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Z Psychosom Med Psychother ; 65(3): 288-303, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31476999


Is the influence of religiousness on fearful, depressive and somatic symptoms and psychic traumatization overestimated? A representative cross-sectional study Objectives: The aim of this study is to prove if religious faith, spirituality and religious praxis are joined with lower depression, anxiety and physical pain-level and if subjects with traumatic experiences report more spirituality. Methods: In this consecutive study, 2508 adults of a representative sample in Germany were interviewed about religious faith and spirituality in relation to depression, anxiety, physical disorders as well as traumatic experiences. Results: Unlike our hypotheses people who are charged with mental (PHQ-4; Löwe et al. 2010) or physical disorders (GBB_8; Kliem et al. 2017) report more spirituality and more private religious/spiritual praxis than people without mental or physical problems. As expected people with traumatic experiences in their childhood (CTS; Grabe et al. 2012) describe significantly more spirituality than people without these experiences. Conclusions: Other than expected people with more mental or physical disorders report more spirituality and more private religious/spiritual praxis. It is to discuss if spirituality is less a protective factor for mental or physical disorders than disorders activate to look for spirituality and private religious/spiritual praxis.

Ansiedade/psicologia , Depressão/psicologia , Medo/psicologia , Sintomas Inexplicáveis , Trauma Psicológico/psicologia , Religião e Psicologia , Espiritualidade , Adulto , Ansiedade/epidemiologia , Criança , Estudos Transversais , Depressão/epidemiologia , Alemanha/epidemiologia , Humanos , Entrevistas como Assunto , Trauma Psicológico/epidemiologia
Medicina (B Aires) ; 79(4): 251-256, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31487243


Our objective was to evaluate clinical characteristics, results and morbi-mortality in primary angioplasty (PA), of patients treated with PA within 36 hours of a myocardial infarction (MI), included in a prospective, transversal, multicenter and national survey (ARGEN-IAM-ST). A total of 1142 patients treated with PA were registered, 61.2 ± 12 years old, 88% male, 20% diabetics and 58% with hypertension; 77.6% in Killip Kimball I and 6.2% in cardiogenic shock. The time from the onset of pain until admission was 153 (75-316) minutes, and door-balloon of 91 (60-150) minutes. The transferred patients (17%) showed longer delay to admission, 200 minutes (195-420; p = 0.0001) and door-to-balloon 113.5 minutes (55-207); p = 0.099. In 47.6% of the cases, the PA was made in the anterior descending artery, in 36.4% in the right coronary artery, in 14.8% in the circumflex artery and in 1.2% in the left coronary artery; in 95% with stent (29% pharmacological); 95% was successful, 1.3% presented post-infarct angina (APIAM), 1.3% re-infarct, 8.8% shock and 3.2% bleeding. Age > 64 years (OR 6.2 (95% CI: 3.2-12), p <0.001), diabetes (OR 2.5, 95% CI 1.6-3.9, p < 0.001), re-infarction or APIAM (OR 3.3, 95% CI 1.3-8.3, p = 0.011) and shock (OR 29.2 (15.6-54.8), p < 0.001) were independently associated with higher mortality. In-hospital mortality of acute myocardial infarction with ST-segment elevation treated with PA was 7.6%. Transference from other center was associated with delay in the admission and treatment. Cardiogenic shock and post-infarct ischemia were associated with high mortality. There were no procedural variables associated with mortality.

Angioplastia Coronária com Balão , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Idoso , Angioplastia Coronária com Balão/mortalidade , Argentina , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Infarto do Miocárdio com Supradesnível do Segmento ST/mortalidade , Resultado do Tratamento
J Glob Health ; 9(2): 010412, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31489183


Background: Antimicrobial resistance (AMR) driven by antibiotic consumption is a growing global health threat. However, data on antimicrobial consumption patterns in low- and middle-income countries (LMICs) is sparse. Here, we investigate the patterns of antibiotic sales in humans and livestock in urban Nairobi, Kenya, and evaluate the level of awareness and common behaviours related to antibiotic use and AMR amongst human and veterinary pharmacists. Methods: A total of 40 human and 19 veterinary drug store pharmacists were interviewed in Nairobi in 2018 using a standard questionnaire. Data recorded included demographic variables, types of antibiotics sold, antibiotic customers, antibiotic prescribing practices and knowledge of antibiotic use and AMR. Results: Our study shows that at the retail level, there is a considerable overlap between antibiotic classes (10/15) sold for use in both human and veterinary medicine. Whilst in our study, clinical training significantly influenced knowledge on issues related to antibiotic use and AMR and respondents had a relatively adequate level of knowledge about AMR, several inappropriate prescribing practices were identified. For example, we found that most veterinary and human drug stores (100% and 52% respectively) sold antibiotics without a prescription and noted that customer preference was an important factor when prescribing antibiotics in half of the drug stores. Conclusion: Although more research is needed to understand the drivers of antibiotic consumption in both human and animal populations, these findings highlight the need for immediate strategies to improve prescribing practices across the pharmacists in Nairobi and by extension other low- and middle-income country settings.

