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Arch Med Res ; 2020 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-32747155


BACKGROUND: The population in Mexico has high prevalence rates of noncommunicable diseases (NCDs). Hospitalization and death of COVID-19 patients in the countries most affected by the pandemic has been associated to chronic comorbidities. OBJECTIVE: To describe the prevalence of NCDs in patients with COVID-19 in Mexico and analyze the increased risk due to comorbidities and risk factors on hospitalization, utilization of intensive care units and death. METHODS: A cross-sectional study was performed from 212,802 confirmed COVID-19 cases reported by the Ministry of Health up to June 27, 2020. Odds ratios were performed using logistic regression model. RESULTS: Up to 47.40% of patients with COVID-19 diagnosis were also reported with a comorbidity, with hypertension being the most frequent (20.12%). The report of at least one NCD significantly increased the risk of death with respect to patients without such diagnoses. Chronic kidney disease increased the risk of death the most (OR 2.31), followed by diabetes (OR 1.69), immunosuppression (OR 1.62), obesity (OR 1.42), hypertension (OR 1.24), chronic obstructive pulmonary disease (OR 1.20). The comorbidities that most increased the risk of ICU and of intubation were diabetes, immunosuppression and obesity. CONCLUSION: NCD comorbidities increase the severity of COVID-19 infection. Given high NCD prevalence rates among the Mexican population, the pandemic poses a special threat to the health system and to society. Special prevention measures need to be strengthened for persons with NCD diagnoses in the short-term. In the mid-term, disease control strategies need to be improved to protect these patients against COVID-19 severity.

Opt Express ; 28(12): 17124-17142, 2020 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-32679926


We demonstrate efficient pulse-energy extraction from a partly quenched erbium-doped aluminosilicate fiber amplifier. This has a high erbium concentration that allows for short devices with reduced nonlinear distortions but also results in partial quenching and thus significant unsaturable absorption, even though the fiber is still able to amplify. Although the quenching degrades the average-power efficiency, the pulse energy remains high, and our results point to an increasingly promising outcome for short pulses. Furthermore, unlike unquenched fibers, the conversion efficiency improves at low repetition rates, which we attribute to smaller relative energy loss to quenched ions at higher pulse energy. A short (2.6 m) cladding-pumped partly quenched Er-doped fiber with 95-dB/m 1530-nm peak absorption and saturation energy estimated to 85 µJ reached 0.8 mJ of output energy when seeded by 0.2-µs, 23-µJ pulses. Thus, according to our results, pulses can be amplified to high energy in short highly Er-doped fibers designed to reduce nonlinear distortions at the expense of average-power efficiency.

Cancer Cytopathol ; 2020 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-32520446


BACKGROUND: The goal of this study was to determine whether the detection of histologically confirmed cases of cervical high-grade squamous intraepithelial lesions or worse (HSIL+) can be increased by having each liquid-based cytology (LBC) slide read by 2 cytotechnologists as part of routine screening. METHODS: Over 36,212 women aged 30 to 64 years participated in the Forwarding Research for Improved Detection and Access for Cervical Cancer Screening and Triage (FRIDA) Study in Mexico between 2013 and 2016. For each participant, 2 cervical samples were collected at the same clinic visit, one to test for high-risk human papillomavirus (hrHPV) and the other for LBC, which was used to triage those with a hrHPV positive result. LBC slides were evaluated by 7 cytotechnologists, with each slide read independently by 2 blinded cytotechnologists. All women with atypical cells of undetermined significance or a worse result were referred to colposcopy for further evaluation and diagnosis. Three pathologists evaluated the biopsy specimens to confirm the final HSIL+ diagnosis. The HSIL+ detection rates for the single versus double reading were estimated and compared. RESULTS: A total of 3,914 women with a positive hrHPV result were triaged with LBC. The first and second cytology readings resulted in 43 HSIL+ cases detected; the double-reading strategy detected 9 additional HSIL+ cases, resulting in a total of 52 HSIL+ cases. The HSIL+ detection rate increased from 10.99/1000 with a single reading to 13.29/1000 with the double-reading strategy (P = .004). CONCLUSION: A 20.9% increase in HSIL+ cases detected was achieved with a double reading of the LBC slides in this sample of hrHPV-positive women.

J Biomol Struct Dyn ; : 1-12, 2020 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-32238092


DNA topology changes continuously as replication proceeds. Unwinding of the DNA duplex by helicases is favored by negative supercoiling but it causes the progressive accumulation of positive supercoiling ahead of the fork. This torsional stress must be removed for the fork to keep advancing. Elimination of this positive torsional stress may be accomplished by topoisomerases acting solely ahead of the fork or simultaneously in the un-replicated and replicated regions after diffusion of some positive torsional strain from the un-replicated to the replicated regions by swivelling of the replication forks. In any case, once replication is completed fully replicated molecules are known to be heavily catenated and this catenation derives from pre-catenanes formed during replication. Although there is still controversy as to whether fork swiveling redistributes this positive torsional stress continuously or only as termination approaches, the forces that cause fork rotation and the generation of pre-catenanes are still poorly characterized. Here we used a numerical simulation, based on the worm-like chain model and the Metropolis Monte Carlo method, to study the interchange of supercoiling and pre-catenation in a naked circular DNA molecule of 4,440 bp partially replicated in vivo and in vitro. We propose that a dynamic gradient of torsional stress between the un-replicated and replicated regions drives fork swiveling allowing the interchange of supercoiling and pre-catenation.Communicated by Ramaswamy H. Sarma.

