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1.
Equine Vet J ; 52(1): 98-103, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30991461

RESUMO

BACKGROUND: Salmonella enterica subsp. enterica serovar Abortusequi (S. Abortusequi) is a serotype restricted to equines, which produces abortion outbreaks. Nowadays the disease is being reported in different countries including Argentina thus generating an important impact in the equine industry. Molecular characterization of the 95 kb virulence plasmid and the spvC gene of S. Abortusequi demonstrated their importance in the pathogenicity of the serotype. In the last decades, high clonality of S. Abortusequi was identified in Japan, Mongolia and Croatia. OBJECTIVES: The aim of this work was to characterize S. Abortusequi isolates obtained in Argentina between 2011 and 2016 by virulence-gene profiling and pulsed-field gel electrophoresis. STUDY DESIGN: Case report. METHODS: S. Abortusequi isolates were studied by virulence-gene profiling and pulsed-field gel electrophoresis. RESULTS: Four virulence profiles and nine pulsed-field gel electrophoresis pulsotypes were identified among the 27 isolates included in the study. Different strains were found in the same outbreak and/or farm suggesting the presence of different sources of infection or mutation of isolates. MAIN LIMITATIONS: The number of related and nonrelated strains. More isolates may be necessary for a more intensive study. CONCLUSIONS: Most strains presented the same virulence profile, being positive for all the studied genes except gipA and sopE1, which are involved in intestinal virulence. Only few isolates showed different results in the same outbreak or farm. Unlike other studies, our results demonstrate a considerable diversity of S. Abortusequi pulsed-field gel electrophoresis pulsotypes, which suggests that different sources of infection may be involved within the same outbreak.


Assuntos
Genótipo , Doenças dos Cavalos/microbiologia , Salmonelose Animal/microbiologia , Salmonella enterica/genética , Animais , Argentina/epidemiologia , Doenças dos Cavalos/epidemiologia , Cavalos , Salmonelose Animal/epidemiologia , Salmonella enterica/classificação , Salmonella enterica/patogenicidade , Transcriptoma , Virulência
2.
Evid. actual. práct. ambul ; 22(3): e002023, nov. 2019.
Artigo em Espanhol | LILACS | ID: biblio-1046944

RESUMO

Al igual en otras partes del mundo, en Argentina la mortalidad específica por cáncer mamario disminuyó de forma sostenida entre 1996 y 2017. Es probable que en la actualidad la mamografía sea la herramienta más importante para detectar precozmente, evaluar y llevar un seguimiento de las personas con esta patología. Sin embargo existe mucha controversia acerca de los beneficios del tamizaje poblacional y de la realización de diagnósticos precoces de cáncer de mama. El propósito de esta revisión narrativa es brindar una mirada contraintuitiva, cuestionadora de los beneficios de esta práctica,ponderando también sus riesgos, escasamente visibilizados por las estrategias comunicacionales concordantes con el modelo deprevenir es mejor que curar y la lucha contra la historia natural del cáncer. (AU)


As in other parts of the world, in Argentina, breast cancer specific mortality declined steadily between 1996 and 2017. Mammography is currently the most important tool for early detection, evaluation and follow-up of people suffering fromthis disease. However, there is a controversy about the benefits of population screening and early diagnosis of breastcancer. The aim of this narrative review is to provide a counterintuitive, questioning view of the benefits of this practice, also weighing its risks, poorly visible through communication strategies consistent with the model of prevention is betterthan cureand the fight against the natural history of cancer. (AU)


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Neoplasias da Mama/diagnóstico por imagem , Mamografia/efeitos adversos , Programas de Rastreamento/efeitos adversos , Argentina/epidemiologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/mortalidade , Neoplasias da Mama/prevenção & controle , Neoplasias da Mama/terapia , Mamografia/mortalidade , Mamografia/tendências , Saúde Pública , Tomada de Decisões
4.
Medicina (B Aires) ; 79(4): 257-264, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31487244

