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Since 1941, outbreaks of Neisseria meningitidis have been recorded in Chile which, to date, have varied according to clinical form, incidence, lethality, and the responsible serogroup. OBJECTIVE: To summarize the available evidence on the epidemiological profile of acute bacterial meningitis due to Neisseria meningitidis in Chile, analyzing the incidence between 1990 and 2019. METHOD: A systematized review of primary articles was carried out following the Cochrane Collaboration standards. The information sources were PubMed, Scielo, and LILACS. Publications on acute bacterial meningitis due to Neisseria meningitidis were included, with a descriptive design, and in English and Spanish. Studies on the effectiveness of vaccines and diagnostic techniques were excluded. RESULTS: Between 1990 and 2019, the evidence collected focuses exclusively on the year 2012. Of the 133 cases of invasive meningococcal disease (IMD) reported that year, 42 cases presented with meningitis. Of the IMD cases caused by serogroup W135 strains, 21.7% of the cases presented with meningitis (13 cases), compared with the "Non-W135" strains, in which it was 67.4% (29 cases). Lethality due to IMD was higher in patients affected by serogroup W135 (26.7%), compared with patients affected by serogroup "Non-W135" (13.9%). DISCUSSION: The year 2012 shows a change in the prevalent serogroup from serogroup B to W, with a decrease in cases of meningitis and an increase in cases of meningo- coccemia and the lethality of IMD.

Assuntos

Meningite Meningocócica , Neisseria meningitidis , Chile/epidemiologia , Humanos , Meningite Meningocócica/epidemiologia , Meningite Meningocócica/diagnóstico , Incidência , Neisseria meningitidis/classificação , Neisseria meningitidis/isolamento & purificação , Surtos de Doenças , Sorogrupo , Criança

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OBJETIVO: Identificar factores promotores, dificultades y estrategias para el inicio y continuación de la lactancia materna (LM), en base a la experiencia de mujeres lactantes. METODOLOGÍA: Estudio cualitativo fenomenológico realizado en la Región de Murcia (España) en el 2019. Se reclutaron a veintisiete mujeres que alimentaron a sus hijos/as con LM en el periodo de 2012-2018 mediante una asociación de LM y un muestreo de bola de nieve. Se realizaron entrevistas personales abiertas y un análisis temático de las transcripciones. RESULTADOS: Se estructuraron en tres temas: 1) Facilidades para el inicio y mantenimiento de la LM, 2) Dificultades ante la LM y 3) Estrategias utilizadas por las mujeres para solventar las barreras. Mientras que la motivación para amamantar y el apoyo recibido facilitaron la LM, las barreras más comunes se relacionaron con miedos e inseguridades personales, cansancio, problemas físicos y la respuesta social frente a la LM. Los motivos de abandono fueron el déficit de producción de leche, la incorporación laboral y la actitud del bebé. Las participantes desarrollaron autocuidados, búsqueda de información y asociaciones de LM y estrategias de conciliación familiar-laboral para paliar las dificultades. CONCLUSIÓN: Es necesaria una mayor implicación por parte de las/os profesionales de la salud para apoyar a las mujeres a través de la herramienta de educación para la salud, el apoyo por pares y medidas institucionales que favorezcan la LM en el lugar de trabajo.

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OBJECTIVE: To identify promoting factors, difficulties, and strategies related to the initiation and continuation of breastfeeding (BF), based on the experiences of breastfeeding women. METHODOLOGY: A phenomenological qualitative study conducted in the Region of Murcia (Spain) in 2019. Twenty-seven women who breastfed their children from 2012 to 2018 were recruited through a breastfeeding association and snowball sampling. Personal open interviews were conducted, and a thematic analysis of the transcriptions was performed. RESULTS: The findings were organized into three themes: 1) Facilitators for the initiation and maintenance of BF, 2) Difficulties faced during BF, and 3) Strategies employed by women to overcome the difficulties. While the motivation to breastfeed and provision of support facilitated BF, common challenges were noted, including personal fears and insecurities, fatigue, physical problems, and societal response to BF. Reasons for discontinuation included low milk production, the need to return to work, and the baby's attitude. Participants developed self-care practices, sought information, joined breastfeeding associations, and implemented work-family reconciliation strategies to address the challenges. CONCLUSION: Greater involvement from healthcare professionals is necessary to support women who breastfeed through health education, peer support, and institutional measures that promote BF in the workplace.

