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1.
Rev. argent. salud publica ; 39(9): 38-41, Julio 2019.
Artigo em Espanhol | LILACS, BINACIS, ARGMSAL | ID: biblio-1007593

RESUMO

: INTRODUCCIÓN: En Argentina desde 1998 ocurrieron brotes de dengue todos los años excepto 2001 y 2005 en diferentes áreas, en 15 jurisdicciones, con identificación de los 4 serotipos. El objetivo de este estudio fue identificar poblaciones con mayor riesgo de desarrollar formas graves de la enfermedad como insumo para la posible introducción de una estrategia de prevención. METODOS: Se realizó un estudio retrospectivo descriptivo de los casos de dengue confirmados autóctonos a partir de publicaciones oficiales, notificaciones al SNVS e información aportada por las áreas de epidemiología provinciales. Se elaboró una estratificación del riesgo de dengue grave por departamento para el período 1998-2018. RESULTADOS: Se elaboraron 5 criterios de estratificación de riesgo: registro de casos autóctonos en al menos 2 de los 5 cinco últimos años, registro de 2 o más serotipos causantes del 10% o más de los casos cada uno, incidencia acumulada mayor a 500 casos por 100 mil habitantes, incidencia acumulada mayor a 5 casos por mil menores de 15 años y registro de casos graves o fallecidos. Se obtuvieron 60 departamentos con 1 criterio, 19 con 2, 8 con 3, 4 con 4, 1 con 5 y 129 no cumplieron criterios. DISCUSION: Solo 13 departamentos sumaron 3 criterios o más, resultado del predominio de DENV-1, la baja incidencia en menores de 15 años y el bajo número de casos graves y fatales. La estratificación del riesgo poblacional con criterios de registro sistemático se orienta a obtener una herramienta de evaluación de los escenarios de dengue que puedan presentarse en el futuro.


Assuntos
Humanos , Dengue/epidemiologia , Sistema de Vigilância Sanitária , Argentina/epidemiologia , Epidemiologia Descritiva , Estudos Retrospectivos , Dengue/prevenção & controle
2.
Rev. argent. salud publica ; 39(9): 19-24, Julio 2019. Tab
Artigo em Espanhol | LILACS, BINACIS, ARGMSAL | ID: biblio-1007688

RESUMO

INTRODUCCIÓN: Los cánceres de mama (CM) y colorrectal (CCR) presentan una elevada carga de enfermedad en Argentina, por lo que el estudio de la epidemiología de estos tumores constituye una prioridad en salud pública. El objetivo del presente trabajo fue describir la prevalencia de antecedentes familiares de CM y CCR, y estimar la incidencia de los tumores en adultos de 35 a 74 años de dos ciudades de Argentina: Bariloche y Marcos Paz. MÉTODOS: En el marco de la cohorte prospectiva de población general CESCAS I (Estudio de detección y seguimiento de enfermedad cardiovascular y factores de riesgo en el Cono Sur de Latinoamérica), se recolectó información individual sobre antecedentes familiares de CM y CCR en una muestra representativa de las ciudades de Bariloche y Marcos Paz. Los casos de cáncer fueron investigados mediante documentación médica respaldatoria. RESULTADOS: Durante 2016-2017 se obtuvo información de 3245 participantes. El 8,4% de la población reportó antecedente familiar de CCR, y el 15,2% de las mujeres, de CM. La incidencia anual para el período 2011-2017 fue de 55,2/100 000 mujeres de 35 a 74 años (IC95%: 22,8-133,7) para CM y 8,5/100 000 adultos de 35 a 74 años (IC95%: 15,3-96,8) para CCR. CONCLUSIONES: Además de garantizar el acceso universal a los programas de tamizaje, se debe tener en cuenta la importancia de indagar sobre los antecedentes familiares de cáncer para identificar pacientes con riesgo aumentado, que requieren algoritmos particulares de detección temprana y vigilancia.


INTRODUCTION: Breast cancer (BC) and colorectal cancer (CRC) both present a high burden of disease in Argentina. Hence, studying the epidemiology of these tumors constitutes a public health priority. The objective of this study was to describe the prevalence of family history of BC and CRC and to estimate the incidence of these tumors in adults aged between 35 and 74 years from two cities in Argentina: Bariloche and Marcos Paz. METHODS: As part of the prospective population-based cohort CESCAS I (Study of detection and monitoring of cardiovascular disease and risk factors in the Southern Cone of Latin America), individual information on family history of BC and CRC was collected from a representative sample of the cities of Bariloche and Marcos Paz. Cancer cases were investigated using supporting medical documentation. RESULTS: During 2016-2017, information from 3245 participants was obtained. Family history of CRC was reported by 8.4% of the population, and 15.2% of women reported a family history of BC. The annual incidence for the 2011-2017 period was 55.2/100 000 women aged 35 to 74 years (95%CI: 22.8-133.7) for BC and 38.5/100 000 adults aged 35 to 74 years (95%CI: 15.3-96.8) for CRC.CONCLUSIONS: Besides guaranteeing universal access to screening programs, it is important to evaluate family history of cancer to identify patients with increased risk, who require specific early detection and surveillance algorithms.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias da Mama/epidemiologia , Neoplasias Colorretais/epidemiologia , Argentina/epidemiologia , Coleta de Dados/métodos , Anamnese/métodos
3.
Rev Fac Cien Med Univ Nac Cordoba ; 76(2): 92-100, 2019 06 19.
Artigo em Espanhol | MEDLINE | ID: mdl-31216163

