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1.

Realidades de la estomatología en comunidades de pobreza extrema y nuevas urbanizaciones del estado Carabobo/ Realities of estomatology in extreme poverty communities and in the new urbanizations of Carabobo state

Pérez Barrero, Bernardo Ricardo; Ortiz Moncada, Clara; Santana Corrales, Maykel; Gan Cardero, Bárbara; Noriega Roldán, Silvana Oliveros
| Idioma(s): Español
Se realizó un estudio descriptivo, observacional, longitudinal y retrospectivo, de todos los pacientes notificados en los registros estadísticos de las comunidades de pobreza extrema y las nuevas urbanizaciones del estado Carabobo, durante el primer semestre del 2016, con vistas a identificar las actividades desarrolladas en estos, de acuerdo a las siguientes variables: consultas estomatológicas, actividades de promoción de salud, otros procedimientos estomatológicos y las remisiones al segundo nivel de atención. Entre los resultados se obtuvo que el mayor porcentaje de consultas se realizara en el primer trimestre del año, con predominio de las consultas-convenios, así como de las actividades de promoción de la salud. El grupo etario de menores de 18 años fue el más beneficiado con las actividades afectivo-participativas impartidas, en tanto los procedimientos estomatológicos preponderaron también en el primer trimestre, a excepción de la aplicación de laca de flúor, y la enfermedad periodontal fue la causa más frecuente de remisión al segundo nivel de atención A descriptive, observational, longitudinal and retrospective study, from all the patients notified in the statistical records of extreme poverty communities and from the new urbanizations of the state Carabobo was carried out during the first semester of 2016, with the objective of describing the activities developed in them, according to the following variables: estomatological visits, health promotion activities, other estomatological activities and referral at the second care level. Among the results it was obtained that the highest percentage of visits was carried out in the first trimester of the year, with prevalence of the visits-agreements, as well as of the health promotion activities. The age group younger than 18 years had the greatest benefits with the delivered affective-participative activities, while the estomatological procedures also prevailed in the first trimester, except the use of fluorine, and the periodontal disease was the most frequent cause of referral to the second care level
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2.

La alimentación de los venezolanos: encuesta nacional de condiciones de vida 2016/ The food of venezuelans: national survey of living conditions 2016

Landaeta-Jiménez, Maritza; Herrera-Cuenca, Marianella; Ramírez, Guillermo; Vásquez, Maura
;
| Idioma(s): Español
La Encuesta Nacional de Condiciones de Vida (ENCOVI) en su tercera edición, es una contribución de las Universidades Católica Andrés Bello, Universidad Simón Bolívar, Universidad Central de Venezuela y Fundación Bengoa, para obtener información sobre algunas variables relacionadas con el bienestar de los venezolanos. En 6413 hogares en ciudades grandes incluyendo Caracas y las principales del interior del país, ciudades medianas, pequeñas y caseríos, se investiga la composición de la canasta semanal de alimentos y patrón de alimentación según Línea de Pobreza, hábitos alimentarios, hábitos de vida, enfermedades relacionadas y variación del peso. La harina de maíz, arroz y trigo representan 30 % del total de la compra semanal. Entre los diez primeros alimentos que adquieren se encuentran hortalizas (63,9 %) y tubérculos (52 %), superior que los que incluyen proteínas de origen animal, carnes rojas (44,1 %) y aves (43,6 %), grasas (37,5 %), quesos (37,1 %), pescados (32,3 %) y leche 24 %. En 93,3 % de hogares el ingreso no alcanza para la compra de alimentos, 32,5 % de los entrevistados ingiere 2 o menos comidas al día, 48% considera que su dieta es monótona y deficiente y 72 % de los entrevistados refieren que en promedio perdieron 8,7 kg en el último año. En los hogares venezolanos se observa una tendencia regresiva en la compra de alimentos que integran la cesta semanal entre 2014 y 2016 en cantidad (menos alimentos) y en calidad (menor variedad) debido a la imposibilidad de adquirir los alimentos, situación que está generando mayor inseguridad alimentaria y desnutrición en la población más vulnerable(AU) The National Survey of Living Conditions (ENCOVI), in its third edition, is a contribution of the Andrés Bello Catholic University, Simón Bolívar University, the Central University of Venezuela and the Bengoa Foundation, to obtain information on some variables related to the Venezuelans standard living conditions. 6413 households were studied in large cities, including Caracas and the main and medium-sized cities, small towns and villages on the country side. The composition of the weekly food basket and feeding pattern was assessed according to the Poverty Line and food habits. Life style, related diseases and weight variation were also evaluated. Corn, rice and wheat flour represent 30 % of the total weekly purchase. Among the first ten foods that households acquire are vegetables (63.9 %) and tubers (52 %), higher than those foods that include proteins of animal origin: red meats (44.1 %) and poultry (43.6 %), fats (37.5 %), cheeses (37.1 %), fish (32.3 %) and milk 24 %. In 93.3 % of households the income was not enough to buy food, 32.5 % of the interviewees eat 2 or less meals a day, 48% report that the diet is monotonous and deficient and 72 % of the subjects stated that on average they lost 8.7 kg during the last year. In Venezuelan households, there is a regressive trend in the purchase of foods that made up the weekly basket between 2014 and 2016 in quantity (less food) and quality (less variety) due to the inability to buy foods, a situation that is promoting food insecurity and malnutrition in the most vulnerable population(AU)
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3.

