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SUMMARY STATEMENT: Bone marrow cell transplant has proven to be an effective therapeutic approach to treat peripheral nervous system injuries as it not only promoted regeneration and remyelination of the injured nerve but also had a potent effect on neuropathic pain.
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Axônios , Remielinização , Sistema Nervoso Periférico , Regeneração Nervosa/fisiologia , Remielinização/fisiologia , Células da Medula ÓsseaRESUMO
Introducción: 25% de personas con hiperinsulinismo desarrolla diabetes 3-5 años luego del primer diagnóstico y 70% lo hará en el resto de la vida. Intervenir los niveles de glicemia desde que se detecta hiperinsulinemia evita la progresión a diabetes y restaura el metabolismo glicémico. Objetivos: Determinar la prevalencia de hiperinsulinismo patológico post-carga de glucosa (HPPG) y su relación con factores de riesgo cardiovascular en adultos 100 UI/ml a las 2 horas), sexo, hipertensión arterial, dislipidemia, malnutrición por exceso, sedentarismo, tabaquismo, ateromatosis e infarto miocárdico documentado. Con STATA 17 se calculó la prevalencia de variables en población general y según categoría de HPPG y se evaluó la significancia con prueba exacta de Fisher. Se compararon medias con ANOVA y t-test con nivel de significancia <0,05. Se usó regresión binomial para estimar Razón de Prevalencia e intervalos de confianza en variables cuantitativas y cualitativas. Resultados: la prevalencia de HPPG fue 41%. La edad promedio 37,5 años, el sexo masculino 52,9%, la hipertensión-arterial 40,5% y la dislipidemia 74,4%. Al comparar las poblaciones con y sin HPPG existieron diferencia estadísticamente significativa en las variables dislipidemia, hipertensión-arterial, malnutrición por exceso y sexo-masculino. La razón de prevalencia alcanzó a un 62%, 37%, 59% y 20% respectivamente. Conclusión: Se encontró una alta prevalencia de HPPG. Los factores de riesgo asociados a ella fueron dislipidemia, hipertensión arterial, malnutrición por exceso y sexo masculino. Esto sugiere que encontrar HPPG puede ser de utilidad para detectar precozmente a la población con un mayor riesgo de enfermedad cardiovascular.
Introduction: 25% of people with hyperinsulinism develop diabetes 3-5 years after the first diagnosis and 70% will do so in the rest of their lives. To control glycemia levels as soon as hyperinsulinemia is detected, progression to diabetes is prevented and glycemic metabolism is restored. Aim: To determine the prevalence of post-glucose load pathological hyperinsulinism (HPPG) and its relationship with cardiovascular risk factors in adults 100 uIU/ ml at 2 hours), sex, hypertension, dyslipidemia, excess malnutrition due to, sedentary lifestyle, smoking, documented atheromatosis and myocardial infarction. The prevalence of variables in the general population was calculated and, in relation to the HPPG category, significance is evaluated with Fisher's exact test. Finally means are compared with ANOVA and t-test. With significance level <0.05. Binomial regression was used to estimate the prevalence ratio and confidence intervals in quantitative and qualitative variables. Statistical analysis was performed with the STATA 17 software. Results: HPPG prevalence was 41%, mean age 37.5 years, male sex 52.9%, arterial hypertension 40.5% and dyslipidemia 74.4%. Un relation to the presence of HPPG a statistically significant difference in the variables dyslipidemia, arterial hypertension, malnutrition due to excess and male sex was found. The prevalence ratios were 62%, 37%, 59% and 20%, respectively. Conclusion: A high prevalence of HPPG was found. Risk factors associated to HPPG were dyslipidemia, arterial hypertension, malnutrition due to excess and male sex. Thus, HPPG can play a role in the early detection of a higher risk of cardiovascular disease in the general population.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Fatores de Risco de Doenças Cardíacas , Hiperinsulinismo/epidemiologia , Resistência à Insulina , Prevalência , Estudos Transversais , Fatores de Risco , Análise de Variância , Intolerância à Glucose/epidemiologia , Glucose/administração & dosagemRESUMO
Methods: Undergraduate students from the University of Chile's health careers were divided at random into control (n = 7) and treated groups (n = 15). The treated group participated in an active meditation program once a week for three months. This treatment included different techniques such as Chakra Sounds, Nataraj, Mandala, Kundalini, Devavani, Gourishankar, and Nadabrahma. Hair samples were taken before and after the treatment period to measure cortisol. Results: The control group increased cortisol level 168.9 ± 76.8 pg/mg compared with initial levels. The treated group shows a decrease of initial cortisol values in 28.5 ± 12.8 pg/mg after meditation protocol application. Conclusions: Blending active meditation in students' daily routine through occupational therapy intervention might prevent undergraduate students' stress in healthcare careers.
