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BACKGROUND: Social and environmental factors in advanced heart failure (HF) patients may be crucial to cope with the end stages of the disease. This study analyzes health inequalities and mortality according to place of residence (rural vs urban) in HF patients at advanced stages of the disease. METHODS: Population-based cohort study including 1148 adult patients with HF attended in 279 primary care centers. Patients were followed for at least 1 year after reaching New York Heart Association IV functional class, between 2010 and 2014. Data came from primary care electronic medical records. Cox regression models were applied to determine the hazard ratios (HR) of mortality. RESULTS: Mean age was 81.6 (SD 8.9) years, and 62% were women. Patients in rural areas were older, particularly women aged > 74 years (p = 0.036), and presented lower comorbidity. Mortality percentages were 59 and 51% among rural and urban patients, respectively (p = 0.030). Urban patients living in the most socio-economically deprived neighborhoods presented the highest rate of health service utilization, particularly with primary care nurses (p-trend < 0.001). Multivariate analyses confirmed that men (HR 1.60, 95% confidence interval (CI) 1.34-1.90), older patients (HR 1.05, 95% CI 1.04-1.06), Charlson comorbidity index (HR 1.16, 95% CI 1.11-1.22), and residing in rural areas (HR 1.35, 95% CI 1.09 to 1.67) was associated with higher mortality risk. CONCLUSIONS: Living in rural areas determines an increased risk of mortality in patients at final stages of heart failure.
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Insuficiência Cardíaca , Idoso de 80 Anos ou mais , Estudos de Coortes , Registros Eletrônicos de Saúde , Feminino , Humanos , Masculino , Atenção Primária à Saúde , População RuralRESUMO
Background: Information regarding short-term vital prognosis in patients with heart failure at advanced stages of the disease is scarce. Objective: To develop a three-month mortality predictive model for patients with advanced heart failure. Methods: Prospective observational study carried out in primary care and a convalescence community facility. Heart failure patients either New York Heart Association (NYHA) III with at least two HF hospitalizations during the previous six months or NYHA IV with/without previous recent hospitalization were included in the study. Multivariable predictive models using Cox regression were performed. Results: Of 271 patients included, 55 (20.3%) died during the first three months of follow-up. Mean age was 84.2 years (SD 8.3) and 59.8% were women. Predictive model including NT-proBNP had a C-index of 0.78 (95% CI 0.71; 0.85) and identified male gender, low body mass index, high potassium and NT-proBNP levels, and moderate-to-severe dependence for daily living activities (Barthel index < 40) as risk factors of mortality. In the model without NT-proBNP, C index was 0.72 (95% CI 0.64; 0.79) and, in addition to gender, body mass index, low Barthel index, and severe reductions in glomerular filtration rate showed the highest predictive hazard ratios for short-term mortality. Conclusions: In addition to age, male gender, potassium levels, low body mass index, and low glomerular filtration, dependence for activities of daily living add strong power to predict mortality at three months in patients with advanced heart failure.
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In 2006, the presence of a pest in guava was detected for the first time in the Province of Vélez, Santander, Colombia, known as the bander worm. Research on the biology of this pest is scarce and no natural enemies have been registered. The aim of the study was to establish the taxonomy, life cycle, damage (distribution, incidence, and severity) and natural enemies of this pest to be used in future integrated management programs. This study was carried out between May 2013 and December 2014. The taxonomy and morphological descriptions of the life stages of the bander worm correspond to Carmenta theobromae ( Busck, 1910). The life cycle in the field was 120-150 days, with 2-3 generations per year: egg, 15-30 days; larva, 60 days; pupa, 25 days; adult, 10-30 days. In the laboratory, the life cycle was 90-110 days: egg, 10-20 days; larval stages 6-7, 50-60 days; pupa, 20-22 days; adult, 5-7 days. The incidence was 98% in 124 farms with 9.87 ± 1.94 infested trees in relation to 40.74 ± 5.52 observed trees (n = 4,970). Severity was moderate (n = 48). The damage involves the removal of the bark to reach the vascular cambium. Biological control associated with the parasitoids Brachymeria pedalis and Telenomus sp., the entomopathogens Lecanicillium lecanii, Beauveria bassiana and B. brongniartii, and the practices like weeding and pruning represent a potential control strategy.
