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1.
Multimedia | Recursos Multimídia | ID: multimedia-9716

RESUMO

Dos mesas de debate cuando se cumple un nuevo aniversario del natalicio de Floreal Ferrara, médico sanitarista y discípulo de Ramón Carrillo. Floreal Ferrara fue un médico, pensador, profesor, investigador, trabajador incansable, defensor de lo público, un revolucionario y peronista. Floreal fue sobre todo un militante de la salud. Retomar sus ideas constituye un acto necesario a la hora de descifrar el funcionamiento del poder y construir una alternativa popular transformadora. Bajo el lema "Se lucha por el derecho a la salud. Pero la lucha misma es la salud", el evento se desarrolla de la siguiente manera: 10 hs. Juan Sasturain (director de la Biblioteca Nacional, escritor, periodista y guionista), Florencia Rojas (bibliotecóloga, periodista, nieta de Floreal), Mauro Rojas (economista, docente, miembro de CEPA, nieto de Floreal). 10:30 hs. Daniel Gollán (diputado nacional, ex ministro de Salud de la Nación y de la Provincia de Buenos Aires), Nicolás Kreplak (ministro de Salud de la Provincia de Buenos Aires), Alicia Stolkiner (psicóloga, profesora de Salud Pública y Salud Mental en la UBA), Héctor Amichetti (secretario general Federación Gráfica, referente de la Corriente Federal de los Trabajadores), Mario Rovere (director de la Escuela de Gobierno en Salud “Floreal Ferrara”), Jorge Rachid (médico sanitarista, docente, presidente IIDEART, integrante del Proyecto UMBRAL). 13 hs. Interpretación musical a cargo de Damián Romagnoli (flautista y director orquestal, ex integrante de la orquesta del Teatro Colón). 14 hs. Susana Etchegoyen (médica farmacóloga, docente, ex diputada de la Ciudad de Buenos Aires), Pedro Cazes Camarero (farmacéutico, docente, diplomado en Salud Pública, investigador, sobreviviente de la masacre de Trelew), Facundo Maidana (médico, director ejecutivo del Ministerio de Salud PBA), Alejandro Irurzun (psicólogo, director de El Sauce Espacio de Salud), Mariano lozza (médico generalista, director SEDRONAR Chivilcoy, docente).


Assuntos
Saúde Pública , Argentina , Direito à Saúde , Ministério Público , Pessoas Famosas , Equidade em Saúde
2.
Multimedia | Recursos Multimídia | ID: multimedia-9717

RESUMO

El propósito de esta exposición es acercar la Colección digital de Floreal Ferrara. La creación de la Escuela de Gobierno en Salud Floreal Ferrara actuó como disparador para desempolvar sus libros de los estantes, digitalizarlos y brindarlos en acceso completo, pero también para pensar esta exposición en la cual son nuestr@s lector@s quienes recomiendan los libros del autor y quienes responden a la pregunta ¿Por qué leer a Ferrara?, en la firme convicción de que no hay nada mejor que un lector y una lectora para despertar en otr@s el deseo de la lectura. Agradecemos especialmente a A Horacio García de editorial Catálogos y Javier Riera de editorial Arcana y editorial Biblos por permitirnos la digitalización de las obras puestas a disposición del público en esta exposición. Y a la familia de Floreal Ferrara, su hijo y su nieto, por permitirnos la difusión de los libros. Listado de obras: Ferrara, Floreal; Peña, Milcíades. Título: Qué piensan los médicos argentinos sobre los problemas de la profesión- Revista de Salud Pública;1: 110-128, Set-Dic. 1961. Ferrara, Floreal; Ferrero, Carlos; Colombo, Carlos; Marchevsky, Naum. Estructura de la mortalidad en la provincia de Buenos Aires. Fuente: Revista de Salud Pública;7: 86-94, Ene-Dic. 1964 Ferrara, Floreal. Título: Desarrollo y bienestar argentino. Fuente: La Plata; Renacimiento; 1966. 300 p Ferrara, Floreal; Acebal, Eduardo; Paganini, José M. Título: Medicina de la comunidad: medicina preventiva, medicina social y medicina administrativa. Fuente: Buenos Aires; Intermedica; 1972. 414 p. Ferrara, Floreal. En torno al concepto de salud. Fuente: Revista de Salud Pública;8: 117-120, 1975 García Rodríguez Tejedor, Antonio (seúd.) Condicionantes estructurales en el uso y difusión de la tecnología médica. Fuente: Cuadernos Médico Sociales, Nro. 19, Enero 1982. Ferrara, Floreal. Título: Teoría social y salud. Fuente: Buenos Aires: Catálogos, 1985. 300 p. Buenos Aires. Ministerio de Salud*.Título: Sistema de atención ambulatoria y domiciliaria de la salud ATAMDOS. Fuente: La Plata; Ministerio de Salud; 1987?. 45 p. Ferrara, Floreal A. Título: Teoría política y salud: seis papeles para una Teoría Política [Maquiavelo, Hobbes, Hegel, Marx, Weber, Alberdi]: apuntes para el análisis de poder, hacia el entendimiento del sector salud.-v. 1 Fuente: Buenos Aires; Catálogos; 1992. 403 p. Ferrara, Floreal A. Título: Teoría política y salud: abordando la salud, la práctica médica y otras diferencias, las obras sociales.-v. 2 Fuente: Buenos Aires; Catálogos; 1993. 288 p. Ferrara, Floreal A. Título: Teoría política y salud: las desdichas de la atención de salud, los cuidados de la salud, la planificación como teoría, la participación popular.-v. 3 Fuente: Buenos Aires; Catálogos; 1995. 351 p. Ferrara, Floreal A. Título: Salud y corrupción: una teoría de la corrupción para la salud.-1 Fuente: Buenos Aires; Catálogos; ; 1998. 291 p. Ferrara, Floreal A. Título: Salud y corrupción: el discurso de la medicina.-2 Fuente: Buenos Aires; Catálogos; ; 1999. 283 p. Ferrara, Floreal Antonio. Título: Teoría de la verdad y salud. Fuente: Buenos Aires; Arcana ; 2009. 294 p. Svampa, Maristella. Certezas, incertezas y desmesuras de un pensamiento político. Conversaciones con Floreal Ferrara. Editorial: Ediciones Biblioteca Nacional. 2011. 296 p. (entrevista)