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Meditação , Terapia Ocupacional , Atenção à Saúde , Cabelo , Humanos , Hidrocortisona , Meditação/métodos , Estresse Psicológico/terapia , EstudantesRESUMO
Although infection with Leishmania braziliensis is perhaps the key reason to treat New World cutaneous leishmaniasis (CL) and mucosal leishmaniasis (ML), the total literature contains relatively few reported cases. With the aim of supplementing the meager clinical information available, we searched the records of Jorochito (Dermatology) Hospital, Bolivia, for the years 1999-2020 and identified treatment records for 1,696 naive CL patients and 355 naive ML patients. Because follow-up was poor for this real-world treatment experience in the developing world, only 255 CL patients (15%) and 114 ML patients (32%) attended follow-up at Hospital. We therefore engaged in an Active Search for "lost" patients, located a further 542 CL patients (32%) and 142 ML patients (44%), thus eventually accomplished follow up on 697 CL patients (41%) and 256 ML patients (72%). Granular adverse event data derived from hospital records is listed for the 902 CL and 86 ML patients administered Glucantime intramuscularly, the 401 CL and 202 ML patients administered Glucantime intravenously, and the 163 CL and 89 ML patients administered miltefosine orally. Efficacy was obtained from hospital records for patients seen at hospital and from patient recall communicated by telephone for the patients found in the Active Search. The overall CL cure rate was 508 of 697 CL patients (73%) with follow-up: intramuscular Glucantime-196/293 (67%); intravenous Glucantime-90/126 (71%); intralesional Glucantime-34/54 (63%); oral miltefosine-52/69 (75%). The overall ML cure rate was 161 of 256 ML patients (63%) with follow-up: intramuscular Glucantime-26/48 (54%); intravenous Glucantime-66/104 (63%); intravenous amphotericin B deoxycholate-19/35 (54%); oral miltefosine-50/71 (70%). We offer this extensive adverse event and efficacy experience as useful guides for clinicians presented with a L. braziliensis infection. The cure rates also illustrate the quandary of New World CL and ML chemotherapy: sufficiently high to be useful but nevertheless needing augmentation with new agents.
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Antiprotozoários , Leishmania braziliensis , Leishmaniose Cutânea , Leishmaniose Mucocutânea , Bolívia/epidemiologia , Humanos , Leishmaniose Cutânea/tratamento farmacológico , Leishmaniose Cutânea/epidemiologia , Leishmaniose Mucocutânea/tratamento farmacológico , Leishmaniose Mucocutânea/epidemiologia , Antimoniato de Meglumina/uso terapêutico , Resultado do TratamentoRESUMO
The Readiness for Interprofessional Learning Scale (RIPLS) has been widely used to measure students' and professionals' attitudes toward interprofessional learning. However, inconsistencies have been reported concerning its validity and reliability. This study aimed to translate, adapt, and validate the RIPLS questionnaire to be applied to Spanish-speaking health sciences students in Chile. Content and construct validity evidence of the newly created Spanish version of the RIPLS scale were analyzed. An exploratory (EFA) and confirmatory (CFA) analysis were conducted, determining goodness-of-fit indexes. Reliability was evaluated through Cronbach's Alpha Coefficient. We assessed sensitivity to change of the RIPLS scale by comparing pre- and post-interprofessional education workshop scores. The EFA showed that there were three factors. In the CFA, most of the standardized factor loadings were higher than 0.3. Regarding internal consistency, Cronbach's Alpha was 0.86. The differences between the total RIPLS scores before and after the workshops were statistically significant. The Spanish version of RIPLS showed evidence of validity and reliability for use amongst health sciences students. The construct was adequately measured and was shown that it could be used to assess the impact of interprofessional education workshops.
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Relações Interprofissionais , Estudantes de Ciências da Saúde , Atitude do Pessoal de Saúde , Comportamento Cooperativo , Humanos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
Traumatic peripheral nerve injuries constitute a huge concern to public health. Nerve damage leads to a decrease or even loss of mobility of the innervated area. Adult stem cell therapies have shown some encouraging results and have been identified as promising treatment candidates for nerve regeneration. A major obstacle to that approach is securing a sufficient number of cells at the injured site to produce measurable therapeutic effects. The present work tackles this issue and demonstrates enhanced nerve regeneration ability promoted by magnetic targeted cell therapy in an in vivo Wallerian degeneration model. To this end, adipose-derived mesenchymal stem cells (AdMSC) were loaded with citric acid coated superparamagnetic iron oxide nanoparticles (SPIONs), systemically transplanted and magnetically recruited to the injured sciatic nerve. AdMSC arrival to the injured nerve was significantly increased using magnetic targeting and their beneficial effects surpassed the regenerative properties of the stand-alone cell therapy. AdMSC-SPIONs group showed a partially conserved nerve structure with many intact myelinated axons. Also, a very remarkable restoration in myelin basic protein organization, indicative of remyelination, was observed. This resulted in an improvement in nerve conduction, demonstrating functional recovery. In summary, our results demonstrate that magnetically assisted delivery of AdMSC, using a non-invasive and non-traumatic method, is a highly promising strategy to promote cell recruitment and sciatic nerve regeneration after traumatic injury. Last but not least, our results validate magnetic targeting in vivo exceeding previous reports in less complex models through cell magnetic targeting in vitro and ex vivo. STATEMENT OF SIGNIFICANCE: Traumatic peripheral nerve injuries constitute a huge public health concern. They can lead to a decrease or even loss of mobility of innervated areas. Due to their complex pathophysiology, current pharmacological and surgical approaches are only partially effective. Cell-based therapies have emerged as a useful tool to achieve full tissue regeneration. However, a major bottleneck is securing enough cells at injured sites. Therefore, our proposal combining biological (adipose derived mesenchymal stem cells) and nanotechnological strategies (magnetic targeting) is of great relevance, reporting the first in vivo experiments involving "magnetic stem cell" targeting for peripheral nerve regeneration. Using a non-invasive and non-traumatic method, cell recruitment in the injured nerve was improved, fostering nerve remyelination and functional recovery.
