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2.
Rev. chil. nutr ; 50(6)dic. 2023.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1550792

RESUMO

Actualmente, en Chile se ha evidenciado un aumento de la población vegetariana, sin embargo, existen escasos datos sociodemográficos, por lo cual, el objetivo del presente estudio es caracterizar, según antecedentes sociodemográficos y alimentarios a personas vegetarianas chilenas en el año 2022. Se utilizó el paradigma cuantitativo y el diseño metodológico fue no experimental, descriptivo, exploratorio de corte transversal. Se aplicó una encuesta de caracterización mediante Google Forms a 504 personas y para el análisis de la información se utilizó el programa SPSS v. 24. El 85,7% declaró ser de género femenino, la edad promedio fue 26,3 ± 5,7 años, 45,5% de los encuestados se declararon ovolactovegetarianos, seguido por vegetarianos estrictos (38,7%) y la principal motivación fue principios animalistas (68,7%). El 87,8% cursó educación superior y el 36,5% correspondió al área de salud. El principal motivo de asistencia al nutricionista fue el asesoramiento con un 80%. Se destacó que la población vegetariana consideró que es fundamental la asistencia a un profesional nutricionista para practicar este estilo de vida de forma óptima, por lo que es fundamental que los profesionales de salud se involucren en conocer a esta población, con el objetivo de otorgar una atención más cercana e integral. Finalmente, la presente investigación corresponde al primer estudio que permite caracterizar a la población vegetariana en Chile.


Currently, in Chile there has been an increase in the vegetarian population; however, there are few sociodemographic data, therefore, the objective of this study is to characterise, according to sociodemographic and dietary background, Chilean vegetarians in the year 2022. The quantitative paradigm was used and the methodological design was non-experimental, descriptive, exploratory cross-section. A characterisation survey was applied using Google Forms to 504 people and SPSS v. 24. 85.7% declared to be female, the average age was 26.3 ± 5.7 years, 45.5% of those surveyed declared themselves lacto-ovo vegetarians, followed by strict vegetarians (38.7%) and the main motivation was animalistic principles (68.7%). 87.8% attended higher education and 36.5% corresponded to the health area. The main reason for helping the nutritionist was the advice with 80%. It was highlighted that the vegetarian population considered that it is essential to assist a professional nutritionist in practising this lifestyle optimally, so it is essential that health professionals get involved in getting to know this population, with the aim of providing closer and more comprehensive care. Finally, this research corresponds to the first study that allows characterising the vegetarian population in Chile.

3.
Rev. méd. Chile ; 151(8): 1078-1087, ago. 2023. tab, ilus
Artigo em Espanhol | LILACS | ID: biblio-1565692

RESUMO

INTRODUCCIÓN: Los Servicios de Salud Públicos de la Región Metropolitana (RM) cuentan con 9 camas psiquiátricas de corta estadía por 100.000 habitantes adultos, por debajo de las recomendaciones internacionales. OBJETIVO: El presente estudio evaluará la capacidad de resolución del principal Servicio de Urgencias Psiquiátricas de la RM lo que puede ser de utilidad para evaluar el impacto de la disponibilidad de camas de corta estadía en la RM. MATERIALES Y MÉTODO: Se realizó un estudio observacional retrospectivo de todas las atenciones realizadas en el Servicio de Urgencias del Instituto Psiquiátrico "Dr. José Horwitz B." entre los años 2017 y 2020 y las indicaciones de hospitalización y su resolución. Se obtuvieron Razones de Tasas de Incidencia crudas y ajustadas para la indicación de hospitalización, las efectuadas y aquellas rechazadas por falta de vacantes. RESULTADOS: Se realizaron 90.464 atenciones a 41.541 usuarios y se indicó la hospitalización al 12,5% de ellas. La hospitalización se efectúa en el 59,5% de las atenciones y 35,9% no se pueden realizar por falta de vacantes. Al comparar las Tasas de Incidencia ajustadas se observó solamente una mayor tasa de hospitalización efectuada para los usuarios de regiones (IRR = 1,27; IC95%: 1,11-1,44; valor-p < 0,001) y durante el primer semestre de 2020 (IRR = 1,49; IC95%: 1,35-1,65; valor-p < 0,001). CONCLUSIONES: La evidente demanda por las hospitalizaciones psiquiátricas y la baja disponibilidad de camas de corta estadía en la Región Metropolitana probablemente tiene consecuencias insospechadas. Su abordaje es un desafío que requiere de una planificación multinivel entre todos los actores involucrados.


