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1.
AIDS Behav ; 2020 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-32889660

RESUMO

Predictive approaches in HIV to estimate a patient's risk to present with relevant health outcomes, such as hospitalizations and AIDS-related death, long before they happen, could be highly useful. We aimed to develop a risk classification instrument for virological failure through a scoring system that identifies patients with a low, medium, and high risk after six months of ART treatment. A case-control design was implemented through 355 HIV-positive Colombian adults who were assessed using the designed instrument. The variables with independent predictive values were selected using logistic regression analysis, and the diagnostic performance of the prediction score was evaluated using the area under the curve. The prediction score included relevant psychosocial and biological risk factors, some of them modifiable variables like substance use and low health literacy. The area under the curve value for the total prediction score was 0.85 (CI 0.80-0.90). Therefore, this instrument could be a valuable tool to identify at-risk patients of virological failure. In low and middle-income countries, the associated risk factors of virological failure are little known. Assessing such risk would lead to make individualized decisions regarding the patient's management and minimize the chance of non-desirable outcomes.

2.
Clin Infect Dis ; 2020 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-32803236

RESUMO

BACKGROUND: The SARS-CoV-2 pandemic has caused substantial morbidity and mortality worldwide. Few reports exist in Latin America, a current epicenter of transmission. Here, we aim to describe the epidemiology and outcomes associated with COVID-19 in Honduras. METHODS: Baseline clinical and epidemiological information of SARS-CoV-2 RT-PCR confirmed cases detected between March 17th-May 4th in the San Pedro Sula Metropolitan area was collected, and, for hospitalized cases, clinical data was abstracted. Logistic regression models were fit to determine factors associated with hospitalization. RESULTS: 877 COVID-19 cases were identified of which 25% (n=220) were hospitalized. The 19-44-year age group (57.8%) and males (61.3%) were predominant in overall COVID-19 cases. 34% of the cases (n=299) had at least one pre-existing medical condition. Individuals aged 45-69 years [aOR= 4.05, 95% CI: 2.85-5.76], ≥70 years [aOR= 9.12, 95% CI:5.24-15.86], of male sex [aOR =1.72, CI 95%: 1.21-2.44] and those with a pre-existing condition [aOR= 2.12, 95% CI: 1.43-3.14] had a higher odd of hospitalization. Fifty percent of inpatients were hospitalized more than 7 days. Median length of hospitalization was 13 days [IQR: 8-29] among individuals aged 19-44 years, and 17 days [IQR: 11-24.6] among those aged 45-69. Forty-two percent of the fatal cases occurred among adults under 60 years old. CONCLUSIONS: Our findings show that a high proportion of COVID-19 cases in Honduras occurred among younger adults, who also constituted a significant proportion of severe and fatal cases. Pre-existing conditions were associated with severe outcomes independently from age and were highly prevalent in Honduran COVID-19 cases.

3.
Am J Orthopsychiatry ; 2020 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-32853008

RESUMO

Immigration is at the forefront of national, state, and local policy struggles in the United States, and Latinx/@ immigrants have experienced increased deportations, detention, and individual threats. A mobilities perspective allows analysis to extend our view of migration beyond frameworks confined to pre- and postmigration, examining trajectories of social inclusion and exclusion that are influenced by multiple factors in the receiving country. The Immigrant Well-being Project, a community-based participatory research project involving university faculty, students, staff, and representatives from 4 community-based organizations (CBOs), was initiated in New Mexico in 2017 to better understand and promote Latinx/@ immigrant mental health and integration by creating change at multiple levels. We began these efforts by conducting an in-depth study of the mental health needs, stressors, current socioeconomic, legal, and political context, and local solutions as experienced by 24 Latinx/@ immigrants and their mixed status families. Five trajectories of immigrant integration emerged: continuous exclusion, simultaneous exclusion and inclusion, continuous inclusion, movement from exclusion to inclusion, and movement from inclusion to exclusion. These diverse mobilities were shaped by participants' social locations, agency, and experiences with CBOs, which played critical roles in creating, maintaining, and/or transforming immigrants' trajectories. However, CBOs could not completely buffer immigrants from the current hostile climate and related stressors that resulted in experiences of exclusion or movement from inclusion to exclusion. These findings add to understandings of immigrant mental health, complex ongoing mobility, and mechanisms of resilience and resistance within the United States and have important implications for policy and practice. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

