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The COVID-19 pandemic has generated a global crisis with severe consequences for public health. There have been negative impacts on people's quality of life and mental health due to various stressors arising in this context, such as physical, social, economic, and psychological challenges. Noteworthy among these are the indirect effects of health measures, especially social distancing and confinement, which have significantly altered people's daily lives and social activities, producing high levels of anxiety, depression, and stress. This study proposes developing and validating a cross-sectional scale called the "Environmental Stressors Scale (ECSS-20)" to address the need to measure the impact of environmental stressors during confinement. The scale, which has been validated following ethical and methodological guidelines, consists of four dimensions: economic stressors (EE), social activities (SA), habitability (H), and exposure to virtual media (EMV). A pilot study (n = 113) and a main study (n = 314) were applied. The results showed that the instrument has a reliable and valid structure, with satisfactory internal consistency and factorial validity. Likewise, gender invariance tests supported its suitability for its applicability to women and men. Overall, the ECSS-20 is a valuable instrument for assessing the impact of confinement and improving the understanding of people's subjective experiences in this situation. Future research could further develop its applicability in different contexts and populations to better understand its usefulness and psychometric properties.
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The present study evaluated the psychometric properties of the Academic Psychological Capital Questionnaire 12 (APCQ-12) in a sample of 2,196 Chilean high school students (51% girls) aged 12 to 17 years (mean 14.83 years). Results showed that: (1) the APCQ-12 produces adequate scores in terms of reliability, (2) the internal structure of the questionnaire obtains adequate fit indices, for a second order model, which is consistent with previous research, and (3) the APCQ-12 proved to be sex and age invariant. Overall, the APCQ-12 proved to be an adequate questionnaire for measuring academic psychological capital in Chilean high school students, producing valid and reliable scores.
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Objectives: In this study, we identify knowledge, attitudes, and practices (KAPs) of the people of the State of Tabasco (Mexico) as they influence transmission and mitigation of COVID-19. Methods: We used an Internet-based survey (N=1848) from March to July 2021, with a probabilistic sampling stratified by municipalities. Results: Most respondents demonstrated knowledge about the etiology and symptoms of COVID-19 - they assume that anyone can contract the disease, and at least 53.5% knew that the cause is a virus. They believed that it constitutes a problem for their community due to its easy transmission; however, they consider themselves to be only at medium risk. They have adopted preventive measures such as handwashing, staying home, and social distancing; however, when analyzing protecting the community, they refer to other people as having responsibility for preventing disease spread. Conclusions: Interventions focused on social and cultural contexts are required. Sociodemographic and ideological factors influence disinformation, limited interventions, and cognitive dissonance. This type of research contributes to discovering areas of opportunity for government and public health organizations to prioritize practical actions and reduce eventual outbreaks.
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COVID-19 , COVID-19/prevenção & controle , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , México , Pandemias/prevenção & controle , SARS-CoV-2 , Inquéritos e QuestionáriosRESUMO
Around two-thirds of women who are of reproductive age use some type of contraception. Two of the most effective long-acting reversible contraceptives (LARC) are the intrauterine device (IUD) and the subdermal contraceptive implant (SCI). Despite their effectiveness, women often report abnormal uterine bleeding as the reason for discontinuation. In this review, we analyze key aspects regarding the mechanisms of action of IUDs (both copper-containing and levonorgestrel-releasing) and SCIs, as well as how they change the intrauterine environment in order to provide effective contraception at a physiological level. Additionally, we introduce the pathophysiology of different types of abnormal intrauterine bleeding provoked by the mentioned LARCs. These three contraceptive methods work in diverse ways, thus, the etiology of abnormal uterine bleeding is different and multifactorial according to each LARC. This review intends to provide information in order to better our understanding of bleeding induced by these contraceptive methods, as well as introduce current and potential new therapies. Furthermore, this review intends to provide updated and concise information that could be available firsthand not only to health care providers but scientists who are innovating and revolutionizing this field. In 2013, the American College of Obstetricians and Gynecologists published a management of abnormal uterine bleeding, however, there is limited updated data regarding the physiology and pathophysiology of abnormal uterine bleeding and its treatment based on different LARCs (hormonal and non-hormonal).