BACKGROUND: The Public Health Services at the Metropolitan Region (MR) of Chile have nine acute psychiatric beds per 100,000 inhabitants, under international recommendations. AIM: The present study will evaluate the resolution capacity of the main MR Psychiatric Emergency Room (PER), which may help assess the impact of the availability of acute beds in the MR. MATERIAL AND METHODS: A retrospective observational study of electronic patient records for all adult patients attending PER of the Psychiatric Institute "Dr. José Horwitz B." between 2017 and 2020 was analyzed. Crude and adjusted Incidence Rate Ratios were obtained for the indication of hospitalization, admissions, and those rejected due to lack of acute psychiatric beds. RESULTS: 90,464 attendances were evaluated on 41,541 patients, and hospitalization was indicated for 12.5% of them. Admissions were carried out in 59.5%, and 35.9% did not occur due to a lack of acute psychiatric beds. When comparing the adjusted Incidence Rates, only a higher hospitalization rate was observed for users from regions (IRR = 1,267; 95% CI: 1,11-1,44; p-value < 0.001) and during the first half of 2020 (IRR = 1.49; CI95%: 1.35-1.65; p-value < 0.001). CONCLUSIONS: The demand for psychiatric hospitalizations and the low availability of acute psychiatric beds in the MR probably have unsuspected consequences. The solution requires multilevel planning among all the actors involved.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Número de Leitos em Hospital/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Chile/epidemiologia , Estudos Retrospectivos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Transtornos Mentais/terapia , Transtornos Mentais/epidemiologia
4.
Acta Paediatr ; 112(11): 2346-2351, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37485863

RESUMO

AIM: The aim of the study was to determine whether overcooling (temperature <33°C) during passive hypothermia when transporting neonates with perinatal asphyxia increased the risk of short-term neurological injury. METHODS: A retrospective observational study was performed. Newborns transferred to the LaCardio neonatal unit between January 2021 and April 2022 with moderate and severe perinatal asphyxia and who received passive hypothermia during transport were included. A temperature of <33°C was considered overcooling. A composite outcome of neurological injury was defined by the presence of abnormalities on brain magnetic resonance imaging, video telemetry, seizure before discharge or both. RESULTS: The study included 101 newborns. A total of 18 neonates had a temperature <33°C after transportation. Neurological injuries were present in 21.8% of the temperature <33°C group and 78.2% of the temperature ≥33°C group. Temperature <33°C at the end of transport (aOR 9.2, 95% CI 1.1-77.3) were associated with neurological injury before discharge from the unit. CONCLUSION: During transportation, overcooling in neonates with asphyxia increases the risk of neurological injury before discharge from the neonatal unit. It is important to qualify the transport team with adequate training and equipment for therapeutic hypothermia.


Assuntos
Asfixia Neonatal , Hipotermia Induzida , Hipotermia , Hipóxia-Isquemia Encefálica , Feminino , Gravidez , Recém-Nascido , Humanos , Lactente , Hipotermia/complicações , Asfixia/complicações , Asfixia/terapia , Colômbia/epidemiologia , Hipóxia-Isquemia Encefálica/terapia , Hipóxia-Isquemia Encefálica/complicações , Hipotermia Induzida/efeitos adversos , Hospitais , Asfixia Neonatal/terapia , Asfixia Neonatal/complicações
5.
Schizophr Bull ; 49(5): 1355-1363, 2023 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-37030007

RESUMO

BACKGROUND: Psychosis is related to neurochemical changes in deep-brain nuclei, particularly suggesting dopamine dysfunctions. We used an magnetic resonance imaging-based technique called quantitative susceptibility mapping (QSM) to study these regions in psychosis. QSM quantifies magnetic susceptibility in the brain, which is associated with iron concentrations. Since iron is a cofactor in dopamine pathways and co-localizes with inhibitory neurons, differences in QSM could reflect changes in these processes. METHODS: We scanned 83 patients with first-episode psychosis and 64 healthy subjects. We reassessed 22 patients and 21 control subjects after 3 months. Mean susceptibility was measured in 6 deep-brain nuclei. Using linear mixed models, we analyzed the effect of case-control differences, region, age, gender, volume, framewise displacement (FD), treatment duration, dose, laterality, session, and psychotic symptoms on QSM. RESULTS: Patients showed a significant susceptibility reduction in the putamen and globus pallidus externa (GPe). Patients also showed a significant R2* reduction in GPe. Age, gender, FD, session, group, and region are significant predictor variables for QSM. Dose, treatment duration, and volume were not predictor variables of QSM. CONCLUSIONS: Reduction in QSM and R2* suggests a decreased iron concentration in the GPe of patients. Susceptibility reduction in putamen cannot be associated with iron changes. Since changes observed in putamen and GPe were not associated with symptoms, dose, and treatment duration, we hypothesize that susceptibility may be a trait marker rather than a state marker, but this must be verified with long-term studies.