A change in coral extension rates and stable isotopes after El Niño-induced coral bleaching and regional stress events.

Hetzinger, S; Pfeiffer, M; Dullo, W-Chr; Zinke, J; Garbe-Schönberg, D
| Idioma(s): Inglés
Coral reefs are biologically diverse ecosystems threatened with effective collapse under rapid climate change, in particular by recent increases in ocean temperatures. Coral bleaching has occurred during major El Niño warming events, at times leading to the die-off of entire coral reefs. Here we present records of stable isotopic composition, Sr/Ca ratios and extension rate (1940-2004) in coral aragonite from a northern Venezuelan site, where reefs were strongly impacted by bleaching following the 1997-98 El Niño. We assess the impact of past warming events on coral extension rates and geochemical proxies. A marked decrease in coral (Pseudodiploria strigosa) extension rates coincides with a baseline shift to more negative values in oxygen and carbon isotopic composition after 1997-98, while a neighboring coral (Siderastrea siderea) recovered to pre-bleaching extension rates simultaneously. However, other stressors, besides high temperature, might also have influenced coral physiology and geochemistry. Coastal Venezuelan reefs were exposed to a series of extreme environmental fluctuations since the mid-1990s, i.e. upwelling, extreme rainfall and sediment input from landslides. This work provides important new data on the potential impacts of multiple regional stress events on coral isotopic compositions and raises questions about the long-term influence on coral-based paleoclimate reconstructions.
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4.

Spectral sensitivity of guppy visual pigments reconstituted in vitro to resolve association of opsins with cone cell types.

