Asunto(s)

RESUMEN

The underline hypothesis of this study was that SARS-CoV-2 can infect individuals regardless of health condition, sex, and age in opposition to the classical epidemiological assumption of an identifiable susceptible subpopulation for epidemic development. To address this issue, a population cohort with 24.4 million metadata associated with 226,089 official RT-qPCR positive and 283,450 negative cases, including 27,769 deceased, linked putatively to B.1. and B.1.1. SARS-CoV-2 lineages were analyzed. The analysis baseline was to determine the infection and mortality structure of the diseased cohort at the onset-exponential phase of the first epidemic wave in Mexico under the assumption of limited herd immunity. Individuals with nonchronic diseases (NOCDs) were compared with those exhibiting at least one of 10 chronic diseases (CDs) adjusted by age and sex. Risk factors for infection and mortality were estimated with classification and regression tree (CART) and cluster analysis based on Spearman's matrix of rho-values in RStudio®, complemented with two proposed mortality indices. SARS-CoV-2 infection was independent of health condition (52.8% NOCD vs. 47.2% CDs; p = 0.001-0.009) but influenced by age >46 in one risk analysis scenario (p < 0.001). Sex contributed 9.7% to the overall risk. The independent effect was supported by the health structure of negative cases with a similar tendency but a higher proportion of NOCDs (61.4%, p = 0.007). The infection probability in individuals with one CD was determined by the disease type and age, which was higher in those older individuals (≥56 years) exhibiting diabetes (12.3%, cp = 0.0006), hypertension (10.1%, cp < 0.0001), and obesity (7.8%, cp = 0.001). In contrast, the mortality risk was heavily influenced by CD conditioned by sex and age, accounting for 72.3% of total deaths (p = 0.001-0.008). Significant mortality risk (48%) was comprised of women and men (w, m) aged ≥56 years with diabetes (19% w and 27.9% m, cp < 0.0004), hypertension (11.5% w, cp = 0.0001), and CKD (3.5% w and 5.3% m, cp = 0.0009). Older people with diabetes and hypertension comorbidity increased the risk to 60.5% (p = 0.001). Based on a mortality-weighted index, women were more vulnerable to preexisting metabolic or cardiovascular diseases. These findings support our hypothesis and justify the need for surveillance systems at a communitarian level. This is the first study addressing this fundamental epidemiological question.

Asunto(s)

RESUMEN

This study evaluates the psychometric properties of the Access of Older Adults to Outpatient Primary-Care Health Services Scale (AOAOPHSS), in research conducted among 707 Mexican older adults selected by convenience from 14 rural and one urban locations. The AOAOPHSS explores 10 dimensions of two integrated subscales: Accessibility and Personal Abilities. Data analysis was performed in five phases. First, potentially biased responses were identified. Second, the response efficiency of the items and their association with external variables were evaluated. Third, the basic properties of the scores for the subscales' dimensions of the AOAOPHSS were identified using non-parametric Mokken Scaling Analysis (MSA). Fourth, the Structural Equation Modeling methodology was used to identify the properties of the internal structure of the latent construct. Finally, reliability and internal consistency were evaluated at both score and item levels. The following findings emerged. 13 items with inefficient response options were removed, and 24 were retained using the MSA. The latent structure of the latter was defined based on 21 items of five Accessibility Subscale dimensions. Its internal consistency reliability ranged between 0.67 and 0.81 (omega coefficients) and between 0.61 and 0.78 (alpha coefficients). Accordingly, this paper discusses the overall implications of using the Accessibility Subscale.

Asunto(s)

RESUMEN

The present work describes the purification of an enzyme capable of degrading punicalagin. The enzyme was produced by Aspergillus niger GH1 by solid-state fermentation, and the enzyme production was induced by using ellagitannins as the sole carbon source. The purification steps included the concentration by lyophilization, desalting, anionic exchange, and gel filtration chromatography. The enzyme kinetic constants were calculated by using punicalagin, methyl gallate, and sugar beet arabinans. The molecular mass of the protein was estimated by SDS-PAGE. The identified bands were excised and digested using trypsin, and the peptides were submitted to HPLC-MS/MS analysis. The docking analysis was conducted, and a 3D model was created. The purification fold increases 75 times compared with the cell-free extract. The obtained Km values were 0.053 mM, 0.53% and 6.66 mM for punicalagin, sugar beet arabinans and methyl gallate, respectively. The optimal pH and temperature for the reaction were 5 and 40 °C, respectively. The SDS-PAGE and native PAGE analysis revealed the presence of two bands identified as α-l-arabinofuranosidase. Both enzymes were capable of degrading punicalagin and releasing ellagic acid.