Assuntos
Argentina , Assistência à Saúde Culturalmente Competente , Saúde Pública , Participação da Comunidade , Equidade em Saúde , Direito à Saúde , Pessoas Famosas , Política de Saúde
3.
Toxicon ; 214: 108-111, 2022 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-35643117

RESUMO

Pascalia glauca, a perennial herb known for its toxicity in ruminants, is one of the most important toxic plants in northwestern Argentina. This work describes several outbreaks of natural intoxication with P. glauca from different sources affecting cattle, sheep and goats in different production systems, with morbidity varying between 1% and 100%. Clinical signs included tremors in the hindquarters, recumbency and death. The liver showed swelling, congestion and a mottled appearance. Histopathologic findings included centrilobular hepatocellular necrosis with hemorrhage.


Assuntos
Doenças dos Bovinos , Intoxicação por Plantas , Doenças dos Ovinos , Animais , Argentina/epidemiologia , Bovinos , Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/patologia , Surtos de Doenças/veterinária , Cabras , Intoxicação por Plantas/epidemiologia , Intoxicação por Plantas/patologia , Intoxicação por Plantas/veterinária , Ruminantes , Ovinos , Doenças dos Ovinos/epidemiologia , Doenças dos Ovinos/patologia
4.
PLoS One ; 17(6): e0267355, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35648734

RESUMO

The Blue-fronted Amazon (Amazona aestiva) is a Neotropical parrot with a large distribution in South America, including areas in Brazil, Bolivia, Argentina and Paraguay. A substantial part of the population of this parrot is concentrated in the Pantanal, a large wetland located in the center of South America. There, the clearing of forest and savannas has occurred through the years to accommodate beef-cattle pasture, and crops. Our objective was to understand the direct and indirect effects of time, availability of forest and savannas, and rainfall over the number of nestlings and fledged young of Blue-fronted Amazons inhabiting the southern Pantanal. We surveyed their nests from 1997 to 2018 and counted the number of nestlings produced and the number of fledglings capable to leave the nest in each year. Additionally, we used available data on the area covered by arboreal vegetation, and rainfall data collected at a Meteorological Station located in a central area of the study, as predictors of the numbers of nestlings and fledglings produced every year. Then, we applied structural equation modeling to examine both the direct and indirect effects of time, arboreal habitat availability, and annual cumulative rainfall on the number of nestlings and fledgling per nest. Finally, we estimated the long-term trend of the number of fledglings per nest as a surrogate to the populational trend of Blue-fronted Amazon. We found that none of the variables in our model explained the number of nestlings in nests, but the number of nestlings and the arboreal habitat availability directly and positively affected the number of fledglings. Time indirectly and negatively affected the number of fledglings per nest, whereas rainfall affected it indirectly positively. Additionally, we detected a concerning decrease of about 30% of the fledglings during the 22-years study, which could lead to a change in the species conservational status.


Assuntos
Amazona , Animais , Argentina , Bolívia , Brasil/epidemiologia , Bovinos , Árvores
5.
Cad Saude Publica ; 38(5): e00163921, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-35649097

RESUMO

The study aimed to analyze the socio-spatial differences in COVID-19 mortality in the pandemic's three waves in the city of Buenos Aires, Argentina. COVID-19 mortality data were obtained from the COVID-19 Database and reported by the Buenos Aires Autonomous Government from March 7, 2020, to September 30, 2021. Three waves were identified: the first from March to December 2020, the second from December 2020 to March 2021, and the third from March to September 2021. Multivariate regressions were calculated for each wave to analyze the association between risk of COVID-19 mortality in two age groups (0-59 years and 60 years or older) and the percentage of households with unmet basic needs as indicator of neighborhood poverty level, and population density. During the first wave and in both age groups, the neighborhood in the tertile with the highest percentages of households with unmet basic needs showed higher risk of COVID-19 mortality when compared to neighborhoods in the tertile with the lowest percentages of households with unmet basic needs. These inequalities disappeared in the second wave in both age groups, while the third wave saw a similar geographic pattern to the first wave. Higher levels of immunity in neighborhoods with high poverty levels might partially explain the absence of socio-spatial inequalities in the second wave, while the emergence of the gamma and lambda variants could partially explain the return to inequalities observed in the first wave.


