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1.

Modelo operativo de promoción de la salud y prevención de enfermedades bucales en preescolares de Cuautla, Morelos-México/ Operational model of health promotion and prevention of oral diseases in preschool children in Cuautla, Morelos-Mexico

Flores-Alatorre, José Francisco; Caballero-García, Cristina Raquel; Bonilla-Fernández, Pastor; Atrisco-Olivos, Rosaura; Arenas-Monreal, María de la Luz
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| Idioma(s): Español
Las estrategias tradicionales para abordar la salud bucal en México han carecido de un enfoque integrado a la promoción de la salud y a los factores de riesgo en común con otras patologías, principalmente crónicas. De unir esfuerzos se aprovecharían mejor los limitados recursos sanitarios. Esta investigación tuvo como objetivo implementar un modelo operativo de promoción de la salud y prevención de las enfermedades bucales, usando un ciclo de mejora continua en el preescolar de la comunidad Peña-Flores, Cuautla, Morelos. Se realizó un estudio cuasi-experimental con 120 niños de ambos sexos. La implementación contempló: diagnóstico epidemiológico bucal y social, capacitación de actores clave, ejecución del programa de salud bucal, monitoreo, análisis y evaluación de resultados. Se levantaron datos mediante una guía de observación participante, de reuniones con madres de familia y maestras bajo la perspectiva participativa del triple diagnóstico de educación popular. Se determinó el índice de dientes cariados, a extraer y obturados. Se realizó la medición de la placa dento-bacteriana utilizando el índice de sedimento dental (DIS). Como resultado del control y sistematización del proceso de cepillado dental y del monitoreo de la placa dento-bacteriana, se identificó una disminución del DIS de 1,04 a 0,47. Con la implementación de un menú escolar, se mejoró la alimentación infantil. El modelo implementado constituye una posible solución a la problemática de salud bucal del preescolar de la comunidad Peña-Flores, situado en un contexto de desventaja social por factores como pobreza, migración y déficit de servicios públicos(AU)
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2.

Government expenditure on health and maternal mortality in México: A spatial-econometric analysis.

Pérez-Pérez, Eduardo; Serván-Mori, Edson; Nigenda, Gustavo; Ávila-Burgos, Leticia; Mayer-Foulkes, David
| Idioma(s):
OBJECTIVE: To assess the relationship between government expenditure on maternal health (GE) and maternal mortality (MM) in Mexican poor population between 2000 and 2015 in the 2457 Mexican municipalities. METHODS: Using administrative data, we performed the analysis in three stages: First, we tested the presence of selection bias in MM. Next, we assessed the presence of spatial dependence in the incidence and severity of MM. Finally, we estimated a spatial error model considering the correction of estimates for the spatial dependence and selection bias assessed before. RESULTS: MM and GE were not randomly distributed throughout the Mexican territory; the most socially vulnerable municipalities exhibited the highest levels of MM severity but the lowest levels of GE and available human and physical resources for maternal health; the incidence of MM was independent of GE; elasticity of GE-severity in MM was -4% (P < 0.01). CONCLUSIONS: Resource allocation for maternal health must move towards a more comprehensive vision, and efforts to achieve an effective delivery of universal health services must improve, particularly regarding the most vulnerable municipalities.
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3.

Mercury and other trace metals in lettuce (Lactuca sativa) grown with two low-salinity shrimp effluents: Accumulation and human health risk assessment.

León-Cañedo, Jesús A; Alarcón-Silvas, Suammy G; Fierro-Sañudo, Juan F; Rodríguez-Montes de Oca, Gustavo A; Partida-Ruvalcaba, Leopoldo; Díaz-Valdés, Tomás; Páez-Osuna, Federico
| Idioma(s): Inglés
Shrimp farming effluents from two sources of low-salinity water, well water (WW) and diluted seawater (DSW) (salinity, 1.7 g L ; electrical conductivity, 2.7 dS m ), were used to grow lettuce (L. sativa) in order to assimilate the nutrients present in shrimp effluents and produce edible biomass. The two treatments, WW and DSW, were tested in triplicate. Additionally, one hydroponic system in triplicate was constructed to grow lettuce using a nutritive solution as the control treatment (HS). The production variables of lettuce in the two crop varieties (Parris Island (VPI) and Tropicana M1 (VTM1)) showed a general trend of DSW > HS > WW with regards to the size, weight and total foliage, except for the number of leaves, which was higher with HS treatment than with WW and DSW treatments. The accumulation of Cu, Hg, Mn and Zn in edible lettuce tissue and the health risk by the intake of lettuce were evaluated. Heavy metal concentrations in edible lettuce tissue for the three treatments showed the same trend of Mn > Zn > Cu > Hg, with concentration ranges of 47.1 to 188.7, 35.7 to 66.2, 4.1 to 6.4, and 0.01 to 0.02 mg kg (dry weight), respectively. Such concentrations did not exceed the safe limits (CAC, 1984). The health risk index and target hazard quotient were <1, which indicates that the population exposed to these metals due to intake from lettuce consumption is unlikely to have adverse health effects when shrimp farming effluents are used to grow lettuce plants.
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4.