RESUMEN

The objective of this work was to validate the content of a scale formulated in Spanish for older adults in Mexico, with the aim of comprehensively measuring the access of this population group to outpatient primary-care services. To this end, we carried out a methodological content-validity study in four stages: (1) construction of the scale; (2) evaluation of item legibility; (3) quantitative content evaluation by two groups of judges selected by convenience: participant-judges including older adults with adequate reading comprehension, surveyed in person (n = 23), and expert-judges comprised of researchers specialized in the fields of health services, psychometrics and aging, surveyed online (n = 7); and (4) collection of qualitative feedback from several of the participant-judges (older adults, n = 4). The content was validated both by sequentially examining the level of consensus in the responses of both groups of judges, using the Tastle and Wierman method, and by calculating Aiken's Validity Coefficient with a 90% confidence interval. The scale contained 65 items pertaining to 10 dimensions of two major constructs: accessibility (n = 39) and personal abilities (n = 26). Five items were eliminated in accordance with the minimum-consensus criterion (0.5). This is the first psychometric scale to be developed in Mexico with the view of integrating the characteristics of health-care services and the abilities of the older adults in a single questionnaire designed to measure the access of this population group to outpatient primary-care services.

Asunto(s)

RESUMEN

This study provides a safe and low-cost in-house protocol for RT-qPCR-based detection of SARS-CoV-2 using mouthwash-saliva self-collected specimens to achieve clinical and epidemiological surveillance in a real-time web environment applied to ambulatory populations. The in-house protocol comprises a mouthwash-saliva self-collected specimen, heat virus inactivation, and primers to target virus N-gene region and the human RPP30-gene. Aligning with 209 SARS-CoV-2 sequences confirmed specificity including the Alpha variant from the UK. Development, validation, and statistical comparison with official nasopharyngeal swabbing RT-qPCR test were conducted with 115 specimens of ambulatory volunteers. A web-mobile application platform was developed to integrate a real-time epidemiological and clinical core baseline database with mouthwash-saliva RT-qPCR testing. Nine built-in algorithms were generated for decision-making on testing, confining, monitoring, and self-reports to family, social, and work environments. Epidemiological and clinical follow-up and SARS-CoV-2 testing generated a database of 37,351 entries allowing individual decision-making for prevention. Mouthwash-saliva had higher sensitivity than nasopharyngeal swabbing in detecting asymptomatic and mild symptomatic cases with 720 viral copy number (VCN)/mL as the detection limit (Ct = 37.6). Cycling threshold and viral loading were marginally different (p = 0.057) between asymptomatic (35 Ct ± 2.8; 21,767.7 VCN/mL, range 720-77,278) and symptomatic (31.3 Ct ± 4.5; 747,294.3 VCN/mL, range 1433.6-3.08 × 106). We provided proof-of-concept evidence of effective surveillance to target asymptomatic and moderate symptomatic ambulatory individuals based on integrating a bio-safety level II laboratory, self-collected, low-risk, low-cost detection protocol, and a real-time digital monitoring system. Mouthwash-saliva was effective for SARS-CoV-2 sampling for the first time at the community level.

Asunto(s)

RESUMEN

OBJECTIVES: To inform next steps in pediatric diarrhea burden reduction by understanding the shifting enteropathogen landscape after rotavirus vaccine implementation. METHODS: We conducted a case-control study of 1788 medically attended children younger than 5 years, with and without gastroenteritis, after universal rotavirus vaccine implementation in Peru. We tested case and control stools for 5 viruses, 19 bacteria, and parasites; calculated coinfection-adjusted attributable fractions (AFs) to determine pathogen-specific burdens; and evaluated pathogen-specific gastroenteritis severity using Clark and Vesikari scales. RESULTS: Six pathogens were independently positively associated with gastroenteritis: norovirus genogroup II (GII) (AF 29.1, 95% confidence interval [CI]: 28.0-32.3), rotavirus (AF 8.9, 95% CI: 6.8-9.7), sapovirus (AF 6.3, 95% CI: 4.3-7.4), astrovirus (AF 2.8, 95% CI: 0.0-4.0); enterotoxigenic Escherichia coli heat stable and/or heat labile and heat stable (AF 2.4, 95% CI: 0.6-3.1), and Shigella spp. (AF 2.0, 95% CI: 0.4-2.2). Among typeable rotavirus cases, we most frequently identified partially heterotypic strain G12P[8] (54 of 81, 67%). Mean severity was significantly higher for norovirus GII-positive cases relative to norovirus GII-negative cases (Vesikari [12.7 vs 11.8; P < .001] and Clark [11.7 vs 11.4; P = .016]), and cases in the 6- to 12-month age range relative to cases in other age groups (Vesikari [12.7 vs 12.0; P = .0002] and Clark [12.0 vs 11.4; P = .0016]). CONCLUSIONS: Norovirus is well recognized as the leading cause of pediatric gastroenteritis in settings with universal rotavirus vaccination. However, sapovirus is often overlooked. Both norovirus and sapovirus contribute significantly to the severe pediatric disease burden in this setting. Decision-makers should consider multivalent vaccine acquisition strategies to target multiple caliciviruses in similar countries after successful rotavirus vaccine implementation.