4.
Rev Neurosci ; 31(3): 245-268, 2020 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-32250284

RESUMO

The strength and efficiency of synaptic connections are affected by the environment or the experience of the individual. This property, called synaptic plasticity, is directly related to memory and learning processes and has been modeled at the cellular level. These types of cellular memory and learning models include specific stimulation protocols that generate a long-term strengthening of the synapses, called long-term potentiation, or a weakening of the said long-term synapses, called long-term depression. Although, for decades, researchers have believed that the main cause of the cognitive deficit that characterizes Alzheimer's disease (AD) and aging was the loss of neurons, the hypothesis of an imbalance in the cellular and molecular mechanisms of synaptic plasticity underlying this deficit is currently widely accepted. An understanding of the molecular and cellular changes underlying the process of synaptic plasticity during the development of AD and aging will direct future studies to specific targets, resulting in the development of much more efficient and specific therapeutic strategies. In this review, we classify, discuss, and describe the main findings related to changes in the neurophysiological mechanisms of synaptic plasticity in excitatory synapses underlying AD and aging. In addition, we suggest possible mechanisms in which aging can become a high-risk factor for the development of AD and how its development could be prevented or slowed.

5.
Rev. colomb. cardiol ; 27(1): 7-12, ene.-feb. 2020. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1138747

RESUMO

Resumen Objetivo: describir las características y el comportamiento clínico de pacientes tratados con sacubitril/valsartán en una clínica de falla cardiaca de un hospital de alta complejidad. Métodos: se analizaron en retrospectiva 56 pacientes en manejo con sacubitril/valsartán, entre enero de 2017 y mayo de 2018. A los tres meses de inicio del tratamiento, 87% de los pacientes fueron evaluados. Se determinaron cambios en clase funcional, fracción de eyección ventricular izquierda (FEVI) y presión arterial sistólica y diastólica. Se registraron reingresos hospitalarios por falla cardiaca, mortalidad cardiovascular y eventos adversos asociados a la medicación. Resultados: la edad promedio fue 71,3 años; 51,7% correspondían al sexo masculino, 73% tenía etiología isquémica, 35% clase funcional NYHA II y 60% NYHA III antes de iniciar el tratamiento con sacubitril/valsartán. Al finalizar el seguimiento, 57% mejoró su clase funcional y 81,7% se encontraba en clase funcional NYHA II (IC95%, -0,52 a-0,18; p=0,0002). Hubo mejoría significativa en los valores de FEVI respecto a los basales (IC95%, 4,27 a 11,86; p=0,0002). Se observó una disminución significativa de la presión arterial tanto sistólica como diastólica (p<0,01). Un paciente presentó muerte súbita (2%) y uno hospitalización por falla cardiaca (2%). Ningún paciente descontinuó la terapia por efectos adversos. Conclusión: sacubitril/valsartán es una terapia útil en pacientes con falla cardiaca sintomática y FEVI reducida. La población evaluada tenía un perfil demográfico y clínico semejante al del ensayo clínico PARADIGM-HF, lo cual sugiere que los desenlaces clínicos son similares en la población colombiana.


Abstract Objective: The aim of this study is to describe the characteristics and clinical behaviour of patients treated with sacubitril/valsartan in a heart failure clinic of a high complexity hospital. Methods: A retrospective analysis was performed on a total of 56 patients on treatment with sacubitril/valsartan, between January 2017 and May 2018. At three months from the start of the treatment, 87% of the patients were evaluated. Changes were observed in functional class, left ventricular ejection fraction (LVEF), and systolic and diastolic arterial pressure. A record was made of hospital re-admissions due to heart failure, cardiovascular mortality, and adverse events associated with the medication. Results: The mean age of the patients was 71.3 years, of which 51.7% were male. An ischaemic origin was found in 73%. NYHA II and NYHA III functional class was observed 35% and 60%, respectively, before starting the treatment with sacubitril/valsartan. At the end of follow-up, 57% improved their functional class, and 81.7% were found to be in NYHA II functional class (95% CI; -0.52 to -0.18:=0.0002). There was a significant improvement in the LVEF values compared to baseline (95% CI; 4.27 to 11.86; P=0.0002). A significant decrease was observed in both systolic and diastolic blood pressure (P<0.01). There was sudden death in one (2%) patient and one (2%) patient admitted due to heart failure. None of the patients stopped the therapy due to secondary effects. Conclusion: Sacubitril/valsartan is a useful therapy in patients with symptomatic heart failure and a decreased LVEF. The population evaluated had a demographic and similar clinical signs and symptoms to the PARADIGM-HF clinical trial, which suggests that the clinical outcomes are similar in the Colombian population.

