RESUMEN
The concentration of gases in the atmosphere is a topic of growing concern due to its effects on health, ecosystems etc. Its monitoring is commonly carried out through ground stations which offer high precision and temporal resolution. However, in countries with few stations, such as Ecuador, these data fail to adequately describe the spatial variability of pollutant concentrations. Remote sensing data have great potential to solve this complication. This study evaluates the spatiotemporal distribution of nitrogen dioxide (NO2) and ozone (O3) concentrations in Quito and Cuenca, using data obtained from ground-based and Sentinel-5 Precursor mission sources during the years 2019 and 2020. Moreover, a Linear Regression Model (LRM) was employed to analyze the correlation between ground-based and satellite datasets, revealing positive associations for O3 (R2 = 0.83, RMSE = 0.18) and NO2 (R2 = 0.83, RMSE = 0.25) in Quito; and O3 (R2 = 0.74, RMSE = 0.23) and NO2, (R2 = 0.73, RMSE = 0.23) for Cuenca. The agreement between ground-based and satellite datasets was analyzed by employing the intra-class correlation coefficient (ICC), reflecting good agreement between them (ICC ≥0.57); and using Bland and Altman coefficients, which showed low bias and that more than 95% of the differences are within the limits of agreement. Furthermore, the study investigated the impact of COVID-19 pandemic-related restrictions, such as social distancing and isolation, on atmospheric conditions. This was categorized into three periods for 2019 and 2020: before (from January 1st to March 15th), during (from March 16th to May 17th), and after (from March 18th to December 31st). A 51% decrease in NO2 concentrations was recorded for Cuenca, while Quito experienced a 14.7% decrease. The tropospheric column decreased by 27.3% in Cuenca and 15.1% in Quito. O3 showed an increasing trend, with tropospheric concentrations rising by 0.42% and 0.11% for Cuenca and Quito respectively, while the concentration in Cuenca decreased by 14.4%. Quito experienced an increase of 10.5%. Finally, the reduction of chemical species in the atmosphere as a consequence of mobility restrictions is highlighted. This study compared satellite and ground station data for NO2 and O3 concentrations. Despite differing units preventing data validation, it verified the Sentinel-5P satellite's effectiveness in anomaly detection. Our research's value lies in its applicability to developing countries, which may lack extensive monitoring networks, demonstrating the potential use of satellite technology in urban planning.
RESUMEN
OBJECTIVE: To systematically review literature on therapeutic options for treating hemifacial microsomia (HFM), in young patients with growth potential, classifying and comparing the different dentofacial treatment methods. STUDY DESIGN: An independent review of databases (Scopus, Embase, Ovid, Cochrane Library and PubMed) following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA), conducted by four evaluators. The protocol of this study was registered in International prospective register of systematic reviews (PROSPERO), under the number CRD42021293076. RESULTS: Between 1970-2021, a total number of 1137 articles were published of which 27 were included in this study according to the selection criteria: one randomized multicentric trial, two case-control studies, three case series and 21 case reports. CONCLUSIONS: The most common orthopedic treatments provide vertical stimulation of the maxillary process in the affected side. Orthodontic approaches are mainly applied for vertical correction and stabilization of the occlusal plane. Other treatment options include orthognathic surgery, osteogenic distraction, temporomandibular reconstruction and grafting. It is recommended that prospective clinical randomized controlled studies be conducted using homogeneous pediatric groups with long-term follow-up, to establish recommended evidence-based methods for treating each set of hemifacial microsomia symptoms.
Asunto(s)
Síndrome de Goldenhar , Humanos , Niño , Síndrome de Goldenhar/cirugía , Asimetría Facial/cirugía , Resultado del Tratamiento , Estudios Retrospectivos , Estudios Prospectivos , Mandíbula , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
INTRODUCTION: The prison environment in Peru is one of the worst in the continent. In situations such as these, where there is considerable stress, many inmates can develop antisocial disorders, especially if they come from a conflictive family setting. OBJECTIVES: To determine the association between family relationships, social environment and features of antisocial personality disorder (ASPD) in the Peruvian prison population in 2016. MATERIAL AND METHOD: Analytical cross-sectional study based on a sub-analysis of the First National Penitentiary Census of Peru in 2016. The sample is the prison population (≥18 years old) that participated in said census, which was carried out in 66 correctional facilities nationwide and reached a coverage of 98.8%. RESULTS: Of the 77,086 prisoners, 76,152 participated in the analysis. The prevalence of antisocial traits was 96% and half of the population met two criteria for the disorder. Independently associated factors were, being male (RPa: 1.35; 1.30-1.40), born outside the capital (RPa: 0.89; 0.88-0, 91), friends in the neighborhood who committed offences (RPa: 1.01; 1.00-1.02) and not living with a father (RPa: 1.00; 1.00-1.01). DISCUSSION: The prevalence of antisocial personality disorder traits in the Peruvian prison population was 96%. We found greater association with the male sex, in those born in Lima and in those who escaped from their home before the age of 15.
