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Introduction: Death is a natural phenomenon inherent to the human condition and an inevitable consequence of life. As future professionals, nursing students should face the process of death and recognize their limitations, because emotional aspects can influence the quality of health care, especially in Spanish-speaking countries. This study aimed to quantify the level of fear of death among nursing students in a higher education institution in a region of Colombia. Methods: A quantitative correlational study including 258 university students selected by stratified sampling were administered the Collet-Lester Fear of Death Scale; the results were analyzed for the age, religion, marital status, number of children, and academic level of the respondents. Results: On average, the students were 22.9 years old; 83.3% of them were female, 75.6% were Catholic, 14.1% had at least one child, and 66.7% had experienced bereavement in the family. An association was found between the female gender and the fear of one's own death (p = .025). Conclusion: These findings differ from those reported in other Latin American countries where higher academic level and clinical experience are related to lower fear of death.

RESUMO

Resumen Objetivo: Determinar la prevalencia de la osteoporosis en mujeres costarricenses posmenopáusicas, atendidas en el Hospital San Juan de Dios de la Caja Costarricense del Seguro Social, y relacionar con características clínicas y de estilo de vida. Métodos. Estudio transversal. Se analizó un total de 923 estudios de densitometría ósea de mujeres con edad entre los 45 y 80 años, en etapa posmenopáusica; se registró un valor de T-score obtenido por densitometría ósea para columna lumbar y cadera; se documentó las variables como la edad, el índice de masa corporal, tabaquismo y otros reconocidos factores de riesgo; se estimó la prevalencia y se analizó la relación con los factores. Resultados. A partir de 923 estudios y los factores de riesgo comúnmente asociados con la enfermedad, fueron estadísticamente significativos los siguientes: la edad (p<0,001), la edad en la menarquia (p = 0,001), la cantidad de años transcurridos desde la menopausia (p<0,001) y el antecedente familiar de fractura de cadera (p = 0,01). Otros factores no resultaron significativos. Conclusiones. Para la población estudiada, se demostró una prevalencia de 47% para osteopenia y de 39% para osteoporosis en mujeres posmenopáusicas. No se logró establecer una relación en las variables de estilo de vida, tales como tabaquismo, alcoholismo, actividad física y consumo de lácteos. Se deben realizar otras investigaciones con un mayor control sobre estas variables para conocer su riesgo relacionado con la enfermedad.

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Abstract Aim: To determine the prevalence of osteoporosis in postmenopausal Costa Rican women treated at the San Juan de Dios Hospital of the Costa Rican Social Security Fund, and relate it to clinical and lifestyle characteristics. Methods. Transversal study. A total of 923 bone densitometry studies of postmenopausal women aged between 45 and 80 years were analyzed; A T-score value obtained by bone densitometry was recorded for the lumbar spine and hip; variables such as age, bodymass index, smoking, and other recognized risk factors were documented; the prevalence was estimated and the relationship with the factors was analyzed. Results. From 923 studies and risk factors commonly associated with the disease, the following were statistically significant: age (p<0.001), age at menarche (p = 0.001), number of years since menopause (p<0.001) and family history of hip fracture (p = 0.01). Other factors were not significant. Conclusions. For the population studied, a prevalence of 47% for osteopenia and 39% for osteoporosis in postmenopausal women was demonstrated. It was not possible to establish a relationship in lifestyle variables, such as smoking, alcoholism, physical activity and dairy consumption. Other investigations with greater control over these variables should be carried out to know their risk related to the disease.

Assuntos

Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Doenças Ósseas Metabólicas/diagnóstico , Osteoporose Pós-Menopausa/diagnóstico , Osteoporose/diagnóstico , Costa Rica

