuguese was used to measure their Sentence Recognition Thresholds in Silence and Noise. RESULTS: In silence, there were no statistically significant differences in performance when comparing the bilingual to the monolingual individuals, and when comparing the bilingual speakers among themselves. On the other hand, in noise, there was a significant difference between the bilingual groups and the monolingual one. However, there were no significant differences between the bilingual groups when their performance was compared. CONCLUSION: Bilingualism positively influenced the development of language and listening skills, which led the bilinguals to outperform in speech recognition in the presence of noise. Also, the period of a second language acquisition did not influence bilingual performance.


Asunto(s)
Multilingüismo , Ruido , Percepción del Habla/fisiología , Adolescente , Adulto , Estudios de Casos y Controles , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prueba del Umbral de Recepción del Habla , Adulto Joven
14.
Rev Col Bras Cir ; 46(4): e20192222, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31644720

RESUMEN

OBJECTIVE: to evaluate the clinical, surgical, and nutritional profile of surgical patients admitted to a reference hospital in Recife city, Pernambuco state, Brazil. METHODS: a cross-sectional study carried out in the wards of the General Surgery Service of Hospital da Restauração Governador Paulo Guerra, from June to September 2018. We included adult and elderly patients (both genders) who were submitted to thoracoabdominal procedures and elective or emergency abdominal surgeries, and in which the assessment of nutritional status could be performed within 72 hours of hospital admission. Data on nutritional status and surgical procedures, as well as clinical and biochemical information, were collected. RESULTS: we studied 140 patients with median age of 45 years. Among all, 59.3% were female and 23% malnourished, according to Subjective Global Assessment. The median preoperative fasting time was 15 hours for size I surgeries and 13.5 hours for size II ones. Longer postoperative hospital stay showed a strong correlation with the total length of hospital stay in both surgical sizes. Malnourished patients had a longer period of perioperative fasting and hospital stay when compared to well-nourished patients (p<0.001). CONCLUSION: the perioperative fasting time for elective surgeries was longer than recommended by literature. Patients with longer fasting spent more time in hospital.


Asunto(s)
Ayuno , Estado Nutricional , Atención Perioperativa/métodos , Adulto , Estudios Transversales , Procedimientos Quirúrgicos Electivos , Urgencias Médicas , Femenino , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Derivación y Consulta , Factores de Tiempo
15.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190003.SUPL.2, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31596374

RESUMEN

OBJECTIVE: To describe reference values for blood counts obtained from laboratory tests in the Brazilian adult population according to laboratory results from the National Health Survey (Pesquisa Nacional de Saúde - PNS), by gender, age group and skin color. METHODS: The initial sample consisted of 8,952 adults. To determine the reference values, individuals with prior diseases and outliers were excluded. Mean values, standard deviation and limits were stratified by gender, age group and skin color. RESULTS: For red blood cells, men presented a mean value of 5.0 million per mm3 (limits: 4.3-5.8) and women, 4.5 million per mm3 (limits: 3.9-5.1). Hemoglobin levels were higher among men with a mean of 14.9 g/dL (13.0-16.9), and in women, 13.2 g/dL (11.5-14.9). The mean number of white blood cells among men was 6.142/mm3 (2.843-9.440) and 6.426/mm3 (2.883-9.969) for women. Other parameters showed close values between the genders. Regarding age groups and skin color, mean values, standard deviation and limits of the exams presented small variations. CONCLUSION: Hematological reference values based on the national survey allow for the establishment of specific reference limits for gender, age and skin color. The results presented here may contribute to the establishment of better evidence and criteria for the care, diagnosis and treatment of diseases.


Asunto(s)
Recuento de Células Sanguíneas/normas , Técnicas de Laboratorio Clínico/normas , Encuestas Epidemiológicas/normas , Adolescente , Adulto , Factores de Edad , Brasil/etnología , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Factores Sexuales , Adulto Joven
16.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190006.SUPL.2, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31596377

