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In adolescence and especially in females, greater body dissatisfaction has been evidenced, which is defined as a negative evaluation of one's own body, being a strong predictor of eating disorders and obesity. OBJECTIVE: To relate body dissatisfaction with self-esteem, depression, and body mass index in adolescents. SUBJECTS AND METHOD: Quantitative, correlational, and cross-sectional study in a sample of 397 school adolescents (180 males and 217 females) from Concepción, Chile, aged 10 to 19 years, to whom the following instruments were applied: Body Shape Questionnaire (BSQ) to assess body dissatisfaction, Rosenberg Self-Esteem Scale, Beck's Depression Inventory-II for those older than 14 years, and Birleson Depression Self-Rating Scale for those younger than 14 years. Body mass index z-score was determined. Spearman's correlation coefficient was estimated for all variables. RESULTS: Body dissatisfaction was reported in 54.9 % of females and 18.3 % of males. Body dissatisfaction was positively correlated with age, z-BMI, and depression (p < 0.01) and negatively correlated with self-esteem (p < 0.01). When body dissatisfaction was differentiated by sex, the same significant correlations remained, except for age. CONCLUSIONS: The results confirm the relationship between body dissatisfaction with self-esteem, depression, and BMI. The importance of promoting healthy self-esteem and body image from an early age to prevent eating disorders and obesity is emphasized.
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Insatisfacción Corporal , Estado Nutricional , Masculino , Femenino , Adolescente , Humanos , Depresión/diagnóstico , Estudios Transversales , ObesidadRESUMEN
La necesidad de servicios de cuidados prolongados a adultos mayores origina la actividad de ayuda no profesional y a la figura del cuidador principal informal. El objetivo de la investiga-ción fue describir el perfil del cuidador principal informal acompañante del paciente a consulta externa del Hospital de Atención Integral del Adulto Mayor en el último trimestre de 2021. Se hizo un estudio cuantitativo, observacional y descriptivo, en una población de 322 cuidadores principales informales de adultos mayores en el último trimestre de 2021, seleccionando una muestra de 190 individuos mediante un procedimiento del tipo sujetos voluntarios. El instrumento aplicado fue una guía de entrevista estructurada basada en la Encuesta de caracterización del cuidado de la díada cuidador familiar-persona con enfermedad crónica. Existió un predominio del cuidador de sexo femenino (83,2%); los hijos de los adultos mayores (57,9%); las personas casadas (48,9%); los que viven con el adulto mayor (42,6%); aquellos que ejercen esa función desde entre 1 y 6 años (57,9%) y los que dedican hasta 15 horas (58,9%). Además, el 86,3% realiza quehaceres domésticos. Se observó un deterioro de la condición de salud luego de iniciar en las funciones del cuidado y todos mencionaron padecer de alguna enfermedad; sin embargo, prevalecieron los que señalan recibir efectos emocionales positivos a partir del cuidado.
The need for long-term care services for the elderly originates the activity of non-professional help and the figure of the informal primary caregiver. This research aimed to describe the profile of the primary informal caregiver who accompanied the patient to the outpatient clinic of the Hospital de Atención Integral del Adulto Mayor in the last quarter of 2021. A quantitative, obser-vational, and descriptive study was carried out in a population of 322 primary informal caregi-vers of the elderly in the last quarter of 2021, selecting a sample of 190 individuals through a voluntary subject-type procedure. The applied instrument was a structured interview guide based on the Survey of Characterization of the Care of the Family Caregiver-person with a Chro-nic Illness Dyad. The care falls on the woman (83.2%), children (57.9%), married (48.9%), live with the elderly (42.6%), care for up to 4 family members; 17.9% who never receive help, care for between 1 and 6 years and dedicate up to 15 hours. In addition, 86.3% do housework. A dete-rioration of the health condition was observed after starting the care functions, and all of them mentioned suffering from some disease; however, those who reported receiving positive emotio-nal effects from care prevailed
