RESUMEN
[ABSTRACT]. As the leading risk for death, population control of increased blood pressure represents a major challenge for all countries of the Americas. In the early 1990’s, Canada had a hypertension control rate of 13%. The control rate increased to 68% in 2010, accompanied by a sharp decline in cardiovascular disease. The unprece- dented improvement in hypertension control started around the year 2000 when a comprehensive program to implement annually updated hypertension treatment recommendations started. The program included a com- prehensive monitoring system for hypertension control. After 2011, there was a marked decrease in emphasis on implementation and evaluation and the hypertension control rate declined, driven by a reduction in control in women from 69% to 49%. A coalition of health and scientific organizations formed in 2011 with a priority to develop advocacy positions for dietary policies to prevent and control hypertension. By 2015, the positions were adopted by most federal political parties, but implementation has been slow. This manuscript reviews key success factors and learnings. Some key success factors included having broad representation on the program steering committee, multidisciplinary engagement with substantive primary care involvement, unbiased up to date credible recommendations, development and active adaptation of education resources based on field experience, extensive implementation of primary care resources, annual review of the program and hypertension indicators and developing and emphasizing the few interventions important for hypertension control. Learnings included the need for having strong national and provincial government engagement and support, and retaining primary care organizations and clinicians in the imple- mentation and evaluation.
[RESUMEN]. La hipertensión arterial representa el principal riesgo de muerte; controlarla a nivel de la población constituye un desafío importante para todos los países de la Región de las Américas. A principios de la década de 1990, Canadá presentaba una tasa de control de la hipertensión del 13%. La tasa de control aumentó al 68% en el 2010, lo que vino acompañado por una disminución importante de las enfermedades cardiovasculares. Esta mejora sin precedentes en el control de la hipertensión empezó alrededor del año 2000 cuando se inició un programa integral para aplicar las recomendaciones sobre el tratamiento de la hipertensión, actualizadas anualmente. El programa incluyó un sistema de monitoreo integral para el control de la hipertensión. Después del 2011, hubo una marcada disminución del énfasis en la implementación y la evaluación, y la tasa de control de la hipertensión disminuyó, impulsada por una reducción en el control en las mujeres, que pasó del 69% al 49%. En el 2011, se formó una coalición de organizaciones científicas y de salud con la prioridad de elaborar una campaña de defensa y promoción de las políticas alimentarias para prevenir y controlar la hipertensión. Para el año 2015, esta postura fue adoptada por la mayoría de los partidos políticos federales, aunque la implementación ha sido lenta. En este artículo se revisan los factores clave de éxito y las lecciones aprendidas. Algunos factores clave de éxito fueron tener una amplia representación en el comité directivo del programa; el compromiso multidisci- plinario con la participación sustantiva del sector de la atención primaria; unas recomendaciones creíbles, imparciales y actualizadas; el desarrollo y la adaptación activa de recursos educativos basados en la expe- riencia en el terreno; la amplia implementación de los recursos de la atención primaria; la revisión anual del programa y de los indicadores de hipertensión; y el desarrollo y el énfasis en unas pocas intervenciones importantes para el control de la hipertensión. Entre las lecciones aprendidas se encontró la necesidad de contar con un fuerte compromiso y apoyo del gobierno nacional y provincial, y de mantener a las organi- zaciones de atención primaria y al personal médico en la implementación y la evaluación.