Asunto(s)
Trastorno de Personalidad Antisocial , Prisioneros , Adolescente , Trastorno de Personalidad Antisocial/epidemiología , Estudios Transversales , Humanos , Masculino , Perú/epidemiología , Prisiones , Medio SocialRESUMEN
BACKGROUND & AIMS: Evening chronotype has been linked with obesity, diabetes and metabolic syndrome (MetS) in middle-aged and older adults. However, few studies have analyzed this association in young adults. The aim of this study was to assess potential associations between individual chronotype and cardiometabolic outcomes in young adults of two independent populations from Europe and America. METHODS: Total population comprised 2 223 young adults (18-29 years old), 525 from Spain (Europe) and 1 698 from Mexico (America). Anthropometric, body composition and biochemical analyses were performed. Circadian preference was determined using the Morningness-Eveningness Questionnaire (MEQ). RESULTS: In these two young adult populations, a higher metabolic risk was found in those individuals with evening chronotypes, whereas those with neither or morning chronotypes showed lower cardiometabolic risk. Evening chronotypes showed lipid alterations with increased levels of triglycerides in both populations, VLDL-c in Spaniards and total cholesterol and LDL-c in Mexicans. Among the Mexican population, evening chronotypes showed higher MetS risk and more obesity traits than the other two chronotypes; no significant differences for the same comparison were found among the equivalent Spanish chronotypes. Evening chronotypes showed lower carbohydrates and higher fat intake in Spaniards, while they had lower fiber intake in Mexicans. The associations between MEQ score and cardiometabolic risk were independent of the dietary characteristics. Lifestyle factors differed among chronotypes with more smokers and habitual drinkers among evening chronotypes than in neither or morning chronotypes (P < 0.05). CONCLUSIONS: This study performed in two American and European independent populations shows that even in apparently healthy young adults, evening chronotypes have increased cardiometabolic risk and lipid alterations as compared to neither or morning chronotypes.
Asunto(s)
Ritmo Circadiano , Triglicéridos/sangre , Adolescente , Adulto , Composición Corporal , Factores de Riesgo Cardiometabólico , Estudios Transversales , Dieta , Femenino , Humanos , Masculino , México , Obesidad , Sueño , España , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Mercury (Hg) was measured in the muscle, liver, and gonads of Haemulopsis elongatus and Pomadasys macracanthus from Mazatlán (SE Gulf of California) to determine the relationships of the hepatosomatic index (HSI) and gonadosomatic index (GSI) of fish with Hg concentrations in the corresponding tissues. Health risk to consumers was assessed by using the hazard quotient (HQ), considering the average rate of fish consumption in Mexico and Hg concentration in the edible tissue. In H. elongatus, the highest Hg levels were measured in the liver (3.748 µg g-1); in P. macracanthus, the highest Hg concentration was quantified in the muscle (0.574 µg g-1). In P. macracanthus, the HSI was negatively correlated with Hg concentration in the liver; in H. elongatus, there was also a negative relationship between Hg levels in gonads and the GSI. Mean HQ values in Haemulopsis elongatus (0.005) and Pomadasys macracanthus (0.002) were below the value (HQ ≥ 1) of concern. The significant reduction of HSI and GSI with Hg increase in the liver and gonads may suggest that Hg bioaccumulation in these fish shows adverse physiological effects. Though HQ values in both species were below the unit, i.e., the consumption of the muscle from this species does not represent a health risk, it is necessary to carry out surveys of fish consumption rates in coastal areas of Mexico to do a more precise health risk assessment associated to Hg intake.
Asunto(s)
Mercurio , Contaminantes Químicos del Agua , Animales , Bioacumulación , California , Monitoreo del Ambiente , Mercurio/análisis , México , Medición de Riesgo , Contaminantes Químicos del Agua/análisisRESUMEN
AIM: To describe the findings of implementing May Measurement Month 2017 in the adult Colombian population to raise awareness of the importance of blood pressure measuring, monitoring, and awareness. MATERIALS AND METHODS: May Measurement Month is a cross-sectional survey that follows the directives of the International Society of Hypertension and the World Hypertension League, which gathers information on cardiovascular risk factors and blood pressure readings. Its implementation in Colombia was lead by the Santander Ophthalmological Foundation (FOSCAL) and the Latin American Society of Hypertension (LASH) with the support of the Colombian Network for the Prevention of Cardiovascular Diseases and Diabetes (RECARDI). RESULTS: Data was collected from 11 departments on 21,797 people, 58.7% of whom were female, with an average age of 40.5±17.7 years. The overall prevalence of high blood pressure (HBP) was 20.8% (self-reported antihypertensive treatment or systolic blood pressure reading [systolic blood pressure≥140mmHg]). Of the total number of hypertensives, 46.5% had systolic blood pressure readings classified as uncontrolled (systolic blood pressure<140mmHg), and 26.4% were unaware that they were hypertensive who, in this report, we consider to be new cases of HBP. CONCLUSION: The prevalence of (elevated) blood pressure is high in this young adult population, whose lack of awareness of HBP is also high, and HBP in those aware of their condition is poorly controlled. These results highlight the need to implement effective detection programmes for hypertensive patients and to establish standardised treatments to improve HBP control as a strategy to reduce cardiovascular events.
Asunto(s)
Antihipertensivos/administración & dosificación , Determinación de la Presión Sanguínea/métodos , Presión Sanguínea/fisiología , Hipertensión/diagnóstico , Adulto , Colombia , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Hipertensión/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Adulto JovenRESUMEN
RESUMEN Los efectos nocivos de la radiación solar han sido reportados, pero casi no se ha estudiado la población laboral de Latinoamérica. Este es un estudio transversal analítico realizado en ocho países. Las preguntas sobre protección solar se tomaron de trabajos previos; además, se preguntó por las características laborales; ambos datos se cruzaron para obtener datos estadísticos de asociación. De los 3.222 trabajadores encuestados, el 71% (2270) tenía piel mestiza. Hubo asociación del enrojecimiento de la piel según la cantidad de horas de exposición solar directa (p<0,001) e indirecta (p<0,001). El 47% (995) usaban protector/bloqueador solar, el 54% (1150) usaban ropa adecuada y el 50% (1056) usaban alguna gorra o sombrero; siendo estadísticamente diferente el medio de adquisición de dichos equipos. El 21% (446) no usaba ninguno de los equipos de protección personal ante los efectos del sol. Concluimos que es alarmante el bajo porcentaje de trabajadores que reciben adecuada protección contra los efectos de la radiación solar. Esto podría generar problemas a corto, mediano y largo plazo entre los empleados, lo que podría aumentar la morbi-mortalidad y el riesgo de cáncer de piel.