RESUMO

Objetive: To quantify the contribution of risk factors and treatments in the reduction of mortality due to coronary heart disease in Argentina between 1995 and 2010. Results: We used the validated IMPACTCHD model integrating data on effectiveness, use of treatments and changes in the risk factors between 1995 and 2010 in people older than 25 years in Argentina. The difference between the coronary deaths observed and expected in 2010 was distributed between treatments and risk factors. Conclusions: One out of every two MPP due to coronary heart disease in Argentina between 1995 and 2010 was due to treatments and one third to the improvement of risk factors. The decrease in blood pressure, cholesterol and smoking was limited by increases in the prevalence of obesity, sedentary lifestyle and diabetes. This study was possible thanks to the collaborative work to the cardiovascular epidemiology.


Assuntos
Doença das Coronárias/mortalidade , Adulto , Argentina/epidemiologia , Humanos , Prevalência , Fatores de Risco
4.
BMC Public Health ; 19(1): 809, 2019 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-31234866

RESUMO

BACKGROUND: Physical activity is a cornerstone in the prevention and treatment of obesity. There are relatively few studies that explore the effect of accelerometer-determined moderate-to-vigorous physical activity (MVPA) on neck circumference (NC), most of them confined to single high-income countries. The present study investigated the association of accelerometer-determined MVPA with NC in adolescents and adults from eight Latin American countries, which are mostly upper-middle income countries. METHODS: The sample consisted of 2370 participants (47.8% male) from the Latin American Study of Nutrition and Health, a multicenter cross-sectional nutrition and health surveillance study of a nationally representative sample from eight Latin American countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru, and Venezuela). Times (min/day) in MVPA (defined as time accumulated at ≥1952 activity counts/min) was assessed by ActiGraph GT3X+ accelerometer over 7 days. NC for adolescent was categorized as abnormal if circumference was > 34.5 cm for boys and > 31.25 for girls, whereas for adults the cut-off points for abnormal were > 39 cm for men and > 35 cm women. Multilevel logistic models, including country and region as random effects and adjusted for sex, age, socioeconomic level, and educational level, were used to study the association between MVPA and NC. RESULTS: The average time of MVPA was 34.88 min/day, ranging from 31.16 in Venezuela to 40.27 in Chile. Concerning NC, 37.0% of the sample was classified as having elevated NC. Chile was the country with the highest percentage of people with elevated NC (56.9%), and Colombia had the lowest percentage (24.8%). Overall, the MVPA (min/day) was associated with elevated NC (OR = 0.994, CI95% = 0.990-0.998). In Costa Rica and Peru, there were significant associations between MVPA and NC when analyzed by country. CONCLUSIONS: The present study provided evidence of significant associations between MVPA and NC in adolescents and adults from Latin America, independent of sex, age, socioeconomic level, and educational level. This analysis of accelerometry data and NC represents the first examination of these associations in eight Latin America countries. Further research is required to understand the differences between countries in the observed associations. TRIAL REGISTRATION: ClinicalTrials.Gov NCT02226627 . Retrospectively registered on August 27, 2014.


Assuntos
Acelerometria/estatística & dados numéricos , Tamanho Corporal , Exercício , Pescoço/fisiopatologia , Vigilância da População , Adolescente , Adulto , Argentina/epidemiologia , Brasil/epidemiologia , Chile/epidemiologia , Colômbia/epidemiologia , Costa Rica/epidemiologia , Estudos Transversais , Equador/epidemiologia , Feminino , Humanos , América Latina , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Obesidade/epidemiologia , Peru/epidemiologia , Venezuela/epidemiologia , Adulto Jovem
6.
An. psicol ; 35(2): 290-299, mayo 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-181699

RESUMO

Creativity and actions aimed at fostering it became a matter of interest in higher education. Since creativity is a multidimensional phenomenon, its diverse dimensions must be assessed. Among them, personality arises as the most relevant one. Therefore, the local adaptation of Gough’s Creative Personality Scale to be used in college students is proposed. This scale is composed of adjectives to be responded according to the examinees’ identification with each one of them. Two independent samples (n= 150 each) were employed to develop an exploratory factor analysis and an internal consistency analysis, on the one hand, and a confirmatory factor analysis and a convergent validity study. The exploratory procedure retained eight items and a 1-dimension structure with a good internal consistency (ordinal alpha= .853). This model was empirically verified by the confirmatory analysis which showed good fit indices, as well as an adequate internal consistency coefficient. Moreover, adequate convergent validity evidences were obtained. Findings are discussed taking into account the theoretical model and the study weaknesses along with practical and theoretical outcomes. Further research lines are proposed