J. coloproctol. (Rio J., Impr.) ; 40(1): 20-23, Jan.-Mar. 2020. tab
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1090843


Abstract Introduction The use of regional anesthetic block has increased, along with the reduction of the use of spine anesthetic in this particular field of surgical activity. In the last decade ambulatory surgery and local anesthetic have lower surgical time, complications of the anesthetic itself, and hospital stay. Objective Presenting the results obteained with the use of local anesthesic and analgesic in the resolution of benign anorectal pathology. Methods A prospective, longitudinal, study, from January 2017 to December 2017, patients were classified according to surgical procedures performed using analogical visual scale to determine the pain tolerance, during the procedure, 24 h later and in the 5th post operative day. Results 253 procedures were performed with 116 local analgesia, 116 were male (45.86%) years 137 female (54%), Milligan-Morgan hemorroidectomy with Ligasure and fistulotomy were the most frequently performed procedures 32% each, followed by biopsy 16%, left lateral esfinterotomy 13% and cutaneous appendix 12%. Females presented better pain tolerance than males patients (92 vs. 81), 68% referred good tolerance through the procedure. Conclusions 68% of all the patients obtained good pain tolerance through anal anesthetic block, females manifested better pain tolerance than males, in non-complicated anorectal pathology local block ha shown to be safe and reproductible for the treatment of benign anorectal pathology in the Guatemalan Institute for Social Security.

Resumo Introdução O uso de bloqueio anestésico regional aumentou ao mesmo tempo em que diminuiu o uso do anestésico espinhal nesse campo específico da atividade cirúrgica. Na última década, a cirurgia ambulatorial e o anestésico local apresentaram um tempo cirúrgico menor, menos complicações associadas ao próprio anestésico e redução da permanência hospitalar. Objetivo Apresentar os resultados obtidos com o uso de anestésico local e analgésico na resolução da patologia anorretal benigna. Métodos Estudo prospectivo, longitudinal, realizado no período de janeiro a dezembro de 2017. Com o uso de uma escala visual analógica, os pacientes foram classificados para determinar a tolerância à dor durante o procedimento, 24 horas após a cirurgia e no quinto dia de pós-operatório. Resultados No total, 253 procedimentos foram realizados com 116 analgesias locais; 116 pacientes eram do sexo masculino (4586%) e 137 do sexo feminino (54%). A técnica de Milligan-Morgan para hemorroidectomia com ligadura e a fistulotomia foram os procedimentos realizados com mais frequência (32% cada), seguidos de biópsia (16%), esfincterotomia lateral esquerda (13%) e apêndice cutâneo (12%). As mulheres apresentaram melhor tolerância à dor que os homens (92 vs. 81), e 68% apresentaram boa tolerância durante o procedimento. Conclusões De todos os pacientes, 68% apresentaram boa tolerância à dor com o uso de bloqueio anestésico por via retal; as mulheres manifestaram melhor tolerância à dor que os homens. Na patologia anorretal não complicada, o bloqueio local mostrou ser seguro e reprodutível para o tratamento da patologia anorretal benigna no Instituto Guatemalteco de Seguridade Social.

PLoS One ; 15(3): e0229417, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32134941


Streptococcus pneumoniae infections are one of the major causes of morbility and mortality worldwide. Although vaccination and antibiotherapy constitute fundamental and complementary strategies against pneumococcal infections, they present some limitations including the increase in non-vaccine serotypes and the emergence of multidrug-resistances, respectively. Ribosomally-synthesized antimicrobial peptides (i.e. bacteriocins) produced by Lactic Acid Bacteria (LAB) may represent an alternative or complementary strategy to antibiotics for the control of pneumococal infections. We tested the antimicrobial activity of 37 bacteriocinogenic LAB, isolated from food and other sources, against clinical S. pneumoniae strains. Streptococcus infantarius subsp. infantarius LP90, isolated from Venezuelan water-buffalo milk, was selected because of its broad and strong anti-pneumococcal spectrum. The in vitro safety assessment of S. infantarius LP90 revealed that it may be considered avirulent. The analysis of a 19,539-bp cluster showed the presence of 29 putative open reading frames (ORFs), including the genes encoding 8 new class II-bacteriocins, as well as the proteins involved in their secretion, immunity and regulation. Transcriptional analyses evidenced that the induction factor (IF) structural gene, the bacteriocin/IF transporter genes, the bacteriocin structural genes and most of the bacteriocin immunity genes were transcribed. MALDI-TOF analyses of peptides purified using different multichromatographic procedures revealed that the dairy strain S. infantarius LP90 produces at least 6 bacteriocins, including infantaricin A1, a novel anti-pneumococcal two-peptide bacteriocin.