ABSTRACT The harmful effects of solar radiation have been reported, but the work population in Latin America has hardly been studied. The objective is describe the type of sun protection they use and find associations according to their characteristics in Latin American workers. The methodology isCross-sectional analytical study carried out in 8 countries, the questions of sun protection were taken from previous work, in addition, asked about the labor characteristics; Both were crossed to obtain association statistics. Our results: Of the 3.222 workers surveyed, 71% (2270) had mestizo skin. There was association of skin redness according to the number of hours of direct (p <0.001) and indirect sun exposure (p <0.001). 47% (995) wore the sunscreen / protector, 54% (1150) wore appropriate clothing and 50% (1056) wore a cap or hat; statistically different according to the means of acquisition of such equipment (p value <0.001 for all three cases). 21% (446) did not wear any personal protective equipment to the effects of the sun. It is alarming that the low percentage of workers who receive adequate protection against the effects of solar radiation can cause problems in the short, medium and long term among employees. This could increase morbidity and mortality and the risk of skin cancer. It is important to do more research in this regard, as this issue is of utmost importance because of the changes that have occurred in radiation levels, which could generate a public health problem in this work group.
RESUMEN
INTRODUCTION: Chemotherapy-induced peripheral neuropathy is a common adverse reaction in a variety of medications frequently used for a great number of cancer treatments. This condition consists of mainly sensory-type symptoms, motor components and autonomic changes. Reported prevalence ranges from 30-68%, after the completion of chemotherapy in non-Latin American people with different populations and socioeconomic levels. AIM: To determine the prevalence of chemotherapy-induced peripheral neuropathy in a Colombian population. PATIENTS AND METHODS: A real-world evidence cross-sectional retrospective study was performed in all patients from oncological clinical centers in Colombia, which received pharmacological therapy for any cancer between January 2015 and December 2016, with taxanes (paclitaxel, docetaxel), alkylators (oxaliplatin), proteasome inhibitors (bortezomib), and epothilone B analogs (ixabepilone). RESULTS: A total of 1,551 patients in four cities were included, and 11,280 doses were applied; predominantly females (n = 1,094; 70.5%), with a mean age of 57 ± 13 years old. Paclitaxel was the most commonly prescribed drug (n = 788; 50.8%). Chemotherapy-induced peripheral neuropathy was developed in 48.9% of paclitaxel, 58.5% of oxaliplatin, 50.5% of docetaxel, 43.7% of bortezomib and 95.2% of ixabepilone patients. Thirty-three patients were treated with two of these medications simultaneously. CONCLUSIONS: Chemotherapy-induced peripheral neuropathy is a frequent adverse reaction to daily cancer therapy in Colombian patients managed with taxanes, alkylators, proteasome inhibitors, and epothilone B analogs. Hence, it is necessary to establish more successful diagnostic methods and incorporate validated scales in the routine evaluation of all patients receiving these medications in our environment.
TITLE: Prevalencia de neuropatia periferica asociada a quimioterapia en cuatro centros oncologicos de Colombia.Introduccion. La neuropatia periferica inducida por quimioterapia es una reaccion comun a una variedad de medicamentos usados en el tratamiento del cancer, que consiste principalmente en sintomas sensitivos, con componentes motores y cambios autonomicos. La prevalencia es del 30-68% despues de terminar la quimioterapia en paises no latinoamericanos. Objetivo. Determinar la prevalencia de la neuropatia periferica inducida por quimioterapia en la poblacion colombiana. Pacientes y metodos. Estudio retrospectivo con evidencia del mundo real en la totalidad de pacientes atendidos en cuatro centros oncologicos de Colombia, quienes recibieron terapia farmacologica para algun tipo de cancer entre enero de 2015 y diciembre de 2016 con taxanos (paclitaxel, docetaxel), agentes alquilantes (oxaliplatino), inhibidores de proteasoma (bortezomib) y analogos de epotilona B (ixabepilona). Resultados. Se siguio a un total de 1.551 pacientes en cuatro ciudades a quienes se les aplicaron 11.280 dosis, con predominio femenino (n = 1.094; 70,5%) y una edad media de 57 ± 13 años. El paclitaxel fue el farmaco mas prescrito (n = 788; 50,8%). La neuropatia inducida por quimioterapia se presento en el 48,9% de los pacientes con paclitaxel, el 58,5% de los pacientes con oxaliplatino, el 50,5% de los pacientes con docetaxel, el 43,7% de los pacientes con bortezomib y el 95,2% de los pacientes con ixabepilona. Se trato a 33 pacientes con dos de estos medicamentos simultaneamente. Conclusiones. La neuropatia periferica inducida por quimioterapia es una reaccion adversa frecuente en pacientes con cancer en Colombia tratados con taxanos, alquilantes, inhibidores de proteasoma e ixabepilona. Es necesario establecer metodos diagnosticos efectivos e incorporar escalas validadas en la evaluacion rutinaria de los pacientes que reciben estas medicaciones.
