Coronary heart disease mortality is decreasing in Argentina, and Colombia, but keeps increasing in Mexico: a time trend study.

BACKGROUND: Mortality rates due to coronary heart disease (CHD) have decreased in most countries, but increased in low and middle-income countries. Few studies have analyzed the trends of coronary heart disease mortality in Latin America, specifically the trends in young-adults and the effect of correcting these comparisons for nonspecific causes of death (garbage codes). The objective of this study was to describe and compare standardized, age-specific, and garbage-code corrected mortality trends for coronary heart disease from 1985 to 2015 in Argentina, Colombia, and Mexico. METHODS: Deaths from coronary heart disease were grouped by country, year of registration, sex, and 10-year age bands to calculate age-adjusted and age and sex-specific rates for adults aged ≥25. We corrected for garbage-codes using the methodology proposed by the Global Burden of Disease. Finally, we fitted Joinpoint regression models. RESULTS: In 1985, age-standardized mortality rates per 100,000 population were 136.6 in Argentina, 160.6 in Colombia, and 87.51 in Mexico; by 2015 rates decreased 51% in Argentina and 6.5% in Colombia, yet increased by 61% in Mexico, where an upward trend in mortality was observed in young adults. Garbage-code corrections produced increases in mortality rates, particularly in Argentina with approximately 80 additional deaths per 100,000, 14 in Colombia and 13 in Mexico. CONCLUSIONS: Latin American countries are at different stages of the cardiovascular disease epidemic. Garbage code correction produce large changes in the mortality rates in Argentina, yet smaller in Mexico and Colombia, suggesting garbage code corrections may be needed for specific countries. While coronary heart disease (CHD) mortality is falling in Argentina, modest falls in Colombia and substantial increases in Mexico highlight the need for the region to propose and implement population-wide prevention policies.

Estado nutricional, factores sociodemográficos y de salud en estudiantes de nuevo ingreso a la UAZ / Nutritional status and social-demographical and health factors among newly enrolled students at UAZ / Estado nutricional, fatores sociodemográficos e de saúde em estudantes de novo ingresso à UAZ

Introducción El sobrepeso y obesidad son factores de riesgo para desarrollar complicaciones a corto y largo plazo. La población de nuevo ingreso a la universidad se considera un colectivo, especialmente, vulnerable desde el punto de vista nutricional. Objetivo Describir el estado nutricional, factores sociodemográficos y de salud en estudiantes de nuevo ingreso a la UAZ. Metodología Estudio de tipo observacional, transversal y descriptivo, que se realizó a 3,972 estudiantes universitarios de nuevo ingreso. Se logró el consentimiento verbal de los alumnos. Se capacitaron y estandarizaron a los pasantes de enfermería, medicina y nutrición, para llevar a cabo las mediciones. Se obtuvo información del estado nutricional, factores sociodemográficos y salud, así como mediciones antropométricas. Resultados Los hombres tienen mayor prevalencia de sobrepeso (24.1%) y obesidad (9.2%) que las mujeres (p < 0.001). Los hombres realizan mayor actividad física (73.6% vs 51.1%), consumen más alcohol (58.3% vs 34.3%) y tabaco (20.8% vs 9.5%) (p < 0.000). Se encontró una asociación positiva en los momios de sobrepeso en relación con los hombres (RM=1.22, IC 95% 1.02-1.45), edad de 19 años (RM=1.36, IC 95% 1.02-1.45), en las áreas de ciencias de la salud (RM=1.88, IC 95% 1.05-3.35), ciencias sociales (RM=1.93, IC 95% 1.06-3.48), humanidades y educativas (RM=1.90, IC 95% 1.01-3.53), ingenierías y tecnologías (RM=1.83, IC 95% 1.01-3.30). Discusión y conclusión Se puede contribuir a reducir las prevalencias de sobrepeso y obesidad de los estudiantes, a través de intervenciones dirigidas a modificar las conductas de riesgo durante la estancia universitaria, mejorar la alimentación y promover estilos de vida saludables.

Introduction Obesity and overweight are risk factors to developing short and long-term health-related complications; and newly enrolled university students are considered a vulnerable group in terms of their nutritional progression status. Objective To describe the nutritional status, and social-demographical and health factors among newly enrolled students at UAZ. Methodology This is an observational, transversal, and descriptive study on a sample of 3,972 newly enrolled university students who verbally consented on their participation. Nursing, medicine, and nutrition intern students were trained to carry out diverse assessments related to the nutritional status, social-demographical and health factors, and anthropometric data on the sample. Results Newly enrolled male students showed a higher prevalence of overweight (24.1%) and obesity (9.2%) in comparison to their female counterparts (p < .001). Male students showed having more physical activity (73.6% vs 51.1%) but also consuming more alcohol (58.3% vs 34.3%) and tobacco (20.8% vs 9.5%) (p < .000). Positive associations were found between the overweight numbers and, being male (RM=1.22, CI 95% 1.02-1.45), being 19 years old (RM = 1.36, CI 95% 1.02-1.45), being in the areas of health sciences (RM=1.88, CI 95% 1.05-3.35), being in the areas of social sciences (RM=1.93, CI 95% 1.06-3.48), being in the areas of humanities and education (RM=1.90, CI 95% 1.01-3.53), and being in the areas of engineering and technology (RM=1.83, CI 95% 1.01-3.30). Discussion and conclusion It is necessary to address to obesity and overweight problems among university students through interventions aimed at modifying risky behaviors during their university stay, improving the quality of nutrition, and promoting healthy life-styles.