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Cuidadores , Factores Sociodemográficos , Pacientes , Atención , Cuidados a Largo PlazoRESUMEN
OBJECTIVE: To adapt and assess reliability of the Chilean version of Nutritional Environment Measurement for Stores (NEMS-S-CHILE) to measure the food environment of stores in urban areas. DESIGN: NEMS-S-CHILE was the NEMS-S tool adapted to the Chilean food patterns; foods were grouped according to level of processing in (a) unprocessed or minimally processed foods, (b) processed culinary ingredients, (c) processed foods, and (d) ultra-processed foods, and scored according to NEMS-S-CHILE tool. Reliability inter evaluators was measured. SETTING: City of Concepción, Bio-Bio region, Chile. PARTICIPANTS: Seventeen of a total of 25 supermarkets, and 9 out of 10 street markets according to the municipal registry and the street market trade unions, representing 74.3% of both types of food premises in Concepción. RESULTS: Reliability inter evaluators was measured by the following aspects: product availability, price, quality, and variety, through the intraclass correlation coefficient (ICC), percent agreement, and Cohen's kappa analysis. Reliability was high for availability, where the kappa index and ICC were acceptable, ranging from moderate to high (0.42 to 1.00 for the kappa coefficient and 0.65 to 1.00 for ICC), as well as for prices (ICC: 0.65-1.00 ), variety (kappa: 0.76-1.00) and quality (percent agreement: 68.2- 100%). CONCLUSIONS: The adapted instrument, NEMS-S-CHILE, has a high reliability inter evaluators and can be useful to measure the availability of foods by the level of processing according to the prevalent food system in developing countries.
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Comercio , Abastecimiento de Alimentos , Chile , Humanos , Encuestas Nutricionales , Reproducibilidad de los ResultadosRESUMEN
Helicobacter pylori is capable of entering into yeast, but the factors driving this endosymbiosis remain unknown. This work aimed to determine if temperatures outside the optimal range for H. pylori increase its harboring within Candida. H. pylori strains were co-cultured with Candida strains in Brucella broth supplemented with 5% fetal bovine serum and incubated at 4, 25, 37 or 40 °C. After co-culturing, yeasts containing bacteria-like bodies (Y-BLBs) were observed by optical microscopy, and the bacterium were identified as H. pylori by FISH. The H. pylori 16S rRNA gene was amplified from the total DNA of Y-BLBs. The viability of intra-yeast H. pylori cells was confirmed using a viability assay. All H. pylori strains were capable of entering into all Candida strains assayed. The higher percentages of Y-BLBs are obtained at 40 °C with any of the Candida strains. H pylori also increased its harboring within yeast in co-cultures incubated at 25 °C when compared to those incubated at 37 °C. In conclusion, although H. pylori grew significantly at 40 °C, this temperature increased its harboring within Candida. The endosymbiosis between both microorganisms is strain-dependent and permits bacterial cells to remain viable under the stressing environmental conditions assayed.
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Background: Familial hypercholesterolemia (FH) is commonly associated with mutations in-LDL receptor (LDLR), apolipoprotein B (APOB) and proprotein convertase subtilisin/kexin type 9 (PCSK9). Aim: To identify genetic variants associated with FH in a population of children and adolescents with hypercholesterolemia or a family history of-demonstrated early CVD. Material and Methods: Clinical and biochemical parameters were evaluated, and nine genes related to FH were sequenced namely LDLR, APOB, PCSK9, LDLRAP1, LIPA, APOE, ABCG5, ABCG8 and STAP1, in 55 children and adolescents aged 1 to 18 years old, from non-consanguineous families. Results: Mutations associated with FH were found in 17 children and adolescents, corresponding to p.Asp47Asn, duplication of exons 13-15 and p.Ser326Cys of the LDLR gene; p.Glu204* and Ile268Met of the APOE gene. Thirteen patients were heterozygous, two homozygous, two compound heterozygous, and one double heterozygous. Conclusions: Children and adolescents carrying mutations associated with FH were found by selective screening, which constitutes the first stage in the identification of genetic variants in our country.