Asunto(s)

RESUMEN

OBJECTIVES: We aimed to determine the prevalence of anti-carbamylated protein (anti-CarP) antibodies in Mexican Hispanics with established rheumatoid arthritis (RA) and to assess their relationship with disease activity. METHODS: A cohort study was conducted in 278 patients with established RA during an 18-month follow-up. We measured IgG/IgM/IgA rheumatoid factor (RF), IgG anticitrullinated protein antibodies (ACPA) and IgG/IgM/IgA anti-CarP antibodies using enzyme-linked immunosorbent assay (ELISA). For disease activity, we performed the 28-joint disease activity score with erythrocyte sedimentation rate (DAS28-ESR). Repeated measures one-way ANOVA was used to test the association between anti-CarP IgG antibody status and longitudinal DAS28-ESR scores. Patients were evaluated at baseline and at 6, 12, and 18 months during follow-up. RESULTS: Anti-CarP IgG antibodies were positive in 47.8% of patients and, accounting for all isotypes, in 9.5% of patients with negative RF and ACPA. Triple antibody positivity was present in 42.6% of patients in our sample. Anti-CarP IgG antibody positivity did not show statistically significant differences in mean DAS28-ESR when compared to anti-CarP IgG antibody negative patients at baseline, 6, 12 or 18 months. CONCLUSION: Anti-CarP IgG antibodies are not associated to a higher disease activity in Hispanic patients with established RA. Our findings suggest that the clinical value of measuring anti-CarP antibodies in RA diminishes over time.

Asunto(s)

RESUMEN

The role and mechanism of elagitannase is misunderstood because it exhibited different activities due to the low purity or complexity of substrates, and there is no available information about the biochemical, physicochemical and molecular characteristics of the enzyme. This study was aimed to obtain enzymatic extracts by Aspergillus niger GH1 in solid-state fermentation, using dextrose and ellagitannins as inducers of ellagitannase. Protein and bioinformatic analysis were performed to identify the protein sequence expressed in terms of culture conditions. The presence of ellagitannins increased ellagitannase activity 1143-fold compared to dextrose. The higher ellagitannase activity was found at 18 h of culture (1143.30 U g-1PE). Three groups of proteins were identified in both cultures: ß-glucosidase, phospholipase C, and triacylglycerol lipase. However, only phospholipase C was overexpressed with ellagitannins as inducers, showing the most spontaneous reaction with punicalagin (ΔG -8.56). These results suggest that phospholipase could be involved in ellagitannins biosynthesis.

Asunto(s)

RESUMEN

The advance of Next Generation Sequencing (NGS) technologies allows high-throughput genotyping at a reasonable cost, although, in the case of peach, this technology has been scarcely developed. To date, only a standard Genotyping by Sequencing approach (GBS), based on a single restriction with ApeKI to reduce genome complexity, has been applied in peach. In this work, we assessed the performance of the double-digest RADseq approach (ddRADseq), by testing 6 double restrictions with the restriction profile generated with ApeKI. The enzyme pair PstI/MboI retained the highest number of loci in concordance with the in silico analysis. Under this condition, the analysis of a diverse germplasm collection (191 peach genotypes) yielded 200,759,000 paired-end (2 × 250 bp) reads that allowed the identification of 113,411 SNP, 13,661 InDel and 2133 SSR. We take advantage of a wide sample set to describe technical scope of the platform. The novel platform presented here represents a useful tool for genomic-based breeding for peach.

Asunto(s)

RESUMEN

Resumen Objetivo Identificar los determinantes de acceso a los servicios de atención primaria en adultos mayores, residentes en áreas rurales y urbanas de diferentes regiones del mundo. Materiales y Métodos Se realizó una revisión sistemática de la literatura en bases electrónicas, a partir de publicaciones cualitativas y cuantitativas de fuente primaria o secundaria, descritas entre 2015 y 2019. Se determinaron palabras clave enmarcadas bajo el Modelo de Dimensiones y habilidades de Levesque, Harris y Russell. El análisis se efectuó utilizando una lista de chequeo con cinco criterios técnicos de evaluación, elegidos por conveniencia técnico-académica. Resultados La búsqueda inicial identificó 118 manuscritos para revisión. Los estudios fueron analizados y clasificados en cinco segmentos que involucran a cinco regiones del mundo. Los principales determinantes de acceso encontrados, fueron clasificados en habilidades personales de los adultos mayores y características propias del sistema de salud, tanto para el área rural como urbana. Conclusiones A nivel mundial el principal determinante de acceso a los servicios de atención primaria en adultos mayores, residentes de áreas rurales es la falta de disponibilidad de servicios; mientras los de población urbana, mantienen las barreras financieras como el principal obstáculo para su acceso a la salud.

Abstract Objective The determinants of access to primary care services in elderly people living in rural and urban areas of different regions of the world. Material and Method A systematic review of the literature in electronic databases was carried out from qualitative and quantitative publications, of primary or secondary source, described between 2015 and 2019. Key words were determined framed under the Levesque Dimensions and Skills Model, Harris and Russell. The analysis was carried out using a checklist with five technical evaluation criteria chosen for technical-academic convenience. Results The initial search identified 118 manuscripts for review. The studies were analyzed and classified in to five segments that involve five regions of the world. The main determinants of access found were classified in to personal skills of the elderly and characteristics of the health system for both rural and urban areas. Conclusions It is concluded that at the global level the main determinant of access to primary care services in elderly residents of rural areas is the lack of availability of services; while urban older adults maintain financial barriers as the main obstacle to their access to health.