La creatividad y las prácticas ligadas a fomentarla en el ámbito universitario constituyen en la actualidad un tema de interés. La creatividad en tanto fenómeno multidimensional requiere ser evaluada en sus distintas facetas, siendo la personalidad una de las que mayor relevancia reviste. Se propone así, adaptar localmente la Escala de Personalidad Creativa (EPC) de Gough para ser aplicada en el ámbito universitario. El instrumento se compone de 30 adjetivos a ser respondidos por los evaluados según se identifiquen o no con cada uno de ellos. Se realizó un análisis factorial exploratorio y de consistencia interna (n = 150) y otro confirmatorio y de validez convergente (n = 150) a partir de dos muestras independientes. El procedimiento exploratorio conservó ocho ítems y una estructura factorial unidimensional con una óptima consistencia interna (alfa ordinal = .853). Este modelo se verificó empíricamente mediante el análisis confirmatorio que arrojó óptimos índices de ajuste y un apropiado índice de consistencia interna. Adicionalmente se obtuvieron adecuadas evidencias de validez convergente del instrumento en relación a otros constructos teóricamente afines. Los resultados se discuten a la luz de la teoría y las limitaciones del diseño, destacando los alcances del estudio y las futuras líneas de investigación


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Testes de Personalidade , Criatividade , Escala de Avaliação Comportamental , Psicometria/instrumentação , Argentina/epidemiologia , Determinação da Personalidade/estatística & dados numéricos , Transtornos da Personalidade/diagnóstico , Estudantes/psicologia , Reprodutibilidade dos Testes
7.
Medicina (B Aires) ; 79(2): 81-89, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31048272

RESUMO

In Argentina, around 1500 children are born each year with Trypanosoma cruzi infection. Mother-to-child transmission is the main source of new cases of Chagas disease and of its occurrence in non-endemic areas. Our objective was to survey the information available on congenital T. cruzi infection, to analyze its evolution and its relation with the index of maternal infection and the risk for vector-borne infection by province of Argentina. Data concerning the public health sector for the period 1997-2014 were retrieved from national and local records. An increase in the number and proportion of pregnant women examined for Chagas was observed, reaching 60.3% coverage in 2014. The prevalence of maternal infection dropped from 9.0% to 2.6%. The control of newborns from infected women was highly variable (23.3%-93.6%), and data quality was deficient, varying amply by province and year. The rate of congenital infection had an irregular evolution and its national average fluctuated between 1.9 and 8.2%. An association was observed between the risk for vector-borne infection and the prevalence of maternal infection by province (Wilcoxon test p = 0.017). The rate of congenital transmission by province was neither associated with the rate of maternal infection (linear regression p = 0.686) nor with the risk for vectorial infection (Kruskal-Wallis test p = 0.3154). The available data show insufficient control of children born from infected mothers, as well as deficient recording of these procedures. Both aspects must be improved to achieve better epidemiological information and to enable timely access of infected children to treatment.


Assuntos
Doença de Chagas/epidemiologia , Doença de Chagas/transmissão , Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Complicações Parasitárias na Gravidez/epidemiologia , Argentina/epidemiologia , Doença de Chagas/congênito , Feminino , Humanos , Lactente , Recém-Nascido , Modelos Lineares , Masculino , Gravidez , Prevalência , Medição de Risco , Fatores de Risco , Estatísticas não Paramétricas , Fatores de Tempo
8.
Medicina (B Aires) ; 79(2): 90-94, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31048273

RESUMO

Misdiagnosis is a challenging risk in young patients with ischemic stroke that leads to delayed recognition, prevents thrombolytic therapy and increases morbidity and mortality. To assess the frequency and reasons for misdiagnosis of ischemic stroke in young adults in the emergency department, we retrospectively evaluated 101 consecutive patients. The diagnosis required both the presence of an ischemic lesion in diffusion-weighted MRI as well as neurological symptoms. Twenty-three individuals were misdiagnosed (15 females, mean age 43 years [range 26-55 years]). The most common diagnostic errors included headache/neck pain n = 11 (48%) and peripheral vertigo n = 4 (17.3%), and the most common missed etiology was arterial dissection (AD) n = 15 (65.2%). The initial diagnosis was made by emergency physicians in 22 persons. The group with misdiagnosis had a significantly higher frequency of AD at 15 vs. 8 (p < 0.01), posterior territory involvement at 12 vs. 6 (p < 0.01), and female predominance. Misdiagnosis occurred in a third of young patients with an ischemic stroke and was more frequent in those with arterial dissection involving the posterior circulation and presenting with non-specific symptoms.


