RESUMO
INTRODUCTION: Sporadic Parkinson's disease (PD) is a neurodegenerative disorder of unknown etiology. In recent years, it has been established that a genetic component underlies different forms of the disease. For instance, mitochondrial genome variants have been implicated in the pathogenesis of the PD. AIM OF THE STUDY: To determine the association of tRNA(Gln) 4336 and 8701A>G (ATP6: Thr59Ala) mitochondrial DNA polymorphisms with the presence of PD in Mexican mestizo patients. MATERIAL AND METHODS: This was a cross-sectional study in which patients were recruited from four tertiary-care level hospitals in Mexico. Genotyping was performed using real-time PCR with TaqMan genotyping assays. Genotypes were confirmed by automated sequencing. RESULTS: The 4336C allele of the tRNAGln gene was present at a low frequency, and the 8701G allele of the MT-ATP6 gene was not associated with PD. CONCLUSIONS: The 4336C variant of the tRNAGln gene was uncommon in the study population, and 8701A/G of MT-ATP6 was not associated with PD in Mexican Mestizos.
Assuntos
DNA Mitocondrial/genética , Predisposição Genética para Doença , ATPases Mitocondriais Próton-Translocadoras/genética , Doença de Parkinson/genética , Feminino , Genótipo , Humanos , Masculino , México/epidemiologia , Mitocôndrias/metabolismo , Doença de Parkinson/epidemiologia , Polimorfismo Genético/genética , RNA de Transferência de GlutaminaRESUMO
Resumen:
Introducción: las metas internacionales para la seguridad del paciente (MISP) son directrices importantes a nivel internacional para promover mejoras específicas en el proceso de atención médica segura y de alta calidad.
Objetivo: medir el nivel de cumplimiento de las MISP que lleva a cabo el personal de enfermería de un hospital de tercer nivel de atención.
Metodología: Estudio descriptivo. Se diseñó un instrumento con opción de respuestas "Sí", "No" y "No aplica"; posteriormente se hizo la prueba de Kuder Richardson 20 (Kr-20), que reportó 0.89. Se audita-ron 97 profesionales de enfermería. Una vez obtenida la calificación, se estableció una semaforización en cuatro rubros por colores según el nivel de cumplimiento: verde (82-100 %), amarillo (71-80 %), rojo (60-70 96) y negro, equivalente a < 59 %; se obtuvo el tiempo promedio de su aplicación. Resultados: el nivel de cumplimiento del instrumento fue de 72.6 %, y se asignó el color amarillo La calificación global de NA fue de 2.9 %. El tiempo promedio fue de 20 minutos con un mínimo de 13 y un máximo de 50 minutos, con una desviación estándar de 7.93.
Conclusiones: el enlace de turno es el momento idóneo para aplicar la medición. Según la semaforización, el nivel de cumplimiento en general se encuentra en color amarillo, por lo que se requiere reforzar la capacitación para la aplicación de las metas y asegurar una atención de calidad que pueda verse reflejada en la disminución de eventos adversos por los profesionales de enfermería.
Abstract:
Introduction: The international patient safety goals (IPSG) are important guidelines at the international level to promote specific improvements in the process of providing safe and high-quality patient care.
Objective: To measure the level of compliance of the IPSG that is carried out by nursing staff in a tertiary care level hospital.
Methodology: Descriptive study. We designed an instrument with three choices: "Yes", "No" and "Not applicable" (NA). Then, we applied the Kuder Richardson 20 (Kr-20), with a result of 0.89. We surveyed a total of 97 nurses. Once we obtained scores, we established a four-item color code, according to the level of compliance: green (82-100 %), yellow (71-80 %), red (60-70 %) and black, whose value was < 59 %. Then, the average implementation time was obtained. Results: The level of compliance was 72.6 % and the yellow color was assigned, according to the color scheme established. The overall rating of NA was 2.9 %. The average time was 20 minutes with a minimum of 13 and a maximum of 50 minutes, with a standard deviation of 7.93. Conclusions: This instrument is efficient to measure the way the IPSG are applied. Shift change is the ideal time to apply the measurement. According to the color code, the overall level of compliance is in yellow, so it is necessary to reinforce training in order to improve the application of these goals and provide high-quality care to patients.
