RESUMO
The normative process of autonomy development in adolescence involves changes in adolescents' information management typically characterized by decreasing disclosure and increasing concealment. These changes may have an important impact on the early detection and timely treatment of mental health conditions and risky behavior. Therefore, the objective was to extend our understanding of how these developmental changes in adolescent disclosure might impact adolescent mental health interviews. Specifically, we estimated the effects of third party presence and type of third party presence (adult, child, or both) on adolescents' reports of psychiatric symptoms, substance use, suicidal behavior, and childhood adversity. In this representative sample of 3005 adolescents from Mexico City (52.1 % female), administered the World Mental Health Composite International Diagnostic Interview (WMH-CIDI-A), adult presence influenced reporting the most; in their presence, adolescents reported more ADHD, parental mental illness and economic adversity, but less panic disorder, PTSD, drug use and disorder, and suicidal behavior. The presence of children was associated with increased odds of reporting conduct disorder, opportunity for drug use, parental criminal behavior, neglect, and the death of a parent. While adolescent information management strategies are normative and even desirable as a means of gaining emotional autonomy, they may also interfere with timely detection and treatment or intervention for mental health conditions and risky behaviors. Research and practical implications of these findings are discussed.
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Comportamento do Adolescente/psicologia , Revelação , Entrevista Psicológica/métodos , Saúde Mental/estatística & dados numéricos , Psicologia do Adolescente , Adolescente , Adulto , Feminino , Humanos , Masculino , México , Pais , Assunção de RiscosRESUMO
Half of mental disorders have their first onset before adulthood when the presence of a disorder may be particularly disruptive to developmental milestones. Retrospective prevalence estimates have been shown to underestimate the burden of mental illness and scarce data are available on the incidence of disorders throughout the adolescent period, especially in developing countries. Thus, the objective was to determine the incidence of mental disorders in an 8-year period from adolescence to young adulthood, onset of service use and their predictors in a Mexican cohort. 1071 respondents from a representative two-wave panel sample participated in the Mexican Adolescent Mental Health Survey in 2005 and in the follow-up survey in 2013. Disorders were evaluated with the World Mental Health Composite International Diagnostic Interview. 37.9% experienced the onset of a psychiatric disorder and 28.4% sought services for the first time. Substance use disorders had the greatest incidence, followed by mood and behavior disorders, anxiety disorders and lastly eating disorders. Sex, age, school dropout, childhood adversities and prior mental disorders predicted the onset of new disorders. Being female, having more educated parents and most classes of disorder predicted first time service use. These findings contribute to a paradigm shift in conceptions of mental disorder similar to how we think of common physical afflictions as near universal experiences across the life course, but less frequent at any given moment. Adolescents are particularly vulnerable. Therefore, public health policy should focus on early universal promotion of positive mental health and structural determinants of mental health.
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Serviços de Saúde do Adolescente/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Psicopatologia/métodos , Adolescente , Adulto , Transtornos de Ansiedade/diagnóstico , Feminino , Seguimentos , Inquéritos Epidemiológicos , Humanos , Incidência , Estudos Longitudinais , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Saúde Mental , México/epidemiologia , Prevalência , Escalas de Graduação Psiquiátrica , Estudos Retrospectivos , Índice de Gravidade de Doença , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Inquéritos e Questionários , Adulto JovemRESUMO
OBJECTIVE: To estimate the individual and societal costs of common mental and physical health conditions in the Mexican population with regards to the number of days out of role. MATERIALS AND METHODS: 5,826 adults were evaluated in 2001-2002 with the Composite International Diagnostic Interview and the WHO Disability Assessment Schedule. General linear models were used to estimate individual-level effects. Societal-level effects were estimated with the population attributable risk proportion which takes into account prevalence and comorbidity of disorders. RESULTS: The conditions with the strongest individual -level effects were major depression, post-traumatic stress disorder and bipolar disorder. The strongest societal-level effects were associated with major depression, pain, insomnia and cardiovascular conditions. CONCLUSION: The findings suggest the importance of investing in mental health expenditure to a level commensurate with the costs to society of mental health disorders.
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Doença Crônica/economia , Transtornos Mentais/economia , Adolescente , Adulto , Idoso , Doença Crônica/epidemiologia , Efeitos Psicossociais da Doença , Humanos , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Adulto JovemRESUMO
OBJECTIVE: To report on the results of the first stage of the Pause for Your Health program, designed to promote physical exercise during the work journey day in addition to an eating plan to contribute to the employees' general well-being. MATERIAL AND METHODS: The participants were 36 employees of a national institute on health working at a research area. The indicators assessed before and after the program were: sedentary lifestyle, cardiovascular adaptation to exercise test, anthropometric measures, serico-lipoglycemic profile, blood pressure, perception of lifestyle and general well-being and finally opinion about program. RESULTS: Data showed significant changes in five anthropometric indicators, the most significant was waist circumference. As to clinical assessment, the most prominent change was observed in glucose level. The results also showed that people who were overweight at the start of the program at the end of it lost weight, which was statistically significant. CONCLUSIONS: Participants showed attitude of great involvement regarding physical activity and increased awareness of the best way to eat. One of the immediate benefits of using this program was that it allowed identifying risk factors among the employees and increased motivation to participate and to take specific measures regarding their health care.