Assuntos
Isquemia Encefálica/diagnóstico , Erros de Diagnóstico/estatística & dados numéricos , Acidente Vascular Cerebral/diagnóstico , Adulto , Fatores Etários , Argentina/epidemiologia , Isquemia Encefálica/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Acidente Vascular Cerebral/epidemiologia
9.
Medicina (B Aires) ; 79(2): 95-103, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31048274

RESUMO

The early identification of patients with palliative needs has shown benefits in terms of quality of life and treatment goals. No prospective methods have been applied in Argentina to identify palliative needs in cancer patients. The NECPAL tool combines the physician's own insight with objective indicators of disease progression and indicators of chronic advanced conditions. The aim of this study was to identify prognostic factors of mortality in hospitalized and ambulatory patients with cancer and palliative needs according to the NECPAL tool in a University Hospital in Buenos Aires city. Study variables were obtained by interviews with 10 physicians in charge of 317 patients with cancer over a 2-year follow-up period. A total of 183 patients with palliative needs were labelled as NECPAL+. Of these, 137 died after a median 4-month follow-up period. The death rate was 11% patients/month. The mortality was higher in inpatients during the first month (p < 0.003). In the multivariate model, the best predictors of mortality combining relevant indicators were: inpatients (HR 1.87; 95% CI 1.24-2.84; p = 0.003), initial diagnosis other than breast cancer (HR 2.04; 95% CI 1.23-3.40; p = 0.006), metastatic disease (HR 1.67; 95% CI 1.15-2.42; p = 0.007), functional deterioration (HR 1.95; 95% CI 1.28-2.97; p = 0.002), and malnutrition (HR 1.53; 95% CI 1.04-2.23; p = 0.02 9). The major breakthrough was the systematic prospective identification of palliative needs in cancer patients for the first time in Argentina. The NECPAL tool can improve the prediction of mortality in hospital settings.


Assuntos
Determinação de Necessidades de Cuidados de Saúde , Neoplasias/terapia , Cuidados Paliativos/métodos , Inquéritos e Questionários/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Estado Terminal , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Neoplasias/diagnóstico , Neoplasias/mortalidade , Cuidados Paliativos/estatística & dados numéricos , Prognóstico , Estudos Prospectivos , Qualidade de Vida , Reprodutibilidade dos Testes , Medição de Risco/métodos , Fatores de Risco , Fatores de Tempo , Adulto Jovem
10.
Ann Parasitol ; 65(1): 27-33, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31102575

RESUMO

Records of lizard parasitizing ticks in Argentina are scarce and incomplete. We recorded a new population of Liolaemus eleodori, a lizard endemic to Argentina, parasitized by the hard tick Amblyomma parvitarsum. Hence, the objective of this study is to report this new association and enhance knowledge about its parasitism on reptiles of Argentina. To do this, we researched ectoparasitic loads. We determined different ecological predictors: intensity, mean intensity and prevalence. Our results provide the first data on the parasitism of nymphal stages on this lizard. We found a tick prevalence of 91.6% and a mean intensity of 2.45. Considering sexes, mean intensity was higher in females than in males. The gular region and lower ventral abdomen were the highest parasitized anatomical regions. This new record of the host-parasite association suggests that this relationship is not accidental, with this lizard species being central to the tick's life cycle. Probably, the microhabitat of this lizard species is essential for the tick to reach high prevalence. Our study represents an important contribution and provides additional information on parasitism in lizards of Argentina.


Assuntos
Ixodidae , Lagartos , Animais , Argentina/epidemiologia , Feminino , Ixodidae/fisiologia , Lagartos/parasitologia , Masculino , Ninfa , Prevalência , Fatores Sexuais , Infestações por Carrapato/epidemiologia
11.
Prev Vet Med ; 168: 75-80, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31097126

RESUMO

Wild boar (Sus scrofa) was introduced in many countries of the world and is recognized as carrier of many infectious diseases. Wild game meat consumption is recognized as a source of transmission of Toxoplasma gondii and Trichinella spp. The aim of the present study was to evaluate the prevalence of antibodies to T. gondii and Trichinella spp. in free-range wild boars in Northeastern Argentine Patagonia. Between 2014 and 2018, 144 blood samples and 423 muscle samples from 423 carcasses were collected. To detect T. gondii IgG, 144 sera were processed by an immunofluorescent antibody test, and to detect anti-Trichinella IgG, 125 sera and 304 muscle juice samples were processed by ELISA. Detection of first stage larvae in muscle was performed by artificial digestion. A total of 423 wild boars muscle samples were negative to Trichinella spp. by artificial digestion. Antibodies to Trichinella spp. were detected in 2.4% (3/125) of serum samples and in 1.64% (5/304) of meat juice samples. Antibodies to T. gondii infection were detected in 12.5% (18/144) of the serum samples. This is the first study to reveal the presence of antibodies to T. gondii in wild boars from Argentina. The present results suggest that consumption of raw or undercooked wild boar meat could represent a potential source risk for toxoplasmosis in humans and that Trichinella spp. is infrequent and/or that it circulates in low burdens among wild boars in Northeastern Patagonia.