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In 2006, a new limiting pest in guava was reported in the provincia de Vélez, Santander, Colombia, known as the borer worm. There is no knowledge of the biology of this pest so far. The aim of this study, conducted between May 2013 and December 2014, was to establish the taxonomy, lifecycle, damage (distribution, incidence, and severity), and control alternatives of this new limiting pest in guava, as input for an integrated management program. Results showed that this pest corresponds to Simplicivalva ampliophilobia (Davis et al., 2008). The life cycle in the field lasts 330-360 days, with one generation per year (univoltine): egg, 15-30 days; larva, 270 days; prepupa, 15 days; pupa, 30 days; adult, 15-30 days. Under laboratory conditions the lifecycle lasts 259-266 days, unknown egg state duration; larva, 7-8 instars, 210 days; pupa, 42 days; imago, 7-14 days (n = 60, α = 5%, 25.4 °C ± 4.93 °C, 55.6% ± 11.58% RH, photoperiod 0: 24). The incidence was 94% in 124 silvopastoral system farms with 7.51 ± 1.69 infested trees compared to 40.74 ± 5.52 observed trees (n = 4,970). The technified system showed a reduction in the average incidence of 50.83% compared to the silvopastoral guava cropping system. Severity was moderate (n = 48) in both systems. Morphometric descriptions of eggs, larvae, pupae, and imagos were performed. Damage and associated symptoms occur when larvae remove the conducting tissues of the plant adjacent to the medulla. Crop technification combined with the use of the parasitoid Apanteles sp., and the fungi Metarhizium anisopliae and Lecanicillium lecanii represent an alternative control for this pest.
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AIMS: Gynaecological malignancies such as breast, ovarian and cervical cancers have become an important public health problem. Detection of molecular alterations in cancer research is fundamental since it can reveal specific pathogenic patterns and genes that could serve as markers. Our aim was to characterize common genomic and transcriptomic signatures for the three gynaecologic malignancies with the highest incidence and mortality to try to identify new molecular markers, therapeutic targets and molecular signatures. METHODS: Here we analysed a total of 723 microarray libraries corresponding to equal number of breast, ovary and cervical cancer and non-cancer patient samples. Copy number variation (CNV) was carried out using 428 libraries and transcriptomic analysis using the 295 remaining samples. RESULTS: Our results showed that breast, ovary and cervical malignancies are characterized by gain of 1q chromosome. At transcriptomic level, they share 351 coding and non-coding genes, which could represent core transcriptome of gynaecological malignancies. Pathway analysis from the resulting gene lists from CNV and expression showed participation in cell cycle, metabolism, and cell adhesion molecules among others. CONCLUSIONS: Chromosome 1q characterize the gynaecological malignancies, which could harbour a richness of genetic repertoire to mine for molecular markers and targets, particular gynaecologic expression profile, containing FANCI, FH and MIR155HG among others, could represent part of the transcriptomic core for diagnostic test and attractive therapeutic targets. It may not be long before every human cancer sample is profiled for a detections test to ascertain a molecular diagnosis and prognosis and to define an optimal and precise treatment strategy.
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Biomarcadores/metabolismo , Perfilação da Expressão Gênica/métodos , Neoplasias dos Genitais Femininos/economia , Neoplasias dos Genitais Femininos/genética , Genômica/métodos , Medicina de Precisão/métodos , Transcriptoma/genética , Feminino , Humanos , PrognósticoRESUMO
RESUMEN En Colombia, el departamento de Boyacá tiene uno de los mayores rendimientos de caña de azúcar (Saccharum spp.), para la producción de panela; sin embargo, los productores demandan constantemente la evaluación de material genético, que pueda aumentar los rendimientos por unidad de área y las características agroindustriales de los materiales tradicionales, de mayor dominio en la región. Con la finalidad de estimar los rendimientos de caña y de panela por hectárea, se evaluaron, a nivel experimental, los cultivares CC 01-1940, CC 99-2282, CC 05-940, CC 03-469, CC 06-791, en el municipio de Moniquirá, Boyacá. Posteriormente, se realizaron pruebas comerciales de molienda, con el mejor cultivar en Moniquirá y en San José de Pare, Boyacá, junto a los testigos de cada zona Caña Buena y RD 75-11, respectivamente. Experimentalmente, se destacó el cultivar CC 01-1940, con una producción de 183,3t/ha de caña (TCH), 24,2 toneladas de panela por hectárea (TPH), así como una conversión de 13,2% de panela (CP). En prueba comercial de molienda en San José de Pare, se encontró que CC 01-1940 alcanzó una producción de 221,9 TCH y 26,1 TPH, superando por más de 30 toneladas de caña y 5,2 toneladas de panela, al reporte alcanzado por RD 75-11. Para el municipio de Moniquirá, CC 01-1940 obtuvo 158,5 TCH, 18,5 TPH y 11,6% CP, superando al cultivar testigo Caña Buena.