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Anticoncepcionais Femininos , Dispositivos Intrauterinos de Cobre , Dispositivos Intrauterinos Medicados , Dispositivos Intrauterinos , Anticoncepção/métodos , Anticoncepcionais , Anticoncepcionais Femininos/efeitos adversos , Feminino , Humanos , Dispositivos Intrauterinos de Cobre/efeitos adversos , Dispositivos Intrauterinos Medicados/efeitos adversos , Levanogestrel/efeitos adversos , Hemorragia Uterina/tratamento farmacológico , Hemorragia Uterina/etiologiaRESUMO
A viable alternative for the next generation of wound dressings is the preparation of electrospun fibers from biodegradable polymers in combination with inorganic nanoparticles. A poly(vinyl alcohol)-chitosan-silver nanoparticles (PVA-CTS-Ag NPs) system has been developed for antimicrobial and wound healing applications. Here, the preparation of PVA-CTS-Ag electrospun fibers using a two-step process is reported in order to analyze changes in the microstructural, mechanical, and antibacterial properties and confirm their potential application in the biomedical field. The Ag nanoparticles were well-dispersed into the chitosan matrix and their cubic structure after the electrospinning process was also retained. The Ag NPs displayed an average diameter of ~33 nm into the CTS matrix, while the size increased up to 213 nm in the PVA-CTS-Ag(NPs) fibers. It was observed that strong chemical interactions exist between organic (CTS) and inorganic phases through nitrogenous groups and the oxygen of the glycosidic bonds. A defect-free morphology was obtained in the PVA-CTS-Ag NPs final fibers with an important enhancement of the mechanical properties as well as of the antibacterial activity compared with pure PVA-CTS electrospun fibers. The results of antibacterial activity against E. coli and S. aureus confirmed that PVA-CTS-Ag(NPs) fibers can be potentially used as a material for biomedical applications.
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OBJECTIVE: To determine the efficacy of clindamycin compared with amoxicillin-metronidazole after a 7-day regimen during nonsurgical treatment of periodontitis in patients with type 2 diabetes mellitus. RESEARCH DESIGN AND METHODS: In this double-blind, randomized clinical trial, a total of 42 patients with chronic periodontitis and type 2 diabetes were included. Patients were randomly assigned to treatment with either clindamycin or amoxicillin-metronidazole three times a day during 7 days. Clinical determinations (probing depth, bleeding on probe, and plaque index) were performed to determine the extent and severity of periodontitis before and after the pharmacological treatment. RESULTS: After 7 days of administration of clindamycin or amoxicillin-metronidazole, no differences were observed between the clinical determinations, probing depth (0.44 vs 0.50 mm, p=0.624), plaque index (17.62 vs 15.88%, p=0.910), and bleeding on probing (16.12 vs 22.17%, p=0.163), respectively. There were no adverse events in either group. CONCLUSION: The administration during 7 days of clindamycin or amoxicillin/metronidazole showed the same efficacy for the reduction of probing depth, plaque index, and bleeding on probing in patients with periodontitis and type 2 diabetes.
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Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Clindamicina/uso terapêutico , Diabetes Mellitus Tipo 2/complicações , Metronidazol/uso terapêutico , Periodontite/tratamento farmacológico , Adolescente , Adulto , Idoso , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Periodontite/etiologia , Periodontite/patologia , Prognóstico , Adulto JovemRESUMO
BACKGROUND: Poly-ADP-ribose (PAR) is a polymer synthesized by poly-ADP-ribose polymerases (PARPs) as a postranslational protein modification and catabolized mainly by poly-ADP-ribose glycohydrolase (PARG). In spite of the existence of cytoplasmic PARPs and PARG, research has been focused on nuclear PARPs and PAR, demonstrating roles in the maintenance of chromatin architecture and the participation in DNA damage responses and transcriptional regulation. We have recently detected non-nuclear PAR structurally and functionally associated to the E-cadherin rich zonula adherens and the actin cytoskeleton of VERO epithelial cells. Myelinating Schwann cells (SC) are stabilized by E-cadherin rich autotypic adherens junctions (AJ). We wondered whether PAR would map to these regions. Besides, we have demonstrated an altered microfilament pattern in peripheral nerves of Trembler-J (Tr-J) model of CMT1-E. We hypothesized that cytoplasmic PAR would accompany such modified F-actin pattern. METHODS: Wild-type (WT) and Tr-J mice sciatic nerves cryosections were subjected to immunohistofluorescence with anti-PAR antibodies (including antibody validation), F-actin detection with a phalloidin probe and DAPI/DNA counterstaining. Confocal image stacks were subjected to a colocalization highlighter and to semi-quantitative image analysis. RESULTS: We have shown for the first time the presence of PAR in sciatic nerves. Cytoplasmic PAR colocalized with F-actin at non-compact myelin regions in WT nerves. Moreover, in Tr-J, cytoplasmic PAR was augmented in