RESUMO

The epidemiology of infectious endocarditis (IE) has undergone changes due to a series of factors such as aging, comorbidities and medical procedures. The aim of this study was to evaluate the main clinical, epidemiological and etiological changes of the IE in the last 25 years in Argentina. A comparative analysis of three observational prospective registries was performed in which cases of definite and possible IE were consecutively included according to the Duke criteria: two multicentre studies (EIRA-1 [1992-1994] and EIRA-2 [2001-2002]) and one study in a reference cardiology center (CRC [2007-2017]). In the 1065 episodes of EI evaluated, there were no differences regarding sex, and the patients were older in each period (p < 0.001). Intracardiac device-associated IE was more frequent in the last decade: pacemaker (5.4 vs. 23% p < 0.0001) and prosthetic valve IE (8.5% vs. 19.2% vs. 47.5% p < 0.0001). On the other hand, IE associated with intravenous drugs (P < 0.0001) and congenital heart diseases (p = 0.001) was significantly less frequent. The etiology changed substantially: Streptococcus viridans group decreased (30.8% vs. 26.8% vs. 15.9%, p < 0.001) and IE by Staphylococcus spp. predominated over other microorganisms, with a statistically significant increase in IE due to coagulase-negative Staphylococcus. Surgical treatment was more frequently implemented in the last decade and was accompanied by a trend towards lower mortality in the CRC (23.5%, 24.3% vs. 17.2% p = 0.058).


Assuntos
Endocardite Bacteriana/epidemiologia , Adulto , Idoso , Argentina/epidemiologia , Endocardite Bacteriana/etiologia , Endocardite Bacteriana/microbiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência
5.
Evid. actual. práct. ambul ; 22(2): e002010, sept. 2019.
Artigo em Espanhol | LILACS | ID: biblio-1046657

RESUMO

En esta editorial se analiza el concepto de seguridad alimentaria y se desarrollan tres de sus dimensiones (disponibilidad,acceso y utilización). Se destaca que la dimensión de disponibilidad (producción) está en una curva creciente, al tiempo que se plantea la duda sobre el impacto en la salud por los sistemas de producción actual. Esclarece acerca de la situación de inseguridad alimentaria creciente en las dimensiones de acceso (vinculadas fuertemente a las condiciones socioeconómicas) y de utilización (indicadores de epidemia de sobrepeso y obesidad). Por último, aporta información relevada para Argentina y la contradicción de que su población atraviese situaciones de falta de acceso, siendo este país uno de los mayores productores de alimentos a nivel mundial.(AU)


In this editorial, the concept of food safety is analyzed and three of its dimensions (availability, access and use) are considered. It is emphasized that the dimension of availability (production) has an increasing curve, while raising questions about the impact on health by current production systems. It clarifies the situation of increasing food insecurity in the dimensions of access (strongly linked to socio-economic conditions), and utilization (epidemic indicators of overweightand obesity). Finally, it provides relevant information from Argentina and the contradiction of its population attracted by situations of lack of access, being one of the largest food producers countries worldwide. (AU)


Assuntos
Humanos , Segurança Alimentar e Nutricional , Argentina/epidemiologia , Fatores Socioeconômicos , Produção de Alimentos , Fatores Culturais , Fome Oculta , Sobrepeso/epidemiologia , Alimentos/história , Obesidade/epidemiologia
6.
Enferm. intensiva (Ed. impr.) ; 30(3): 108-115, jul.-sept. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182969

RESUMO

Objetivo: El síndrome de burnout entre los profesionales de cuidados intensivos ha sido ampliamente documentado internacionalmente. Pocos estudios abordan la prevalencia en América Latina, y específicamente en Argentina no existen estudios de peso que aborden esta problemática. El objetivo del presente estudio fue determinar la prevalencia de burnout entre las enfermeras de cuidados intensivos de Argentina y los factores de riesgo relacionados. Materiales y métodos: Encuesta en línea, autoadministrada, para evaluar variables demográficas y puntuación en el Índice de Burnout de Maslach en 486 enfermeras de cuidados críticos entre los meses de junio y septiembre de 2016. Resultados: El 84,4% de los participantes presentan niveles moderados/altos de síndrome de burnout (IC 95% 80,8 a 87,4). No se encontró asociación significativa entre el burnout y el género, la edad, los años de práctica, el grado académico, el rol o la multiplicidad de empleos. No hubo diferencias estadísticamente significativas en la prevalencia de burnout entre los distintos tipos de población de atención (neonatal, pediátrica o de adultos). Se encontró que la variable relación enfermera:paciente de 1:3 o más se encuentra estadísticamente relacionada con las subescalas de agotamiento emocional y despersonalización (p = 0,002 y 0,0039, respectivamente). Conclusión: Más del 80% de las enfermeras que tienen a cargo el cuidado de pacientes críticamente enfermos en Argentina muestran niveles moderados/altos de burnout y esto se relaciona con una relación enfermera:paciente ≥ 1:3