Asunto(s)
Antineoplásicos/efectos adversos , Enfermedades del Sistema Nervioso Periférico/inducido químicamente , Adulto , Anciano , Antineoplásicos/uso terapéutico , Bortezomib/efectos adversos , Instituciones Oncológicas/estadística & datos numéricos , Colombia/epidemiología , Estudios Transversales , Epotilonas/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oxaliplatino/efectos adversos , Enfermedades del Sistema Nervioso Periférico/diagnóstico , Enfermedades del Sistema Nervioso Periférico/epidemiología , Prevalencia , Inhibidores de Proteasas/efectos adversos , Estudios Retrospectivos , Taxoides/efectos adversosRESUMEN
INTRODUCTION: Anterior shoulder pain is one of the most common symptoms in the orthopedic consultation, much of it is associated with the pathology of the long head biceps tendon; in general, its management is conservative, including injections which are performed blindly as a common clinical practice. With the advent of imaging support in the performance of these procedures such as ultrasound can improve the accuracy of biceps tendon sheath injections to obtain a better clinical result. OBJECTIVE: To describe the clinical results of patients with chronic biceps tendinitis who were injected by ultrasound guidance. MATERIAL AND METHODS: Observational single-cohort study with prospective follow-up which included patients with chronic tendonitis of the long biceps brachii who were candidates for ultrasound-guided infiltration. The presence of pain (Visual Analogue Scale) and functionality (Constant-Murley Test) was evaluated after two weeks. Quantitative variables are reported as averages and standard deviation. RESULTS: The study comprised 18 patients with an average age of 59.6 years, the EVA score decreased from 7.2 (SD 1.6) before-injection to 3.7 (2.7) post-injection. The Constant-Murley score improved from 51.1 (SD 9.5) before injection to 65.9 (15.7) at follow-up. No complications were reported. DISCUSSION: Ultrasound-guided infiltration is a safe procedure that results in improvement of pain and functionality of patients with tendonitis of the biceps brachial.
INTRODUCCIÓN: El dolor anterior de hombro es uno de los síntomas más comunes en la consulta ortopédica, gran parte está asociada con la patología del tendón de la porción larga del bíceps; por lo general su manejo es conservador e incluye infiltraciones, las cuales se efectúan a «ciegas¼ como una práctica clínica común. Con el surgimiento del apoyo imagenológico en la realización de estos procedimientos, como la ecografía, se puede mejorar la precisión de las infiltraciones para obtener un mejor resultado clínico. OBJETIVO: Describir los resultados clínicos de los pacientes con tendinitis crónica del bíceps que fueron infiltrados mediante guía ecográfica en la Clínica Universitaria Colombia. MATERIAL Y MÉTODOS: Estudio observacional de cohorte única y con seguimiento prospectivo en el que se incluyeron pacientes con tendinitis crónica de la porción larga del bíceps braquial que eran candidatos a infiltración guiada ecográficamente. Se evaluó la presencia de dolor (escala visual análoga) y funcionalidad (test de Constant-Murley) a las dos semanas. Las variables cuantitativas se reportan como promedios y desviación estándar. RESULTADOS: Se incluyeron 18 pacientes con un promedio de edad de 59.6 años. La intensidad del dolor disminuyó de 7.2 (DE 1.6) preinfiltración a 3.7 (DE 2.7) postinfiltración. La puntuación de Constant-Murley mejoró de 51.1 (DE 9.5) antes de la infiltración a 65.9 (15.7) en el seguimiento. No se registraron complicaciones. DISCUSIÓN: La infiltración guiada por ecografía es un procedimiento seguro que se traduce en mejoría de dolor y funcionalidad de pacientes con tendinitis del bíceps braquial.
Asunto(s)
Tendinopatía , Ultrasonografía Intervencional , Estudios de Cohortes , Humanos , Persona de Mediana Edad , Estudios Prospectivos , Tendinopatía/terapiaRESUMEN
INTRODUCCIÓN La depresión postparto ha sufrido un crecimiento significativo, pero en la sierra central peruana no existen estudios acerca de este tema. OBJETIVOS Identificar y establecer los factores de riesgo para desarrollar depresión postparto en las madres que tienen a sus hijos hospitalizados en unidades de pediatría y neonatología en la ciudad de Huancayo. MÉTODOS Estudio de casos y controles. Se incluyeron las fichas de recolección de datos de las madres que tuvieron hospitalizados a sus hijos en unidades de pediatría y neonatología durante 2017. Los casos fueron las que tuvieron "presencia de síntomas de depresión postparto". Se cruzó esta variable con otras mediante la regresión logística. Se obtuvieron los Odds ratio, sus intervalos de confianza al 95% y los valores p. RESULTADOS Se evaluaron 61 fichas de madres que padecieron depresión postparto (casos) y 61 fichas de madres sin este tipo de patología (controles). Al realizar el análisis multivariado, se encontró que aquellas madres con una condición laboral de tipo desempleada (p < 0,001), así como aquellas que fueron solteras (valor p < 0,001) y las que tuvieron un embarazo no planificado (p = 0,003); tuvieron una mayor posibilidad de depresión postparto). Por el contrario, aquellas que manifestaron tener problemas graves con su pareja tuvieron una menor oportunidad de depresión postparto (p = 0,003); ajustado por nueve variables. CONCLUSIONES Se encontraron diversos factores relacionados con la depresión postparto: el estado civil, la relación con la pareja, la condición laboral y la no planificación del embarazo.
INTRODUCTION Postpartum depression has increased significantly worldwide, but in the central Peruvian mountain, there are no studies that address this problem. OBJECTIVES To identify and to establish risk factors for postpartum depression in mothers whose children are hospitalized in pediatrics/neonatology units in Huancayo. METHODS This is a case-control study. Medical records of mothers whose children were hospitalized in pediatrics/neonatology units during 2017 were included. The cases were defined as patients who "had symptoms of postpartum depression." This variable was crossed with other variables using logistical regression, odds ratio were obtained, their confidence intervals were set to 95%, and the p values were calculated. RESULTS Sixty-one medical records of mothers with postpartum depression (cases) and 61 medical records of mothers without postpartum depression (control) were evaluated. In the multivariate analysis, the unemployed mothers had a bigger chance of postpartum depression (p < 0.001), as well as single mothers (p < 0.001), and those with an unplanned pregnancy (p = 0.003). Conversely, mothers who reported having serious problems with their partner had a smaller chance of postpartum depression (p = 0.003). CONCLUSIONS Different factors were found to be related to postpartum depression: marital situation, relationship with their partners, work conditions, and having an unplanned pregnancy.