Assuntos
Academias e Institutos , Exercício Físico , Comportamento Alimentar , Promoção da Saúde , Saúde Ocupacional , Pesquisadores , Adaptação Fisiológica , Adulto , Antropometria , Atitude do Pessoal de Saúde , Glicemia/análise , Pressão Sanguínea , Teste de Esforço , Feminino , Educação em Saúde/organização & administração , Promoção da Saúde/organização & administração , Humanos , Lipídeos/sangue , Masculino , México , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Pesquisadores/psicologia , Comportamento SedentárioRESUMO
Frugivorous birds vary in seed dispersal effectiveness (SDE) depending on their body mass. It has been suggested that large birds are more effective dispersers than small ones because they consume a large number of fruits, disperse seeds of distinct sizes, and transport seeds over long distances. Yet, few studies have evaluated the impact of body mass on SDE of birds. In this study, we compiled one database for the quantity (i.e., frequency of visits to plants and number of seeds removed per visit) and quality (i.e., germination of seeds after gut passage and gut retention time of seeds) of seed dispersal by frugivorous birds to evaluate the impact of body mass on SDE. In addition, we compiled data on plant characteristics such as life-form, fruit type, number of seeds per fruit, and size of seed to evaluate their influence on the quantity and quality of seed dispersal. Data were analyzed with linear mixed effects models and quantile regressions to evaluate the relationship between body mass of birds and quantity, quality, and SDE, in addition to the influence of plant characteristics on SDE. The body mass of birds was negatively related to the frequency of visits to plants. Furthermore, it was positively related to the number of seeds removed per visit, although negatively related to seed size. The life-form of plants was the only factor explaining the germination of seeds after gut passage. Yet, the body mass of birds was positively related to the gut retention time of seeds. Small and medium birds have a relatively higher SDE than large birds. These results differ from the assertion that large birds are more effective dispersers of plants. Small and medium birds are also effective dispersers of plants that should be preserved and protected from the impact of human activities.
RESUMO
BACKGROUND: Depression is a leading cause of disease burden around the globe, often develops during adolescence and is recurrent. Thus, disentangling risk factors for incidence from those of recurrence during adolescence is relevant and might suggest different strategies for prevention of onset than for relapse. The aim was to evaluate the relative risk of socio-demographic and clinical factors and traumatic events associated to incidence and recurrence of depression in youth from Mexico City. METHODS: This is a prospective longitudinal general population survey in which 1071 respondents from the Mexican Adolescent Mental Health Survey were interviewed between the ages of 12 and 17 and again eight years later when they were between 19 and 26 years of age. The World Mental Health Composite International Diagnostic Interview evaluated incidence and persistence of major depression and risk factors. RESULTS: Eight-year incidence was 12.9% while recurrence was 46.1%. Risk factors for incidence (female sex, any incident trauma, and specifically sexual abuse and an other/private event) differed from the risk factors for recurrence (childhood onset and domestic violence) with the exception of having a parent with depression, which was associated to increased risk for both. LIMITATIONS: The follow-up response rate was limited by inability to locate participants at wave II. Statistical power was limited for persistence due to low rate of depression at wave I. CONCLUSIONS: Intervening with both depressed and non-depressed children of parents with depression may have beneficial effects on both the development of depression as well as recurrence.
Assuntos
Depressão , Adolescente , Adulto , Criança , Depressão/epidemiologia , Feminino , Seguimentos , Inquéritos Epidemiológicos , Humanos , Incidência , Estudos Longitudinais , México/epidemiologia , Estudos Prospectivos , Recidiva , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
Abstract Introduction: Seed removal by ants is an interaction that may greatly affect the dynamic and structure of the vegetation. This aspect is well known for granivorous ants; however, there is little information on the effect of omnivorous ants. Objective: To assess the potential impact of the omnivorous ant Dorymyrmex insanus on vegetation. Methods: In the Pedregal Reserve, Mexico City, we identified the items in the refuse piles of ten ant colonies, for one year, covering the rainy and dry seasons. For each season we calculated seed diversity and analyzed the possible relationship between seed size and their abundance in the refuse piles, with regression models. We also did germination tests with seeds of Tagetes micrantha, comparing seeds from piles and from plants. Results: D. insanus removed seeds of 19 plant species as well as plant remains (such as leaves, twigs, roots), and remains of insects. Seed diversity was higher in the rainy season but the greatest abundance was in the dry season. When analyzing the relationship between seed length and abundance in the refuse piles, we found that the ants preferred seeds of around 10 mm. We also found that more seeds of T. micrantha germinated when they were previously handled by ants. Conclusions: The ant D. insanus actively participates in the removal of seeds from several species, favoring germination, and seasonality affects the selectivity of resources.