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The presence of ultrafine clay particles that are difficult to remove by conventional filtration creates many operational problems in mining processing systems. In this work, the removal of clay suspensions has been investigated using an electroflotation (EF) process with titanium electrodes. The results show that EF is a viable and novel alternative for removing ultrafine particles of kaolinite-type clay present in sedimentation tank overflows with low salt concentrations (<0.1 mol/L) in copper mining facilities based on the saline water splitting concept. Maximum suspended solid removal values of 91.4 and 83.2% in NaCl and KCl solutions, respectively, were obtained under the experimental conditions of the constant applied potential of 20 V/SHE, salinity concentration of 0.1 mol/L, and electroflotation time of 10 and 20 min in NaCl and KCl solutions, respectively. Furthermore, the visual evidence of particle aggregation by flocculation during the experiments indicates a synergy between EF and electrocoagulation (EC) that enhances the removal of ultrafine particles of kaolinite.

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The solar electroflotation (EF) processes using saline electrolytes are today one of the great challenges for the development of electrochemical devices, due to the corrosion problems that are generated during the operation by being in permanent contact with Cl- ions. This manuscript discloses the corrosion behavior of titanium electrodes using a superposition model based on mixed potential theory and the evaluation of the superficial performance of the Ti electrodes operated to 4 V/SHE solar electroflotation in contact with a solution of 0.5 M NaCl. Additionally provided is an electrochemical analysis of Ti electrodes regarding HER, ORR, OER, and CER that occur during the solar saline EF process. The non-linear superposition model by mixed potential theory gives electrochemical and corrosion parameters that complement the information published in scientific journals, the corrosion current density and corrosion potential in these conditions is 0.069 A/m2 and -7.27 mV, respectively. The formation of TiO2 and TiOCl on the anode electrode was visualized, resulting in a reduction of its weight loss of the anode electrode.

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Background: The addition of cyclin-dependent kinases inhibitors (CDKi) to endocrine therapy (ET) as the first- or second line treatment improves progression-free and overall survival (OS) in hormone receptor-positive, HER2 negative (HR+/HER2-) advanced stage breast cancer (ABC). Our study compared survival rates and prognostic factors in Chilean patients that used palbociclib as first or subsequent (≥second) lines of treatment in a real-world setting. Methods: Our retrospective population-cohort study included HR+/HER2- ABC patients. We calculated 5-year OS and performed a multivariate analysis to determine prognostic factors. Results: A total of 106 patients were included. Median age was 49 years (19-86), 28.3% (30) had de novo stage IV disease; 63% received palbociclib with ET as first line, 54% of them with aromatase inhibitor over fulvestrant. Median OS for the entire cohort was 99 months and 5-year OS was 69%. Patients that received first line palbociclib had a 5-year OS of 89% versus 43% for ET monotherapy or ≥second line palbociclib (p = 0.0062). Multivariate analysis showed that the year at diagnosis and CDKi timing (first line versus ≥second line) were significantly associated with OS. Conclusion: Our real-world data show that first-line CDKi + ET provides a statistically significant benefit in OS versus ≥second line in HR+/HER2- ABC patients.

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BACKGROUND: We summarize comparative ethnoornithological data for ten Mexican Indigenous communities, an initial step towards a comprehensive archive of the avian diversity conserved within Mexico's Indigenous territories. We do so by counting highlighted species listed for bird conservation status on widely recognized "red lists" and their cultural value to build biocultural policies in Mexico for their conservation. METHODS: Indigenous bird names for each study site were determined to allow calculation of the "Scientific Species Recognition Ratio" (SSRR) for high cultural value birds obtained across communities. This demonstrated patterns of cultural prominence. A matrix of 1275 bird versus seven biocultural values was analysed using a correspondence analysis (InfoStat/L-v2020) to illustrate patterns of concordance between bird conservation status and cultural values. RESULTS: This paper contributes to quantitative and qualitative data on the role of ethnoornithology and ethnobiology in biocultural conservation. The areas studied provide refugia for almost 70% of the Mexican avifauna within a fraction of 1% of the national territory, that is 769 bird species recorded for all communities. The global correspondence of regions of biological and linguistic megadiversity is well established, while linguistic diversity is widely accepted as a good proxy for general cultural diversity. Our correspondence analysis explained 81.55% of the variation, indicating a strong relation between cultural importance and bird conservation status. We propose three main categories to establish a bioculturally informed public policy in Mexico for the conservation of what we described as high, medium, and bioculturally prominent bird species all include cultural value in any material or symbolic aspect. High are those species appearing on any threatened list, but also considered in any endemic status, while medium include threatened listed species. The last category included species not necessarily listed on any threat list, but with a wide range of social and cultural uses. We suggest that the concept might be extended to other species of biocultural importance. CONCLUSIONS: We argue that bird conservation policies should be biocultural, that is they should recognize birds of cultural value on a par with bird species "of special interest" because they are most critical for biodiversity conservation. The desire of local people to protect their traditional community lands and livelihoods can be an effective biodiversity conservation strategy, which should be recognized in national biocultural policies.