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Células-Tronco Mesenquimais , Traumatismos dos Nervos Periféricos , Humanos , Fenômenos Magnéticos , Regeneração Nervosa , Traumatismos dos Nervos Periféricos/terapia , Nervo IsquiáticoRESUMO
Abstract Introduction: The multiple academic demands in the university environment generate high levels of stress among students. Although said stress may be useful to meet such demands, in many cases, it can have a negative impact on their health. Objective: To assess whether the implementation of active meditation in the daily routine of health sciences university students impacts their physical and psycho-emotional stress indicators. Materials and methods: Exploratory and quantitative pilot study carried out in a sample of 22 university students who agreed to participate in a 3-month active meditation elective course (18 sessions). Participants were asked to fill out the Global State Perception Questionnaire (CPGE) ex-ante and ex-post taking the course. Results: 18 participants completed the GSPC ex-ante and ex-post, but only 16 were valid for data processing. Most students reported an improvement in their perception of coping with different stressful situations after completing the course. For example, 87.5% reported remaining in a relaxed state during stressful situations, 81% stated feeling decreased mental exhaustion, and 81% said they were better at handling stressful situations. Conclusions: The implementation of active meditation in the daily routine of this group of university students decreased their physical and psycho-emotional indicators of stress. Therefore, it is necessary to carry out new studies with larger samples to confirm the positive effect of this type of course on the health of university students, which will undoubtedly lead to better academic performance as a result of a better mental state.
Resumen Introducción. Las múltiples exigencias académicas a las que los estudiantes universitarios se enfrentan les generan altos niveles de estrés; si bien el estrés puede ayudarles a afrontar tales exigencias, en muchos casos este puede causarles diversos problemas de salud. Objetivo. Evaluar si la implementación de la meditación activa en la rutina diaria de estudiantes universitarios de las ciencias de la salud tiene un efecto en sus indicadores físicos y psicoemocionales. Materiales y métodos. Estudio piloto exploratorio y cuantitativo realizado en una muestra de 22 estudiantes universitarios que aceptaron participar en un curso electivo de meditación activa de 3 meses (18 sesiones). A los participantes se les solicitó diligenciar el Cuestionario de Percepción Global de Estado (CPGE) ex ante y ex post al curso. Resultados. 18 participantes completaron el CPGE ex ante y ex post, pero solo 16 fueron válidos para el procesamiento de datos. La mayoría de los estudiantes reportó una mejora respecto a su percepción sobre cómo enfrentar diferentes situaciones estresantes luego de completar el curso, por ejemplo, el 87.5% manifestó permanecer en un estado de relajación en situaciones estresantes; el 81%, una disminución del agotamiento mental, y el 81%, un mejor manejo de las situaciones estresantes. Conclusiones. La incorporación de la meditación activa en la rutina diaria de estos estudiantes disminuyó sus indicadores físicos y psicoemocionales de estrés, por lo que es necesario realizar nuevos estudios con muestras más grandes que permitan confirmar el efecto positivo de este tipo de cursos en la salud de los estudiantes universitarios, lo que sin duda repercutirá en un mejor rendimiento académico producto de un mejor estado mental.
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Humanos , Estudantes , Saúde , MeditaçãoRESUMO
Human infection with Fasciola hepatica leads to obstruction of the common bile duct by adult worms and disease characterized by biliary colic, epigastric pain, and nausea. Recommended treatment is a single dose of triclabendazole (TCBZ) (10 mg/kg). Because in the 1990s the Bolivian Altiplano bordering Lake Titicaca was thought to have the highest prevalence of human fascioliasis worldwide, the Bolivian Ministry of Health instituted TCBZ mass drug administration (MDA). From 2008 to 2016 (excepting 2015), one dose of 250 mg was administered, usually in September/October, to each resident of highly endemic regions willing to participate. This is apparently the first reported use of MDA for Fasciola. The proportion of persons in key regions receiving TCBZ MDA was 87% in 2016. In 2017, we resurveyed key regions, and found that the MDA program had been dramatically successful. Whereas Fasciola prevalence was reported as 26.9% in Huacullani/Tiahuanaco and 12.6% in Batallas in 1999, there was 0.7% prevalence in Huacullani/Tiahuanaco and 1% in Batallas in 2017. However, lessons from schistosomiasis control efforts suggest that for sustained control of Fasciola infection, Fasciola MDA needs to be maintained and coupled with measures to control infection in the intermediary snail and in the animal hosts of F. hepatica.