Resumo Objetivo Identificar os determinantes do acesso aos serviços de atenção primária em idosos, residentes em áreas rurais e urbano de diferentes regiões do mundo. Material e Método Foi realizada uma revisão sistemática da literatura sobre bases eletrônicas com base em publicações qualitativas e quantitativas de fonte primária ou secundária descritas entre 2015 e 2019. Foram determinadas as palavras-chave enquadradas no Modelo de Dimensões e Habilidades de Levesque, Harrise Russell. A análise foi realizada pormeio de uma lista de verificação com cinco critérios de avaliação técnica, escolhidos por conveniência técnico-acadêmica. Resultados A pesquisa inicial identificou 118 manuscritos para revisão. Os estudos foram analisados e clasificados em cinco segmentos, envolvendo cinco regiões do mundo. Os principais determinantes de acesso encontrados foram classificados em habilidades pessoais dos idosos e características do sistema de saúde, tanto nas áreas rurais quanto nas urbanas. Conclusões O principal determinante do acesso a serviços de atenção primária a idosos residentes em áreas rurais é a falta de disponibilidade de serviços; enquanto a população urbana mantém as barreiras financeiras como o principal obstáculo ao acesso à saúde.

Résumé Objectif Identifier les déterminants de l'accès aux services de soins primaires de personnes âgées vivant en zone rurale et urbaine de différentes régions du monde. Matériel et Méthode Une revue systématique de la littérature a été réalisée en cherchant dans des bases de données électroniques des publications qualitatives et quantitatives, de source primaire ou secondaire, décrites entre 2015 et 2019. Les mots-clés ont été déterminés d'après le modèle de dimensions et compétences de Levesque, Harris et Russell. L'analyse a été effectuée à l'aide d'une liste de contrôle avec cinq critères techniques d'évaluation, choisis par convenance technique et académique. Résultats La recherche initiale a permis d'identifier 118 manuscrits à examiner. Ces études ont été analysées et classées en cinq segments correspondant à cinq régions du monde. Les principaux déterminants de l'accès trouvés ont été classés selon les capacités personnelles des personnes âgées et selon les caractéristiques propres du système de santé, tant pour les zones rurales que pour les zones urbaines. Conclusions Mondialement, le principal déterminant de l'accès aux services de soins primaires de la part des personnes âgées vivant en zone rurale est le manque de disponibilité des services; tandis que pour la population urbaine, il s'agit de barrières financières.

RESUMEN

Brucellosis, caused by Brucella abortus, is a major disease of cattle and humans worldwide distributed. Eradication and control of the disease has been difficult in Central and South America, Central Asia, the Mediterranean and the Middle East. Epidemiological strategies combined with phylogenetic methods provide the high-resolution power needed to study relationships between surveillance data and pathogen population dynamics, using genetic diversity and spatiotemporal distributions. This information is crucial for prevention and control of disease spreading at a local and worldwide level. In Costa Rica (CR), the disease was first reported at the beginning of the 20th century and has not been controlled despite many efforts. We characterized 188 B. abortus isolates from CR recovered from cattle, humans and water buffalo, from 2003 to 2018, and whole genome sequencing (WGS) was performed in 95 of them. They were also assessed based on geographic origin, date of introduction, and phylogenetic associations in a worldwide and national context. Our results show circulation of five B. abortus lineages (I to V) in CR, phylogenetically related to isolates from the United States, United Kingdom, and South America. Lineage I was dominant and probably introduced at the end of the 19th century. Lineage II, represented by a single isolate from a water buffalo, clustered with a Colombian sample, and was likely introduced after 1845. Lineages III and IV were likely introduced during the early 2000s. Fourteen isolates from humans were found within the same lineage (lineage I) regardless of their geographic origin within the country. The main CR lineages, introduced more than 100 years ago, are widely spread throughout the country, in contrast to new introductions that seemed to be more geographically restricted. Following the brucellosis prevalence and the farming practices of several middle- and low-income countries, similar scenarios could be found in other regions worldwide.

Asunto(s)

RESUMEN

INTRODUCTION: The US-Mexico region is at high risk of elevated tuberculosis (TB) incidence due to mobility and migration. Knowledge of how socio-demographic factors varies geographically, provides clues to understanding the determinants of tuberculosis and may provide guidance for regional prevention and control strategies to improve public health in Mexico. The aim of the present study was to describe the epidemiologic characteristics and spatial patterns of the incidence of tuberculosis in Tonala, Jalisco (Mexico) from 2013-2015. METHODOLOGY: The Surveillance System Database from the Health Department, complemented by information from the National Institute of Statistics and Geography, was used to obtain data for a spatial-temporal analysis of TB cases. For the geographical analysis map creation and geoinformation storing, ArcGIS software was used. RESULTS: This study sought to characterize problem areas and jurisdictional locations of TB via a spatial approach based on analyses of case distributions and individual patient variables. The study found that tuberculosis cases were dispersed throughout Tonala County and were mainly concentrated on the Guadalajara city border. The TB cases were mainly individuals between 31 and 45 years old. Most of the cases reported during the observation period were male patients, and most cases primarily had lung involvement; however, there were quite a few cases with lymph node and intestinal disease. CONCLUSION: Our findings show that TB cases are essentially located in areas close to the city of Guadalajara and that most TB cases were pulmonary cases spread throughout the whole jurisdiction.