Antibacterianos/metabolismo , Bacteriocinas/genética , Bacteriocinas/metabolismo , Infecções Pneumocócicas/metabolismo , Streptococcus/efeitos dos fármacos , Streptococcus/isolamento & purificação , Sequência de Aminoácidos , Antibacterianos/administração & dosagem , Antibacterianos/isolamento & purificação , Bacteriocinas/administração & dosagem , Bacteriocinas/isolamento & purificação , Humanos , Infecções Pneumocócicas/genética , Infecções Pneumocócicas/microbiologia , Streptococcus/classificação
Bioessays ; 42(5): e1900204, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32115727


During replication, the topology of DNA changes continuously in response to well-known activities of DNA helicases, polymerases, and topoisomerases. However, replisomes do not always progress at a constant speed and can slow-down and even stall at precise sites. The way these changes in the rate of replisome progression affect DNA topology is not yet well understood. The interplay of DNA topology and replication in several cases where progression of replication forks reacts differently to changes in DNA topology ahead is discussed here. It is proposed, there are at least two types of replication fork barriers: those that behave also as topological barriers and those that do not. Two-Dimensional (2D) agarose gel electrophoresis is the method of choice to distinguish between these two different types of replication fork barriers.

Theriogenology ; 143: 35-43, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31835098


A repeatable protocol for equine in vitro fertilization (IVF) has remained elusive. This is likely, in part, due to suboptimal composition of capacitation or IVF media that are currently in use. Hence, we aimed to analyse the metabolome of equine oviductal fluid (OF) at the pre- (PRE) and immediate post-ovulatory (PST) stages using proton magnetic resonance spectroscopy (1H NMR). Oviductal fluid from eight PRE and six PST mares were used to prepare a total of five samples per group. A total of 18 metabolites were identified. The five metabolites with the highest concentrations in the OF samples were lactate, myoinositol, creatine, alanine and carnitine. Only fumarate and glycine showed significant differences in their concentrations between PRE and PST OF samples, with higher concentrations in the PST samples. In a preliminary study, stallion spermatozoa (n = 3 ejaculates) were incubated with different concentrations of PST OF from one mare (0, 0.0625, 0.125, 0.25, 0.5 or 1%; v:v). After 4 h of sperm incubation, protein tyrosine phosphorylation (PY) by western blotting, sperm motility, and acrosomal status were evaluated. An increase of PY was observed in sperm from two stallions when treated with 0.0625% and 0.125% of OF; however no change in PY was noted in the other stallion. There were no effects of OF on spermatozoa motility or acrosome status. These results provide the first information on the metabolomics of equine OF at different stages of the estrus cycle, and present the possibility that OF may affect PY in stallion spermatozoa.

Salud Publica Mex ; 62(1): 87-95, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-31869565


OBJECTIVE: To assess the relationship between labor quality of life (LQL) and organizational workers performance (OWP) from seven public hospitals, analyzing the influence of the personnel management (PM) as mediator of this relationship. MATERIALS AND METHODS: A cross-sectional study was conducted in 866 professionals and managers of public hospitals from Tlaxcala and Mexico City. The LQL was assessed with a validated questionnaire, OWP with 34 indicators, and PM with an instrument designed for this study. RESULTS: Mean scores of LQL, were significantly lower among workers from Tlaxcala. Participants who perceived an adequate PM, they increased at 2.7 times their likelihood of having highest LQL, and participants categorized in the high LQL presented 69% higher likelihood of having an adequate OWP. CONCLUSIONS: The appropriate PM was associated with greater LQL, showing to be a mediator variable between the positive relationship of CVL and the OWP.

Hospitais Públicos , Satisfação no Emprego , Administração de Recursos Humanos em Hospitais , Qualidade de Vida , Desempenho Profissional/normas , Adulto , Estudos Transversais , Eficiência Organizacional , Feminino , Humanos , Masculino , México , Saúde do Trabalhador
Artigo em Inglês | MEDLINE | ID: mdl-31788767


Bacteriocins are antimicrobial peptides produced by bacteria to compete with other bacteria for nutrients and ecological niches. The antimicrobial effect of these peptides on the bacterial populations in the gut is likely dynamic as the survival of the microbes in this environment depends on both competition and cooperation. In this study, we evaluated four different bacteriocins from lactic acid bacteria (LAB): nisin, enterocin A (EntA), enterocin K1 (EntK1), and garvicin ML (GarML), which have different inhibition spectra and physicochemical properties. The bacteriocins were tested in vitro using fecal slurry batch cultures from infants. The abundances of some bacterial populations in the cultures were determined using quantitative PCR (qPCR) and the metabolic activity of the gut microbiota was assessed by measuring the production of short-chain fatty acids (SCFA) using gas chromatography. The effects of the bacteriocins correlated well with their antimicrobial spectra and the administered concentrations. Nisin and GarML, with broad antimicrobial spectra, shifted the abundance of several intestinal bacterial groups, while EntA and EntK1, with relative narrower inhibition spectra, showed no or little effect. Moreover, the results from the SCFA analysis were consistent with changes obtained in the bacterial composition. In particular, a reduction in acetate concentration was observed in the samples with low abundance of Bifidobacterium, which is a well-known acetate producer. The variability imposed on the intestinal bacterial populations by the different bacteriocins tested suggests that this type of antimicrobials have great potential to modulate the gut microbiota for medical purposes.

