RESUMO
Clopidogrel, an oral platelet P2Y12 receptor blocker, is used in the treatment of acute coronary syndrome. Interindividual variability in treatment response and the occurrence of adverse effects has been attributed to genetic variants in CYP2C19. The analysis of relevant pharmacogenes in ethnically heterogeneous and poorly studied populations contributes to the implementation of personalized medicine. We analyzed the coding and regulatory regions of CYP2C19 in 166 patients with acute coronary syndrome (ACS) treated with clopidogrel. The allele frequencies of CYP2C19 alleles *1, *2, *4, *17, *27 and *33 alleles were 86.1%, 7.2%, 0.3%, 10.2%, 0.3% and 0.3%, respectively. A new potentially pathogenic mutation (p.L15H) and five intronic variants with potential splicing effects were detected. In 14.4% of the patients, a new haplotype in strong linkage disequilibrium was identified. The clinical outcome indicated that 13.5% of the patients presented adverse drugs reactions with a predominance of bleeding while 25% of these patients were carriers of at least one polymorphic allele. We propose that new regulatory single-nucleotide variants (SNVs) might potentially influence the response to clopidogrel in Colombian individuals.
RESUMO
Se comenta acerca de los determinantes sociales y sanitarios protectores en las instituciones de educación superior de Latinoamérica, así como también de los factores de riesgo en ese entorno, a la vez que se mencionan algunas experiencias relacionadas con las universidades promotoras de la salud en América Latina y el Caribe, donde representan un gran desafío en el contexto histórico actual.
It is a comment on health and social determinants protectors in the higher education institutions from Latin America; as well as on the risk factors in this environment, at the same time, some experiences are mentioned in relation to health promoter universities in Latin America and the Caribbean, which represent a great challenge in the present historical context.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Determinantes Sociais da Saúde/tendências , Promoção da Saúde , Universidades , UniversidadesRESUMO
La promoción de estilos de vida saludables comprende la creación de ambientes favorables como una actividad clave en la salud pública, la reorientación de la atención sanitaria a la población para garantizar un desarrollo sostenible, la lucha contra las enfermedades infecciosas, la desnutrición y los factores ambientales desfavorables como la carencia de agua potable, saneamiento básico y seguridad alimentaria; la contaminación atmosférica por la industrialización, el calentamiento global y las conductas de riesgo como las adicciones, la obesidad y otras. En diversos países de América Latina y el Caribe se incumplen muchas de las acciones para lograr entornos saludables por no promoverse suficientemente la educación para la salud, de manera que se impone insistir una y otra vez sobre ello(AU)
The promotion of healthy lifestyles comprises the creation of favorable atmospheres as a key activity in the public health, reorientation of health care for the population to guarantee a sustainable development, fight against infectious diseases, malnutrition and unfavorable environmental factors as lack of drinkable water, basic cleaning up and alimentary security; pollution due to industrialization, global warming and risk behaviors as addictions, obesity and others. In several Latin American and Caribbean countries many of the actions to achieve healthy environments are not fulfilled because health education is not sufficiently promoted, so it is imperative to insist one time and another on this matter(AU)
Assuntos
Humanos , Educadores em Saúde , Promoção da Saúde , Política de Saúde , Saúde Ambiental , ComunicaçãoRESUMO
La promoción de estilos de vida saludables comprende la creación de ambientes favorables como una actividad clave en la salud pública, la reorientación de la atención sanitaria a la población para garantizar un desarrollo sostenible, la lucha contra las enfermedades infecciosas, la desnutrición y los factores ambientales desfavorables como la carencia de agua potable, saneamiento básico y seguridad alimentaria; la contaminación atmosférica por la industrialización, el calentamiento global y las conductas de riesgo como las adicciones, la obesidad y otras. En diversos países de América Latina y el Caribe se incumplen muchas de las acciones para lograr entornos saludables por no promoverse suficientemente la educación para la salud, de manera que se impone insistir una y otra vez sobre ello
The promotion of healthy lifestyles comprises the creation of favorable atmospheres as a key activity in the public health, reorientation of health care for the population to guarantee a sustainable development, fight against infectious diseases, malnutrition and unfavorable environmental factors as lack of drinkable water, basic cleaning up and alimentary security; pollution due to industrialization, global warming and risk behaviors as addictions, obesity and others. In several Latin American and Caribbean countries many of the actions to achieve healthy environments are not fulfilled because health education is not sufficiently promoted, so it is imperative to insist one time and another on this matter
Assuntos
Humanos , Saúde Ambiental/educação , Educação em Saúde/métodos , Política de Saúde , Estilo de Vida Saudável , Promoção da Saúde , Região do Caribe/epidemiologia , Riscos Ambientais , América Latina/epidemiologiaRESUMO
La promoción de la salud, como función esencial de la salud pública, ha sido un importante tema de debate desde el pasado siglo. De hecho, se han realizado nueve conferencias para abordar ampliamente sus aspectos conceptuales, su vínculo con la educación en salud y la participación comunitaria al respecto. En este artículo se exponen elementos relacionados con la evolución y la situación actual de la promoción de la salud, así como los retos y las perspectivas sobre este asunto en América Latina, donde se hace más evidente la brecha que aún persiste entre la teoría y la práctica(AU)
Health promotion, as essential function of public health, has been an important debate topic since the last century. In fact, nine conferences have been carried out to approach thoroughly its conceptual aspects, its link with education in health and the community participation in this respect. In this work elements related to the evolution and current situation of health promotion are exposed, as well as the challenges and perspectives on this matter in Latin America, where the breach that still persists between theory and practice becomes more evident(AU)
Assuntos
Humanos , Masculino , Feminino , Promoção da Saúde , Educação em Saúde , Planejamento Social , Relações Comunidade-Instituição , Atenção à SaúdeRESUMO
La promoción de la salud, como función esencial de la salud pública, ha sido un importante tema de debate desde el pasado siglo. De hecho, se han realizado nueve conferencias para abordar ampliamente sus aspectos conceptuales, su vínculo con la educación en salud y la participación comunitaria al respecto. En este artículo se exponen elementos relacionados con la evolución y la situación actual de la promoción de la salud, así como los retos y las perspectivas sobre este asunto en América Latina, donde se hace más evidente la brecha que aún persiste entre la teoría y la práctica
Health promotion, as essential function of public health, has been an important debate topic since the last century. In fact, nine conferences have been carried out to approach thoroughly its conceptual aspects, its link with education in health and the community participation in this respect. In this work elements related to the evolution and current situation of health promotion are exposed, as well as the challenges and perspectives on this matter in Latin America, where the breach that still persists between theory and practice becomes more evident