[RESUMO]. O controle populacional da hipertensão arterial – o maior fator de risco de morte – representa um grande desafio para todos os países das Américas. No início da década de 1990, o Canadá tinha uma taxa de controle de hipertensão de 13%. Esse índice aumentou para 68% em 2010, acompanhado por um declínio acentuado das doenças cardiovasculares. A melhoria sem precedentes no controle da hipertensão começou por volta do ano 2000, quando teve início um programa abrangente para implementar recomendações de tratamento de hipertensão atualizadas anualmente. O programa incluía um sistema integral de monitoramento do controle da hipertensão. Após 2011, houve uma acentuada redução da ênfase na implementação e aval- iação, e a taxa de controle de hipertensão caiu, principalmente às custas de uma redução deste controle em mulheres (de 69% para 49%). Uma coalizão de organizações científicas e de saúde formou-se em 2011 com a prioridade de desenvolver posições de defesa de políticas alimentares para prevenir e controlar a hiper- tensão. Até 2015, essas posições haviam sido adotadas pela maioria dos partidos políticos federais, mas a implementação tem sido lenta. Este manuscrito examina fatores-chave de sucesso e aprendizados. Alguns fatores-chave de sucesso incluíram uma ampla representatividade no comitê diretor do programa, engajamento multidisciplinar (com envolvimento significativo da atenção primária), recomendações imparciais e confiáveis, elaboração e adap- tação ativa de recursos didáticos com base na experiência de campo, ampla implementação dos recursos da atenção primária, revisão anual do programa e dos indicadores de hipertensão e desenvolvimento e ênfase das poucas intervenções realmente importantes para o controle da hipertensão. As lições aprendidas incluíram a necessidade de ter forte envolvimento e apoio dos governos nacional e subnacionais e manter organizações e médicos da atenção primária engajados na implementação e avaliação.
Asunto(s)
Enfermedades Cardiovasculares , Hipertensión , Atención Primaria de Salud , Educación , Canadá , Enfermedades Cardiovasculares , Hipertensión , Atención Primaria de Salud , Educación , Canadá , Enfermedades Cardiovasculares , Hipertensión , Atención Primaria de Salud , EducaciónRESUMEN
ABSTRACT As the leading risk for death, population control of increased blood pressure represents a major challenge for all countries of the Americas. In the early 1990's, Canada had a hypertension control rate of 13%. The control rate increased to 68% in 2010, accompanied by a sharp decline in cardiovascular disease. The unprecedented improvement in hypertension control started around the year 2000 when a comprehensive program to implement annually updated hypertension treatment recommendations started. The program included a comprehensive monitoring system for hypertension control. After 2011, there was a marked decrease in emphasis on implementation and evaluation and the hypertension control rate declined, driven by a reduction in control in women from 69% to 49%. A coalition of health and scientific organizations formed in 2011 with a priority to develop advocacy positions for dietary policies to prevent and control hypertension. By 2015, the positions were adopted by most federal political parties, but implementation has been slow. This manuscript reviews key success factors and learnings. Some key success factors included having broad representation on the program steering committee, multidisciplinary engagement with substantive primary care involvement, unbiased up to date credible recommendations, development and active adaptation of education resources based on field experience, extensive implementation of primary care resources, annual review of the program and hypertension indicators and developing and emphasizing the few interventions important for hypertension control. Learnings included the need for having strong national and provincial government engagement and support, and retaining primary care organizations and clinicians in the implementation and evaluation.
RESUMEN La hipertensión arterial representa el principal riesgo de muerte; controlarla a nivel de la población constituye un desafío importante para todos los países de la Región de las Américas. A principios de la década de 1990, Canadá presentaba una tasa de control de la hipertensión del 13%. La tasa de control aumentó al 68% en el 2010, lo que vino acompañado por una disminución importante de las enfermedades cardiovasculares. Esta mejora sin precedentes en el control de la hipertensión empezó alrededor del año 2000 cuando se inició un programa integral para aplicar las recomendaciones sobre el tratamiento de la hipertensión, actualizadas anualmente. El programa incluyó un sistema de monitoreo integral para el control de la hipertensión. Después del 2011, hubo una marcada disminución del énfasis en la implementación y la evaluación, y la tasa de control de la hipertensión disminuyó, impulsada por una reducción en el control en las mujeres, que pasó del 69% al 49%. En el 2011, se formó una coalición de organizaciones científicas y de salud con la prioridad de elaborar una campaña de defensa y promoción de las políticas alimentarias para prevenir y controlar la hipertensión. Para el año 2015, esta postura fue adoptada por la mayoría de los partidos políticos federales, aunque la implementación ha sido lenta. En este artículo se revisan los factores clave de éxito y las lecciones aprendidas. Algunos factores clave de éxito fueron tener una amplia representación en el comité directivo del programa; el compromiso multidisciplinario con la participación sustantiva del sector de la atención primaria; unas recomendaciones creíbles, imparciales y actualizadas; el desarrollo y la adaptación activa de recursos educativos basados en la experiencia en el terreno; la amplia implementación de los recursos de la atención primaria; la revisión anual del programa y de los indicadores de hipertensión; y el desarrollo y el énfasis en unas pocas intervenciones importantes para el control de la hipertensión. Entre las lecciones aprendidas se encontró la necesidad de contar con un fuerte compromiso y apoyo del gobierno nacional y provincial, y de mantener a las organizaciones de atención primaria y al personal médico en la implementación y la evaluación.
