RESUMO
BACKGROUND: Previous models that assess quality-of-Life (QoL) in patients with rheumatic diseases have a strong biomedical focus. We evaluated the impact of COVID-19 related-health care interruption (HCI) on the physical, psychological, social relationships and environment QoL-dimensions, and explored factors associated with QoL when patients were reincorporated to the outpatient clinic, and after six-month follow-up. PATIENTS AND METHODS: Study phase-1 consisted of a COVID-19 survey administered from June 24th-October 31st 2020, to outpatients with rheumatic diseases who had face-to-face consultation at outpatient clinic reopening. Study phase-2 consisted of 3 consecutive assessments of patient´s QoL (WHOQOL-BREF), disease activity/severity (RAPID-3), and psychological comorbidity/trauma (DASS-21 and IES-R) to patients from phase-1 randomly selected. Sociodemographic, disease and treatment-related information, and comorbidities were obtained. Multiple linear regression analysis identified factors associated with the score assigned to each WHOQOL-BREF dimension. RESULTS: Patients included (670 for phase-1 and 276 for phase-2), had primarily SLE and RA (44.2% and 34.1%, respectively), and all the dimensions of their WHOQOL-BREF were affected. There were 145 patients (52.5%) who referred HCI, and they had significantly lower dimensions scores (but the environment dimension score). Psycho-emotional factors (primarily feeling confused, depression and anxiety), sociodemographic factors (age, COVID-19 negative economic impact, years of scholarship, HCI and having a job), and biomedical factors (RAPID-3 score and corticosteroid use) were associated with baseline QoL dimensions scores. Psycho-emotional factors showed the strongest magnitude on dimensions scores. Most consistent predictor of six-month follow-up QoL dimensions scores was each corresponding baseline dimension score, while social determinants (years of scholarship and having a job), emotional factors (feeling bored), and biomedical aspects (RAPID 3) had an additional impact. CONCLUSIONS: HCI impacted the majority of patient´s QoL dimensions. Psycho-emotional, sociodemographic and biomedical factors were consistently associated with QoL dimensions scores, and these consistently predicted the QoL trajectory.
Assuntos
COVID-19/psicologia , Pandemias , Qualidade de Vida , Doenças Reumáticas/psicologia , SARS-CoV-2 , Adulto , COVID-19/epidemiologia , COVID-19/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Reumáticas/epidemiologia , Doenças Reumáticas/fisiopatologia , Doenças Reumáticas/terapiaRESUMO
INTRODUCTION: The low quality of life in heart failure patients is related to low self-care and treatment adherence. Consequently, innovative strategies are needed to improve them. The objective of this work is to determine the effectiveness of the use of a home telemonitoring system to improve the self-care and treatment adherence of heart failure patients. METHODS: A randomized clinical trial that compares the efficacy of a home telemonitoring system -intervention group versus usual care control group - among heart failure outpatients over a 90-day monitoring period was carried out. The home telemonitoring system consists of an application that collects measurements of different parameters on a daily basis and provides health education to patients. The home telemonitoring system processes data gathered and generates an alert if a risky situation arises. The outcomes observed were significant changes in patients' self-care (European Heart Failure Self-care Behaviour Scale), treatment adherence (Morisky Modified Scale) and re-hospitalizations over the follow-up period. RESULTS: 104 heart failure patients were screened; 40 met the inclusion criteria; only 30 completed the study. After the follow-up, intragroup analysis of the control group indicated a decrease in treatment adherence (p = 0.02). The mean European Heart Failure Self-care Behaviour Scale overall score indicated an improved self-care in the intervention group patients (p = 0.03) and a worsened self-care in the control group (p = 0.04) with a p value of 0.004 in the intergroup analysis. Thanks to the home telemonitoring system alerts, two re-hospitalizations were avoided. DISCUSSION: This study demonstrated that the proposed home telemonitoring system improves patient self-care when compared to usual care and has the potential to avoid re-hospitalizations, even considering patients with low literacy levels.Trial Registration: Home Telemonitoring System for Patients with Heart Failure. clinicaltrials.gov Identifier: NCT04071093.