Assuntos
Sus scrofa , Doenças dos Suínos/epidemiologia , Toxoplasmose Animal/epidemiologia , Triquinelose/veterinária , Animais , Animais Selvagens/parasitologia , Anticorpos Anti-Helmínticos/sangue , Anticorpos Antiprotozoários/sangue , Argentina/epidemiologia , Feminino , Masculino , Estudos Soroepidemiológicos , Suínos , Doenças dos Suínos/parasitologia , Toxoplasma , Toxoplasmose Animal/parasitologia , Triquinelose/epidemiologia
12.
Environ Sci Pollut Res Int ; 26(20): 20981-20988, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31115805

RESUMO

The impact evaluation of pesticide exposure is conducted using combined data from biomonitoring and environmental monitoring. Damage to the human genome is, probably, the leading cause of chronic-degenerative disorders, reproductive toxicology, and developmental problems. Although the general population is exposed to pesticides, workers in the agrochemical industry and farmers represent a high-risk group due to the occupational and environmental exposure. The aim of this study is to determine whether occupational exposure to agrochemicals in Córdoba (Argentina) constitute a factor of genotoxic damage. The study was conducted in 30 pesticide applicators from the province of Córdoba. Chromosomal aberrations (CAs), micronuclei (MN), and comet assays (CO) were performed. The current study shows that occupational exposure to pesticides increases values of CAs, MN, and DNA fragmentation biomarkers, all indicators of damage to the genetic material. Evidence suggests that chronic exposure to pesticides is a potential risk to workers health.


Assuntos
Doenças dos Trabalhadores Agrícolas/epidemiologia , Dano ao DNA/efeitos dos fármacos , Exposição Ocupacional/efeitos adversos , Praguicidas/toxicidade , Adulto , Argentina/epidemiologia , Biomarcadores/sangue , Colinesterases/sangue , Colinesterases/toxicidade , Aberrações Cromossômicas/induzido quimicamente , Aberrações Cromossômicas/estatística & dados numéricos , Monitoramento Ambiental/estatística & dados numéricos , Humanos , Masculino , Exposição Ocupacional/estatística & dados numéricos , Praguicidas/sangue
13.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(3): 206-211, abr. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-181710

RESUMO

Introducción y objetivos: El cáncer de mama es la causa más frecuente de metástasis cutáneas. En la literatura revisada no hallamos estudios que estimen la prevalencia de las mismas en Latinoamérica ni que comparen la sobrevida con relación a la localización de las metástasis cutáneas y al diagnóstico de metástasis viscerales. Los objetivos de este trabajo fueron: describir prevalencia, clínica y sobrevida de las metástasis cutáneas de acuerdo con la localización y con relación al diagnóstico de metástasis viscerales. Materiales y métodos: Cohorte retrospectiva. Se evaluó a pacientes con cáncer de mama con metástasis cutáneas confirmadas por histopatología. Resultados: Se analizó a 914 pacientes con cáncer de mama en el período 2007-2014. Presentaron metástasis cutáneas 31 pacientes (prevalencia 3,4%, IC del 95%: 2,3%-4,7%), todas mujeres. La forma nodular, metacrónica y asintomática fue la más frecuente. En 5/21 pacientes hubo discordancia en la inmunohistoquímica entre el tumor primario y la metástasis cutánea. En 23 pacientes las metástasis cutáneas fueron locorregionales y en 8, a distancia. Entre estos 2 grupos, no hubo diferencias en la sobrevida desde el diagnóstico del tumor primario (mediana 4,7 y 4,8 años respectivamente; p = 0,85) ni desde el diagnóstico de las metástasis cutáneas (mediana 2,9 años y 1,1 años; p = 0,06). La menor sobrevida la presentaron las pacientes con diagnóstico simultáneo de metástasis cutánea y visceral. Conclusiones: Este es el primer estudio en Latinoamérica que estima la prevalencia de metástasis cutáneas de cáncer de mama, siendo inferior a la comunicada por autores de otras regiones del mundo