Nuestro propósito fue investigar las diferencias de las desigualdades socioespaciales de la mortalidad por COVID-19 entre tres olas de propagación del virus en la Ciudad Autónoma de Buenos Aires (CABA), Argentina. Los datos de mortalidad por COVID-19 se obtuvieron de la base de datos de casos de COVID-19, informados por el gobierno de la CABA, desde el 7 de marzo de 2020 hasta el 30 de septiembre de 2021. Se determinaron tres olas: la primera ola, entre los meses de marzo y diciembre de 2020, la segunda ola, entre diciembre y marzo de 2021, y la tercera ola, entre marzo y septiembre de 2021. En cada ola se calcularon regresiones multivariadas para analizar la asociación entre el riesgo de mortalidad por COVID-19, en dos grupos etarios (0-59 años y 60 o más años), y el porcentaje de hogares con necesidades básicas insatisfechas, como indicador del nivel de pobreza de los barrios, y la densidad poblacional. Durante la primera ola y en ambos grupos etarios, los barrios del tercil con mayores porcentajes de hogares con necesidades básicas insatisfechas tuvieron un riesgo mayor de mortalidad por COVID-19, en comparación a los barrios del tercil con menores porcentajes de hogares con necesidades básicas insatisfechas. Estas desigualdades desaparecieron durante la segunda ola en ambos grupos etarios, mientras que en la tercera ola pareció emerger un patrón geográfico similar al de la primera ola. Es posible que mayores niveles de inmunidad en barrios con niveles altos de pobreza pudieran explicar parcialmente la ausencia de desigualdades socioespaciales durante la segunda ola, mientras que la irrupción de las variantes gamma y lambda podría explicar parcialmente el retorno a las desigualdades observadas en la primera ola.


A proposta era investigar as diferenças nas desigualdades socioespaciais da mortalidade por COVID-19 entre três ondas de propagação do vírus na Cidade Autônoma de Buenos Aires, Argentina. Os dados de mortalidade por COVID-19 foram obtidos a partir da base de dados dos casos de COVID-19 informados pelo governo da Cidade Autônoma de Buenos Aires, do dia 7 de março de 2020, até 30 de setembro de 2021. Foram identificadas três ondas: a primeira, entre os meses de março e dezembro de 2020, a segunda, entre dezembro e março de 2021, e a terceira, entre março e setembro de 2021. Para cada uma delas, foram calculadas regressões multivariadas, visando analisar a associação entre o risco de mortalidade por COVID-19 em dois grupos etários (0-59 anos e 60 anos ou mais), e o percentual de domicílios com necessidades básicas não atendidas, como indicador do nível de pobreza dos bairros, e a densidade populacional. Durante a primeira onda e em ambos grupos etários, os bairros do tercil com maiores percentuais de domicílios com necessidades básicas não atendidas apresentaram um risco maior de mortalidade por COVID-19 na comparação com os bairros do tercil com menores taxas de domicílios com necessidades básicas não atendidas. Estas desigualdades desapareceram durante a segunda onda nos dois grupos etários, ao passo que, na terceira onda parece ter emergido um padrão geográfico similar ao da primeira onda. Maiores níveis de imunidade em bairros com altas taxas de pobreza poderiam explicar parcialmente a ausência de desigualdades socioespaciais durante a segunda onda, sendo que a irrupção das variantes gama e lambda poderia explicar parcialmente a volta para as desigualdades observadas na primeira onda.


Assuntos
COVID-19 , Adolescente , Adulto , Argentina/epidemiologia , Brasil , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , SARS-CoV-2 , Adulto Jovem
6.
BMJ Open ; 12(6): e058198, 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35667729

RESUMO

OBJECTIVES: Value-based healthcare (VBHC) is a health system reform gradually being implemented in health systems worldwide. A previous national-level survey has shown that Latin American countries were in the early stages of alignment with VBHC. Data at the healthcare provider organisations (HPOs) level are lacking. This study aim was to investigate how HPOs in five Latin American countries are implementing VBHC. DESIGN: Mixed-methods research was conducted using online questionnaire, semistructured interviews based on selected elements of the value agenda (from December 2018 to June 2020), analyses of aggregated data and documents. Qualitative analysis was performed using NVivo QSR International, 1.6.1 (4830). Quantitative analysis used Fisher's exact test. Univariate analysis was used to compare organisations in relation to the implementation of VBHC initiatives. A p≤0.05 was considered significant. PARTICIPANTS: Top and middle-level executives from 70 HPOs from Argentina, Brazil, Chile, Colombia and Mexico. RESULTS: The definition of VBHC varied across participating organisations. Although the value equation had been cited by 24% of participants, its composition differed in most case from the original Equation. Most VBHC initiatives were related to care delivery organisation (56.9%) and outcomes measurement (22.4%) but in most cases, integrated practice unit features had not been fully developed and outcome data was not used to guide improvement. Information, stakeholders buy-in, compensation and fragmented care delivery were the most cited challenges to VBHC implementation. Fee-for-service predominated, although one-third of organisations were experimenting with alternative payment models. CONCLUSIONS: A wide variation in the definition and level of VBHC implementation existed across organisations. Our finding suggests investments in information systems and on education of key stakeholders will be key to foster VBHC implementation in the region. Further research is needed to identify successful implementation cases that may serve as regional benchmark for other Latin American organisations advancing with VBHC.


Assuntos
Atenção à Saúde , Pessoal de Saúde , Argentina , Brasil , Chile , Colômbia , Humanos , América Latina , México , Inquéritos e Questionários
7.
Stud Health Technol Inform ; 290: 219-221, 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35673004

RESUMO

WHO and UNICEF highlight vaccination as the most cost-effective method of prevention of infectious diseases. An effective public health strategy requires efficient tracking of vaccination to assess coverage, safety, and efficacy of these vaccines. Paper-based immunization records are still being used in most low and middle-income countries. Adequate Electronic Logistic Management Information Systems, Immunization Registries and Records are crucial for proper data collection and analysis, and for making better decisions at an individual and at a population level. In this paper we share our experience in the redesign of an interoperable immunization record to track vaccination, including the recently developed vaccines for the novel coronavirus SARS-CoV-2 (COVID-19).


