RESUMO
Introducción: La calidad de vida relacionada con la salud (CVRS) y los estados de ánimo son indicadores cruciales del bienestar en adolescentes, pero su relación con estudiantes de Antioquia, Colombia, no ha sido ampliamente estudiada. Objetivo: Determinar la CVRS y los estados de ánimo en escolares de Antioquia-Colombia. Materiales y métodos: Estudio transversal con 1957 escolares de 9 a 20 años. Se aplicaron mediciones de CVRS, ansiedad, depresión, hostilidad y alegría, actividad física, comportamiento sedentario, apoyo social de padres y nivel socioeconómico. Resultados: La calidad de vida alta (CVA) es más elevada en hombres, personas con alegría, estudiantes con apoyo de padres, activos físicamente y personas de nivel socioeconómico alto y medio. AL aumentar un año de edad, disminuye en un 15 % la CVA, y al aumentar la depresión, la ansiedad y el comportamiento sedentario disminuye la CVA. Además, los niveles de depresión y ansiedad son mayores en mujeres, estudiantes mayores, sin apoyo de los padres y personas sedentarias. Conclusiones: La CVRS se asocia con estados de ánimo, actividad física, comportamiento sedentario y apoyo de los padres; mientras que los estados de ánimo se asocian con el sexo, el apoyo de los padres, la CVS y el sedentarismo.
Introduction: Even though health-related quality of life (HRQL) and mood states are key indicators of the well-being of adolescents, their relationship has not been analyzed in students from Antioquia, Colombia. Objective: To determine HRQL and mood states in schoolchildren from Antioquia. Materials and methods: A cross-sectional study was conducted on 1,957 schoolchildren and adolescents aged between 9 and 20 years. Measurements of HRQL, anxiety, depression, hostility and happiness, physical activity, sedentary behavior, parental social support, and socioeconomic status were applied. Results: A high quality of life (HQL) was observed more frequently in male participants, students with parental support, physically active, and those belonging to medium and high socioeconomic status. HQL decreased 15% as their age increased by one year. Also, HQL was reduced when depression, anxiety, and sedentary behavior increased. Furthermore, depression and anxiety levels were higher in women, older students, as well as in those without parental control and with sedentary behavior. Conclusions: HRQL is associated with mood states, physical activity, sedentary behavior, and parental support. In contrast, mood states are related to gender, parental support, HQL, and sedentary lifestyle.
Introdução: A qualidade de vida relacionada à saúde (CVRS) e os estados de humor são indicadores cruciais de bem-estar em adolescentes, mas sua relação com estudantes de Antioquia, Colômbia, não foi amplamente estudada. Objetivo: Determinar a CVRS e os estados de humor em escolares de Antioquia-Colômbia. Materiais e métodos: Estudo transversal com 1.957 escolares de 9 a 20 anos. Foram aplicadas medidas de QVRS, ansiedade, depressão, hostilidade e felicidade, atividade física, comportamento sedentário, apoio social dos pais e nível socioeconômico. Resultados: A alta qualidade de vida (CVA) é maior em homens, pessoas com alegria, estudantes com apoio parental, fisicamente ativos e pessoas de nível socioeconômico alto e médio. À medida que a idade aumenta em um ano, diminui em 15% o CVA, e ao aumentar a depressão, a ansiedade e o comportamento sedentário aumentam, o CVA diminui. Além disso, os níveis de depressão e ansiedade são mais elevados nas mulheres, nos estudantes mais velhos, sem apoio dos pais e nas pessoas sedentárias. Conclusões: A QVRS está associada a estados de humor, atividade física, comportamento sedentário e apoio parental; enquanto os estados de humor estão associados ao sexo, apoio parental, CVS e estilo de vida sedentário.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Saúde , Emoções , Felicidade , HostilidadeRESUMO
The study of firearm violence in Mexico has primarily focused on homicides and trafficking. Less attention has been given to understanding how firearms affect other crimes and facilitate criminal activity beyond drug markets. By analyzing two questions, this study explores the role of firearms in extortions perpetrated in Mexico from 2012 to 2021. Questions are: What is the likelihood of reporting extortions to the police if offenders exhibited firearms? What is the likelihood of compliance with demands when offenders are armed with firearms? We obtained data from Mexico's National Crime Victimization Surveys and analyzed 2,619 extortions reported from 2012 to 2021. To explore our research questions, we ran two binary logistic regressions. Our dependent variables were dichotomous (reported to police = 1, complied with demands = 1). The independent variables were weapon types (extortions involving firearms as the reference group). We controlled for victim demographics as well as crime characteristics. Our results indicate that 40% of these extortions (n = 1,058) were perpetrated with a firearm. Fifty-two percent of extortions were perpetrated by unarmed offenders (n = 1,348) and 8% (n = 213) were perpetrated with other weapons (no firearms). Models suggest that, when compared to extortions perpetrated by unarmed offenders or those exhibiting other weapons (no firearms), victims of extortions involving firearms are less likely to report these crimes to police, mainly because of fear of reprisal. Similarly, victims are more likely to comply with demands if offenders exhibit firearms. Findings highlight the role of firearms in criminal enterprises and support the need for a comprehensive policy agenda to address firearm violence in Mexico.