Resumen Introducción: La remoción de semillas por parte de las hormigas es una interacción que puede afectar en gran medida la dinámica y estructura de la vegetación. Este aspecto es bien conocido para las hormigas granívoras; sin embargo, hay poca información sobre el efecto de las omnívoras. Objetivo: Evaluar el impacto potencial de la hormiga omnívora Dorymyrmex insanus sobre la vegetación. Métodos: En la Reserva Pedregal, Ciudad de México, se identificaron los ítems en el área del basurero para diez colonias de hormigas, durante un año, cubriendo la época de lluvia y sequía. Para cada temporada calculamos la diversidad de semillas y analizamos la posible relación entre el tamaño de las semillas y su abundancia en los basureros, con modelos de regresión. También hicimos pruebas de germinación con semillas de Tagetes micrantha, comparando las encontradas en los basureros con las provenientes de las plantas. Resultados: D. insanus eliminó semillas de 19 especies de plantas, así como restos de plantas (hojas, ramitas, raíces) y restos de insectos. La diversidad de semillas fue mayor en la estación lluviosa pero la mayor abundancia lo fue en la estación seca. Al analizar la relación entre la longitud de las semillas y la abundancia en el área del basurero, encontramos que las hormigas preferían semillas de alrededor de 10 mm. También encontramos que germinaron más semillas de T. micrantha cuando fueron manipuladas previamente por hormigas. Conclusiones: La hormiga D. insanus participa activamente en la remoción de semillas de varias especies, favoreciendo la germinación, y la estacionalidad afecta la selectividad de recursos.
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Animais , Formigas , Cinturão Ecológico , Dispersão de Sementes , Himenópteros/classificação , MéxicoRESUMO
BACKGROUND: Non-suicidal self-injury (NSSI) may lead to scarring, infection, accidental death and psychological distress. Little is known about NSSI in the general population of young adults in developing countries like Mexico. The current study examined the prevalence of any NSSI and each type of NSSI, the prevalence of meeting DSM-5 proposed criteria, and finally the association of NSSI with socio-demographic variables, suicidal behavior and psychiatric disorders. METHODS: This study was conducted in a community sample of 1071 young adults between 19 and 26 years of age residents of Mexico City. RESULTS: The lifetime prevalence of NSSI was 18.56% with females having 87% greater odds. The 12-month prevalence was 3.19%. Only 0.22% of the total sample and 6.96% of those that self-injured in the past 12 months met full criteria proposed by DSM-5, in part due to the lack of reported impairment; 39.99% of those that self-injured reported impairment. Suicidal behavior commonly co-occurred with NSSI. All lifetime anxiety, mood, disruptive behavior and substance use disorders were associated with greater risk for lifetime NSSI whereas only 12-month depression and substance use disorder was associated with greater risk of 12-month NSSI. LIMITATIONS: The cross-sectional nature of the study precludes conclusions of causality and directionality and the study excluded institutionalized and homeless young adults. CONCLUSIONS: NSSI is a concerning problem in young adults from Mexico City due to the important associations with all types of psychiatric disorders and suicidal behavior. Because many who self-injure do not perceive impairment, they are unlikely to seek treatment.