6.
Parkinsonism Relat Disord ; 66: 182-188, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31445906

RESUMO

INTRODUCTION: Spinocerebellar ataxia type 10 (SCA10) is a hereditary neurodegenerative disorder caused by repeat expansions in the ATXN10 gene. Patients present with cerebellar ataxia frequently accompanied by seizures. Even though loss of cerebellar Purkinje neurons has been described, its brain degeneration pattern is unknown. Our aim was to characterize the gray and white matter degeneration patterns in SCA10 patients and the association with clinical features. METHODS: We enrolled 18 patients with molecular diagnosis of SCA10 and 18 healthy individuals matched for age and sex. All participants underwent brain MRI including high-resolution anatomical and diffusion images. Whole-brain Tract-Based Spatial Statistics (TBSS) and Voxel-Based Morphometry (VBM) were performed to identify white and grey matter degeneration respectively. A second analysis in the cerebellum identified the unbiased pattern of degeneration. Motor impairment was assessed using the SARA Scale. RESULTS: TBSS analysis in the patient group revealed white matter atrophy exclusively in the cerebellum. VBM analysis showed extensive grey matter degeneration in the cerebellum, brainstem, thalamus, and putamen. Significant associations between cerebellar degeneration and SARA scores were found. Additionally, degeneration in thalamic GM and WM in the cerebellar lobule VI were significantly associated with the presence of seizures. CONCLUSION: The results show that besides cerebellum and brainstem, brain degeneration in SCA10 includes predominantly the putamen and thalamus; involvement of the latter is strongly associated with seizures. Analysis of the unbiased degeneration pattern in the cerebellum suggests lobules VIIIb, IX, and X as the primary cerebellar targets of the disease, which expands to the anterior lobe in later stages.


Assuntos
Cerebelo/patologia , Substância Cinzenta/patologia , Putamen/patologia , Ataxias Espinocerebelares/patologia , Tálamo/patologia , Substância Branca/patologia , Adulto , Cerebelo/diagnóstico por imagem , Expansão das Repetições de DNA , Feminino , Substância Cinzenta/diagnóstico por imagem , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Linhagem , Putamen/diagnóstico por imagem , Ataxias Espinocerebelares/diagnóstico por imagem , Tálamo/diagnóstico por imagem , Substância Branca/diagnóstico por imagem
7.
Noise Health ; 21(98): 25-34, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32098928

RESUMO

Introduction: Noise is one of the main sources of discomfort in modern societies. It affects physiology, behavior, and cognition of exposed subjects. Although the effects of noise on cognition are well known, gender role in noise-cognition relationship remains controversial. Aim: We analyzed the effects of noise on the ability of male and female rats to execute the Radial Arm Water Maze (RAWM) paradigm. Materials and Methods: Male and female Wistar rats were exposed to noise for 3 weeks, and the cognitive effects were assessed at the end of the exposure. RAWM execution included a three-day training phase and a reversal-learning phase conducted on the fourth day. Escape latency, reference memory errors, and working memory errors were quantified and compared between exposed and non-exposed subjects. Results: We found that male rats were in general more affected by noise. Execution during the three-day learning phase evidenced that male exposed rats employed significantly more time to acquire the task than the non-exposed. On the other hand, the exposed females solved the paradigm in latencies similar to control rats. Both, males and females diminished their capacity to execute on the fourth day when re-learning abilities were tested. Conclusion: We conclude that male rats might be less tolerable to noise compared to female ones and that spatial learning may be a cognitive function comparably more vulnerable to noise.


Assuntos
Aprendizagem em Labirinto , Ruído/efeitos adversos , Animais , Cognição , Feminino , Masculino , Memória de Curto Prazo , Ratos , Ratos Wistar , Fatores Sexuais , Natação
8.
Int J Cancer ; 144(9): 2181-2191, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30485434

RESUMO

Latino women show lower incidences of breast cancer (BC) than non-Hispanic whites. Large-scale genetic association studies have identified variants robustly associated with BC risk in European women. We examine here the relevance of these variants to Colombian BC and possible interactions with genetic ancestry. Native American, European and African proportions were estimated for 1022 Colombian BC cases and 1023 controls. Logistic regression was applied to assess the association between 78 variants and BC risk and interactions between the variants and ancestry proportions. We constructed a multifactorial risk score combining established BC risk factors, associated risk variants and individual ancestry proportions. Each 1% increase in the Native American proportion translated into a 2.2% lower BC risk (95% CI: 1.4-2.9). Thirteen variants were associated with BC in Colombian women, with allele frequencies and risk effects partially different from European women. Ancestry proportions moderated the risk effects of two variants. The ability of Native American proportions to separate Colombian cases and controls (area-under-the-curve (AUC) = 0.61) was similar to the discriminative ability of family history of BC in first-degree female relatives (AUC = 0.58) or the combined effect of all 13 associated risk variants (AUC = 0.57). Our findings demonstrate ample potential for individualized BC prevention in Hispanic women taking advantage of individual Native American proportions, information on established susceptibility factors and recently identified common risk variants.