Assuntos
Vítimas de Crime , Armas de Fogo , Humanos , Armas de Fogo/estatística & dados numéricos , Armas de Fogo/legislação & jurisprudência , Masculino , Feminino , México , Adulto , Vítimas de Crime/estatística & dados numéricos , Pessoa de Meia-Idade , Adulto Jovem , Adolescente , Criminosos/estatística & dados numéricos , Violência/estatística & dados numéricos , Violência com Arma de Fogo/estatística & dados numéricos , Crime/estatística & dados numéricosAssuntos
Humanos , Feminino , Adolescente , Adulto , Adulto Jovem , Sistema Único de Saúde , Dispositivos Intrauterinos , Saúde Pública , AnticoncepçãoRESUMO
La evaluación de la marcha en cinta caminadora puede resultar relevante para la toma de decisiones clínicas. No obstante, factores demográficos como la edad y el IMC pueden alterar la interpretación de los resultados. Nuestro objetivo fue obtener variables espacio- temporales, energéticas y costo de transporte durante la velocidad autoseleccionada en cinta caminadora para una muestra representativa de adultos uruguayos (n=28) y evaluar si diferentes rangos de edades e IMC pueden ser factores a tener en cuenta en pruebas clínicas donde se consideren dichas variables. Participaron 17 hombres y 11 mujeres (39,3 ± 14,8 años, 75,9 ± 12,5 kg, 1,74 ± 0,09 m, IMC 25,2 ± 4,06). Se realizó una reconstrucción 3D del movimiento en forma sincronizada con el consumo energético. Se obtuvieron valores de referencia y luego de agrupar los participantes según su IMC y rango de edad se compararon los datos mediante test de t (p≤0.05). Los resultados revelaron discrepancias significativas en las medidas espacio-temporales y energéticas de los adultos uruguayos al caminar en cinta con respecto a la literatura. La marcha difiere entre adultos jóvenes y de mediana edad en su velocidad autoseleccionada (p=0,03), longitud de zancada (p=0,01), trabajo mecánico externo (<0,001) y recuperación de energía mecánica (0,009), destacando la importancia de considerar la edad en evaluaciones clínicas. El IMC no influyó significativamente en estas variables. Estos hallazgos subrayan la necesidad de ajustar las interpretaciones de las pruebas clínicas de la marcha sobre cinta caminadora en adultos uruguayos de mediana edad (45 a 65 años).
Treadmill gait assessment can be relevant for clinical decision-making. However, demographic factors such as age and BMI may alter result interpretation. Our aim was to obtain spatiotemporal, energetic, and cost of transport variables during self-selected treadmill walking speed for a representative sample of Uruguayan adults (n=28) and to assess if different age ranges and BMI could be factors to consider in clinical tests involving these variables. Seventeen men and eleven women participated (39.3 ± 14.8 years, 75.9 ± 12.5 kg, 1.74 ± 0.09 m, BMI 25.2 ± 4.06). A synchronized 3D motion reconstruction was performed with energy consumption. Reference values were obtained and data were compared using t-tests (p≤0.05), after grouping participants by BMI and age range. Results revealed significant discrepancies in spatiotemporal and energetic measures of Uruguayan adults walking on the treadmill, compared to the literature. Gait differed between young and middle-aged adults in their self-selected speed (p=0.03), stride length (p=0.01), external mechanical work (p<0.001), and mechanical energy recovery (0.009), emphasizing the importance of considering age in clinical evaluations. BMI did not significantly influence these variables. These findings underscore the need to adjust interpretations of treadmill gait clinical tests in middle-aged Uruguayan adults (45 to 65 years).
A avaliação da marcha na esteira pode ser relevante para a tomada de decisões clínicas. No entanto, fatores demográficos como idade e IMC podem alterar a interpretação dos resultados. Nosso objetivo foi obter variáveis espaço-temporais, energéticas e custo de transporte durante a velocidade de caminhada autoselecionada na esteira para uma amostra representativa de adultos uruguaios (n = 28) e avaliar se diferentes faixas etárias e IMC podem ser fatores a serem considerados em testes clínicos que envolvam essas variáveis. Dezessete homens e onze mulheres participaram (39,3 ± 14,8 anos, 75,9 ± 12,5 kg, 1,74 ± 0,09 m, IMC 25,2 ± 4,06). Foi realizada uma reconstrução tridimensional do movimento sincronizada com o consumo de energia. Foram obtidos valores de referência e os dados foram comparados usando testes t (p≤0,05), após agrupar os participantes por IMC e faixa etária. Os resultados revelaram discrepâncias significativas nas medidas espaço-temporais e energéticas dos adultos uruguaios ao caminhar na esteira, em comparação com a literatura. A marcha diferiu entre adultos jovens e de meia-idade em sua velocidade autoselecionada (p=0,03), comprimento da passada (p=0,01), trabalho mecânico externo (<0,001) e recuperação de energia mecânica (0,009), destacando a importância de considerar a idade em avaliações clínicas. O IMC não influenciou significativamente essas variáveis. Esses achados destacam a necessidade de ajustar as interpretações dos testes clínicos de marcha na esteira em adultos uruguaios de meia- idade (45 a 65 anos).
