Indigenous health in Latin America and the Caribbean.

This review is the second in a series on Indigenous health, covering different regions and issues. We look briefly at the current state of Indigenous health in Latin America and the Caribbean, a region with over 400 different indigenous groups and a total population of 45 to 48 million people. We describe the complex history and current reality of Indigenous peoples' situation within the American continent. We discuss the importance of Indigenous health systems and medicines, and look at changing political environments in the region. The paper concludes with a discussion of the changing political and legislative environment in Latin American countries.

A case of Evan's syndrome in pregnancy refractory to primary treatment options.

Evan's syndrome is a rare hematological condition defined as immune thrombocytopenic purpura and hemolytic anemia. We describe herein a case of Evan's syndrome diagnosed in a term pregnancy that was refractory to primary therapeutic options. We also describe current treatment options in pregnancy and briefly discuss the pathophysiology of Evan's syndrome and perinatal outcome.

Percepción sobre las prácticas de salud ambiental en estudiantes y profesores universitarios / Development of investigative skills on healthy and sustainable environment in postgraduate students

Se ha evidenciado el detrioro del ambiente y la necesidad en promover prácticas que permitan minimizar el impacto negativo de las actividades humanas sobre la salud del planeta. La inserción de los estudiantes universitarios puede proporcionar solución a estos problemas. Siendo indispensable crear planes y estrategias para promoveer el desarrollo de buenas prácticas con responsabilidad, mejorar el desempeño ambiental y disminuir el impacto del efecto del cambio climático. En este contexto, se planteó establecer la percepción y aplicación de las prácticas ambientales en el estudiantado y docentes de la Universidad Regional Autónoma de los Andes. Como resultado se observó actitud de preocupación sobre la preservación del ambiente, los estudiantes manifestaron realizar actividades como siembra de árboles, uso de transporte alternativos y disposición de desechos peligrosos de manera segura, con evidencia estadisticamente significativa. Sin embargo, la percepción, en general, sobre las buenas prácticas ambientales fueron deficiente, la importancia atribuida fue mayor en las categorias "uso eficiente de los recursos" (IF= 0,84), seguida por "promoción de la salud ambiental" (IF=0,51), "gestión de los desechos" (IF= 0,5), y "clima sostenible" (IF= 0,46). Por ende, es escencial que desde las universidades se fomenten campañas permanentes de formación e información integrando a la comunidad activamente en las buenas prácticas ambientales(AU)

The deterioration of the environment and the need to promote practices that minimize the negative impact of human activities on the health of the planet have been evidenced. The insertion of university students can provide a solution to these problems. It is essential to create plans and strategies to promote the development of good practices with responsibility, improve environmental performance and reduce the impact of the effect of climate change. In this context, it was proposed to establish the perception and application of environmental practices in the students and teachers of the Universidad Regional Autónoma de los Andes. As a result, an attitude of concern about the preservation of the environment was observed, the students reported carrying out activities such as planting trees, using alternative transportation and disposing of hazardous waste safely, with statistically significant evidence. However, the perception, in general, about good environmental practices was deficient, the importance attributed was greater in the categories "efficient use of resources" (IF= 0.84), followed by "promotion of environmental health" (IF=0.51), "waste management" (IF= 0.5), and "sustainable climate" (IF= 0.46). Therefore, it is essential that universities promote permanent training and information campaigns actively integrating the community in good environmental practices(AU)

Análisis del sobrepeso, obesidad, actividad física y autoestima de la niñez en el área metropolitana de la región educativa panameña / Analysis of Overweight, Obesity, Physical Activity and Self-Estimation of Children in the Metropolitan Area of the Educational Region of Panama City, Panama

Resumen Los altos niveles de sobrepeso y obesidad que producen diabetes, hipertensión u otras enfermedades crónicas son un problema de salud pública, que inicia desde la infancia hasta alcanzar la edad adulta y alteran, directamente, la calidad de vida de la persona. El propósito de este estudio es determinar los niveles de sobrepeso y obesidad, los niveles de actividad física y de autoestima de escolares de 9 a 13 de edad, en 13 centros educativos de la ciudad de Panamá centro. Se evaluaron un total de 748 estudiantes. Las variables se midieron por medio por medio del tallímetro y la pesa para calcular el índice de masa corporal, el cuestionario PAQ-C para medir la actividad física y el LAWSEQ para medir la autoestima de los niños y las niñas. En la población estudiada, se mostró un 17 % de estudiantes con sobrepeso, un 13 % con obesidad; un 70.05 % con actividad física moderada y un 25.67 % con bajos niveles de actividad física. En cuanto a la autoestima, se evidenció un 50.5 % con autoestima promedio y un 44 % con autoestima baja. En conclusión, el análisis de los resultados indica una mayor prevalencia de obesidad en las niñas, y un mayor nivel de actividad física en los niños; en el caso de la autoestima, la edad juega un papel importante en la percepción personal, especialmente en el género femenino.