Antibacterianos/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Farmacêuticos/psicologia , Adulto , Animais , Estudos Transversais , Resistência Microbiana a Medicamentos , Feminino , Humanos , Prescrição Inadequada/estatística & dados numéricos , Quênia , Masculino , Farmacêuticos/estatística & dados numéricos , Inquéritos e Questionários
Univ. salud ; 21(2): 127-131, mayo-ago. 2019.
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1004850


Resumen Introducción: El índice de masa corporal (IMC) se asocia inversamente a la frecuencia de exacerbaciones en pacientes con enfermedad pulmonar obstructiva crónica (EPOC); sin embargo, esta puede variar según el contexto. Objetivo: Cuantificar la asociación entre el IMC y la frecuencia de exacerbaciones en pacientes en Santa Marta, Colombia. Materiales y métodos: Estudio transversal de adultos con EPOC. Se calculó el IMC y la frecuencia de exacerbaciones se estimó a partir de la clasificación GOLD de estado global. Resultados: Participaron 292 pacientes entre 49 y 95 años; 61,6% eran hombres. Los IMC se observaron entre 12,8 y 40,2 (media=24,2; DE=4,5) distribuidos en 21 pacientes (7,2%) con desnutrición; 153 (52,4%), saludables; y 118 (40,4%), sobrepeso-obesidad. Un total de 146 pacientes (53,4%) se clasificaron GOLD A o B (exacerbaciones no frecuentes); y 136 pacientes (46,6%), GOLD C o D (exacerbaciones frecuentes). El 85,7% de los pacientes con desnutrición presentaron exacerbaciones frecuentes comparado con 51,6% en pacientes con peso saludable y 33,1% en pacientes con sobrepeso-obesidad (OR=0,18; IC95% 0,05-0,66 para peso saludable y OR=0,08; IC95% 0,02-0,29 para sobrepeso-obesidad frente a desnutrición). Conclusiones: El IMC presenta una relación inversa con la frecuencia de exacerbaciones en pacientes con EPOC de Santa Marta, Colombia.

Abstract Introduction: Body mass index (BMI) is inversely related to the exacerbation frequency in patients with chronic obstructive pulmonary disease (COPD). However, this relationship may vary depending on the context. Objective: To quantify the association of BMI with exacerbation frequency in patients from Santa Marta-Colombia. Materials and methods: A cross-sectional study of adults with COPD. We calculated the BMIs, and the exacerbation frequencies were estimated using the Global initiative for Chronic Obstructive Lung Disease (GOLD) classification. Results: 292 patients aged between 49-95 years were included. From those, 180 (61.6%) were male, 153 (52.4%) were healthy, 21 (7.2%) showed malnutrition, and 118 (40.4%) were overweight/obese patients. The observed IMCs were between 12.8 and 40.2 (median=24.2; SD=4.5). Whereas 156 patients (53,4%) were classified as GOLD A or B (infrequent exacerbations), 136 of them (46.6%) were GOLD C of D (frequent exacerbations). 85,7% of the patients with malnutrition showed frequent exacerbations, compared to both patients with healthy weight (51,6%) and overweight/obese patients (33.1%) (OR=0.18; CI95% 0.05-0.66 for healthy weight and OR=0.08; CI95% 0.02-0.29 for overweight/obesity, both compared to patients with malnutrition). Conclusions: BMI is inversely correlated with exacerbation frequency in patients with COPD from Santa Marta-Colombia.

Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Índice de Massa Corporal , Estudos Transversais
Rev. méd. panacea ; 8(2): 58-63, mayo-ago. 2019. tab
Artigo em Espanhol | LILACS | ID: biblio-1015872


Objetivo: Determinar la influencia de la sintomatología depresiva en la adherencia al tratamiento antituberculoso en pacientes del Hospital Santa Maria del Socorro de Ica, (HSMSI), 2018. Materiales y métodos: Estudio de tipo transversal, observacional y analítico. La variable independiente fue el nivel de sintomatología depresiva medida con el Test de depresión de Zung; la variable dependiente fue la adherencia al tratamiento recibido mediante el Test de Morisky- Green, se incluyeron todos los pacientes mayores de 18 años atendidos en la Estrategia Sanitaria de Prevención y Control de Tuberculosis del HSMS registrados en el Libro de seguimiento del año 2018. Resultados: La mediana de edad fue de 30 años, RIQ (21 a 44). El 58,6% de los pacientes fueron hombres; el, 58,6% lleva recibiendo más de tres meses tratamiento, el 10,3% presentaban otras comorbilidades como Diabetes Mellitus y VIH/SIDA; el 17,2% refieren como habito nocivo consumo de alcohol. El grado de sintomatología depresiva leve fue del 37,9%, seguido de un grado moderado y severo con el 34.5% y 10,3% respectivamente. El 65,5% de los pacientes presentaron mala adherencia al tratamiento. Se encontró que conforme aumenta los grados de sintomatología depresiva la probabilidad de no adherencia al tratamiento se incrementa, sin embargo, no existe asociación significativamente estadística tanto en el análisis crudo como en el ajustado por edad y sexo. Conclusiones: Los grados de manifestación de sintomatología depresiva se incrementan con una mala adherencia al tratamiento antituberculoso en los pacientes atendidos en el Hospital Santa María de Socorro de Ica- 2018. (AU)

Objective: To determine if depressive symptomatology influences the adherence to antituberculous treatment in HSMS-Ica patients, 2018. Materials and methods: It is a cross-sectional, observational, analytical and prospective study. The Zung depression test was used to measure the level of depression; while the Morisky-Green Test was used to measure adherence to antituberculous treatment, and the population of patients treated in the Health Strategy for Prevention and Control of Tuberculosis of the HSMS registered in the follow-up book was studied. year 2018, over 18 years. Results: Patients without depressive symptomatology 60% are adhered and 40% are not adherent to antituberculous treatment. Among patients with mild depressive symptoms, the highest percentage is 63.6% and 36.4% adheres to treatment. Patients with moderate depressive symptomatology 70% are not adherent to the treatment and 30% if they are adherent to the treatment. Finally, 100% of patients with severe depressive symptoms are not adherent to the treatment. As the degree of depressive symptomatology increases, the probability of non-adherence to treatment increases, however, there is no statistically significant association in both the crude analysis and that adjusted for age and sex. (p = 0.425). Conclusions: According to the results of the study, depressive symptomatology is associated with poor adherence to antituberculous treatment in patients of Santa Maria de Socorro Hospital in Ica- 2018. (AU)