Assuntos
Neoplasias da Mama/epidemiologia , Neoplasias da Mama/genética , Predisposição Genética para Doença/genética , Estudo de Associação Genômica Ampla/métodos , Estudos de Casos e Controles , Colômbia/epidemiologia , Feminino , Frequência do Gene/genética , Genótipo , Humanos , Polimorfismo de Nucleotídeo Único/genética , Risco
9.
Rev Chil Pediatr ; 89(5): 600-605, 2018 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-30571802

RESUMO

INTRODUCTION: The objective of this study is to evaluate the association between the duration of ini tial empirical antibiotic treatment and the subsequent development of late-onset sepsis, necrotizing enterocolitis (NEC) and death in very low birth weight (VLBW) infants. PATIENTS AND METHODS: Quantitative, cross-sectional, analytical study of VLBW infants admitted to the neonatal ICU were included over a period of five years. Initial empirical antibiotic therapy was that which started immediately after birth, without knowing the results of blood cultures. It was considered prolonged antibiotic therapy when the treatment duration was > 5 days. Perinatal variables, as well as the inci dence of late-onset sepsis, confirmed NEC and mortality were analyzed. RESULTS: 266 VLBW infants were studied, with an average gestational age and birth weight of 28.8 ± 2.5 weeks and 1.127 ± 264 g respectively. 213 infants received initial empiric antibiotic therapy (80.0%), which was prolonged in 67.6% of cases. All infants received two different antibiotics. 136 episodes of late-onset sepsis were described. The most common pathogens were coagulase-negative Staphylococcus and Staphylococcus aureus. Among the newborns with prolonged antibiotic therapy, there were 20 cases of confirmed NEC and 15 of the studied infants died (10.4%). When comparing the use of antibiotic therapy during > 5 days versus treatment less than 5 days duration, a statistically significant association was observed between prolonged antibiotic therapy and late-onset sepsis (p = 0.03) and confirmed NEC (p = 0.03), but not of mortality (p = 0.12). CONCLUSION: The use of empirical antibiotic therapy for five days or more was associated with an increased risk of late-onset sepsis and NEC, but not of mortality in VLBW infants.


Assuntos
Antibacterianos/efeitos adversos , Enterocolite Necrosante/induzido quimicamente , Doenças do Prematuro/induzido quimicamente , Recém-Nascido de muito Baixo Peso , Sepse Neonatal/induzido quimicamente , Infecções Estafilocócicas/induzido quimicamente , Antibacterianos/administração & dosagem , Estudos Transversais , Esquema de Medicação , Enterocolite Necrosante/mortalidade , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/mortalidade , Masculino , Sepse Neonatal/mortalidade , Estudos Retrospectivos , Fatores de Risco , Infecções Estafilocócicas/mortalidade
10.
Rev. chil. pediatr ; 89(5): 600-605, oct. 2018. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-978131

RESUMO

Resumen: Introducción: El objetivo de este estudio es evaluar la asociación entre la duración del tratamien to antibiótico empírico inicial y el desarrollo posterior de sepsis tardía, enterocolitis necrotizante (NEC) y muerte en recién nacidos de muy bajo peso al nacer (RNMBP). Pacientes y Método: Estudio cuantitativo, transversal analítico, en RNMBP ingresados a UCI neonatal durante un período de 5 años. Se consideró antibioterapia empírica inicial aquella que comenzó desde el nacimiento, sin conocer resultado de hemocultivos. Antibioterapia prolongada se estimó cuando la duración del tratamiento fue > 5 días. Se analizaron variables perinatales, e incidencia de sepsis tardía, NEC confirmada y mortalidad. Resultados: Se estudiaron un total de 266 RNMBP, con edad gestacional y peso de nacimiento promedios de 28,8 ± 2,5 semanas y 1.127 ± 264 g respec tivamente. Recibieron antibioterapia empírica inicial 213 (80,0%), siendo ésta prolongada en el 67,6%. Todos recibieron antibioterapia biasociada. Se pesquisaron 136 episodios de sepsis tardía, siendo los gérmenes más frecuentes el Staphylococcus coagulasa negativo y el Staphylococcus au reus. Del total de RN con antibioterapia empírica prolongada, hubo 20 casos de NEC confirmada y 15 fallecidos (10,4%) en el grupo analizado. Al comparar el uso de antibioterapia > 5 días ver sus tratamiento menor de 5 días, se observó una asociación estadísticamente significativa entre la antibioterapia prolongada y sepsis tardía (p = 0,03) y además de NEC confirmada (p = 0,03), pero no de mortalidad (p = 0,12). Conclusión: El uso de antibioterapia empírica inicial por 5 días o más se asoció a un riesgo aumentado de sepsis tardía y de NEC, pero no de la mortalidad en RNMBPN.