Assuntos
Dopamina , Transtornos Psicóticos , Humanos , Encéfalo/metabolismo , Mapeamento Encefálico/métodos , Imageamento por Ressonância Magnética/métodos , Ferro/metabolismo , Transtornos Psicóticos/diagnóstico por imagem
6.
Front Endocrinol (Lausanne) ; 14: 1073833, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36742410

RESUMO

Objective: The magnitude of the mortality benefit conferred by good integral metabolic control in diabetes in not sufficiently known, especially among Latin American patients. We prospectively studied the association between sustained control of blood glucose (HbA1c<7%), systolic blood pressure (SBP) (<130 mmHg) and LDL (LDLc, <100mg/dL) and non-HDL (non-HDLc, <130 mg/dL) cholesterol, and death from any cause among all adult patients with diagnosed diabetes in Colombia. Methods: We retrospectively analyzed data from a nationwide, centralized, mandatory registry of all patients with diagnosed diabetes assisted by the Colombian health system between July 1, 2015, and June 30, 2019. We estimated the associations of sustained achievement of each goal, and of the joint triple goal (HbA1c + SBP + LDLc) with all-cause death. Associations were assessed after adjustment for sex, age, race, insurance type and BMI in multivariable logistic models. Results: We studied 1 352 846 people with diabetes. Sustained SBP (OR 0.42 [0.41-0.43]), HbA1c (OR 0.25 [0.24-0.26]) and LDLc (OR 0.28 [0.27-0.29]) control had strong negative associations with death. Moreover, among the 5.4% of participants who achieved joint, sustained metabolic control, the OR for death was 0.19 (0.18-0.21). Importantly, the impact of sustained, joint metabolic control was significantly smaller for patients of black race compared to other races (OR 0.31 [0.23-0.43] versus 0.18 [0.17-0.20], p-value for interaction <0.001), mostly at the expense of a smaller impact of LDLc control. The results were similar across body-mass index categories. Conclusions: Sustained and simultaneous metabolic control was associated with remarkably lower odds of death.


Assuntos
Diabetes Mellitus Tipo 2 , Mortalidade , Adulto , Humanos , Colesterol , Colômbia/epidemiologia , Hemoglobinas Glicadas , Estudos Retrospectivos
7.
J Endocr Soc ; 7(3): bvac193, 2023 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-36632486

RESUMO

Context: The relative importance of the control of different metabolic risk factors for the prevention of chronic kidney disease among patients with diabetes in real life conditions is insufficiently understood. Objective: We evaluated the effect of the achievement of glycated hemoglobin A1c (HbA1c), systolic blood pressure (SBP), and low-density lipoprotein cholesterol (LDLc) or non-high-density lipoprotein cholesterol (non-HDLc) goals (ABC goals) on the development of incident chronic kidney disease (iCKD) among patients with diabetes. Methods: In a nationwide registry of all individuals diagnosed with diabetes assisted by the health system in Colombia, we analyzed the association between baseline or sustained goal achievement and development of iCKD over a 4-year follow-up. iCKD was defined as a new occurrence of an estimated glomerular filtration rate less than 60 mL/min/1.73 m2, hemodialysis, peritoneal dialysis, or kidney transplant. Results: The study included 998 790 adults with diabetes (56% female, mean age 59). There were 125 626 cases of iCKD. After adjustment for multiple confounders, a baseline SBP less than 130 mm Hg (odds ratio [OR] 0.79 [0.78-0.80]) and a baseline HbA1c less than 7.0% (OR 0.86 [0.85-0.87]) were negatively associated with iCKD. Sustained achievement showed stronger negative associations with iCKD than just baseline achievement. Considering each goal separately, sustained non-HDLc less than 130 mg/dL had the strongest negative association with iCKD (OR 0.67 [0.65-0.69]). Patients who maintained the triple ABC goal over the entire follow-up had 32% (29-34) lower odds of developing CKD, 38% (34-42) if they additionally kept a normal body mass index (BMI). Sustained ABC control including a normal BMI was more strongly associated with a lower incidence of CKD in patients of Black race (OR 0.72 vs 0.89; P for interaction = .002). Conclusion: At the country level, sustained achievement of ABC goals and most especially non-HDLc were associated with substantial reductions in iCKD.