Assuntos
Insuficiência Cardíaca , Telemedicina , Insuficiência Cardíaca/terapia , Hospitalização , Humanos , Qualidade de Vida , AutocuidadoRESUMO
OBJECTIVES: This work sought to know the state of the art related to the theme of Interprofessional Education (IPE) in the training of Nursing and Medical students and the level of evidence developed thus far. METHODS: This was an exploratory systematic review, declared as scoping review by the Joanna Briggs Institute, JBI, in which a search was performed in Embase, Science direct, Pubmed-Medline, Academic search complete, BVS, Scopus and ERIC databases, limiting between 2009 - 2019 by using the DeCS and MeSH terms of Interprofessional education, education research, healthcare professionals, nursing and medicine, selecting 39 original articles after carrying out the review process with the criteria by the JBI. RESULTS: Four thematic nuclei emerged: Experiences and perceptions of interprofessional learning, Didactics related with IPE, Empirical indicators related with IPE, and Development of professional skills. The highest level of evidence is presented by the articles dealing with didactics; on the contrary, no articles were found that dealt with topics related with early inclusion of IPE in the medical and nursing curricula, which are currently necessary to complement the focus of patient-centered care. CONCLUSIONS: The thematic nuclei show that the level of evidence in the literature is varied, although mostly descriptive in scope, highlighting the development of professional skills as a result of interprofessional education.
Assuntos
Estudantes de Medicina , Estudantes de Enfermagem , Currículo , Pessoal de Saúde , Humanos , Educação Interprofissional , AprendizagemRESUMO
Objective. This work sought to know the state of the art related to the theme of Interprofessional Education (IPE) in the training of Nursing and Medical students and the level of evidence developed thus far. Methods. This was an exploratory systematic review, declared as scoping review by the Joanna Briggs Institute, JBI, in which a search was performed in Embase, Science direct, Pubmed-Medline, Academic search complete, BVS, Scopus and ERIC databases, limiting between 2009 - 2019 by using the DeCS and MeSH terms of Interprofessional education, education research, healthcare professionals, nursing and medicine, selecting 39 original articles after carrying out the review process with the criteria by the JBI. Results. Four thematic nuclei emerged: Experiences and perceptions of interprofessional learning, Didactics related with IPE, Empirical indicators related with IPE, and Development of professional skills. The highest level of evidence is presented by the articles dealing with didactics; on the contrary, no articles were found that dealt with topics related with early inclusion of IPE in the medical and nursing curricula, which are currently necessary to complement the focus of patient-centered care. Conclusion. The thematic nuclei show that the level of evidence in the literature is varied, although mostly descriptive in scope, highlighting the development of professional skills as a result of interprofessional education.
Objetivo. Conocer el estado del arte, relacionado con la temática de Educación Interprofesional (EIP) en la formación de estudiantes de enfermería y medicina, y el nivel de evidencia desarrollado hasta el momento. Métodos. Revisión Sistemática exploratoria, declarada como Scoping review por la Joanna Briggs Institute -JBI-, en la que se realizó una búsqueda en bases de datos de Embase, Science direct, Pubmed-Medline, Academic search complete, BVS, Scopus y ERIC, entre 2009-2019 utilizando los términos DeCS y MeSH de Interprofessional education, education research, healthcare professionals, nursing y medicine. Se seleccionaron 39 artículos originales luego del proceso de crítica con los criterios de JBI. Resultados. Emergieron cuatro núcleos temáticos: Experiencias y percepciones del aprendizaje interprofesional, Didácticas vinculadas a la EIP, Indicadores empíricos relacionados con la EIP y Desarrollo de competencias profesionales. El mayor nivel de evidencia lo presentan los artículos sobre empleo de didácticas; por el contrario, no se encontraron artículos que trataran temáticas relacionadas con la inclusión temprana de EIP en los currículos de enfermería y medicina, pues son actualmente necesarios para complementar el enfoque de atención centrada en el paciente. Conclusión. Los núcleos temáticos muestran que el nivel de evidencia de la literatura es variado, aunque en su mayoría de alcance descriptivo, lo que resalta el desarrollo de competencias profesionales como resultado de la educación interprofesional.