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Composição Corporal/fisiologia , Caminhada/fisiologia , Teste de Esforço/estatística & dados numéricos , Índice de Massa Corporal , Distribuição por IdadeRESUMO
Colombia is among the countries with the most robust financial protection against personal health spending in the world, with out-of-pocket spending ranking lowest across OECD countries. We investigate the evolution, distribution, and persistence of health spending by age group, sex, health care setting, health condition and geographic region for over 19 million users of Colombia's health system between 2013 and 2021 (contributory scheme). We use average patient-level expenditure data from the Health-Promoting Entities of the Ministry of Health and Social Protection. We applied multivariate statistical techniques such as multiple correspondence analysis, factor maps and correlations. For both sexes, average health expenditure increases gradually with age until 60 years, accelerating thereafter abruptly. Health conditions with the highest percentage of expenditure were those related to neoplasms, blood diseases, circulatory system, pregnancy, puerperium and perinatal period. We found that home-based care in Amazonía-Orinoquía is almost non-existent, and that outpatient care represents a high proportion in all age groups (over 65%) compared to the other regions. There is a strong persistence of expenditure from one year to the next (i.e. they can provide relevant information for prediction), especially in areas with a larger supply of health services such as Bogotá-Cundinamarca. To the authors' knowledge, this is the most comprehensive and detailed micro-analysis of health spending that has been developed for a Latin American country to date.
Assuntos
Gastos em Saúde , Colômbia , Humanos , Gastos em Saúde/estatística & dados numéricos , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Idoso , Adolescente , Pré-Escolar , Adulto Jovem , Lactente , Criança , Recém-NascidoRESUMO
INTRODUCTION: The tetravalent live virus vaccine developed by Takeda called Qdenga® is available in Argentina and approved for use from 4 years of age without age limit. The objective was to describe clinical characteristics and evolution of the initial reports of rash after the first dose. MATERIAL AND METHODS: The records of Events Supposedly Attributable to Vaccination or Immunization Reported in a Private Vaccination Center were reviewed between 15/11/2023 and 12/12/2023. Cases with skin rash that occurred outside the application site area were included. The main variables analyzed were age, sex, history of dengue, characteristics of the skin rash, accompanying symptoms, time elapsed from vaccination to the onset of the rash and evolution. The incidence of rash was calculated: cases/10,000 vaccinated. RESULTS: Out of 12 551 doses applied, 15 cases were included. Median age: 35 years, female sex: 8/15. Clinical forms of presentation: generalized micropapular (3/15), maculopapular (3/15), scarlatiniform (1/15), urticarian (1/15), multiform (1/15), erythematous in the face (1/15) and unspecified (5/15). Most common concomitant symptoms: pruritus (5/15), fever or low-grade fever (6/15), headache (3/15), retro-ocular pain (2/15), asthenia (2/15). Three cases reported a history of dengue. The median number of days of rash presentation was 8 days' postvaccination. All patients progressed favorably. The overall incidence was 1.2/1000 vaccinated. CONCLUSIONS: In passive surveillance, after more than 12 000 first doses administered, the presence of rash was observed in less than 0.12% of those vaccinated. Everyone evolved favorably.
Introducción: La vacuna tetravalente a virus vivos del laboratorio Takeda, denominada Qdenga®, está disponible en Argentina y aprobada para su uso a partir de los 4 años sin límite de edad. El objetivo fue describir las características clínicas y evolución de los primeros reportes de exantema post primera dosis. Material y métodos: Se revisaron los registros de los Eventos Supuestamente Atribuidos a la Vacunación e Inmunización reportados en los Centros Vacunar entre el 15/11/2023 al 12/12/2023. Se incluyeron los casos con exantema cutáneo que se presentaron fuera del área del sitio de aplicación. Las principales variables analizadas fueron edad, sexo, antecedente de dengue, características del exantema cutáneo, síntomas acompañantes, tiempo transcurrido desde la vacunación al inicio del exantema y evolución. Se calculó la incidencia del exantema: casos/1000 vacunados. Resultados: Sobre 12551 dosis aplicadas se incluyeron 15 casos. Mediana de edad: 35 años, sexo femenino: 8/15. Formas clínicas de presentación: generalizado micropapular (3/15), maculopapular (3/15), escarlatiniforme (1/15), urticariano (1/15), multiforme (1/15), eritematoso en cara (1/15) y sin especificar (5/15). Síntomas concomitantes más frecuentes: prurito (5/15), fiebre o febrícula (6/15), cefalea (3/15), dolor retro ocular (2/15), astenia (2/15). Tres casos refirieron antecedente de dengue. La mediana de días de presentación del exantema fue de 8 días post vacunación. Todos los pacientes evolucionaron favorablemente. La incidencia fue de 1.2/1000 vacunados. Conclusiones: En la vigilancia pasiva, luego de más de 12 000 primeras dosis administradas, se observó la presencia de exantema en menos del 0.12% de los vacunados. Todos evolucionaron favorablemente.