Abstract: Introduction: The objective of this study is to evaluate the association between the duration of ini tial empirical antibiotic treatment and the subsequent development of late-onset sepsis, necrotizing enterocolitis (NEC) and death in very low birth weight (VLBW) infants. Patients and Methods: Quantitative, cross-sectional, analytical study of VLBW infants admitted to the neonatal ICU were included over a period of five years. Initial empirical antibiotic therapy was that which started im mediately after birth, without knowing the results of blood cultures. It was considered prolonged antibiotic therapy when the treatment duration was > 5 days. Perinatal variables, as well as the inci dence of late-onset sepsis, confirmed NEC and mortality were analyzed. Results: 266 VLBW infants were studied, with an average gestational age and birth weight of 28.8 ± 2.5 weeks and 1.127 ± 264 g respectively. 213 infants received initial empiric antibiotic therapy (80.0%), which was prolonged in 67.6% of cases. All infants received two different antibiotics. 136 episodes of late-onset sepsis were described. The most common pathogens were coagulase-negative Staphylococcus and Staphylococcus aureus. Among the newborns with prolonged antibiotic therapy, there were 20 cases of confirmed NEC and 15 of the studied infants died (10.4%). When comparing the use of antibiotic therapy during > 5 days versus treatment less than 5 days duration, a statistically significant association was observed between prolonged antibiotic therapy and late-onset sepsis (p = 0.03) and confirmed NEC (p = 0.03), but not of mortality (p = 0.12). Conclusion: The use of empirical antibiotic therapy for five days or more was associated with an increased risk of late-onset sepsis and NEC, but not of mortality in VLBW infants.

12.
Hum Mutat ; 39(5): 593-620, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29446198

RESUMO

The prevalence and spectrum of germline mutations in BRCA1 and BRCA2 have been reported in single populations, with the majority of reports focused on White in Europe and North America. The Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA) has assembled data on 18,435 families with BRCA1 mutations and 11,351 families with BRCA2 mutations ascertained from 69 centers in 49 countries on six continents. This study comprehensively describes the characteristics of the 1,650 unique BRCA1 and 1,731 unique BRCA2 deleterious (disease-associated) mutations identified in the CIMBA database. We observed substantial variation in mutation type and frequency by geographical region and race/ethnicity. In addition to known founder mutations, mutations of relatively high frequency were identified in specific racial/ethnic or geographic groups that may reflect founder mutations and which could be used in targeted (panel) first pass genotyping for specific populations. Knowledge of the population-specific mutational spectrum in BRCA1 and BRCA2 could inform efficient strategies for genetic testing and may justify a more broad-based oncogenetic testing in some populations.


Assuntos
Proteína BRCA1/genética , Proteína BRCA2/genética , Internacionalidade , Mutação/genética , Bases de Dados Genéticas , Família , Geografia , Humanos
13.
Front Plant Sci ; 8: 1654, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28993785

RESUMO

The potato yellow vein disease, caused by the potato yellow vein virus (PYVV), is a limiting potato disease in northern South America. The virus can be transmitted either by the greenhouse whitefly (GWF), Trialeurodes vaporariorum (Westwood) (Hemiptera: Aleyrodidae), or through vegetative propagules, such as infected tubers. Recently, GWF populations have been spotlighted as one of the main drivers of PYVV re-emergence, and consequently, PYVV management has been predominantly directed toward vector control, which is heavily based on insecticide use. However, the drivers of the PYVV outbreaks as well as the contribution of GWF populations on the spread of PYVV among potato crops are still not completely understood. This study aims to assess the role of the GWF as a driver of the PYVV epidemic in the potato-producing areas in Colombia, one of the countries more severely affected by the PYVV epidemic, and whose geography allows the study of the spatial association between the vector and the disease epidemic across a wide altitude range. The geographical clusters where the PYVV epidemic is concentrated, as well as those of farms affected by the GWF were identified using a novel spatial epidemiology approach. The influence of altitude range on the association between PYVV and T. vaporarioum was also assessed. We found a relatively poor spatial association between PYVV epidemic and the presence of the GWF, especially at altitudes above 3,000 m above mean sea level. Furthermore, GWF populations could only explain a small fraction of the extent of the PYVV epidemic in Colombia. Movement of infected seed tubers might be the main mechanism of dispersion, and could be a key driver for the PYVV infection among potato crops. Agricultural policies focused on improving quality of seed tubers and their appropriate distribution could be the most efficient control intervention against PYVV dispersion.