Asunto(s)

RESUMEN

RESUMEN Introducción: La salud bucal del paciente discapacitado intelectual ha sido una gran preocupación a nivel mundial. Cuba no se escapa de ello, por lo que ha implementado programas que priorizan a este tipo de individuos. Objetivo: Determinar la necesidad de tratamiento estomatológico de los pacientes con discapacidad intelectual según la categoría diagnóstica de la Escuela Especial Jardín de la Alegría. Métodos: Estudio descriptivo transversal realizado en el período comprendido entre 2016-2017. El universo de estudio estuvo constituido por 105 niños que representa la matrícula total de la escuela. El examen clínico de los escolares se realizó en el sillón dental. Para la recolección de la información se confeccionó una planilla encuesta teniendo en cuenta las características del grupo objeto de estudio: edad, sexo, categoría diagnóstica, índice COP-D y ceo-d, índice de necesidad de tratamiento periodontal comunitario, y la higiene bucal mediante el índice de higiene bucal simplificado de Greene y Vermillon. Resultados: La categoría diagnóstica que prevaleció fue el discapacitado intelectual leve con 82,8 por ciento. El 68,6 por ciento de la población estudiada presentó higiene bucal regular. El 67,6 por ciento de los niños presentó enfermedad periodontal, el 59,0 por ciento maloclusión y el 54,2 por ciento caries dental. Según necesidad de tratamiento, el 67,0 por ciento requiere tratamiento periodontal, el 59,0 por ciento tratamiento ortodóncico y el 45,7 por ciento tratamiento conservador. Conclusiones: Existió una alta necesidad de tratamiento periodontal en los individuos con discapacidad intelectual leve(AU)

ABSTRACT Introduction: The oral health of the intellectually disabled patient has been a great concern worldwide. Cuba does not escape this concern by implementing programs that prioritize this type of individuals. Objective: To determine the need for stomatological treatment of patients with intellectual disability according to the diagnostic category of the Jardín de la Alegría Special School. Methods: a cross-sectional descriptive study conducted in the period 2016-2017. The clinical examination of the students was carried out in the dental chair. For the collection of the information a survey form was made taking into account the characteristics of the group under study: age, sex, diagnostic category, COP-D index and ceo-d, index of need for community periodontal treatment, and oral hygiene using the simplified oral hygiene index of Greene and Vermillon. The universe of study was constituted by 105 children that represents the total enrollment of the school. Results: the diagnostic category that prevailed was the mild intellectual disability with 82.8. 68.6 percent of the studied population presented regular oral hygiene. 67.6 percent of the children presented periodontal disease, 59.0 percent malocclusion and 54.2 percent dental caries. According to need of treatment, 67 percent need periodontal treatment, 59.0 percent orthodontic treatment and 45.7 percent need conservative treatment. Conclusions: there was a high need for periodontal treatment in individuals with mild intellectual disability(AU)

Asunto(s)

RESUMEN

BACKGROUND: Norovirus is a leading cause of acute gastroenteritis worldwide. Routine norovirus diagnosis requires stool collection. The goal of this study was to develop and validate a noninvasive method to diagnose norovirus to complement stool diagnostics and to facilitate studies on transmission. METHODS: A multiplex immunoassay to measure salivary immunoglobulin G (IgG) responses to 5 common norovirus genotypes (GI.1, GII.2, GII.4, GII.6, and GII.17) was developed. The assay was validated using acute and convalescent saliva samples collected from Peruvian children <5 years of age with polymerase chain reaction (PCR)-diagnosed norovirus infections (n = 175) and controls (n = 32). The assay sensitivity and specificity were calculated to determine infection status based on fold rise of salivary norovirus genotype-specific IgG using norovirus genotype from stool as reference. RESULTS: The salivary assay detected recent norovirus infections and correctly assigned the infecting genotype. Sensitivity was 71% and specificity was 96% across the evaluated genotypes compared to PCR-diagnosed norovirus infection. CONCLUSIONS: This saliva-based assay will be a useful tool to monitor norovirus transmission in high-risk settings such as daycare centers or hospitals. Cross-reactivity is limited between the tested genotypes, which represent the most commonly circulating genotypes.