Purpose: Burnout syndrome among intensive care professionals has been widely documented internationally. Few studies address the incidence and prevalence in Latin America. And there are no validated studies about the situation in Argentina. Our goal was to determine burnout prevalence among intensive care nurses in Argentina and related risk factors. Materials and methods: Online self-administered survey evaluating demographic variables and the Maslach Burnout Inventory in 486 critical care nurses between June and September 2016. Results: A percentage of 84.4 of participants show moderate or high levels of burnout syndrome (95% CI 80.8 to 87.4). No significant association was found between burnout and gender, age, years of practice, academic degree, role or multiplicity of jobs. There was no statistical difference in burnout prevalence among different types of populations of care (neonatal, paediatric or adult care). Nurse to patient ratios of 1:3 or higher was found to be a statistically significant risk factor for emotional exhaustion and depersonalization sub-scales (P = .002 and .0039, respectively). Conclusion: More than 80% of nurses caring for critically ill patients in Argentina show moderate or high levels of burnout syndrome and this is related to a high nurse:patient ratio (1:3 or higher)


Assuntos
Humanos , Masculino , Feminino , Adulto , Esgotamento Psicológico/epidemiologia , Cuidados Críticos , Fatores de Risco , Unidades de Cuidados Coronarianos/estatística & dados numéricos , Argentina/epidemiologia , Inquéritos e Questionários , Enfermeiras e Enfermeiros/estatística & dados numéricos , Análise Quantitativa , Estudos Transversais , Intervalos de Confiança , Despersonalização
7.
Arch Virol ; 164(11): 2715-2724, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31456086

RESUMO

Bovine coronavirus (BCoV) is a recognized cause of severe neonatal calf diarrhea, with a negative impact on animal welfare, leading to economic losses to the livestock industry. Cattle production is one of the most important economic sectors in Uruguay. The aim of this study was to determine the frequency of BCoV infections and their genetic diversity in Uruguayan calves and to describe the evolutionary history of the virus in South America. The overall detection rate of BCoV in Uruguay was 7.8% (64/824): 7.7% (60/782) in dairy cattle and 9.5% (4/42) in beef cattle. The detection rate of BCoV in samples from deceased and live calves was 10.0% (6/60) and 7.6% (58/763), respectively. Interestingly, there was a lower frequency of BCoV detection in calves born to vaccinated dams (3.3%, 8/240) than in calves born to unvaccinated dams (12.2%, 32/263) (OR: 4.02, 95%CI: 1.81-8.90; p = 0.00026). The frequency of BCoV detection was higher in colder months (11.8%, 44/373) than in warmer months (1.5%, 3/206) (OR: 9.05, 95%CI: 2.77-29.53, p = 0.000013). Uruguayan strains grouped together in two different lineages: one with Argentinean strains and the other with Brazilian strains. Both BCoV lineages were estimated to have entered Uruguay in 2013: one of them from Brazil (95%HPD interval: 2011-2014) and the other from Argentina (95%HPD interval: 2010-2014). The lineages differed by four amino acid changes, and both were divergent from the Mebus reference strain. Surveillance should be maintained to detect possible emerging strains that can clearly diverge at the antigenic level from vaccine strains.


Assuntos
Antígenos Virais/genética , Doenças dos Bovinos/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/veterinária , Coronavirus Bovino/isolamento & purificação , Animais , Antígenos Virais/imunologia , Argentina/epidemiologia , Brasil/epidemiologia , Bovinos , Doenças dos Bovinos/prevenção & controle , Doenças dos Bovinos/virologia , Infecções por Coronavirus/prevenção & controle , Coronavirus Bovino/genética , DNA Viral/genética , Disenteria/epidemiologia , Disenteria/veterinária , Disenteria/virologia , Variação Genética/genética , Uruguai/epidemiologia , Vacinação
8.
Arch Virol ; 164(11): 2769-2774, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31392428

RESUMO

Feline immunodeficiency virus (FIV), genus Lentivirus, is responsible for feline immunodeficiency syndrome in domestic cats. FIV has been classified into six subtypes: A, B, C, D, E and F, based on regions of the env gene as well as the gag gene. In Argentina, the circulation of subtypes B and E was reported more than two decades ago. The objective of this work was to study the FIV variants circulating presently in the city of Buenos Aires in naturally infected cats utilizing a nested PCR targeting the gag gene. A phylogenetic comparison with representative sequences of five previously published subtypes shows a clustering with subtypes A and B. This is the first report of FIV subtype A in Argentina.