Asunto(s)
Humanos , Femenino , Embarazo , Recién Nacido , Adulto , Adulto Joven , Niño Hospitalizado/psicología , Depresión Posparto/epidemiología , Madres/psicología , Perú , Estudios de Casos y Controles , Factores de Riesgo , Embarazo no Planeado/psicología , Empleo/estadística & datos numéricos , Relaciones InterpersonalesRESUMEN
Objetivo Determinar la relación entre la falta de seguimiento, adherencia al tratamiento con multivitamínicos y niveles séricos de 25-OH vitamina D (Vit-D) en mujeres post-cirugía BPRY, en la UNEME de la ciudad de Tijuana, Baja California, México. Métodos Estudio Transversal analítico que incluyó mujeres post-cirugía BPRY (GCa, n=13), con Obesidad Mórbida (GOM, n=13) y mujeres aparentemente sanas (GCo, n=13). Posterior a la autorización mediante consentimiento informado escrito, se realizó una historia clínica, valoración antropométrica, aplicación del instrumento de medición y en una segunda cita se tomó una muestra sanguínea para la cuantificación de Vit-D. El instrumento de medición fue validado mediante Kappa de Cohen mayor al 80% y alfa de Cronbach de 1. El análisis estadístico de los datos se realizó mediante pruebas de diferencia de medias t de Student y ANOVA donde se consideró una p < 0.05 en una prueba a dos colas. Se determinó prevalencia, significancia estadística de la falta de adherencia y seguimiento en relación a los niveles de Vit-D. Resultados La prevalencia de falta de adherencia al tratamiento multivitamínico en estas mujeres con post-cirugía BPRY fue de 85% y la falta de seguimiento post quirúrgico que incluye pruebas de laboratorio de micronutrientes fue del 100%. Se encontró una diferencia estadísticamente significativa entre las medias de los niveles de Vit-D entre las mujeres con y sin adherencia al multivitamínico p < 0.05, IC 95%. Conclusiones Se demostró que la falta de adherencia y seguimiento al tratamiento con multivitamínicos son factores de riesgo para la insuficiencia y deficiencia de Vit-D en pacientes con post-cirugía BPRY.
Objective To determine the interrelationships among lack of compliance, multi-vitamin treatment adherence, and serum levels of 25-OH vitamin D among women with Roux-en-Y bariatric surgery in the UNEME of Tijuana, Baja California, Mexico. Methods This is an analytical and transversal study on women with Roux-en-Y bariatric surgery (GCa, n=13) with morbid obesity (GOM, n=13), and apparently healthy women (GCo, n=13). After the corresponding written informed consents, in a first appointment, the medical record, the anthropometric assessment, and the administration of the instrument were performed, while in a second appointment, blood samples were taken in order to measure the vitamin D levels. The assessment instrument was validated through a Cohen Kappa greater than 80% and a Cronbach Alpha of 1. Student's t test and two-tailed, p < 0.05 ANOVAS were calculated. Results While a lack of adherence to multi-vitamin treatment was found in 85% of the women, a lack of post-surgical follow-up, including micro-nutrients lab tests, was found in 100%. A statistically significant difference between the mean vitamin D levels of women with and without multi-vitamin treatment adherence was found (p < 0.05, CI 95%). Conclusions It was demonstrated that the lack of adherence to multi-vitamin treatments is a vitamin D deficiency risk factor among patients with Roux-en-Y bariatric surgery.
Objetivo Determinar a relação entre a falta de seguimento, aderência ao tratamento com multivitamínicos e niveis séricos de 25-OH vitamina D (Vit-D) em mulheres post-cirurgia BPRY, na UNEME da cidade de Tijuana, Baja California, México. Métodos. Estudo Transversal analítico que incluiu mulheres post-cirurgia BPRY (GCa, n=13), com Obesidade Mórbida (GOM, n=13) e mulheres aparentemente saudáveis (GCo, n=13). Posterior à autorização mediante consentimento informado escrito, realizou-se uma história clínica, avaliação antropométrica, aplicação do instrumento de medição e em uma segunda consulta tomou-se uma amostra sanguínea para a quantificação de Vit-D. O instrumento de medição foi validado mediante Kappa de Cohen maior a 80% e alfa de Cronbach de 1. A análise estatística dos dados realizou-se mediante probas de diferencia de média t de Student e ANOVA onde se considerou uma p < 0.05 em um teste bilateral. Determinou-se prevalência, significância estatística da falta de aderência e seguimento em relação aos níveis de Vit-D. Resultados A falta de aderência ao tratamento multivitamínico nestas mulheres bariátricas foi de 85% e a falta de seguimento post cirúrgico que inclui testes de laboratório de micronutrientes foi de 100%. Encontrou-se uma diferença estatisticamente significativa entre a média dos níveis de Vit-D entre as mulheres com e sem aderência no multivitamínico p < 0.05, IC 95%. Conclusões . Demostrou-se que a falta de aderência e seguimento no tratamento com multivitamínicos são fatores de risco para a insuficiência e deficiência de Vit-D em pacientes bariátricos.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Vitamina D , Deficiencia de Vitamina D , Mujeres , Cirugía BariátricaRESUMEN
INTRODUCTION AND AIMS: Dyspepsia is a multifactorial disease that can involve alcohol, tobacco, or nonsteroidal anti-inflammatory drug use, as well as lifestyle, diet, socioeconomic elements, or psychologic factors. The aim of the present article was to establish the frequency of uninvestigated dyspepsia and determine its associated factors in students at 4 Latin American schools of medicine. MATERIALS AND METHODS: A cross-sectional, analytic study was conducted, in which a survey made up of closed-ended questions was applied at just one point in time. The association between the variables was then analyzed. A new questionnaire for the diagnosis of dyspepsia was one of the tests utilized to diagnose uninvestigated dyspepsia. Generalized linear models were used for the bivariate and multivariate analyses, employing the Poisson model with the log link function, obtaining crude prevalence ratios, adjusted prevalence ratios, and their 95% confidence intervals. RESULTS: Of the 1,241 individuals surveyed, 54% (841) were females and the median age was 21 years (range: 19-23 years). Prevalence of uninvestigated dyspepsia was 46%. The factors that had a direct association with dyspepsia were: depression, difficulty sleeping, and coffee consumption. On the contrary, eating regularly in a boarding house and the male sex had an inverse association. CONCLUSIONS: Uninvestigated dyspepsia frequency was high in students at 4 Latin American schools. Depression, difficulty sleeping, and steady coffee drinking were factors directly associated with dyspepsia, whereas male sex and eating out at regular hours were factors with a reverse association. Therefore, we recommend that universities implement early detection programs for this highly preventable pathology.