Assuntos
COVID-19 , Vacinas , Argentina/epidemiologia , COVID-19/epidemiologia , COVID-19/prevenção & controle , Hospitais , Humanos , Imunização , Programas de Imunização , Pandemias/prevenção & controle , SARS-CoV-2 , Vacinação
8.
Stud Health Technol Inform ; 290: 301-303, 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35673022

RESUMO

A Chatbot or Conversational Agent is a computer application that simulates the conversation with a human person (by text or voice), giving automated responses to people's needs. In the healthcare domain, chatbots can be beneficial to help patients, as a complement to care by health personnel, especially in times of high demand or constrained resources such as the COVID-19 Pandemic. In this paper we share the design and implementation of a healthcare chatbot called Tana at the Hospital Italiano de Buenos Aires. Considering best practices and being aware of possible unintended consequences, we must take advantage of information and communication technologies, such as chatbots, to analyze and promote useful conversations for the health of all people.


Assuntos
COVID-19 , Argentina , COVID-19/epidemiologia , Atenção à Saúde , Hospitais Universitários , Humanos , Pandemias
9.
Stud Health Technol Inform ; 290: 377-379, 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35673039

RESUMO

Since Argentina's government declared a national emergency to combat the COVID-19 pandemic with a lockdown status, it has produced consequences on the healthcare system. We aimed to quantify the effect on the Emergency Department (ED) visits at Hospital Italiano de Buenos Aires. Our electronic health data showed that ED in-person visits declined 46% during the COVID-19 pandemic, from an overall of 176,370 visits during 2019 to 95,421 visits during 2020. Simultaneously, there was a telehealth visits boom when mandatory quarantine began (March 20, 2020): from a median of 12 daily in February 2020 to a median of 338 daily in April 2020; reaching a maximum daily peak of 1,132 on March 26 2020. For a while, teleconsultations replaced ED visits. Then, when face-to-face visits began to increase, teleconsultations began to decrease slowly, as the phenomenon reversed.


Assuntos
COVID-19 , Telemedicina , Argentina/epidemiologia , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Serviço Hospitalar de Emergência , Humanos , Pandemias , Estudos Retrospectivos , SARS-CoV-2
10.
Stud Health Technol Inform ; 290: 993-994, 2022 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-35673172

RESUMO

Updating electronic health record systems to meet new clinic needs and government regulations presents an ongoing challenge for health care organizations. To redesign an existing system for two HIV clinics in Argentina, we employed a three-phase approach of exploration, participatory design, and prototyping. The process and resulting architecture of the HIV-centered "RedClin" electronic health record may inform electronic health records at other clinics in Latin America and worldwide.


Assuntos
Registros Eletrônicos de Saúde , Infecções por HIV , Argentina , Assistência Integral à Saúde , Humanos , América Latina
11.
J Infect Dev Ctries ; 16(5): 835-842, 2022 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-35656955

RESUMO

INTRODUCTION: The Burkholderia cepacia complex (BCC) bacteria are opportunistic pathogens that cause nosocomial infections and are especially dangerous for cystic fibrosis (CF) patients. Burkholderia contaminans is an emerging BCC species isolated from CF patients that also occurs as a contaminant in pharmaceutical and personal care products, sometimes linking it with outbreaks. METHODOLOGY: A total of 55 B. contaminans isolates from CF and non-CF patients in Argentina were identified by recA sequencing and MALDI TOF MS. A standardized Pulsed Field Gel Electrophoresis (PFGE) protocol was set up in order to assess genetic diversity, outbreak investigations, and possible clone persistence. RESULTS: All isolates were identified as B. contaminans by both MALDI-TOF MS and recA sequence analysis. PFGE has enabled us to compare and determine the genetic relationship between B. contaminans isolates. Isolates were distributed in different PFGE clusters with evidence of the presence and persistence of a clone, over a period of 3 years, in the same hospital. This large hospital outbreak involved CF and non-CF patients. Moreover, PFGE results showed a good correlation between sporadic or outbreak-related isolates and the available epidemiological information. CONCLUSIONS: These findings highlight the importance of B. contaminans in Argentina and provide evidence for encouraging the surveillance of highly transmissible clones. The study also contributes to global knowledge about B. contaminans infections.


Assuntos
Infecções por Burkholderia , Complexo Burkholderia cepacia , Fibrose Cística , Argentina/epidemiologia , Burkholderia , Infecções por Burkholderia/epidemiologia , Infecções por Burkholderia/microbiologia , Complexo Burkholderia cepacia/genética , Fibrose Cística/complicações , Humanos
12.
Vet Parasitol Reg Stud Reports ; 32: 100742, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35725109

RESUMO

Rodents play an important role in vector-borne pathogens cycle. To detect Anaplasma, Ehrlichia, Neorickettsia, Rickettsia and Borrelia species in rodents from a protected urban area in Buenos Aires City (Argentina) were analyzed 203 organ pools of Mus musculus, Oligoryzomys flavescens, Rattus norvegicus, Deltamys kempi and Scapteromys aquaticus by PCR. Only one O. flavescens (1.2%) was positive by PCR for 16S rRNA fragment for the Anaplasmataceae family and the sequence had 99.7% identity with Neorickettsia risticii. Plus, the sequence obtained for a fragment of the p51 gene for the genus Neorickettsia from positive sample had 95.3-96.1% identity with N. risticii found previously in bats Tadarida brasiliensis from Buenos Aires City. Our study presents the first finding of Neorickettsia in rodents from natural environment, but further studies are necessary about these vector-borne bacteria and the rol of rodents in its epidemiology.