Assuntos
Transtornos Mentais/complicações , Comportamento Autodestrutivo/epidemiologia , Ideação Suicida , Adulto , Ansiedade/complicações , Estudos Transversais , Depressão/complicações , Países em Desenvolvimento , Feminino , Humanos , Masculino , México/epidemiologia , Prevalência , Fatores de Risco , Comportamento Autodestrutivo/psicologia , Fatores Sexuais , Transtornos Relacionados ao Uso de Substâncias/complicações , Tentativa de Suicídio/estatística & dados numéricos , Adulto JovemRESUMO
The purpose of this study was to identify relationships between spoligotypes of M. bovis from cattle in Mexico and those reported in countries with free trade of cattle with Mexico: Australia, Canada, New Zealand and the United States of America. Mexican spoligotypes were obtained from isolates collected from cattle in different parts of the country. Spoligotypes from Canada and New Zealand were obtained from different reports in the literature. Those from the United States were obtained from the database of the National Veterinary Services Laboratory in APHIS-USDA. In order to perform the analysis in a single data set, spoligotypes were all converted to binary data and classified according to www.mbovis.org or www.pasteur-guadeloupe.fr:8081. Epidemiologic information included country and species infected. From 3,198 isolates, 174 different spoligotypes were obtained, 95 were orphans. Ninety one percent of the isolates came from the Unites States (n = 1,609) and Mexico (n = 1,323). Spoligotype SB0265 is shared between Canada and the United States in cattle and wildlife. Six spoligotypes, SB0673, SB0121, SB0145, SB0971, SB0140 and SB1165, were frequent in cattle and wildlife in the United States and cattle in Mexico, suggesting wide exchange of strains. Spoligotype SB0669 was found only in Mexico. Spoligotype SB0140 was the most common in Australia and the sixth in the United States and Mexico. In a phylogenetic analysis, spoligotype SB0140 appears as the oldest spoligotype in the data set, suggesting this as the ancestral spoligotype for all spoligotypes in the five countries. Some spoligotypes are shared by animals and humans, corroborating the zoonotic importance of M. bovis.
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Comércio , Internacionalidade , Mycobacterium bovis/genética , Animais , Técnicas de Tipagem Bacteriana , Bovinos , México , Mycobacterium bovis/classificaçãoRESUMO
Colletotrichum species are associated with Apple bitter rot (ABR) and Glomerella leaf spot (GLS). Whereas both apple diseases occur frequently in Brazil, only the former has been reported in Uruguay. This work was aimed at identifying and comparing morpho-cultural characteristics and pathogenic variability of thirty-nine Colletotrichum isolates from both countries. Sequencing of the internal transcribed spacer (ITS) rDNA, glyceraldehyde-3-phosphate dehydrogenase (GAPDH), and ß-tubulin (TUB2) allowed the identification of three species causing ABR and GLS in Brazil, i.e., Colletotrichum fructicola, Colletotrichum karstii, and Colletotrichum nymphaeae; and three species causing ABR in Uruguay, i.e., C. fructicola, Colletotrichum theobromicola, and Colletotrichum melonis. Six groups of colony colours were recorded with group 1 (mycelium white to pink and in reverse pinkish) and group 2 (mycelium white to grey and in reverse pinkish) the most frequent. Isolates of C. fructicola and C. theobromicola were sensitive to benomyl, while C. karstii, C. nymphaeae, and C. melonis were resistant. Conidia were predominantly cylindrical for C. fructicola and C. karstii, fusiform for C. nymphaeae and C. melonis, and obclavate for C. theobromicola. Brazilian isolates caused ABR in wounded fruits, but only five in non-wounded ones. Uruguayan isolates produced symptoms in fruits with or without previous wounding. All Brazilian isolates from GLS and twelve from ABR were able to cause GLS symptoms, while a sole Uruguayan ABR-isolate caused leaf spot symptoms. This study gives a better insight on the new species causing apple disease in both countries and discusses their pathogenic potential.
Assuntos
Colletotrichum/classificação , Colletotrichum/isolamento & purificação , Malus/microbiologia , Doenças das Plantas/microbiologia , Brasil , Análise por Conglomerados , Colletotrichum/citologia , Colletotrichum/genética , DNA Espaçador Ribossômico/química , DNA Espaçador Ribossômico/genética , Gliceraldeído-3-Fosfato Desidrogenase (Fosforiladora)/genética , Dados de Sequência Molecular , Micélio/citologia , Filogenia , Análise de Sequência de DNA , Esporos Fúngicos/citologia , Tubulina (Proteína)/genética , UruguaiRESUMO
OBJECTIVE: To estimate the prevalence, sex, age distribution, and socio-demographic correlates of any alcohol use, consumption patterns, and any alcohol use disorder in a representative sample of Mexican adolescents. METHODS: 3005 youth (52.1% female) aged 12-17 from a stratified multistage area probability sample were representative of adolescents residing in the Mexico City Metropolitan Area. Alcohol use and disorder and their socio-demographic correlates were evaluated with the World Mental Health adolescent version of the Composite International Diagnostic Interview. Data were post-stratified to the total Mexico City adolescent population. RESULTS: 59% has used alcohol, this proportion increasing significantly with age. By age 17, 82.5% has used alcohol. Consumption patterns are mostly of low/moderate quantity or infrequent high quantity. Lifetime DSM-IV alcohol use disorder criteria are met by 3.8%, reaching 8.1% for 16-17 years-olds. While males have greater frequency and quantity of drinking, there are no gender differences for alcohol use disorders. Non-school attending youth have twice the odds of a lifetime (OR=2.0, 95% CI=1.13-3.53) and 12-month disorder (OR=2.1, 95% CI=1.10-4.15). Low parental monitoring is associated with 1.72 times the odds of a lifetime disorder (95% CI=1.10-2.68). CONCLUSIONS: Over a third of 12 year-olds had ever drunk an alcoholic beverage in their lifetime suggesting that the prevention of alcohol use and disorders must begin in late childhood. Initiatives to foment parental monitoring and to prevent, identify, and treat alcohol use problems in non-school attending youth in particular should be a priority for the wellbeing of Mexico City adolescents.
Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Alcoolismo/epidemiologia , Adolescente , Fatores Etários , Idade de Início , Criança , Interpretação Estatística de Dados , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Inquéritos Epidemiológicos , Humanos , Modelos Logísticos , Masculino , Saúde Mental , México/epidemiologia , Prevalência , Fatores Sexuais , Fatores Socioeconômicos , População UrbanaRESUMO
"Test-and-slaughter" has been successful in industrialized countries to control and eradicate tuberculosis from cattle; however, this strategy is too expensive for developing nations, where the prevalence is especially high. Vaccination with the Calmette-Guérin (BCG) strain has been shown to protect against the development of lesions in vaccinated animals: mouse, cattle and wildlife species. In this study, the immune response and the pathology of vaccinated (BCG-prime and BCG prime-CFP-boosted) and unvaccinated (controls) calves were evaluated under experimental settings. A 10(6) CFU dose of the BCG strain was inoculated subcutaneously on the neck to two groups of ten animas each. Thirty days after vaccination, one of the vaccinated groups was boosted with an M. bovis culture filtrate protein (CFP). Three months after vaccination, the three groups of animals were challenged with 5×10(5) CFU via intranasal by aerosol with a field strain of M. bovis. The immune response was monitored throughout the study. Protection was assessed based on immune response (IFN-g release) prechallenge, presence of visible lesions in lymph nodes and lungs at slaughter, and presence of bacilli in lymph nodes and lung samples in histological analysis. Vaccinated cattle, either with the BCG alone or with BCG and boosted with CFP showed higher IFN-g response, fewer lesions, and fewer bacilli per lesion than unvaccinated controls after challenge. Animals with low levels of IFN-g postvaccine-prechallenge showed more lesions than animals with high levels. Results from this study support the argument that vaccination could be incorporated into control programs to reduce the incidence of TB in cattle in countries with high prevalence.
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Vacina BCG/imunologia , Mycobacterium bovis/imunologia , Tuberculose Bovina/prevenção & controle , Animais , Vacina BCG/administração & dosagem , Bovinos , Interferon gama/sangue , Testes de Liberação de Interferon-gama , Pulmão/microbiologia , Pulmão/patologia , Linfonodos/microbiologia , Linfonodos/patologia , Teste Tuberculínico , Tuberculose Bovina/diagnóstico , Vacinação/veterináriaRESUMO
The molecular fingerprints of 878 isolates of Mycobacterium bovis collected from cattle between 2009 and 2010 in different regions of Mexico were used in this study. One hundred and ninety-four spoligotypes were observed in total with a high degree of heterogeneity. Sixty-four percent of the isolates grouped into just nine spoligotypes, and 27% fell into only two spoligotypes: SB0673 and SB0669; 149 were orphan spoligotypes. The two predominant spoligotypes were found in almost all states in Mexico, especially in central Mexico, where there is a high concentration of dairy cattle; however, some spoligotypes were closely associated with restricted geographical areas. The hypothetical evolutionary relationship among spoligotypes was estimated using the spoligoforest program in the spolTools webpage. Four trees with connected components and nine unconnected nodes were found. The biggest tree had SB0140 strain as a root, suggesting this as the oldest strain in the tree. However, the relationship of this spoligotype with SB0673 and SB0669 was weak. The discriminatory power of spoligotyping for this M. bovis sample of isolates was 0.94, and the recent transmission index (RTI) 0.83, suggesting a high rate of recent transmission of some strains of M. bovis in the population. This parameter indicates that new measures are required to stop the dissemination of tuberculosis in cattle.