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Antiplatelmínticos/administração & dosagem , Fasciola hepatica , Fasciolíase/epidemiologia , Fasciolíase/prevenção & controle , Administração Massiva de Medicamentos , Triclabendazol/administração & dosagem , Adolescente , Adulto , Animais , Antiplatelmínticos/uso terapêutico , Bolívia/epidemiologia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Triclabendazol/uso terapêutico , Adulto JovemRESUMO
BACKGROUND: Cutaneous leishmaniasis (CL) presents as 1 or more skin lesions, which makes local therapy inherently attractive compared to systemic therapy that exposes the whole body to a drug. For 30 years, 15% paromomycin topical formulations have been in clinical experimentation. Recently, 15% paromomycin in Aquaphilic, a complex base to facilitate adsorption into the lesion, was found superior to aquaphilic vehicle for Old World Leishmania major disease. METHODS: We performed a randomized trial of 15% paromomycin in Aquaphilic (40 patients) vs Aquaphilic vehicle (20 patients) vs a positive control (intralesional pentamidine; 20 patients) against L. braziliensis CL in Bolivia. RESULTS: Cure rates after 6 months of follow-up were 31 of 40 (77.5%, 95% confidence interval [CI] 62.5-88%) for paromomycin-Aquaphilic, 2 of 20 (10%, 95% CI 3-30%) for Aquaphilic vehicle (P < .0001 vs paromomycin-Aquaphilic), and 14 of 20 (70%, 95% CI 48-85.5%) for intralesional pentamidine. Both paromomycin-Aquaphilic and the Aquaphilic vehicle were very well tolerated, with only grade 1 adverse reactions in 5-10% of patients. CONCLUSIONS: Against L. braziliensis CL, a prevalent, aggressive form of New World CL, 15% paromomycin-aquaphilic was vastly superior to a negative vehicle control and was comparable in efficacy to a positive control. This study enlarges the potential use of 15% paromomycin-Aquaphilic from one form of Old World CL to CL more generally. CLINICAL TRIALS REGISTRATION: NCT03096457.
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Antiprotozoários/uso terapêutico , Leishmania braziliensis , Leishmaniose Cutânea/tratamento farmacológico , Paromomicina/uso terapêutico , Administração Tópica , Adulto , Antiprotozoários/administração & dosagem , Humanos , Paromomicina/administração & dosagem , Pentamidina/administração & dosagem , Pentamidina/uso terapêutico , Adulto JovemRESUMO
Bolivian cutaneous leishmaniasis due to Leishmania braziliensis was treated with the combination of miltefosine (150 mg/day for 28 days) plus intralesional pentamidine (120 µg/mm2 lesion area on days 1, 3, and 5). Ninety-two per cent of 50 patients cured. Comparison to historic controls at our site suggests that the efficacy of the two drugs was additive. Adverse effects and cost were also additive. This combination may be attractive when a prime consideration is efficacy (e.g., in rescue therapy), avoidance of parenteral therapy, or the desire to treat locally and also provide systemic protection against parasite dissemination.
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Antiprotozoários/uso terapêutico , Leishmania braziliensis/efeitos dos fármacos , Leishmania/efeitos dos fármacos , Leishmaniose Cutânea/tratamento farmacológico , Pentamidina/uso terapêutico , Fosforilcolina/análogos & derivados , Adulto , Antiprotozoários/administração & dosagem , Antiprotozoários/economia , Bolívia , Quimioterapia Combinada/efeitos adversos , Quimioterapia Combinada/economia , Feminino , Humanos , Masculino , Pentamidina/administração & dosagem , Pentamidina/efeitos adversos , Pentamidina/economia , Fosforilcolina/administração & dosagem , Fosforilcolina/efeitos adversos , Fosforilcolina/economia , Fosforilcolina/uso terapêutico , Resultado do TratamentoRESUMO
Bone marrow mononuclear cells (BMMC) constitute a heterogeneous population with potential to promote tissue regeneration. For this reason, this cell fraction has recently become a therapeutic alternative to mesenchymal stem cells, as culture is not required and phenotypic transformations can be hence avoided. In this work, and in order to attain long-lasting cell labeling and study longer survival times, we used BMMC isolated from adult transgenic rats expressing GFP to reproduce our wild type model and evaluate their remyelination ability in a reversible model of Wallerian degeneration. RT-PCR and flow cytometry analysis confirmed that cells isolated from the transgenic strain exhibited similar expression levels of markers specific to multipotent progenitors (CD34, CD90 and CD105) and Schwann cells (MPZ, MBP, S100ß and p75NTR) compared to wild type BMMC. BMMC expressing GFP retained their migration capacity, arriving exclusively at the injured nerve. Most importantly, and as detected through long-lasting cell tracking, some of these BMMC settled in the demyelinated area, mingled with endogenous cells, underwent phenotypic changes and colocalized with Schwann cell markers MBP and S100ß. Also worth highlighting, transgenic BMMC replicated wild type BMMC effects in terms of MBP organization and levels. On the basis of these findings, BMMC isolated from transgenic animals constitute a useful tool to evaluate their role in peripheral nervous system demyelination-remyelination and the underlying mechanisms.