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Humanos , Lactante , Preescolar , Niño , Adolescente , Proproteína Convertasa 9/genética , Hiperlipoproteinemia Tipo II/diagnóstico , Hiperlipoproteinemia Tipo II/genética , Hiperlipoproteinemia Tipo II/epidemiología , Chile , MutaciónRESUMEN
First-line treatment for Helicobacter pylori includes amoxicillin and clarithromycin or metronidazole plus a proton pump inhibitor. Treatment failure is associated with antibiotic resistance and possibly also with internalization of H. pylori into eukaryotic cells, such as yeasts. Factors triggering the entry of H. pylori into yeast are poorly understood. Therefore, the aim of this study was to evaluate whether clarithromycin or amoxicillin trigger the entry of H. pylori into C. albicans cells. METHODS: H. pylori J99 and C. albicans ATCC 10231 were co-cultured in the presence of subinhibitory concentrations of amoxicillin and clarithromycin as stressors. Bacterial-bearing yeasts were observed by fresh examination. The viability of bacteria within yeasts was evaluated, confirming the entry of bacteria into Candida, amplifying, by PCR, the H. pylori16S rRNA gene in total yeast DNA. RESULTS: Amoxicillin significantly increased the entry of H. pylori into C. albicans compared to the control. CONCLUSION: the internalization of H. pylori into C. albicans in the presence of antibiotics is dependent on the type of antibiotic used, and it suggests that a therapy including amoxicillin may stimulate the entry of the bacterium into Candida, thus negatively affecting the success of the treatment.
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BACKGROUND: Familial hypercholesterolemia (FH) is an inherited disorder mainly caused by mutations in the LDL receptor (LDL-R) and characterized by elevation of low-density lipoprotein cholesterol (LDL-C) levels and premature cardiovascular disease. OBJECTIVE: In this study, we evaluated the clinical phenotype of the p.Asp47Asn, described as an uncertain pathogenic variant, and its effect on the structure of LDL-R and ligand interactions with apolipoproteins. METHODS: 27 children and adolescents with suspected FH diagnosis were recruited from a pediatric endocrinology outpatient clinic. Blood samples were collected after 12 h fasting for lipid profile analysis. DNA sequencing was performed for six FH-related genes by Ion Torrent PGM platform and copy number variation by MLPA. For index cases, a familial cascade screening was done restricted to the same mutation found in the index case. In silico analysis were developed to evaluate the binding capacity of LDL-R to apolipoproteins B100 and E. RESULTS: Lipid profile in children and adolescents demonstrated higher LDL-C levels in p.Asp47Asn carriers compared to the wild type genotype. In silico analysis predicted a reduction in the binding capacity of the ligand-binding modules LA1-2 of p.Asp47Asn LDL-R for ApoB100 and ApoE, which was not produced by local structural changes or folding defects but as a consequence of a decreased apparent affinity for both apolipoproteins. CONCLUSION: The clinical phenotype and the structural effects of p.Asp47Asn LDL-R mutation suggest that this variant associates to FH.
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Variaciones en el Número de Copia de ADN , Hiperlipoproteinemia Tipo II , Adolescente , Adulto , Humanos , Fenotipo , Receptores de LDLRESUMEN
RESUMEN Introducción: Los hábitos alimentarios en escolares se han relacionado con las habilidades cognitivas y el rendimiento académico. Objetivo: Determinar la relación entre hábitos alimentarios y rendimiento académico en escolares chilenos. Métodos: Estudio transversal en 733 escolares de quinto al octavo básico. Se evaluaron hábitos alimentarios mediante frecuencia de consumo de grupos de alimentos, tiempos de comida, habilidades culinarias y gusto por preparar alimentos. Estas variables se relacionaron con calificaciones de las asignaturas de matemática y lenguaje. Resultados: Los escolares presentaron baja proporción de frecuencia de consumo saludable (FCS). Las niñas presentaron mayor FCS de pan (p<0,001), los niños presentaron mayor FCS de lácteos (p= 0,016). Por sexo, se observó diferencia en el rendimiento académico en lenguaje (p= 0,013). La FCS de lácteos se asoció con diferencias del rendimiento académico en lenguaje (p= 0,017) y matemática (p= 0,035). Desayunar se asoció a diferencias en el rendimiento académico en matemática (p= 0,028) y lenguaje (p= 0,001). No consumir pasteles y masas dulces (p= 0,016), y papas fritas, completos y masas fritas (p= 0,025) se asoció al rendimiento académico en matemática. Un 29,1% tiene habilidades culinarias, siendo 54% niñas (p= 0,006). La presencia de habilidades culinarias se relacionó significativamente con 7 de los 12 grupos de alimentos analizados. Conclusión: Los hábitos alimentarios se asociaron con el rendimiento académico de escolares.