Introdução O sobrepeso e a obesidade são fatores de risco para desenvolver complicações a curto e longo prazo. A população de novo ingresso à universidade considera-se um coletivo, especialmente, vulnerável desde o ponto de vista nutricional. Objetivo Descrever o estado nutricional, fatores sociodemográficos e de saúde em estudantes de novo ingresso à UAZ. Metodologia Estudo de tipo observacional, transversal e descritivo, que se realizou a 3,972 estudantes universitários de novo ingresso. Conseguiu-se o consentimento verbal dos alunos. Capacitaram-se e padronizaram os formados de enfermagem, medicina e nutrição, para levar a cabo as medições. Obteve-se informação do estado nutricional, fatores sociodemográficos e saúde, assim como medições antropométricas. Resultados Os homens de novo ingresso têm maior prevalência de sobrepeso (24.1%) e obesidade (9.2%) quanto as mulheres (p < 0.001). Homens realizam mais atividade física que mulheres (73.6% vs. 51.1%), consomem mais álcool (58.3% vs. 34.3%) e tabaco (20.8% vs. 9.5%) (p < 0.000). Encontrou-se uma associação positiva nas chances de sobrepeso em relação com aos homens (RM = 1.22, IC 95% 1.02-1.45), ter 19 anos de idade (RM = 1.36, IC 95% 1.02-1.45) nas áreas de ciências da saúde (RM = 1.88, IC 95% 1.05-3.35), ciências sociais (RM = 1.93, IC 95% 1.06-3.48), humanidades e educativas (RM = 1.90, IC 95% 1.01-3.53), engenharias e tecnologias (RM = 1.83, IC 95% 1.01-3.30). Discussão e conclusão Pode-se contribuir a reduzir as prevalências de sobrepeso e obesidade dos estudantes, a través de intervenções dirigidas a modificar as condutas de risco durante a permanência universitária, melhorar a alimentação e promover estilos de vida saudáveis.

[APACHE II and SAPS II as predictors of brain death development in neurocritical care patients]. / APACHE II y SAPS II como predictores de evolucion a muerte encefalica en pacientes neurocriticos.

AIM: To assess the prognostic value of APACHE II and SAPS II scales to predict brain death evolution of neurocritical care patients. PATIENTS AND METHODS: Retrospective observational study performed in a tertiary hospital. Include 508 patients over 16 years old, hospitalized in ICU for at least 24 hours. The variables of interest were: demographic data, risk factors, APACHE II, SAPS II and outcome. RESULTS: Median age: 41 years old (IR: 25-57). Males: 76.2%. Most frequent reason for admission: trauma (55.3%). Medians: Glasgow Coma Scale (GCS), 10 points; APACHE II, 13 points; SAPS II, 31 points; and ICU stay, 5 days. Mortality in the ICU was 28.5% (n = 145) of whom 44 (8.7%) evolved to brain death. Univariate logistic regression analysis showed that GCS, APACHE II and SAPS II scores, as well as ICU stay days behaved as predictors of brain death evolution. However, the multivariate analysis performed including APACHE II and SAPS II scores showed that only APACHE II maintained statistical significance, despite the good discrimination of both scores. CONCLUSION: Transplant coordinators might use the APACHE II score as a tool to detect patients at risk of progression to brain death, minimizing the loss of potential donors.

TITLE: APACHE II y SAPS II como predictores de evolucion a muerte encefalica en pacientes neurocriticos.Objetivo. Evaluar si las escalas pronosticas APACHE II (Acute Physiology and Chronic Health Evaluation II) y SAPS II (Simplified Acute Physiology Score II) son capaces de predecir la evolucion a muerte encefalica en pacientes neurocriticos. Pacientes y metodos. Estudio retrospectivo, observacional, realizado en un hospital de tercer nivel. Se incluyo a 508 pacientes mayores de 16 años, ingresados con patologia neurocritica aguda, con estancia en la unidad de cuidados intensivos de al menos 24 horas. Las variables de interes fueron: datos demograficos, factores de riesgo, APACHE II, SAPS II y resultado pronostico. Resultados. Mediana de edad: 41 años (rango intercuartilico: 25-57). Varones: 76,2%. Motivo de ingreso mas frecuente: traumatismo (55,3%). Medianas: escala de coma de Glasgow (GCS), 10 puntos; APACHE II, 13 puntos; SAPS II, 31 puntos; y estancia en cuidados intensivos, cinco dias. La mortalidad en la unidad de cuidados intensivos fue de 145 (28,5%). De ellos, 44 (8,7%) evolucionaron a muerte encefalica. El analisis de regresion logistica univariante mostro que la GCS, las escalas APACHE II y SAPS II, y los dias de estancia en la unidad de cuidados intensivos se comportaron como variables predictoras de evolucion a muerte encefalica. Sin embargo, en el analisis multivariante realizado con APACHE II y SAPS II, se evidencio que solo APACHE II mantiene significacion estadistica, a pesar de la buena discriminacion de ambas escalas. Conclusion. Los coordinadores de trasplantes podrian usar la escala APACHE II como una herramienta para detectar pacientes con riesgo de evolucion a muerte encefalica, minimizando la perdida de potenciales donantes.

Atención priorizada al niño menor de un año y la mujer embarazada / Attention prioritized to the smaller boy of a year and the pregnant woman

La obra de la Revolución en la salud pública ha priorizado siempre a los grupos poblacionales de riesgo, así han sido destacadas las acciones sociales y de salud en relación a la mujer y los niños.Por la importancia en el desarrollo morfogenético dentario del niño, y que en ocasiones se desconece se brindan conocimientos actualizados para lograr una mayor motivación de los mismos, y poder revertir estos conocimientos a todos aquellos que se relacionan al niño, lo cual redundará en un incremento de la salud general y bucal de todos