Humanos , Masculino , Feminino , Tuberculose/terapia , Depressão , Cooperação e Adesão ao Tratamento , Estudos Transversais , Estudos Observacionais como Assunto
Rev. méd. panacea ; 8(2): 64-68, mayo-ago. 2019. tab
Artigo em Espanhol | LILACS | ID: biblio-1015975


Objetivo: Precisar la prevalencia de sobre peso y de obesos en alumnos de la Universidad San Juan Bautista de Ica mayo 2019. Materiales y métodos: Estudio de tipo observacional, transversal retrospectivo y descriptivo sobre una población de 3500 alumnos con una muestra de estudio de 348 alumnos de la Universidad en mención, de cualquier escuela profesional y de cualquier sexo que se encuentre en el rango de edad de 15 a 30 años. Resultados: La prevalencia de sobre peso y obesidad en alumnos de dicha Universidad de Ica en mayo del 2019 es 29%. La frecuencia de Sobre peso grado I es de 17.8%, de Sobre peso grado II es de 8.0% y de Obesidad es de 3.2%. La prevalencia de sobre peso y obesidad es significativamente más frecuente en los alumnos de entre 20 a 30 años (35.2%) en relación a los de 15 a 19 años (22.7%). La prevalencia de sobre peso y obesidad es significativamente más frecuente en los alumnos de sexo masculino (42.7%) en relación a las de sexo femenino (18.7%). Conclusiones: La prevalencia de sobre peso y obesidad en los alumnos de la Universidad San Juan Bautista de Ica en mayo del 2019 es de 29% siendo la edad de 20 a 30 años y el sexo riesgos para el sobre peso y obesidad. (AU)

Objective: To determine the prevalence of overweight and obesity in the students of the San Juan Bautista University, Ica, May 2019. Materials and methods: Observational, retrospective and descriptive cross-sectional study on a population of 3,500 students with a study sample of 348 students of the San Juan Bautista University Ica affiliate of any Professional school and of any sex that is in the age range of 15 to 30 years. Results: The prevalence of overweight and obesity in students of the San Juan Bautista University in Ica in May 2019 is 29%. The frequency of Overweight Grade I is 17.8%, Overweight Grade II is 8.0% and Obesity is 3.2%. The prevalence of overweight and obesity is significantly more frequent in students between 20 and 30 years old (35.2%) in relation to those aged 15 to 19 (22.7%). The prevalence of overweight and obesity is significantly more frequent in male students (42.7%) in relation to female students (18.7%). Conclusions: The prevalence of overweight and obesity in the students of the San Juan Bautista Ica branch school in May 2019 is 29%, with the age of 20 to 30 years and sex risk for overweight and obesity. (AU)

Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Prevalência , Sobrepeso , Obesidade , Epidemiologia Descritiva , Estudos Transversais , Estudos Retrospectivos , Estudo Observacional
Rev. méd. panacea ; 8(2): 69-72, mayo-ago. 2019. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1015988


Objetivo: Determinar el uso de los micronutrientes y grado de anemia en niños menores de 3 años atendidos en un Centro de Salud de Ica 2017. Materiales y métodos: El estudio fue cuantitativo, de tipo descriptivo, y transversal, la muestra estuvo conformada por 40 niños menores de tres años con sus respectivas madres, la técnica que se utilizó fue la observación y el análisis documental. Resultados: En relación a los datos generales de la madre, el 47.5% (19) tienen 19 a 34 años, el 50% (20) tienen instrucción superior, el 40% (16) son solteras y el 57.5% (23) trabaja fuera de casa; sobre los datos del niño, el 55% (22) tienen de 6 a 12 meses, el 72.5% (29) recibió solo lactancia materna hasta los seis meses y el 100% (40) inició la alimentación complementaria a los 6 meses. El uso de micronutrientes es adecuado en el 82.5% (33) de las madres y es inadecuado en el 17.5% (07). Según valores de hemoglobina, el 62.5% (25) de los niños no presentan anemia, el 37.5% (15) presentan anemia leve, no encontrando niños con anemia moderada ni anemia severa. Conclusiones: El uso de micronutrientes que administran las madres a sus niños es adecuado y los niños no presentan anemia en su mayoría, existiendo porcentajes menores de niños con anemia leve por lo que se sugiere que se continúe con el abastecimiento continuo de los micronutrientes realizando campañas educativas a fin de comprometer a las madres en la administración correcta de los micronutrientes en sus menores hijos aprovechando los momentos de contacto con las madres para la educación respectiva en las sala de espera, durante sus controles de inmunizaciones, controles CRED, y realizar un monitoreo periódico del control de hemoglobina. (AU)