Asunto(s)

RESUMEN

Introducción: durante los últimos 20 años la incidencia del embarazo ectópico se ha duplicado o triplicado, principalmente en los países desarrollados. Este incremento se comporta de forma diferente en países, regiones o áreas poblacionales. Objetivo: caracterizar el comportamiento del embarazo ectópico en el Hospital General Docente de Guantánamo Dr Agostinho Neto durante el año 2006. Método: el universo estuvo constituido por 763 pacientes con embarazo ectópico en el período 2002-2006. La muestra fue de 175, todas del año 2006. Las variables estudiadas fueron: grupo de edades, síntomas al ingreso, medios diagnóstico, formas clínicas y operaciones realizadas. Resultados: se obtuvo discreto crecimiento en el número de embarazos ectópicos durante los años de estudio. El grupo de edades de 20-24 obtuvo el 31,4 por ciento en frecuencia y el de 25-29 el 34,9 por ciento. El 85,7 por ciento de las pacientes acudió con los síntomas de dolor bajo vientre y sangramiento vaginal anormal, seguidas por las que presentaron dolor bajo vientre y amenorrea (78,3 por ciento). En 73 pacientes fue diagnosticado por la clínica más culdocentesis en el 41,8 por ciento de los casos y solo en 9 por clínica más laparoscopia. Conclusiones: hubo incremento de los embarazos ectópicos. El año de mayor frecuencia fue 2006. Predominó el grupo de edades de 25 a 29 años y las pacientes primíparas. El síntoma al ingreso predominante fue el dolor bajo vientre y el sangramiento vaginal anormal. El diagnóstico con más frecuencia fue la clínica más culdocentesis. El embarazo ectópico complicado inestable, el sitio de implantación tubárica y la localización ampular con salpingectomía total como operación fueron las más frecuentes.(AU)

Introduction: during the last 20 years the incidence of ectopic pregnancy has doubled or tripled, mainly in developed countries. This increase behaves differently in countries, regions or population areas. Objective: to characterize the behavior of ectopic pregnancy in the Guantánamo General Teaching Hospital Dr Agostinho Neto during the year 2006. Method: the universe consisted of 763 patients with ectopic pregnancy in the period 2002-2006. The sample was 175, all of the year 2006. The variables studied were: age group, symptoms on admission, means of diagnosis, clinical forms and operations performed. Results: discrete growth was obtained in the number of ectopic pregnancies during the years of study. The age group of 20-24 obtained 31.4 percent in frequency and that of 25-29 and 34.9 percen. 85.7 percent of the patients presented with symptoms of abdominal pain and abnormal vaginal bleeding, followed by those with lower abdominal pain and amenorrhea (78.3%). In 73 patients it was diagnosed by the clinic plus culdocentesis in 41.8% of the cases and only in 9 by clinical plus laparoscopy. Conclusions: there was an increase in ectopic pregnancies. The year of greatest frequency was 2006. The age group of 25 to 29 years and the primiparous patients predominated. The predominant symptom of admission was lower abdominal pain and abnormal vaginal bleeding. The diagnosis with more frequency was the clinic plus culdocentesis. The complicated unstable ectopic pregnancy, the tubal implantation site and the ampullary location with total salpingectomy as the operation were the most frequent(AU)

Introdução: nos últimos 20 anos, a incidência de gravidez ectópica dobrou ou triplicou, principalmente nos países desenvolvidos. Esse aumento se comporta de maneira diferente em países, regiões ou áreas de população. Objetivo: caracterizar o comportamento da gravidez ectópica no Hospital Geral de Ensino de Guantánamo Dr Agostinho Neto durante o ano de 2006. Método: o universo consistiu em 763 pacientes com gravidez ectópica no período 2002-2006. A amostra foi de 175, durante todo o ano de 2006. As variáveis estudadas foram: faixa etária, sintomas na admissão, meios de diagnóstico, formas clínicas e operações realizadas. Resultados: crescimento discreto foi obtido no número de gestações ectópicas durante os anos de estudo. A faixa etária de 20 a 24 anos obteve 31,4% de frequência e a de 25 a 29 e 34,9%. 85,7% dos pacientes apresentavam sintomas de dor abdominal e sangramento vaginal anormal, seguidos por dor abdominal baixa e amenorreia (78,3%). Em 73 pacientes foi diagnosticada pela clínica mais culdocentese em 41,8% dos casos e somente em 9 pela clínica mais laparoscopia. Conclusões: houve aumento de gravidez ectópica. O ano de maior frequência foi 2006. A faixa etária de 25 a 29 anos e as primíparas predominaram. O sintoma predominante da admissão foi dor no baixo ventre e sangramento vaginal anormal. O diagnóstico com maior frequência foi a clínica e culdocentese. A gestação ectópica complicada e instável, o local de implantação das trompas e a localização ampular com salpingectomia total como operação foram os mais frequentes(AU)

Asunto(s)