14.
Nursing (Säo Paulo) ; 20(229): 1746-1750, jun.2017.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1029241

RESUMO

O objetivo do presente estudo foi identificar a influência da infecção por HIV na qualidade de vida da pessoa idosa. Trata-sede uma revisão integrativa de literatura, na qual foram utilizados 6 artigos (5 internacionais e 1 nacional) publicados entre 2006 a 2016.Foi identificado que a infecção por HIV tem forte influência negativa sobre a qualidade de vida das pessoas idosas, pois além da presençadas comorbidades associadas ao processo de envelhecimento humano, existe o preconceito por causa da idade e também o forte estigmarelacionado ao HIV. Faz-se necessário a reformulação das políticas públicas relacionadas ao HIV de forma que venha esclarecer à sociedadeque este não é um problema apenas de jovens e que incentive a prática do sexo seguro na terceira idade, uma vez que a maioria daspolíticas voltadas para esse público tem foco na socialização.


Assuntos
Masculino , Feminino , Humanos , Idoso , Idoso de 80 Anos ou mais , Perfil de Impacto da Doença , Qualidade de Vida , Saúde do Idoso , Serviços de Saúde para Idosos , Soropositividade para HIV , Síndrome de Imunodeficiência Adquirida
15.
Rev Med Inst Mex Seguro Soc ; 55(1): 82-89, 2017.
Artigo em Espanhol | MEDLINE | ID: mdl-28092252

RESUMO

This paper presents the theorical development of accesibility as process and product. The process consists of the elements that converge to meet the objectives of providing medical care in a timely manner. As product is a component of effective care. Accesibility itself is subject to a combination of economic, cultural, social, geographic and contextual aspects. Beyond the right of persons to receive health care, availability of institutions and the means to achieve.


Assuntos
Política de Saúde , Acesso aos Serviços de Saúde/organização & administração , Necessidades e Demandas de Serviços de Saúde , Serviços de Saúde do Indígena/organização & administração , Disparidades em Assistência à Saúde/etnologia , Humanos , México , Serviços de Saúde Rural/organização & administração , Determinantes Sociais da Saúde
16.
Rev. Fac. Med. (Bogotá) ; 64(supl.1): 119-126, oct.-dic. 2016. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-956823

RESUMO

Resumen Introducción. El programa 40X40 promueve el deporte formativo en Bogotá. Esta estrategia requiere un diagnóstico poblacional, a partir del estado nutricional antropométrico en el puntaje Z del índice de masa corporal (IMC) 1, para promover hábitos saludables. Objetivo. Determinar las características del IMC en los escolares del programa 40X40 dentro de Bogotá. Materiales y métodos. Investigación con enfoque cuantitativo y estudio descriptivo transversal, respecto a las variables antropométricas y a las características socio-demográficas. Resultados. Participaron 1 035 escolares, 564 mujeres y 471 hombres. También se tuvieron 18 instituciones educativas distritales (IED) en 10 localidades y se incluyeron 17 deportes: 31% pelota, 28% combate, 16% arte y presión, 23% tiempo, marca y deportes urbanos y nuevas tendencias (DUNT) 2%. Hubo medición de las variables de peso, talla y uso de los índices IMC e IMCzscore. En el IMC se obtuvo un 38.2% bajo peso, 46.2% normal, 12.2% sobrepeso y 2.8% obesidad, mientras que el IMCzscore reportó 16.5% bajo peso, 79.8% normal, 3.5% sobrepeso y 0.2% obesidad. Conclusiones. Se reportaron diferencias significativas entre el IMC e IMCzscore, de modo que el primero relaciona peso y talla y el segundo ajusta las dos anteriores más la edad, por tanto, se determina que este último valora de forma integral el proceso de crecimiento y desarrollo.


Abstract Introduction: The 40X40 training program promotes sports in Bogotá. This strategy requires a diagnosis of population based on anthropometric nutritional status through the Zscore body mass index (BMI) 1 to promote healthy habits. Objective: To determine the characteristics of BMI in school children enrolled in the 40X40 Program in Bogotá. Materials and methods: Research with a quantitative approach and descriptive study, regarding anthropometric variables and socio-demographic characteristics. Results: 1 035 school children participated, including 564 women and 471 men. 18 public educational institutions, in 10 localities, and 17 sports were included: ball 31%, combat 28%, art and pressure 16%, time 23% time, and urban sports and new trends (DUNT for its acronym in Spanish) 2%. Variables measuring weight, height and BMI and BMIzscore were considered. BMI showed 38.2% underweight, 46.2% average weight, 12.2% overweight and 2.8% obese children, while BMIzscore reported 16.5% underweight, 79.8% average, 3.5% overweight and 0.2% obese children. Conclusions: Significant differences between BMI and BMIzscore were reported; the first shows weight and height and the second adjusts both variables plus age. Therefore, it was determined that BMIzscore evaluates comprehensively the process of growth and development.