Kawamura, Shoji; Kasagi, Satoshi; Kasai, Daisuke; Tezuka, Ayumi; Shoji, Ayako; Takahashi, Akiyoshi; Imai, Hiroo; Kawata, Masakado
| Idioma(s): Inglés
The guppy (Poecilia reticulata) shows remarkable variation of photoreceptor cells in the retina, especially those sensitive to middle-to-long wavelengths of light. Microspectrophotometry (MSP) has revealed varying "green", "green-yellow" and "yellow" cone cells among guppies in Trinidad and Venezuela (Cumana). In the guppy genome, there are four "long-wave" opsin loci (LWS-1, -2, -3 and -4). Two LWS-1 alleles have potentially differing spectral sensitivity (LWS-1/180Ser and LWS-1/180Ala). In addition, two "middle-wave" loci (RH2-1 and -2), two "short-wave" loci (SWS2-A and -B), and a single "ultraviolet" locus (SWS1) as well as a single "rhodopsin" locus (RH1) are present. However, the absorption spectra of these photopigments have not been measured directly and the association of cell types with these opsins remains speculative. In the present study, we reconstituted these opsin photopigments in vitro. The wavelengths of maximal absorbance (λmax) were 571nm (LWS-1/180Ser), 562nm (LWS-1/180Ala), 519nm (LWS-3), 516nm (LWS-2), 516nm (RH2-1), 476nm (RH2-2), 438nm (SWS2-A), 408nm (SWS2-B), 353nm (SWS1) and 503nm (RH1). The λmax of LWS-3 is much shorter than the value expected (560nm) from the "five-sites" rule. The two LWS-1 alleles could explain difference of the reported MSP λmax values for the yellow cone class between Trinidad and Cumana guppies. Absence of the short-wave-shifted LWS-3 and the green-yellow cone in the green swordtail supports the hypothesis that this cell class of the guppy co-expresses the LWS-1 and LWS-3. These results reveal the basis of variability in the guppy visual system and provide insight into the behavior and ecology of these tropical fishes.
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5.

Molecular identification of Spirometra spp. (Cestoda: Diphyllobothriidae) in some wild animals from Brazil.

Almeida, Gregório Guilherme; Coscarelli, Daniel; Melo, Maria Norma; Melo, Alan Lane; Pinto, Hudson Alves
| Idioma(s): Inglés
Species of the genus Spirometra are diphyllobothriid tapeworms with complex life cycles and are involved in human sparganosis, a neglected disease that affects individuals worldwide. Although some species were reported in wild felids and human cases of sparganosis were described in Brazil, the biology and taxonomy of these parasites are poorly understood. In the present study, samples of diphyllobothriids (eggs and/or proglottids) obtained from the stools of wild carnivores (Leopardus pardalis and Lycalopex vetulus) and plerocercoid larvae found in a snake (Crotalus durissus) from Brazil were analysed by amplifying a fragment of the gene cytochrome c oxidase subunit 1 (cox 1). The DNA sequences obtained here for the first time from the Spirometra spp. from Brazil were used to evaluate the phylogenetic relationships with other species. Molecular data identified two species in the Brazilian samples (evolutionary divergence of 17.8-19.2%). The species were identified as Spirometra sp. 1, found in Le. pardalis, and Spirometra sp. 2 found in Ly. vetulus and C. durissus, and they differed from Asian isolates of Spirometra erinaceieuropaei (17.5-20.2% and 12.2-15.6%, respectively), a species previously considered to be distributed worldwide. Moreover, Spirometra sp. 1 is genetically distinct from Sparganum proliferum from Venezuela (19.6-20.4%), while Spirometra sp. 2 is more closely related with the Venezuelan species (6.1-7.0%). Sequences of Spirometra sp. 2 revealed that it is conspecific with the Argentinean isolate of Spirometra found in Lycalopex gymnocercus (1.9-2.2%). Taxonomic and phylogenetic aspects related to New World species of Spirometra are briefly discussed.
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6.

In wealthier countries, patients perceive worse impact of the disease although they have lower objectively assessed disease activity: results from the cross-sectional COMORA study.