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Transplante de Medula Óssea , Rastreamento de Células/métodos , Proteínas de Fluorescência Verde/genética , Remielinização/genética , Animais , Animais Geneticamente Modificados , Células da Medula Óssea/ultraestrutura , Linhagem da Célula/genética , Citometria de Fluxo , Regulação da Expressão Gênica/genética , Humanos , Leucócitos Mononucleares/metabolismo , Leucócitos Mononucleares/patologia , Ratos , Células de Schwann/metabolismo , Células de Schwann/ultraestrutura , Transgenes/genética , Degeneração Walleriana/genética , Degeneração Walleriana/patologiaRESUMO
BACKGROUND: Resection of liver-isolated metastases of colorectal cancer (CRC) offers the greatest likelihood of cure. Nevertheless, recurrence rates after this procedure are high, and chemotherapy is a reasonable choice with inconclusive evidence. We aimed to determine if there is a survival difference between patients receiving systemic therapy with surgery versus surgery alone for resection of liver metastases. METHODS: From a source population of 170 patients treated in our National Centre (Centro Nacional de Cirugía Hepatobiliar, San José, Costa Rica), with liver metastases from various primary sites, we selected 51 patients with CRC who underwent hepatic resection with curative intent. We categorized patients according to the treatment received (fluoropyrimidine-based chemotherapy plus or minus monoclonal antibody and surgery v surgery alone) and then calculated the overall survival (OS) rate according to the Kaplan-Meier method. A Cox proportional hazard model was used to assess the influence of potential confounding variables on OS. RESULTS: After a median follow-up of 41.6 months, OS was significantly better for patients treated with systemic therapy (before and/or after hepatic resection) versus surgery alone (3-year OS: 66.7% v 41.7%; hazard ratio, 0.37; 95% CI, 0.15 to 0.91; log-rank test: P = .025). There were no differences among patients who underwent neoadjuvant (48.7%), perioperative (46.2%), and adjuvant therapy (5.1%). The use of systemic therapy was significantly associated with better OS after adjustment for confounding variables (hazard ratio, 0.23; 95% CI, 0.07 to 0.92; P = .03). CONCLUSION: Our findings support the use of systemic therapy (either perioperative, neoadjuvant, or adjuvant) as part of isolated hepatic metastasectomy from CRC.
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Fragile X syndrome (FXS) is the most common form of inherited intellectual disability (ID) and co-morbid autism. It is caused by an amplification of the CGG repeat (>200), which is known as the full mutation, within the 5'UTR of the FMR1 gene. Expansions between 55-200 CGG repeats are termed premutation and are associated with a greater risk for fragile X-associated tremor/ataxia syndrome and fragile X-associated premature ovarian insufficiency. Intermediate alleles, also called the grey zone, include approximately 45-54 repeats and are considered borderline. Individuals with less than 45 repeats have a normal FMR1 gene. We report the occurrence of CGG expansions of the FMR1 gene in Chile among patients with ID and families with a known history of FXS. Here, we present a retrospective review conducted on 2321 cases (2202 probands and 119 relatives) referred for FXS diagnosis and cascade screening at the Institute of Nutrition and Food Technology (INTA), University of Chile. Samples were analysed using traditional cytogenetic methods and/or PCR. Southern blot was used to confirm the diagnosis. Overall frequency of FMR1 expansions observed among probands was 194 (8·8%), the average age of diagnosis was 8·8 ± 5·4 years. Of 119 family members studied, 72 (60%) were diagnosed with a CGG expansion. Our results indicated that the prevalence of CGG expansions of the FMR1 gene among probands is relatively higher than other populations. The average age of diagnosis is also higher than reference values. PCR and Southern blot represent a reliable molecular technique in the diagnosis of FXS.
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Proteína do X Frágil da Deficiência Intelectual/genética , Síndrome do Cromossomo X Frágil/genética , Predisposição Genética para Doença , Mutação/genética , Sequências Repetitivas de Ácido Nucleico/genética , Adolescente , Adulto , Southern Blotting , Criança , Pré-Escolar , Família , Feminino , Testes Genéticos , Genótipo , Humanos , Lactente , Masculino , Reação em Cadeia da Polimerase , Estudos Retrospectivos , Adulto JovemRESUMO
A novel therapy, intralesional (IL) pentamidine, was compared to intralesional therapy with antimony (ILSb), a World Health Organization-recommended therapy, for single Bolivian Leishmania braziliensis lesions. In Study 1, 90 patients were randomized equally between three injections of ILSb over 5 days, five injections of ILSb over 11 days, and three injections of IL pentamidine (120 µg/mm(2)lesion area [ILPenta-120-3]) over 5 days. Cure rates at 6 months were 57% for ILSb-3 injections, 73% for ILSb-5 injections, and 72% for ILPenta-120-3 injections. Adverse effects were local irritation and injection-site pain-ILSb (60 patients): mild (25), moderate (4); IL pentamidine (30 patients): mild (4), moderate (3). In Study 2, 60 patients were randomized equally between five injections of ILSb and three injections of a double dose of IL pentamidine (240 µg/mm(2)[ILPenta-240-3]). In Study 2, cure rates were 67% for ILSb-5 injections and 73% for ILPenta-240-3. For three IL injections of pentamidine, efficacy was optimized at a dose of 120 µg/mm(2)lesion area. The cure rate of that regimen was similar to that for ILSb-5 injections and nonstatistically larger than that of ILSb-3 injections. IL pentamidine is an attractive alternative to ILSb on the basis of efficacy for Bolivian L. braziliensis, the threat of Sb-resistant parasites, tolerance, and patient convenience of three visits over 5 days.