Background and objectives: Breast cancer is the most common cause of cutaneous metastases. In our review of the literature, we found no studies that have investigated the prevalence of cutaneous metastases from breast cancer in Latin America or compared survival in relation to the site of cutaneous involvement or the presence of visceral metastases. The aims of this study were to characterize the prevalence and clinical features of cutaneous metastases from breast cancer and analyze survival in relation to site of involvement and the concomitant presence of visceral metastases. Materials and methods: Retrospective cohort study. We evaluated patients with breast cancer and histologically confirmed cutaneous metastases. Results: Data from 914 patients with breast cancer seen between 2007 and 2014 were analyzed. Thirty-one of the patients, all women, had cutaneous metastases (prevalence, 3.4%; 95% CI, 2.3%-4.7%). The most common form of metástasis was nodular, metachronous, and asymptomatic. There were discrepancies between the immunohistochemical findings for the primary tumor and the metastases in 5 of 21 women. The metastases were locorregional in 23 patients and distant in 8. No differences were observed between patients with locorregional and distant metastases for survival after diagnosis of the primary tumor (median of 4.7 vs. 4.8 years; P=.085) or the cutaneous metastases (median of 2.9 vs. 1.1 years, P=.06). Women with a simultaneous diagnosis of cutaneous and visceral metastases had the shortest survival. Conclusions: This is the first study in Latin America to estimate the prevalence of cutaneous metastases from breast cancer and we found it to be lower than rates reported for other parts of the world


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/etiologia , Neoplasias Cutâneas/complicações , Neoplasias Cutâneas/secundário , Metástase Neoplásica , Neoplasias da Mama/patologia , Neoplasias Cutâneas/epidemiologia , Imuno-Histoquímica , Estudos Retrospectivos , Argentina/epidemiologia , Registros Eletrônicos de Saúde/estatística & dados numéricos
14.
Rev Assoc Med Bras (1992) ; 65(3): 419-423, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30994842

RESUMO

Premature Ovarian Insufficiency is defined as a decline in ovarian function that is accompanied by two biochemical determinations of Follicle Stimulating Hormone in hypergonadotropic values, in addition to low levels of circulating estrogens in women under 40 years old. Although some of its possible etiologies are recognized and diagnosed, most of the time, its cause remains unknown. It is a pathology with medical, psychological, and reproductive implications. Patients may experience climacteric symptoms, infertility, and emotional distress. In the medium and long term, cardiovascular and bone health can be affected, and some degree of cognitive deterioration can be evidenced. The therapeutic approach needs to be comprehensive for the patient and multidisciplinary. SAEGRE created in Argentina an interhospital network dedicated to gathering relevant statistical information regarding this and other pathologies in order to provide better assistance for these patients.


Assuntos
Insuficiência Ovariana Primária/epidemiologia , Adulto , Argentina/epidemiologia , Comorbidade , Feminino , Fertilidade/fisiologia , Humanos , Menopausa/fisiologia , Ciclo Menstrual/fisiologia , Insuficiência Ovariana Primária/etiologia , Fatores de Risco
15.
BMC Cancer ; 19(1): 367, 2019 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-31014287

RESUMO

BACKGROUND: Cervical Cancer is still a major public health challenge in low and middle-income countries. HPV testing has been an innovative approach, which was introduced in Argentina for women aged 30+ through the Jujuy Demonstration Project (JDP) carried out between 2012 and 2014. After a positive HPV-test, cytology is used as triage method. Under this protocol, the group of women with HPV+ and normal cytology are recommended to repeat the test within 12-18 months. Studies have shown that this group has increased risk of CIN2+, however, assuring high levels of repeating test among these women is difficult to achieve. We analyze those factors associated with lower re-test attendance among HPV+/ cytology negative women at a programmatic level in low-middle income settings. METHODS: We used data of women aged 30+ HPV-tested in the JDP and followed until 2018 (n = 49,565). We performed a set of different adjusted logistic regression models. Primary outcomes were re-test attendance and re-test attendance within recommended timeframe. We assessed as covariates age, health insurance status, year of HPV-testing, Pap testing in the past 3 years, HPV-testing modality (clinician-collected (CC) tests/self-collected (SC) tests), and span between HPV-test collection and report of results. RESULTS: Forty nine thousand five hundred sixty five women were HPV-tested and 6742 had a positive HPV-test. Among HPV+ women, a total of 4522 were HPV+/Cytology negative (67.1%). In total, 3172 HPV+/Cytology negative women (70.1%) had a record of a second HPV test as of March 2018. Only 1196 women (26%) completed the second test within the timeframe. Women with no record of a previous Pap (OR: 0.46, 95% CI: 0.4-0.53, p < 0.001), aged 64+ (OR: 0.46, 95% CI: 0.31-0.68, p < 0.001) were less likely to be retested; while women with clinician-collected samples had higher odds of being re-tested (OR: 1.42, 95% CI: 1.06-1.91, p < 0.001). CONCLUSIONS: Low re-test rates were found in HPV +/ normal cytology women. Tailored interventions are needed to increase the effectiveness of the screening in this group, especially for those women with characteristics associated to lower attendance.