Putrik, Polina; Ramiro, Sofia; Hifinger, Monika; Keszei, Andras P; Hmamouchi, Ihsane; Dougados, Maxime; Gossec, Laure; Boonen, Annelies
| Idioma(s): Inglés
OBJECTIVES: To investigate patterns in patient-reported and physician-reported disease outcomes in patients with rheumatoid arthritis (RA) from countries with different level of socioeconomic development. METHODS: Data from a cross-sectional multinational study (COMOrbidities in RA) were used. Contribution of socioeconomic welfare (gross domestic product (GDP); low vs high) of country of residence to physician-reported (tender joint count, swollen joint count (SJC), erythrocyte sedimentation rate, disease activity score based on 28 joints assessment (DAS28)-3v based on these three components and physician global assessment) and patient-reported (modified Health Assessment Questionnaire (mHAQ), patient global assessment and fatigue) disease outcomes was explored in linear regressions, adjusting for relevant confounders. RESULTS: In total, 3920 patients with RA from 17 countries (30 to 411 patients per country) were included, with mean age of 56 years (SD13) and 82% women. Mean SJC varied between 6.7 (Morocco) and 0.9 (The Netherlands), mean mHAQ ranged between 0.7 (Taiwan) and 1.5 (The Netherlands). Venezuela had the lowest (1.7) and the Netherlands the highest score on fatigue (5.0). In fully adjusted models, lower GDP was associated with worse physician-reported outcomes (1.85 and 2.84 more swollen and tender joints, respectively, and 1.0 point higher DAS28-3v), but only slightly worse performance-based patient-reported outcome (0.15 higher mHAQ), and with better evaluation-based patient-reported outcomes (0.43 and 0.97 points lower on patient global assessment and fatigue, respectively). CONCLUSIONS: In patients with RA, important differences in physician-reported and patient-reported outcomes across countries were seen, with overall a paradox of worse physician-reported outcomes but better patient-reported outcomes in low-income countries, while results indicate that these outcomes in multinational studies should be interpreted with caution. Research on explanatory factors of this paradox should include non-disease driven cultural factors influencing health.
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7.

Addressing Disease-Related Malnutrition in Healthcare: A Latin American Perspective.

Correia, Maria Isabel; Hegazi, Refaat A; Diaz-Pizarro Graf, José Ignacio; Gomez-Morales, Gabriel; Fuentes Gutiérrez, Catalina; Goldin, Maria Fernanda; Navas, Angela; Pinzón Espitia, Olga Lucia; Tavares, Gilmária Millere
| Idioma(s): Inglés
Alarmingly high rates of disease-related malnutrition have persisted in hospitals of both emerging and industrialized nations over the past 2 decades, despite marked advances in medical care over this same interval. In Latin American hospitals, the numbers are particularly striking; disease-related malnutrition has been reported in nearly 50% of adult patients in Argentina, Brazil, Chile, Costa Rica, Cuba, Dominican Republic, Ecuador, Mexico, Panama, Paraguay, Peru, Puerto Rico, Venezuela, and Uruguay. The tolls of disease-related malnutrition are high in both human and financial terms-increased infectious complications, higher incidence of pressure ulcers, longer hospital stays, more frequent readmissions, greater costs of care, and increased risk of death. In an effort to draw attention to malnutrition in Latin American healthcare, a feedM.E. Latin American Study Group was formed to extend the reach and support the educational efforts of the feedM.E. Global Study Group. In this article, the feedM.E. Latin American Study Group shows that malnutrition incurs excessive costs to the healthcare systems, and the study group also presents evidence of how appropriate nutrition care can improve patients' clinical outcomes and lower healthcare costs. To achieve the benefits of nutrition for health throughout Latin America, the article presents feedM.E.'s simple and effective Nutrition Care Pathway in English and Spanish as a way to facilitate its use.
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8.

The Evolving HIV-1 Epidemic in Warao Amerindians Is Dominated by an Extremely High Frequency of CXCR4-Utilizing Strains.