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Leishmania braziliensis/efeitos dos fármacos , Leishmaniose Cutânea/tratamento farmacológico , Pentamidina/administração & dosagem , Tripanossomicidas/administração & dosagem , Adulto , Antimônio/administração & dosagem , Antimônio/uso terapêutico , Esquema de Medicação , Feminino , Humanos , Injeções Intralesionais/métodos , Masculino , Pentamidina/uso terapêutico , Resultado do Tratamento , Tripanossomicidas/uso terapêuticoRESUMO
Introducción: La disfunción eréctil (DE) afecta a millones de personas en el mundo. Se caracteriza por daño endotelial vascular y actualmente es considerado un marcador de riesgo de enfermedad cardiovascular. Sin embargo, no es evaluada normalmente por el personal médico y los pacientes se rehúsan a discutirlo. El objetivo de este trabajo es determinar la prevalencia de DE y sus factores asociados en pacientes con indicación de rehabilitación cardíaca. Material y Método: Estudio descriptivo, transversal, incluyó 225 pacientes con indicación de rehabilitación cardíaca de 6 países de Latinoamérica: Chile (CH), Brasil (BR), Perú (PE), Colombia (CO), Argentina (AR) y Paraguay (PY) en el período de marzo-agosto 2014. Se obtuvo datos demográficos y se utilizó el cuestiona-rio Índice Internacional de Función Eréctil (CIIFE) auto administrado. Las variables fueron procedencia, edad, peso, talla, IMC, obesidad, hipertensión arterial (HTA), diabetes mellitus (DM), infarto agudo del miocardio (IAM), tabaquismo y uso de fármacos. Resultados: Se evaluó a 225 hombres. De acuerdo al CIIFE, 80,1% tuvo algun tipo de DE; 8,9% severa; 10,7% moderada; 26,2% media a moderada y 35,6% media. Los factores asociados significativamente fueron el país de procedencia, la DM, la edad y el tabaquismo. Conclusión: La prevalencia de Disfunción Eréctil en pacientes con indicación de rehabilitación cardíaca de Chile, Brasil, Perú, Colombia, Argentina y Paraguay fue 80,1% y sus factores asociados son edad, obesidad, IAM, DM, HTA y tabaquismo.
Background: Erectile dysfunction (ED) affects millions of males around the world. It is characterized by endothelial dysfunction and is currently considered to be a marker of cardiovascular disease. However, it is seldom evaluated by medical personnel and patients frequently refuse to discuss the subject. The aim of this investigation was to determine incidence and prevalence of ED and associated factors in patients referred for cardiac rehabilitation. Method: A descriptive, cross sectional study was performed in 225 patients referred for cardiac rehabilitation in 6 Latin American countries: Chile (CH), Brazil (BR), Perú (PE), Colombia (CO), Argentina (AR) and Paraguay (PY), from March to August 2014. Demographic data were collected and the self-administered International ED questionnaire was applied to evaluate ED. Variables included age, weight, height, BMI, obesity, hypertension (HT), diabetes mellitus (DM), acute myocardial infarction, smoking habit and use of different medications Results: 80.1% of subjects had some type of ED: it was severe in 8.9%, moderate in 10.7%. moderate to intermediate in 26.2% and intermediate in 35.6%. Factors associated to the presence of ED were country of origin, DM, age, and smoking habit Conclusion: ED was present in a mean of 80.1% of patients referred for cardiac rehabilitation in Chile, Brazil, Perú, Colombia, Argentina, and Paraguay. ED was associated to age, obesity, myocardial infarction, DM, HT, and smoking habit.
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Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Idoso , Reabilitação Cardíaca , Disfunção Erétil/epidemiologia , Comorbidade , Estudos Transversais , Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia , América Latina/epidemiologia , Prevalência , Fatores de Risco , Inquéritos e Questionários , Tabagismo/epidemiologiaRESUMO
El presente estudio pretendió diseñar y validar el Cuestionario de Imagen Corporal para Personas con Discapacidad Física. La muestra incidental estuvo conformada por 114 personas de 18 a 50 años, residentes en Bogotá, que presentaban una discapacidad física. Se diseñaron 40 ítems, evaluados por jueces expertos, se aplicaron a la muestra y se definieron los criterios de calificación. El análisis factorial evidenció la existencia de tres factores constituyentes del constructo de imagen corporal: atractivo, funcionalidad y satisfacción. El cuestionario cumplió con las condiciones de confiabilidad y validez necesarias, por lo que se concluye que es posible utilizarlo, aunque es preciso continuar con el proceso de validación.