Objective: To determine the use of micronutrients and the degree of anemia in children under 3 years of age served in an Ica Health Center 2017. Materials and methods: The study was quantitative, descriptive, and cross-sectional, the sample consisted of 40 children under three years with their respective mothers, the technique used was observation and documentary analysis. Results: In relation to the general data of the mother, 47.5% (19) are 19 to 34 years old, 50% (20) have higher education, 40% (16) are single and 57.5% (23) work ; On the data of the child, 55% (22) have from 6 to 12 months, 72.5% (29) received only breastfeeding until six months and 100% (40) started complementary feeding at 6 months. The use of micronutrients is adequate in 82.5% (33) of mothers and is inadequate in 17.5% (07). According to hemoglobin values, 62.5% (25) of the children do not have anemia, 37.5% (15) have mild anemia, and there are no children with moderate anemia or severe anemia. Conclusions: The use of micronutrients administered by mothers to their children is mostly adequate and children do not have anemia in their majority. There are smaller percentages of children with mild anemia, so it is suggested that continuous supply of the micronutrients conducting educational campaigns in order to engage mothers in the correct administration of micronutrients in their younger children, taking advantage of the moments of contact with mothers for the respective education in the waiting room, during their immunization controls, CRED controls, and perform periodic monitoring of hemoglobin control. (AU)

Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Micronutrientes/uso terapêutico , Anemia , Análise Quantitativa , Epidemiologia Descritiva , Estudos Transversais
Rev. méd. panacea ; 8(2): 73-77, mayo-ago. 2019. tab
Artigo em Espanhol | LILACS | ID: biblio-1016002


Objetivo: Identificar las bacterias presentes en superficies inertes del área de cirugía y conocer su respectiva sensibilidad antibiótica según corresponda. Materiales y métodos: Estudio observacional, descriptivo, transversal, prospectivo. Investigación para identificar microorganismos patógenos en superficies inanimadas del Hospital Regional de Ica. Se procedió a las tomas de muestra humedeciendo el hisopo en el caldo cerebro corazón y luego sembrado en agar sangre 5%, agar Mac Conkey y agar manitol salado, incubándolos durante 24 horas a 37ºC, tinción de Gram, pruebas de catalasa y oxidasa. Se realizó la primera lectura dentro de las 24 horas. Resultados: Estafilococus coagulasa negativo se aislaron en el lavadero, coche de medicación, mesa de comer, coche de curación de cirugía B y mesa de comer. Bacillus sp. se aislaron en pared y mesa de comer de Cirugía General. Staphylococsus aureus se aislaron en coche de medicación y coche de curación. Pseudomonas sp. Se aisló en mesa de comer de Cirugía General. El Staphylococcus aureus es resistente a la mayoría de antibióticos que usualmente se utiliza en el departamento de cirugía general del Hospital Regional de Ica. La Psudomona Sp. es resistente a antibióticos que usualmente se utiliza en el servicio de cirugía general, aunque es sensible a algunos antibióticos utilizados en este servicio. Conclusiones: Se encontraron gérmenes en superficies inanimadas que están en intimo contacto con pacientes del departamento de cirugía del Hospital Regional de Ica que pone en riesgo a contraer infecciones intrahospitalarias. El Staphylococcus aureus presenta mayor resistencia antibiótica que la Pseudomona Sp. (AU)

Objective: To identify the bacteria present in inert surfaces of the surgery area and to know their respective antibiotic sensitivity as appropriate. Materials and methods: Observational, descriptive, cross-sectional, prospective study. Research to identify pathogenic microorganisms on inanimate surfaces of the Regional Hospital of Ica. The samples were taken by moistening the swab in the brain heart broth and then seeded on 5% blood agar, Mac Conkey agar and salted mannitol agar, incubating them for 24 hours at 37 ° C, Gram stain, catalase and oxidase tests. The first reading was made within 24 hours. Results: Staphylococcus coagulase negative were isolated in the laundry, medication car, eating table, surgery B healing car and eating table. Bacillus sp. They were isolated in the wall and table of eating of General Surgery. Staphylococcus aureus were isolated in medication car and healing car. Pseudomonas sp. It was isolated on a General Surgery table. Staphylococcus aureus is resistant to most antibiotics that is usually used in the general surgery service of the Regional Hospital of Ica. And Psudomona Sp. Is resistant to antibiotics that is usually used in the general surgery service, although it is sensitive to some antibiotics used in this service. Conclusions: Germs were found on inanimate surfaces that are in intimate contact with patients of the surgical departament of the Regional Hospital of Ica, which puts them at risk of contracting nosocomial infections. Staphylococcus aureus has greater antibiotic resistance than Pseudomona Sp. (AU)

Humanos , Salas Cirúrgicas , Bactérias , Análise Bacteriológica , Antibioticoprofilaxia , Epidemiologia Descritiva , Estudos Transversais , Estudos Prospectivos , Estudo Observacional
Mem. Inst. Invest. Cienc. Salud (Impr.) ; 17(2): 6-15, ago. 2019. tab, ilus
Artigo em Espanhol | LILACS, BDNPAR | ID: biblio-1008344


Este trabajo quiere contribuir con otra perspectiva a la solución del problema del Dengue en México. El objetivo fue determinar tipos de criadero de Aedes aegypti, condiciones de la vivienda e identificar dimensiones que determinen la enfermedad con enfoque integral social en la colonia centro de Mazatepec, Morelos. El estudio es de corte transversal descriptivo, se llevó a cabo en temporada de sequía (2015), se realizó colecta entomológica para identificar criaderos del vector, aplicación de Índice de Condición de Vivienda (ICV) y cuestionario con perspectiva de la Determinación Social de la Salud a 80 casas. Se detectaron 3,221 recipientes sin agua y 655 con agua, 25.34% tratables (tanques, tinacos), 9.46% controlables (botes y cubetas) y 4.7% diversos chicos, el ICV identificó 14 casas positivas (57.69%-tratables), 47.5% de medio riesgo para crecimiento del vector, el 83.3% atribuyó el problema a condiciones de vida y posesión de recursos, 40.83% responsabilizó a la comunidad, falta de interés y mala organización. Las estrategias y políticas en salud deben de tomar en cuenta la perspectiva social y análisis de las comunidades, mejorar las condiciones de vivienda, trabajo y organización comunitaria para preservar la salud(AU)