Assuntos
Garantia da Qualidade dos Cuidados de Saúde , Qualidade da Assistência à Saúde , Segurança do Paciente , México , HumanosRESUMO
BACKGROUND: Since osteoporosis is a complex disease characterized by low bone mineral density (BMD), which is determined by an interaction of genetics with metabolic and environmental factors, the aim of this study was to analyze the possible association among one polymorphism of VDR and two polymorphisms of ESR1; as well as their haplotypes with BMD in postmenopausal Mexican-mestizo women. METHODS: We studied 742 postmenopausal Mexican-mestizo women. A structured questionnaire for risk factors was applied and BMD was measured in the lumbar spine and total hip by dual-energy X-ray absorptiometry. DNA was obtained from blood leukocytes. One polymorphism of VDR (rs11568820) and two of ESR1 (rs2234693 and rs9340799) were studied. Real-time PCR allelic discrimination was used for genotyping. The differences between the means of the BMDs according to genotype were analyzed with covariance. Hardy-Weinberg equilibrium was tested. Pairwise linkage disequilibrium between single nucleotide polymorphisms was calculated by direct correlation r(2); haplotype analysis was conducted. RESULTS: Rs9340799 of ESR1 and one haplotype formed by the two polymorphisms of the ESR1 were significantly associated with FN-BMD variations. Moreover, analysis of the genotype of rs11568820 of VDR and the rs2234693 of ESR1 showed no significant differences with BMD variations. CONCLUSIONS: Our results showed that rs9340799 and one haplotype of ESR1 were significantly associated with BMD only at the femoral neck and this association remained after adjusting for covariates.
Assuntos
Densidade Óssea/genética , Receptor alfa de Estrogênio/genética , Polimorfismo de Nucleotídeo Único , Receptores de Calcitriol/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Colo do Fêmur/fisiopatologia , Frequência do Gene , Genética Populacional , Haplótipos , Humanos , México , Pessoa de Meia-Idade , Pós-Menopausa/genéticaRESUMO
Resumen:
Introducción: a la fecha, los estándares de cuidado que se relacionan con las metas internacionales de seguridad del paciente (MISP) se han auditado de forma independiente, lo cual alarga el tiempo que se emplea para su verificación. Por lo tanto, es necesario contar con un instrumento que facilite su implementación y medición. Para esto, es importante considerar la percepción del personal de enfermería como un primer momento que dé origen a la creación de un indicador de calidad para conocer si es factible agrupar las MISP.
Objetivo: identificar la percepción del personal de enfermería en torno a la agrupación de las MISP como indicador de calidad.
Metodología: se realizó un estudio descriptivo transversal en 100 enfermeras de un hospital general del Distrito Federal, México, con una muestra por conglomerados distribuidos homogéneamente en servicios clínicos. Se aplicó un instrumento que agrupa las MISP. La prueba piloto mostró una confiabilidad de 0.88 de alfa de Cronbach.
Resultados: la calificación obtenida del instrumento sobre la percepción de la agrupación de las MISP es 96 % buena, 3 % regular y 1 % mala. No hay asociación con la edad del personal de enfermería y la agrupación; tampoco existe correlación entre la percepción y las variables de antigüedad del personal, el nivel de estudios y la categoría.
Conclusiones: la percepción del personal de enfermería sobre la agrupación de las MISP es buena (96 %). El 100 % de los participantes consideran que un indicador basado en la agrupación de las MISP sería útil. No influyeron variables intervinientes sobre la percepción.
Abstract:
Introduction: To date, the standards of care related to the international patient safety goals (MISP, according to their initials in Spanish) have been independently audited, which lengthens the time needed for their verification. Therefore, is needed a tool to facilitate their implementation and measurement. To evaluate if a quality indicator for grouping the MISP is feasible, the perception of nursing must be considered from the outset.
Objective: To measure the perception of nurses regarding grouping of the MISP as a quality indicator. Method: Descriptive, cross-sectional study of 100 nurses in a general hospital in Mexico City, Mexico. Cluster samples were evenly distributed by clinical service. An instrument that grouped the MISP was used. The pilot test showed a Cronbachs alpha reliability of 0.88.
Results: Perception of the MISP grouping was rated 96 % good, 3 % regular, 1 % poor. No association was found regarding age clinical service cluster, and there was no correlation between perception and staff seniority variables, educational level or category.
Conclusions: Nurses perception of the MISP grouping is good (96 %); 100 % of the participants thought that an indicator based on the MISP grouping would be helpful. No intervening variables influenced perception.