Objetivo. Conhecer o estado da arte, relacionado com a temática de Educação Interprofissional (EIP) na formação de estudantes de enfermagem e medicina, e o nível de evidência desenvolvido até o momento. Métodos. Revisão Sistemática exploratória, declarada como Scoping review pela Joanna Briggs Institute -JBI-, na qual se realizou uma busca em bases de dados de Embase, Science direct, Pubmed-Medline, Academic search complete, BVS, Scopus e ERIC, limitando entre 2009-2019 utilizando os termos DeCS e MeSH de Interprofessional education, education research, healthcare professionals, nursing and medicine. Se selecionaram 39 artigos originais após de realizado o processo de crítica com os critérios de JBI. Resultados. Emergiram quatro núcleos temáticos: Experiências e percepções da aprendizagem interprofissional, Didáticas vinculadas à EIP, Indicadores empíricos relacionados com a EIP e Desenvolvimento de competências profissionais. O maior nível de evidência o apresentam os artigos sobre emprego de didáticas; pelo contrário, não se encontraram artigos que trataram temáticas relacionadas com a inclusão precoce de EIP nos currículos de enfermagem e medicina, sendo atualmente necessários para complementar o enfoque de atenção centrada no paciente. Conclusão. Os núcleos temáticos mostram que o nível de evidência da literatura é variado, embora na sua maioria de alcance descritivo, ressaltando o desenvolvimento de competências profissionais como resultado da educação interprofissional.
Assuntos
Humanos , Estudantes de Medicina , Estudantes de Enfermagem , Revisão , Currículo , Educação Médica , Educação em EnfermagemRESUMO
Objetivos: Determinar la prevalencia de asma en niños y niñas entre 5 y 6 años en la parroquia de Calderón, Llano Chico, Guayllabamba y su asociación con factores de riesgo. Materiales: Se utilizó como referencia la encuesta ISAAC (International Study of Asthma and Allergies in Childhood) adaptada en términos comunes a nuestro medio. Métodos: Estudio descriptivo transversal de corte que se realizó en los centros educativos de la zona a los representantes legales de los alumnos aplicando la encuesta ISAAC, previo consentimiento informado. Resultados: La prevalencia de asma en este estudio fue del 8%, de ellos el 52,08% fueron niños, 86% no reportó antecedentes familiares de asma, 78% no presentó antecedente de prematuridad, el 72, 9% no refirió diagnóstico previo de asma. Respecto a la patología, el 18,75 % de casos no presentó episodios severos, el 63,9 % presentó de 1 a 3 episodios severos en el último año; apenas el 12.5 % presentó más de 1 ataque de asma que despertó al niño, en el 75 % de los casos niega episodios de sibilancias que afecten el habla del niño sin embargo el 43 % refirió la presencia de sibilantes durante o después de la actividad física además de tos seca nocturna sin antecedente de infección activa. En los factores de riesgo la prematuridad, tráfico pesado y fábricas a 300 metros del hogar aumentando respectivamente en 2,01 veces (IC 95% 1,37 3,2); 2,23 veces (IC 95% 1,38 3,62) y 2, 37 (IC 95% 1,61 3,47) veces el riesgo de presentar síntomas asmáticos respecto quien no está expuesto. Conclusiones: La prevalencia de asma en la zona de Calderón en el último año en este estudio fue del 8 % con asociaciones estadísticamente significativas para prematuridad, tráfico pesado y fabricas a 300 metros del hogar.