Assuntos
Síndrome de Imunodeficiência Adquirida Felina/epidemiologia , Produtos do Gene env/genética , Produtos do Gene gag/genética , Vírus da Imunodeficiência Felina/classificação , Vírus da Imunodeficiência Felina/genética , Animais , Argentina/epidemiologia , Gatos , Síndrome de Imunodeficiência Adquirida Felina/virologia , Genes env/genética , Vírus da Imunodeficiência Felina/isolamento & purificação , Filogenia , Reação em Cadeia da Polimerase
10.
Rev Fac Cien Med Univ Nac Cordoba ; 76(3): 159-163, 2019 08 29.
Artigo em Espanhol | MEDLINE | ID: mdl-31465183

RESUMO

Background: Excess weight (EW) and alterations in lipid metabolism constitute risk factors for cardiovascular disease in adults and children. Prevalence of dyslipidemia in schoolchildren from Jujuy with EW is analyzed in this study. Methods: Cross-sectional descriptive study of 891 schoolchildren 10-14 years old (367 girls; 524 boys) from the province of Jujuy (Northwestern Argentina). Prevalence of dyslipidemia for Overweight (OW) and Obesity (OB) were calculated, according to the International Obesity Task Force cut-off points. Prevalence of lipid alterations were analyzed and 7 dyslipidemic profiles were established. Comparisons and associations between variables were analyzed by Chi-square test. Crude and adjusted odds ratio were estimated from a logistic regressions. Results: Regardless of sex and nutritional status, 13.7%, 21.8%, and 16.5% of schoolchildren showed high values of total cholesterol, triglycerides, and LDL cholesterol, respectively, and 20.3% had low HDL cholesterol. Significantly higher values of HDL cholesterol were found in OW, and of triglycerides in OB. A significant association was recorded between OB and high triglycerides. Schoolchildren with OB have a 54% more chances of showing at least one lipid alteration. Conclusion: EW, and especially OB, constitutes an important risk factor in the development of dyslipidemia in schoolchildren from Jujuy.


Assuntos
Dislipidemias/sangue , Dislipidemias/etiologia , Sobrepeso/complicações , Adolescente , Argentina/epidemiologia , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/etiologia , Criança , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Estudos Transversais , Dislipidemias/epidemiologia , Feminino , Humanos , Masculino , Obesidade/complicações , Sobrepeso/epidemiologia , Prevalência , Instituições Acadêmicas , Triglicerídeos/sangue
11.
BMC Vet Res ; 15(1): 264, 2019 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-31351494

RESUMO

BACKGROUND: Staphylococcus pseudintermedius is the leading cause of pyoderma in dogs and the frequent use of antimicrobial treatment is associated to the development of resistance to nearly all classes of antibiotics. Despite S. pseudintermedius significance, our understanding of the molecular mechanism of ß-lactam resistance and its genetic diversity remains limited. We aimed to: i) determine the phenotypic resistance profile of methicillin resistant Staphylococcus pseudintermedius (MRSP) isolated from infected dogs in three different veterinary hospitals in Buenos Aires, Argentina; ii) identify the SCCmec elements and resistance genes; and iii) analyze the clonal relationship between isolates and in regard of dominant lineages found in the world. RESULTS: In addition to the differential levels of ß-lactam resistance, MRSP isolates (n = 10) showed resistance to 5-6 families of antibiotics, and were therefore categorized as multidrug-resistant. All the isolates were variant of SCCmec V homologous to S. aureus; additional SCCmecFinder analysis classified five of the genomes as SCCmec type V (5C2&5) with mecA (encodes for PBP2a), mecRI and mecI and all the genes closely related to the reference SCCmec type V S. aureus TSGH17 strain. In the remaining five strains, mecA was present, although other genes associated with SCCmec V including mecR1 and mecI were missing. PBP2a was inducible in low level resistance strains (MRSP 8151), and constitutively expressed in MRSP 8150, suggesting different mecA regulatory mechanisms. MRSP isolates showed significant genetic diversity: eight PFGE clonal types and six multilocus-sequence typing (MLST) sequence types (STs) (339, 649, 919, 920, 921 and 922), including four new STs genetically distinct from STs reported in other geographic areas. Comparative genomics and phylogenetic analyses of the MRSP showed a correlation between the genetic content and the phenotypes, and established the genetic relationship between the isolates. CONCLUSIONS: MRSP could be a threat to animal health due to it concerning level of antimicrobial resistance. Our study highlights genetic and epidemiological aspects of multidrug-resistant MRSP strains from Argentina showing high degree of correlation between the resistance genes and the phenotype of the isolates and, furthermore, they appeared evolutionary closer to major worldwide reported ST68 and ST71.