Asunto(s)
Dispepsia/epidemiología , Facultades de Medicina/estadística & datos numéricos , Estudiantes de Medicina/estadística & datos numéricos , Estudios Transversales , Femenino , Humanos , América Latina , Masculino , Prevalencia , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVE: The aim of the study was to provide scientific evidence that would permit DEJ separation to be used as a parameter to estimate the temperature to which burnt, carbonized or incinerated cadavers or human remains had been subjected. MATERIALS AND METHODS: A descriptive pseudo-experimental study was carried out in vitro using cone beam tomography to determine the physical behavior of the dentine-enamel junction in 60 human premolars submitted to high temperatures (200°C, 400°C, 600°C, 800°C and 1000°C). RESULTS: Spearman's concordance and correlation index was used to determine the relationship between longitudinal separation of the dentine-enamel junction (mm) and temperature (°C) and a simple linear regression model developed to show that once micro- and macrostructural changes are initiated in the enamel and dentine. CONCLUSIONS: The dentine-enamel junction begins to separate from the cervical towards the occlusal as temperature increases.
Asunto(s)
Diente Premolar/diagnóstico por imagen , Tomografía Computarizada de Haz Cónico , Esmalte Dental/diagnóstico por imagen , Dentina/diagnóstico por imagen , Calor , Diente Premolar/patología , Estudios Transversales , Esmalte Dental/patología , Dentina/patología , Odontología Forense , Humanos , Imagenología Tridimensional , Técnicas In Vitro , Modelos Logísticos , FotograbarRESUMEN
BACKGROUND: For the last 15 years, infection from Helicobacter pylori (H. pylori) has been recognized in gastritis pathogenesis, and is known to trigger an important inflammatory response in these patients. AIM: To determine the association between follicular gastritis and H. pylori infection in children seen at a public hospital in Peru. METHODOLOGY: An analytic, cross-sectional study was conducted on all the children treated at the Hospital Nacional Docente Madre "Niño San Bartolomé" in Lima, Peru, within the time frame of 2011-2012. All the personal data from the patients' medical histories and endoscopic procedures were collected. The crude prevalence ratios (PR) were obtained and adjusted (aPR) with their 95% confidence intervals (95%CI), using generalized linear models with the binomial family and log link function. RESULTS: A total of 123 children met the study criteria. Forty-eight (39%) of the study sample were girls and the mean age of the children was 12 years. H. pylori was present in 44% of the sample and 9% presented with more than 100 bacteria per field (classified as +++). Thirty-five percent of the children had esophagitis due to concomitant reflux. The presence of H. pylori was associated with follicular gastritis (P<0.01; aPR: 2.3; 95% CI:1.49-3.49), adjusted by the children's age. CONCLUSIONS: Based on the data analyzed, it was concluded that the children with follicular gastritis had a greater likelihood of having H. pylori than those that did not present with gastritis. These results can be extrapolated to other similar populations and should be evaluated in each setting so that this does not become a public health problem within the next few years.
Asunto(s)
Gastritis/complicaciones , Infecciones por Helicobacter/complicaciones , Helicobacter pylori , Adolescente , Niño , Estudios Transversales , Femenino , Gastritis/epidemiología , Reflujo Gastroesofágico/complicaciones , Infecciones por Helicobacter/epidemiología , Hospitales Públicos , Humanos , Masculino , Perú/epidemiología , PrevalenciaRESUMEN
Objetivo: determinar si la presencia pre-operatoria de condiciones psicológicas adversas afecta la pérdida de peso en pacientes sometidos a bypass gástrico. Metodología: estudio de cohortes histórico. La pérdida de peso fue expresada como Porcentaje de Exceso de IMC Perdido (PEIMCP). Mediante el uso de modelos de Ecuaciones de Estimación Generalizada (GEE) y modelos de riesgos proporcionales de COX, se comparó la evolución post-quirúrgica del PEIMCP y el tiempo en el que se logró una pérdida de peso exitosa (PEIMCP ≥50%) entre los sujetos que presentaron trastornos psiquiátricos o acontecimientos vitales traumáticos y aquellos que no presentaron estas condiciones antes de la cirugía. Resultados: de 155 pacientes estudiados, el 35.5% presentó trastornos psiquiátricos y el 26.5% presentó acontecimientos vitales traumáticos antes de la cirugía. Tanto en los sujetos que presentaron trastorno psiquiátrico o acontecimiento vital traumático como en los que no presentaron estas condiciones, la probabilidad de lograr una pérdida de peso exitosa entre los 12 y 18 meses post-quirúrgicos fue del 80%, aproximadamente. La ausencia de trastorno psiquiátrico antes de la cirugía disminuyó el PEIMCP en 3%, con respecto a la presencia pre-operatoria de psicopatología, aunque tal disminución no fue estadísticamente significativa (p =0.08); mientras que la ausencia previa de acontecimiento vital traumático incrementó el PEIMCP en 2.9%, con respecto a la existencia pre-operatoria de esta condición, aunque tal incremento tampoco fue estadísticamente significativo (p =0.06). Conclusiones: la enfermedad psiquiátrica y los acontecimientos vitales traumáticos previos al bypass gástrico no afectan negativamente la pérdida de peso post-quirúrgica. Por lo tanto, no se puede contraindicar la cirugía.