RESUMO

BACKGROUND: Acute gastroenteritis (AGE) is a major cause of morbidity and mortality in children aged less than 5 years in low- and middle-income countries where limited access to potable water, poor sanitation, deficient hygiene, and food product contamination are prevalent. Research on the changing etiology of AGE and associated risk factors in Latin America, including Colombia, is essential to understand the epidemiology of these infections. The primary objectives of this study were to describe etiology of moderate to severe AGE in children less than 5 years of age from Bucaramanga, Colombia, a middle-income country in Latin American, and to identify the presence of emerging E. coli pathotypes. METHODOLOGY/PRINCIPAL FINDINGS: This was a prospective, matched for age, case-control study to assess the etiology of moderate to severe AGE in children less than 5 years of age in Bucaramanga, Colombia, South America. We tested for 24 pathogens using locally available diagnostic testing, including stool culture, polymerase chain reaction, microscopy and enzyme-linked immunoassay. Adjusted attributable fractions were calculated to assess the association between AGE and each pathogen in this study population. The study included 861 participants, 431 cases and 430 controls. Enteric pathogens were detected in 71% of cases and in 54% of controls (p = <0.001). Co-infection was identified in 28% of cases and in 14% of controls (p = <0.001). The adjusted attributable fraction showed that Norovirus GII explained 14% (95% CI: 10-18%) of AGE, followed by rotavirus 9.3% (6.4-12%), adenovirus 3% (1-4%), astrovirus 2.9% (0.6-5%), enterotoxigenic Escherichia coli (ETEC) 2.4% (0.4-4%), Cryptosporidium sp. 2% (0.5-4%), Campylobacter sp. 2% (0.2-4%), and Salmonella sp.1.9% (0.3 to 3.5%). Except for Cryptosporidium, all parasite infections were not associated with AGE. Three emergent diarrheagenic E. coli pathotypes were identified in cases (0.7%), including an enteroaggregative/enterotoxigenic E.coli (EAEC/ETEC), an enteroaggregative/enteropathogenic E.coli (EAEC/EPEC), and an emergent enteroinvasive E. coli with a rare O96:H19. No deaths were reported among cases or controls. CONCLUSIONS/SIGNIFICANCE: Norovirus and rotavirus explained the major proportion of moderate to severe AGE in this study. Higher proportion of infection in cases, in the form of single infections or co-infections, showed association with AGE. Three novel E. coli pathotypes were identified among cases in this geographic region.

Assuntos

Gastroenterite/epidemiologia , Gastroenterite/etiologia , Gastroenterite/microbiologia , Gastroenterite/virologia , Adenoviridae , Infecções por Adenoviridae/complicações , Infecções por Adenoviridae/epidemiologia , Infecções por Astroviridae/complicações , Infecções por Astroviridae/epidemiologia , Infecções por Caliciviridae/complicações , Infecções por Caliciviridae/epidemiologia , Campylobacter , Infecções por Campylobacter/complicações , Infecções por Campylobacter/epidemiologia , Estudos de Casos e Controles , Pré-Escolar , Coinfecção/microbiologia , Coinfecção/virologia , Colômbia/epidemiologia , Criptosporidiose/complicações , Criptosporidiose/epidemiologia , Cryptosporidium , Diarreia/epidemiologia , Diarreia/etiologia , Diarreia/microbiologia , Diarreia/virologia , Escherichia coli Enterotoxigênica , Infecções por Escherichia coli/complicações , Infecções por Escherichia coli/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Norovirus , Reação em Cadeia da Polimerase , Rotavirus , Infecções por Rotavirus/complicações , Infecções por Rotavirus/epidemiologia , Salmonella , Infecções por Salmonella/complicações , Infecções por Salmonella/epidemiologia

RESUMO

Resumen Este artículo describe los biomarcadores saturados (n־alcanos, hopanos y esteranos) identificados en los extractos obtenidos de un carbón bituminoso, tratado con ácido y un solvente no convencional. Los extractos de carbones bituminosos venezolanos se obtuvieron a través de cloroformo (solvente convencional) y N,N־dimetilformamida ־DMF־ como solvente de alto poder extractivo, con y sin tratamiento ácido previo, con el fin de evaluar el rendimiento y distribución de biomarcadores característicos. El rendimiento de extracción con DMF alcanzó 44% p/p, mientras que con CHCl3, este valor no superó el 2% p/p. La desmineralización previa con HCl incrementó el rendimiento de extracción sin afectar la distribución de los biomarcadores, salvo en la relación de hidrocarburos ligeros respecto a los pesados. Se propone DMF como solvente de elección para obtener información geoquímica en carbones meteorizados.

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Abstract This article describes saturated biomarkers (n־alkanes, hopanes and steranes) identified in the extracts obtained from a bituminous coal treated with acid and an unconventional solvent. Extracts of Venezuelan bituminous coals were obtained through chloroform (conventional solvent) and N,N־ dimethylformamide ־DMF־ as high extractive solvent, with and without previous acid treatment, to evaluate the performance and distribution of characteristic biomarkers. The extraction yield with DMF reached 44% w/w, while with CHCl3, this value did not exceed 2% w/w. Previous demineralization with HCl increased the extraction yield without affecting the distribution of the biomarkers, except in the ratio of light hydrocarbons to the heavy ones. DMF, therefore, is proposed as the solvent of choice to obtain geochemical information on weathered carbons.

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Resumo Este artigo de pesquisa descreve os biomarcadores saturados identificados (n־alcanos, hopanos y esteranos) em extratos obtidos a partir de carvão betuminoso, tratado com ácido e um solvente não convencional. Extratos de carvão betuminoso venezuelano foram obtidos utilizando־se clorofórmio (solvente convencional) e N,N־ dimetilformamida ־DMF־ como solvente extrativo elevado, com e sem tratamento ácido prévio, com o objectivo de avaliar o rendimento e distribuição de biomarcadores característicos. O rendimento de extração com DMF atingiu 44% p/p; com CHCl3 o valor não excedeu 2% p/p. A desmineralização prévia com HCl aumentou o rendimento da extração sem afetar a distribuição dos biomarcadores, exceto na proporção de hidrocarbonetos leves e pesados. DMF é proposto como o solvente de eleição para obter informações geoquímicas sobre os carvões intemperizados.