Assuntos
Doenças do Cão/microbiologia , Resistência a Meticilina , Infecções Estafilocócicas/veterinária , Staphylococcus/genética , Staphylococcus/isolamento & purificação , Animais , Antibacterianos/farmacologia , Argentina/epidemiologia , Cães , Epidemiologia Molecular , Tipagem de Sequências Multilocus/veterinária , Filogenia , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Staphylococcus/efeitos dos fármacos
12.
BMC Public Health ; 19(1): 904, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286922

RESUMO

BACKGROUND: On an absolute basis, Argentina is the country with the largest affected population with Chagas Disease (ChD). This constitutes a significant public health issue. As a consequence of Argentina's migratory patterns, there has been a significant increase of affected population in urban centers. An innovative project for early diagnosis and timely treatment of ChD was designed for Municipal Primary Care Facilities of La Plata City, a non- endemic area, in line with a proposal from the Pan-American Health Organization. The project was a public -private intervention. The objectives of this study were to demonstrate the feasibility of the primary healthcare level for early diagnosis and timely treatment of ChD; to design and implement a tailor made program and to innovate in a public-private association. METHODS: The healthcare barriers for early diagnosis and timely treatment for the population with ChD of La Plata were analyzed. The four dimensions described by Peters et al. (Ann N Y Acad Sci 1136:161-71, 2008) were used. The baseline was measured during a previous pilot project and the same items were evaluated at the end of 2017. The model from Damschroder et al. (Implement Sci 4:50, 2009) was used during the implementation process. RESULTS: With all the information gathered during this investigation, a "patient-centered" model was designed. During the program, 17,894 people were serologically tested for ChD, 1,394 were positive and 1,035 were treated. Additionally, 3,750 children from 46 public schools were evaluated for risk factors of ChD. CONCLUSIONS: This project showed the feasibility of the primary healthcare level for early diagnosis and timely treatment of ChD. Tailor made programs and public-private associations should be considered for vulnerable populations in emerging economies in order to enhance efforts and obtain better results. This program may be replicated in other countries of Latin America were Chagas is a main public health issue and, with the corresponding adaptations, for other neglected diseases as well.


Assuntos
Doença de Chagas/diagnóstico , Atenção Primária à Saúde/métodos , Saúde Pública/métodos , Parcerias Público-Privadas , Adolescente , Adulto , Argentina/epidemiologia , Doença de Chagas/epidemiologia , Doença de Chagas/terapia , Criança , Diagnóstico Precoce , Estudos de Viabilidade , Feminino , Implementação de Plano de Saúde , Humanos , Masculino , Projetos Piloto , Fatores de Risco , Instituições Acadêmicas , Tempo para o Tratamento , População Urbana , Adulto Jovem
13.
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
14.
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
15.
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
16.
Acta Odontol Latinoam ; 32(1): 44-48, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-31206574