8.
Rev Med Chil ; 151(8): 1078-1087, 2023 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-39093200

RESUMO

BACKGROUND: The Public Health Services at the Metropolitan Region (MR) of Chile have nine acute psychiatric beds per 100,000 inhabitants, under international recommendations. AIM: The present study will evaluate the resolution capacity of the main MR Psychiatric Emergency Room (PER), which may help assess the impact of the availability of acute beds in the MR. MATERIAL AND METHODS: A retrospective observational study of electronic patient records for all adult patients attending PER of the Psychiatric Institute "Dr. José Horwitz B." between 2017 and 2020 was analyzed. Crude and adjusted Incidence Rate Ratios were obtained for the indication of hospitalization, admissions, and those rejected due to lack of acute psychiatric beds. RESULTS: 90,464 attendances were evaluated on 41,541 patients, and hospitalization was indicated for 12.5% of them. Admissions were carried out in 59.5%, and 35.9% did not occur due to a lack of acute psychiatric beds. When comparing the adjusted Incidence Rates, only a higher hospitalization rate was observed for users from regions (IRR = 1,267; 95% CI: 1,11-1,44; p-value < 0.001) and during the first half of 2020 (IRR = 1.49; CI95%: 1.35-1.65; p-value < 0.001). CONCLUSIONS: The demand for psychiatric hospitalizations and the low availability of acute psychiatric beds in the MR probably have unsuspected consequences. The solution requires multilevel planning among all the actors involved.


Assuntos
Número de Leitos em Hospital , Hospitalização , Humanos , Chile/epidemiologia , Estudos Retrospectivos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Hospitalização/estatística & dados numéricos , Número de Leitos em Hospital/estatística & dados numéricos , Adulto Jovem , Adolescente , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Idoso
9.
Diabetes Res Clin Pract ; 186: 109823, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35271878

RESUMO

AIMS: To assess the achievement of essential treatment goals among patients with diabetes in Colombia. METHODS: We analyzed data from a nationwide registry of all individuals with diagnosed diabetes, hypertension or CKD assisted by the health system. We explored the prevalence of treatment goals (HbA1c < 7% [<53 mmol/mol], systolic blood pressure (SBP) < 130 mmHg and LDLc < 100 mg/dL), and their variations by race and type of health insurance, between July 1, 2015, and June 30, 2019. RESULTS: We studied 1 352 846 patients with diagnosed diabetes. The prevalence of HbA1c < 7% (<53 mmol/mol) remained steady at 52%, systolic blood pressure (SBP) < 130 mmHg was also stable at 80-82%. Meanwhile, the prevalence of both LDLc < 100 mg/dL and non-HDLc < 130 mg/dL increased by 6 percentage points. Achievement of the triple HbA1c + SBP + LDLc goal was only 21.4% in 2015, increasing to 24.4% by 2019. Goal achievement was consistently lower among patients of black race, especially for HbA1c (5% lower than other races), but also for the SBP, LDLc and joint goals. Patients under third-party insurance reached better HbA1c, SBP, and LDLc control. CONCLUSIONS: Achievement of treatment goals of patients with diabetes in Colombia remains substantially low, despite improvements in LDLc control.


Assuntos
Diabetes Mellitus Tipo 2 , Objetivos , Adulto , Pressão Sanguínea/fisiologia , Colômbia/epidemiologia , Hemoglobinas Glicadas/análise , Humanos , Sistema de Registros
10.
Schizophr Res ; 235: 102-108, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34340062

RESUMO

INTRODUCTION: Little is known about predictors of clinical response to clozapine treatment in treatment-resistant psychosis. Most published cohorts are small, providing inconsistent results. We aimed to identify baseline clinical predictors of future clinical response in patients who initiate clozapine treatment, mainly focusing on the effect of age, duration of illness, baseline clinical symptoms and homelessness. METHODOLOGY: Retrospective cohort of patients with treatment-resistant schizophrenia, aged between 15 and 60 years, that initiated clozapine between 2014 and 2017. Sociodemographic characteristics, years from illness diagnosis, and clinical presentation before the initiation of clozapine were collected and analyzed. All-cause discontinuation at two years follow-up was used as the primary measure of clozapine response. RESULTS: 261 patients were included with a median age at illness diagnosis of 23 years old (IQR 19-29) and a median age at clozapine initiation of 25 (IQR: 21-33). 72.33% (183/253) continued clozapine after two years follow-up. Being homeless was associated to higher clozapine non-adherence, with an OR of 2.78 (95%CI 1.051-7.38) (p = 0.039, controlled by gender). Older age at clozapine initiation and longer delay from first schizophrenia diagnosis to clozapine initiation were also associated with higher clozapine non-adherence, with each year increasing the odds of discontinuation by 1.043 (95%CI 1.02-1.07; p = 0.001) and OR 1.092 (95%CI 1.01-1.18;p = 0.032) respectively. CONCLUSION: Starting clozapine in younger patients or shortly after schizophrenia diagnosis were associated with better adherence.