Rangel, Héctor R; Bello, Gonzalo; Villalba, Julian A; Sulbaran, Yoneira F; Garzaro, Domingo; Maes, Mailis; Loureiro, Carmen L; de Waard, Jacobus H; Pujol, Flor H
| Idioma(s): Inglés
We previously reported a high prevalence of HIV-1 infection in Warao Amerindians from Venezuela due to the rapid spread of a single B subtype strain. In this study we evaluated the coreceptor use of the HIV-1 strains infecting this Amerindian community. Sequences of the HIV-1 V3 loop from 56 plasma samples were genotyped for coreceptor use. An extremely high frequency of CXCR4 strains was found among HIV-1-infecting Waraos (47/49, 96%), compared to HIV-1 strains infecting the non-Amerindian Venezuelan population (35/79, 44%, p < 0.00001). Evolutionary analysis showed that a significant number of infections occurred between 1 and 12 months before collection and that a great proportion (50-70%) of HIV-1 transmissions occurred within the very early phase of infection (≤12 months). This is consistent with an initial infection dominated by an X4 strain or a very rapid selection of X4 variants after infection. This Amerindian population also exhibits the highest prevalence of tuberculosis in Venezuela, being synergistically bad prognostic factors for the evolution of morbidity and mortality in this vulnerable population.
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9.

Vector and reservoir control for preventing leishmaniasis.

González, Urbà; Pinart, Mariona; Sinclair, David; Firooz, Alireza; Enk, Claes; Vélez, Ivan D; Esterhuizen, Tonya M; Tristan, Mario; Alvar, Jorge
| Idioma(s): Inglés
BACKGROUND: Leishmaniasis is caused by the Leishmania parasite, and transmitted by infected phlebotomine sandflies. Of the two distinct clinical syndromes, cutaneous leishmaniasis (CL) affects the skin and mucous membranes, and visceral leishmaniasis (VL) affects internal organs. Approaches to prevent transmission include vector control by reducing human contact with infected sandflies, and reservoir control, by reducing the number of infected animals. OBJECTIVES: To assess the effects of vector and reservoir control interventions for cutaneous and for visceral leishmaniasis. SEARCH METHODS: We searched the following databases to 13 January 2015: Cochrane Infectious Diseases Group Specialized Register, CENTRAL, MEDLINE, EMBASE, LILACS and WHOLIS, Web of Science, and RePORTER. We also searched trials registers for ongoing trials. SELECTION CRITERIA: Randomized controlled trials (RCTs) evaluating the effects of vector and reservoir control interventions in leishmaniasis-endemic regions. DATA COLLECTION AND ANALYSIS: Two review authors independently searched for trials and extracted data from included RCTs. We resolved any disagreements by discussion with a third review author. We assessed the quality of the evidence using the GRADE approach. MAIN RESULTS: We included 14 RCTs that evaluated a range of interventions across different settings. The study methods were generally poorly described, and consequently all included trials were judged to be at high or unclear risk of selection and reporting bias. Only seven trials reported clinical outcome data which limits our ability to make broad generalizations to different epidemiological settings and cultures. Cutaneous leishmaniasisOne four-arm RCT from Afghanistan compared indoor residual spraying (IRS), insecticide-treated bednets (ITNs), and insecticide-treated bedsheets, with no intervention. Over 15 months follow-up, all three insecticide-based interventions had a lower incidence of CL than the control area (IRS: risk ratio (RR) 0.61, 95% confidence interval (CI) 0.38 to 0.97, 2892 participants, moderate quality evidence; ITNs: RR 0.32, 95% CI 0.18 to 0.56, 2954 participants, low quality evidence; ITS: RR 0.34, 95% CI 0.20 to 0.57, 2784 participants, low quality evidence). No difference was detected between the three interventions (low quality evidence). One additional trial of ITNs from Iran was underpowered to show a difference.Insecticide treated curtains were compared with no intervention in one RCT from Venezuela, where there were no CL episodes in the intervention areas over 12 months follow-up compared to 142 in control areas (RR 0.00, 95% CI 0.00 to 0.49, one trial, 2938 participants, low quality evidence).Personal protection using insecticide treated clothing was evaluated by two RCTs in soldiers, but the trials were underpowered to reliably detect effects on the incidence of CL (RR 0.40, 95% CI 0.13 to 1.20, two trials, 558 participants, low quality evidence). Visceral leishmaniasisIn a single RCT of ITNs versus no intervention from India and Nepal, the incidence of VL was low in both groups and no difference was detected (RR 0.99, 95% CI 0.46 to 2.15, one trial, 19,810 participants, moderate quality evidence).Two trials from Brazil evaluated the effects of culling infected dogs compared to no intervention or IRS. Although they report a reduction in seroconversion over 18 months follow-up, they did not measure or report effects on clinical disease. AUTHORS' CONCLUSIONS: Using insecticides to reduce phlebotomine sandfly numbers may be effective at reducing the incidence of CL, but there is insufficient evidence from trials to know whether it is better to spray the internal walls of houses or to treat bednets, curtains, bedsheets or clothing.
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10.