RESUMO

BACKGROUND: Recent evidence suggests that increasing dietary intake of minerals reduces the risk of dementia. This study aimed to examine the relationship between potassium and diagnosis of mild cognitive impairment (MCI) in a sample of older Mexican-Americans from rural and urban populations. METHODS: The sample was formed of a total of 139 participants with MCI and 371 normal controls from two independent cohorts: a rural cohort (Facing Rural Obstacles to Healthcare Now through Intervention, Education and Research [Project FRONTIER]) and an urban cohort (the Health and Aging Brain among Latino Elders [HABLE] study). Serum electrolytes examined were sodium and potassium. Age and education were entered in the model as covariates. RESULTS: Across both cohorts, the Project FRONTIER (OR = 3.1; p = 0.01) and the HABLE Project (OR = 2.0; p = 0.04), the results indicated that serum potassium levels significantly increased the risk of diagnosis of MCI. CONCLUSION: Our finding suggested a link between serum potassium levels and a diagnosis of MCI in Mexican-Americans. The results of this study support a previous research which has suggested that the risk factors for MCI may vary by ethnicity.

RESUMO

This study aimed to provide normative references for Mexican Americans on neuropsychological measures of cognitive functioning. Data were analyzed from a total of 797 Mexican-Americans recruited across three Texas-based studies with approximately one-half of the participants tested in Spanish. Normative tables include: MMSE, AMNART, WMS-III (Logical Memory I, II; Visual Reproduction I, II; Digit Span), CERAD, RAVLT, Exit25, CLOX 1 & 2, Trail Making Test- A&B, BNT, COWA, and Animal Naming. The norms were stratified by education then age. Normative references were generated for Texas-based Mexican Americans and data may be limited to the population sampled.

Assuntos

Testes Neuropsicológicos , Idoso , Feminino , Humanos , Idioma , Masculino , Americanos Mexicanos , Pessoa de Meia-Idade , Texas

RESUMO

The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) is an assessment of neuropsychological functioning commonly used in clinical and research settings. To our knowledge, normative data for the RBANS is not available for Hispanic, Mexican Americans, which the current study sought to establish. Data from 136 Hispanic, Mexican Americans from Project FRONTIER were analyzed. Approximately half of the sample was administered testing in Spanish. Normative tables were created for English and Spanish speaking Mexican Americans. Generated RBANS normative references are provided for unadjusted raw scores as well as output adjusted by education level.

Assuntos

Testes Neuropsicológicos , Adulto , Idoso , Feminino , Humanos , Idioma , Masculino , Americanos Mexicanos , Pessoa de Meia-Idade , Texas

RESUMO

Objetivo: calcular la escala de severidad de trauma RTS Revised Trauma Score y realizar un análisis comparativo con la clasificación de los pacientes según el sistema de Triage. Describir los indicadores de oportunidad en la atención y el gasto hospitalario.El Estado, establece el sistema de priorización de pacientes que consultan al servicio de urgencias y define tiempos de espera según la clasificación. Se aplica con el fin de optimizar los recursos institucionales. Materiales y métodos: estudio observacional descriptivo retrospectivo. La población estuvo conformada por 6401 pacientes, la muestra por 248 pacientes. Resultados: 81% Triage II (Paciente Agudo). Según la escala de trauma RTS, el 92.7% correspondían a Trauma leve y 1.6% trauma grave.El 40% de los lesionados fueron poli-traumatizados, 56% presentaron lesión en pelvis y extremidades inferiores. La mortalidad fue del 2.4%. El 48.4% de los lesionados accedió a urgencias en ambulancia, el tiempo promedio para el acceso fue de 60 minutos, 39.1% de las víctimas, 61% requirió interconsulta por Ortopedia y 26% de los pacientes requirieron recursos del Sistema de Seguridad Social. Conclusiones: la escala de trauma RTS score utiliza parámetros fisiológicos medibles, clasificó el 1.6% de los lesionados como graves, lo cual se relaciona con el 2.4% de mortalidad de las víctimas del estudio. La medición de los indicadores de accesibilidad y oportunidad en la atención en salud, mostró en esta institución de salud de alta complejidad que los tiempos son acordes a la normatividad vigente del Ministerio de Salud..(AU)