RESUMO O controle populacional da hipertensão arterial - o maior fator de risco de morte - representa um grande desafio para todos os países das Américas. No início da década de 1990, o Canadá tinha uma taxa de controle de hipertensão de 13%. Esse índice aumentou para 68% em 2010, acompanhado por um declínio acentuado das doenças cardiovasculares. A melhoria sem precedentes no controle da hipertensão começou por volta do ano 2000, quando teve início um programa abrangente para implementar recomendações de tratamento de hipertensão atualizadas anualmente. O programa incluía um sistema integral de monitoramento do controle da hipertensão. Após 2011, houve uma acentuada redução da ênfase na implementação e avaliação, e a taxa de controle de hipertensão caiu, principalmente às custas de uma redução deste controle em mulheres (de 69% para 49%). Uma coalizão de organizações científicas e de saúde formou-se em 2011 com a prioridade de desenvolver posições de defesa de políticas alimentares para prevenir e controlar a hipertensão. Até 2015, essas posições haviam sido adotadas pela maioria dos partidos políticos federais, mas a implementação tem sido lenta. Este manuscrito examina fatores-chave de sucesso e aprendizados. Alguns fatores-chave de sucesso incluíram uma ampla representatividade no comitê diretor do programa, engajamento multidisciplinar (com envolvimento significativo da atenção primária), recomendações imparciais e confiáveis, elaboração e adaptação ativa de recursos didáticos com base na experiência de campo, ampla implementação dos recursos da atenção primária, revisão anual do programa e dos indicadores de hipertensão e desenvolvimento e ênfase das poucas intervenções realmente importantes para o controle da hipertensão. As lições aprendidas incluíram a necessidade de ter forte envolvimento e apoio dos governos nacional e subnacionais e manter organizações e médicos da atenção primária engajados na implementação e avaliação.
RESUMEN
Tar spot of corn has been a major foliar disease in several Latin American countries since 1904. In 2015, tar spot was first documented in the United States and has led to significant yield losses of approximately 4.5 million t. Tar spot is caused by an obligate pathogen, Phyllachora maydis, and thus requires a living host to grow and reproduce. Due to its obligate nature, biological and epidemiological studies are limited and impact of disease in corn production has been understudied. Here we present the current literature and gaps in knowledge of tar spot of corn in the Americas, its etiology, distribution, impact and known management strategies as a resource for understanding the pathosystem. This will in tern guide current and future research and aid in the development of effective management strategies for this disease.
Asunto(s)
Enfermedades de las Plantas , Zea mays , Américas , Estados UnidosRESUMEN
Staphylococcus aureus is an important pathogen in both community and healthcare associated pneumonia. We describe a case of severe pneumonia caused by the methicillin resistant Staphylococcus aureus (MRSA) clone USA 300 in a 44-year old post-partum woman and the subsequent vertical transmission of this virulent organism to her neonate.
Asunto(s)
Transmisión Vertical de Enfermedad Infecciosa , Staphylococcus aureus Resistente a Meticilina , Neumonía Estafilocócica/transmisión , Infección Puerperal , Adulto , Femenino , Genotipo , Humanos , Recién Nacido , Masculino , Staphylococcus aureus Resistente a Meticilina/genética , Neumonía Estafilocócica/microbiología , Embarazo , Infecciones Estafilocócicas/transmisiónRESUMEN
Staphylococcus aureus is an important pathogen in both community and healthcare associated pneumonia. We describe a case of severe pneumonia caused by the methicillin resistant Staphylococcus aureus (MRSA) clone USA 300 in a 44-year old post-partum woman and the subsequent vertical transmission of this virulent organism to her neonate.