ABSTRACT In Colombia, the department of Boyacá has one of the highest yields of sugar cane (Saccharum spp.) for panela production. However, producers constantly demand the evaluation of genetic material that could increase the yields per area and the agro-industrial characteristics of the traditional material of greater dominance in the region. In order to estimate cane and panela yields per hectare, cultivars CC 01-1940, CC 99-2282, CC 05-940, CC 03-469, CC 06-791 were evaluated experimentally in the municipality of Moniquirá, Boyacá. Subsequently, commercial milling tests were carried out with the best cultivar in Moniquirá and San José de Pare, Boyacá, together with the control materials from each zone, Caña Buena and RD 75-11, respectively. Experimentally, the cultivar CC 01-1940 stood out with a production of 183.3t/ha of sugarcane (TCH), 24.2 tons of panela per hectare (TPH), as well as a conversion of 13.2% of panela (CP). In a commercial milling test in San José de Pare, it was found that the cultivar CC 01-1940 had a production of 221.9 TCH and 26.1 TPH, surpassing by more than 30 tons of cane and 5.2 tons of panela, for what was reported by RD 75-11. For the municipality of Moniquirá, the cultivar CC 01-1940 obtained 158.5 TCH, 18.5 TPH and 11.6% CP, surpassing the cultivar Caña Buena.
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RESUMEN La caña de azúcar (Saccharum officinarum L.) es una fuente importante de carbohidratos para la panela. En Colombia, la principal región panelera está ubicada en la Hoya del Río Suarez; sin embargo, falta aún consolidar una producción suficientemente rentable, competitiva y amigable con el ambiente. Uno de los aspectos más determinante en la producción de panela es la nutrición mineral, debido a que, actualmente, se hace de forma convencional, desconociendo los niveles de extracción de los materiales genéticos utilizados. El objetivo fue determinar el requerimiento nutricional, producción de biomasa y productividad en segundo corte, en el municipio de Suaita (Santander). El diseño empleado fue bloques al azar (BCA), con 3 tratamientos (las variedades CC 93-7711, CC 93-7510 y RD 75-11) y 5 repeticiones. Se realizaron 4 muestreos, a los 118, 252, 335 y 392 días después de corte (ddc). Se observó que la mayor absorción de N, Ca y Mg ocurrió a los 335 ddc, mientras que para P y K, aconteció a los 392. Los nutrientes se acumularon, especialmente, en los tallos; la CC 93-7711 superó a las otras variedades, con una absorción total en kilogramos por hectárea, de 448 N, 296 K, 85 Ca, 43 P y 40 Mg, seguida por RD 75-11, que presentó, aproximadamente, 16% menos en N-K-Ca-P-Mg. El patrón de absorción de los nutrientes fue N>K>Ca>P>Mg y, referente a la productividad, se destacó RD 75-11, luego CC 93-7711 y CC 93-7510, con 172,6, 171,1 y 159,9 toneladas de caña por hectárea, respetivamente.
ABSTRACT Sugarcane (Saccharum officinarum L.) is a primary carbohydrates source for panela; in Colombia the main panela region is located in the Hoya del Rio Suarez, however, it has not been consolidated a production sufficiently profitable, competitive and environmentally friendly production. One of the most decisive aspects in the production of panela is mineral nutrition, due to the fact that it is currently done in a conventional way without knowing the levels of extraction of the genetic materials used. The objective was to determine the nutritional requirement, production of biomass and productivity in second cut in the municipality of Suaita (Santander), the design used was blocks at random, with 3 treatments (the varieties CC 93-7711, CC 93-7510 and RD 75-11) and 5 repetitions, 4 samplings were made at 118, 252, 335 and 392 days after cutting (ddc). It was observed that the highest absorption of N, Ca and Mg occurred at 335 ddc, while for P and K, occurred at 392 ddc; nutrients accumulated especially in the stems; CC 93-7711 outperformed the other varieties with a total absorption in kilograms per hectare of 448 N, 296 K, 85 Ca, 43 P and 40 Mg, followed by RD 75-11 that presented approximately 16% less in N-K-Ca-P-Mg, the nutrient absorption pattern was N>K>Ca>P>Mg and as for productivity, RD 75-11 stood out, then CC 93-7711 and CC 93-7510 with 172.6, 171,1 and 159.9 tons of cane per hectare, respectively.
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Este trabajo refleja la evolución del concepto de lepra que dependió de circunstancias históricas determinadas y estrechamente relacionadas con el manejo institucional. Notamos que a pesar de los avances científicos no se ha logrado determinar muchos aspectos de la enfermedad tan importantes como los postulados de Koch. Desde los leprocomios iniciales, con los cuales se intentó solucionar el problema de salud pública que reemplazaba la lepra hasta el manejo individualizado, integral y ambulatorio actúal, se evidencia una inadecuada e irregular enfoque del problema que da como resultado en que su control no haya sido el esperado y que aún en el momento no se cuente con una estadística veráz acerca de la mágnitud del mismo en el País