Assuntos
Neoplasia Intraepitelial Cervical/diagnóstico , Detecção Precoce de Câncer/economia , Detecção Precoce de Câncer/psicologia , Infecções por Papillomavirus/complicações , Cooperação do Paciente/estatística & dados numéricos , Neoplasias do Colo do Útero/diagnóstico , Adulto , Idoso , Argentina/epidemiologia , Neoplasia Intraepitelial Cervical/epidemiologia , Neoplasia Intraepitelial Cervical/virologia , Citodiagnóstico , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/virologia , Cooperação do Paciente/psicologia , Pobreza , Prognóstico , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia , Esfregaço Vaginal
16.
Maturitas ; 123: 73-77, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31027681

RESUMO

Sleep disorders, resulting from hormonal changes and vasomotor symptoms, are common in both peri- and postmenopausal women. Poor sleep quality is associated with increased metabolic and cardiovascular risk, depression and a global impairment in health status. OBJECTIVES: Our study aimed to assess sleep quality in a sample of postmenopausal women and to identify the factors associated with poor sleep quality. It also considered the negative impact of sleep disorders such as insomnia, hypersomnia and breathing disturbances. SUBJECTS & METHODS: Data came from a cross-sectional study of 195 postmenopausal women conducted at the Italian Hospital of Buenos Aires, Argentina. Their sociodemographic, gynecological and clinical characteristics were recorded and sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Oviedo Sleep Questionnaire (Cuestionario Oviedo de Sueño, COS). RESULTS: The mean PSQI score was 6.90 ± 4.43. Sleep problems were common, with 46.7% of participants scoring over 5 on the PSQI. Snoring was reported by 13% of the patients (PSQI item 10 A). While 10% of the poor sleepers reported episodes of apnea during rest (PSQI item 10B), 7.1% reported leg spasm (PSQ I item 10C). The mean total COS score was 17.57 ± 7. According to COS item 1, all the subjects reported some dissatisfaction with the quality of their sleep. According to the COS, the prevalence of insomnia was 3.6% using ICD-10 criteria and 15.4% using DSM-IV criteria. The mean ESS score was 6.12 ± 4.09. CONCLUSION: Postmenopausal women are likely to complain of disturbed sleep. Almost half of the women in this survey said their sleep quality was impaired, and most of that group would benefit from medical attention.


Assuntos
Fogachos/epidemiologia , Pós-Menopausa , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Sono , Adulto , Argentina/epidemiologia , Estudos Transversais , Sonhos , Feminino , Nível de Saúde , Humanos , Incidência , Pessoa de Meia-Idade , Prevalência , Síndromes da Apneia do Sono/epidemiologia , Transtornos do Sono-Vigília/epidemiologia , Ronco/epidemiologia , Inquéritos e Questionários , Sudorese
17.
Vet Microbiol ; 230: 228-234, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30827392

RESUMO

Extended-spectrum ß-lactamase (ESBL), plasmid-mediated AmpC (pAmpC) and MCR-1 phosphoethanolamine transferase enzymes have been pointed out as the main plasmid-mediated mechanisms of resistance to third generation cephalosporins (TGC) and colistin, respectively, and are currently considered a major concern both in human and veterinary medicine. Little data on these resistance determinants prevalence in companion animal infections is available. The aim of this study was to determine the resistance profile of Escherichia coli isolated from pet infections, in Argentina, and to characterize the resistance mechanisms to TGC, as well as the presence of the plasmid-borne colistin resistance gene, mcr-1. A total of 54 E. coli isolates were collected from clinical samples in dogs and cats; from them, 20/54 (37%, CI95: [24%; 51%]) displayed resistance to TGC. In this regard, thirteen pAmpC-producing isolates were positive for blaCMY-2 genes, whereas seven ESBL- producers harboured blaCTX-M-2 (n = 4), blaCTX-M-15 (n = 2) and blaCTX-M-14 (n = 1) genes. One E. coli strain (V80), isolated from a canine urinary tract infection, showed resistance to colistin (MIC = 8 µg/ml) and whole-genome sequencing analysis revealed co-occurrence of mcr-1.1, blaCTX-M-2, aadA1, ant(2'')-Ia, catA1 and sul1 genes; the former being carried by a 60,587-bp IncI2 plasmid, previously reported in human colistin-resistant E. coli. E. coli V80 belonged to ST770 and the highly virulent phylogenetic group B2. In general, most of these multidrug-resistant isolates belonged to the phylogenetic group F (11/20) and to a lesser extent B2 (5/20), B1 (2/20), D (1/20) and E (1/20). In summary, CMY- and CTX-M-type ß-lactamases may constitute the main TGC resistance mechanism in E. coli isolated from pet infections in Argentina, whereas dissemination of colistin resistance mechanism MCR-1 in the human-animal interface has been mediated by IncI2 plasmids.