Assuntos
Neorickettsia , Anaplasma/genética , Animais , Argentina/epidemiologia , Camundongos , Neorickettsia/genética , RNA Ribossômico 16S/genética , Ratos , Roedores , Sigmodontinae
13.
Sex Reprod Health Matters ; 30(1): 2079808, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35713531

RESUMO

Globally, people self-manage their medication abortions without clinical assistance. Feminist activist collectives (accompaniment groups) support people through self-managed abortion with evidence-based guidance. We sought to understand the impact of COVID-19 and related restrictions on the need for and experiences of self-managed abortion with accompaniment support across varied legal and social contexts. Between May and October 2020, we conducted in-depth interviews with individuals who self-managed abortions with support from accompaniment groups during the pandemic in Argentina, Indonesia, Nigeria, and Venezuela. We conducted a thematic analysis to understand the impact of COVID-19 on participants' experiences with accompanied self-managed abortions. Across 43 in-depth interviews, participants in all four countries described how the COVID-19 pandemic created challenges at each step of their abortion process, from confirming the pregnancy, accessing abortion pills, finding a private, comfortable place, and verifying abortion completion. For most people, conditions related to the pandemic made it harder to self-manage an abortion; for a minority, being at home made aspects of the experience somewhat easier. Nonetheless, all participants reported feeling supported by accompaniment groups, and COVID-19 and related lockdowns reinforced their preference for accompaniment-supported self-managed abortion. These findings highlight the essential role that accompaniment groups play in ensuring access to high-quality abortion care in a multiplicity of settings, particularly during the COVID-19 pandemic. Efforts are needed to expand the reach of accompaniment groups to increase access to the high-quality abortion support they provide, filling a critical gap left by health systems and legal infrastructure.


Assuntos
COVID-19 , Autogestão , Argentina , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Feminino , Humanos , Indonésia , Nigéria , Pandemias , Gravidez , Venezuela
14.
Rev Fac Cien Med Univ Nac Cordoba ; 79(2): 150-155, 2022 06 06.
Artigo em Espanhol | MEDLINE | ID: mdl-35700458

RESUMO

Introduction: Hand-assisted laparoscopic colorectal surgery (HALS) is an alternative to straight laparoscopic approach (SL) that requires the use of a specific device to maintain the pneumoperitoneum. Our group has described an original double glove technique to replace it. Our purpose was to compare perioperative outcomes of patients undergoing HALS using this original technique vs SL. Methods: Retrospective review of a prospective database including patients who underwent elective laparoscopic colorectal resections between 2004 to 2020 at the Hospital Italiano, Argentina. Logistic regression analysis, propensity score matching, and inverse probability weighting were used to estimate adjusted treatment effects for perioperative outcomes. Results: HALS (n=458) and SL (n=1692) cases were demographically similar. HALS was associated with a shorter operative time (170.3 vs 206.9 minutes, p<0.001). Such difference was even more pronounced in obese (44.1 min), large patients (37.5 min), complex procedures (33.8 min) and surgeries carried out by non-trained surgeons (57,6 vs 31,6 minutes, p<0.001). Hand-assisted was associated with a lower conversion rate (5% vs 9.9%, p<0.001) with an adjusted odds ratio of 0.45 (95%CI 0.28-0.73). No difference in hospital stay, morbidity, and readmission rates was found. Conclusions: HALS with double-glove technique is comparable to SL in terms of postoperative outcomes keeping reduced operative time and conversion rates, especially in obese patients undergoing complex procedures.


Introducción: La cirugía colorrectal laparoscópica mano asistida (CLMA) es un abordaje alternativo a la laparoscopia directa (LD) que requiere de un dispositivo específico para mantener el neumoperitoneo. Nuestro grupo describió una técnica original de doble guante como alternativa a este dispositivo. El objetivo del presente trabajo fue analizar los resultados de esta técnica comparándola con la técnica de LD. Métodos: Se analizó una serie consecutiva de pacientes sometidos a cirugías colorrectales laparoscópicas entre 2004 y 2020 en el Hospital Italiano de Bs, As, Argentina. Se realizó un modelo de regresión múltiple de selección progresiva y apareamiento por puntaje de propensión para analizar los resultados perioperatorios. Resultados: Los casos de CLMA (n=458) y LD (n=1692) fueron demográficamente similares. CLMA se asoció a un menor tiempo operatorio (170,3 vs 206,9 minutos, p<0.001). Dicha reducción fue más marcada en obesos (44.1 min), pacientes grandes (37.5 min), cirugías complejas (33.8 min) y en procedimientos realizados por cirujanos no entrenados (57,6 vs 31,6 minutos, p<0.001). CLMA resultó tener menor índice de conversión (5% vs 9.9%, p<0.001) con una razón de probabilidades ajustada de 0,45. No se hallaron diferencias en cuanto a estadía hospitalaria, morbimortalidad y readmisión. Conclusión: CLMA con doble guante es comparable a la LD manteniendo un tiempo operatorio reducido y bajo índice de conversión, particularmente en pacientes obesos sometidos a procedimientos complejos.