close correlation with actin. In addition, nuclear PAR was detected in WT SC and was moderately increased in Tr-J SC. DISCUSSION: The presence of PAR associated to non-compact myelin regions (which constitute E-cadherin rich autotypic AJ/actin anchorage regions) and the co-alterations experienced by PAR and the actin cytoskeleton in epithelium and nerves, suggest that PAR may be a constitutive component of AJ/actin anchorage regions. Is PAR stabilizing the AJ-actin complexes? This question has strong implications in structural cell biology and cell signaling networks. Moreover, if PAR played a stabilizing role, such stabilization could participate in the physiological control of axonal branching. PARP and PAR alterations exist in several neurodegenerative pathologies including Alzheimer's, Parkinson's and Hungtington's diseases. Conversely, PARP inhibition decreases PAR and promotes neurite outgrowth in cortical neurons in vitro. Coherently, the PARP inhibitor XAV939 improves myelination in vitro, ex vivo and in vivo. Until now such results have been interpreted in terms of nuclear PARP activity. Our results indicate for the first time the presence of PARylation in peripheral nerve fibers, in a healthy environment. Besides, we have evidenced a PARylation increase in Tr-J, suggesting that the involvement of cytoplasmic PARPs and PARylation in normal and neurodegenerative conditions should be re-evaluated.
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La tripanosomiasis americana o enfermedad de Chagas es una de las parasitosis transmitidas por insectos hematófagos de mayor importancia epidemiológica en América Latina y es producida por el protozoo Trypanosoma cruzi, se presentan dos fases clínicas importantes: aguda y crónica. Objetivo: presentar una actualización de la enfermedad de Chagas de forma integral, especificando contenidos claves como su definición, etiología, ciclo de vida, epidemiología, diagnóstico, manifestaciones clínicas y tratamiento. Metodología de búsqueda: se llevó a cabo una revisión bibliográfica en bases de datos y bibliotecas virtuales como OvidSP, Medline, EBSCO host, Pubmed, Uptodate, New England Journal of Medicine, Cochrane y SciELO, usando palabras clave como cardiomiopatía chagásica, enfermedad de Chagas, Trypanosoma cruzi e insectos. Resultados: el tipo de lesión cardíaca más frecuente en la enfermedad de Chagas crónica es la cardiomiopatía, cuyo diagnóstico y pronóstico clínico está ligado a una continua monitorización del electrocardiograma y la ecocardiografía. Para una detección por laboratorio es necesario identificar clínicamente la fase de la enfermedad para escoger la prueba diagnóstica que tenga mayor sensibilidad. Desde el punto de vista terapéutico se tienen pocas alternativas farmacológicas para la erradicación del parásito, por lo cual se requieren modelos de prevención y promoción acordes a la población colombiana en general. Conclusión: la compresión de la enfermedad en todos sus aspectos es una herramienta fundamental en la creación de nuevas alternativas preventivas y de tratamiento, para controlar este tipo infección que en la actualidad agobia a la población de zonas urbanas y rurales principalmente de América Latina, mejorando de esta manera la calidad de vida de los pacientes...
The American Trypanosomiasis or Chagas disease is one of the parasitic diseases that has most epidemiological importance in Latin America and is transmitted by blood-sucking insects and it is caused by the protozoan Trypanosoma cruzi. This disease presents itself in two important clinical phases: acute and chronic. Objective: submit an update on the Chagas disease, specifying key information like its definition, etiology, life cycle, epidemiology, diagnosis, clinical manifestations and treatment. Methodology: we reviewed a great amount of literature found in databases and virtual libraries such as: OvidSP, Medline, EBSCO host, Pubmed, Uptodate, New England Journal of Medicine, Cochrane and SciELO, using words like Chagas cardiomyopathy, Chagas disease, Trypanosoma cruzi, Insects. Discussion: the most common type of cardiac damage in chronic Chagas is the cardiomyopathy, whose clinical diagnosis and prognosis is linked to a continuous variety of monitoring methods such as echocardiography and electrocardiograms, for laboratory detection clinically necessary to identify the phase of the disease to select the diagnostic test be more sensitive. Now from a therapeutic point of view, there is a low amount of pharmacological alternatives for the eradication of the parasite, reason for which it is important to have prevention models for the Colombian population in general. Conclusion: understanding and knowing the disease in all its aspects is a fundamental tool in the Artículo recibido el 10 de septiembre de 2014 y aceptado para publicación el 21 de diciembre de 2014. MéD. UIS. 2015;28(1):81-90 82 Palmezano JM, Plazas LK, Rivera KE, Rueda VP creation of new prevention options and treatments to control this type of disease, which currently affects a big amount of the population found in urban areas all over the world but most importantly in Latin America, and this way helping improve the quality of life of each patient...