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Objective: calculate the trauma severity scale RTS Revised Trauma Score and perform a comparative analysis with the classification of patients according to the Triage system. Describe the indicators of opportunity in hospital care and expenditure. The State establishes the system of prioritization of patients who consult the emergency service and defines waiting times according to the classification. It is applied in order to optimize institutional resources. Materials and methods: retrospective descriptive observational study. The population consisted of 6401 patients, the sample by 248 patients. Results: 81% Triage II (Acute Patient). According to the RTS trauma scale, 92.7% corresponded to mild trauma and 1.6% serious trauma. 40% of the injured were poly-traumatized, 56% had pelvic and lower extremity injuries. Mortality was 2.4%. 48.4% of the injured accessed the emergency room by ambulance, the average time for access was 60 minutes, 39.1% of the victims, 61% required interconsultation by Orthopedics and 26% of the patients required resources from the Social Security System. Conclusions: the RTS score trauma scale uses measurable physiological parameters, classified 1.6% of the injured as serious, which is related to the 2.4% mortality of the victims of the study. The measurement of accessibility and opportunity indicators in health care showed in this highly complex health institution that the times are in accordance with the current regulations of the Ministry of Health.

Assuntos

Humanos , População

RESUMO

BACKGROUND: This study explored the combined impact of depression and inflammation on memory functioning among Mexican-American adults and elders. METHODS: Data were analyzed from 381 participants of the Health and Aging Brain study among Latino Elders (HABLE). Fasting serum samples were collected and assayed in duplicate using electrochemiluminesce on the SECTOR Imager 2400A from Meso Scale Discovery. Positive DepE (depression endophenotype) was codified as any score >1 on a five-point scale based on the GDS-30. Inflammation was determined by TNFα levels and categorized by tertiles (1st, 2nd, 3rd). WMS-III LMI and LMII as well as CERAD were utilized as measures of memory. ANOVAs examined group differences between positive DepE and inflammation tertiles with neuropsychological scale scores as outcome variables. Logistic regressions were used to examine level of inflammation and DepE positive status on the risk for MCI. RESULTS: Positive DepE as well as higher inflammation were both independently found to be associated with lower memory scores. Among DepE positive, those who were high in inflammation (3rd tertile) were found to perform significantly worse on WMS-III LM I (F = 4.75, p = 0.003), WMS-III LM II (F = 8.18, p < 0.001), and CERAD List Learning (F = 17.37, p < 0.001) when compared to those low on inflammation (1st tertile). The combination of DepE positive and highest tertile of inflammation was associated with increased risk for MCI diagnosis (OR = 6.06; 95% CI = 3.9-11.2, p < 0.001). CONCLUSION: Presence of elevated inflammation and positive DepE scores increased risk for worse memory among Mexican-American older adults. Additionally, the combination of DepE and high inflammation was associated with increased risk for MCI diagnosis. This work suggests that depression and inflammation are independently associated with worse memory among Mexican-American adults and elders; however, the combination of both increases risk for poorer memory beyond either alone.

Assuntos

Disfunção Cognitiva/etnologia , Depressão/etnologia , Inflamação/etnologia , Transtornos da Memória/etnologia , Americanos Mexicanos , Idoso , Disfunção Cognitiva/complicações , Estudos de Coortes , Depressão/complicações , Feminino , Humanos , Inflamação/complicações , Modelos Logísticos , Masculino , Transtornos da Memória/complicações , Pessoa de Meia-Idade , Testes Neuropsicológicos , Fatores de Risco , Estados Unidos/epidemiologia

RESUMO

BACKGROUND: Late life depression is a prodromal feature and a risk factor for Alzheimer's disease (AD) and mild cognitive impairment (MCI). We identified five items in the Geriatric Depression scale (DepE) that are important as a risk for MCI and AD: memory problems, feeling blue, crying, feeling worthless, and trouble concentrating. OBJECTIVE: Our goal was to examine the relationship between DepE and cognition in a cohort of Mexican Americans. METHODS: Data from 317 Mexican Americans from the HABLE study were analyzed. DepE scores were dichotomized into two groups: endorsement of 1 item or less, and endorsement of 2 or more items. Cognition was assessed via neuropsychological tests, and diagnosis was based on consensus review. We utilized linear regression to examine the association between DepE and cognitive performance, and logistic regression to examine the utility of DepE in predicting MCI. To examine the impact of DepE on memory over 12 months, we performed ANOVA analysis. RESULTS: Elevated DepE scores were associated with poorer performance on various measures of memory and cognition, but not executive or visual spatial skills. Over 12 months, we found a decline in immediate memory among women but not men. Those with high scores were 4 times more likely to have MCI. ANOVA of total scores revealed differences between groups on immediate memory (p < 0.05) in women, with no significant differences on delay recall in either gender. CONCLUSION: DepE can be utilized in Mexican Americans to identify those at risk of memory related cognitive decline.