Assuntos

Aves , Políticas , Humanos , Animais , México , Biodiversidade , Espécies em Perigo de Extinção

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Introducción: La COVID-19 causó que varios sectores profesionales hayan tenido que enfrentarlo en primera línea, viéndose afectados ante la vulnerabilidad de contraer el virus. A pesar de la baja tasa de mortalidad de los momentos actuales y la poca saturación de pacientes con COVID-19 en los centros de salud, la aplicación de una cuarta dosis de inoculación ha generado posturas diferentes entre varios países. Objetivo: Determinar si el personal considerado con altos riesgos de vulnerabilidad de la ciudad de Santo Domingo de los Colorados, en Ecuador, tiene intenciones favorables para la aplicación de la cuarta dosis de la vacuna contra la COVID-19. Método: Se desarrolló un estudio cuantitativo de alcance correlacional y diseño transversal. Un cuestionario conformado por 16 preguntas midió las variables: riesgo de contagio, conocimiento percibido sobre la vacuna, confianza sobre la vacuna e intención de vacunarse; el cual fue aplicado a 375 participantes. Los análisis estadísticos fueron desarrollados a través de Excel y Statistical Package for Social Sciences 21 (SPSS 21). Resultados: Los análisis estadísticos evidenciaron que el riesgo de contagio (β=0,178**), el conocimiento percibido sobre la vacuna (β=0,218**) y la confianza sobre la vacuna (β=0,192**) se correlacionan significativamente con la intención de vacunarse, ante lo cual se evidencia la necesidad de recibir una cuarta dosis de inoculación por parte de los sectores vulnerables. Conclusiones: Esta es la primera investigación que expone resultados respecto a la intención de vacunación en las personas vulnerables y pone en evidencia la intención de acceder a una cuarta dosis de inoculación.

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Introduction: COVID-19 caused healthcare professional workers have faced the pandemic on the frontline at the risk of being infected with the virus. Despite the low mortality rate at present and the low presence of patients with COVID-19 in health care centers, the application of a fourth booster dose has generated different positions among several countries. Objective: To determine whether personnel considered being at high risk of vulnerability in the city of Santo Domingo de los Colorados, Ecuador, have favorable intentions for receiving the fourth booster dose of the COVID-19 vaccine. Method: A quantitative study of correlational scope and cross-sectional design was developed. A questionnaire consisting of 16 questions measured the following variables: risk of infection, perceived knowledge of the vaccine, confidence in the vaccine and intention to be vaccinated; this questionnaire was applied to 375 participants. Statistical analyses were developed using the microsoft Excel spreadsheed and Statistical Packagefor Social Sciences 21 (SPSS 21). Results: Statistical analyses showed that the risk of infection (β=0.178**), perceived knowledge about the vaccine (β=0.218**) and confidence about the vaccine (β=0.192**) are significantly correlated with the intention to be fully vaccinated, thus showing the need for a fourth booster dose by vulnerable sectors. Conclusion: This is the first research that presents results regarding the intention to vaccinate vulnerable people and highlights the intention to access a fourth booster dose.

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Introdução: O COVID-19 fez com que diversos setores profissionais o enfrentassem na linha de frente, sendo afetados pela vulnerabilidade de contrair o vírus. Apesar da baixa taxa de mortalidade atual e da baixa saturação de pacientes com COVID-19 nos centros de saúde, a aplicação de uma quarta dose de inoculação gerou posições diferentes entre vários países. Objetivo: Determinar se o pessoal considerado de alto risco de vulnerabilidade na cidade de Santo Domingo de los Colorados, no Equador, tem intenções favoráveis para a aplicação da quarta dose da vacina contra COVID-19. Método: Foi desenvolvido um estudo quantitativo com escopo correlacional e delineamento transversal. Um questionário composto por 16 questões mediu as variáveis: risco de contágio, conhecimento percebido sobre a vacina, confiança sobre a vacina e intenção de se vacinar; que foi aplicado a 375 participantes. As análises estatísticas foram realizadas no Excel e no Statistical Package for the Social Sciences 21 (SPSS 21). Resultados: As análises estatísticas mostraram que o risco de contágio (β=0,178**), o conhecimento percebido sobre a vacina (β=0,218**) e a confiança sobre a vacina (β=0,192**) estão significativamente correlacionados com a intenção de ser vacinado, o que evidencia a necessidade de receber uma quarta dose de inoculação por setores vulneráveis. Conclusões: Esta é a primeira pesquisa que expõe resultados sobre a intenção de vacinação em pessoas vulneráveis e evidencia a intenção de acessar uma quarta dose de inoculação.