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Humanos , Cardiomiopatia Chagásica , Doença de Chagas , Trypanosoma cruziRESUMO
Determinar los factores relacionados a la morbilidad materna extrema (MME) en las pacientes ingresadas a la Unidad de Cuidados Intensivos Matemos (UCIM) del Instituto Nacional Materno Perinatal (INMP) durante el periodo enero-diciembre 2012. Metodología: estudio observacional, retrospectivo, de corte transversal. Se revisó las historias clínicas de todas las pacientes obstétricas que ingresaron a la UCIM durante el periodo enero-diciembre 2012 y que cumplieron alguno de los criterios de inclusión para MME relacionados con la enfermedad específica, falla orgánica o manejo. Se analizó las variables sociodemográficas y obstétricas siguiendo el protocolo establecido en la metodología para la vigilancia de la FLASOG. Resultados: en el periodo estudiado se analizó 263 historias clínicas de pacientes con MME, hallándose una razón de 16.3 x 1000 NV, razón de muerte materna (MM) 55.92 x 100000 NV, índice de MM 3.3 por ciento, relación MME/MM 29.2, relación criterios/caso 4, MME con >=3 criterios de inclusión 62.7 por ciento. Estuvo relacionado con pacientes jóvenes cuya edad promedio fue 28 años, nivel educativo intermedio, uniones estables, multigrávidas, periodo intergenésico entre 18-60 meses, >=4 controles prenatales, gestaciones a término, productos vivos, parto por cesárea, estancia promedio en UCIM de 3.6 días y un promedio de hospitalización de 8 días, con un promedio de 3.4 unidades de hemoderivados transfundidos a la mitad de las pacientes, la histerectomía fue la intervención quirúrgica más frecuente. La principal causa de MME fueron los trastornos hipertensivos: PES/sd HELLP (48.6 por ciento). La falla orgánica fue el criterio de inclusión más frecuente (52.5 por ciento) y de ellos los trastornos de la coagulación, seguido de la falla hepática y respiratoria, seguido por criterios de manejo (34.4 por ciento) dado por el ingreso a UCI y por los criterios de enfermedad (13.1 por ciento) dado por el shock hipovolémico. El mayor porcentaje...
To determine the factors related to extreme maternal morbidity (MME) in patients admitted to the Intensive Care Unit Maternal (MICU) National Perinatal Maternal Institute (INMP) during the period January to December 2012. Methodology: An observational, retrospective, cross-sectional. We reviewed the medical records of a11 obstetric patients admitted to the MICU during the period January to December 2012 and met one of the inclusion criteria for MME related to the specific disease or organ failure handling. We analyzed sociodemographic and obstetric fo11owing the protocol established in the methodology for monitoring the FLASOG. Results: During the study period was analyzed medical records of 263 patients with MME, being a ratio of 16.3 per 1.000 live births, maternal mortality ratio (MM) 55.92 x 100.000 NV, MM index 3.3 per cent, relative MME/MM 29.2, relationship criteria/case 4, MME with >=3 inclusion criteria 62.7 per cent. Was associated with younger patients whose average age was 28 years, intermediate educational level, stable unions, multigravidae, intergenesic between 18-60 months, >=4 antenatal, term gestations, live products, cesarean delivery, the average stay in MICU 3.6 days and an average hospital stay of eight days, with an average of 3.4 units of blood transfused half the patients, hysterectomy was the most common surgical procedure. The main cause of MME were hypertensive disorders: PES/sd HELLP (48.6 per cent). Organ failure was the most common inclusion criterion (52.5 per cent) and of these clotting disorders, followed by liver and respiratory failure, followed by management criteria (34.4 per cent) given by the UCI and admission criteria disease (13.1 per cent) given by hypovolemic shock. The highest percentage of patients referred were from Maharashtra (45 per cent). Conclusions: The MME is presented in a significant proportion of cases in the MICU of INMP in the period 2012, the most common being hypertensive disorders...