This work aims to contribute to the solution to the dengue problem in Mexico with a different approach. The objectives of the research were to determine the types of hatcheries for Aedes aegypti and housing conditions, as well as to identify the dimensions that determine the disease with an integral social approach in the Colonia Centro of Mazatepec, Morelos, Mexico. This is a descriptive cross-sectional studycarried out during the dry season in 2015, an entomological collection was made to identify the vector hatcheries, the Housing Condition Index (HCI) and a questionnaire were applied to establish the Social Determinants of Health for 80 houses. A total of 3,221 containers without water and 655 with water were detected, out of these 25.34% were tagged as manageable (water tanks), 9.46% as controllable (buckets and cans) and 4.7% as various small items. The HCI identified 14 positive houses (57.69% as manageable), 47.5% as medium risk for the development of the vector. Eighty three point three percent of the questionnaire participants attributed the problem to life conditions and resources property, 40.83% to the community, the lack of interest and disorganization as responsible. Health strategies and policies must take into account the social approach and analysis of the communities, improving housing, work and community organization conditions to preserve health(AU)

Animais , Dengue , Determinantes Sociais da Saúde , Epidemiologia , Estudos Transversais
Bone Joint J ; 101-B(8): 941-950, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31362549


AIMS: The EuroQol five-dimension (EQ-5D) questionnaire is a widely used multiattribute general health questionnaire where an EQ-5D < 0 defines a state 'worse than death' (WTD). The aim of this study was to determine the proportion of patients awaiting total hip arthroplasty (THA) or total knee arthroplasty (TKA) in a health state WTD and to identify associations with this state. Secondary aims were to examine the effect of WTD status on one-year outcomes. PATIENTS AND METHODS: A cross-sectional analysis of 2073 patients undergoing 2073 THAs (mean age 67.4 years (sd 11.6; 14 to 95); mean body mass index (BMI) 28.5 kg/m2 (sd 5.7; 15 to 72); 1253 female (60%)) and 2168 patients undergoing 2168 TKAs (mean age 69.3 years (sd 9.6; 22 to 91); BMI 30.8 kg/m2 (sd 5.8; 13 to 57); 1244 female (57%)) were recorded. Univariate analysis was used to identify variables associated with an EQ-5D score < 0: age, BMI, sex, deprivation quintile, comorbidities, and joint-specific function measured using the Oxford Hip Score (OHS) or Oxford Knee Score (OKS). Multivariate logistic regression was performed. EQ-5D and OHS/OKS were repeated one year following surgery in 1555 THAs and 1700 TKAs. RESULTS: Preoperatively, 391 THA patients (19%) and 263 TKA patients (12%) were WTD. Multivariate analysis identified preoperative OHS, deprivation, and chronic obstructive pulmonary disease in THA, and OKS, peripheral arterial disease, and inflammatory arthropathy in TKA as independently associated with WTD status (p < 0.05). One year following arthroplasty EQ-5D scores improved significantly (p < 0.001) and WTD rates reduced to 35 (2%) following THA and 53 (3%) following TKA. Patients who were WTD preoperatively achieved significantly (p < 0.001) worse joint-specific Oxford scores and satisfaction rates one year following joint arthroplasty, compared with those not WTD preoperatively. CONCLUSION: In total, 19% of patients awaiting THA and 12% awaiting TKA for degenerative joint disease are in a health state WTD. Although specific comorbidities contribute to this, hip- or knee-specific function, mainly pain, appear key determinants and can be reliably reversed with an arthroplasty. Cite this article: Bone Joint J 2019;101-B:941-950.

Artroplastia de Quadril/psicologia , Artroplastia do Joelho/psicologia , Indicadores Básicos de Saúde , Osteoartrite do Quadril/psicologia , Osteoartrite do Joelho/psicologia , Qualidade de Vida/psicologia , Listas de Espera , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Osteoartrite do Quadril/cirurgia , Osteoartrite do Joelho/cirurgia , Satisfação do Paciente , Resultado do Tratamento , Adulto Jovem
Pan Afr Med J ; 33: 27, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384342


Introduction: In Nigeria, approximately 4.33 million adults suffer from hypertension and about a third of them do not adhere to prescribed medications. Depression has been reported to significantly predict poor medication adherence. The relationship between medication non-adherence and co-morbid depressive disorder in patients with hypertension has not been adequately explored in this environment. The study aimed to determine the prevalence of depression in patients with hypertension. The association between socio-demographic characteristics and presence of co-morbidity on medication adherence was also determined. Methods: A cross-sectional descriptive research design was adopted for the study. A socio-demographic questionnaire, the modified Morisky Medication Adherence Scale (MMAS), the Hamilton Rating Scale for Depression (HAM-D) and the Mini International Neuropsychiatric Interview (MINI), were administered to four hundred patients with hypertension attending medical out-patient clinic between August and September 2012. Results: About 43% (168) were aged 61 to 64 years the majority being females, with a female to male ratio of 1.63:1. The prevalence of comorbid depression was 22.8%, made up of mild (21.8%) and moderate (1.0%) depressive episodes only. Depression was commoner among females than males in a ratio of 3:1. A majority of the participants (96.8%) had high medication adherence; 2.8% and 0.4% had moderate and low adherence respectively. Depression was more among patients with good medication adherence. Conclusion: The occurrence of mild depressive disorder among hypertensives did not affect the level of medication adherence. Review of Antihypertensive drugs should also be done often to ensure patients are not likely to have depressive illness as a side effect of drugs used.