Objective: To determine whether the preoperative presence of adverse psychological conditions affects weight loss in patients undergoing gastric bypass. Methods: Historical cohort study. Weight loss was expressed as a percentage of excess BMI lost (%EBMIL). Using models of Generalized Estimating Equations (GEE) and Cox proportional hazards, we compared the post-surgical evolution of %EBMIL and the time in which successful weight loss was achieved (%EBMIL ≥50%) among subjects who had psychiatric disorders and/or traumatic life events and those who did not have these conditions before surgery. Results: Of the 155 patients studied, 35.5% had psychiatric disorders and 26.5% had traumatic life events before surgery. Both in the subjects that had psychiatric disorders or traumatic life events and in those who did not have these conditions, the probability of achieving successful weight loss between 12 and 18 months post-surgery was approximately 80%. The absence of psychiatric disorder before surgery decreased the %EBMIL by 3% with respect to preoperative presence of psychopathology, although this decrease was not statistically significant (p =0.08). The absence of previous traumatic life event increased the %EBMIL by 2.9% compared to the preoperative existence of this condition, although this increase was not statistically significant (p =0.06). Conclusions: Psychiatric illness and traumatic life events prior to gastric bypass do not adversely affect weight loss post-surgery. Thus, surgery is not contraindicated.
Objetivo: determinar se a presença pré-operatória de condições psicológicas adversas afeta a perda de peso em pacientes sometidos a bypass gástrico. Metodologia: estudo de coortes histórico. A perda de peso foi expressada como Porcentagem de Excesso de IMC Perdido (PEIMCP). Mediante o uso de modelos de Equações de Estimação Generalizada (GEE) e modelos de riscos proporcionais de COX, se comparou a evolução post-cirúrgica do PEIMCP e o tempo no que se conseguiu uma perda de peso com sucesso (PEIMCP ≥50%) entre os sujeitos que apresentaram transtornos psiquiátricos ou acontecimentos vitais traumáticos e aqueles que não apresentaram estas condições antes da cirurgia. Resultados: de 155 pacientes estudados, 35.5% apresentou transtornos psiquiátricos e 26.5% apresentou acontecimentos vitais traumáticos antes da cirurgia. Tanto nos sujeitos que apresentaram transtorno psiquiátrico ou acontecimento vital traumático como nos que não apresentaram estas condições, a probabilidade de conseguir uma perda de peso com sucesso entre os 12 e 18 meses post-cirúrgicos foi de 80%, aproximadamente. A ausência de transtorno psiquiátrico antes da cirurgia diminuiu o PEIMCP em 3%, com respeito à presença pré-operatória de psicopatologia, embora tal diminuição não foi estatisticamente significativa (p =0.08); enquanto que a ausência prévia de acontecimento vital traumático incrementou o PEIMCP em 2.9%, com respeito à existência pré-operatória desta condição, embora tal incremento tampouco foi estatisticamente significativo (p =0.06). Conclusões: a doença psiquiátrica e os acontecimentos vitais traumáticos prévios ao bypass gástrico não afetam negativamente a perda de peso post-cirúrgica. Por tanto, não se pode contraindicar a cirurgia.
Asunto(s)
Humanos , Cirugía Bariátrica , Psicopatología , Obesidad Mórbida , Derivación Gástrica , Pérdida de Peso , Trastornos MentalesRESUMEN
Latin America has a high rate of community-associated infections caused by multidrug-resistant Enterobacteriaceae relative to other world regions. A review of the literature over the last 10 years indicates that urinary tract infections (UTIs) by Escherichia coli, and intra-abdominal infections (IAIs) by E. coli and Klebsiella pneumoniae, were characterized by high rates of resistance to trimethoprim/sulfamethoxazole, quinolones, and second-generation cephalosporins, and by low levels of resistance to aminoglycosides, nitrofurantoin, and fosfomycin. In addition, preliminary data indicate an increase in IAIs by Enterobacteriaceae producing extended-spectrum ß-lactamases, with reduced susceptibilities to third- and fourth-generation cephalosporins. Primary-care physicians in Latin America should recognize the public health threat associated with UTIs and IAIs by resistant Gram-negative bacteria. As the number of therapeutic options become limited, we recommend that antimicrobial prescribing be guided by infection severity, established patient risk factors for multidrug-resistant infections, acquaintance with local antimicrobial susceptibility data, and culture collection.
Asunto(s)
Antibacterianos/farmacología , Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/microbiología , Farmacorresistencia Bacteriana , Infecciones por Enterobacteriaceae/epidemiología , Infecciones por Enterobacteriaceae/microbiología , Enterobacteriaceae/efectos de los fármacos , Enterobacteriaceae/aislamiento & purificación , Humanos , Infecciones Intraabdominales/epidemiología , Infecciones Intraabdominales/microbiología , América Latina/epidemiología , Pacientes Ambulatorios , Neoplasias Urológicas/epidemiología , Neoplasias Urológicas/microbiologíaRESUMEN
Studies have found that biotin favors glucose and lipid metabolism, and medications containing biotin have been developed. Despite the use of biotin as a pharmacological agent, few studies have addressed toxicity aspects including the possible interaction with cytochrome P450 enzyme family. This study analyzed the effects of pharmacological doses of biotin on the expression and activity of the cytochrome P4501A subfamily involved in the metabolism of xenobiotics. Wistar rats were treated daily with biotin (2 mg/kg, i.p.), while the control groups were treated with saline. All of the rats were sacrificed by cervical dislocation after 1, 3, 5, or 7 days of treatment. CYP1A1 and CYP1A2 mRNAs were modified by biotin while enzyme activity and protein concentration were not affected. The lack of an effect of biotin on CYP1A activity was confirmed using other experimental strategies, including (i) cotreatment of the animals with biotin and a known CYP1A inducer; (ii) the addition of biotin to the reaction mixtures for the measurement of CYP1A1 and CYP1A2 activities; and (iii) the use of an S9 mixture that was prepared from control and biotin-treated rats to analyze the activation of benzo[a]pyrene (BaP) into mutagenic metabolites using the Ames test. The results suggest that biotin does not influence the CYP1A-mediated metabolism of xenobiotics.