Assuntos

Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/etnologia , Depressão/diagnóstico , Depressão/etnologia , Americanos Mexicanos/psicologia , Idoso , Idoso de 80 Anos ou mais , Cognição , Envelhecimento Cognitivo , Endofenótipos , Função Executiva , Feminino , Humanos , Estudos Longitudinais , Masculino , Memória , Pessoa de Meia-Idade , Testes Neuropsicológicos , Escalas de Graduação Psiquiátrica , Fatores Sexuais , Percepção Espacial , Percepção Visual

RESUMO

BACKGROUND: The links between diabetes, depression, and Alzheimer's disease (AD) has been established, but they are still poorly understood. However, little research has examined the effect that comorbidity of depression and diabetes has on cognitive impairment in an ethnically diverse sample. OBJECTIVE: The purpose of this study was to investigate the relationship between comorbid diabetes and depression on cognitive dysfunction; and examine the relationship in an ethnically diverse population. METHODS AND RESULTS: Analyses of data from 2,436 participants (914 men and 1,522 women) of three separate cohorts: HABLE, FRONTIER, and TARCC. In the HABLE cohort, comorbidity (odds ratio [OR] = 3.008; 95% CI = 1.358-6.667), age (OR = 1.138; 95% CI = 1.093-1.185), and education (OR = 0.915; 95% CI = 0.852-0.982) increased the risk of mild cognitive impairment (MCI) diagnosis among elderly Mexican American. In the TARCC cohort, results showed an increase risk of MCI in both non-Hispanic whites (OR = 18.795; 95% CI = 2.229-158.485) and Mexican Americans (OR = 8.417; 95% CI = 2.967-23.878). Finally, results in the FRONTIER cohort showed that in elderly Mexican Americans, comorbidity (OR = 2.754; 95% CI = 1.084-6.995) and age (OR = 1.069; 95% CI = 1.023-1.118) significantly increased risk of MCI. In non-Hispanic whites, comorbidity did not significantly increase risk of MCI. CONCLUSIONS: Among elderly Mexican Americans, comorbid depression and diabetes significantly increased risk for MCI and AD across cohorts. Effects of comorbid diabetes and depression on MCI were inconclusive. Our results support the link between comorbid diabetes and depression and risk for cognitive decline among Mexican Americans. This finding is of critical importance as the Hispanic population is at higher risk of developing AD.

Assuntos

Envelhecimento , Doença de Alzheimer/etiologia , Disfunção Cognitiva/etiologia , Depressão/complicações , Depressão/epidemiologia , Diabetes Mellitus/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/etnologia , Doença de Alzheimer/etnologia , Disfunção Cognitiva/etnologia , Estudos de Coortes , Comorbidade , Depressão/etnologia , Diabetes Mellitus/etnologia , Feminino , Humanos , Modelos Logísticos , Masculino , Americanos Mexicanos/estatística & dados numéricos , Pessoa de Meia-Idade , Testes Neuropsicológicos , Escalas de Graduação Psiquiátrica , Fatores de Risco , População Branca

RESUMO

Injuries due to traffic collision have become a local, national, and worldwide public health issue which are related to multiple factors such as socioeconomic development, motor vehicle growth, infrastructure, breaking of traffic rules, and intake of alcoholic and psychoactive substances among others. Objective: To characterize trauma events due to traffic collisions in relation to the individual and the event. Methodology: Observational, descriptive and retrospective study. Results: 75.40 % of injured people were men. The average age was 33.80 (DE = 16.1), and 43.20% of the total population studied ranged from 18 to 29 years old. 40.70% were single, 32.20% were married, 13.30 % were a couple and 2.00% were divorced. 77.80% of the cases, the involved vehicle was a motorcycle, 52.80% stated to be drivers, 18.50% passengers, 16.90% pedestrians, and 3.60% bikers; 50.40% of the events took place over the weekend, 58.00% of the crashes happened during the day; 97.60% of the injured people were alive at discharge. The highway that communicates the towns of Bucaramanga, Floridablanca and Piedecuesta was where most of the road traffic accidents took place. Conclusions: Motorcycles seem to be more frequently involved in traffic collision events, which compared to low and medium income countries, shows the lack of prevention programs departments of education, social development, health and environment have.

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As lesُes provocadas pelas colisُes no trânsito tornaram-se um problema de saْde pْblica de ordem local, nacional e global, estando relacionadas a muitos fatores tais como o desenvolvimento socioeconômico, o crescimento de veيculos, a infra-estrutura, a violaçمo das regras no trânsito, o consumo de substâncias psicoativas incluindo o لlcool, etc. Objetivo: Caracterizar os acontecimentos de trauma em colisُes no trânsito em relaçمo ao indivيduo e ao evento. Metodologia: O estudo é observacional, descritivo e retrospectivo. Resultados: dos usuلrios lesionados 75.40% eram homens. A idade média foi de 33.80 anos (DP = 16.1), 43.20% da populaçمo estudada, estava na faixa de 18-29 anos.O 40.70% eram solteiros, 32.20% casados, 13.30% coabitaçُes e 2.00% separados. Nos 77.80% dos casos, o veيculo envolvido foi uma moto, nos quais 52.80% declararam ser os motoristas, 18.50% passageiros, 16.90% pedestres e 3.60% ciclistas; 50.40% dos acidentes registrados ocorreram nos fins de semana, 58.00% ocorreram durante o dia e 97.60% do total estudado, saiu com vida no momento de receber alta hospitalar. A estrada que liga as cidades de Bucaramanga, Floridablanca e Piedecuesta, é o local de maior ocorrência de acidentes de trânsito. Conclusُes: O estudo revelou que as motos sمo mais frequentes nos eventos de colisمo no trânsito, o que é comparلvel com outros estudos nos paيses de renda média e baixa, revelando a falta de programas de prevençمo articuladas com os ministérios da educaçمo, desenvolvimento social, de saْde e meio ambiente.