Assuntos
Antipsicóticos , Clozapina , Transtornos Psicóticos , Esquizofrenia , Adolescente , Adulto , Idoso , Antipsicóticos/uso terapêutico , Clozapina/uso terapêutico , Humanos , Pessoa de Meia-Idade , Transtornos Psicóticos/tratamento farmacológico , Transtornos Psicóticos/epidemiologia , Estudos Retrospectivos , Esquizofrenia/tratamento farmacológico , Adulto Jovem
11.
Diabetes Ther ; 12(1): 71-86, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33185853

RESUMO

Diabetes is a highly prevalent disease with complications that impact most bodily systems. However, the impact of diabetes on bone health is frequently ignored or underestimated. Both type 1 (T1D) and type 2 diabetes (T2D) are associated with a higher risk of fractures, albeit through different mechanisms. T1D is characterized by near total insulinopenia, which affects the anabolic tone of bone and results in reduced bone mineral density (BMD). Meanwhile, patients with T2D have normal or high BMD, but carry an increased risk of fractures due to alterations of bone microarchitecture and a local humoral environment that stimulates osteoclast activity. Chronic hyperglycemia induces non-enzymatic glycation of collagen in both types of diabetes. Epidemiological evidence confirms a largely increased fracture risk in T1D and T2D, but also that it can be substantially reduced by opportune monitoring of fracture risk and appropriate treatment of both diabetes itself and osteopenia or osteoporosis if they are present. In this review, we summarize the mechanistic, epidemiological, and clinical evidence that links diabetes and bone fragility, and describe the impact of available diabetes treatments on bone health.

12.
Rev. MED ; 28(2): 103-110, jul.-dic. 2020. graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1406910

RESUMO

Resumen: El embarazo ectópico se define como la Implantación del saco gestaclonal fuera del útero y representa el 3 % de todos los embarazos. La ubicación anatómica más frecuente es en la trompa uterina, en donde se presenta en un 95 %, dejando así un 5 % a otras localizaciones como el ovario, la cavidad abdominal, cervlcouterina y cicatriz uterina previa. El caso es relevante por su baja prevalencia y por los hallazgos ecográficos, las posibles opciones terapéuticas para la paciente y los hallazgos intraoperatorios. Se realizó una revisión de la literatura, utilizando bases de datos como PubMed, Medline y Science Direct, con el fin de evaluar y analizar el estado del arte de esta condición patológica. Presentamos el caso de una paciente con un embarazo de 7 semanas localizado a nivel ístmico cervical por ecografía, inicialmente tratada de manera conservadora con Metotrexato (MTX) sistémico, sin respuesta al tratamiento, por lo cual requirió intervención quirúrgica y preservación de la fertilidad. Se realiza una revisión actualizada del tema con los diferentes enfoques terapéuticos.


Abstract: Ectopic pregnancy is defined as the implantation of the gestational sac outside the uterus and it represents 3% of all pregnancies. The most frequent anatomical location is in the uterine tube, where it occurs in 95% of the cases, thus leaving 5% to other locations such as the ovary, the abdominal cavity, the cervix and a previous uterine scar. The case is relevant because of its low prevalence and because of the ultrasound findings, the possible therapeutic options for the patient, and the intraoperative findings. A literature review was carried out, using databases such as PubMed, Medline and Science Direct, in order to evaluate and analyze the state of the art of this pathological condition. Here, we present the case of a patient with a 7-week pregnancy located at the cervical isthmus level by ultrasound, initially treated conservatively with systemic Methotrexate (MTX), with no response to the treatment, and therefore she required surgical intervention and preservation of fertility. An updated review of the subject is carried out with the different therapeutic approaches.


Resumo: A gravidez ectópica é definida como a Implantação do saco gestaclonal fora do útero e representa 3 % de todas as gestações. A localização anatómica mais frequente é na trompa uterina, onde é apresentada em 95 %, deixando assim 5 % a outras localizações, como ovário, cavidade abdominal, cervicouterina e cicatriz uterina prévia. O caso é relevante por sua baixa prevalência e pelos achados ecográficos, as possíveis opções terapêuticas para a paciente e os achados intraope-ratórios. Foi realizada uma revisão da literatura com a utilização de bases de dados como PubMed, Medline e Science Direct, a fim de avaliar e analisar o estado da arte dessa condição patológica. Apresentamos o caso de uma paciente com uma gravidez de sete semanas localizada no nível Istmo cervical por ecografia, inicialmente tratada de maneira conservadora com metotrexato (MTX) sistémico, sem resposta ao tratamento, razão pela qual requiriu intervenção cirúrgica e preservação da fertilidade. Foi realizada uma revisão atualizada do tema com diferentes abordagens terapêuticas.