RESUMEN

OBJECTIVE: To analyze the prevalence of diabetes mellitus (DM) according to different diagnostic criteria, in the Brazilian adult population, according to laboratory results from the Brazilian National Health Survey. METHODS: Analysis of laboratory data from the National Health Survey, collected between 2014 and 2015. The prevalence of diabetes was calculated according to different diagnostic criteria. The prevalence of diabetes was calculated according to the criterion of glycosylated hemoglobin ≥ 6.5% or using medication, using Poisson regression and calculating crude and adjusted PR and 95%CI. RESULTS: The prevalence of diabetes according to different criteria varies from 6.6 to 9.4%. Intermediate or pre-diabetes hyperglycemia ranged from 6.8 to 16.9%. Considering laboratory criteria or medication use, the prevalence of DM was 8.4 (95%CI 7.65-9.11). The adjusted PR for gender, age, educational level and region was lower for males (PR 0.75; 95%CI 0.63 - 0.89), increased with age: 30 to 34 years (PR 2.32; 95% CI 1.33 - 4.07), 40 to 59 years PR 8.1; 95%CI 4.86 - 13.46), 60 years old or older (PR 12.6; 95%CI 7.1 - 21.0), and higher educational levels was protective (PR 0.8; 95%CI 0.6 - 0.9). Therewas a higher PR in the Central West Region (PR 1.3; 95%CI 1.04 - 1.7), in overweight people (PR 1.8; 95%CI 1.4 - 2.1), and in obese people (PR 3.3; 95%CI 2.6 - 4.1). CONCLUSION: The prevalence of diabetes was higher in females, people over 30 years of age, in populations with low educational levels, and people who were overweight and obese. The study advances in determining the diabetes situation in the country through laboratory criteria.


Asunto(s)
Diabetes Mellitus/epidemiología , Hemoglobina A Glucada/análisis , Encuestas Epidemiológicas/métodos , Adolescente , Adulto , Distribución por Edad , Brasil/epidemiología , Estudios Transversales , Femenino , Encuestas Epidemiológicas/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Sobrepeso/epidemiología , Prevalencia , Factores de Riesgo , Distribución por Sexo , Factores Socioeconómicos , Adulto Joven
17.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190007.SUPL.2, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31596378

RESUMEN

OBJECTIVE: To describe the prevalence of hemoglobinopathies in the Brazilian adult population, according to laboratory tests from the National Health Survey. METHODS: A descriptive study was carried out with National Health Survey laboratory data collected between 2014 and 2015. The hemoglobinopathies test was performed using the High Performance Liquid Chromatography method. The results of the individual tests were interpreted as providing normal, homozygous or heterozygous results for S, C and D hemoglobin, in addition to other possible hemoglobinopathies. Prevalence of hemoglobinopathies according to gender, skin color, region, age and schooling was estimated. RESULTS: Hemoglobinopathies were present in 3.7% of the population. The main ones were the sickle cell trait (2.49%), thalassemia minor (0.30%) and suspected thalassemia major (0.80%). In relation to the sickle cell trait and suspected thalassemia major, there was a statistically significant difference for the skin color variable (p<0.05). The prevalences found for sickle cell trait according to skin color was: 4.1% among dark-skinned blacks, 3.6% among light-skinned blacks, 1.2% among whites, and 1.7% among others. CONCLUSION: The most prevalent hemoglobinopathies were the sickle cell trait and minor thalassemia, and were predominate among light- and dark-skinned black people. The study helps in identifying hemoglobinopathies and in genetic counseling in pre-conception.


Asunto(s)
Encuestas Epidemiológicas/métodos , Rasgo Drepanocítico/epidemiología , Talasemia beta/epidemiología , Adolescente , Adulto , Distribución por Edad , Brasil/epidemiología , Cromatografía Líquida de Alta Presión , Estudios Transversales , Femenino , Encuestas Epidemiológicas/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Distribución por Sexo , Factores Socioeconómicos , Adulto Joven
18.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190008.SUPL.2, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31596379

RESUMEN

OBJECTIVE: To verify the prevalence of anemia in Brazilian adults and elderly. METHODS: This is a cross-sectional study consisted of 8,060 subjects aged over 18 years old in all Brazilian states. We used data from laboratory tests of the Brazilian National Health Survey (Pesquisa Nacional de Saúde - PNS). The following indicators obtained by erythrogram were used: hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and red cell distribution width (RDW). Reference values of the World Health Organization (WHO) were used to determine anemia, which considers hemoglobin levels below 13.0 g/dL for men and less than 12.0 g/dL for women. Sociodemographic information was obtained by interview. RESULTS: The prevalence of anemia among Brazilian adults and elderly was 9.9%. Higher prevalence of anemia and more severe cases were found among women, elderly, people with low schooling, black skin color and residents of the North and Northeast regions. Normocytic normochromic anemia was the most common type of anemia (56.0%). CONCLUSION: The anemia prevalence found in the study was in agreement with the literature. It must be stressed that higher anemia prevalence was found in disadvantaged and older population. Considering the increase of the population over 60 years of age, interventions to prevent and treat anemia among adults and elderly is imperative in the health service network.