Objectives: To determine the prevalence of asthma in children between 5 and 6 years old in the Calderon area, Llano Chico, Guayllabamba and its association with risk factors. Methods: Cross-sectional descriptive study that was carried out in the educational centers of the area to the legal representatives of the students applying the ISAAC survey, with prior informed consent. Results: The prevalence of asthma in this study was 8%, of which 52.08% were children, 86% did not report a family history of asthma, 78% had no history of prematurity, 72%, 9% did not report the previous diagnosis of asthma. Regarding the symptomatology, 18.75% of cases did not present serious episodes, 63.9% presented 1 to 3 severe episodes in the last year; only 12.5% had more than 1 asthma attack that awoke the child, in 75% of cases of episodes of wheezing that affected the child's speech, however, 43% reported the presence of wheezing during or after physical activity in addition to a dry night without a history of active infection. In the risk factors of prematurity, heavy traffic and factories at 300 meters from the home, respectively, in 2.01 times (95% CI 1.37 - 3.2); 2.23 times (95% CI 1.38 - 3.62) and 2.37 (95% CI 1.61 - 3.47) times the risk of presenting asthmatic symptoms. Conclusions: The prevalence of asthma in the Calderón area in the last year in this study was 8% with statistically significant associations for prematurity, heavy traffic and fabric 300 meters from home.
Assuntos
Asma , Fatores de Risco , Meio AmbienteRESUMO
INTRODUCCIÓN: La evaluación de la salud mental en los servicios de salud no se realiza de forma regular, generando un subregistro diagnóstico que afecta la planificación y distribución de recursos. El Test Mini Entrevista Neuropsiquiátrica Internacional es una entrevista breve y estructurada que permite diagnosticar los principales trastornos psiquiátricos; su confiabilidad es alta al compararla pruebas similares. El presente estudio tuvo como objetivo caracterizar la aplicación de éste instrumento entre la población que acude a las unidades de primer nivel de atención. MÉTODOS: Estudio descriptivo-transversal con una muestra de 155 personas que acudieron a los centros de primer nivel de las parroquias urbanas y rurales del cantón Cuenca en el mes de abril de 2017. Se aplicó el test Mini Entrevista Neuropsiquiátrica Internacional y una encuesta para recolectar información relacionada con las variables estudiadas. Los resultados fueron analizados en SPSS versión 25.0 RESULTADOS: El tiempo promedio de aplicación del Test fue 21.6 minutos sin diferencia importante entre sexo, edad e instrucción; y 20.93 minutos en quienes presentaron trastornos psiquiátricos. La depresión mayor fue la patología más frecuente, presente mayormente en personas viudas, sin instrucción y con discapacidad. CONCLUSIÓN: No existe diferencia importante entre el tiempo de aplicación del Test considerando las distintas variables demográficas respecto al modelo estándar; se lo considera como una herramienta útil para ser utilizado en el primer nivel de atención.(au)
BACKGROUND: The evaluation of mental health in health services is not carried out on a regular basis. This led to an underreport diagnosis that affected the planning and distribution of resources. The Mini-International Neuropsychiatric Interview is a brief and structured interview that allows diagnosing the main psychiatric disorders with high reliability when compared similar evaluations. The aim of this study was to characterize the application of this instrument in the population that went to the first level care units. METHODS: Cross-sectional descriptive study with a sample of 155 people who attended the first level centers of the urban and rural communities in Cuenca. The Mini-International Neuropsychiatric Interview and a survey were applied to collect additional information related to the studied variables. The results were analyzed in SPSS 25.0. RESULTS: The average time of application of the test was 21.6 minutes without significant difference between sex, age and instruction; and 20.93 minutes in those with psychiatric disorders. Depressive disorder was the most frequent and it was present in widowed, uneducated and disabled people. CONCLUSION: No significant difference was found between the test application times considering the different demographic variables with respect to the standard model, so it is considered as a useful tool to be used in the first level of care.(au)
Assuntos
Humanos , Masculino , Feminino , Escalas de Graduação Psiquiátrica Breve , Transtornos Mentais/diagnóstico , Atenção Primária à Saúde/estatística & dados numéricos , Programas de RastreamentoRESUMO