Rev. andal. med. deporte ; 12(4): 342-347, dic. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192156


OBJETIVO: establecer y comparar criterios de evaluación de los niveles de sobrepeso y obesidad en adolescentes canarios y si la información proporcionada por los indicadores Índice de Masa Corporal e Índice Cintura-Altura se corresponden. MÉTODO: participaron en dicho estudio 4282 escolares de centros públicos de Canarias con edades comprendidas entre los 11.75 y los 16.25 años, de los cuales 2154 fueron de sexo masculino y 2128 del sexo femenino. A partir de la medida de la masa y la altura, se construyeron los valores del Índice de Masa Corporal, utilizando los puntos críticos de las tablas de la Fundación Orbegozo para segmentos de 6 meses de edad, y se clasificaron en normopeso, sobrepeso y obesidad. Con la información sobre el perímetro de la cintura se obtuvieron los valores del Índice Cintura-Altura y se definieron puntos críticos que situarán el mismo porcentaje en normopeso, sobrepeso y obesidad para cada uno de los segmentos de edad clasificados según el Índice de Masa Corporal, obteniendo, de esta manera, puntos críticos Índice Cintura-Altura para estos grupos por edad y sexo. Posteriormente se utilizaron funciones splines para definir puntos críticos como funciones continuas de la edad. RESULTADOS: muestran que las funciones splines aplicadas a los percentiles obtenidos para el Índice de Masa Corporal e Índice Cintura-Altura muestran evoluciones diferenciadas según la edad y el sexo. CONCLUSIÓN: las modificaciones antropométricas en la adolescencia sólo pueden ser tenidas en cuenta con criterios que contemplen el cambio continuo con la edad y que la información obtenida por el Índice de Masa Corporal debe ser complementada por indicadores como Índice Cintura Altura, más sensible a dichas modificaciones

OBJECTIVE: to compare and establish criteria for assessing the levels of overweight and obesity in Canarian adolescents. METHOD: 4282 students from public schools from the ages of 11.75 to 16.25 years took part in the study. 2154 were male and 2128 were female. From the registered information about weight and height, their Body Mass Index (BMI) was calculated, and, once pupils were classified into age segments of six months, the Orbegozo limit values 2011, were taken into account to classify them as normal weight, overweight and obese. From additional information about waist circumference, the Waist to Height Ratio was also obtained. Critical values for Waist to Height Ratio were also calculated in such a way that the percentages of pupils classified as normal weight, overweight and obese into each age segment were the same as the ones from the Body Mass Index results. Then, by estimating splines fitted to these critical points for each six-month age segment, value limits are defined as continuous functions of age. RESULTS: Spline functions fitted to the limit values for Body Mass Index or Waist to Height Ratio show different trends according to teenagers' age and gender. CONCLUSION: due to anthropometric transformations in teenagers, overweight criteria should take into account that such transformations are a continuous function of age. Furthermore, beyond the information provided by Body Mass Index, Waist to Height Ratio may be a measure which is more sensitive to anthropometric changes

OBJETIVO: estabelecer e comparar critérios para avaliação dos níveis de sobrepeso e obesidade em adolescentes canários e se as informações fornecidas pelos indicadores de Índice de Massa Corporal e índice cintura-estatura se correspondem. MÉTODO: participaram do estudo 4282 escolares de centros públicos de Canárias com idades compreendidas entre os 11.75 e os 16.25 anos, dos quais 2154 eram do sexo masculino e 2128 do sexo feminino. Através da medida de peso corporal e altura, foram construídos os valores de Índice de Massa Corporal, utilizando os pontos críticos das tabelas da Fundação Orbegozo para segmentos dos 6 meses de idade, e foram classificados como peso normal, sobrepesados e obesos. Com as informações sobre a circunferência da cintura foram obtidos os valores dos índices cintura-estatura e definidos pontos críticos que colocaram a mesma porcentagem em peso normal, sobrepeso e obesidade para cada um dos segmentos classificados segundo o Índice de Massa Corporal, obtendo, desta forma, pontos críticos de índice cintura-estatura para esses grupos por idade e sexo. Posteriormente funções splines foram usadas para definir pontos críticos como funções contínuas de idade. RESULTADOS: mostram que as funções splines aplicadas aos percentis obtidos para o Índice de Massa Corporal e Índice de cintura-estatura mostram diferentes evoluções de acordo com a idade e o sexo. CONCLUSÃO: as modificações antropométricas na adolescência só podem ser levadas em consideração com critérios que contemplam a mudança contínua com a idade e que as informações obtidas pelo Índice de Massa Corporal devem ser complementadas por indicadores como o Índice Cintura-Altura, mais sensível a essas modificações