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Técnicas de Tipagem Bacteriana/veterinária , Mycobacterium bovis/classificação , Mycobacterium bovis/genética , Filogenia , Tuberculose Bovina/microbiologia , Animais , Bovinos , Feminino , Masculino , México/epidemiologia , Epidemiologia Molecular , Mycobacterium bovis/isolamento & purificação , Oligonucleotídeos/análise , Tuberculose Bovina/epidemiologiaRESUMO
BACKGROUND: Controversy exists in treatment planning relative to the attempt of saving a tooth with unfavorable prognosis or extracting it and placing an immediate or delayed implant. Preextraction radiographic assessments of teeth are traditionally performed using two-dimensional periapical and panoramic radiographs. These can reveal bone loss around a tooth, but have limited use in assessing implant risk before tooth extraction. Three-dimensional radiographs or cone-beam (CB) or computerized tomographic (CT) scans are often taken after tooth extraction and socket healing to assess the healed ridge as a potential implant site. However, when treatment planning for an immediate implant in the posterior mandible, a CT scan taken before tooth extraction can be of value in assessing the available bone and anatomy of the area. This allows the clinician and patient to consider alternative options, such as treating and maintaining the tooth or using a delayed implant protocol, when the site presents a high risk for immediate implant placement (IIP). The purpose of the present study is to assess the prevalence of sites associated with the mandibular second premolar, mandibular first molar, and mandibular second molar teeth that present high risk for IIP using a preextraction CT scan to assess the available apical bone and the anatomy of the posterior mandible in the area of the anticipated extraction site. METHODS: One hundred consecutive CT scans were obtained and screened from the New York University College of Dentistry, Office of Quality Assurance-Approved Implant Dentistry Database. Forty-one of these CT scans were further assessed because they included the presence of ≥2 of the following tooth types: mandibular second premolars, mandibular first molars, and mandibular second molars. Measurements were obtained on the axial sections of the selected teeth to evaluate the amount of bone available apical to the root apices to determine the frequency of sites where an IIP protocol presented a high risk for inferior alveolar nerve injury or lingual plate perforation. RESULTS: Of the 135 teeth assessed from 41 CT scans, 65% of the mandibular second premolars, 53% of the mandibular first molars, and 73% of mandibular second molars had <6 mm of bone available for IIP, presenting high risk for inferior alveolar nerve injury. Of the sites in which the inferior alveolar canal did not limit available bone for IIP, 7% of the second premolars, 9% of the first molars, and 31% of the second molars presented high risk for lingual plate perforation. CONCLUSIONS: Preextraction CT scans may present a useful diagnostic aid to assess the risk of inferior alveolar nerve injury and lingual plate perforation for IIP in the posterior mandible. This information may be used for assessing risk when deciding whether to retain a questionable tooth or replace it with an implant with either an IIP or delayed protocol.
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Perda do Osso Alveolar/diagnóstico por imagem , Implantação Dentária Endóssea/efeitos adversos , Mandíbula/diagnóstico por imagem , Medição de Risco/métodos , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Extração Dentária/efeitos adversos , Processo Alveolar/lesões , Dente Pré-Molar , Traumatismos dos Nervos Cranianos/prevenção & controle , Implantação Dentária Endóssea/métodos , Humanos , Dente Molar , Planejamento de Assistência ao Paciente , Cuidados Pré-Operatórios , Fatores de Tempo , Traumatismos do Nervo TrigêmeoRESUMO
Objetivo Identificar y analizar las principales situaciones de crisis que enfrentan los familiares de pacientes con esquizofrenia, así como sus necesidades en la atención psiquiátrica en momentos de crisis. Método Con metodología cualitativa de recolección y análisis, la técnica utilizada fue la creación de un grupo de discusión con ocho familiares de pacientes con esquizofrenia. Las sesiones grupales se grabaron y transcribieron para analizar posteriormente la información. Además, se realizaron entrevistas individuales a cada familiar. Resultados Los familiares destacaron tres principales situaciones de crisis: 1. La crisis psicótica; 2. La crisis familiar ante el diagnóstico y en el proceso de aceptación de la enfermedad; 3. La crisis ante las recaídas subsecuentes. También se detallan: 4. Las deficiencias en la atención en situaciones de crisis y 5. Las necesidades de los familiares en estas situaciones. Conclusiones Desde la narrativa de los familiares se puede destacar la experiencia de una falta de información tanto a familiares y a pacientes como a la población en general, para que se conozcan los principales rasgos y síntomas que caracterizan a la esquizofrenia, para lograr con ello una detección temprana que facilite el tratamiento y la prevención de crisis posteriores. Es conveniente desarrollar intervenciones en los momentos de crisis y establecer una red social de apoyo en la comunidad.
Objetive This article presents the main crisis situations faced by the relatives of schizophrenic patients, as well as their needs in psychiatric attention at moments of crisis. Method Qualitative study. A discussion group of eight parents of patients with schizophrenia was conformed. The group sessions were recorded and transcribed to analyze the information later on. In addition, the information was complemented with individual interviews of the relatives. Results Parents emphasized three main crisis situations: 1. a first psychotic crisis, 2. family crisis facing the diagnosis and in the process of acceptance of the disease, and 3. subsequent relapses. 4. Deficiencies in the care crisis, and 5. needs of families in crisis situations are also detailed. Conclusions According to the narratives related by the relatives of the discussion group, we can conclude that it is necessary to provide information to the family, the patients and the general population, so that there is a knowledge of the main characteristics and symptoms of schizophrenia. This should be carried out with the purpose of obtaining an early detection that facilitates the treatment and prevents later crises interventions and creating a social support network in the community.