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Background: Previous studies have examined the "fat but fit" paradox, revealing that greater levels of physical fitness may diminish the harmful consequences of excess weight on cardiometabolic risk. Despite the above, specific information about the "fat but fit" paradox in prepuberal population is scarce. The aim of this study was to determine the relationship between cardiometabolic risk across (individual and combined) physical fitness and excess weight status and whether the "fat but fit" paradox is met in the sample of schoolchildren analyzed. Methods: A cross-sectional study was conducted including 452 children (59.1% girls), aged 7-9 years from Santiago (Chile). Physical fitness was assessed as cardiorespiratory fitness and muscular fitness. Cardiorespiratory fitness was determined by the 6-minute-walk-test and muscle strength was assessed by the handgrip and standing long jump tests. Excess weight (overweight and obesity) was computed through body mass index (z-score). Cardiometabolic risk was established by summing the z-score of the serum glucose, triglycerides, high-density lipoprotein, insulin and waist-to-height ratio. Results: Schoolchildren with high physical fitness (individual or combined) showed the lowest cardiometabolic risk mean scores (P for trend <0.001 for all physical fitness groups). Conversely, schoolchildren with low physical fitness (individual or combined) showed the highest cardiometabolic risk mean scores (P for trend <0.001 for all categories). Additionally, schoolchildren without excess weight and with high individual or combined physical fitness status exhibits lower cardiometabolic risk mean scores compared to schoolchildren with excess weight and low physical fitness status (individual or combined) (P for trend <0.001 for all physical fitness groups). A lower odd of having high cardiometabolic risk was found in schoolchildren without excess weight and with both high physical fitness (both cardiorespiratory fitness and muscular fitness) [odds ratio (OR) =0.08; 95% confidence interval (CI): 0.04 to 0.16] in comparison to those with excess weight and low physical fitness. Conclusions: Our results suggest that improvements in both fatness and aerobic fitness could be associated with lower cardiometabolic risk.

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Helicobacter pylori have coevolved with mankind since its origins, adapting to different human groups. In America, H. pylori has evolved into several subpopulations. We analysed the genome of 154 Colombian strains along with 1,091 strains from worldwide populations to discern the ancestry and adaption to Colombian people. Population structure and ancestry was inferred with FineStructure and ChromoPainter. Phylogenetic relationship and the relative effect of recombination were analysing the core SNPs. Also, a Fst index was calculated to identify the gene variants with the strongest fixation in the Colombian subpopulations compared to their parent population hspSWEurope. FineStructure allowed the identification of two Colombian subpopulations, the previously described hspSWEuropeColombia and a novel subpopulation named hspColombia, that included three subgroups following their geographic origin. Colombian subpopulations represent an admixture of European, African and Indigenous ancestry; although some genomes showed a high proportion of self identity, suggesting an advanced adaption to these mestizo Colombian groups. We found that recombination is more important that punctual mutations in H. pylori genome diversity, 13.9 more important in hspSWEurope, 12.5 in hspSWEColombia and 10.5 in hspColombia, reflecting the divergence of these subpopulations. Fst analysis identified 82 SNPs fixed in 26 genes of the hspColombia subpopulation that encode for outer membrane and central metabolism proteins. Strongest fixation indexes were identified in genes encoding HofC, HopE, FrpB-4 and Sialidase A. These findings demonstrate that H. pylori has evolved in Colombia to give rise to subpopulations with a self identity ancestry, reflected in allele changes on genes encoding for outer membrane proteins.

Assuntos

Helicobacter pylori , Alelos , Colômbia , Helicobacter pylori/genética , Humanos , Filogenia , Recombinação Genética