Humanos , Masculino , Feminino , Criança , Adolescente , Sobrepeso/diagnóstico , Obesidade/diagnóstico , Índice de Massa Corporal , Razão Cintura-Estatura , Espanha
Ansiedad estrés ; 25(2): 125-131, jul.-dic. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-190734


INTRODUCCIÓN Y OBJETIVOS: La literatura científica ha evidenciado diversos predictores de tipo psicoemocional de la ansiedad ante los exámenes. Sin embargo, no se ha estudiado el efecto conjunto que tienen sobre la ansiedad ante los exámenes variables psicoemocionales relativas a la ansiedad-rasgo y al burnout académico, y a la satisfacción con diversos aspectos personales (consigo mismo -autoestima-, con la vida y con el sueño). El objetivo de este estudio ha sido determinar si un grupo de variables de tipo psicoemocional (ansiedad-rasgo, autoestima, burnout académico, satisfacción con la vida), de sueño (satisfacción subjetiva de sueño) y sociodemográfico (edad) constituyen predictores significativos de la ansiedad ante los exámenes en estudiantes de Enfermería. MATERIAL Y MÉTODOS: Estudio descriptivo, transversal, mediante encuesta, llevado a cabo en un grupo de 494 estudiantes de Enfermería. Se analizan los datos mediante pruebas de correlación, de comparación de medias y un modelo de regresión. RESULTADOS: El análisis de regresión explica un 39,3% de la varianza (p < .01) de la ansiedad ante los exámenes debido a los factores de riesgo estadísticamente significativos: ansiedad-rasgo, burnout académico, satisfacción subjetiva de sueño y edad. Las mujeres obtuvieron una media más alta en ansiedad ante los exámenes que los hombres. CONCLUSIONES: El estudio revela que altas puntuaciones en ansiedad-rasgo, burnout académico, insatisfacción con el sueño y tener menos edad fueron predictores de ansiedad ante los exámenes. Las mujeres padecen mayor ansiedad ante los exámenes que los hombres. Se discute la necesidad de equipos de atención psicológica en las facultades de Enfermería para reducir la incidencia de ansiedad ante los exámenes en los estudiantes

INTRODUCTION AND OBJECTIVES: The scientific literature has shown several psychoemotional predictors of test anxiety. However, the combined effect that psychoemotional variables relating to trait anxiety and academic burnout, and satisfaction with several personal aspects (self-esteem, life and sleep) have not been studied. The objective of this study was to determine if a group of psychoemotional variables (trait anxiety, self-esteem, academic burnout, satisfaction with life), sleep variables (subjective sleep satisfaction) and sociodemographic parameters (age) have a significant predictive effect on test anxiety in Nursing students. MATERIAL AND METHODS: A descriptive, cross-sectional, survey-based study carried out on a group of 494 nursing students. The data are analysed using correlation tests, mean comparison tests and a regression model. RESULTS: Regression analysis explains 39.3% of the variance (p < .01) of test anxiety due to statistically significant risk factors: trait anxiety, academic burnout, subjective sleep satisfaction, and age. Women showed a higher average in test anxiety than men. CONCLUSIONS: the study reveals that high scores on trait anxiety, academic burnout, sleep dissatisfaction and being younger were predictors of test anxiety. Women experienced greater test anxiety than men. The need for psychological care teams in Nursing faculties to reduce the incidence of test anxiety in students is discussed

Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Estudantes de Enfermagem/psicologia , Transtornos do Sono-Vigília , Esgotamento Psicológico/psicologia , Satisfação Pessoal , Estresse Psicológico , Ansiedade/psicologia , Fatores Socioeconômicos , Estudos Transversais , Fatores de Risco
Educ. med. (Ed. impr.) ; 20(6): 341-346, nov.-dic. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-191840


Un nivel bajo de alfabetización puede dificultar la comprensión de la información necesaria para tomar decisiones apropiadas en relación con la propia salud. Esta situación está relacionada con una peor adherencia a los tratamientos, un peor estado de bienestar y una mortalidad más elevada, sobre todo en personas de edad avanzada. Resulta esencial que la información pueda ser comprendida por el paciente y su familia. Este artículo tiene como objetivo presentar las recomendaciones internacionales existentes para el diseño y la elaboración de materiales o recursos educativos para pacientes crónicos y familiares. Se describen aspectos metodológicos que engloban la inclusión de los pacientes en distintos puntos durante el proceso de desarrollo del material, la adaptación del formato y el contenido al nivel de comprensión del paciente, así como su participación en una prueba piloto antes de la publicación de los mismos. Los materiales educativos que se han elaborado con la colaboración de los pacientes resultan más adaptados a su contexto y promueven cambios positivos en su salud