Assuntos
Cirurgia Colorretal , Laparoscopia Assistida com a Mão , Argentina , Humanos , Estudos Retrospectivos
15.
Rev Fac Cien Med Univ Nac Cordoba ; 79(2): 146-149, 2022 06 06.
Artigo em Espanhol | MEDLINE | ID: mdl-35700471

RESUMO

The purpose of this study was to identify the social representations of the health/illness/care process from a dental dimension in rural dwellers in the north of the province of Cordoba, Argentina. Qualitative research was conducted based on the interpretivist paradigm. A purposive sampling was designed and selected to set up interviews with women who attend the hospital in Villa Candelaria Norte, and in-depth interviews with a subsample of dwellers from the area. The data were analyzed based on the grounded theory using Atlas Ti Software. The research was approved by the Ethics Committee (Res. 384/13). The people interviewed were separated into three groups: a) dwellers from the town center, b) dwellers from surrounding areas, and c) the health care team. The analysis dimension of the health/illness/care process is identified from a dental dimension in two sub-categories: perception of pain and loss of teeth. The results obtained serve to highlight the fact that "health" is associated with the demand for care when faced with an oral disease, which reproduces a biomedical model ­ repairing illness; pain and loss of teeth have become naturalized. It can be concluded that the results obtained reflect the lack of a positive conception of oral health which would lead to preventive care. Acknowledging these social representations related to health guides the construction of knowledge to plan actions pertaining to oral health care and disease.


El objetivo de este estudio fue identificar las representaciones sociales del proceso salud/enfermedad/atención desde una dimensión odontológica en pobladores rurales en el norte de Córdoba, Argentina. Se realizó una investigación de carácter cualitativo a partir del paradigma interpretativista. Se realizó observación, registrada en un cuaderno de bitácora. Se diseñó y seleccionó un muestreo intencional para la implementación de entrevistas a mujeres que asisten al hospital de Villa Candelaria Norte y efectores de salud, así como entrevistas en profundidad a una submuestra de mujeres. La información fue cargada en el Software Atlas Ti para su análisis a través de la teoría fundamentada. El proyecto fue aprobado por un Comité de Ética (Res. 384/13). Las personas entrevistadas se clasificaron en 3 grupos: a) pobladoras del centro de la localidad, b) pobladoras de parajes y c) equipo de salud. Se identifica la dimensión de análisis "proceso salud/enfermedad/atención desde una dimensión odontológica" en dos sub-categorías: a través de la percepción de dolor y la pérdida de elementos dentarios. Los resultados alcanzados ponen en evidencia que "salud" se asocia a la demanda de atención que surge ante una enfermedad bucal, reproduciendo un modelo biomédico - reparador de la enfermedad; existe una naturalización del dolor y de la pérdida de elementos dentarios. Se concluye que los resultados expuestos reflejan ausencia de una concepción de salud bucal positiva e integral que permita su cuidado desde una perspectiva preventiva. El reconocimiento de las representaciones sociales de la salud orienta la construcción de conocimientos sobre salud y enfermedad bucal.


Assuntos
Assistência Odontológica , Argentina , Feminino , Humanos , Estudos Retrospectivos
16.
Rev Fac Cien Med Univ Nac Cordoba ; 79(2): 123-131, 2022 06 06.
Artigo em Espanhol | MEDLINE | ID: mdl-35700473

RESUMO

Introduction: The therapeutic use of the "cannabis" oil is a social problem that puts legal, health, scientific and cultural aspects under stress. Difficulty in access generates an emptiness exploited by the illegal market, to which patients and relatives resort to improve their health and quality of life. These oils, with unknown chemical composition, are used without therapeutic follow-up. An interdisciplinary team from the Universidad Nacional de Córdoba (UNC) started the study of this problem with the aim of characterizing the socio-therapeutic use of "cannabis" oil in Córdoba and establishing a relationship with the real content of cannabinoids. Methodology: Observational-descriptive and cross-sectional study approved by the Comité Institucional de Ética de las Investigaciones en Salud, Hospital Nacional de Clínicas from UNC (CIEIS-HNC-UNC): interviews with patients/caregivers of legal age who used the "cannabis" oil (year 2019). Experimental study: analysis of oil samples obtained from interviewees to determine their cannabinoid content, specifically delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD), by High Performance Liquid Chromatography analysis (HPLC). Results: thirty-seven interviews were conducted, and 48 samples were analysed. The 73% were adults and older adults. The 92% started using the oil without prescription or medical suggestion, mainly due to the lack of effectiveness of other therapies (54%) and in the search for therapeutic alternatives (33%). The 84% perceived it to be effective (moderate to highly effective), and 78% reported no adverse events. Main uses: refractory epilepsy 27% and arthritis/arthrosis 24%. Fifteen percent of the samples showed no quantifiable content of CBD and THC, and 67% had only THC. The quantifiable content of cannabinoids was very low. Conclusions: This work allowed carrying out a preliminary information-gathering on several aspects (social and therapeutic) about the use of "cannabis" oil in Córdoba, and to analyze the chemical quality of the oils consumed. An important finding was the discrepancy between the effectiveness perceived by users and the low cannabinoid content detected.