RESUMO

Clinically, Molar-Incisor Hypomineralization (MIH) lesions are not distributed symmetrically, and their severity varies even within the same arcade. AIM: To estimate the frequency of asymmetries in hypomineralized lesions on permanent molars and incisors of children with MIH. METHODS: Three pediatric dentists, calibrated following the diagnostic criteria of Mathu-Muju and Wright (2006) (Kappa 0.87) identified presence and severity of opacities on molars and incisors of patients with MIH. Six pairs of teeth (permanent maxillary and mandibular first molars, central and lateral incisors) were evaluated in each patient. Degree of lesion severity (0-none, 1-mild, 2-moderate, 3-severe) was recorded for each tooth. For each pair containing any affected teeth, asymmetry of presence (one tooth in the pair with lesion and the other intact), asymmetry of severity (both teeth with lesions but with different degrees of severity) or symmetry of severity (both affected teeth with the same degree of severity) were evaluated. The recorded values were entered into a database to calculate percentages, 95% confidence intervals and Chi-Square test for comparisons. RESULTS: The sample consisted of475 of the 1032 pairs of teeth evaluated in the 172 patients included in the study, mean age 11±2.2 years, and 50% female. Asymmetry was found for 67.5% (63.1 - 71.7) of the pairs of the studied teeth. There was a significant relationship between asymmetries and symmetries (p=0.038). A total 50.1% of the pairs were asymmetrical for presence of opacities. Of these, 62.2% scored severity 1 (mild). Symmetry of severity was found for 32.5% of the lesions. Among the pairs of affected teeth, the most frequently observed degrees of lesion severity were mild and moderate, with the exception of lower molars, in which 49% had severe lesions. CONCLUSIONS: In this study, MIH lesions were asymmetrical both in presence and severity for all tooth types.


Assuntos
Hipoplasia do Esmalte Dentário/epidemiologia , Incisivo/patologia , Maxila/patologia , Dente Molar/patologia , Desmineralização do Dente/epidemiologia , Adolescente , Argentina/epidemiologia , Criança , Hipoplasia do Esmalte Dentário/classificação , Feminino , Humanos , Masculino , Prevalência , Índice de Gravidade de Doença , Desmineralização do Dente/classificação
17.
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
18.
Parasitol Res ; 118(7): 2079-2086, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31187226

RESUMO

Cryptosporidiosis of calves is caused by the enteroprotozoan Cryptosporidium spp. The disease results in intense diarrhea of calves associated with substantial economic losses in dairy farming worldwide. The aim of this study was to determine calf, herd, and within-herd Cryptosporidium prevalence and identify Cryptosporidium species and subtypes in calves with diarrhea in intensive dairy herds in central Argentina. A total of 1073 fecal samples were collected from 54 randomly selected dairy herds. Cryptosporidium-oocysts were isolated and concentrated from fecal samples using formol-ether and detected by light microscopy with the modified Ziehl-Neelsen technique. Overall prevalence of oocyst-excreting calves was found to be 25.5% (274/1073) (95% C.I. 22.9; 28.1%). Of the herds studied, 89% (48/54) included at least one infected calf, whereas within-herd prevalence ranged from the absence of infection to 57% (20/35). A highly significant association was found between the presence of diarrhea and C. parvum infection (χ2 = 55.89, p < 0.001). For species determination, genomic DNA isolated from oocyst-positive fecal samples was subjected to PCR-RFLP of the 18S rRNA gene resulting exclusively in Cryptosporidium parvum identification. C. parvum isolates of calves displaying diarrhea and high rate of excretion of oocysts were subtyped by PCR amplification and direct sequencing of the 60 kDa glycoprotein (GP60) gene. Altogether five GP60 subtypes, designated IIaA18G1R1, IIaA20G1R1, IIaA21G1R1, IIaA22G1R1, and IIaA24G1R1 were identified. Interestingly, IIaA18G1R1 and IIaA20G1R1 were predominant in calves with diarrhea and high infection intensity. Notably, IIaA24G1R1 represents a novel, previously unrecognized C. parvum subtype. The subtype IIaA18G1R1, frequently found in this study, is strongly implicated in zoonotic transmission. These results suggest that calves might be an important source for human cryptosporidiosis in Argentina.


Assuntos
Doenças dos Bovinos/epidemiologia , Criptosporidiose/epidemiologia , Cryptosporidium parvum/classificação , Cryptosporidium/classificação , Diarreia/veterinária , Animais , Argentina/epidemiologia , Bovinos , Doenças dos Bovinos/parasitologia , Criptosporidiose/parasitologia , Criptosporidiose/transmissão , Cryptosporidium/genética , Cryptosporidium/isolamento & purificação , Cryptosporidium parvum/genética , Cryptosporidium parvum/isolamento & purificação , Diarreia/epidemiologia , Diarreia/parasitologia , Fezes/parasitologia , Feminino , Glicoproteínas/genética , Humanos , Oocistos , Reação em Cadeia da Polimerase/veterinária , Polimorfismo de Fragmento de Restrição , Prevalência , Zoonoses
19.
Med. infant ; 26(2): 177-188, Junio 2019. Tab
Artigo em Espanhol | LILACS | ID: biblio-1021533