Una etnografía del aborto clandestino en contextos de interrupción legal del embarazo. Estudio de caso entre estudiantes de la Ciudad de México/ An ethnography of clandestine abortion in contexts of legal interruption of pregnancy. A case study among students of Mexico City/ Uma etnografia do aborto clandestino em contextos de interrupção legal da gravidez. Estudo de caso entre alunos da Cidade do México

Hernández-Rosete, Daniel; Hipólito, Rocío Estrada
| Idioma(s): Español
Resumen En este artículo se analizan las creencias sobre embarazo juvenil y su relación con la decisión de interrumpir un embarazo no deseado de manera clandestina, a pesar de la existencia de la Interrupción Legal del Embarazo (ILE). Se trata de un estudio con enfoque fenomenológico, que explora los universos de sentido y significado, sustentado en observación etnográfica y en 32 entrevistas a estudiantes y a 3 profesores de un bachillerato en la Ciudad de México. Se encontró que la sexualidad es vivida en una dimensión culposa que afecta la dignidad y dificulta la toma de conciencia en materia de derechos sexuales y reproductivos. La laicidad sólo funciona como un ideal constitucional, ya que las creencias y prejuicios juegan un papel imprescindible en la creación de puntos de vista entre los estudiantes. Sin embargo, el aborto sigue siendo visto como un pecado pero, paradójicamente, supone prácticas de clandestinaje que ponen en riesgo la salud sexual y reproductiva de las jóvenes menores de edad, debido a inconsistencias legales. Abstract This article analyzes the beliefs youth pregnancy and its relationship with the decision to interrupt an unwanted pregnancy clandestinely, despite a Legal Interruption of Pregnancy (ILE) being available. It is a study with a phenomenological approach, which explores the universes of meaning, based on ethnographic observation and 32 interviews with students and 3 teachers in Mexico City. Results show sexuality is lived in a guilt dimension affecting dignity and awareness of sexual and reproductive rights. Secularism works only as a constitutional ideal, since beliefs and prejudices play an essential role in the creation of points of view among students. Abortion is still seen as a sin but, paradoxically, it involves clandestine practices that put the sexual and reproductive health of young girls at risk, due to legal inconsistencies. Resumo Este trabalho analisa as crenças sobre a gravidez na juventude e sua relação com a decisão de interromper uma gravidez indesejada clandestinamente, a despeito da existência da Interrupção Legal da Gravidez (ILE). Trata-se de um estudo com abordagem fenomenológica que explora os universos de significado e sentido, respaldado por observação etnográfica e 32 entrevistas com alunos e 3 professores na Cidade do México. Constatou-se que a sexualidade é vivenciada em uma dimensão de culpa que afeta a dignidade e dificulta a tomada de consciência sobre os direitos sexuais e reprodutivos. O secularismo funciona apenas como um ideal constitucional, uma vez que as crenças e os preconceitos desempenham um papel essencial na criação de pontos de vista entre os estudantes. No entanto, o aborto ainda é visto como um pecado, mas, paradoxalmente, envolve práticas clandestinas que colocam em risco a saúde sexual e reprodutiva das meninas devido a inconsistências legais.
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7.

Variability of defensin genes from a Mexican endemic Triatominae: (Hemiptera: Reduviidae).

Díaz-Garrido, Paulina; Sepúlveda-Robles, Omar; Martínez-Martínez, Ignacio; Espinoza, Bertha
| Idioma(s): Inglés
Chagas disease remains a serious health problem for countries where the most common mode of transmission is infection contracted from the feces of a Triatominae insect vector. In México, 32 species of Triatoma have been identified; amongst them, is an endemic species reported to have high percentages of infection with Defensins, cysteine-rich cationic peptides, are a family of antimicrobial peptides (AMPs); the synthesis of these molecules is crucial for insect's immune defense. In the present study, the genes encoding defensins in were sequenced with the purpose of identifying the variability of these genes in a Mexican vector of We found 12 different genes encoding three mature peptides, all of which had the typical folding of a functional insect defensin. In this work two Defensins type 1 and one type 4 were identified. The pro-peptide domain was highly variable and the mature peptide was not. This is the first report focus on variability of defensins from an epidemiologically important in Mexico.
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8.