El proceso de cambio de hábitos comienza con la educación del paciente, promocionando el desarrollo de un aceptable control de la placa. Dentro de este contexto, varios métodos se emplean para ejecutarlo, sin embargo el valor de cepillado en la prevención depende no solo del tipo de cepillo de dientes, sino también en la técnica de cepillado apropiada y del tiempo que se dedique a la ejecución del mismo. El objetivo del estudio fue comparar los tiempos de cepillado con técnica habitual y de Bass en estudiantes de la Cátedra de Odontología Preventiva de la Universidad del Pacífico. El estudio es cuasi-experimental e incluyó la participación de 21 estudiantes del primer año de la carrera de Odontología matriculados en el 2014.En la clase previa al desarrollo del contenido programático "Control mecánico de placa microbiana", se invitó a participar del estudio a todos los estudiantes. Con un espejo de rostro y el cepillo personal del estudiante se le solicitó a cada uno que proceda a cepillarse con su técnica habitual y posterior a la clase, con la de Bass, se registraron en la ficha los tiempos que cada uno tomo, en segundos, a través cronómetro digital. El tiempo promedio con la técnica de Bass fue significativamente (p<0,0001) mayor que con la técnica habitual (193,9±51,9versus 109,6±34,5segundos). El mayor tiempo que se ocupa para el cepillado con la técnica de Bass puede resultar particularmente importante, considerando que el ritmo actual de vida del estudiante y de la población en general implica una carrera contra reloj, limitando así las posibilidades de un adecuado control mecánico de la placa microbiana, reconocida como uno de los más importantes factores cariogénico y periodontopático.
The process of changing habits starts with patients education, promoting thedevelopment of an acceptable plaque control. Within this context, several methods areused, however, the value of brushing in prevention depends not only on the type oftoothbrush, but also in the art of proper brushing and time devoted to the execution of it.The aim of this study was to compare regular brushing times and Bass techniques instudents of the Department of Preventive Dentistry at the Universidad del Pacífico. TheQuasi-experimental study involves the participation of 21 first year students of the career ofDentistry enrolled in 2014. In the previous class to the development of the content"Mechanical control of microbial plaque", all students were invited to participate in thisstudy. Using a mirror and personal thoot brushe very student was asked to proceed to brushing with conventional technique and after class using Bass technique, time spent inevery process was measured by a digital stopwatch and written in the file. The average timeusing Bass technique was significantly greater than (p <0.0001) using the standardtechnique (193.9 ± 51.9 versus 109.6 ± 34.5 seconds). More time dealing for brushingusing Bass technique may be particularly important given the current pace of student lifeand the population generally involves a time rush, limiting the possibilities of a suitablemechanical control of microbial plaque, recognized as one of the more important cariogenicand periodontopathic facts.
Assuntos
Humanos , Escovação Dentária/métodos , Estudos de Tempo e Movimento , Placa DentáriaRESUMO
Viven con discapacidad aproximadamente 600 millones de individuos, cifra que va en aumento; de éstos el 80 % reside en países de bajos ingresos. En el Paraguay, se estima que aproximadamente el 15 % de la población presenta algún tipo de discapacidad. El objetivo fue describir el estado de salud oral de las personas con discapacidad que residen en la Fundación Pequeño Cottolengo Don Orione de Mariano Roque Alonso, Paraguay 2012. Se realizó un estudio observacional descriptivo de corte transversal en 37 niños, jóvenes y adultos en edades comprendidas entre 12 y 68 años. Fueron analizadas las lesiones de caried a través del índice CPO-D, lesiones no cariosas, lesiones de tejidos blandos y la presencia de factores de riesgo como nivel y frecuencia de higiene, placa microbiana, saliva y dieta. El índice CPO-D fue 16,24; se detectó presencia de lesiones no cariosas en 48,65 % y fluorosis en 2,70 %. Se encontraron fracturas a nivel de esmalte en 43,24 % y la higiene oral fue deficiente medido por medio del índice de Loë y Silness. El 24,32 % tenía saliva viscosa; el Índice de placa bacteriana fue de 2,04. Mientras que, en ninguno de los casos los momentos de azúcar superaron tres. El 100 % de la población se cepilla una vez al día por la mañana antes del desayuno. En la población de estudio existen valores elevados en cuanto a caries y dientes perdidos, por tanto, se deben aumentar los programas de concientización en los cuidadores para promover la preservación de los dientes y la salud oral.