ABSTRACT Introduction: Eating habits in school-age children have been associated with cognitive skills and academic performance. Aim: To determine the relationship between eating habits and academic performance in Chilean school-age children. Methods: Cross-sectional study with 733 school-age children. Eating habits were assessed by the frequency of consumption of food groups, mealtimes, cooking skills and if they liked to cook. Grades of math and language subjects were reported. Results: There was a low proportion of healthy consumption frequency (HCF). Girls had a higher HCF of bread (p<0.001), boys had a higher HCF of dairy (p= 0.016). By sex, academic performance in language was different in girls (p= 0.013). HCF of dairy was associated with academic performance in language (p= 0.017) and mathematics (p= 0.035). Eating breakfast was associated with academic performance in mathematics (p= 0.028) and language (p= 0.001). Not consuming cakes and sweet doughs (p= 0.016), French fries, hot dogs and sopaipillas (p= 0.025) was associated with academic performance in mathematics. 29.1% of children had cooking skills, 54.0% being girls (p= 0.006). Having cooking skills was significantly associated with 7 of the 12 food groups analyzed. Conclusion: Eating habits are associated to the academic performance of Chilean school-age children.
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BACKGROUND: Helicobacter pylori transmission routes are not entirely elucidated. Since yeasts are postulated to transmit this pathogen, this study aimed to detect and genotype intracellular H. pylori harbored within vaginal yeast cells. METHODS: A questionnaire was used to determine risk factors of H. pylori infection. Samples were seeded on Sabouraud Dextrose Agar and horse blood-supplemented Columbia agar. Isolated yeasts were identified using and observed by optical microscopy searching for intra-yeast H. pylori. Total yeast DNA, from one random sample, was extracted to search for H. pylori virulence genes by PCR and bacterial identification by sequencing. RESULTS: 43% of samples contained yeasts, mainly Candida albicans (91%). Microscopy detected bacteria such as bodies and anti-H. pylori antibodies binding particles in 50% of the isolated yeasts. Total DNA extracted showed that 50% of the isolated yeasts were positive for H. pylori 16S rDNA and the sequence showed 99.8% similarity with H. pylori. In total, 32% of H. pylori DNA positive samples were cagA+ vacAs1a vacAm1 dupA-. No relationship was observed between possible H. pylori infection risk factors and vaginal yeasts harboring this bacterium. CONCLUSION: H. pylori having virulent genotypes were detected within vaginal yeasts constituting a risk for vertical transmission of this pathogen.
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BACKGROUND: Familial hypercholesterolemia (FH) is commonly associated with mutations in-LDL receptor (LDLR), apolipoprotein B (APOB) and proprotein convertase subtilisin/kexin type 9 (PCSK9). AIM: To identify genetic variants associated with FH in a population of children and adolescents with hypercholesterolemia or a family history of-demonstrated early CVD. MATERIAL AND METHODS: Clinical and biochemical parameters were evaluated, and nine genes related to FH were sequenced namely LDLR, APOB, PCSK9, LDLRAP1, LIPA, APOE, ABCG5, ABCG8 and STAP1, in 55 children and adolescents aged 1 to 18 years old, from non-consanguineous families. RESULTS: Mutations associated with FH were found in 17 children and adolescents, corresponding to p.Asp47Asn, duplication of exons 13-15 and p.Ser326Cys of the LDLR gene; p.Glu204* and Ile268Met of the APOE gene. Thirteen patients were heterozygous, two homozygous, two compound heterozygous, and one double heterozygous. CONCLUSIONS: Children and adolescents carrying mutations associated with FH were found by selective screening, which constitutes the first stage in the identification of genetic variants in our country.