Assuntos
Atenção à Saúde , Cuidados de Enfermagem , Indicadores de Qualidade em Assistência à Saúde , Segurança do Paciente , México , HumanosRESUMO
Osteoporosis is characterized by low bone mineral density (BMD). One of the most important factors that influence BMD is the genetic contribution. The collagen type 1 alpha 1 (COL1A1) and the JAGGED (JAG1) have been investigated in relation to BMD. The aim of this study was to investigate the possible association between two single-nucleotide polymorphisms (SNPs) of COL1A1, their haplotypes, and one SNP of JAG1 with BMD in postmenopausal Mexican-Mestizo women. Seven hundred and fifty unrelated postmenopausal women were included. Risk factors were recorded and BMD was measured in lumbar spine, total hip, and femoral neck by dual-energy X-ray absorptiometry. DNA was obtained from blood leukocytes. Two SNPs in COL1A1 (rs1800012 and rs1107946) and one in JAG1 (rs2273061) were studied. Real-time PCR allelic discrimination was used for genotyping. The differences between the means of the BMDs according to genotype were analyzed with covariance. Deviations from Hardy-Weinberg equilibrium were tested. Pairwise linkage disequilibrium between single nucleotide polymorphisms was calculated by direct correlation r (2), and haplotype analysis of COL1A1 was conducted. Under a dominant model, the rs1800012 polymorphism of the COL1A1 showed an association with BMD of the lumbar spine (P = 0.021). In addition, analysis of the haplotype of COL1A1 showed that the G-G haplotype presented a higher BMD in lumbar spine. We did not find an association between the s1107946 and rs2273061 polymorphisms of the COL1A1 and JAG1, respectively. Our results suggest that the rs1800012 polymorphism of the COL1A1, in addition to one haplotype, were significantly associated with BMD variation in Mexican-Mestizo postmenopausal women.
Assuntos
Densidade Óssea/genética , Proteínas de Ligação ao Cálcio/genética , Colágeno Tipo I/genética , Peptídeos e Proteínas de Sinalização Intercelular/genética , Proteínas de Membrana/genética , Osteoporose/genética , Polimorfismo de Nucleotídeo Único , Absorciometria de Fóton , Análise de Variância , Distribuição de Qui-Quadrado , Cadeia alfa 1 do Colágeno Tipo I , Feminino , Genótipo , Haplótipos , Humanos , Proteína Jagged-1 , México , Pessoa de Meia-Idade , Osteoporose/etnologia , Pós-Menopausa , Fatores de Risco , Proteínas Serrate-Jagged , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: Osteoporosis is a complex health disease characterized by low bone mineral density (BMD), which is determined by an interaction of genetics with metabolic and environmental factors. The tumor necrosis factor receptor superfamily, member 11b (TNFRSF11B) gene, has been investigated in relation to BMD. Three polymorphisms in/nearby TNFRSF11B have been associated with BMD variations in some populations. The aim of this study was to investigate the possible association among three SNPs of TNFRSF11B and their haplotypes with the presence of BMD variations in postmenopausal Mexican Mestizo women. SUBJECTS AND METHODS: One thousand unrelated postmenopausal women of Mexican-Mestizo ethnic origin, who attended the outpatient clinic for routine, general medical evaluation, were invited and 750 women accepted to participate in the study. A structured questionnaire for risk factors was applied and BMD was measured in total hip and lumbar spine by dual-energy X-ray absorptiometry. DNA was obtained from blood leukocytes. Three single-nucleotide polymorphisms in TNFRSF11B gene were studied: rs4355801, rs2073618, and rs6993813. Real-time PCR allelic discrimination was used for genotyping. Deviations from Hardy-Weinberg equilibrium were tested. Pairwise linkage disequilibrium between single nucleotide polymorphisms was calculated by direct correlation r(2), and haplotype analysis was conducted. RESULTS: Of the subjects, 31% had osteoporosis, 45.1% had osteopenia, and 23.9% had normal BMD. Genotype and allele distributions showed no significant differences; however, A-G-T haplotype was associated with variations in femoral neck BMD (P=0.022). CONCLUSIONS: In our study population, analysis of the haplotypes of TNFRSF11B is a better genetic marker for variations in BMD.
Assuntos
Densidade Óssea/genética , Doenças Ósseas Metabólicas/genética , Fêmur/metabolismo , Haplótipos , Osteoporose Pós-Menopausa/genética , Osteoprotegerina/genética , Polimorfismo de Nucleotídeo Único , Absorciometria de Fóton , Idoso , Alelos , Doenças Ósseas Metabólicas/epidemiologia , Feminino , Marcadores Genéticos , Humanos , Leucócitos , Desequilíbrio de Ligação , México/epidemiologia , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/epidemiologia , Pós-Menopausa , Prevalência , Valores de Referência , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: Considering that the Mexican mestizo population seems to be the result of a genetic admixture, we proposed that further research is needed to evaluate the role of ethnicity in conjunction with health-related factors to better understand ethnic differences in bone mineral density (BMD). The aim of this study was to analyze several risk factors related to the development of osteoporosis in postmenopausal Mexican mestizo women. METHODS: We included 567 postmenopausal Mexican mestizo women. A structured questionnaire for risk factors was applied and BMD was measured in total hip and lumbar spine by dual-energy x-ray absorptiometry. Nonconditional logistic regression was used to estimate crude and adjusted odds ratio. RESULTS: Using World Health Organization criteria, 28.7% of postmenopausal women had osteoporosis, 46.4% had osteopenia, and 24.9% had normal BMD. Each clinical risk factor had a different significance for osteopenia/osteoporosis; however, duration of total breast-feeding, body mass index, and number of years since menopause remained significantly associated with osteopenia/osteoporosis after bone density was added to the nonconditional model. Interestingly, extended periods of accumulated breast-feeding for 24 and 36 months were, in both cases, significantly associated with osteopenia/osteoporosis. CONCLUSIONS: Our results confirm the importance of considering the duration of breast-feeding as an important risk factor for osteopenia/osteoporosis. In addition, we find that body mass index is positively associated with BMD. Because of the heterogeneity of the Mexican mestizo population, the risk factor for osteoporosis may not be the same in different ethnic groups.