Assuntos

Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Acidentes de Trânsito , Ferimentos e Lesões , Mortalidade , Prevenção de Acidentes , Traumatologia

RESUMO

Introducción: cuando un recién nacido tiene un peso inferior a 2500 gramos, independientemente de su edad gestacional, se considera bajo peso. Objetivo: caracterizar algunos factores de riesgo asociados al bajo peso al nacer. Métodos: se realizó un estudio retrospectivo y longitudinal de 242 recién nacidos, atendidos en el Hospital General Docente "Orlando Pantoja Tamayo" de Contramaestre, en la provincia de Santiago de Cuba, desde enero hasta diciembre del 2012. Resultados: prevalecieron los recién nacidos con bajo peso al nacer pertenecientes al área de salud América I (41,3 %), las infecciones vaginales (74,8 %) y el periodo intergenésico menor de 2 años. De los neonatos con esa insuficiencia ponderal, 67,3 % fueron producto de partos pretérmino. Los hábitos tóxicos y la edad materna extrema constituyeron los factores de riesgo predominantes. Conclusiones: el bajo peso constituye un problema de salud que se acrecienta aún más cuando hay desnutrición, debido a la repercusión negativa que tiene para los padres, la familia y la sociedad.

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Introduction: when a new born has an weight lower than 2500 grams, independently from its gestacional age, it is considered underweight. Objective: to characterize some risk factors associated with low birth weight. Methods: A retrospective and longitudinal study of 242 newborns, assisted in "Orlando Pantoja Tamayo" Teaching General Hospital from Contramaestre was carried out in Santiago de Cuba province, from January to December, 2012. Results: the underweight newborns who belonged to the health area América I (41.3%), the vaginal infections (74.8%) and the intergenesis period shorter than 2 years prevailed. Of the neonates with that ponderal deficit, 67.3% resulted from preterm childbirths. The toxic habits and the extreme maternal age constituted the predominant risk factors. Conclusions: the low birthweight constitutes a health problem that increases even more when there is malnutrition, due to the negative repercussion that has for the parents, the family and the society.

Assuntos

Fatores de Risco , Idade Gestacional , Recém-Nascido de Baixo Peso

RESUMO

Objetivo: Analizar el comportamiento y distribución espacial de los focos rábicos en la provincia La Habana, de 1998 hasta 2010. Métodos: Se realizó un estudio observacional descriptivo retrospectivo de los casos de especie animal positivos a rabia, examinados en el Departamento de Rabia del Laboratorio Provincial de forma pasiva, de 1998 hasta 2010. Se incluyó 1 196 muestras de cerebros de carnívoros, quirópteros y herbívoros estudiados en la provincia. Se empleó la técnica de inmunofluorescencia directa para el diagnóstico de rabia. La descripción de la distribución espacial se realizó a partir de los sistemas de información geográficos digitalizados. Resultados: Los municipios periféricos tienen mayor índice de casos positivos a rabia en mangostas (mal llamado hurón en Cuba), perros y gatos; con 85 casos positivos de un total 1 196 muestras (7,11%) en un periodo de 13 años. Conclusiones: La utilización de mapas nos brinda gran utilidad ubicando geográficamente los focos rábicos. El mayor reporte de casos se notificó en cuatro municipios periféricos (Boyeros, Arroyo Naranjo, Cotorro y Guanabacoa), ubicados geográficamente en el centro y sur de la provincia La Habana.

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Objective: To analyze the behavior and spatial distribution of rabies foci in the province of Havana, 1998-2010. Methods: We conducted a retrospective observational study of cases of animal species positive for rabies, examined passively in the Department of Rabies of the Provincial Laboratory, from 1998-2010. 1196 brain samples of carnivores and herbivores bats studied in the province were included. We used the direct immunofluorescence technique for the diagnosis of rabies. The description of the spatial distribution was made from the digitized geographical information systems. Results: The peripheral municipalities have larger number of cases positive for rabies in mongooses (so-called ferret in Cuba), dogs and cats, with 85 positive cases out of a total 1196 samples (7.11%) over a period of 13 years. Conclusions: The use of maps is useful in the geographic location of rabies foci. The greater reporting of cases occurred in four peripheral municipalities (Boyeros, Arroyo Naranjo, Cotorro and Guanabacoa), geographically located in the center and south of the province of Havana.