El estafilococo dorado (Staphylococcus aureus) es un patógeno importante tanto en la atención a las comunidades como en el cuidado de la salud en relación con la pulmonÃa. Se describe un caso de pneumonia severa causada por el clon USA 300 del estafilococo dorado resistente a la meticilina (EDRM) en una mujer de 44 anos en periodo de post-parto, y la posterior transmisión vertical de este virulento organismo a su neonato.
Asunto(s)
Adulto , Femenino , Humanos , Recién Nacido , Masculino , Embarazo , Transmisión Vertical de Enfermedad Infecciosa , Staphylococcus aureus Resistente a Meticilina , Neumonía Estafilocócica/transmisión , Infección Puerperal , Genotipo , Staphylococcus aureus Resistente a Meticilina/genética , Neumonía Estafilocócica/microbiología , Infecciones Estafilocócicas/transmisiónRESUMEN
The effects of supplemented protein level (PL) during the periconceptional period and their interaction with body condition were evaluated in sheep. Multiparous Rambouillet ewes (n = 12) received two PL of rumen undegradable protein (UIP) during a 30-day pre-mating and 15-day post-mating period: low [LPL, 24% crude protein (CP), 14 g UIP and 36 g/CP animal/day] and high [HPL, 44% CP, 30 g UIP and 50 g/CP animal/day]. While ovulation rate (OR) did not differ between treatments (1.6 +/- 0.5, mean +/- SEM), a lower fertility rate, a decreased embryo number and a reduced uterine pH (UpH) was observed in the HPL group (p < 0.05), irrespective of BC. Luteal tissue weight, volume and progesterone secretion did not differ among treatments. Sheep with lower UpH also had lower conceptus weight (Cwt; p < 0.05, r = 0.65) and conceptuses with lower mass tended to secrete less INF-tau and IGF-1, and the correspondent endometrial explants had a higher basal PGF(2alpha) release. Current study indicates that high protein diets during the periconceptional period in sheep modify uterine and embryonic relationships, increasing early pregnancy losses and inducing embryo growth retardation. Surviving embryos were affected by weight reductions, which could compromise later foetal growth and birth weight. Results evidence the key role of a balanced diet in reproductive success and indicate that the quality and nutrient composition of the maternal diet are essential for an adequate establishment of pregnancy, having paramount effects on the interplay of the embryo and the uterus.
Asunto(s)
Aborto Veterinario/etiología , Alimentación Animal/análisis , Dieta/veterinaria , Proteínas en la Dieta/farmacología , Preñez , Ovinos/embriología , Animales , Proteínas en la Dieta/administración & dosificación , Relación Dosis-Respuesta a Droga , Femenino , Retardo del Crecimiento Fetal/inducido químicamente , Retardo del Crecimiento Fetal/veterinaria , Embarazo , Ovinos/fisiología , Útero/efectos de los fármacos , Útero/fisiologíaRESUMEN
In ruminants, nutrition is one of the exogenous inputs affecting reproductive function at different levels of the hypothalamic-hypophyseal-gonadal axis. However, the exact mechanisms or even the identification of the signalling metabolic compounds by which nutrition affects reproductive function still need further clarification. The role of static body condition (BC) and its interaction with a short-term protein supplementation (PL), on secretion of metabolic hormones [growth hormone (GH), insulin and insulin-like growth factor-1 (IGF-1)], as well as on secretion of LH and progesterone (P4) was evaluated in sheep. Twenty-four Rambouillet ewes divided into two groups, with lower (LBC) and higher body condition (HBC), were randomly assigned within BC to one of two PL levels: low (LPL, 24% of crude protein; 14 g/animal/day), and high (HPL, 44% of crude protein; 30 g/animal/day). The secretion of GH, insulin, IGF-1 and LH was evaluated on day 10 of the oestrous cycle; appearance and timing of oestrous behaviour were previously detected using rams. Progesterone secretion was evaluated on day 13 of the same cycle. No differences were found (p > 0.05) between PL groups on serum GH concentrations during the sampling period (overall mean of 4.0 +/- 0.3 ng/ml), but a trend for lower values in HBC sheep was found (3.6 +/- 0.4 vs 4.4 +/- 0.4 ng/ml, p = 0.06). A BC effect was observed (p < 0.05) on serum IGF-1 level, with higher values in HBC sheep (p < 0.05). Neither BC nor PL affected (p > 0.05) secretion of LH and the number of corpora lutea, nor serum P4 and insulin concentrations. Results indicate a predominance of the static component of nutrition on sheep metabolic hormone responses, GH and IGF-1, with no effect of short-term PL on secretion of pituitary and ovarian hormones as well as luteal number and activity.