17.
Rev. peru. med. exp. salud publica ; 33(4): 695-699, oct.-dic. 2016. tab
Artigo em Espanhol | LILACS-Express | LILACS, LIPECS | ID: biblio-845760

RESUMO

RESUMEN Con el objetivo de evaluar criterios mínimos de celularidad de las unidades de sangre de cordón umbilical (USCU) según los estándares NETCORD en el Instituto Nacional Materno Perinatal de Lima, Perú, se realizó un estudio transversal que incluyó 100 USCU; se determinó el volumen, el recuento de células nucleadas totales (CNT) por hematología y el número de células CD34+ totales, así como también la viabilidad celular, por citometría de flujo. Se encontró que el 56% de las USCU no cumplen los umbrales mínimos de celularidad para ser criopreservadas en un banco de sangre de cordón umbilical. Se encontró, además, que las USCU de recién nacidos de mayor peso y de sexo femenino presentan mayor volumen y recuentos de células. En conclusión, es necesario considerar estas variables para optimizar la colecta de las USCU y obtener mayores recuentos de células que permita almacenar unidades de alta calidad en un futuro banco de sangre de cordón umbilical en Perú.


ABSTRACT A cross-sectional study that included 100 units of umbilical cord blood (UCB) was conducted to evaluate the minimum criteria of cellularity in UCB units, according to NetCord standards at Instituto Nacional Materno Perinatal in Lima, Peru. The volume, total count of nucleated cells by hematological tests and total number of CD34+ as well as cell viability by flow cytometry were determined. The study revealed that 56% of UCB units do not fulfill the minimum criteria of cellularity to be cryopreserved in an umbilical cord blood bank. Furthermore, the UCB units of newborns who weighed more and were female had a higher volume and cell count. In conclusion, these variables must undoubtedly be considered to optimize the collection of UCB units and obtain greater cell counts that enable the storage of high-quality units in a future umbilical cord blood bank in Peru.

18.
Oncologist ; 21(7): 832-9, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27286788

RESUMO

BACKGROUND: Numerous epidemiological factors affect the probability of developing breast or ovarian cancer, but no predictor is as determinant as inheriting a mutation in BRCA1 or BRCA2. The concept of the founder effect explains the reduced genetic variability in some populations, according to the theory that new populations can be formed from a reduced number of individuals, so the new population would carry only a small fraction of the genetic variability of the original population. The main purpose of this review is to provide an update on the state of the art in founder mutations and some recurrent mutations that have recently been described in Latin America. METHODS: A literature search was performed in the electronic databases of PUBMED, EMBASE, LILACS, and BIREME using the terms BRCA1, BRCA2, founder mutation, Latin American population, and Hispanic. Sixty-two papers were identified, of which 38 were considered relevant for this review. Each result is shown per country. RESULTS: In Latin America, clear founder effects have been reported in Mexico (BRCA1 del exons 9-12), Brazil (BRCA1 5382insC and BRCA2 c.156_157insAlu), and Colombia (BRCA1 3450del4, A1708E, and BRCA2 3034del4) and in Latinas residing in Southern California (BRCA1 185delAG, IVS5+1G>A, S955x, and R1443x). Of these, mutation BRCA1 3450del4 has also been reported in Brazil and Chile, whereas mutation BRCA2 3034del4 has been reported in Argentina and Peru. These data support the idea that although most Hispanic populations are the result of a mixture between Europeans, Africans, and Amerindians, the relative proportion of each genetic component varies throughout the Hispanic populations, making it necessary to identify the mutations characteristic of each population to generate mutation profiles adjusted to each one of them. CONCLUSION: In Latin American countries, and even among regions of the same country, there is great heterogeneity of ancestors. Therefore, Latinas should not be analyzed like other population groups without taking into account their genetic ancestry. The presence of founder mutations in specific population groups represents a cost-effective analysis. The importance of determining the founder mutations lies mainly in the decrease in costs. If we manage to decrease costs, screenings could be offered more widely and cover a larger number of women. IMPLICATIONS FOR PRACTICE: Hispanic and African-American populations are four to five times less likely than other populations worldwide to receive screening for BRCA mutations, a main reason being the high costs of these tools. The present study seeks to identify the prevalent mutations and the founder effect in the BRCA gene in the Hispanic population to address specific panels for this population group in the future and develop strategies for population screening.