Introducción: El uso terapéutico del aceite de "cannabis" es una problemática social que pone en tensión aspectos legales, sanitarios, científicos y culturales. La dificultad en el acceso genera un vacío aprovechado por el mercado ilegal, al que recurren pacientes y familiares para mejorar su salud y calidad de vida. Estos aceites, de composición química desconocida, se emplean sin un seguimiento terapéutico. Un equipo interdisciplinario de la UNC se involucró en esta problemática con el objetivo de aportar elementos para su caracterización en nuestro medio. Metodología: Estudio observacional-descriptivo y transversal (aprobado por el CIEIS-HNC-UNC): entrevistas a pacientes/cuidadores mayores de edad que usaban el aceite (2019). Estudio experimental: análisis de muestras de aceites de los entrevistados para determinar su contenido de cannabinoides (THC y CBD), mediante HPLC. Resultados: Se realizaron 37 entrevistas y analizaron 48 muestras. El 73% fueron adultos y adultos-mayores. El 79% empiezan a usar el aceite por recomendación de parientes/amigos o por iniciativa propia, principalmente por falta de efectividad de otras terapias (54%) y por búsqueda de alternativas (33%). El 84% lo percibe efectivo (moderado-muy efectivo) y el 78% no manifestó eventos adversos. Usos principales: epilepsia refractaria 27% y artritis/artrosis 24%. El 15% de las muestras no presentaron contenidos cuantificables de CBD y THC, y el 67% presentó THC sin CBD. El contenido de cannabinoides cuantificables fue muy bajo. Conclusiones: Se obtuvo una aproximación sobre el uso terapéutico del aceite de "cannabis" en Córdoba y su calidad. Se observó discrepancia entre la efectividad percibida y el bajo contenido de cannabinoides detectados.


Assuntos
Cannabis , Argentina , Dronabinol , Humanos , Estudos Retrospectivos
17.
Nat Commun ; 13(1): 3411, 2022 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-35701433

RESUMO

The Tafí del Valle depression (~27° S) in the eastern Andes of Argentina provides a record of late Pleistocene dust deposition in the subtropics of South America. We present large-n U-Pb geochronology data for detrital zircons from upper Pleistocene loess-paleosol deposits. When compared to regional data, the age spectra from the Tafí del Valle samples are most like the southern Puna Plateau, supporting derivation largely from the west and northwest. This runs counter to hypotheses suggesting these loessic sediments were derived from the low elevation plains to the east or extra-Andean Patagonia. Mapping of linear wind erosion features on the Puna Plateau yield a mean orientation of 125.7° (1 s.d. = 12.4°). These new data and existing records are consistent with a westerly-northwesterly dominated (upper- and lower-level) wind system over the southern Puna Plateau (to at least ~27° S) during periods of high dust accumulation in Tafí del Valle.


Assuntos
Poeira , Vento , Argentina , Poeira/análise , América do Sul
18.
Cad Saude Publica ; 38(5): e00252021, 2022.
Artigo em Espanhol | MEDLINE | ID: mdl-35703595

RESUMO

Growing evidence of the global transition in food systems exists, affecting the availability, accessibility, affordability, and convenience of highly processed foods. This study aimed to evaluate the apparent consumption of energy, saturated fat, added sugars, and sodium according to the degree of food processing in Argentina from 1996 to 2018 and according to income level. This is a descriptive and cross-sectional study with data on food and beverage expenditures and income from the National Household Expenditure Survey for years 1996-1997, 2004-2005, 2012-2013, and 2017-2018, including more than 20,000 households in each period. The apparent daily consumption of energy, saturated fat, added sugars, and sodium per adult for: (1) minimally processed foods; (2) processed culinary ingredients; (3) processed foods; and (4) ultra-processed products, was calculated for each period and according to per capita income quintile in each household. Descriptive statistical analysis was performed. Reductions in the proportion of energy and all nutrients evaluated from minimally processed foods, culinary ingredients and processed foods were observed, as well as an increase in the consumption of ultra-processed products. One also observes a greater share from ultra-processed foods as household income increases but with decreasing differences over time. Therefore, future strategies in Argentina should promote the consumption of minimally processed foods and discourage the availability and accessibility of ultra-processed ones, especially for the most vulnerable groups.


Existe una creciente evidencia de la transición global en los sistemas alimentarios que afectan la disponibilidad, accesibilidad, asequibilidad y conveniencia de los alimentos altamente procesados. El objetivo de este trabajo fue evaluar el consumo aparente de energía, grasas saturadas, azúcares agregados y sodio según el grado de procesamiento de los alimentos en la Argentina entre 1996 y 2018, según el nivel de ingreso. Se trata de un estudio descriptivo y transversal, con datos de gastos de alimentos y bebidas e ingresos de la Encuesta Nacional de Gastos de los Hogares de 1996-1997, 2004-2005, 2012-2013 y 2017-2018, que incluye más de 20.000 hogares en cada período. Se calculó el consumo aparente diario de energía, grasas saturadas, azúcares agregados y sodio por adulto equivalente de: (1) alimentos mínimamente procesados; (2) ingredientes culinarios procesados; (3) alimentos procesados y (4) productos ultraprocesados, para cada periodo y según el quintil de ingresos per cápita del hogar. Fue utilizado análisis estadístico descriptivo. En energía y todos los nutrientes evaluados, se observa la reducción de la proporción proveniente de alimentos mínimamente procesados, ingredientes culinarios y alimentos procesados, y el aumento de productos ultraprocesados. Con una mayor contribución a partir de ultraprocesados, a medida que aumentan los ingresos del hogar, pero con diferencias que disminuyen a lo largo del tiempo. Dados los resultados, las estrategias futuras en Argentina deberían promover el consumo de alimentos mínimamente procesados y desalentar la disponibilidad y accesibilidad de alimentos ultraprocesados, con especial énfasis en los grupos más vulnerados.