Anti-Hipertensivos/administração & dosagem , Depressão/epidemiologia , Hipertensão/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Adulto , Anti-Hipertensivos/efeitos adversos , Estudos Transversais , Depressão/diagnóstico , Feminino , Humanos , Hipertensão/psicologia , Masculino , Pessoa de Meia-Idade , Nigéria , Escalas de Graduação Psiquiátrica , Índice de Gravidade de Doença , Fatores Sexuais , Inquéritos e Questionários , Centros de Atenção Terciária , Adulto Jovem
Pan Afr Med J ; 33: 28, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31384343


Poor compliance with therapy is frequently encountered in most of patients with chronic diseases. It increases the risk of morbi-mortality and healthcare costs. Patients on chronic haemodialysis often have poor compliance with treatment. This study aims to assess the level of compliance with treatment in our patients on chronic hemodialysis and to identify the predictive factors of poor compliance with treatment. We conducted a cross-sectional study at the Oujda Hospital in November 2011. The compliance with treatment was measured using a questionnaire: the compliance evaluation test (CET) assessed the compliance with medication treatment and diet. A rate of 85% was retained arbitrarily as a threshold for good compliance with treatment. Patient in a zone of partial adherence had a rate between 57% and 85% while a lower rate (57%) indicated poor compliance with treatment. Different demographic and clinicobiologic parameters were analyzed and predictive factors for good and poor compliance with treatment were identified. Our study involved 101 patients on chronic haemodialysis; the sex ratio was 1.2, the average age of patients was 15.6 years. CET showed that 23.4% of patients had good compliance with treatment, 39.4% partial compliance with treatment and 37.2% poor compliance with treatment. Statistical analysis showed that poor compliance with treatment was associated with a lower socio-economic and intellectual status, with co-morbidities and with long term hemodialysis. Good compliance with treatment was observed in very old patients helped by a third person, taking a reduced number of medications, with a higher intellectual level.

Dieta/normas , Adesão à Medicação/estatística & dados numéricos , Cooperação do Paciente/estatística & dados numéricos , Diálise Renal/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
Pan Afr Med J ; 33: 30, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384345


Introduction: In Ghana, there is no data regarding physical activity habits and lipid profiles of students. Therefore, the aim of this study was to investigate the relationship between physical activities, Body Mass Index (BMI) and lipid profile of students in Ghana. Methods: Cluster and systematic sampling techniques were employed to recruit 120 students, aged 18 years and above. This cross-sectional study was carried out among students from the University of Ghana. Biochemical analysis was conducted analysing total cholesterol (TC), high density lipoprotein (HDL), low density lipoprotein (LDL) and triglycerides (TG) in serum samples. Anthropometry measurements were also taken and BMI calculated. The physical activities, undertaken over a 7-day period, by the students were assessed using the International Physical Activity Questionnaire (IPAQ). Results: 31.7% and 21.7% of the students were overweight and obese respectively. 61.5% of the obese students were engaged in high level physical activity as compared to 45.5% and 36.8% of the normal and overweight students, respectively. Normal weight students and overweight students showed significant differences in means of TC; [(4.56 ± 0.930 mmol/L) and (5.06 ± 0.93 mmol/L), respectively] and also between normal weight group (4.54 ± 0.93 mmol/L) and the obese students (5.24 ± 1.18 mmol/L). Significant correlations were also observed between TG, TC and BMI; and TC and TG, HDL and a strong correlation between LDL and TC (r=0.967). Conclusion: Strong correlations between BMI, physical activity and lipid profile indices among students in Ghana. Comprehensive efforts should be applied to reduce the incidence of CVDs among students.

Índice de Massa Corporal , Exercício/fisiologia , Lipídeos/sangue , Estudantes/estatística & dados numéricos , Adolescente , Adulto , Peso Corporal/fisiologia , Doenças Cardiovasculares/prevenção & controle , Análise por Conglomerados , Estudos Transversais , Feminino , Gana , Humanos , Masculino , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Universidades , Adulto Jovem
Pan Afr Med J ; 33: 32, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384347


Introduction: Antiretroviral therapy (ART) is vital for people living with HIV (PLWHIV) and a substantial number of HIV/AIDS patients still face stigmatization from family and other members of the community. Stigma could lead to poor retention in HIV care and consequently result in decreased chances of survival and increased risk of HIV transmission. The aim of this study was to determine the retention of patients in HIV care and community participation in the retention of patients in HIV care at the Muyuka Health District, South-West Region, Cameroon. Methods: This was an analytic cross-sectional retrospective study where 385 hospital records of people living with HIV (PLWHIV) enrolled in HIV care were reviewed, and we administered 348 questionnaires to community members. Data were collected and analysed using bivariate analysis and chi-square test. The Susan Rifkin's scoring method was used to measure community participation. Statistical significance was set at P-value < 0.05. Results: A total number of 112(29.1%) of people living with HIV (PLWHIV) enrolled in HIV care were retained in HIV care against 273(70.9%), who were lost to follow-up over a two year and four months period. Patients on a Zidovudine containing ART regimen were about 7 times more likely to be lost to follow-up (OR 6.92; 95% CI 1.80-26.60, P-value = 0.005). The overall community participation in the retention of adults in HIV care in the Muyuka Health District was low; mean resource allocation score = 2.43, mean leadership score = 1.0; mean organization factor score = 1.30; but the mean needs assessment score was good (4.0). Conclusion: retention of patients enrolled in HIV care, and the community participation in the retention were low. Collaborations between health care structures and community initiatives should be resourced to foster continuum of care for people living with HIV (PLWHIV).