Assuntos
Densidade Óssea , Osteoporose Pós-Menopausa/etnologia , Pós-Menopausa , Absorciometria de Fóton , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Doenças Ósseas Metabólicas/epidemiologia , Doenças Ósseas Metabólicas/etnologia , Aleitamento Materno , Feminino , Número de Gestações , Humanos , Modelos Logísticos , México/epidemiologia , Pessoa de Meia-Idade , Razão de Chances , Osteoporose Pós-Menopausa/epidemiologia , Gravidez , Fatores de Risco , Inquéritos e Questionários , Fatores de TempoRESUMO
El glaucoma congénito primario es una enfermedad de tratamiento esencialmente quirúrgico. La trabeculectomía con mitomicina-C ha sido utilizada tanto como primera elección o como segunda cirugía cuando ha fallado algún otro procedimiento quirúrgico. En esta revisión se analizaron de manera retrospectiva los casos presentados en nuestro hospital en los últimos 10 años y se compararon con los casos en donde se realizó trabeculectomía simple o esclerectomía, valorando la agudeza visual, la presión intraocular, el diámetro corneal y la excavación papilar tanto pre como postquirúrgica, así como la formación de la vesícula filtrante. Se encontró mayor éxito en la trabeculectomía con mitomicina-C comparada con las otras 2 técnicas, además de que las complicaciones no fueron mucho mayores a lo reportado en la literatura. Concluimos que la técnica de trabeculectomía con mitomicina-C puede ser segura pero sugerimos un estudio prospectivo para poder tener suficiente poder estadístico, mejorar la calidad de las mediciones y controlar las variables adecuadamente.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Adolescente , Trabeculectomia , Esclerostomia , Glaucoma/congênito , Mitomicina/uso terapêutico , Cirurgia Filtrante/métodos , Procedimentos Cirúrgicos Oftalmológicos/métodosRESUMO
Se describe una información encaminada a evaluar el flujo informativo en la especialidad de Oncología, que incluye el análisis de la distribución de la producción de artículos por continentes y países, las direcciones generales del desarrollo de la Oncología, los idiomas más utilizados en las publicaciones y los títulos de revistas más productivos en esta rama. Se utilizó como fuente primaria de información los resúmenes de los 32 números de la revista referativa Excerpta Médica, Sección 16 Cáncer de 1984. En total fueron revisados 10 764 resúmenes de articulos, publicados originalmente en 803 revistas periódicas y seriadas en 11 lenguas provenientes de 28 paises. Los resultados de la investigación, que son comparados con una similar realizada en 1976, permiten afirmar que ha habido una fuerte concentración de producción de artículos a favor de los Estados Unidos y en detrimento de los demás países, incluidos los europeos, las líneas fundamentales de desarrollo de la Oncología no han variado sustancialmente, se manifiesta una fuerte tendencia en el procesamiento de información en idioma inglés y que un núcleo de 7 prestigiosas revistas, continúan estando entre las primeras productoras de artículos de la especialidad, y se observa una tendencia renovadora entre los demás títulos de mayor producción
Assuntos
Informática Médica , Oncologia , Sistemas de InformaçãoRESUMO
Se describe una información encaminada a evaluar el flujo informativo en la especialidad de Oncología, que incluye el análisis de la distribución de la producción de artículos por continentes y países, las direcciones generales del desarrollo de la Oncología, los idiomas más utilizados en las publicaciones y los títulos de revistas más productivos en esta rama. Se utilizó como fuente primaria de información los resúmenes de los 32 números de la revista referativa Excerpta Médica, Sección 16 Cáncer de 1984. En total fueron revisados 10 764 resúmenes de articulos, publicados originalmente en 803 revistas periódicas y seriadas en 11 lenguas provenientes de 28 paises. Los resultados de la investigación, que son comparados con una similar realizada en 1976, permiten afirmar que ha habido una fuerte concentración de producción de artículos a favor de los Estados Unidos y en detrimento de los demás países, incluidos los europeos, las líneas fundamentales de desarrollo de la Oncología no han variado sustancialmente, se manifiesta una fuerte tendencia en el procesamiento de información en idioma inglés y que un núcleo de 7 prestigiosas revistas, continúan estando entre las primeras productoras de artículos de la especialidad, y se observa una tendencia renovadora entre los demás títulos de mayor producción