13.
Rev. méd. Chile ; 148(11)nov. 2020.
Artigo em Espanhol | LILACS | ID: biblio-1389238

RESUMO

Background: Cannabis use among young people in Chile has increased significantly in the last years. There is a consistent link between cannabis and psychosis. Aim: To compare cannabis use in patients with a first episode of psychosis and healthy controls. Material and Methods: We included 74 patients aged 20 ± 3 years (78% males) admitted to hospital with a first episode of psychosis and a group of 60 healthy controls aged 23 ± 4 years (63% males). Cannabis consumption was assessed, including age of first time use and length of regular use. Results: Patients with psychosis reported a non-significantly higher frequency of life-time cannabis use. Patients had longer periods of regular cannabis use compared with healthy subjects (Odds ratio [OR] 2.4; 95% confi-dence intervals [CI] 1.14-5.05). Patients also used cannabis for the first time at an earlier age (16 compared with 17 years, p < 0.0). The population attributable fraction for regular cannabis use associated with hospital admissions due to psychosis was 17.7% (95% CI 1.2-45.5%). Conclusions: Cannabis use is related to psychosis in this Chilean group of patients. This relationship is stronger in patients with early exposure to the drug and longer the regular use. One of every five admissions due to psychosis is associated with cannabis consumption. These data should influence cannabis legisla-tion and the public policies currently being discussed in Chile.


Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Transtornos Psicóticos , Cannabis , Transtornos Psicóticos/epidemiologia , Estudos de Casos e Controles , Chile/epidemiologia , Fatores de Risco
14.
Rev Med Chil ; 148(11): 1606-1613, 2020 Nov.
Artigo em Espanhol | MEDLINE | ID: mdl-33844766

RESUMO

BACKGROUND: Cannabis use among young people in Chile has increased significantly in the last years. There is a consistent link between cannabis and psychosis. AIM: To compare cannabis use in patients with a first episode of psychosis and healthy controls. MATERIAL AND METHODS: We included 74 patients aged 20 ± 3 years (78% males) admitted to hospital with a first episode of psychosis and a group of 60 healthy controls aged 23 ± 4 years (63% males). Cannabis consumption was assessed, including age of first time use and length of regular use. RESULTS: Patients with psychosis reported a non-significantly higher frequency of life-time cannabis use. Patients had longer periods of regular cannabis use compared with healthy subjects (Odds ratio [OR] 2.4; 95% confi-dence intervals [CI] 1.14-5.05). Patients also used cannabis for the first time at an earlier age (16 compared with 17 years, p < 0.0). The population attributable fraction for regular cannabis use associated with hospital admissions due to psychosis was 17.7% (95% CI 1.2-45.5%). CONCLUSIONS: Cannabis use is related to psychosis in this Chilean group of patients. This relationship is stronger in patients with early exposure to the drug and longer the regular use. One of every five admissions due to psychosis is associated with cannabis consumption. These data should influence cannabis legisla-tion and the public policies currently being discussed in Chile.


Assuntos
Cannabis , Transtornos Psicóticos , Adolescente , Adulto , Estudos de Casos e Controles , Chile/epidemiologia , Feminino , Humanos , Masculino , Transtornos Psicóticos/epidemiologia , Fatores de Risco , Adulto Jovem
15.
Vet Sci ; 6(4)2019 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-31635257

RESUMO

Molecular typing of bacterial isolates provides a powerful approach for distinguishing Mycobacterium bovis (M. bovis) genotypes. It is known that M. bovis strain virulence plays a role in prevalence and spread of the disease, suggesting that strain virulence and prevailing genotypes are associated. However, it is not well understood whether strain virulence correlates with particular genotypes. In this study, we assessed the in vitro intracellular growth of 18 M. bovis isolates in bovine macrophages as an indicator of bacterial virulence and sought a relationship with the genotype identified by spoligotyping. We found 14 different spoligotypes-11 were already known and three spoligotypes had never been reported before. We identified 2 clusters that were phylogenetically related, containing 10 and 6 strains, respectively, and 2 orphan strains. Intracellular growth and phagocytic rates of 18 M. bovis strains were heterogeneous. Our results suggest that M. bovis intracellular growth and phagocytosis are independent of the bacterial lineage identified by spoligotyping.