Asunto(s)
Biotina/farmacología , Citocromo P-450 CYP1A1/metabolismo , Citocromo P-450 CYP1A2/metabolismo , Suplementos Dietéticos , Animales , Benzo(a)pireno/farmacología , Biocatálisis/efectos de los fármacos , Citocromo P-450 CYP1A1/biosíntesis , Citocromo P-450 CYP1A1/genética , Citocromo P-450 CYP1A2/biosíntesis , Citocromo P-450 CYP1A2/genética , Inducción Enzimática/efectos de los fármacos , Regulación Enzimológica de la Expresión Génica/efectos de los fármacos , Hígado/efectos de los fármacos , Hígado/enzimología , Masculino , MicroARNs/genética , MicroARNs/metabolismo , Pruebas de Mutagenicidad , ARN Mensajero/genética , ARN Mensajero/metabolismo , Ratas , Ratas WistarRESUMEN
BACKGROUND: The emergence of new synthetic drugs related to peptic ulcer perforation has been reported. Recently an increase in the use of inhaled methamphetamine has been observed and we have described an association of frequent use with peptic disease symptomatology and perforation. AIMS: To determine whether methamphetamine use is a factor related to peptic acid disease and perforation and to establish its demographic variables. MATERIAL AND METHODS: A retrospective, comparative, descriptive, and observational study was carried out through the evaluation of medical records of patients admitted to the Surgery Service with perforated ulcer, within the time frame of January 2002 to March 2005. A descriptive analysis was carried out, along with the Z test, odds ratio, confidence interval, p value and the Student's t test. RESULTS: Forty-two patients were divided into 2 groups: methamphetamine users (n=25) and nonusers (n=17). There was a statistically significant difference in relation to age, which was lower in the methamphetamine user group (38,7 years vs 58,88 years, p=0.0001). In addition, there was a trend in the user group to develop peptic ulcer perforation at earlier ages compared with the nonuser group (p=0.0001). There were no statistically significant differences between the two groups in regard to clinical presentation. CONCLUSIONS: Methamphetamine use is related to ulcer perforation in age groups of younger patients when compared with nonuser patients.
Asunto(s)
Trastornos Relacionados con Anfetaminas/complicaciones , Estimulantes del Sistema Nervioso Central/efectos adversos , Metanfetamina/efectos adversos , Úlcera Péptica Perforada/inducido químicamente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Úlcera Péptica Perforada/epidemiología , Estudios Retrospectivos , Factores de RiesgoRESUMEN
El uso más extendido de los fármacos antirretrovirales ha traído como consecuencia la transmisión de variantes virales con mutaciones de resistencia que se pueden mantener en individuos sin tratamiento antirretroviral. La frecuencia de estas mutaciones de resistencia transmitida es relativamente alta en países desarrollados, muchas veces con tendencias de aumento. En países en vías de desarrollo, en los que la terapia antirretroviral (ARV) se introdujo posteriormente, las frecuencias de resistencia primaria tienden a ser menores, probablemente porque su uso se encuentra basado en una disponibilidad relativamente limitada...
Asunto(s)
Humanos , Antirretrovirales/efectos adversos , Antirretrovirales/farmacología , Epidemiología Molecular/normas , VIHRESUMEN
OBJECTIVE: To examine the shape (functional form) of the association between the rate of gestational weight gain, pre-pregnancy body mass index (BMI), and preterm birth and its subtypes. DESIGN: Retrospective cohort study. SETTING: National reference obstetric centre in Lima, Peru. POPULATION: Pregnant women who delivered singleton babies during the period 2006-2009, resident in Lima, and beginning prenatal care at ≤ 12 weeks of gestation (n=8964). METHODS: Data were collected from the centre database. The main analyses consisted of logistic regression with fractional polynomial modelling. MAIN OUTCOME MEASURES: Preterm birth and its subtypes. RESULTS: Preterm birth occurred in 12.2% of women, being mostly idiopathic (85.7%). The rate of gestational weight gain was independently associated with preterm birth, and the shape of this association varied by pre-pregnancy BMI. In women who were underweight, the association was linear (per 0.1 kg/week increase) and protective (OR 0.88; 95% CI 0.82-1.00). In women of normal weight or who were overweight, the association was U-shaped: the odds of delivering preterm increased exponentially with rates <0.10 or >0.66 kg/week, and <0.04 or >0.50 kg/week, respectively. In women who were obese, the association was linear, but non-significant (OR 1.01; 95% CI 0.95-1.06). The association described for preterm birth closely resembled that of idiopathic preterm birth, although the latter was stronger. The rate of gestational weight gain was not associated with indicated preterm birth or preterm prelabour rupture of membranes. CONCLUSIONS: In Peruvian pregnant women starting prenatal care at ≤ 12 weeks of gestation, the rate of gestational weight gain is independently associated with preterm birth, mainly because of its association with idiopathic preterm birth, and the shape of both associations varies by pre-pregnancy BMI.