The objective of this study was to design and validate the Body Image Questionnaire for Physically Disabled Persons. The incidental sample was composed by 114 persons aged 18 to 50 and residing in Bogotá, who had some type of physical disability. 40 items evaluated by expert judges were designed and administered to the sample, and scoring criteria were defined. Factor analysis showed the existence of three factors that constitute the body image construct: attractiveness, functionality, and satisfaction. Results show that the questionnaire met the necessary conditions of reliability and validity, although it is necessary to continue with the validation process.
O presente estudo pretendeu desenhar e validar o Questionário de Imagem Corporal para Pessoas com Necessidades Físicas Especiais. A amostra incidental esteve conformada por 114 pessoas de 18 a 50 anos, residentes em Bogotá, que apresentavam uma necessidade física especial. Desenharam-se 40 itens, avaliados por especialistas, que foram aplicados à amostra e definiram-se os critérios de qualificação. A análise fatorial evidenciou a existência de três fatores constituintes do construto de imagem corporal: atrativo, funcionalidade e satisfação. O questionário cumpriu com as condições de confiabilidade e validade necessárias, razão pela qual se conclui que é possível utilizá-lo, embora seja preciso continuar com o processo de validação.
RESUMO
The present study descriptive - correlational pretended to describe the relationship between dispositional optimism, psychosocial factors such as coping, spirituality and stressful life events in parents or family caregivers and teachers and sociodemographic factors such as age, education level, family composition, gender and socioeconomic status. The sample was formed by 319 high school students (male and female), between 12 and 18 years old; 138 parents and 19 teachers. It was used the Cuestionario de Optimismo Disposicional (Londoño et al., 2013); the Coping Style Inventory (Archila & Londoño, 2004), Stressful Life Events Scale (WHO); the Index of Spirituality and Wellness (Daaleman & Frey, 2004). The comparative and associative multivariate analysis showed that mixed coping in young people (social support, fantasy and self-blame) in addition to mixed coping in parents (problem solving and social support) predicted dispositional optimism in young people.
El presente estudio descriptivo correlacional pretende describir la relación entre optimismo disposicional y factores psicosociales como afrontamiento, espiritualidad, acontecimientos vitales estresantes y optimismo disposicional en padres o familiares acudientes y maestros; y con factores sociodemográficos (edad, nivel educativo, conformación familiar, género y estrato). La muestra fue de 319 jóvenes, entre 12 y 18 años de ambos géneros, 138 padres y 19 maestros. Se usaron el Cuestionario de Optimismo Disposicional (Londoño et al., 2013), el Inventario de Estilos de Afrontamiento (Archila & Londoño, 2004), la Escala de Eventos Vitales Estresantes de la OMS, el Índice de Espiritualidad y Bienestar (Daaleman & Frey, 2004). Los análisis multivariantes comparativos y de asociación evidenciaron que el afrontamiento mixto en jóvenes (búsqueda de soporte social, fantasía y auto culpa), sumado al afrontamiento mixto en los padres (solución de problemas y búsqueda de soporte social), predecían el optimismo disposicional en los jóvenes.
Assuntos
Humanos , Masculino , Adolescente , Feminino , Criança , Adaptação Psicológica , Personalidade , Inquéritos e Questionários , Satisfação PessoalRESUMO
El presente estudio correlacional descriptivo se propuso evaluar los factores que determinan la calidad de vida (CV) relacionada con la salud en 78 personas con discapacidad física que vivían en Bogotá, y hacían parte de un proyecto de inclusión laboral dirigido por una ONG. Se evaluó la calidad de vida relacionada con la salud (Cuestionario de Salud SF36 y visita domiciliaria), al igual que las condiciones asociadas a la discapacidad y algunos factores psicológicos (Escala de Autoeficacia Generalizada, Prueba de Imagen Corporal, Inventario de Estilos de Afrontamiento, Prueba de optimismo disposicional, Inventario de Depresión de Beck y Escala de Ansiedad de Zung). Se utilizó un modelo de ecuaciones estructurales para encontrar el poder predictivo de las variables en la calidad de vida. El modelo obtenido predecía un 39% de la varianza, incluyendo en orden de peso relativo aportando variables como condiciones de enfermedad, depresión, afrontamiento centrado en la fantasía, trascendencia, pesimismo, ansiedad y autoeficacia. Se discuten los hallazgos y las limitaciones del estudio.