Fármacos Anti-HIV/administração & dosagem , Participação da Comunidade/estatística & dados numéricos , Infecções por HIV/tratamento farmacológico , Estereotipagem , Adulto , Camarões , Estudos Transversais , Feminino , Infecções por HIV/psicologia , Humanos , Perda de Seguimento , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estigma Social , Inquéritos e Questionários , Adulto Jovem
Pan Afr Med J ; 33: 34, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384349


Introduction: A cross-sectional study was conducted between the months of April to October 2015, to determine the effects of intestinal parasitic infections (IPIs) on nutritional status of school age children in Owerri and Orlu geographical zones, in Imo State, Nigeria. Methods: Faecal samples were examined using Kato Katz method and formol-ether concentration techniques, while blood samples were examined using cyamethahaemoglobin method. Anthropometric indices were used as indicators of nutritional status, children whose Height-for-Age, Weight-for-Age and Weight-for-Height were <-2 standard deviation (SD) were classified as stunted, wasted, and underweight respectively. Results: Total prevalence rate of 16.6% was recorded in the study areas with Ascaris lumbricoides (4.0%), Trichuris trichiura (0.6%), Hookworm (1.0%) Taenia sp (0.3%), Entaomeba histolytica (5.3%), Entamoeba coli (2.7%) and Giardia lambia (2.7) Majority (73.4%) of the children had light intensity. Anthropometric study results showed that 79(31.3%) of the children were malnourished. The prevalence of stunting, under-weight and wasting were higher in uninfected (86.1%, 90.0% and 10%) respectively than in infected children (13.9%, 10.0% and 0.0%) respectively, although not significant at p = 0.857, 0.587 and 0.368 respectively. Prevalence of anaemia was 17.4%, anaemia was insignificantly (p = 0.09) higher in infected (21.1%) than in uninfected (16.5%) children. Children that had co-infection recorded higher prevalence (2.2%) of severe anaemia. There was an association (p = 0.002) between anaemia and intensity of helminth infection. Malnutrition was insignificantly (p = 0.319) higher in children with heavy (100.0%) and moderate (75.0%) intensity of helminth infection than children that had light intensity (41.7%) of helminth infection. Conclusion: When compared with previous study, there were decline in the prevalence of intestinal parasitic infections and anaemia among school age children. Low intensity parasitemia with intestinal parasites had no significant effect on the malnutrition and haemoglobin profile of the children in the study areas. Therefore, improved sanitation and more deworming efforts should be intensified to ensure further decline in prevalence of intestinal parasitic infections.

Anemia/epidemiologia , Transtornos da Nutrição Infantil/epidemiologia , Enteropatias Parasitárias/epidemiologia , Estado Nutricional , Adolescente , Anemia/parasitologia , Criança , Transtornos da Nutrição Infantil/parasitologia , Pré-Escolar , Estudos Transversais , Fezes/parasitologia , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/parasitologia , Humanos , Enteropatias Parasitárias/complicações , Enteropatias Parasitárias/parasitologia , Nigéria/epidemiologia , Prevalência , Magreza/epidemiologia , Magreza/parasitologia , Síndrome de Emaciação/epidemiologia , Síndrome de Emaciação/parasitologia
Pan Afr Med J ; 33: 35, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384350


Introduction: Spontaneous bacterial peritonitis (SBP) is one of the most common and life-threatening complications of patients with cirrhotic ascites. Recognition and prompt treatment of this condition is essential to prevent serious morbidity and mortality. This study aimed to determine the prevalence of SBP among in-patients with cirrhotic ascites attending our facility and to determine the clinical and laboratory parameters associated with SBP. Methods: A cross-sectional study was conducted involving one hundred and three (103) patients admitted at medical block in the Korle-Bu Teaching Hospital (KBTH) with cirrhotic ascites from 25th March, 2016 to 25th November, 2016. Demographic and clinical data were collected using a standardized questionnaire. Ascitic fluid culture and cell count were conducted. Positive ascitic fluid culture and/or ascitic polymorphonuclear leukocyte ≥ 250cells/mm3 were diagnostic for SBP. Results: Of the 103 patients with cirrhotic ascites, the mean age was 43.5 ± 12.2 years. There were fifty eight (58) male patients. The prevalence of SBP was 25.24% (26/103). Majority, 5 (55.6%) of the bacteria isolated from ascitic fluid with SBP was Escherichia coli. Severe ascites and high INR were found to be independent predictors of SBP. Conclusion: SBP is common among patients with cirrhotic ascites admitted at KBTH. Severe ascites and high INR were highly suggestive of SBP. Diagnostic paracentesis should be done immediately on admission to confirm the diagnosis irrespective of the clinical characteristics as part of baseline investigation.