Assuntos

Raiva/epidemiologia , Raiva/patologia , Vírus da Raiva , Zoonoses , Epidemiologia Descritiva , Estudo Observacional , Estudos Retrospectivos

RESUMO

Internal hernia is a relatively common complication of laparoscopic Roux-en-Y gastric bypass. Laparoscopic treatment may be a challenge for nonbariatric surgeons if small-bowel obstruction is present. The aim of this paper is to present a systematic laparoscopic technique for hernia reduction and mesenteric defect closure in patients with small-bowel obstruction due to an internal hernia as a postoperative complication of laparoscopic Roux-en-Y gastric bypass. From February 2007 to May 2011, this technique was used in 41 consecutive patients. One case was converted to an open approach due to extensive bowel necrosis. There were no complications related to the technique but 2 patients suffered pulmonary aspiration during anesthesia. After the internal hernia repair patients reported no further abdominal symptoms. Treatment of small-bowel obstruction due to an internal hernia should be attempted by laparoscopy except in the setting of bowel necrosis. The technique presented in this article represents a safe and effective option for the management of this complication.

Assuntos

Derivação Gástrica/efeitos adversos , Hérnia Abdominal/cirurgia , Herniorrafia/métodos , Obstrução Intestinal/cirurgia , Intestino Delgado/cirurgia , Laparoscopia/métodos , Feminino , Hérnia Abdominal/etiologia , Humanos , Obstrução Intestinal/etiologia , Tempo de Internação , Mesentério/cirurgia , Obesidade Mórbida/cirurgia , Gravidez , Complicações na Gravidez/cirurgia , Técnicas de Sutura

RESUMO

Objetivo: Los desordenes músculo esqueléticos y especialmente el síndrome del conducto carpiano es uno de los problemas de salud pública más importantes de los últimos años. Es la mayor causa de morbilidad profesional en Colombia, y uno de los ámbitos laborales con mayor incidencia es el sector floricultor. El estudio se propuso establecer si la fuerza de aprehensión en el corte de flores se ve afectada por la altura del corte y la postura del brazo. Método: Participaron 12 operarias y se utilizó un arreglo factorial 2x2 con la altura de corte y postura en pronación o supinación del antebrazo como los factores que influyen en la fuerza de aprehensión. Resultados: El análisis estadístico muestra que no existe interacción entre los factores, pero si efectos importantes sobre la fuerza de aprehensión. La variación de la flexión del brazo tiene un mayor efecto en comparación con el cambio de la postura del antebrazo (pronación o supinación). Conclusiones: La postura ideal para realizar la tarea de corte es la pronación debido a que el esfuerzo necesario para realizar dicha tarea es menor. Se propone que las investigaciones futuras deben estudiar los efectos de las desviaciones de la muñeca en el sector floricultor.

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Objective: Musculoskeletal disorders, particularly carpal tunnel syndrome, have been one of the most important public health problems during recent years. It is the leading cause of occupational morbidity in Colombia, the flower industry being one of the areas of work having the highest incidence. This study was thus aimed at ascertaining whether flower-cutters' strength of apprehension has been affected by cutting height and arm posture. Method: The study involved 12 operating personnel; a 22 factorial arrangement was used and the effect of cutting height and posture on forearm pronation or supination ans the factors influencing the strength of apprehension. Results: Statistical analysis showed no interaction between the factors; however, it did reveal a significant effect on the strength of apprehension. Varying how the arm bent had a greater effect than changing the position of the forearm (pronation or supination). Conclusions: Pronation was the ideal flower-cutting posture because it involved less effort to perform such task. Further research should examine the effects of wrist deviation angle in the flower industry.

Assuntos

Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Antebraço/fisiologia , Força da Mão , Saúde Ocupacional , Postura , Pronação , Supinação , Flores

RESUMO

OBJECTIVE: Musculoskeletal disorders, particularly carpal tunnel syndrome, have been one of the most important public health problems during recent years. It is the leading cause of occupational morbidity in Colombia, the flower industry being one of the areas of work having the highest incidence. This study was thus aimed at ascertaining whether flower-cutters' strength of apprehension has been affected by cutting height and arm posture. METHOD: The study involved 12 operating personnel; a 22 factorial arrangement was used and the effect of cutting height and posture on forearm pronation or supination ans the factors influencing the strength of apprehension. RESULTS: Statistical analysis showed no interaction between the factors; however, it did reveal a significant effect on the strength of apprehension. Varying how the arm bent had a greater effect than changing the position of the forearm (pronation or supination). CONCLUSIONS: Pronation was the ideal flower-cutting posture because it involved less effort to perform such task. Further research should examine the effects of wrist deviation angle in the flower industry.