Abstract The high levels of overweight and obesity that produce diabetes, hypertension, and other chronic diseases are a public health threat that starts from childhood through the adult age, altering a person´s quality of life directly. The purpose of this study is to determine the levels of overweight and obesity, the levels of physical activity and self-esteem of children aging 9 to 13 years, in educational establishments from the center of Panama City, Panama. Thirteen (13) educational centers participated pertaining to eight (8) territories from the capital of the country, where 748 students were evaluated. The instruments used to measure these variables were the measuring rod, the weight scale to measure the body mass index, the PAQ-C survey to measure the physical activity, and LAWSEQ to measure self-esteem in children. The studied population showed 17% of the students to be overweight, 13% obese, 70.05% with moderate physical activity, and 25.67% with low levels of physical activity. As far as self-esteem is concerned, 50.5% showed average self-esteem and 44% low self-esteem. In conclusion, it is important to perform physical activities as prevention and attention actions to obesity, overweight, and improvement of self-esteem. The analysis of the results indicates a higher prevalence of obesity in girls, and greater levels of physical activity in boys, in the case of self-esteem, age plays an important role in personal perception, especially in the female sex.

Resumo Os altos níveis de sobrepeso e obesidade que produzem diabetes, hipertensão ou outras doenças crônicas são um problema de saúde pública que começa na infância e continua na idade adulta e altera diretamente a qualidade de vida de uma pessoa. O objetivo deste estudo foi determinar os níveis de sobrepeso e obesidade, os níveis de atividade física e autoestima de crianças entre 9 e 13 anos de idade, em 13 centros educativos no centro da cidade do Panamá. Foram avaliados 748 estudantes. As variáveis foram medidas por meio do medidor de altura e do peso para calcular o índice de massa corporal, o questionário PAQ-C para medir a atividade física e o LAWSEQ para medir a autoestima das criancas. De acordo a população estudada, 17% tinham excesso de peso, 13% eram obesos, 70,05% moderadamente ativos fisicamente e 25,67% com baixos níveis de atividade física. Em termos de autoestima, 50,5% tinham autoestima média e 44% baixa autoestima. Em conclusão, a análise dos resultados indica uma maior prevalência de obesidade nas meninas e um maior nível de atividade física nos meninos; no caso da autoestima, a idade desempenha um papel importante na percepção pessoal, especialmente para o gênero feminino.

Effect of administering recombinant erythropoietin to women with postpartum anemia: a meta-analysis.

OBJECTIVES: Recombinant erythropoietin (rEpo) has been administered to women with postpartum anemia in an attempt to accelerate their increase in hemoglobin concentration and reduce postpartum transfusions. However, it is not clear whether such an approach can be supported by evidence and should be generally recommended. STUDY DESIGN AND METHODS: Medical and scientific literature from January 1990 to December 2002 was searched and studies that reported the administration of rEpo to women with postpartum anemia were evaluated. RESULTS: Eight evaluated studies reported an aggregate of 480 women; 300 rEpo recipients and 180 controls. Significant diversity in design was observed in rEpo dose, route of rEpo administration, iron supplementation, and baseline hemoglobin. No significant safety concerns were reported. In all five studies where it was reported, 4 to 7 days after beginning treatment, greater increases in hemoglobin concentration were observed among the rEpo recipients than among the controls. However, heterogeneity of results (Q-test statistic, p<0.01) indicated that it was not appropriate to apply summary statistics. The effect of rEpo on postpartum transfusion rate was not measurable by summary statistics because of the limited number of transfusions given (no transfusions among the 300 rEpo recipients vs two transfusions among the 180 controls). CONCLUSION: Administration of rEpo to women with postpartum anemia appears to be safe, and is associated with a trend toward a faster increase in hemoglobin concentration. However, its efficacy in terms of diminishing postpartum transfusions is unproven.

El estudio del sistema "enfermedad de Chagas" / Study of system \"Chagas' disease\"

Se un enfoque sistémico, integrado u holístico para el estudio de la enfermedad de Chagas, considerándola como un sistema de alta complejidad. Se mencionan técnicas de análisis y se discuten los modelos de análisis disponibles: el conceptual, de Bucher y Abalos (1981) y el matemático, de Rabinovich (1981). Se presenta un plan de trabajo holístico para el análisis del sistema Chagas en la Argentina (objetos, desarrollo y organización)