Asunto(s)
Fenómenos Fisiológicos Nutricionales de los Animales/fisiología , Constitución Corporal/fisiología , Proteínas en la Dieta/administración & dosificación , Estro/fisiología , Hormona Luteinizante/metabolismo , Ovinos/fisiología , Alimentación Animal , Animales , Suplementos Dietéticos , Relación Dosis-Respuesta a Droga , Femenino , Hormona del Crecimiento/sangre , Insulina/sangre , Factor I del Crecimiento Similar a la Insulina/metabolismo , Fase Luteínica , Progesterona/sangre , Progesterona/metabolismo , Distribución AleatoriaRESUMEN
The effect of prebreeding short-term protein supplementation level (PL) and body condition (BC) on fertility rate (FERT,%), uterine pH and embryonic mortality (EMORT,%) in sheep, was evaluated. Multiparous Rambouillet ewes at low BC (LC; n = 6, 62.7+/-1.7 kg) or high BC (HC; n = 6, 71.9 +/-1.7 kg), received, within BC, one of two levels of ruminally undegradable protein: low (LP, 14 g/ewe per day) and high (HP, 30 g/ewe per day). Once the animals were euthanized, corpus luteum number (CLN), as an indicator of ovulation rate, was registered and uterine horns were irrigated to recover embryonic tissue plus associated membranes as well as to measure uterine pH (UpH). While EMORT- 1 considered a nonadjusted relationship between the number of embryos and CLN, EMORT-2 considered an analysis of covariance using CLN as the covariate. The HP-supplemented ewes had the lowest FERT (p = 0.06; 100% vs 50%) and the highest EMORT (EMORT-1, 16.6% vs 53.8%, p = 0.08; EMORT-2, 52.0% vs 14.5%, p = 0.07) when compared to the LP-supplemented ewes. Neither BC nor PL affected CLN, CL weight or P4 release (p > 0.10). While the lowest UpH (p = 0.04) was observed in the HP-supplemented ewes, this group also showed the lowest fertility and the highest embryonic mortality.
Asunto(s)
Proteínas en la Dieta/administración & dosificación , Fertilidad/fisiología , Estado Nutricional , Ovinos/fisiología , Útero/fisiología , Animales , Constitución Corporal/fisiología , Relación Dosis-Respuesta a Droga , Embrión de Mamíferos/efectos de los fármacos , Femenino , Concentración de Iones de Hidrógeno , Paridad , Embarazo , Distribución Aleatoria , Ovinos/embriologíaRESUMEN
PIP: In Colombia, people displaced by rural violence have crowded Bogota's slums, where inhabitants are plagued by alcoholism, drug dependency, and violence. Violence against children is epidemic in Colombia, and education, which is supposed to be free, is in reality so expensive that over a third of children fail to complete primary school. Street culture beckons children, and one agency has identified 7454 girl prostitutes in Bogota and believes there are another 1000 who have not yet been contacted. Most of these girls are from low-income families residing in inner-city slums, and many were sexually abused at an early age by a male relative. Almost all start using drugs, and more than 80% are infected with sexually transmitted diseases, including 15% who have HIV/AIDS. Even efforts to help these children can go astray, as some learn deviant behavior from fellow residents of children's homes. The biggest danger faced by girls and boys alike on the street is rape, and some children report being raped by policemen. The Renacer Foundation is working to rehabilitate children in its residential units and has achieved success in some cases. In other cases, success is slow to achieve and hard to maintain because it is difficult, if not impossible, for the children to recover from early abuse. Colombia lacks a nationwide needs assessment or primary intervention program to prevent early abuse and to help vulnerable girls. The only programs available to help the children already in trouble use outdated methods and are severely overcrowded.^ieng