Asunto(s)
Anemia/epidemiología , Encuestas Epidemiológicas/métodos , Adolescente , Adulto , Distribución por Edad , Factores de Edad , Anciano , Brasil/epidemiología , Estudios Transversales , Índices de Eritrocitos , Femenino , Encuestas Epidemiológicas/estadística & datos numéricos , Hemoglobinas/análisis , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Valores de Referencia , Índice de Severidad de la Enfermedad , Distribución por Sexo , Factores Sexuales , Factores Socioeconómicos , Adulto Joven
19.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190010.SUPL.2, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31596381

RESUMEN

OBJECTIVE: To evaluate the renal function of the Brazilian adult population, according to laboratory criteria of the National Health Survey (Pesquisa Nacional de Saúde - PNS). METHODOLOGY: A descriptive study was carried out with laboratory data from the PNS, which was collected between the years 2014 and 2015. Population prevalence of the serum creatinine (CR) and estimated glomerular filtration rate (GFR) according to sociodemographic variables, were analyzed from the PNS laboratory data. RESULTS: The sample consisted of 8,535 individuals aged 18 years old or older for the study of CR and 7,457 for the study of GFR. The GFR prevalence < 60 mL/min/1.73 m2 was 6.7% (95%CI 6.0 - 7.4), higher in women (8.2% 95%CI 7.2 - 9.2) than in men (5.0% 95%CI 4.2 - 6.0) p < 0.001, and in elderly > 60 years old it was 21.4%. For the values of CR ≥ 1.3 mg/dL in men were 5.5% (95%CI 4.6 - 6.5), and in women values of CR ≥ 1.1 mg/dL were 4.6% (95%CI 4.0 - 5.4), with no diference between the genders, p = 0.140. CONCLUSION: Results from the PNS laboratory identified a higher prevalence of chronic kidney disease in the Brazilian population than that estimated in self-reported studies, with higher GFR < 60 mL/min/1.73 m2 in women, and reaching one fifth of the elderly. These tests may be useful for the purpose of identifying the disease early on and thus preventing the progression of renal damage and reduce the risk of cardiovascular events and mortality.


Asunto(s)
Encuestas Epidemiológicas/métodos , Insuficiencia Renal Crónica/epidemiología , Insuficiencia Renal Crónica/fisiopatología , Adolescente , Adulto , Distribución por Edad , Brasil/epidemiología , Creatinina/sangre , Estudios Transversales , Femenino , Tasa de Filtración Glomerular , Encuestas Epidemiológicas/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Distribución por Sexo , Factores Socioeconómicos , Adulto Joven
20.
Rev Bras Epidemiol ; 22Suppl 02(Suppl 02): E190011.SUPL.2, 2019.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31596382

RESUMEN

INTRODUCTION: High income concentration prevails in Brazil and socioeconomic status influences living and health conditions, including dietary quality. OBJECTIVE: To measure the magnitude of social inequalities in the food quality profile of the Brazilian population. METHOD: We analyzed data from 60,202 adults who participated in the 2013 National Health Survey. The prevalence of indicators of food quality was estimated according to gender, ethnicity, income, schooling, and health insurance. We calculated prevalence ratios using multiple Poisson regression. RESULTS: Healthy food consumption was more prevalent among females, white people, and individuals with higher socioeconomic status. However, we also found a higher prevalence of some foods considered unhealthy, such as sweets, sandwiches, snacks, and pizzas, among the most favored social segments, in women, and white people, expressing the concomitance of healthy and unhealthy eating habits. The comparison between the consumption of skim and low-fat milk according to income (prevalence ratio - PR = 4.48) presented the most significant difference. CONCLUSION: In addition to the expressive social inequality identified in the Brazilian food profile, mixed patterns were detected, including healthy and unhealthy foods. These results point out the need for monitoring and promoting healthy eating habits, taking into account the social inequalities and contradictions concerning food intake.


Asunto(s)
Conducta Alimentaria , Calidad de los Alimentos , Encuestas Epidemiológicas/métodos , Encuestas Nutricionales/métodos , Clase Social , Adulto , Brasil/epidemiología , Estudios Transversales , Femenino , Encuestas Epidemiológicas/estadística & datos numéricos , Humanos , Seguro de Salud/estadística & datos numéricos , Masculino , Encuestas Nutricionales/estadística & datos numéricos , Prevalencia , Factores Socioeconómicos , Factores de Tiempo
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