RESUMO

Introducción: la trombosis venosa profunda (TVP) es una entidad común que afecta principalmente el sistema venoso profundo de los miembros inferiores, para el cual se han desarrollado múltiples escalas de predicción clínica, las cuales han sido construidas y validadas en pacientes ambulatorios y hospitalizados. Objetivos: validar cinco escalas de predicción clínica para TVP en pacientes atendidos en un centro de tercer nivel en la sabana de Bogotá, Colombia. Métodos: se llevó a cabo un estudio de corte transversal con análisis de prueba diagnóstica en sujetos con sospecha de TVP, incluyendo aquellos que contaran con la realización de ecografía Doppler venosa de miembros inferiores. Se calculó el rendimiento de cinco escalas de predicción clínica para TVP (Wells clásico y modificado, Oudega, CEBI y Constans) para pacientes ambulatorios u hospitalizados, individualizando la población en la que fueron validadas. Resultados: ingresaron al análisis 974 pacientes, de estos 485 (49,7 %) presentaron TVP. La escala de Constans tuvo un mejor rendimiento diagnóstico entre los pacientes hospitalizados y ambulatorios, con un área bajo la curva ROC de 0,73 (95 % 0,70-0,78) al compararla con Wells clásico, Wells modificado, Oudega y CEBI. Al comparar el rendimiento de Constans en ambos grupos de pacientes por separado, también se observó un mejor rendimiento con respecto a las demás escalas. Conclusión: la escala de Constans presenta un mejor rendimiento diagnóstico comparado con las demás escalas al ser aplicada en paciente hospitalizados y ambulatorios.

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Summary Introduction: The deep vein thrombosis (DVT) is a common entity that mainly affects the deep venous system of the lower limbs, for which multiple clinical prediction scales have been developed, which have been constructed and validated in outpatients and inpatients. Objetives: We aimed to validated five clinical prediction scores for the diagnosis of lower limb DVT in patients from La Sabana de Bogota, Colombia. Methods: A cross-sectional study with analysis of a diagnostic test was carried out in patiens with suspected deep vein thrombosis, including those who had venous Doppler ultrasound of the lower limbs for suspected DVT. The performance of five clinical prediction scales for DVT (classic and modified Wells, Oudega, CEBI and Constans) for outpatients and inpatients was calculated in those scores who are validated in both populations and only in ambulatory or hospitalized patients for those that are specific scores. Results: Nine hundred seventy-four patients were entered into the analysis, of which 485 (49.7%) presented DVT. The Constans scale had a better diagnostic performance among inpatients and outpatients with an area under the ROC curve of 0.73 (95% 0.70-0.78) when compared with classic Wells, modified Wells, Oudega and CEBI. When we compared Constans performance in both groups of patients separately, we observed better performance with respect to the other scores. Conclusion: The Constans scale presents a better diagnostic performance compared to the other scales when applied to inpatients and outpatients.

Assuntos

Humanos

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RESUMEN Objetivo Estudiar cómo la diabetes mellitus tipo 2 ha influenciado la sexualidad de 54 varones mellitus que acudieron a consulta a dos hospitales de Taxco, Guerrero. Materiales y Métodos Se aplicó una encuesta a un total de 54 hombres que acudieron a consulta a dos hospitales de Taxco, Guerrero, México. Se consideró a hombres con diabetes mellitus tipo 2, con vida sexual activa, con más de 5 años de evolución de la enfermedad, y que acudieron a consulta periódica. Los casos se eligieron tomando en cuenta los planteamientos sobre muestras por conveniencia. El trabajo fue cuantitativo no probabilístico. El cuestionario de encuesta incluyó 15 variables. Resultados Entre los hallazgos alentadores y positivos se destaca que el 76% de los casos manifestó que nunca ha tenido una disminución en el desempeño sexual, y el 80% de los casos expresó nunca haber presentado dolor o molestia después del coito. Sobre los porcentajes adversos y negativos, el 33% manifestó haber tenido siempre un cambió (de manera nociva o dañina) en el interés ante la sexualidad. Conclusiones Diversos autores destacan cómo la diabetes mellitus es una enfermedad epidémica en México, y que provoca incapacidad, mortalidad prematura, y afecta de manera grave la sexualidad de pacientes. En el presente estudio las respuestas indican, tanto hallazgos positivos, como también, un impacto adverso y negativo en la sexualidad de algunos varones encuestados.

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ABSTRACT Objective To study and analyze how type 2 diabetes mellitus has influenced the sexuality of male patients. Material and Methods A survey was applied to a total of 54 men who attended in two hospitals in Taxco, Guerrero, México. Men with type 2 diabetes mellitus, with an active sexual life, with more than 5 years of evolution of the disease, and who attended periodic consultations were considered. The cases were chosen taking into account the approaches on convenience samples. The work was quantitative, not probabilistic. The survey questionnaire included 15 variables. Results Among the findings encouraging and positive, it is highlighted that 76% of the cases reported never having had a decrease in sexual performance. Likewise, and 80% of the cases expressed never having presented pain or discomfort after inter-course. Regarding the adverse and negative percentages, the 33% stated that they had always had a change (in a harmful way) in their interest in sexuality. Conclusions Several authors highlight how diabetes mellitus is an epidemic disease in Mexico, which can cause disability and premature mortality, and seriously affect the sexuality of patients. In the present study the responses indicate both positive findings, as well as an adverse and negative impact on the sexuality of some male respondents.