RESUMO
OBJETIVO: Estimar los costos individuales y poblacionales de condiciones crónicas físicas y mentales comunes en la población mexicana, en función del número de días perdidos por problemas en el funcionamiento. MATERIAL Y MÉTODOS: 5 826 adultos fueron evaluados entre 2001-2002 con la Entrevista Internacional Psiquiátrica Compuesta y el Cuestionario para la Evaluación de Discapacidades. Se realizaron modelos generales lineales y se estimó la proporción de riesgo atribuible a la población, tomando en cuenta la prevalencia de la condición y la comorbilidad. RESULTADOS: Las condiciones de mayor impacto para el individuo son la depresión, el estrés postraumático y el trastorno bipolar. Las de mayor impacto a nivel poblacional son la depresión, el dolor, el insomnio y las enfermedades cardiovasculares. CONCLUSIÓN: Los hallazgos señalan la importancia de aumentar el gasto en salud mental para asignar una proporción más equitativa para su atención en cuanto al costo que representan para la sociedad.
OBJECTIVE: To estimate the individual and societal costs of common mental and physical health conditions in the Mexican population with regards to the number of days out of role. MATERIALS AND METHODS: 5 826 adults were evaluated in 2001-2002 with the Composite International Diagnostic Interview and the WHO Disability Assessment Schedule. General linear models were used to estimate individual-level effects. Societal-level effects were estimated with the population attributable risk proportion which takes into account prevalence and comorbidity of disorders. RESULTS: The conditions with the strongest individual -level effects were major depression, post-traumatic stress disorder and bipolar disorder. The strongest societal-level effects were associated with major depression, pain, insomnia and cardiovascular conditions. CONCLUSION: The findings suggest the importance of investing in mental health expenditure to a level commensurate with the costs to society of mental health disorders.
Assuntos
Adolescente , Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Doença Crônica/economia , Transtornos Mentais/economia , Doença Crônica/epidemiologia , Efeitos Psicossociais da Doença , Transtornos Mentais/epidemiologiaRESUMO
The purpose of this study was to use geographic information systems (GIS) and geo-statistical methods of ordinary kriging to predict the prevalence and distribution of bovine tuberculosis (TB) in Jalisco, Mexico. A random sample of 2 287 herds selected from a set of 48 766 was used for the analysis. Spatial location of herds was obtained by either a personal global positioning system (GPS), a database from the Instituto Nacional de Estadìstica Geografìa e Informàtica (INEGI) or Google Earth. Information on TB prevalence was provided by the Jalisco Commission for the Control and Eradication of Tuberculosis (COEETB). Prediction of TB was obtained using ordinary kriging in the geostatistical analyst module in ArcView8. A predicted high prevalence area of TB matching the distribution of dairy cattle was observed. This prediction was in agreement with the prevalence calculated on the total 48 766 herds. Validation was performed taking estimated values of TB prevalence at each municipality, extracted from the kriging surface and then compared with the real prevalence values using a correlation test, giving a value of 0.78, indicating that GIS and kriging are reliable tools for the estimation of TB distribution based on a random sample. This resulted in a significant savings of resources.