Approximately 600 million people worldwide live with disabilities, a figure that is increasing; 80 % of these individuals live in low-income countries. In Paraguay, it is estimated that approximately 15 % of the population has some type of disability. The objective of this study was to describe the state of oral health of people with disabilities who reside in the Fundación Pequeño Cottolengo Don Orione de Mariano Roque Alonso, Paraguay 2012. A descriptive cross-sectional study was performed on 37 children, youth and adults aged between 12 and 68 years. We analyzed carious lesions thorough DMF-T index, lesions involving soft tissue and the presence of risk factors such as hygiene, microbial plaque, saliva and diet. The DMFT index was 16.24; presence of non-carious lesions was detected in 48.65 % and 2.70 % fluorosis. Level enamel fractures were found in 43.24 % and oral hygiene was poor by Loë and Silness index. Of the population studied, 24.32 % had viscous saliva and plaque index was 2.04. While they did not exceed sugar times three in any cases; 100 % of the population brushed once a day in the morning before breakfast. In the study population there are high values of missing and decayed teeth, therefore, awareness programs to promote the preservation of the teeth and oral health should be emphasized.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Doenças Dentárias/epidemiologia , Saúde Bucal , Pessoas com Deficiência/estatística & dados numéricos , Higiene Bucal , Paraguai/epidemiologia , Índice CPO , Nível de Saúde , Prevalência , Estudos Transversais , Fatores de Risco , Lares para Grupos , Assistência Odontológica para a Pessoa com Deficiência , Distribuição por Idade , Cárie Dentária/epidemiologia , Deficiência IntelectualRESUMO
The composition and antimicrobial activity of the essential oil from Verbesina negrensis Steyerm. leaves is reported. Analysis was performed by GC/MS. Major constituents were α-pinene (43.1%), α-humulene (13.8%), Δ-cadinene (8.1%), limonene (4.6%) and bicyclogermacrene (4.2%). The essential oil showed in vitro activity against the Gram-positive bacteria Staphylococcus aureus ATCC 25923 and Enterococcus faecalis ATCC 29212 (MIC 500 and 350 µL/mL respectively).
Assuntos
Antibacterianos/análise , Óleos Voláteis/química , Verbesina/química , Antibacterianos/química , Testes de Sensibilidade Microbiana , VenezuelaRESUMO
OBJECTIVE: To evaluate the effect of anti-TNF agents plus synthetic disease modifying antirheumatic drugs (DMARDs) versus DMARDs alone for ankylosing spondylitis (AS) with reduced pulmonary function vital capacity (FVC%). METHODS: In an observational study, we included AS who had FVC% <80% at baseline. Twenty patients were taking DMARDs and 16 received anti-TNF + DMARDs. OUTCOME MEASURES: changes in FVC%, BASDAI, BASFI, 6-minute walk test (6MWT), Borg scale after 6MWT, and St. George's Respiratory Questionnaire at 24 months. RESULTS: Both DMARDs and anti-TNF + DMARDs groups had similar baseline values in FVC%. Significant improvement was achieved with anti-TNF + DMARDs in FVC%, at 24 months, when compared to DMARDs alone (P = 0.04). Similarly, patients in anti-TNF + DMARDs group had greater improvement in BASDAI, BASFI, Borg scale, and 6MWT when compared to DMARDs alone. After 2 years of follow-up, 14/16 (87.5%) in the anti-TNF + DMARDs group achieved the primary outcome: FVC% ≥80%, compared with 11/20 (55%) in the DMARDs group (P = 0.04). CONCLUSIONS: Patients with anti-TNF + DMARDs had a greater improvement in FVC% and cardiopulmonary scales at 24 months compared with DMARDs. This preliminary study supports the fact that anti-TNF agents may offer additional benefits compared to DMARDs in patients with AS who have reduced FVC%.