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Stomach cancer (SC) incidence and mortality are relevant public health issues worldwide. In Colombia, screening for preneoplastic lesions (PNL) and the presence of H. pylori is not routinely performed. Therefore, the aim of this study was to evaluate OLGA-OLGIM staging and the interobserver agreement in gastritis and preneoplastic lesions in patients with gastroduodenal symptoms from Colombia. A cross-sectional study was conducted in 272 patients with gastroduodenal symptoms. Gastric biopsies were taken following the Updated Sydney System with the OLGA-OLGIM classification, and the results were evaluated by two pathologists. Chronic gastritis and PNL were reported in 76% and 24% of the patients, respectively. Furthermore, 25% of the patients with PNL displayed gastric atrophy (GA) and 75% intestinal metaplasia (IM). Agreement in the histopathological reading for IM was good, whereas for OLGA was variable, and for the H. pylori quantity was poor. OLGA-OLGIM stages 0-II were the most frequent (96%), while stage III (4%) and SC (4%) were the least frequent. Age and coffee consumption were associated with a higher prevalence of PNL. This work determined that 4% of the population is at high risk of developing SC and would benefit from follow-up studies. Reinforcement of training programs to improve the agreement in histopathology readings is required.

Assuntos

Gastrite Atrófica , Gastrite , Infecções por Helicobacter , Helicobacter pylori , Lesões Pré-Cancerosas , Neoplasias Gástricas , Estudos Transversais , Gastrite/diagnóstico , Gastrite Atrófica/complicações , Gastrite Atrófica/diagnóstico , Gastrite Atrófica/patologia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/diagnóstico , Humanos , Metaplasia , Variações Dependentes do Observador , Lesões Pré-Cancerosas/diagnóstico , Lesões Pré-Cancerosas/patologia , Fatores de Risco , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/patologia

RESUMO

Dating violence is a public health problem affecting people worldwide. This study evaluated the occurrence of different types of adolescent dating violence using a mixed analysis of each data source. The present study addresses the following research questions: does the occurrence of the types of violence analyzed in the quantitative phase match with the narratives obtained in the qualitative phase? and does the additional information obtained in the qualitative phase improve the understanding of the analyzed phenomenon?In the quantitative phase, 410 participants (aged 13 to 19 years) answered a questionnaire based on the Modified Conflict Tactics Scale, while in the qualitative phase, 26 participated in two focus groups. Data were collected from May to June 2019. Written informed consent was obtained from the parents or legal guardians of those who had agreed to participate. The present research was approved by the Human Research Ethics Committee of the Pontifical Catholic University of Ecuador. The results were divided on: prevalence of dating violence based on age groups and gender, management and resolution of dating conflicts, victimization and perpetration of intimate partner violence, factors favoring intimate partner violence and acceptance of abuse. The results were analyzed via triangulation and indicated that adolescents were involved in the perpetration and victimization of psychological as well as mild and severe physical violence. An analysis of the contributing factors revealed a strong tendency toward the acceptance of the traditional gender model. Challenging these models is crucial to deconstruct hierarchical models, develop conflict resolution skills, and promptly identify abusive behaviors that affect emotional development. The combination of different methodological approaches improved the understanding of the phenomenon studied.

Assuntos

Comportamento do Adolescente , Bullying , Vítimas de Crime , Violência por Parceiro Íntimo , Adolescente , Comportamento do Adolescente/psicologia , Vítimas de Crime/psicologia , Equador , Humanos , Violência por Parceiro Íntimo/psicologia