Assuntos
Vacinas contra Dengue , Exantema , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Argentina/epidemiologia , Dengue/prevenção & controle , Vacinas contra Dengue/efeitos adversos , Vacinas contra Dengue/administração & dosagem , Exantema/induzido quimicamente , Incidência , Estudos Retrospectivos , Vacinação/efeitos adversosRESUMO
INTRODUCTION: The COVID-19 pandemic has had significant impacts on society, particularly on children and adolescents, who have faced serious social, educational, and health consequences due to the loss of their primary caregivers. MATERIALS AND METHODS: Female fertility rates were analyzed, and estimates of male fertility were made to calculate the number of children under 18 years old by age group. Demographic and mortality information from COVID-19 infection was used to calculate the resulting orphanhood in Argentina during the period 2020-2021, considering the loss of one or both parents or the main caregiver grandparent. RESULTS: A total of 25161 Argentine children and adolescents lost one of their primary caregivers due to COVID-19 during the pandemic. Of these, 22729 were orphaned by mother or father during the analyzed period. The majority of cases (79.5%) were related to the father's death. Specific age groups with higher incidence of orphanhood were identified. The loss of caregiver grandparents was also significant, affecting 2432 children and adolescents. DISCUSSION: The findings underscore the need for specific policies and programs to address the comprehensive needs of children and adolescents affected by orphanhood during the pandemic. Potential long-term impacts on the physical, mental, educational, and socioeconomic health of these children and adolescents are highlighted.
Introducción: La pandemia de COVID-19 ha ejercido impactos significativos en la sociedad, particularmente en niños, niñas y adolescentes (NNA), quienes han enfrentado consecuencias sociales, educativas y de salud graves debido a la pérdida de sus cuidadores principales. Materiales y métodos: Se analizaron las tasas de fertilidad femenina y se realizaron estimaciones sobre la fertilidad masculina a fin de calcular los hijos menores de 18 años por grupo de edad. Se utilizó información demográfica y de mortalidad por infección por COVID-19 para calcular la orfandad resultante en Argentina durante el período 2020-2021, considerando la pérdida de uno o ambos progenitores o del cuidador principal abuelo/a. Resultados: Un total de 25161 NNA argentinos perdieron a uno de sus cuidadores principales por el COVID-19 durante la pandemia. De ellos, 22729 NNA quedaron huérfanos de madre o padre durante el periodo analizado. La mayoría de los casos (79.5%) estuvo relacionada con la muerte del padre. Se identificaron grupos de edad específicos con mayor incidencia de orfandad. La pérdida de abuelos cuidadores también fue significativa, afectando a 2432 NNA. Discusión: Los hallazgos subrayan la necesidad de políticas y programas específicos para abordar las necesidades integrales de los NNA afectados por la orfandad durante la pandemia. Se destacan los posibles impactos a largo plazo en la salud física, mental, educativa y socioeconómica de estos niños y adolescentes.
Assuntos
COVID-19 , Crianças Órfãs , Humanos , Argentina/epidemiologia , COVID-19/epidemiologia , Adolescente , Criança , Feminino , Masculino , Crianças Órfãs/estatística & dados numéricos , Pré-Escolar , Lactente , Cuidadores/estatística & dados numéricos , Pandemias , Recém-Nascido , Coeficiente de Natalidade/tendências , SARS-CoV-2RESUMO
Benign childhood myositis is a self-limiting inflammatory condition that primarily affects schoolaged boys during the winter months. It is associated with respiratory viral infections, such as influenza A and B viruses, respiratory syncytial virus (RSV), and Mycoplasma pneumoniae, among others. In September 2022, an epidemiological alert was raised due to a high number of reported cases in the metropolitan area of Buenos Aires. We present two cases of female adolescents, aged 10 and 14 years, who developed this condition in association with influenza B virus infection. Their treatment and follow-up differed based on their clinical presentation and laboratory findings. This entity should be considered in the differential diagnosis of lower limb myalgia, difficulty walking, and functional impotence. It is necessary to establish management guidelines according to the clinic and laboratory. The search for respiratory viruses, mainly influenza, should be done taking into account the local epidemiology.
La miositis benigna de la infancia es un cuadro inflamatorio, asociado a infecciones virales respiratorias, autolimitado que no deja secuelas. Afecta principalmente a varones en edad escolar, durante los meses de invierno. Puede asociarse a virus influenza A y B, VRS, Mycoplasma pneumoniae, entre otros. En el mes de septiembre de 2022 se generó una alerta epidemiológica por el elevado número de casos reportados en el área metropolitana de Buenos Aires. Presentamos los casos de dos adolescentes mujeres de 10 y 14 años con este cuadro asociado a influenza B. El tratamiento y el seguimiento fueron diferentes en base a la clínica y el laboratorio. Hay que tener en cuenta esta entidad como un diagnóstico diferencial de mialgias de miembros inferiores, dificultad en la marcha e impotencia funcional. Es necesario establecer las pautas de manejo según clínica y laboratorio. La búsqueda de virus respiratorios, principalmente influenza, debe hacerse teniendo en cuenta la epidemiología local.
Assuntos
Vírus da Influenza B , Influenza Humana , Miosite , Humanos , Miosite/virologia , Miosite/etiologia , Influenza Humana/complicações , Feminino , Vírus da Influenza B/isolamento & purificação , Adolescente , CriançaRESUMO
OBJECTIVE: Determine the life expectancy in the covered population of the Institute of Security and Social Services of State Workers in México for 2021. METHOD: We used the abrogated method from Reed-Merrel, for calculate the life expectancy in age groups. RESULTS: By 2021, life expectancy general was 79.51 years; 81.40 years and 78.91 years for woman and men, respectively. CONCLUSIONS: The calculated life expectancy not show a reduction in the population of federal and State employees in Mexico.