Aplicación de un programa preventivo de salud bucal en escuelas primarias mexicanas/ Application of an oral health prevention program in Mexican elementary schools

Cruz Martínez, Rosa María; Saucedo Campos, Gerardo Alfonso; Ponce Rosas, Efrén Raúl; González Pedraza Avilés, Alberto
| Idioma(s): Español
Introducción: la alta prevalencia de enfermedades bucales en los escolares, tiene un impacto importante en su salud, lo que ha generado la necesidad de desarrollar programas y estrategias a nivel de políticas públicas para su control. Objetivo: evaluar el Programa de Salud Bucal en alumnos de escuelas primarias mexicanas. Métodos: estudio de intervención comunitaria en dos escuelas primarias públicas de la Secretaria de Salud, en la Delegación de Tlalpan, Ciudad de México. Se incluyeron 111 alumnos de quinto grado de primaria, 53 pertenecientes a la escuela primaria pública del turno matutino Río Pánuco como grupo de intervención con aplicación del Programa de Salud Bucal (grupo de trabajo), y 58 correspondientes a la escuela Ignacio Rodríguez Galván, sin intervensión (grupo control). A todos los alumnos se les realizó determinación de los índices de dientes cariados, perdidos y obturados temporales, y permanentes, y el índice periodontal comunitario. Para el análisis estadístico inferencial se utilizó U de Mann-Whitney y chi cuadrado de Pearson, con nivel de significancia 0,05. Se empleó el programa estadístico SPSS versión 22. Resultados: el promedio de edad de los niños de la escuela con intervención fue de 10,9 y de la escuela control de 10,8. En el índice para dentición temporal, el promedio de dientes cariados fue de 0,49 (IC 95 por ciento 0,07-0,91) para la escuela que intervino en el programa, y de 1,10 (IC 95 por ciento 0,70-1,51) para escuela sin intervención, con diferencias estadísticas significativas (p= 0,003). En el índice periodontal comunitario, se obtuvo 92,4 por ciento de escolares sanos para la escuela que intervino en el programa, y de 70,68 por ciento para la escuela sin intervención, con diferencia estadística significativa (p= 0,003). Conclusiones: los resultados muestran que el programa es efectivo ya que la población intervenida presenta mejores condiciones de salud bucal que los escolares del grupo control, diferencia esta clínicamente relevante(AU) Introduction: the high prevalence of oral disease among school children has a great impact on their health, hence the need to develop control programs and strategies at public policy level. Objective: evaluate the Oral Health Program for Mexican elementary school children. Methods: a community intervention study was conducted in two public elementary schools from the Ministry of Health in the borough of Tlalpan, Mexico City. The study sample was composed of 111 fifth grade students, 53 from Río Pánuco morning session public school as intervention group with application of the oral health program (work group), and 58 from Ignacio Rodríguez Galván school, without intervention (control group). All students were examined to determine the rate of decay, loss, temporary fillings and permanent teeth, and the community periodontal index. Inferential statistical analysis was based on Mann-Whitney U and Pearson's chi-square, with a significance level of 0.05. Data were processed with the statistical software SPSS version 22. Results: mean age was 10.9 at the intervention school and 10.8 at the control school. With respect to the primary dentition index, the average of decayed teeth was 0.49 (CI 95 percent 0.07-0.91) for the school with the intervention program, and 1.10 (CI 95 percent 0.70-1.51) for the school without intervention, with significant statistical differences (p= 0.003). As to the community periodontal index, 92.4 percent of the children were healthy at the school with the intervention program, and 70.68 percent were healthy at the school without intervention, with a significant statistical difference (p= 0.003). Conclusions: results show that the program is effective, since the school children intervened are in better oral health conditions than those in the control group, and the difference is clinically relevant(AU)
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9.

Manifestaciones de salud asociadas a elementos medio ambientales: el caso de la ocurrencia de coccidioidomicosis en México 2004-2015/ Manifestations of health associated with environmental elements: the case of the occurrence of coccidioidemycosis in Mexico 2004-2015