RESUMO

Abstract Objectives: to validate the diagnostic yield of the PERC score for ruling out pulmonary embolism in low-risk patients at high altitudes (>2500 meters above sea level [ASL]). Methods: a cross-sectional study with diagnostic test analysis in patients over the age of 18 with suspected pulmonary embolism on admission or during hospitalization, who underwent chest computed tomography angiography between August 2009 and January 2020 in a tertiary care hospital located on the Bogotá savannah. The yield of the PERC score was assessed, calculated with an SaO2<95% and an SaO2<90% in patients with different risk levels according to the Wells, Geneva and Pisa scores for pulmonary embolism. Results: one thousand eighty-seven were included in the final analysis, 42% with PE. Patients classified as low-risk using the Wells score had a PERC ACOR calculated with SaO2<95% of 0.56 (95%CI:0.50-0.62) (p=0.049), and calculated with SaO2<90% of 0.60 (95%CI:0.54-0.66) (p=0.002). The ACOR for subjects classified as low-risk using the Geneva score, with a PERC calculated with SaO2<95%, was: 0.53 (95%CI:0.45-0.60) (p=0.459) and for a PERC calculated with SaO2<90% it was: 0.55 (95%CI:0.47-0.62) (P=0.218). The ACOR for subjects with a less than 10% probability of PE according to the Pisa score classification, with a PERC calculated with SaO2<95%, was: 0.54 (95%CI:0.44-0.64)(p=0.422), and for a PERC calculated with SaO2<90% it was: 0.56 (95%CI:0.46-0.66)(p=0.236). Conclusions: the PERC score calculated with an oxygen saturation <90% has a similar diagnostic yield to the PERC score calculated with an oxygen saturation <95% for ruling out PE in patients classified as low-risk by the Wells score at high altitudes (>2,500 meters ASL). (Acta Med Colomb 2021; 46. DOI: https://doi.org/10.36104/amc.2021.2010).

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Neuroendocrine Tumors (NETs) encompass a wide variety of tumors arising from neuroendocrine cells, which produce bioactive substances. The incidence of NETs increased significantly lately, becoming one of the most common tumors of the digestive tract. Their clinical presentation is as diverse as their capacity for hormone production. Carcinoid syndrome is the most common hormonal syndrome produced by NETs and is characterized by diarrhea, flushing and cardiac valvular lesions. New research brought multiple changes in the classification of these neoplasms and a new understanding about their diagnosis and treatment, promoting a multidisciplinary approach. Somatostatin analogues, radiation, biological, and cytotoxic drugs have improved the prognosis of these patients, which entails a great challenge for healthcare providers.

Assuntos

Antineoplásicos , Tumores Neuroendócrinos , Antineoplásicos/uso terapêutico , Diarreia , Humanos , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/terapia , Somatostatina/uso terapêutico

RESUMO

BACKGROUND: Fluoropyrimidine plus platinum chemotherapy remains the standard first line treatment for gastric cancer (GC). Guidelines exist for the clinical interpretation of four DPYD genotypes related to severe fluoropyrimidine toxicity within European populations. However, the frequency of these single nucleotide polymorphisms (SNPs) in the Latin American population is low (< 0.7%). No guidelines have been development for platinum. Herein, we present association between clinical factors and common SNPs in the development of grade 3-4 toxicity. METHODS: Retrospectively, 224 clinical records of GC patient were screened, of which 93 patients were incorporated into the study. Eleven SNPs with minor allelic frequency above 5% in GSTP1, ERCC2, ERCC1, TP53, UMPS, SHMT1, MTHFR, ABCC2 and DPYD were assessed. Association between patient clinical characteristics and toxicity was estimated using logistic regression models and classification algorithms. RESULTS: Reported grade ≤ 2 and 3-4 toxicities were 64.6% (61/93) and 34.4% (32/93) respectively. Selected DPYD SNPs were associated with higher toxicity (rs1801265; OR = 4.20; 95% CI = 1.70-10.95, p = 0.002), while others displayed a trend towards lower toxicity (rs1801159; OR = 0.45; 95% CI = 0.19-1.08; p = 0.071). Combination of paired SNPs demonstrated significant associations in DPYD (rs1801265), UMPS (rs1801019), ABCC2 (rs717620) and SHMT1 (rs1979277). Using multivariate logistic regression that combined age, sex, peri-operative chemotherapy, 5-FU regimen, the binary combination of the SNPs DPYD (rs1801265) + ABCC2 (rs717620), and DPYD (rs1801159) displayed the best predictive performance. A nomogram was constructed to assess the risk of developing overall toxicity. CONCLUSION: Pending further validation, this model could predict chemotherapy associated toxicity and improve GC patient quality of life.

Assuntos

Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Compostos de Platina/administração & dosagem , Polimorfismo de Nucleotídeo Único , Neoplasias Gástricas/tratamento farmacológico , Neoplasias Gástricas/genética , Idoso , Capecitabina/efeitos adversos , Estudos de Casos e Controles , Intervalos de Confiança , Proteínas de Ligação a DNA/genética , Di-Hidrouracila Desidrogenase (NADP)/genética , Endonucleases/genética , Feminino , Fluoruracila/efeitos adversos , Frequência do Gene , Genes p53 , Genótipo , Glutationa S-Transferase pi/genética , Glicina Hidroximetiltransferase/genética , Humanos , Leucovorina/efeitos adversos , Modelos Logísticos , Masculino , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Pessoa de Meia-Idade , Proteína 2 Associada à Farmacorresistência Múltipla , Proteínas Associadas à Resistência a Múltiplos Medicamentos/genética , Complexos Multienzimáticos/genética , Nomogramas , Razão de Chances , Compostos Organoplatínicos/efeitos adversos , Orotato Fosforribosiltransferase/genética , Orotidina-5'-Fosfato Descarboxilase/genética , Pirimidinas , Qualidade de Vida , Estudos Retrospectivos , Neoplasias Gástricas/patologia , Proteína Grupo D do Xeroderma Pigmentoso/genética