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Hiperlipoproteinemia Tipo II , Proproteína Convertasa 9 , Adolescente , Niño , Preescolar , Chile , Humanos , Hiperlipoproteinemia Tipo II/diagnóstico , Hiperlipoproteinemia Tipo II/epidemiología , Hiperlipoproteinemia Tipo II/genética , Lactante , Mutación , Proproteína Convertasa 9/genéticaRESUMEN
Yeasts can adapt to a wide range of pH fluctuations (2 to 10), while Helicobacter pylori, a facultative intracellular bacterium, can adapt to a range from pH 6 to 8. This work analyzed if H. pylori J99 can protect itself from acidic pH by entering into Candida albicans ATCC 90028. Growth curves were determined for H. pylori and C. albicans at pH 3, 4, and 7. Both microorganisms were co-incubated at the same pH values, and the presence of intra-yeast bacteria was evaluated. Intra-yeast bacteria-like bodies were detected using wet mounting, and intra-yeast binding of anti-H. pylori antibodies was detected using immunofluorescence. The presence of the H. pylori rDNA 16S gene in total DNA from yeasts was demonstrated after PCR amplification. H. pylori showed larger death percentages at pH 3 and 4 than at pH 7. On the contrary, the viability of the yeast was not affected by any of the pHs evaluated. H. pylori entered into C. albicans at all the pH values assayed but to a greater extent at unfavorable pH values (pH 3 or 4, p = 0.014 and p = 0.001, respectively). In conclusion, it is possible to suggest that H. pylori can shelter itself within C. albicans under unfavorable pH conditions.
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Rheumatoid arthritis (RA) has been associated with a higher risk of developing cardiovascular (CV) diseases. It has been proposed that systemic inflammation plays a key role in premature atherosclerosis development, and is therefore crucial to determine whether systemic components from RA patients promotes endothelial cell-oxidative stress by affecting reactive oxygen species (ROS) and nitric-oxide (NO) production. The aim of this study was to evaluate whether plasma from RA patients impair NO synthesis and ROS production by using the cell-line ECV-304 as a biosensor. NO synthesis and ROS production were measured in cells incubated with plasma from 73 RA patients and 52 healthy volunteers by fluorimetry. In addition, traditional CV risk factors, inflammatory molecules and disease activity parameters were measured. Cells incubated with plasma from RA patients exhibited reduced NO synthesis and increased ROS production compared to healthy volunteers. Furthermore, the imbalance between NO synthesis and ROS generation in RA patients was not associated with traditional CV risk factors. Our data suggest that ECV-304 cells can be used as a biosensor of systemic inflammation-induced endothelial cell-oxidative stress. We propose that both NO and ROS production are potential biomarkers aimed at improving the current assessment of CV risk in RA.
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Técnicas Biosensibles , Inflamación/sangre , Óxido Nítrico/aislamiento & purificación , Plasma , Artritis Reumatoide/sangre , Aterosclerosis/sangre , Aterosclerosis/patología , Línea Celular , Células Endoteliales/efectos de los fármacos , Humanos , Inflamación/patología , Óxido Nítrico/biosíntesis , Estrés Oxidativo/efectos de los fármacos , Especies Reactivas de Oxígeno/química , Especies Reactivas de Oxígeno/aislamiento & purificaciónRESUMEN
Understanding water consumption is crucial for sustainable management of water resources. Under climate change scenarios that project highly variable water availability, the need for public policies that assure efficiency and equity in water resources is increasing. This work analyzes the case of the Cachapoal River agricultural basin (34°S 71°W), which presents temperature increases and a precipitation deficit, with a drought period that began more than eleven years ago having significantly decreased water availability. Water consumption in the basin for food production was determined from the agricultural water footprint (WFagricultural), using the green (WFgreen), blue (WFblue) and gray water footprint (WFgray) indicators, which were measured in the upper, middle and lower basin under conditions of climate variability (dry, wet and normal years). The greatest WFagricultural was established in the dry year, with a total of 18,221â¯m3â¯t-1, followed by 15,902â¯m3â¯t-1 in the wet year and 14,091â¯m3â¯t-1 in the normal year. Likewise, the greatest WFblue and WFgray, of 12,000â¯m3â¯t-1 and 4934â¯m3â¯t-1, respectively, were also observed in the dry year. The greatest WFgreen, 2000â¯m3â¯t-1, was calculated for a normal year. The 63% of agricultural area of the basin was covered by avocado (Persea americana), olive (Olea europaea), corn (Zea mays) and grape (Vitis sp) crops, which presented the greatest WFagricultural. This water footprint data provides a quantitative basis for the assessment of water consumption and degradation, considering agricultural production and its multiple variables. The success of the application of these results lies in the use of indicators to understand change processes and complement future water allocation plans with more rational water management models.