OBJETIVO: Determinar la esperanza de vida en la población amparada del Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado en México para 2021. MÉTODO: Se utilizó el método abreviado de Reed-Merrel para calcular la esperanza de vida en grupos quinquenales de edad. RESULTADOS: Para 2021, la esperanza de vida general fue de 79.51 años; de 81.40 años y 78.91 años para mujeres y para hombres, respectivamente. CONCLUSIONES: La esperanza de vida calculada no presentó reducción después de la pandemia de COVID-19 para la población de empleados federales de México en 2021.
Assuntos
Expectativa de Vida , México , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Adolescente , Previdência Social/estatística & dados numéricos , Pré-Escolar , Criança , Lactente , Empregados do Governo/estatística & dados numéricos , Serviço Social/organização & administração , Academias e InstitutosRESUMO
OBJECTIVE: The objective of this study was to evaluate the effect of open reduction and internal fixation for displaced intra-articular calcaneal fractures through a modified tarsal sinus incision. METHODS: A retrospective review over 3 years of the clinical data of patients with intra-articular calcaneal fractures treated with open reduction and internal fixation through lateral hook curvy incisions. The efficacy of the 25 lateral hook curvy incisions was analyzed. RESULTS: According to the AOFAS hindfoot function scoring criteria, there were 20 excellent (80%), 2 good (8%), 2 fair (8%), and 1 poor patient outcome. The average pre-operative Bohler's angle was 6.8 ± 8.9°, and the average angle at follow-up was 33.6 ± 5.7°. The average pre-operative Gissane angle was 89.2 ± 20.0°, and the average angle at follow-up was 115.5 ± 5.5°. CONCLUSIONS: A lateral hook curvy incision can expose the posterior articular surface of the calcaneus and the calcaneocuboid joint, reduce stripping and pulling of the soft tissue, and avoid calcaneus valgus caused by the pulling of the peroneus tendon.
OBJETIVO: Evaluar el efecto de la reducción abierta y la fijación interna de las fracturas de calcáneo intraarticulares desplazadas a través de una incisión del seno tarsiano modificada. MÉTODO: Revisión retrospectiva de 3 años de los datos clínicos de pacientes con fracturas intraarticulares de calcáneo tratadas con reducción abierta y fijación interna a través de incisiones laterales curvadas en gancho. Se analizó la eficacia de la incisión curvada con 25 ganchos laterales. RESULTADOS: Según los criterios de puntuación de la función del retropié de la AOFAS, hubo 20 resultados excelentes (80%), 2 buenos (8%), 2 regulares (8%) y 1 pobre. El ángulo de Bohler preoperatorio promedio fue de 6.8 ± 8.9° y el ángulo promedio en el seguimiento fue de 33.6 ± 5.7°. El ángulo de Gissane preoperatorio promedio fue de 89.2 ± 20.0° y el ángulo promedio en el seguimiento fue de 115.5 ± 5.5°. CONCLUSIONES: Una incisión curvada en gancho lateral puede exponer la superficie articular posterior del calcáneo y la articulación calcaneocuboidea, reducir el desprendimiento y la tracción del tejido blando, y evitar el calcáneo valgo causado por tracción del tendón peroneo.
Assuntos
Calcâneo , Fixação Interna de Fraturas , Calcâneo/lesões , Calcâneo/cirurgia , Humanos , Estudos Retrospectivos , Fixação Interna de Fraturas/métodos , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Fraturas Intra-Articulares/cirurgia , Redução Aberta/métodos , Adulto Jovem , Resultado do Tratamento , Fraturas Ósseas/cirurgia , Adolescente , IdosoRESUMO
Psychedelics have a complex history marked by traditional use among indigenous cultures, early scientific interest, and subsequent prohibition. Despite their classification as controlled substances, recent decades have witnessed a resurgence of research into their therapeutic potential for various mental health conditions. However, most studies have focused on controlled clinical settings, leaving a significant gap in understanding how these substances are used in naturalistic contexts, particularly in Latin America. This study investigates the regular use of macrodoses of psychedelics among Latin American adults. We aimed to characterize the sociodemographic profiles, consumption practices, and subjective effects experienced by individuals who use psychedelics regularly. Data were collected via an online survey from 4,270 participants across several Latin American countries. Results indicated a diverse user base with varied motivations, predominantly psychological and spiritual well-being. The most frequently used substance was psilocybin mushrooms, with significant associations found between demographic variables and specific psychedelics used. The study provides new insights into the naturalistic use of psychedelics in Latin America, highlighting the need for informed, safe, and legal use frameworks.