Manzanares, Jose Luis
| Idioma(s): Español
Resumen Objetivo: Analizar la dinámica temporal de la coccidioido micosis en México, durante el periodo comprendido entre 2004-2015, en el contexto de sus determinantes socio ambientales e identificar su distribución actual en el territorio nacional mediante la construcción de indicadores de concentración geográfica. Métodos: Se conduce análisis exploratorio de datos a partir de microdatos sobre egresos hospitalarios en el periodo 2004-2015. En términos teóricos, la presente investigación se ubica en el paradigma sobre determinantes sociales y ambientales de las condiciones de salud pública. Resultados: La evolución temporal durante 11 años de información analizada permite identificar un patrón persistente en la concentración de casos, que afecta principalmente a cuatro estados en el país, con una clara carga para la población masculina. Se identifica al estado de Sonora como la entidad de mayor incidencia en México, una entidad cuyos determinantes ambientales analizados sugieren la necesidad de implementar políticas públicas preventivas. Conclusiones: Dada la evolución temporal de egresos hospitalarios por coccidiodomicosis en México y el vínculo ambiental de la enfermedad, la evidencia obtenida representa un área de oportunidad para intervenir mediante estrategias de control focalizadas en territorios específicos, siendo el estado de Sonora un sitio prioritario de atención. Abstract Objective: To analyze the temporal dynamics of coccidioide mycosis in Mexico, during the period between 2004-2015 in the context of its socio-environmental determinants and to identify its actual distribution in the national territory by means of the construction of geographical concentration indicators. Methods: An exploratory analysis of data was made from micro data on hospital discharges in the period 2004-2015. In theoretical terms, this research is located in the paradigm on social and environmental determinants of public health conditions. Results: The time evolution during 11 years of analyzed information allows to identify a persistent pattern in the concentration of cases, which mainly affects four states in the country, with a clear burden for the male population. The state of Sonora was identified as the entity with the highest incidence in Mexico, an entity that determines the environmental factors analyzed and the need to implement preventive public policies. Conclusions: Given the temporal evolution of hospital discharges due to coccidioid mycosis in Mexico and the environmental link of the disease, the evidence obtained represents an opportunity to intervene through control strategies focused on specific territories, with the State of Sonora being a priority site of attention.
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10.

NO instrument intercomparison for laboratory biomass burning source studies and urban ambient measurements in Albuquerque, New Mexico.

Allen, Caroline; Carrico, Christian M; Gomez, Samantha L; Andersen, Peter C; Turnipseed, Andrew A; Williford, Craig J; Birks, John W; Salisbury, Dwayne; Carrion, Richard; Gates, Dan; Macias, Fabian; Rahn, Thom; Aiken, Allison C; Dubey, Manvendra K
| Idioma(s): Inglés
Understanding nitrogen oxides (NO = NO + NO ) measurement techniques is important as air-quality standards become more stringent, important sources change, and instrumentation develops. NO observations are compared in two environments: source testing from the combustion of Southwestern biomass fuels, and urban, ambient NO . The latter occurred in the urban core of Albuquerque, NM, at an EPA NCORE site during February-March 2017, a relatively clean photochemical environment with ozone (O ) <60 ppb for all but 6 hr. We compare two techniques used to measure NO in biomass smoke during biomass burning source testing: light absorption at 405 nm and a traditional chemiluminescence monitor. Two additional oxides of nitrogen techniques were added in urban measurements: a cavity attenuated phase shift instrument for direct NO , and the NO chemiluminescence instrument (conversion of NO to NO by molybdenum catalyst). We find agreement similar to laboratory standards for NO , NO , and NO comparing all four instruments (R > 0.97, slopes between 0.95 and 1.01, intercepts < 2 ppb for 1-hr averages) in the slowly varying ambient setting. Little evidence for significant interferences in NO measurements was observed in comparing techniques in late-winter urban Albuquerque. This was also confirmed by negligible NO contributions as measured with an NO instrument. For the rapidly varying (1-min) higher NO concentrations in biomass smoke source testing, larger variability characterized chemiluminescence and absorption instruments. Differences between the two instruments were both positive and negative and occurred for total NO , NO, and NO . Nonetheless, integrating the NO signals over an entire burn experiment and comparing 95 combustion experiments, showed little evidence for large systematic influences of possible interfering species biasing the methods. For concentrations of <2 ppm, a comparison of burn integrated NOx, NO , and NO yielded slopes of 0.94 to 0.96, R of 0.83 to 0.93, and intercepts of 8 to 25 ppb. We attribute the latter, at least in part, to significant noise particularly at low NO concentrations, resulting from short averaging times during highly dynamic lab burns. Discrepancies between instruments as indicated by the intercepts urge caution with oxides of nitrogen measurements at concentrations <50 ppb for rapidly changing conditions. Implications: Multiple NO measurement methods were employed to measure NO concentrations at an EPA NCORE site in Albuquerque, NM, and in smoke produced by the combustion of Southwestern biomass fuels. Agreement shown during intercomparison of these NO techniques indicated little evidence of significant interfering species biasing the methods in these two environments. Instrument agreement is important to understand for accurately characterizing ambient NO conditions in a range of environments.
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