16.
Int. j. morphol ; 37(3): 872-876, Sept. 2019. graf
Artigo em Espanhol | LILACS | ID: biblio-1012368

RESUMO

Miguel Ángel Buonarroti (1475 - 1564) es considerando uno de los más grandes artistas de la historia. Estudió en detalle la anatomía humana a través de la disección de cadáveres, práctica hasta entonces relegada por motivos religiosos. Desde que en el año 1990 el médico Frank Lynn Meshberger publicara su interpretación del fresco "La Creación de Adán" basada en la neuroanatomía, en donde comparaba la imagen de Dios con la de una sección sagital del cerebro humano, muchos autores han encontrado diversas referencias anatómicas ocultas en la obra de Miguel Ángel. En el presente trabajo exponemos el hallazgo de una inédita lección de anatomía hepática oculta en el fresco La Embriaguez de Noé de la Capilla Sixtina.


Michelangelo Buonarroti (1475 - 1564) is considered one of the greatest artists in history. He studied in detail the human anatomy through corpses dissection, practice until then relegated for religious reasons. Since the physician Frank Lynn Meshberger published in 1990 his interpretation of the fresco "The Creation of Adam" based on neuroanatomy, where he compared the image of God with a sagittal section of the human brain, many authors have found various hidden anatomical references in the work of Michelangelo. In the present paper we expose the finding of a hidden lesson on liver anatomy in the fresco The Drunkenness of Noah of the Sistine Chapel.


Assuntos
Humanos , História do Século XVI , Anatomia/história , Cirrose Hepática Alcoólica/patologia , Medicina nas Artes/história , Intoxicação Alcoólica/patologia
17.
Psiquiatr. salud ment ; 35(3/4): 207-214, jul.-dic. 2018.
Artigo em Espanhol | LILACS | ID: biblio-1000342

RESUMO

La esquizofrenia es una prioridad sanitaria de primer orden, debido a su alta frecuencia en relación con otras enfermedades mentales. Patologías que, por sus propias características y curso evolutivo, ponen más a prueba la solidez y consistencia de las pautas de intervención que sobre ellas se realizan. Además un porcentaje alto de familias sienten estrés y dificultades que afectan de manera significativa su funcionamiento. Desde la década de los noventa se ha postulado que aplicar intervenciones integrales, farmacológicas, psicológicas y psicosociales, en una etapa precoz de la enfermedad, sería una estrategia beneficiosa para los pacientes, logrando con ello mejores resultados en cuanto a la evolución de la enfermedad a largo plazo. Entre ellas está la Psicoeducación (PE), que también tiene la función de contribuir a la no estigmatización de los trastornos psicológicos y disminuir las barreras para el tratamiento. En este trabajo presentamos un estudio en Chile de Psicoeducación con familiares de pacientes en primer episodio de esquizofrenia, aplicada por el sector 1 del Instituto Psiquiátrico Dr. José Horwitz Barak. Los contenidos de éste se basan en las Guías Clínicas GES (2016), y se enmarcan en las políticas públicas de salud promovidas por el Ministerio de Salud.


Schizophrenia should be a health priority because of its high frequency in relation to other mental illnesses. Pathologies that, due to their own characteristics and evolutionary course, put more to the test the solidity and consistency of the intervention guidelines that are carried out on them. In addition, a high percentage of families feel stress and difficulties that significantly affect their functioning. Since the nineties it has been postulated that applying comprehensive, pharmacological, psychological and psychosocial interventions, at an early stage of the disease, would be a beneficial strategy for patients, thereby achieving better results in the evolution of the disease in the long term. Among them is Psychoeducation (PE), which also has the function of contributing to the non-stigmatization of psychological disorders and reducing barriers to treatment. In this paper we present a study in Chile of sychoeducation with family members of patients in the first episode of schizophrenia, applied by sector 1 of the Dr. José Horwitz Barak Psychiatric Institute. The contents are based on the GES Clinical Guidelines (2016), and are framed in public health policies promoted by the Ministry of Health.


Assuntos
Humanos , Transtornos Psicóticos/reabilitação , Esquizofrenia/reabilitação , Saúde da Família , Educação em Saúde/métodos , Psicologia do Esquizofrênico , Família/psicologia , Chile , Cuidadores/psicologia
18.
Ter. psicol ; 30(1): 37-43, abr. 2012. tab
Artigo em Espanhol | LILACS | ID: lil-642015

RESUMO

El 27 de febrero de 2010, Chile vivió uno de los terremotos más fuertes registrados en la historia, provocando serias consecuencias en la salud mental de las personas. El objetivo del presente estudio fue dar una primera evaluación del impacto de dicho fenómeno en la salud mental de los adolescentes. Un total de 304 adolescentes fueron evaluados en depresión, ansiedad y trastorno de estrés post-traumático. Los resultados indican un aumento en la incidencia de todos los desórdenes, corroborando al género femenino como una población de riesgo al alcanzar puntajes significativamente mayores que los hombres en todas las escalas. Además, se demostró una estrecha relación de co-morbilidad entre los síntomas de los trastornos evaluados.