RESUMO

Next-generation sequencing (NGS) is progressively being used in clinical practice. However, several barriers preclude using this technology for precision oncology in most Latin American countries. To overcome some of these barriers, we have designed a 25-gene panel that contains predictive biomarkers for most current and near-future available therapies in Chile and Latin America. Library preparation was optimized to account for low DNA integrity observed in formalin-fixed paraffin-embedded tissue. The workflow includes an automated bioinformatic pipeline that accounts for the underrepresentation of Latin Americans in genome databases. The panel detected small insertions, deletions, and single nucleotide variants down to allelic frequencies of 0.05 with high sensitivity, specificity, and reproducibility. The workflow was validated in 272 clinical samples from several solid tumor types, including gallbladder (GBC). More than 50 biomarkers were detected in these samples, mainly in BRCA1/2, KRAS, and PIK3CA genes. In GBC, biomarkers for PARP, EGFR, PIK3CA, mTOR, and Hedgehog signaling inhibitors were found. Thus, this small NGS panel is an accurate and sensitive method that may constitute a more cost-efficient alternative to multiple non-NGS assays and costly, large NGS panels. This kind of streamlined assay with automated bioinformatics analysis may facilitate the implementation of precision medicine in Latin America.

RESUMO

RESUMEN Objetivo Estudiar el impacto de la diabetes mellitus tipo 2 en la sexualidad de pacientes mujeres. Se analiza el efecto que ha tenido la diabetes mellitus tipo 2 en la sexualidad de 93 mujeres que recibieron consulta en dos hospitales de la comunidad de Taxco, Guerrero. Metodología Se aplicó una encuesta de 15 variables a un total de 93 pacientes mujeres que acudieron a consulta a dos hospitales de Gobierno en la ciudad de Taxco, Guerrero, México. Se contempló a mujeres con diabetes mellitus tipo 2, con vida sexual activa, con más de cinco años de evolución de la enfermedad. Los casos se eligieron tomando en cuenta el concepto de muestras por conveniencia. El diseño fue cuantitativo, no probabilístico. Resultados La diabetes tuvo un impacto desfavorable en la sexualidad de una proporción importante de las mujeres consideradas. Respecto a los porcentajes negativos, se documentó cómo el 32% de las mujeres nunca tuvieron deseo de tener relaciones sexuales. El 25% del universo manifestó que siempre hubo un cambio de interés por las relaciones después el diagnóstico (de forma perjudicial y adversa). El 17% confirmó siempre presentar irritación vaginal. Y el 42% de las pacientes manifestaron nunca experimentar orgasmos. Finalmente, para el 23% de las mujeres nunca fue satisfactoria la frecuencia de dichas relaciones. Conclusiones Se destacan hallazgos nocivos en algunas de las variables que ratifican cómo la diabetes ha tenido un impacto dañino en la sexualidad de un porcentaje importante de las mujeres encuestadas.

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ABSTRACT Objective To study the impact that type 2 diabetes mellitus has had on the sexuality of 93 women. This work analyzes the effect that type 2 diabetes mellitus has had on the sexuality of 93 female patients who received consultations in two hospitals in the city of Taxco, Guerrero. Methodology A survey of 15 variables was applied to a total of 93 female patients who attended in two Hospitals in the city of Taxco, Guerrero, Mexico. Women with type 2 diabetes mellitus, with an active sexual life, with more than 5 years of evolution of the disease, and who attended periodic consultations were considered. The cases were chosen keeping the concept of convenience samples in mind. The design was quantitative, not probabilistic. Results The diabetes had an unfavorable impact on the sexuality of a significant pro-portion of the women considered. Regarding the negative percentages, it was documented how 32% of the women never had a desire to have sexual intercourse. The 25% of the universe stated that there was always a change in interest in relationships after the diagnosis (in adverse way). The 17% always confirmed having vaginal irritation or dryness. And 42% patients reported never experiencing orgasms. Finally, for 23% of the women the frequency of such relationships was never satisfactory. Conclusions They highlighted harmful findings in some of the variables, which confirm how diabetes has had a harmful impact on the sexuality of a significant percentage of the women surveyed.