Prevalencia de anemia, deficiencia de hierro y parasitosis intestinal y su relación con las condiciones socioeconómicas, en menores de 15 años de la comunidad rural Las Bucarita, Estado Lara, Venezuela/ Prevalence of anemia, iron deficiency and intestinal parasitosis and its relation to socioeconomic conditions, in children under 15 years of rural community The Bucarita, Lara state, Venezuela

Mendoza, Norelis; Berné, Yelitza; Moreno, José M; Papalé-Centofanti, Jham; Castro, Manuel; Torres, Mario; Rodríguez, Diolisbeth
;
| Idioma(s): Español
En el presente estudio se determinó la prevalencia de anemia, deficiencia de hierro y parasitosis intestinal y su combinación relacionándolo con condiciones socioeconómicas por los métodos de Necesidades Básicas Insatisfechas y Graffar Modificado de Méndez-Castellano. Se evaluaron 403 niños y niñas menores de 15 años de la comunidad rural La Bucarita, Estado Lara, Venezuela. Se determinó la concentración de ferritina sérica mediante el método de ELISA, el hierro sérico y la Capacidad Total de Fijación de Hierro por absorción atómica adosado a un horno de grafito, y la hemoglobina usando un Coulter ACT8; las muestras fecales se analizaron por el método Kato-Katz cualitativo. Los resultados muestran que el 13,4% de los niños y niñas presentaron anemia, 28,3% eran ferropénicos de los cuales 29,8% eran anémicos ferropénicos. El 79,71% de la muestra estudiada presentó parasitosis intestinal siendo los más frecuentes Áscaris Lumbricoides (65,3%) y TrichurisTrichiura (52,4%). El 98% y el 2% de las familias se encuentran en pobreza absoluta y relativa, respectivamente. De acuerdo al Graffar y al NBI, 98,59% clasificó como hogar en pobreza extrema. Hubo correlación estadísticamente significativa p<0,001 entre los aspectos socioeconómicos y la infestación parasitaria observándose la misma prevalencia entre las personas con pobreza crítica y pobreza extrema (79,6%). In the present study were determined the prevalence of anemia, iron deficiency and intestinal parasitosis and their combinations, associating them to socio-economic conditions using the methods of Unsatisfied Basic Needs and Graffar Mendez-Castellano. 403 children under 15 years of age from the rural community of La Bucarita, Lara state, Venezuela, were evaluated. The concentration of serum ferritin was determined by means of ELISA methods, serum iron and Total Binding Capacity Iron by means of atomic absorption attached to a graphite furnace, hemoglobin by means of Coulter Act8 and fecal samples by means of the Kato-Katz qualitative method. The results show that 13.4% of children had anemia, 28.3% were ferropenics, 29,8 % of whom were anemic ferropenics. 79.71% of the sample had intestinal parasitosis, the most frequent were Ascaris lumbricoides (65.3%) and TrichurisTrichiura (52.4%). 98% of the families were in absolute poverty and 2% of the families were in relative poverty. According to Graffar and to NBI, 98.59% were rated as extremely poor household. There was statistically significant correlation p <0.001 between socio-economic and parasitic infestation, the same prevalence being observed among people in poverty and extreme poverty (79.6%).
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