Assuntos
Alucinógenos , Humanos , Alucinógenos/administração & dosagem , Adulto , América Latina , Feminino , Masculino , Estudos Transversais , Pessoa de Meia-Idade , Adulto Jovem , Inquéritos e Questionários , Adolescente , Psilocibina/uso terapêutico , Psilocibina/administração & dosagemRESUMO
BACKGROUND: Colombia, which hosts over 3 million of the Venezuelan diaspora, is lauded for its progressive approach to social integration, including providing migrants access to its universal health coverage system. However, barriers to healthcare persist for both migrant and host populations, with poorly understood disparities in healthcare-seeking behaviors and associated costs. This is the first study to link healthcare-seeking behaviors with costs for Venezuelan migrants in Colombia, encompassing costs of missing work or usual activities due to healthcare events. METHODS: We use self-reported survey data from Venezuelan migrants and Colombians living in Colombia (September-November 2020) to compare healthcare-seeking behaviors and cost variables by nationality using two-sampled t-tests or Chi-square tests (X2). The International Classification of Diseases was used to compare reported household illnesses for both populations. Average health service direct costs were estimated using the Colombian Government's Suficiencia database and self-reported out-of-pocket (OOP) payments for laboratory and pharmacy services. Indirect costs were calculated by multiplying self-reported days of missed work or usual activities with estimated income levels, derived by matching characteristics using the Gran Enquesta Integrada de Hogares database. We calculate economic burdens for both populations, combining self-reported healthcare-seeking behaviors and estimated healthcare service unit costs across six healthcare-seeking behavior categories. RESULTS: Despite similar disease profiles, Venezuelan migrants are 21.3% more likely to forego formal care than Colombians, with 746.3% more Venezuelans reporting lack of health insurance as their primary reason. Venezuelan women and uninsured report the greatest difficulties in accessing health services, with accessing medications becoming more difficult for Venezuelan women during the COVID-19 pandemic. Colombians cost the health system more per treated illness event (US$40) than Venezuelans (US$26) in our sample, over a thirty-day period. Venezuelans incur higher costs for emergency department visits (123.5% more) and laboratory/ pharmacy OOP payments (24.7% more). CONCLUSIONS: While Colombians and Venezuelans share similar disease burdens, significant differences exist in access, cost, and health-seeking behaviors. Increasing Venezuelan health insurance enrollment and tackling accessibility barriers are crucial for ensuring healthcare equity and effectively integrating the migrant population. Findings suggest that improving migrant access to primary healthcare would produce savings in Colombian healthcare expenditures.
Assuntos
Aceitação pelo Paciente de Cuidados de Saúde , Migrantes , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Colômbia , Custos de Cuidados de Saúde , Gastos em Saúde/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/economia , Disparidades em Assistência à Saúde/economia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , População da América do Sul , Venezuela/etnologiaRESUMO
Pain, a prevalent and debilitating symptom in cancer patients, significantly diminishes the quality of life for both individuals and their families. Addressing this critical issue, our study presents the case of a 15-year-old diagnosed with synchronous multifocal multicentric osteosarcoma. We utilized radiofrequency ablation of bilateral splanchnic nerves, a strategy of multimodal pain and palliative care. This approach not only proved to be safe and effective but also markedly improved the patient's quality of life. Our findings shine a light of hope, emphasizing the paramount importance of innovative pain management in pediatric oncology, especially in the final stages of life. This case report highlights the unwavering dedication to excellence in relieving suffering, offering hope for patients grappling with cancer.
Pain is a common and serious problem for cancer patients, osteosarcoma is a type of bone cancer that often affects children. making life hard for them and their families. We used a therapy called radiofrequency ablation on specific nerves to manage the pain. In the case of the patient's abdominal pain, this therapy was safe, worked well, and greatly improved the patient's quality of life. Our findings show the importance of new pain management methods in helping children with cancer, helping them reduce pain, using fewer strong pain medications and helping children in this case in the final stage of life.
Assuntos
Ablação por Radiofrequência , Nervos Esplâncnicos , Humanos , Adolescente , Nervos Esplâncnicos/cirurgia , Dor Abdominal/etiologia , Osteossarcoma/complicações , Osteossarcoma/cirurgia , Masculino , Cuidados Paliativos/métodos , Neoplasias Ósseas/complicações , Neoplasias Ósseas/cirurgia , Dor Visceral/etiologia , Qualidade de Vida , Dor do Câncer/terapia , Resultado do TratamentoRESUMO
The Preference for Intuition and Deliberation in Food Decision-Making Scale (E-PID) was developed to evaluate both intuitive and deliberative food decision-making within a single instrument. However, its psychometric properties have only been assessed among German-speaking participants. The main aim of the present study was to evaluate evidence of validity and reliability of the E-PID among 604 Brazilian adult women. Exploratory (n = 289) and confirmatory factor analyses (n = 315) were conducted to evaluate the factor structure of the E-PID. Convergent validity was assessed correlating the E-PID with measures of eating behaviors (Tree-Factor Eating Questionnaire-18), intuitive eating (Intuitive Eating Scale-2), and a measure of beliefs and attitudes towards food (Food-Life Questionnaire-SF). McDonald's Omega coefficient (ω) was used to test the internal consistency of the E-PID. Results from an exploratory and confirmatory factor analysis supported a two-factor structure with seven items. We found good internal consistency (McDonald's ω = 0.77-0.81). Furthermore, the E-PID demonstrated adequate convergent validity with measures of intuitive, restrictive, emotional and uncontrolled eating, and beliefs and attitudes towards food. Results support the use of the E-PID as a measure of intuition and deliberation in food decision-making among Brazilian adult women, expanding the literature on eating decision-making styles.