Ascite/epidemiologia , Infecções Bacterianas/epidemiologia , Cirrose Hepática/complicações , Peritonite/epidemiologia , Adolescente , Adulto , Idoso , Ascite/microbiologia , Líquido Ascítico/microbiologia , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/microbiologia , Estudos Transversais , Feminino , Gana/epidemiologia , Hospitais de Ensino , Humanos , Masculino , Pessoa de Meia-Idade , Peritonite/diagnóstico , Peritonite/microbiologia , Prevalência , Adulto Jovem
Pan Afr Med J ; 33: 38, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384353


Introduction: Cervical cancer is a malignant proliferation of the cells of the uterine cervix and can be treated if diagnosed earlier. It is the second most common gynecological malignancy worldwide and the leading cause of cancer associated mortality among women in Africa and Cameroon. This study sort to determine the current state of knowledge of cervical cancer and its risk factors in the Buea Health District of the South West Region of Cameroon. Methods: This was a cross-sectional community based survey. We recruited 433 eligible women, in four (4) Health Areas (Molyko, Bolifamba, Muea and Buea Town) of the Buea Health District and used validated and pre-tested questionnaires to collect data. Collected data were keyed into Epi info version 7.2 statistical software and exported to SPSS Version 25 for analysis. Level of significance was set at P-value < 0.05. Results: Fifty eight percent (58%) of the participants had good knowledge of cervical cancer. 58.99% (95%CI = 54.30-63.52) had good knowledge on the risk factors of cervical cancer. 40% knew at least one of the following risk factors; cigarette smoking, many sexual partners, family history of cervical cancer, being HIV/AIDS positive and giving birth 5 or more times. There was a significant association, OR = 7.5; 95%CI = 2.14-26.33; P = 0.001; X2 = 11.4 between having heard of cervical cancer and having "good" knowledge of cervical cancer among women in Buea. Conclusion: Most of the women had heard of cervical cancer but the knowledge of the risk factors of cervical cancer among women aged 18-68 years in the Buea Health District is low. We found no association between awareness and knowledge of risk factors among the women.

Conhecimentos, Atitudes e Prática em Saúde , Neoplasias do Colo do Útero/etiologia , Adolescente , Adulto , Idoso , Camarões , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários , Neoplasias do Colo do Útero/patologia , Adulto Jovem
Pan Afr Med J ; 33: 42, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384357


Introduction: We investigated an outbreak of influenza-like illness (ILI) at a boarding school in Eastern Cape Province, South Africa. We aimed to confirm the etiological agent, estimate attack rates and identify risk factors for illness. Methods: We conducted a retrospective cohort study including senior school boarders (n=308). Students with ILI (cough and fever) were identified through school medical records. We also conducted a questionnaire-based cross-sectional study among senior students including boarders (n=107) and day students (n=45). We collected respiratory specimens for respiratory pathogen testing by real-time polymerase chain reaction from a subset of symptomatic students. We calculated attack rates of medically attended ILI (medILI) and identified factors associated with medILI using logistic regression. We calculated seasonal influenza vaccine effectiveness (VE) against medILI. Results: Influenza A (H3N2) virus was detected in 61% (23/38) of specimens. Attack rate for medILI was 13% among boarders (39/308) in the cohort study and 20% in both day students (9/45) and boarders (21/107) in the cross-sectional study. Playing squash was associated with medILI (aOR 5.35, 95% confidence interval [95% CI]: 1.68-17.07). Of the boarders, 19% (57/308) were vaccinated before the outbreak. The adjusted VE against medILI was 18% (aOR 0.82, 95% CI 0.38-1.78). The outbreak led to cancellation of several events and the need for academic remedial sessions. Conclusion: We confirmed an influenza A (H3N2) virus outbreak with a high attack rate. The outbreak affected academic and sports activities. Participation in sports and social gatherings while experiencing ILI should be discouraged to reduce viral transmission and impact on school activities.

Surtos de Doenças , Vírus da Influenza A Subtipo H3N2/isolamento & purificação , Vacinas contra Influenza/administração & dosagem , Influenza Humana/epidemiologia , Adolescente , Criança , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Influenza Humana/virologia , Masculino , Estudos Retrospectivos , Fatores de Risco , Instituições Acadêmicas , África do Sul/epidemiologia , Estudantes , Adulto Jovem
BMC Ophthalmol ; 19(1): 184, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412800


BACKGROUND: With the diabetes mellitus (DM) prevalence increasing annually, the human grading of retinal images to evaluate DR has posed a substantial burden worldwide. SmartEye is a recently developed fundus image processing and analysis system with lesion quantification function for DR screening. It is sensitive to the lesion area and can automatically identify the lesion position and size. We reported the diabetic retinopathy (DR) grading results of SmartEye versus ophthalmologists in analyzing images captured with non-mydriatic fundus cameras in community healthcare centers, as well as DR lesion quantitative analysis results on different disease stages. METHODS: This is a cross-sectional study. All the fundus images were collected from the Shanghai Diabetic Eye Study in Diabetics (SDES) program from Apr 2016 to Aug 2017. 19,904 fundus images were acquired from 6013 diabetic patients. The grading results of ophthalmologists and SmartEye are compared. Lesion quantification of several images at different DR stages is also presented. RESULTS: The sensitivity for diagnosing no DR, mild NPDR (non-proliferative diabetic retinopathy), moderate NPDR, severe NPDR, PDR (proliferative diabetic retinopathy) are 86.19, 83.18, 88.64, 89.59, and 85.02%. The specificity are 63.07, 70.96, 64.16, 70.38, and 74.79%, respectively. The AUC are PDR, 0.80 (0.79, 0.81); severe NPDR, 0.80 (0.79, 0.80); moderate NPDR, 0.77 (0.76, 0.77); and mild NPDR, 0.78 (0.77, 0.79). Lesion quantification results showed that the total hemorrhage area, maximum hemorrhage area, total exudation area, and maximum exudation area increase with DR severity. CONCLUSIONS: SmartEye has a high diagnostic accuracy in DR screening program using non-mydriatic fundus cameras. SmartEye quantitative analysis may be an innovative and promising method of DR diagnosis and grading.

Retinopatia Diabética/diagnóstico , Angiofluoresceinografia/métodos , Processamento de Imagem Assistida por Computador/métodos , Retina/diagnóstico por imagem , Seleção Visual/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Adulto Jovem