[Empowerment and social support for patients with chronic kidney disease: case study in Michoacán, MexicoEmpoderamento e apoio social de pacientes com nefropatia crônica: estudo de caso em Michoacán, México]. / Empoderamiento y apoyo social en pacientes con enfermedad renal crónica: estudio de caso en Michoacán, México.

OBJECTIVE: Identify the degree of empowerment and the characteristics of the social support for individuals with chronic kidney disease (CKD). METHODS: Cross-sectional study of people with chronic kidney disease living in the municipality of Hidalgo, Michoacán, Mexico, who belong to the Association of Kidney Patients, Civil Association. The study examined the sociodemographic profile and personal characteristics associated with the disease, the degree of empowerment, the degree of social support, and family functioning. RESULTS: Close to 90% of the sample receives sufficient social support, while 40% of the participants belong to semi-cohesive or cohesive families The overall empowerment score was 117.5 ± 14.3; community empowerment was higher in the older group (P < 0.05). Positive social interaction is the social support component most strongly correlated with the degree of empowerment (r = 0.333; P < 0.01). CONCLUSIONS: Empowerment is determined by, and is a determinant of, social support and has facilitated access to renal replacement therapy in this community.

OBJETIVO: Identificar o nível de empoderamento e apoio social de pacientes com nefropatia crônica. MÉTODOS: Estudo transversal realizado com pacientes com nefropatia crônica residentes no município de Fidalgo, Michoacán, México, que participavam de uma associação civil de pacientes renais crônicos (Asociación de Enfermos del Riñón). Foram investigados aspectos pessoais e sociodemográficos dos pacientes associados à doença, nível de empoderamento e apoio social e funcionamento familiar. RESULTADOS: Cerca de 90% da amostra estudada dispõem de uma rede de apoio social satisfatória e 40% pertencem a famílias com boa coesão ou coesão média. A pontuação global de empoderamento foi de 117,5 ± 14,3 e o empoderamento comunitário foi maior no grupo com idade mais avançada (P < 0,05). Interação social positiva é o componente da rede de apoio social com correlação mais forte com o nível de empoderamento (r = 0,333; P < 0,01). CONCLUSÕES: O empoderamento é determinado pela rede de apoio social, sendo também um determinante deste apoio, e facilita o acesso à terapia renal substitutiva nesta comunidade.

Seroprevalence of Bordetella pertussis in the Mexican population: a cross-sectional study.

SUMMARY Serum samples collected during the National Health and Nutrition survey (ENSANUT 2006) were obtained from subjects aged 1-95 years (January-October 2010) and analysed to assess the seroprevalence of Bordetella pertussis (BP) in Mexico. Subjects' gender, age, geographical region and socioeconomic status were extracted from the survey and compiled into a subset database. A total of 3344 subjects (median age 29 years, range 1-95 years) were included in the analysis. Overall, BP seroprevalence was 47.4%. BP seroprevalence was significantly higher in males (53.4%, P = 0.0007) and highest in children (59.3%) decreasing with advancing age (P = 0.0008). BP seroprevalence was not significantly different between regions (P = 0.1918) and between subjects of socioeconomic status (P = 0.0808). Women, adolescents and young adults were identified as potential sources of infection to infants. Booster vaccination for adolescents and primary contacts (including mothers) for newborns and infants may provide an important public health intervention to reduce the disease burden.

Community intervention to screen risk of cardiovascular diseases in a rural Texas community.

This study describes the effectiveness of cardiovascular risk screening for elderly patients of a primary care practice in a rural community. A controlled trial sample of 44 eligible patients was screened in a primary care practice setting in August 1998. All patients completed health risk questionnaires; 93% of the 44 had laboratory work and a complete physical examination. Cost comparisons were made between the cost of the health screening and the cost of hospitalization for cardiovascular disease in Fort Worth, Tex. Within the sample population, the mean age was 67.9 years (+/- 8.1). A high prevalence of obesity among females (53%), hypertension (58.5%), lipid disorders (63.4%), and elevated glucose levels (19.5%) was found. Preventive health screenings and programs can be cost-effective in identifying and managing major disease (cardiovascular diseases, lipid disorders, and diabetes) and in preventing potential costly hospitalizations.

A short report on highlights of world-wide development of RIX4414: a Latin American experience.