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INTRODUCTION: Mainly due to the high percentage of infection and the ineffectiveness of treatments, Helicobacter pylori is a global health problem. Knowing the age at acquisition is key to preventing the infection. PATIENTS: Sixty-seven mothers and their respective children participated. To evaluate the presence of H. pylori, the faeces of the mother and her child were analysed using the HpSA antigen test. RESULTS: 71.6% (48/67) of pregnant mothers were positive for H. pylori at the term of their pregnancy. In newborns, 8.96% (6/67) of them showed H. pylori colonisation/persistent infection. During the first month of life, a prevalence and incidence of infection of 23.9% and 13%, respectively, was observed. CONCLUSION: Overall, the results suggest that there is a high risk of H. pylori infection during the first month of life, even of the persistent type.
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Infecciones por Helicobacter/congénito , Helicobacter pylori/aislamiento & purificación , Niño , Chile/epidemiología , Heces/microbiología , Femenino , Microbioma Gastrointestinal , Infecciones por Helicobacter/epidemiología , Infecciones por Helicobacter/microbiología , Infecciones por Helicobacter/transmisión , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/microbiología , PrevalenciaRESUMEN
OBJECTIVE: To evaluate the factorial structure and internal consistency of SISCO inventory of academic stress in medical students.. METHODS: The cross-sectional study was conducted at the School of Medicine, University of Concepcion, Chile, in 2014, and comprised second and third year students.Exploratory factor analysis was carried out to determine the reliability of each of the dimensions of SISCO inventory. Descriptive and correlational analyses were also conducted. RESULTS: Of the 155 students, 121(78.1%)were female. The overall mean age was 20.5+/- 1.55 years (range: 18.9-32.2 years). Of the total, 61(39.4%) students were in the nursing programme, 10(6.5%) in speech therapy, 16(10.3%) in kinesiology, 10(6.5%) in medicine, 20(12.9%) in midwifery and 38(24.4%) in medical technology.For stressor, somatisation and coping dimensions, a factor was identified, with Cronbach's alpha values of 0.76, 0.86 and 0.52, respectively. Correlation could only be established between the first two dimensions. CONCLUSIONS: Stressors and somatisation dimensions of the SISCO inventory of academic stress were found to be validity and reliabile.
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Psicometría/métodos , Psicometría/normas , Estrés Psicológico , Estudiantes de Medicina/psicología , Estudiantes de Medicina/estadística & datos numéricos , Adulto , Chile/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
BACKGROUND: There is evidence of detection of Helicobacter pylori (H. pylori) in the stool of newborns and in the yeast that colonizes the oral cavity of this age group. However, there is a lack of research to confirm it. This study proposes to determine the existence of the bacteria at an early age, specifically in newborns. OBJECTIVE: To identify intracellular H. pylori in oral yeasts and to detect antigens of the bacteria in newborn stools. METHODOLOGY: Cross-sectional and descriptive study. Samples were obtained from infants (oral swab and meconium). Identification of yeast species was performed using the following techniques: CHROMagar Candida, Germinal Tube Test and API Candida Identification System, then the yeasts were observed by light microscopy and fluorescence. Detection of H. pylori antigen in meconium and PCR were performed to amplify specific genes of the bacterium (rRNA16S, cagA, vacA s1a, vacA s1b, vacA s2, vacA m1, vacA m2 and dupA). RESULTS: Intracellular H. pylori was detected in yeast of the species Candida glabrata (C. glabrata) isolated from an oral swab of a newborn. CONCLUSION: The results of this study evidenced the existence of intracellular H. pylori in newborns.