Low literacy can difficult the use of information needed to take appropriate decisions in healthcare. This situation is associated with poorer treatment adherence, lower health outcomes and higher mortality among the population and, specifically, the elderly. It is essential that information can be understood by patients and families. This article aims to present the existing international recommendations for the design and development of educational materials and resources to chronic patients and families. This process encompasses the involvement of patients at various levels during the development process of the materials, the adaptation of the format and content to the level of understanding of the patient as well as their participation in the evaluation process. Educational materials that have been developed in collaboration with patients are more adapted to their context and promote positive changes in their health

Humanos , Materiais de Ensino , Saúde da Família/educação , Educação de Pacientes como Assunto/métodos , Doença Crônica/terapia , Letramento em Saúde
Opt Express ; 27(19): 26821-26841, 2019 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-31674556


We use numerical simulations with the beam propagation method (BPM) and rate equations to investigate the pump absorption and amplification characteristics in double-clad ytterbium-doped fibers with small cladding-to-core area ratios, in the range 1-3. The presence of modes with low overlap with the doped region (or alternatively, skew rays) hampers the pump absorption in a circular geometry, but we find that the effect is small for area ratios of ∼2.5 or less. We derive ray-based expressions for the small-signal absorption which show similar results. However, even when the small-signal absorption scales nearly ideally with the inverse of the area ratio, the absorption in an operating amplifier is much lower, and the dependence on the area ratio much weaker, when a large fraction of the Yb-ions is excited in a small-area-ratio fiber. We derive equations which show this, and that in contrast to conventional area ratios of, e.g., 100, the fiber length depends more strongly on the required gain than on the required pump absorption. However, fibers substantially shorter than 1 m still allow for adequate pump absorption and gain. The effective length for nonlinear interactions is less affected by this, since the Yb-excitation is low where the signal power is high. Although we treat single-mode cores, the BPM amplifier simulations show there are a few percent of the signal power in cladding-guided modes with high overlap with the Yb-doped core. Nevertheless, according to our simulations, it is possible to achieve high efficiency and mode purity with a small-area-ratio circularly symmetric double-clad fiber.

Nephron ; 143(4): 264-273, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31487709


INTRODUCTION: Tlaxcala, a small state in central Mexico, has the highest prevalence of chronic kidney disease (CKD) deaths in population aged 5-14 in Mexico, most of them with unknown etiology. OBJECTIVE: To determine the prevalence of CKD in apparently healthy pediatric population in Apizaco, Tlaxcala. METHODS: A cross-sectional pilot study was carried out in children deemed as healthy; subjects with previous diagnosis of CKD were excluded. Informed consent was obtained in all cases. A physical examination was performed, a questionnaire was applied. Blood and urine samples were obtained for serum creatinine, urinalysis, and microalbumin/creatinine ratio. A second and third evaluation was performed after 6 and 18 months in those found with urinary anomalies/CKD to confirm the diagnosis. RESULTS: One hundred and nine subjects completed physical examination, which are the biological samples. Median age was 12 years. CKD stage 2 was confirmed in 5 subjects in the sixth month confirmation visit (4.6%). One patient accepted renal biopsy and Alport Syndrome was found. In a robust multivariate analysis, the risk factors related to reduction in the glomerular filtration rate were males -5.15 mL/min/1.73 m2 (p = 0.002), older participants as by -1.58 mL/min/1.73 m2 per year (p < 0.0001), and among participants living close to a river -3.76 mL/min/1.73 m2 (p = 0.033). DISCUSSION/CONCLUSION: The prevalence of CKD in the population studied in Apizaco Tlaxcala was confirmed in 4.6 cases per 100 inhabitants between 6 and 15 years. Males, older age, and living close to a river were the risk predictive factors. More studies are needed to determine the causes of the high CKD prevalence in this population.

Rev. andal. med. deporte ; 12(3): 210-215, sept. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-191851


OBJETIVO: El presente estudio pretende conocer la influencia que ejerce el estado emocional y la manipulación afectiva en el rendimiento deportivo, de forma experimental. MÉTODO: 126 deportistas universitarios (Medad = 22.79; DT = 4.46), 54 mujeres (42.86%) y 7.78 años de experiencia deportiva (DT = 3.20), participaron en este estudio que midió el optimismo (LOT-R) y el estado emocional (POMS-VIC) antes y después de realizar un test experimental mediante dinamómetro manual digital TKK-5401. RESULTADOS: Al considerar los diferentes grupos (género, experiencia, nivel, optimismo y grupo experimental), destaca la no aparición de diferencias significativas (pre-post). CONCLUSIONES: Los resultados demuestran que tanto estado emocional como las manipulaciones afectivas modifican el rendimiento. En concreto, las manipulaciones afectivas, ligeramente negativas, aumentan significativamente el rendimiento obtenido en la tarea