On february 27th of 2010, Chile experienced one of the strongest earthquakes in recorded history, causing serious consequences on people's mental health. The goal of the present study was to provide a preliminary assessment of the impact of this phenomenon in adolescent's mental health. A total of 304 adolescents were assessed on depression, anxiety and post-traumatic stress disorder. The results indicate an increase in the incidence of all the assessed disorders, confirming that females are a risk population who reached significantly higher scores than males on all scales. The study further demonstrated a close relationship of co-morbidity among the symptoms of the assessed disorders.


Assuntos
Humanos , Masculino , Adolescente , Feminino , Depressão/epidemiologia , Terremotos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Ansiedade , Chile/epidemiologia , Depressão/diagnóstico , Depressão/psicologia , Escalas de Graduação Psiquiátrica , Fatores Sexuais , Grupos de Risco , Incidência , Saúde Mental , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia
19.
Prev Vet Med ; 97(1): 37-44, 2010 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-20828845

RESUMO

The purpose of this study was to evaluate the role of Mycobacterium bovis in human cases of tuberculosis (TB) in an endemic area of the disease in cattle. Sputum, urine and other tissue samples were obtained from: (1) TB-symptomatic patients, (2) dairy farm workers and (3) abattoir workers. Samples of macroscopic lesions suspicious of TB were also obtained from cattle at slaughter in the same geographic area. A total of 562 human samples were collected: 255 from symptomatic patients, 218 from farm workers and 93 from abattoir workers. Samples were analysed by the bacillus acido-alcohol resitant (BAAR) and polymerase chain reaction (PCR) tests and cultured in Stonebrink and Löwenstein-Jensen. Spoligotyping was performed in all isolates obtained by culture and the DNA obtained by PCR. From the total number of human cases, 34 (6%) showed M. bovis spoligotype; eight spoligotypes from cattle showed an identical pattern to three spoligotypes from humans; a different set of spoligotypes from cattle (n = 8) had only one spacer difference to a set of spoligotypes from humans (n = 2). These results provide further evidence that infected cattle represent a risk to public health and support previous reports about the role of M. bovis in Mexican patients. There is no doubt that genotyping M. bovis isolates collected from cattle may have a substantial impact on our understanding of the epidemiology of TB.


Assuntos
Mycobacterium bovis/isolamento & purificação , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose Bovina/epidemiologia , Tuberculose/epidemiologia , Zoonoses , Matadouros , Animais , Bovinos , DNA Bacteriano/análise , Indústria de Laticínios , Genótipo , Humanos , México/epidemiologia , Epidemiologia Molecular , Mycobacterium bovis/genética , Mycobacterium tuberculosis/genética , Fatores de Risco , Tuberculose/microbiologia , Tuberculose/transmissão , Tuberculose Bovina/microbiologia , Tuberculose Bovina/transmissão
20.
Salud Publica Mex ; 50(4): 286-91, 2008.
Artigo em Espanhol | MEDLINE | ID: mdl-18670719

RESUMO

OBJECTIVE: The purpose of the study was to determine the role of bovine TB in cases of human TB. MATERIAL AND METHODS: Two-hundred and fifty-five samples from symptomatic patients were included in the study. All samples were cultured in Stonebrink and Lowënstein-Jensen media and analyzed using a nested PCRMPB70. The molecular analysis was performed by spoligotyping. RESULTS: From 255 samples, 74 were PCR-positive and 20 were culture-positive. From 94 samples positive to PCR or to isolation, 66 (70%) showed a spoligotype compatible with M. tuberculosis, and 13 (13.8%) with M. bovis. Four fingerprints of M. bovis from humans were identical to the fingerprints of M. bovis from cattle in the same region. CONCLUSIONS: Our study shows that M. bovis plays an important role in the epidemiology of TB in humans and that TB in cattle represents a risk to public health.


Assuntos
Tuberculose Bovina/epidemiologia , Tuberculose/epidemiologia , Animais , Bovinos , DNA Bacteriano/análise , Doenças Endêmicas , Humanos , México/epidemiologia , Epidemiologia Molecular , Mycobacterium bovis/genética , Mycobacterium bovis/isolamento & purificação , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose/microbiologia , Tuberculose Bovina/microbiologia
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