Assuntos
Infecções por Escherichia coli/veterinária , Proteínas de Escherichia coli/genética , Escherichia coli/genética , Animais de Estimação/microbiologia , beta-Lactamases/genética , Animais , Antibacterianos/farmacologia , Argentina/epidemiologia , Gatos , Cefalosporinas/farmacologia , Colistina/farmacologia , Cães , Escherichia coli/efeitos dos fármacos , Escherichia coli/enzimologia , Infecções por Escherichia coli/epidemiologia , Testes de Sensibilidade Microbiana , Filogenia , Plasmídeos/genética , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Infecções Urinárias/veterinária
18.
Parasitol Int ; 71: 53-55, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30880157

RESUMO

Of the three Trichinella species described in South America, T. spiralis, T. pseudospiralis and T. patagoniensis, only the former has been implicated in human infections from consumption of pork-derived products. During a presumed trichinellosis outbreak in 2012 in Mendoza, Argentina, we evaluated the serological responses of three patients who had eaten the incriminated food and had signs and symptoms compatible with trichinellosis, using ELISA. We also analyzed potentially contaminated pork sausage by artificial digestion technique and recovered Trichinella muscle larvae, which were identified to the species level using a PCR multiplex assay and by sequencing a region of the mitochondrial gene coding cytochrome oxidase subunit I. No antibodies were detected in the sera of the patients, probably because the samples were collected during the immunological window period. According to molecular identification, all larvae from the sausage corresponded to T. britovi. Trichinella britovi is reported here for the first time in the American Continent, and represents the only cold-tolerant member of the genus in the Neotropics. This species was most likely introduced from Europe to South America during Spanish colonization through pigs, wild boars and/or rats.


Assuntos
Surtos de Doenças , Doenças Transmitidas por Alimentos/parasitologia , Produtos da Carne/parasitologia , Trichinella/isolamento & purificação , Triquinelose/etiologia , Adulto , Animais , Anticorpos Anti-Helmínticos/sangue , Argentina/epidemiologia , Complexo IV da Cadeia de Transporte de Elétrons/genética , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Larva/genética , Masculino , Reação em Cadeia da Polimerase , Suínos , Doenças dos Suínos/parasitologia , Doenças dos Suínos/transmissão , Trichinella/genética , Triquinelose/epidemiologia
19.
Rev Fac Cien Med Univ Nac Cordoba ; 76(1): 47-51, 2019 02 27.
Artigo em Espanhol | MEDLINE | ID: mdl-30882341

RESUMO

Introduction: Chagas´Disease (CD) is endemic en Chaco Región. It is unknown the seroprevalence in population older than 14 years old from rural Chaco areas of Santa Fe Province. This study aimed to determine the seroprevalence of and socio-environmental factors associated with CD in inhabitants >14 years old of rural Chaco areas of Santa Fe, Argentina. Methods: A cross-sectional study was conducted between 2010 and 2015, in people over 14 years old, in the rural districts of the Chaco region, in the North of Santa Fe Province, Argentina. Blood serology for Trypanosoma cruzi antibodies based on two serological tests, and a third in case of discordance, were analized. Semi-structured survey was administered. Association between CD and socio-environmental variables were analyzed using prevalence ratios with 95% confidence intervals. Results: A total of 749 individual were analyzed, with an average of 29.5 years. The seroprevalence was 24.70% (26.69% in women and 20.26% in men). Socio-environmental variables showed association with Trypanosoma cruzi seropositive. The seroprevalence was 7.83 times higher in the children of mothers who had not reached secondary education. Conclusions: Chaco region of Santa Fe is endemic for CD, as well as other provinces of the Region. The low level of education is the more important conditioning for this endemic disease.


Assuntos
Doença de Chagas/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Doença de Chagas/diagnóstico , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , População Rural/estatística & dados numéricos , Estudos Soroepidemiológicos , Fatores Socioeconômicos , Adulto Jovem
20.
Rev Bras Epidemiol ; 22: e190003, 2019 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-30892466

RESUMO

BACKGROUND: In Argentina, approximately 9,000 new cases of tuberculosis (TB) are recorded every year, representing an incidence rate of 22 cases per 100,000 inhabitants. There are no reported studies in Argentina examining the factors that influence the unequal distribution of the disease. The aim of the study was to identify the relationship between the distribution of social and economic factors and TB in Argentina between 2008 and 2012. METHOD: An ecologic study involving 525 departmental jurisdictions was conducted. Simple linear regression analysis was performed, followed by multiple linear regression for each group of determinants. A final model of determinants of TB's incidence was constructed from a model of multiple linear regression. RESULTS: The following determinants explain 43% of the variability of TB's incidence rate among different jurisdictions: overcrowding, proportion of households with a sewage network, proportion of examined patients with respiratory symptoms and proportion of patients who discontinued treatment. DISCUSSION: This study makes an important contribution to a better understanding of the factors influencing the TB occurrence in Argentina, which is the result of a multidimensional and complex process. Thesefactors make part of this disease's social determination. CONCLUSION: TB incidence is associated with different determinants, from multiple levels. Inequalities in its distribution in Argentina are driven by the unequal distribution of key social determinants.


Assuntos
Tuberculose Pulmonar/epidemiologia , Argentina/epidemiologia , Humanos , Incidência , Características de Residência , Fatores de Risco , Fatores Socioeconômicos
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