Assuntos
Tomada de Decisões , Comportamento Alimentar , Preferências Alimentares , Intuição , Psicometria , Humanos , Feminino , Adulto , Brasil , Reprodutibilidade dos Testes , Inquéritos e Questionários/normas , Adulto Jovem , Preferências Alimentares/psicologia , Comportamento Alimentar/psicologia , Pessoa de Meia-Idade , Análise Fatorial , Adolescente , Ingestão de Alimentos/psicologiaRESUMO
Zinc plays a crucial role in cell structure and functionality. Neurodegenerative Duchenne muscular dystrophy (DMD) alters muscle membrane structure, leading to a loss of muscle mass and strength. The objective of this study was to evaluate the changes in phase angle (PA) and bioelectrical impedance vector analysis (BIVA) results in patients with DMD after oral zinc supplementation. This clinical trial included 33 boys aged 5.6 to 24.5 years diagnosed with DMD. They were divided into three groups according to age (G1, G2, and G3) and supplemented with oral zinc. The mean serum zinc concentration was 74 µg/dL, and 29% of patients had concentrations below the reference value. The baseline values (mean (standard deviation)) of the bioelectrical impedance parameters PA, resistance (R), and reactance (Xc) were 2.59° (0.84°), 924.36 (212.31) Ω, and 39.64 (8.41) Ω, respectively. An increase in R and a decrease in PA and lean mass proportional to age were observed, along with a negative correlation (r = -0.614; p < 0.001) between age and PA. The average cell mass in G1 was greater than that in G3 (p = 0.012). There were no significant differences in serum zinc levels or bioelectrical impedance parameters before and after zinc supplementation. We conclude that this population is at risk of zinc deficiency and the proposed dosage of zinc supplementation was not sufficient to alter serum zinc levels, PA and BIVA results.
Assuntos
Suplementos Nutricionais , Impedância Elétrica , Distrofia Muscular de Duchenne , Zinco , Humanos , Distrofia Muscular de Duchenne/tratamento farmacológico , Zinco/administração & dosagem , Zinco/sangue , Zinco/deficiência , Masculino , Adolescente , Criança , Adulto Jovem , Pré-Escolar , Composição Corporal/efeitos dos fármacos , Administração Oral , Músculo Esquelético/efeitos dos fármacosRESUMO
INTRODUCTION: The role of IMP3, CDK4, MDM2 and ß-catenin proteins in Enchondroma and Central Chondrosarcoma is not totally understood. The aim of this study is to evaluate the immunoexpression of these proteins, associating histological grade, clinical data and prognosis to these tumors. METHODS: This is a retrospective-analytical study of 32 Enchondroma and 70 Central Chondrosarcoma. RESULTS: IMP3, CDK4, MDM2 and ß-catenin expression was observed in 22.82 %, 13.82 %, 17.17 % and in 8.8 % of cases, respectively. All Enchondromas positive for these immunomarkers were located in short tubular bones. The positivity for these antibodies is directly proportional to Chondrosarcoma's histological grade increase. No difference was found between Enchondroma and Chondrosarcoma, Grade 1 for IMP3, CDK4 and ß-catenin positivity. Significant metastasis outcome was observed for IMP3, CDK4, MDM2 and death for MDM2 expression. CONCLUSION: IMP3, CDK4, MDM2 and ß-catenin expression in Enchondromas of short bones phenotypically characterizes these tumors. Their expression has not proven to be useful either as diagnostic markers of these neoplasms or in distinguishing between Enchondroma and Chondrosarcoma, Grade 1. The significant immunoexpression of IMP3, CDK4 and MDM2 in metastatic Chondrosarcoma and the lower survival in those with positivity for MDM2 suggest a possible association of these proteins with tumor aggressiveness.
Assuntos
Biomarcadores Tumorais , Neoplasias Ósseas , Condroma , Condrossarcoma , Quinase 4 Dependente de Ciclina , Imuno-Histoquímica , Proteínas Proto-Oncogênicas c-mdm2 , beta Catenina , Humanos , Condrossarcoma/patologia , Condrossarcoma/metabolismo , Proteínas Proto-Oncogênicas c-mdm2/metabolismo , Proteínas Proto-Oncogênicas c-mdm2/análise , Masculino , Feminino , Neoplasias Ósseas/patologia , Neoplasias Ósseas/metabolismo , Pessoa de Meia-Idade , beta Catenina/análise , beta Catenina/metabolismo , Adulto , Estudos Retrospectivos , Biomarcadores Tumorais/análise , Prognóstico , Condroma/patologia , Quinase 4 Dependente de Ciclina/metabolismo , Quinase 4 Dependente de Ciclina/análise , Idoso , Adulto Jovem , Adolescente , Gradação de Tumores , Criança , Proteínas de Ligação a RNARESUMO
Rats are major reservoirs for pathogenic Leptospira, the bacteria causing leptospirosis, particularly in urban informal settlements. However, the impact of variation in rat abundance and pathogen shedding rates on spillover transmission to humans remains unclear. This study aimed to investigate how spatial variation in reservoir abundance and pathogen pressure affect Leptospira spillover transmission to humans in a Brazilian urban informal settlement. A longitudinal eco-epidemiological study was conducted from 2013 to 2014 to characterize the spatial distribution of rat abundance and Leptospira shedding rates in rats and determine the association with human infection risk in a cohort of 2,206 community residents. Tracking plates and live-trapping were used to measure rat abundance and quantify rat shedding status and load. In parallel, four sequential biannual serosurveys were used to identify human Leptospira infections. To evaluate the role of shedding on human risk, we built three statistical models for: (1) the relative abundance of rats, (2) the shedding rate by individual rats, and (3) human Leptospira infection, in which "total shedding", obtained by multiplying the predictions from those two models, was used as a risk factor. We found that Leptospira shedding was associated with older and sexually mature rats and varied spatially and temporally-higher at valley bottoms and with seasonal rainfall (December to March). The point estimate for "total shedding" by rat populations was positive, i.e., Leptospira infection risk increased with total shedding, but the association was not significant [odds ratio (OR) = 1.1; 95% confidence interval (CI): 0.9, 1.4]. This positive trend was mainly driven by rat abundance, rather than individual rat shedding (OR = 1.8; 95% CI: 0.6, 5.4 vs. OR = 1.0; 95% CI: 0.7, 1.4]. Infection risk was higher in areas with more vegetative land cover (OR = 2.4; 95% CI: 1.2, 4.8), and when floodwater entered the house (OR = 2.4; 95% CI: 1.6, 3.4). Our findings indicate that environmental and hydrological factors play a more significant role in Leptospira spillover than rat associated factors. Furthermore, we developed a novel approach combining several models to elucidate complex links between animal reservoir abundance, pathogen shedding and environmental factors on zoonotic spillover in humans that can be extended to other environmentally transmitted diseases.