This descriptive correlational study aimed to assess the factors that determine the quality of life related to health in 78 people with physical disabilities who lived in Bogotá and were part of a labor inclusion project run by a NGO. Quality of life related to health was assessed with the SF36 Health Questionnaire and a home visit, as well as the conditions associated with disability and some psychological factors which were measured with the Generalized Self-Efficacy Scale, Body Image Test, Coping Styles Inventory, Dispositional Optimism Test, Beck Depression Inventory and Zung Anxiety Scale. A structural equation model was used in order to determine the predictive power of the quality of life variables. The obtained model predicted 39% of the variance, including the variables' relative weight order, and provided variables as disease condition, depression, coping style focused on fantasy, transcendence, pessimism, anxiety and self-efficacy. Findings and limitations of the study are discussed.
O presente estudo correlacional descritivo se propôs avaliar os fatores que determinam a qualidade de vida relacionada com a saúde em 78 pessoas com necessidades especiais que moravam em Bogotá, e faziam parte de um projeto de inclusão trabalhista dirigido por uma ONG. Avaliou-se a qualidade de vida relacionada com a saúde (Questionário de Saúde SF36 e visita domiciliar), da mesma forma que as condições associadas à necessidade especial e alguns fatores psicológicos (Escala de Autoeficácia Generalizada, Teste de Imagem Corporal, Inventário de Estilos de Enfrentamento, Teste de otimismo disposicional, Inventário de Depressão de Beck e Escala de Ansiedade de Zung). Utilizou-se um modelo de equações estruturais para encontrar o poder preditivo das variáveis na qualidade de vida. O modelo obtido predizia 39% de variância, incluindo em ordem de peso relativo contribuindo variáveis como condições de doença, depressão, enfrentamento centrado na fantasia, transcendência, pessimismo, ansiedade e autoeficácia. Discutem-se as descobertas e as limitações do estudo.
Assuntos
Humanos , Masculino , Feminino , Qualidade de Vida , Causalidade , Pessoas com DeficiênciaRESUMO
Resumen. El Síndrome X Frágil (SXF) constituye la causa más frecuente de retraso mental hereditario y autismo. Los individuos con mutación completa (MC) presentan alteraciones clínicas que incluyen: déficit cognitivo y atencional, hiperactividad, autismo y problemas emocionales. Los portadores de premutación (PM) pueden afectarse del síndrome de temblor y ataxia asociado a X frágil (FXTAS); el 30 por ciento de las mujeres con PM presentan insuficiencia ovárica prematura(FXPOI). Cuando un individuo presenta una MC es frecuente encontrar otros familiares afectados. El fenotipo al nacer no es evidente, se sugiere que debe hacerse el diagnóstico entre los35-37 meses, sin embargo, la edad de diagnóstico en Chile es en promedio de 8 +/- 5.8 años. El centro de diagnóstico, tratamiento y seguimiento de pacientes con síndrome X frágil (CDTSXF)es un centro multidisciplinario, que incluye diagnósticos moleculares, genetistas médicos, asesoramiento genético, neurólogos, terapeutas ocupacionales, fonoaudiólogo, evaluaciones nutricionales y psicológicas para las familias afectadas. Desde el año 2010 hemos asistido a 28familias y detectado un número significativo de afectados debido a la detección en cascada. Se ha diagnosticado a 63 probandos, 57 MC y ocho mosaicos de MC/PM. Entre las madres portadoras 37 son PM y dos presentaron una MC. En 9/28 familias había un adulto mayor con FXTAS, diez familias presentaron mujeres con FXPOI. 41/63 probandos han participado denle el protocolo multidisciplinario del CDTSXF. Los resultados de este enfoque multidisciplinario nos motiva a seguir trabajando en mejorar el comportamiento y desarrollo cognitivo de los pacientes y atender las principales necesidades de las familias afectadas.
Fragile X Syndrome (FXS) is the most common inherited form of mental retardation and a leading known cause of autism. Individuals with a full mutation (FM) present disabilities including: cognitive and attention deficit, hyperactivity, autism, and other emotional problems. Carriers of a premutation (PM) may be affected by fragile X associated tremor/ataxia syndrome (FXTAS) and primary ovarian insufficiency (FXPOI) in 30 percent of PM women. Therefore, multigenerational family involvement is commonly found when a proband is diagnosed with a FXS mutation. FXS has no obvious phenotype at birth, it is suggested that the diagnosis should be made at 35-37 months; the age of diagnosis in Chile is on average 8+/-5.8 yo. The center for diagnosis, treatment and monitoring of patients with fragile X syndrome (CDTTRABAJOMFXS), is a multidisciplinary center that includes molecular testing, medical geneticists, genetic counseling, neurologists, occupational therapists, physical therapists, and nutritional and psychological interventions to families with an FM proband. Since 2010, we have assisted 28 families with a total of 63 diagnosed probands using specific PCR and Southern blot tests. Among them, 57 had a FM and eight had a mosaic FM/PM. Among the mothers 37 are PM carriers and two presented a FM. An older adult with FXTAS was present in 9/28 families; ten families presented women with FXPOI. A significant number of affected family members have been detected through cascade screening. Among the probands 41 of 63 have received some of the multidisciplinary diagnostic and interventions. The results of this multidisciplinary work allow us to put forward more effort towards improving behavior and cognitive development of patients as well as trying to solve families main needs.