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Candida glabrata , Heces/microbiología , Infecciones por Helicobacter/microbiología , Helicobacter pylori/aislamiento & purificación , Mucosa Bucal/microbiología , Saliva/microbiología , Antígenos Bacterianos , Candida glabrata/aislamiento & purificación , Estudios Transversales , Genotipo , Helicobacter pylori/genética , Humanos , Recién Nacido , Reacción en Cadena de la PolimerasaRESUMEN
Resumen: Objetivo: Describir el perfil de usuarios con diabetes mellitus (DM) e hipertensión arterial (HTA) y su relación con indicadores de resultado clínico. Sujetos y métodos: Estudio transversal, correlacional en usuarios con DM y/o HTA, reclutados desde 4 centros de salud de un Servicio de Salud del centro sur de Chile. Los instrumentos y mediciones incluyeron: cuestionario de variables biodemográficas, "Evaluación de la atención de enfermedades crónicas para pacientes", hemoglobina glicosilada (HbA1c), presión arterial sistólica (PAS) y diastólica (PAD). Resultados: Se evaluaron 222 personas con HTA y/o DM con edad promedio 53,9 (DE 7,5) años, la mayoría mujeres (67,6%). Se encontró un predominio de HTA (53,6%), seguido de DM+HTA (31,1%) y DM (15.3%). El promedio de PAS y de HbA1c fue levemente superior en usuarios con patología mixta (DM+HTA). El promedio de la evaluación de la atención desde la perspectiva del paciente fue 2,61 (DE 1,13), siendo mejor evaluado el "Diseño de un sistema de entrega de cuidados/Apoyo a la decisión". Se encontró relación significativa en usuarios con HTA entre PAS y n° de fármacos (p=0,026); en personas con DM entre HbA1c y años de enfermedad (p=0,002) y en usuarios con multimorbilidad (HTA+ DM) entre años de enfermedad con HbA1c (p=0,01) y con PAS (p=0,01). Conclusión: La evaluación de la atención sugiere la necesidad de mayor esfuerzo en el control de los parámetros terapéuticos, incorporando mejoras en la atención proporcionada. Se necesita más investigación para definir la relación entre el perfil de usuarios con enfermedades crónicas y los resultados clínicos.
Abstracts: Aim: To decribe the profile of users of a health program for chronic diseases (CD), especifically Diabetes Mellitus (DM) and Hypertension (HT), and its relation to indicators of clinical results. Subjects and methods: The subjects had DM and/or HT and were randomly selected form 4 health centers in southern Chile. Questionaires exploring demographic variables, Patient Assessement of Chronic Illness Care (PACIC) measurements of HbA1c, systolic (SBP) and diastolic (DBP) pressures were used as indicators of clinical results. Results: 222 subjects with DM and/or HT were evaluated. Mean age was 53.9 years-old (SD 7.5), 67.6% were females. The prevalence of CD was 53.6% for HT, 31.1% for DM+HT and 15.3% for DM. Mean BP and mean HbA1c were slightly higher in users with DM+HT. As perceived by the patient, the evaluation of care had a mean score 2.61 (SD 1.13). "Design of a method of care delivery / decission support" obtained the highest score. In subjects with HT there was a significant correlation between SBP and the number of drugs being received (p=0.03). Also, a significant correlation between HbA1c and disease duration was found in subjects with DM (p=0.02). In subjects with DM+HT significant correlation (p=0.01) existed between disease duration and both HbA1c and SBP. Conclusion: The evaluation of care suggests the need for a stronger effort in controlling therapeutic measures. Further studies are needed to refine the relation of user profile and clinical results.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Diabetes Mellitus Tipo 2/terapia , Servicios de Salud/estadística & datos numéricos , Hipertensión/terapia , Perfil de Salud , Chile/epidemiología , Estudios Transversales , Encuestas y Cuestionarios , Evaluación de Resultado en la Atención de Salud , Diabetes Mellitus/epidemiología , Hipertensión/epidemiologíaRESUMEN
SUMMARY BACKGROUND: There is evidence of detection of Helicobacter pylori (H. pylori) in the stool of newborns and in the yeast that colonizes the oral cavity of this age group. However, there is a lack of research to confirm it. This study proposes to determine the existence of the bacteria at an early age, specifically in newborns. OBJECTIVE: To identify intracellular H. pylori in oral yeasts and to detect antigens of the bacteria in newborn stools. METHODOLOGY: Cross-sectional and descriptive study. Samples were obtained from infants (oral swab and meconium). Identification of yeast species was performed using the following techniques: CHROMagar Candida, Germinal Tube Test and API Candida Identification System, then the yeasts were observed by light microscopy and fluorescence. Detection of H. pylori antigen in meconium and PCR were performed to amplify specific genes of the bacterium (rRNA16S, cagA, vacA s1a, vacA s1b, vacA s2, vacA m1, vacA m2 and dupA). RESULTS: Intracellular H. pylori was detected in yeast of the species Candida glabrata (C. glabrata) isolated from an oral swab of a newborn. CONCLUSION: The results of this study evidenced the existence of intracellular H. pylori in newborns.