OBJECTIVE: The aim of this study is to experimentally determine the influence of the emotional state and the emotional manipulation in sports performance. METHOD: 126 college athletes (Mage = 22.79; DT = 4.46), 54 women (42.86%) y 7.78 year of sports experience (DT = 3.20), participated in this study, which measured optimism (LOT-R) and emotional state (POMS-VIC) before and after performing an experimental test using digital manual dynamometer TKK-5401. RESULTS: Considering the different groups (gender, experience, level, optimism and experimental group), it emphasizes the non-appearance of significant differences (pre-post). CONCLUSIONS: Results have shown both the emotional state and the effective manipulations modify the performance slightly negative emotional manipulations significantly increase the yield obtained in the task

OBJETIVO: O presente estudo tem como objetivo conhecer a influência exercida pelo estado emocional e manipulação afetiva no desempenho esportivo, de forma experimental. MÉTODO: 126 atletas universitários (idade = 22.79, DP = 4.46), 54 mulheres (42.86%) e 7.78 anos de experiência esportiva (DP = 3.20), participaram deste estudo que mediu otimismo (LOT-R) e estado emocional (POMS-VIC) antes e depois de realizar um teste experimental usando um dinamômetro digital manual TKK-5401. RESULTADOS: Ao considerar os diferentes grupos (gênero, experiência, nível, otimismo e grupo experimental), destaca-se o não aparecimento de diferenças significativas (pré-pós). CONCLUSÕES: Os resultados mostram que tanto o estado emocional quanto as manipulações afetivas modificam o desempenho. Em particular, as manipulações afetivas, levemente negativas, aumentam significativamente o desempenho obtido na tarefa

Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Desempenho Atlético/psicologia , Desempenho Físico Funcional , Psicologia do Esporte , Emoções
Nucleic Acids Res ; 47(14): 7182-7198, 2019 08 22.
Artigo em Inglês | MEDLINE | ID: mdl-31276584


Due to helical structure of DNA, massive amounts of positive supercoils are constantly introduced ahead of each replication fork. Positive supercoiling inhibits progression of replication forks but various mechanisms evolved that permit very efficient relaxation of that positive supercoiling. Some of these mechanisms lead to interesting topological situations where DNA supercoiling, catenation and knotting coexist and influence each other in DNA molecules being replicated. Here, we first review fundamental aspects of DNA supercoiling, catenation and knotting when these qualitatively different topological states do not coexist in the same circular DNA but also when they are present at the same time in replicating DNA molecules. We also review differences between eukaryotic and prokaryotic cellular strategies that permit relaxation of positive supercoiling arising ahead of the replication forks. We end our review by discussing very recent studies giving a long-sought answer to the question of how slow DNA topoisomerases capable of relaxing just a few positive supercoils per second can counteract the introduction of hundreds of positive supercoils per second ahead of advancing replication forks.

Replicação do DNA , DNA Catenado/química , DNA Circular/química , DNA Super-Helicoidal/química , DNA/química , Conformação de Ácido Nucleico , DNA/genética , Células Eucarióticas/metabolismo , Modelos Moleculares , Células Procarióticas/metabolismo
Cost Eff Resour Alloc ; 17: 11, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31285695


Background: In many countries, economic assessments of the routine use of pulse oximetry in the detection of Critical Congenital Heart Disease (CCHD) at birth has not yet been carried out. CCHDs necessarily require medical intervention within the first months of life. This assessment is a priority in low and medium resource countries. The purpose of this study was to assess the cost-effectiveness (CE) relation of pulse oximetry in the detection of cases of CCHD in Colombia. Methods: A full economic assessment of the cost-effectiveness type was conducted from the perspective of society. A decision tree was constructed to establish a comparison between newborn physical examination plus pulse oximetry, versus physical examination alone, in the diagnosis of CCHDs. The sensitivity and specificity of pulse oximetry were estimated from a systematic review of the literature; to assess resource use, micro-costing analyses and surveys were conducted. The time horizon of the economic evaluation was the first week after birth and until the first year of life. The incremental cost-effectiveness ratio (ICER) was determined and, to control for uncertainty, deterministic and probabilistic sensitivity analysis were made, including the adoption of different scenarios of budgetary impact. All costs are expressed in US dollars from 2017, using the average exchange rate for 2017 [$2,951.15 COP for 1 dollar]. Results: The costs of pulse oximetry screening plus physical examination were $102; $7 higher than physical examination alone. The effectiveness of pulse oximetry plus the physical examination was 0.93; that is, 0.07 more than the physical examination on its own. The ICER was $100 for pulse oximetry screening; that is, if one wishes to increase 1% the probability of a correct CCHD diagnosis, this amount would have to be invested. A willingness to pay of $26.292 USD (direct medical cost) per probability of a correct CCHD diagnosis was assumed. Conclusions: At current rates and from the perspective of society, newborn pulse oximetry screening at 24 h in addition to physical examination, and considering a time horizon of 1 week, is a cost-effective strategy in the early diagnosis of CCHDs in Colombia.Trial registration "retrospectively registered".