Assuntos

Antebraço/fisiologia , Força da Mão , Saúde Ocupacional , Postura , Pronação , Supinação , Adulto , Feminino , Flores , Humanos , Pessoa de Meia-Idade , Adulto Jovem

RESUMO

La Microalbuminuria es un marcador de funcionalismo renal que se ha utilizado como factor pronóstico de enfermedades que involucran al riñón tales como diabetes mellitus, enfermedades cardíacas e hipertensión arterial. Con el fin de estudiar la presencia de este marcador en pacientes con hepatopatía crónica en quienes pudiera tener la misma utilidad, se investigó en 39 pacientes consecutivos sin síndrome hepatorrenal, en los cuales se encontró en el 15 por ciento con valor promedio y desviación estándar: 83,25 70 mg/d. Se obtuvo asociación con otras variables de funcionalismo renal como la excreción del sodio urinario / día 78,6 68,5 mmol/L y con la tasa de excreción de sodio urinaria 97,8 52,1 mmol/d, con significancia estadística con relación a los pacientes sin microalbuminuria: p= 3.11E-4, p=1,10E-02 respectivamente en 83,3 por ciento de pacientes con enfermedad hepática severa clase Child Pugh C y etiología alcohólica de la hepatopatía: 83,3 por ciento, guardando poca relación con la presencia o ausencia de ascitis: 50 por ciento - 50 por ciento. La Microalbuminuria en nuestro estudio, ha sido un marcador sencillo y confiable en el monitoreo de la lesión renal que acompaña a la hepatopatía crónica

Assuntos

Masculino , Feminino , Humanos , Albuminúria , Hepatite Crônica , Síndrome Hepatorrenal , Hepatopatias , Modalidades de Secreções e Excreções , Gastroenterologia , Urologia , Venezuela

RESUMO

El presente trabajo tuvo como finalidad determinar los cambios manométricos que se generan en el esfínter esofágico inferior luego de funduplicaturas laparoscópicas totales y parciales, en pacientes con enfermedad por reflujo gastroesofágico, acalasia y hernia paraesofágica gigante; así como establecer la relación de dichos cambios con el control de la enfermedad y las complicaciones posoperatorias. De 42 pacientes sometidos a estos procedimientos, se incluyen en el estudio 28 casos (5 Nissen, 19 Toupet y 4 Dor) en quienes se práctico manometría esofágica a las 8 semanas del posoperatorio. En los tipos de funduplicatura se observaron aumentos estadísticamente significativos de la presión del esfínter esofágico inferior (test de Wilcoxon), sin embargo, no hubo diferencias al comparar los grupos entre sí. Todos los pacientes con funduplicatura de Nissen presentaron disfagia posoperatoria, lo cual no ocurrió en ninguno de los casos con funduplicaturas paraciales. Un paciente con funduplicatura de Toupet presentó recidiva de los síntomas a los dos años de operado debido al deslizamiento de la válvula hacia el mediastino. Esto requirió de nueva cirugía antirreflujo practicada con éxito por laparoscopia. todos los demás pacientes presentan control adecuado del reflujo sin medicación

Assuntos

Humanos , Junção Esofagogástrica , Refluxo Gastroesofágico , Manometria , Complicações Pós-Operatórias , Gastroenterologia , Venezuela

RESUMO

El objetivo del estudio fue estimar la prevalencia de anticuerpos contra el virus de la hepatitis C en trabajadores de la salud y empleados de instituciones sanitarias en Venezuela y correlacionar la presencia de los mismos con factores de riesgo conocidos para dicha infección. A través de un estudio epidemiológico, prospectivo, longitudinal y multicéntrico, se alcanzó una muestra de 13.788 individuos mayores de 16 años quienes laboran en instituciones de salud. Los anticuerpos específicos se detectaron por el método de ELISA. La detección del ácido ribonucleico del virus se realizó mediante la técnica de reacción en cadena de la polimerasa. Se determinó genotipo y carga viral. La prevalencia de anticuerpos anti virus de hepatitis C fue 1,3 por ciento (184/13.788), encontrándose genotipo 1 en el 70 por ciento de los pacientes. Siete (0,48 por ciento) de los médicos presentaron serología positiva. El riesgo relativo fue mayor de 1 para transfusiones y cirugía previa. En conclusión, en Venezuela la infección por virus de la hepatitis C es frecuente en trabajadores de la salud y empleados de instituciones sanitarias, siendo similar a la vista en la población de instituciones sanitarias, siendo similar a la vista en la población general y donantes de sangre. Los principales factores de riesgo fueron antecedentes de transfusiones y procedimientos quirúrgicos

Assuntos

Humanos , Masculino , Feminino , Ensaio de Imunoadsorção Enzimática , Instalações de Saúde , Anticorpos Anti-Hepatite C , Hepacivirus/imunologia , Hepacivirus/patogenicidade , Serviços de Saúde do Trabalhador , Gastroenterologia , Venezuela