RESUMO

El rotular a un niño o adolescente de hipertenso no es una tarea fácil en la actualidad. Sabemos que el pilar para el diagnóstico de Hipertensión Arterial sigue siendo la presión arterial de consultorio; pero tenemos que tener en cuenta que, por su escasa reproducibilidad éste método tiene limitaciones. Hoy existen métodos complementarios reproducibles, validados y confiables como el Monitoreo Ambulatorio de la Presión Arterial (MAPA) y el Monitoreo Domiciliario de la Presión Arterial (MDPA) menos difundido en pediatría, que nos ayudan a llegar a un diagnostico correcto (AU)


Diagnosis of a hypertensive child or adolescent is not an easy task today. We know that the mainstay for diagnosing arterial hypertension remains the measuring of blood pressure at the office; however, it is necessary to bear in mind that, because of its low reproducibility, this method has limitations. Today there are reproducible, validated, and reliable complementary methods, such as ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM), that are less widespread in pediatrics, which may be helpful to make an adequate diagnosis.(AU)


Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Adolescente , Argentina/epidemiologia , Monitorização Ambulatorial da Pressão Arterial/instrumentação , Hipertensão/diagnóstico , Hipertensão Pulmonar/tratamento farmacológico
20.
Med. infant ; 26(2): 151-155, Junio 2019. Tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-1016473

RESUMO

El Programa Nacional de Cardiopatías Congénitas (PNCC) inició el Proyecto de telemedicina en Cardiopatías Congénitas (CC) en el 2015. Los principales objetivos son promover el asesoramiento para el diagnóstico cardiológico en la patología compleja del niño o del feto, promover el conocimiento de patologías complejas de baja prevalencia para su pesquisa precoz, acompañar el proceso de mejora continua en el diagnóstico de CC en hospitales de referencia provinciales y promover la docencia y la capacitación entre los distintos actores de la red. Las videoconferencias fueron el principal método de contacto. Las provincias que más participaron fueron Buenos Aires, Neuquén y Misiones; el 55% de las consultas correspondieron a pacientes portadores de CC, un 20% a embarazadas con diagnóstico fetal de CC, 14% de arritmias y 11% otros motivos. Se mostraron imágenes de ecocardiografía en la mayoría de las conexiones.En un 35% se modificaron conductas, evitando el traslado de pacientes en un 23%. Conclusión: La telemedicina en CC representa una alternativa que llega de modo más efectivo al médico a través de la consulta y respuesta a distancia, optimizando los diagnósticos y las derivaciones oportunas. Además, difunde el conocimiento entre los centros de baja a los de alta complejidad, disminuye las asimetrías en el diagnóstico para los pacientes del interior del país, evita el traslado innecesario de pacientes y afianza el trabajo en red. Se presenta como un modelo innovador para la réplica hacia otras especialidades.(AU)


In 2015, the Project of Telemedicine for Congenital Heart Defects (CHD) was initiated for the National Program of Congenital Heart Disease (NPCHD). The main aims are to provide counseling for the cardiology diagnosis in complex conditions in the child or the fetus, promote knowledge on complex diseases of low prevalence for early screening, accompany the process of continuous improvement in the diagnosis of CHD at provincial reference hospitals, and encourage teaching and training of the different participants in the network. Videoconferences were the main method of interaction. The provinces that participated the most were Buenos Aires, Neuquen, and Misiones; 55% of the consultations concerned patients with CHD, 20% pregnant women with a prenatal diagnosis of CHD, 14% arrhythmias, and 11% other reasons. Echocardiography images were shown in the majority of the contacts. In 35% behaviors were modified, avoiding the transfer of patients in 23%. Conclusion: In CHD, telemedicine is an alternative that reaches physicians more effectively through outreach consultation and response, optimizing timely diagnosis and referrals. In addition, this modality disseminates knowledge among low-level and high-level centers, reduces asymmetries in diagnosis for patients from the provinces, avoids unnecessary transfer of patients, and strengthens networking. This innovative modality may serve as a model for other specialties. (AU)


Assuntos
Humanos , Gravidez , Recém-Nascido , Lactente , Pré-Escolar , Criança , Planos e Programas de Saúde , Telemedicina/instrumentação , Consulta Remota , Videoconferência/instrumentação , Cardiopatias Congênitas/diagnóstico , Argentina/epidemiologia
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