RESUMEN

Background: Sapovirus is one of the primary viral causes of acute gastroenteritis (AGE), especially where rotavirus vaccination has been implemented. The characteristics and impact of natural infection at the community level, however, have not been well documented. Methods: Stool samples were analyzed from 100 children randomly selected from a community-based birth cohort study in Peru. All diarrheal and 1 nondiarrheal stools collected trimonthly from children up to age 2 years (n = 1669) were tested for sapovirus detection. Viral shedding duration was determined by testing additional weekly samples (n = 440) collected before and after a sapovirus-positive sample. Results: The incidence of sapovirus infection in the first and second years of life was 4.3 and 11.1 per 100 child-months, respectively. By age 2 years, 82% of children had at least 1 sapovirus infection, and 64% had at least 1 sapovirus-associated diarrhea episode. The median shedding period was 18.5 days. In 112 of 175 infections, 14 genotypes from 4 genogroups (GI, GII, GIV, and GV) were determined. Among genogroups, GI were more frequently found in symptomatic infections than in asymptomatic infections (odds ratio, 3.1; 95% confidence interval, 1.3-7.4). Fifty-nine children had serial sapovirus infections, but only 3 had repeated infection of the same genotype. Conclusions: Sapovirus was frequently detected in children with AGE at the community level during the first 2 years of life. Serial sapovirus infections by multiple genotypes in a child suggest genotype-specific immunity from each infection, which needs to be taken into account for vaccine development.

Asunto(s)

RESUMEN

A basic pattern in the body plan architecture of many animals, plants and some molecular and cellular systems is five-part units. This pattern has been understood as a result of genetic blueprints in development and as a widely conserved evolutionary character. Despite some efforts, a definitive explanation of the abundance of pentagonal symmetry at so many levels of complexity is still missing. Based on both, a computational platform and a statistical spatial organization argument, we show that five-fold morphology is substantially different from other abundant symmetries like three-fold, four-fold and six-fold symmetries in terms of spatial interacting elements. We develop a measuring system to determine levels of spatial organization in 2D polygons (homogeneous or heterogeneous partition of defined areas) based on principles of regularity in a morphospace. We found that spatial organization of five-fold symmetry is statistically higher than all other symmetries studied here (3 to 10-fold symmetries) in terms of spatial homogeneity. The significance of our findings is based on the statistical constancy of geometrical constraints derived from spatial organization of shapes, beyond the material or complexity level of the many different systems where pentagonal symmetry occurs.

RESUMEN

Introducción: el paciente discapacitado constituye un grupo priorizado dentro de la atención estomatológica cubana ya que su salud bucal está influenciada por diversos factores. Objetivo: determinar factores de riesgo, enfermedades bucales, así como la necesidad de tratamiento estomatológico de los pacientes discapacitados según la categoría diagnóstica de la Escuela Especial "Luis Ramírez López". Método: estudio descriptivo transversal realizado en el período comprendido entre 2016-2017. El universo estuvo constituido por los 72 alumnos matriculados en la escuela. Resultados: la categoría diagnosticada que prevaleció fue el retraso mental leve con 79,2 por ciento. El 55,6 por ciento de la población estudiada presentó higiene bucal adecuada, siendo el retraso mental leve la categoría más representativa. El 62,5 por ciento de los niños presentó caries dental, el 60.0 por ciento enfermedad periodontal y el 33,3 por ciento maloclusión. De la población estudiada el 62,5 por ciento necesitó tratamiento conservador, el 33,3 tratamiento ortodóntico y el 9,7 tratamiento periodontal. Conclusiones: predominaron los niños con retraso mental leve, higiene bucal adecuada y caries dental, condicionando una alta necesidad de tratamiento conservador(AU)

Introduction: the disabled patient is a prioritized group in Cuban dental care since his or her oral health is influenced by several factors. Objective: to determine risk factors, oral diseases, as well as the need for stomatological treatment of disabled patients according to the diagnostic category of the Special School "Luis Ramirez Lopez". Method: a cross-sectional and descriptive study was conducted in the period 2016-2017. The universe was constituted by the 72 students enrolled in the school. Results: the diagnosed category that prevailed was mild mental retardation with 79.2 percent. 55.6 percent of the studied population presented adequate oral hygiene, with mild mental retardation being the most representative category. 62.5 percent of children had dental caries, 60.0 percent periodontal disease and 33.3 percent malocclusion. Of the population, 62.5 percent required conservative treatment, 33.3 orthodontic treatments and 9.7 periodontal treatments. Conclusions: children with mild Mental retardation predominated with adequate oral hygiene, dental caries also conditioning a high need for conservative treatment(AU)