RESUMO
Objetivo. Se estudió la prevalencia del consumo y el abuso en la ingestión de alcohol entre los casos de urgencias médicas, accidentes y violencias atendidos en las salas de urgencias de tres hospitales del sector salud de la ciudad de Pachuca, Hidalgo. Material y métodos. Se aplicó un cuestionario y se hizo una medición de alcohol en sangre a las personas que solicitaron atención por primera vez en estos servicios de urgencias. El cuestionario recabó datos demográficos, patrones de consumo de alcohol, escalas para medir la dependencia y el consumo riesgos de alcohol, tales como el CAGE y el Alcohol Use Disorders Identification Test (AUDIT). Se comparó, por medio de la prueba X², el consumo de alcohol entre los pacientes que ingresaron por un accidente o acto de violencia y aquellos que ingresaron debido a una urgencia médica. Resultados. Se evaluaron 1 511 pacientes. El consumo fue mayor y más frecuente en los pacientes que ingresaron por un accidente o porque fueron víctimas de la violencia, en comparación con las urgencias médicas. De los pacientes con accidentes o víctimas de la violencia, 17.7 por ciento fueron positivos al alcosensor y 15.8 por ciento notificaron consumo de alcohol en las seis horas previas al accidente. El CAGE detectó como dependiente a 9.2 por ciento de los casos, y 10.9 por ciento calificaron como bebedores riesgosos según el AUDIT. Conclusiones. El consumo de bebidas alcohólicas, especialmente en los pacientes atendidos en los servicios de urgencias debido a un accidente o acto de violencia, es elevado. Son indispensables las medidas preventivas para disminuir el costo individual y social del abuso en el consumo de alcohol en esta población
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Serviço Hospitalar de Emergência , Serviço Hospitalar de Emergência/estatística & dados numéricos , Hospitais Gerais , Hospitais Gerais/estatística & dados numéricos , Consumo de Bebidas Alcoólicas , Distribuição de Qui-Quadrado , México/epidemiologiaRESUMO
Se utilizó un diseño de casos y controles. Los casos son los pacientes que ingresaron a los servicios de urgencias por alguna lesión producida por un accidente automovilístico(n = 112), los controles provienen de una encuesta de hogares definido bajo los criterios censales de las áreas geoestadísticas básicas de la población de residentes de la misma ciudad, que aceptaron participar (n = 920). En ambas muestras participaron hombres y mujeres de 18 a 65 años, a los cuales se les aplicó un cuestionario estandarizado de manera individual cara a cara. Por medio de la entrevista se obtuvo información sobre las características sociodemográficas, el patrón de consumo de alcohol, la frecuencia con la que se embriagaban, su consumo de alcohol 6 horas antes de sufrir el accidente, así como las características del accidente vehicular tales como: el uso del cinturón de seguridad y la posición que ocupaban dentro del vehículo en el momento del accidente. La lectura del alcosensor que proporciona los niveles de alcohol en sangre por medio del aliento, fue aplicado únicamente en las salas de urgencias. Ciento doce personas sufrieron lesiones a consecuencia de un accidente automovilístico. En la encuesta de hogares la muestra fue de 920 personas. Al comparar las características sociodemo gráficas de ambas muestras, se encontró que 66 por ciento de los pacientes eran hombres. En la encuesta de hogares la mayoría eran mujeres (54.8 por ciento)(X²=17.41, p=.000). Los sujetos menores de 39 años predominaron en ambas muestras. Al analizar los datos sobre los accidentados ocasionados por vehículos de motor, se encontró que 18.3 por ciento de estos accidentes ocurrieron en domingo, y 93.9 por ciento de los accidentados manifestaron no haber utilizado el cinturón de seguridad. De acuerdo con la lectura del alcosensor, en 13.4 por ciento de los pacientes se encontraron lecturas positivas de alcohol en sangre. El 14.6 por ciento de los pacientes aceptó haber consumido alcohol 6 horas antes de sufrir el accidente (odds ratios=8.60 con intervalo de confianza = 4.00 - 18.49). No se encontraron asociaciones con las variables de consumo de alcohol habitual (en los últimos 12 meses), ni con la dependencia del alcohol
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Fatores de Risco , Alcoolismo , Acidentes de Trânsito , Ferimentos e Lesões , Consumo de Bebidas AlcoólicasRESUMO
La ileítis porcina es una enfermedad que ocasiona importantes pérdidas económicas a la industria porcina. El agente causal de esta enfermedad es Lawsonia intracellularis, un microorganismo de dificl cultivo. Por esta razón, el diagnóstico, generalmente se realiza sólo al sacrificio. Debido a la dificultad del diagnóstico en animales vivos, se han desarrollado técnicas para detectar el ADN de la L. intracellularis por medio de la reacción en cadena de la polimerasa (PCR). El objetivo de este trabajo fue evaluar la técnica de PCR para el diagnóstico de la ileítis porcina en muestras de mucosa intestinal y heces de cerdos sospechosos de la enfermedad. El ADN fue extraído usando tierras diatomeas y tiocainato de guanidina. Para la amplificación del ADN se utilizaron oligonucleótidos específicos que amplifican un fragmento de ADN de L. intracellularis de 319 pb. La estandarización de la técnica se realizó a partir de mucosa intestinal de un cerdo infectado experimentalmente. La mínima cantidad de ADN de mucosa infectada que se detectó por PCR fue de 3.72 ng. Cuando la mucosa infectada fue adicionada a muestras de heces normales se necesitaron 12.4 ng del ADN extraído, para obtener un producto de amplificación visible. El producto de amplificación esperado de 319 pb fue también obtenido de mucosa intestinal o muestras de heces de cerdos infectados con signos clínicos característicos de ileítis porcina. Se concluyó que la técnica de PCR puede ser muy útil para el diagnóstico de esta enfermedad y para la determinación de la prevalencia de la ileítis porcina en diferentes áreas