Assuntos
Genes BRCA1 , Genes BRCA2 , Mutação , Hispano-Americanos , Humanos , América Latina
19.
Invest. educ. enferm ; 34(1): 84-93, Jan.-Apr. 2016. ilus, tab
Artigo em Inglês | LILACS, BDENF - Enfermagem, COLNAL | ID: lil-783554

RESUMO

Objective.To describe the meaning given by adolescents and young adults to the changes in their bodies and corporality after a spinal cord injury. Methods. Qualitative study based on symbolic interactionism in which 12 adolescents and young adults, who had suffered spinal cord injury 6 months or more before, participated. The information was recollected through a series of in-depth interviews and field journals. The guidelines proposed by Corbin and Strauss were followed for the process of codification and categorization of the data. Results. Four categories were identified that describe the meanings given by participants to the changes in their bodies and corporality: Transformation of self-image, living with contradictions in the relationships with others, withstanding the burden of a disability and adapting to the new conditions. Conclusion. The results allow for the comprehension of the meanings that are given by the people who have suffered a spinal cord lesion to their situation. This will in turn open the possibility of offering these people a better individual nursing care that focuses more on the particular needs, so that both they and their families can be helped on their way to adaptation to the new situation.


Objetivo.Describir los significados que otorgan los adolescentes y adultos jóvenes a los cambios en el cuerpo y la corporalidad luego de una lesión traumática de la medula espinal. Métodos. Estudio cualitativo basado en el interaccionismo simbólico, en el cual participaron 12 adolescentes y adultos jóvenes con trauma raquimedular con un tiempo mayor a seis meses desde el evento. La información se recolectó a través de entrevistas de profundidad y diarios de campo. En el proceso de codificación y categorización de los datos, se siguieron los lineamientos propuestos por Corbin y Strauss. Resultados. Se identificaron cuatro categorías que describen los significados que tienen para los participantes los cambios en el cuerpo y la corporalidad: Transformación de la imagen de sí mismo, vivir contradicciones en las relaciones con otros, soportar la carga de la discapacidad y adaptarse a la nueva condición. Conclusión. Los resultados permiten comprender los significados que otorgan las personas con lesión medular a su condición, para poder brindar un cuidado de enfermería individual enfocado en las necesidades particulares, para ayudarlos a ellos y a sus familias a adaptarse a la situación.


Objetivo.Descrever os significados que outorgam os adolescentes e adultos jovens às mudanças no corpo e a corporalidade após de uma lesão traumática da medula espinal. Métodos. Estudo qualitativo baseado no interacionismo simbólico, no qual participaram 12 adolescentes e adultos jovens com trauma raquimedular com um tempo maior a seis meses desde o acontecimento. A informação se recolheu através de entrevistas de profundidade e diários de campo. No processo de codificação e categorização dos dados, se seguiram os alinhamentos propostos por Corbin e Strauss. Resultados. Se identificaram quatro categorias que descrevem os significados que têm para os participantes as mudanças no corpo e a corporalidade: Transformação da imagem de si mesmo, viver contradições nas relações com outros, suportar a carga da deficiência e adaptar-se á nova condição. Conclusão. Os resultados permitem compreender os significados que outorgam as pessoas com lesão medular a sua condição, para poder brindar um cuidado de enfermagem individual enfocado nas necessidades particulares, para ajuda-los a eles e a suas famílias a adaptar-se à situação.


Assuntos
Humanos , Traumatismos da Medula Espinal , Teoria de Enfermagem , Adolescente , Pessoas com Deficiência , Adaptação , Adulto Jovem
20.
Rev Peru Med Exp Salud Publica ; 33(4): 695-699, 2016.
Artigo em Espanhol | MEDLINE | ID: mdl-28327838

RESUMO

A cross-sectional study that included 100 units of umbilical cord blood (UCB) was conducted to evaluate the minimum criteria of cellularity in UCB units, according to NetCord standards at Instituto Nacional Materno Perinatal in Lima, Peru. The volume, total count of nucleated cells by hematological tests and total number of CD34+ as well as cell viability by flow cytometry were determined. The study revealed that 56% of UCB units do not fulfill the minimum criteria of cellularity to be cryopreserved in an umbilical cord blood bank. Furthermore, the UCB units of newborns who weighed more and were female had a higher volume and cell count. In conclusion, these variables must undoubtedly be considered to optimize the collection of UCB units and obtain greater cell counts that enable the storage of high-quality units in a future umbilical cord blood bank in Peru.


Assuntos
Sangue Fetal , Contagem de Células Sanguíneas , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Peru , Gravidez , Bancos de Tecidos
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