RESUMO ANTECEDENTES: Há evidências de detecçâo de Helicobacter pylori (H. pylori) em fezes de recém-nascidos, como também dentro de leveduras que colonizam a cavidade oral dessa faixa etária. No entanto, faltam investigações que confirmem esses achados. OBJETIVO: Identificar H. pylori intracelular em leveduras de origem oral e detectar antígenos dessa bactéria em fezes neonatais. METODOLOGIA: Estudo transversal e descritivo. As amostras foram obtidas de bebês (zaragatoa oral e mecônio). As identificações das espécies de leveduras foram realizadas utilizando as seguintes técnicas: CHROMagar Candida, teste de tubo germinativo e sistema de identificação API Cândida. As leveduras foram observadas por microscopía óptica e fluorescência. Realizou-se a detecçâo de antígeno de H. pylori em mecônio e PCR para a amplificação de genes específicos desta bactéria (rRNA16S, cagA, vacA s1a, vacA s1b, vacA s2, vacA m1, vacA m2 e dupA). RESULTADOS: Foi detectado H. pylori intracelular em leveduras da espécie Candida glabrata (C. glabrata) isoladas a partir de zaragatoas oral de um recém-nascido. CONCLUSÃO: Os resultados deste estudo evidenciaram a existência interna de levedura de H. pylori em recém-nascidos.
Asunto(s)
Humanos , Recién Nacido , Saliva/microbiología , Helicobacter pylori/aislamiento & purificación , Infecciones por Helicobacter/microbiología , Candida glabrata/aislamiento & purificación , Heces/microbiología , Mucosa Bucal/microbiología , Reacción en Cadena de la Polimerasa , Estudios Transversales , Helicobacter pylori/genética , Genotipo , Antígenos BacterianosRESUMEN
In addition to the already known cagA gene, novel genetic markers have been associated with Helicobacter pylori (H. pylori) virulence: the dupA and vacAi genes. These genes might play an important role as specific markers to determine the clinical outcome of the disease, especially the vacAi gene, which has been expected to be a good marker of severe pathologies like gastric adenocarcinoma. In the present study, the association of cagA, dupA, and vacAi genes with gastroduodenal pathologies in Chilean patients was studied. One hundred and thirty-two patients positive for H. pylori were divided into two groups-non-severe and severe gastric pathologies-and investigated for the presence of cagA, dupA, and vacAi H. pylori virulence genes by PCR. The cagA gene was detected in 20/132 patients (15.2%), the vacAi1 gene was detected in 54/132 patients (40.9%), the vacAi2 gene was detected in 26/132 patients (19.7%), and the dupA gene was detected in 50/132 (37.9%) patients. Logistic regression model analysis showed that the vacAi1 isoform gene in the infected strains and the severity of the diseases outcome were highly associated, causing severe gastric damage that may lead to gastric cancer (p < 0.0001; OR = 8.75; 95% CI 3.54-21.64). Conversely, cagA (p = 0.3507; OR = 1.62; 95% CI 0.59-4.45) and vacAi2 (p = 0.0114; OR = 3.09; 95% CI 1.26-7.60) genes were not associated with damage, while the dupA gene was associated significantly with non-severe clinical outcome (p = 0.0032; OR = 0.25; 95% CI 0.09-0.65). In addition, dupA gene exerts protection against severe gastric pathologies induced by vacAi1 by delaying the outcome of the disease by approximately 20 years.