Introdução: o paciente com deficiência é um grupo prioritário no atendimento odontológico cubano, uma vez que sua saúde bucal é influenciada por vários fatores. Objetivo: determinar fatores de risco, doenças bucais, bem como a necessidade de tratamento estomatológico de pacientes com deficiência de acordo com a categoria diagnóstica da Escola Especial "Luis Ramírez López". Método: estudo transversal no período 2016-2017. O universo consistiu de 72 alunos matriculados na escola. Resultados: A categoria que prevaleceu foi diagnosticado retardo mental leve, com 79, por cento. 55,6 por cento da população do estudo tinha a higiene oral, retardo mental leve adequada sendo a categoria mais representativa. 62,5 por cento das crianças tinham cárie dentária, doença periodontal 60,0 por cento e 33,3 por cento de má oclusão. Da população de estudo de 62,5 por cento tratamento conservador necessário, 33,3 e 9,7 tratamento ortodôntico tratamento periodontal. Conclusões: predominaram as crianças com retardo mental leve, boa higiene oral e cárie dentária, determinando uma alta necessidade de tratamento conservador. Método: estudo descritivo transversal, realizado no período 2016-2017. O universo foi constituído pelos 72 alunos matriculados na escola. Resultados: a categoria diagnosticada que prevaleceu foi o retardo mental leve com 79,2 por cento. 55,6 por cento da população estudada apresentavam higiene bucal adequada, sendo o retardo mental leve a categoria mais representativa. 62,5 por cento das crianças tinham cárie dentária, 60,0 por cento doença periodontal e 33,3 por cento maloclusão. Da população estudada, 62,5 por cento necessitaram de tratamento conservador, 33,3 tratamento ortodôntico e 9,7 tratamento periodontal. Conclusões: crianças com retardo mental leve, higiene bucal adequada e cárie dentária predominaram, condicionando grande necessidade de tratamento conservador(AU)

Asunto(s)

RESUMEN

Introducción: el paciente discapacitado constituye un grupo priorizado dentro de la atención estomatológica cubana ya que su salud bucal está influenciada por diversos factores. Objetivo: determinar factores de riesgo, enfermedades bucales, así como la necesidad de tratamiento estomatológico de los pacientes discapacitados según la categoría diagnóstica de la Escuela Especial Luis Ramírez López. Método: estudio descriptivo transversal realizado en el período comprendido entre 2016-2017. El universo estuvo constituido por los 72 alumnos matriculados en la escuela. Resultados: la categoría diagnosticada que prevaleció fue el retraso mental leve con 79,2 por ciento. El 55,6 por ciento de la población estudiada presentó higiene bucal adecuada, siendo el retraso mental leve la categoría más representativa. El 62,5 por ciento de los niños presentó caries dental, el 60.0 por ciento enfermedad periodontal y el 33,3 por ciento maloclusión. De la población estudiada el 62,5 por ciento necesitó tratamiento conservador, el 33,3 tratamiento ortodóntico y el 9,7 tratamiento periodontal. Conclusiones: predominaron los niños con retraso mental leve, higiene bucal adecuada y caries dental, condicionando una alta necesidad de tratamiento conservador(AU)

Introduction: the disabled patient is a prioritized group in Cuban dental care since his or her oral health is influenced by several factors. Objective: to determine risk factors, oral diseases, as well as the need for stomatological treatment of disabled patients according to the diagnostic category of the Special School Luis Ramirez Lopez. Method: a cross-sectional and descriptive study was conducted in the period 2016-2017. The universe was constituted by the 72 students enrolled in the school. Results: the diagnosed category that prevailed was mild mental retardation with 79.2 percent. 55.6 percent of the studied population presented adequate oral hygiene, with mild mental retardation being the most representative category. 62.5 percent of children had dental caries, 60.0 percent periodontal disease and 33.3 percent malocclusion. Of the population, 62.5 percent required conservative treatment, 33.3 orthodontic treatments and 9.7 periodontal treatments. Conclusions: children with mild Mental retardation predominated with adequate oral hygiene, dental caries also conditioning a high need for conservative treatment(AU)

Introdução: o paciente com deficiência é um grupo prioritário no atendimento odontológico cubano, uma vez que sua saúde bucal é influenciada por vários fatores. Objetivo: determinar fatores de risco, doenças bucais, bem como a necessidade de tratamento estomatológico de pacientes com deficiência de acordo com a categoria diagnóstica da Escola Especial Luis Ramírez López. Método: estudo transversal no período 2016-2017. O universo consistiu de 72 alunos matriculados na escola. Resultados: A categoria que prevaleceu foi diagnosticado retardo mental leve, com 79,2 por cento. 55,6 por cento da população do estudo tinha a higiene oral, retardo mental leve adequada sendo a categoria mais representativa. 62,5 por cento das crianças tinham cárie dentária, doença periodontal 60,0 por cento e 33,3 por cento de má oclusão. Da população de estudo de 62,5 por cento tratamento conservador necessário, 33,3 e 9,7 tratamento ortodôntico tratamento periodontal. Conclusões: predominaram as crianças com retardo mental leve, boa higiene oral e cárie dentária, determinando uma alta necessidade de tratamento conservador. Método: estudo descritivo transversal, realizado no período 2016-2017. O universo foi constituído pelos 72 alunos matriculados na escola. Resultados: a categoria diagnosticada que prevaleceu foi o retardo mental leve com 79,2 por cento. 55,6 por cento da população estudada apresentavam higiene bucal adequada, sendo o retardo mental leve a categoria mais representativa. 62,5% das crianças tinham cárie dentária, 60,0 por cento doença periodontal e 33,3 por cento maloclusão. Da população estudada, 62,5% necessitaram de tratamento conservador, 33,3 tratamento ortodôntico e 9,7 tratamento periodontal. Conclusões: crianças com retardo mental leve, higiene bucal adequada e cárie dentária predominaram, condicionando grande necessidade de tratamento conservador(AU)

Asunto(s)