Rev. costarric. salud pública ; 28(1): 4-14, ene.-jun. 2019. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1013971


Resumen Introducción: La mortalidad infantil está asociada con la pobreza y el menor nivel de desarrollo de las comunidades geográficas. Se realizo un estudio de la mortalidad infantil durante nueve años en el cantón central de Cartago, Costa Rica. Objetivo: Determinar los factores asociados con la muerte infantil y compararlos con los encontrados en la literatura internacional. Metodología Se determino cuáles son los factores asociados a la muerte infantil comparando entre cada variable la categoría más deprivada socialmente con la menos deprivada para esto se comparó la tasa de expuestos contra la tasa de no expuestos, se estableció la diferencia de tasas, la razón de prevalencia y el valor p. Resultados: Las variables con mayor riesgo para la muerte infantil fueron; año de muerte, escolaridad de la madre, edad al morir, peso al nacer, condición socioeconómica de la madre, complicaciones en el embarazo, tipo de riesgo en el embarazo, actividad remunerada de la madre, calidad de la vivienda y escolaridad del padre. Discusión: Como resultado se validó la teoría de que la pobreza y las condiciones de desarrollo son los mayores predictores de muerte infantil.

Abstract Introduction: Child Mortality is correlated with poverty and a lower development of geographic communities. A study of child mortality was made over nine years in the central area of Cartago, Costa Rica. Objetive: To determine the factors associated with the infant death and compare them with those found in the international literature. Methodology: The factors related to child mortality were determined by comparing the more socially deprived category with the least in each variable. For this purpose the ¨exposed¨ rate was compared against the ¨not exposed¨, a difference between the rates was established, along with the prevalence ratio and the p value. Results: The variables with a bigger risk for child death were; Year of death, mother's level of study, age at time of death, weight at birth, mother's socioeconomic condition, complications during pregnancy, type of risk in the pregnancy, mother's paid activities, quality of housing and father's level of study. Discussion: As a result a theory was validated, which states that poverty and development conditions are the biggest predictors of child death.

Arch. latinoam. nutr ; 69(2): 113-124, jun. 2019. tab, graf
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1053054


En Venezuela se distribuyen productos lácteos en polvo a través de los Comité Locales de Abastecimiento y Producción (CLAP). Con el objetivo de evaluar la composición nutricional de catorce marcas de productos lácteos provenientes de industrias mexicanas y distribuidos en Venezuela, se realizó un estudio descriptivo y transversal, con muestreo a conveniencia de 14 marcas de lácteos obtenidas en hogares beneficiados del área metropolitana de Caracas-Venezuela. Se cotejó la información presentada en el rotulado del producto y se efectuó un análisis químico de la composición nutricional. Los valores obtenidos se compararon utilizando como referencia a la norma COVENIN. En el etiquetado se encontró que sólo 2 marcas se denominan producto lácteo y el 43% de las marcas expresan el mismo contenido nutricional en el rótulo. En la analítica química se encontró inexactitud con la información presentada en el etiquetado nutricional. El análisis de componentes principales seguido de un conglomerado jerárquico permitió diferenciar 4 clúster o grupos: 2 reales y 2 ideales. La mayoría de los productos analizados son significativamente más altos en carbohidratos y sodio (p<0,05), además de bajos en proteínas y calcio (p<0,05). En conclusión, todas las muestras evaluadas incumplen la normativa correspondiente, al presentar irregularidades en la denominación del producto e informar valores que no se corresponden con el contenido nutricional resultante de los análisis químicos(AU)

In Venezuela, powdered milk products are distributed through the Local Supply and Production Committee (CLAP). The objective was to evaluate the nutritional composition of fourteen brands of dairy products from Mexican industries distributed in Venezuela, a descriptive and cross-sectional study was conducted, with convenience sampling of 14 brands of dairy products obtained in households benefiting from the Caracas Metropolitan area - Venezuela. The information presented in the product labeling was checked and a chemical analysis of the nutritional composition was performed. The values obtained were compared using the COVENIN standard as a reference. In the labeling, it was found that only 2 brands are called dairy products and 43% of the brands express the same nutritional content on the label. The chemical analysis showed inaccuracy with the information presented in the nutritional labeling. The analysis of principal components followed by a hierarchical conglomerate allowed us to differentiate 4 clusters or groups: 2 real and 2 ideal. Most of the products analyzed are significantly higher in carbohydrates and sodium (p <0.05), as well as low in protein and calcium (p <0.05). In conclusion, all the samples evaluated fail to comply with the corresponding regulations, presenting irregularities in the product name and reporting values that do not correspond to the nutritional content resulting from chemical analyzes(AU)

Humanos , Masculino , Feminino , Oryza/química , Sódio/administração & dosagem , Laticínios/análise , Substitutos do Leite/administração & dosagem , Qualidade dos Alimentos , Alimentos, Dieta e Nutrição , Indústria de Processamento de Alimentos