Assuntos
Reservatórios de Doenças , Leptospira , Leptospirose , Zoonoses , Animais , Humanos , Leptospirose/epidemiologia , Leptospirose/microbiologia , Leptospirose/transmissão , Leptospira/isolamento & purificação , Reservatórios de Doenças/microbiologia , Brasil/epidemiologia , Ratos , Zoonoses/microbiologia , Masculino , Feminino , Adulto , Derrame de Bactérias , Estudos Longitudinais , Pessoa de Meia-Idade , Fatores de Risco , População Urbana/estatística & dados numéricos , Adolescente , Adulto JovemRESUMO
Influenza circulation was significantly affected in 2020-21 by the COVID-19 pandemic. During this time, few influenza cases were recorded. However, in the summer of 2021-22, an increase in atypical influenza cases was observed, leading to the resurgence of influenza in the southernmost state of Brazil, Rio Grande do Sul (RS). The present study aimed to identify the circulation of FLUAV, FLUBV and SARS-CoV-2 and characterize the influenza genomes in respiratory samples using high-throughput sequencing technology (HTS). Respiratory samples (n = 694) from patients in RS were selected between July 2021 and August 2022. The samples were typed using reverse transcriptase real-time PCR (RT-qPCR) and showed 32% (223/694) of the samples to be positive for SARS-CoV-2, 7% for FLUAV (H3) (49/694). FLUBV was not detected. RT-qPCR data also resulted in FLUAV and SARS-CoV-2 co-infections in 1.7% (4/223) of samples tested. Whole genome sequencing of FLUAV produced 15 complete genomes of the H3N2 subtype, phylogenetically classified in the 3C.2a1b.2a.2a.3 subclade and revealing the dominance of viruses in the southern region of Brazil. Mutation analysis identified 72 amino acid substitutions in all genes, highlighting ongoing genetic evolution with potential implications for vaccine effectiveness, viral fitness, and pathogenicity. This study underscores limitations in current surveillance systems, advocating for comprehensive data inclusion to enhance understanding of influenza epidemiology in southern Brazil. These findings contribute valuable insights to inform more effective public health responses and underscore the critical need for continuous genomic surveillance.
Assuntos
COVID-19 , Genoma Viral , Influenza Humana , Filogenia , SARS-CoV-2 , Humanos , Brasil/epidemiologia , COVID-19/epidemiologia , COVID-19/virologia , SARS-CoV-2/genética , SARS-CoV-2/classificação , SARS-CoV-2/isolamento & purificação , Influenza Humana/epidemiologia , Influenza Humana/virologia , Pessoa de Meia-Idade , Adulto , Feminino , Genoma Viral/genética , Masculino , Adulto Jovem , Idoso , Adolescente , Surtos de Doenças , Sequenciamento Completo do Genoma , Criança , Pré-Escolar , Lactente , Coinfecção/epidemiologia , Coinfecção/virologia , Sequenciamento de Nucleotídeos em Larga Escala , Idoso de 80 Anos ou mais , GenômicaRESUMO
This cross-sectional study examines treatment received for falls from a section of the US-Mexico border wall with a focus on emergency medical services activation and type of treatment.
Assuntos
Acidentes por Quedas , Humanos , Masculino , México/epidemiologia , Acidentes por Quedas/estatística & dados numéricos , Feminino , Adulto , Pessoa de Meia-Idade , Serviços Médicos de Emergência/estatística & dados numéricos , Estados Unidos/epidemiologia , Idoso , Adolescente , Adulto Jovem , Ferimentos e Lesões/epidemiologiaRESUMO
The etiology of tinea capitis changes over time, mainly due to trends in migration. We report 19 cases of tinea capitis caused by Microsporum audouinii, an uncommon agent in South America, all of them confirmed by molecular methods. All patients were male. The average age was 6.1 years. Fifteen patients were residents of Rio de Janeiro city and four were from neighboring cities. Among the patients submitted to follow-up, griseofulvin was prescribed for eight of them. Due to medication shortages, terbinafine was prescribed for five patients, needing to be switched in three cases, with a bigger total average time until clinical improvement. The study reaffirms the emergence of a new etiological agent in Rio de Janeiro, Brazil.
The etiology of tinea capitis changes over time, mainly due to migratory flows. We report 19 cases of tinea capitis caused by Microsporum audouinii, an uncommon agent in South America, all of them confirmed by molecular methods. The study reaffirms the emergence of a new etiological agent in Rio de Janeiro, Brazil.