Cada vez mais há evidências sobre a mudança global nos sistemas alimentares, que envolvem disponibilidade, acessibilidade, custo e pertinência dos alimentos ultraprocessados. O objetivo deste trabalho foi analisar o consumo aparente de energia, gorduras saturadas, açúcar e sódio conforme o nível de processamento de alimentos e a renda familiar na Argentina no período entre 1996 e 2018. Estudo descritivo e transversal, realizado com dados sobre o consumo de alimentos e bebidas e a renda familiar obtidos da Pesquisa Nacional de Consumo Domiciliar de 1996-1997, 2004-2005, 2012-2013 e 2017-2018, que inclui mais de 20.000 residências em cada período. Foi calculado o consumo diário de energia, gordura saturada, açúcar e sódio por adulto equivalente a partir de: (1) alimentos minimamente processados; (2) ingredientes culinários processados; (3) alimentos processados e (4) alimentos ultraprocessados, para cada período e de acordo com o quintil de renda familiar per capita. Foi aplicada análise estatística descritiva. Em relação à energia e aos nutrientes analisados, foi encontrada uma redução na proporção de alimentos minimamente processados, ingredientes culinários e alimentos processados, e um aumento de alimentos ultraprocessados. O consumo de alimentos ultraprocessados é maior conforme aumenta a renda familiar, mas com diferenças que diminuem ao longo do tempo. Esses resultados evidenciam a necessidade de promover estratégias na Argentina quanto ao consumo de alimentos minimamente processados e desestimular a disponibilidade e o acesso a alimentos ultraprocessados, especialmente para os grupos mais vulneráveis.


Assuntos
Dieta , Ingestão de Energia , Adulto , Argentina , Brasil , Estudos Transversais , Fast Foods , Manipulação de Alimentos , Humanos , Nutrientes , Sódio , Açúcares
20.
Arch. argent. pediatr ; 120(3): 152-157, junio 2022. tab
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1368127

RESUMO

Introducción. La lactancia materna (LM) reduce el riesgo de morbimortalidad en niños, además, provee ventajas medioambientales y económicas. El monitoreo de su práctica es indispensable para las políticas públicas. Objetivos. Los objetivos de este trabajo fueron estimar la prevalencia de LM en la población que demanda al sector público, comparar la prevalencia con datos del 2015 y evaluar variables de interés asociadas. Población y métodos. Estudio transversal observacional. Mediante un cuestionario estructurado, se relevó información de ingestión y datos sociodemográficos de lactantes <6 meses (n = 15 322) y de entre 12 y 15 meses (n = 3243) que concurrieron en forma espontánea a efectores del sector público entre agosto y septiembre de 2017. Resultados. La prevalencia de LM exclusiva (LME) en <6 meses fue del 53,5 % (intervalo de confianza del 95 % [IC95%]: 52,7-54,3); al cuarto y sexto mes, del 51,5 % (IC95%: 49,7-53,4) y del 41,7 % (IC95%: 39,8-43,5) respectivamente. La prevalencia de LME al cuarto y al sexto mes aumentaron en relación con el 2015 (p <0,001). La prevalencia de LM en niños de 12 a 15 meses fue del 77,8 % (IC95%: 76,4-79,3). Las siguientes variables se asociaron en forma independiente con menor frecuencia de LME (en <6 meses) y LM: mayor edad del niño, menor nivel educativo materno, parto por cesárea, bajo peso al nacer, puesta al pecho después de la primera hora y separación de la díada madre-hijo/a ≥4 horas diarias. Conclusiones. La LME al sexto mes y la LM continuada muestran cierta mejora, pero aún la proporción de lactantes amamantados no logra alcanzar niveles deseables.


Introduction. Breastfeeding reduces the risk for morbidity and mortality in children and also provides environmental and financial advantages. Breastfeeding monitoring is critical for public policies. Objectives. The objectives of this study were to estimate the prevalence of breastfeeding in the population seeking care in the public sector, compare this prevalence to data from 2015, and assess associated outcome measures. Population and methods. Cross-sectional, observational study. A structured questionnaire was used to collect intake and sociodemographic data from infants aged < 6 months (n = 15 322) and 12-15 months (n = 3243) who sought care from public sector health care providers spontaneously between August and September 2017. Results. The prevalence of exclusive breastfeeding among infants < 6 months was 53.5% (95% confidence interval [CI]: 52.7-54.3); and at 4 and 6 months, 51.5% (95% CI: 49.7-53.4) and 41.7% (95% CI: 39.8-43.5), respectively. The prevalence of exclusive breastfeeding at 4 and 6 months increased compared to 2015 (p < 0.001). The prevalence of breastfeeding among infants aged 12-15 months was 77.8% (95% CI: 76.4-79.3). The following variables were independently associated with a lower frequency of exclusive breastfeeding (< 6 months old) and breastfeeding: older age, lower level of maternal education, delivery via C-section, low birth weight, initial breastfeeding after the first hour, and separation of the mother-child dyad ≥ 4 hours a day. Conclusions. Exclusive breastfeeding at 6 months and continued breastfeeding showed certain improvement, but the rate of breastfed infants is still below desirable levels.


Assuntos
Humanos , Lactente , Aleitamento Materno , Saúde Pública , Argentina/epidemiologia , Prevalência , Estudos Transversais , Inquéritos e Questionários , Setor Público
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