An oral, human-derived monovalent (G1P1A) rotavirus vaccine, strain RIX4414, has been developed by GlaxoSmithKline, Rixensart, Belgium. The safety, immunogenicity and efficacy of this vaccine were evaluated in a randomized, double-blind, placebo-controlled, phase IIb trial conducted in Brazil, Mexico and Venezuela. Healthy infants were given two doses of vaccine (104.7, 105.2 or 105.8 ffu) or placebo at age 2 and 4 months, with routine DTPw-HBV and Hib vaccines. OPV was given separately, at least 2 weeks before or after administration of the study vaccine. A total of 2155 infants were enrolled, of whom 1618 received one of the three vaccine viral concentrations and 537 were given placebo. Analysis of efficacy included diarrheal episodes occurring from 2 weeks after second dose until one year of age. Efficacy rates against any rotavirus gastroenteritis, severe rotavirus gastroenteritis and hospitalizations for rotavirus disease were as high as 70% (46-84%; 95%CI), 86% (63-96%; 95%CI), and 93% (54-100%; 95%CI), respectively. For non-G1 (mainly G9) serotypes, RIX4414 vaccine conferred protection as high as 83% (40-97%; 95%CI) against severe gastroenteritis. A decrease was noted in the incidence of severe rotavirus-related gastroenteritis after first dose. It is demonstrated that two doses of RIX4414 are highly efficacious against severe rotavirus gastroenteritis and hospitalization, including disease caused by non-G1 strains, namely G9 serotypes.

Diagnósticos enfermeros realizados por un ESAD en pacientes oncológicos en fase terminal / Nursing diagnosis made in terminal cancer patients by a home support team

Objetivo: nuestro objetivo es conocer la prevalencia de los diagnósticos enfermeros en una primera valoración a pacientes oncológicos en fase terminal en su domicilio por el Equipo de Soporte de Atención Domiciliaria(ESAD) del Área II de Madrid. Material y método: es un estudio descriptivo, observacional y retrospectivo. Las herramientas de valoración utilizadas son los patrones funcionales Marjory Gordon, así como la valoración del entorno familiar. La codificación diagnóstica se realizó según la taxonomía Nanda 2001-2002. Se revisaron todas las historias de los pacientes nuevos incluidos en el programa de atención domiciliaria durante cinco meses (desde febrero hasta junio de 2003, ambos inclusive), seleccionando aquellas que correspondían a enfermos nuevos oncológicos en fase terminal, valorados en su domicilio. Se excluyeron todos los pacientes que no eran oncológicos en fase terminal. Resultados: el número de pacientes oncológicos terminales nuevos fue de 58, de los que 40 (69% de la muestra) tenían diagnóstico enfermero en una primera valoración, siendo el 55% mujeres. El número de etiquetas diagnósticas fue de 47. La edad media fue 67 años con un rango de 2 a 92 años. Hubo 44 etiquetas a pacientes, cuyos diagnósticos codificados y por orden de prevalencia fueron: 00011 (25%); 00045 (23%); 00046 (19%); 00002 (6,3%); 00132 (6,3%); 00070 (4,2%); 00146 (2%); 00124 (2%);10008 (2%); 00103 (2%); 00133 (2%); 00021 (2%). Las etiquetas a cuidadores fueron 3: 00061 (6,3%). Conclusiones: un alto porcentaje de los pacientes tienen diagnóstico enfermero en su primera valoración. En algunos de ellos se realizó más de un diagnóstico enfermero en su primera valoración. El estreñimiento es el diagnóstico enfermero más frecuente en nuestro estudio seguido del deterioro de la mucosa oral. En pocos cuidadores se detectó cansancio en el desempeño de su rol en su primera valoración (AU)

Objective: our goal was to find the prevalence of nurse diagnostics on the first evaluation of oncology patients on terminal phase at their own house, by the Medical Home Support Team (ESAD) of Area II of Madrid. Material and method: it is a descriptive, observational and retrospective study. The evaluation tools were the Marjory Gordon functional patterns as well as the assessment of the family environment. The diagnostic coding was based on the Nanda taxonomy 2001-2002. All charts of new terminal patients included on the Program for Home Support during five months (February/03 trough June/03) were reviewed. Only those corresponding to oncology patients were chosen. There were excluded chats from patients who were not terminal cancer patients. Results: the number of oncology patients on terminal phase were 58, and 40 (69% of the sample) had nurse diagnostics on the first visit and 55% where woman.The number of diagnostic labels was 47. The average age was 67 years, from 2 to 92 year. There were 44 labels to patients, whose codified diagnostic by prevalence order was: 00011 (25%); 00045 (23%); 00046 (19%); 00002 (6.3%); 00132 (6.3%); 00070 (4.2%); 00146 (2%); 00124 (2%); 10008 (2%); 00103 (2%); 00133 (2%); 00021 (2%). Labels to the caretakers were 3: 00061 (6.3%). Conclusions: a high percentage of the patients have nurse diagnostic on the first evaluation. Some patients had more than one nurse diagnose on the first evaluation. Constipation is the most frequent diagnostic in this study, followed by damage of the mouth mucosa. A few caretakers, showed fatigue during the development of their work on the first evaluation (AU)