Assuntos
Anticorpos Monoclonais/uso terapêutico , Antirreumáticos/uso terapêutico , Espondilite Anquilosante/tratamento farmacológico , Espondilite Anquilosante/fisiopatologia , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Capacidade Vital/efeitos dos fármacos , Adulto , Idoso , Anticorpos Monoclonais/farmacologia , Antirreumáticos/farmacologia , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Testes de Função Respiratória , Espondilite Anquilosante/diagnóstico , Resultado do TratamentoRESUMO
Introducción: la automedicación es aquella situación en la que los pacientes consiguen y utilizan los medicamentos sin ninguna intervención por parte del médico. Objetivos: determinar la prevalencia de automedicación y condiciones asociadas a la misma en pobladores del Departamento de Itapúa (Paraguay). Material y método: estudio prospectivo, descriptivo, de corte trasverso. Se aplicó una encuesta cerrada y autocompletada en 9 distritos de zonas rurales y urbanas del Departamento de Itapúa. Además de las variables sociodemográficas se indagó problemas de salud relacionados, razones para no asistir al médico y las consecuencias. Resultados: de 2321 encuestados, 57,1% eran mujeres, la edad promedio 30,85 ±12,98 años, 81,6% provenía de zonas urbanas, 41% había culminado sus estudios secundarios. El 92,8% de la muestra se ha automedicado y ha acudido a la farmacia en 50%. El 40,8% de los mismo ha aconsejado alguna vez consumir algún medicamento a alguno de sus parientes cercanos. Valorando la permeabilidad a los métodos publicitarios, 50,8% respondió que nunca ha consumido un medicamento en base a los mismos. La cefalea y los síntomas gripales fueron la causa de la automedicación. La mayoría de los pacientes que se automedican (54,2%) no ha acudido al médico por falta de tiempo. El 33,9% de la población desconoce el efecto que la automedicación pueda tener sobre la salud de la comunidad frente a un 31,8% que sostiene el mal efecto que pudiera tener la misma. A mayor nivel de instrucción mayor porcentaje de automedicación (p<0,05). Conclusión: la automedicación es una práctica muy frecuente en nuestro Departamento, coincidiendo con series de investigaciones similares en Latinoamérica. Se halló una relación significativa entre el nivel de instrucción y el porcentaje de automedicación. Es un problema de salud pública importante y deberíamos optimizar estrategias a fin de poder reducirla. Creemos que esta investigación podría reflejar de alguna forma la realidad de un país con una política salud pública que aún presenta falencias y que resulta asistencialmente insuficiente.
Introduction: self-medication is a situation in which patients get and use drugs without any intervention by the physician. Objectives: to determine the prevalence of self-medication and conditions associated with it on people in the Department of Itapúa (Paraguay). Material and Methods : a prospective, descriptive study of trasverse court. A closed auto-completed in 9 districts in rural and urban areas of the Department of Itapúa survey was conducted. In addition to sociodemographic variables related health problems, we investigated reasons for not attending doctor and consequences. Results: of 2321 respondents, 57.1% were women, average age 30.85 ± 12.98 years, 81.6% came from urban areas, 41% had completed high school. 92.8% of the sample was self-medicated and has come to the pharmacy in 50%. 40.8% of the sample had advised to consume some drugs to their close relatives. Assessing permeability advertising methods, 50.8% said they have never used a drug based on them. Headache and flu-like symptoms were the cause of self-medication. Most patients who self-medicate (54.2%) has not seen a doctor for lack of time. 33.9% of the population is unaware of the effect that self-medication may have on the health of the community against 31.8% knowing the bad effect that would have on them. A higher level of education higher percentage of self-medication (p <0.05). Conclusion: self-medication is a common practice in our Department, coinciding with a series of similar investigations in Latin America. A significant relationship between educational attainment and the percentage of self-medication was found. It is a major public health problem and should optimize strategies in order to reduce it. We believe that this research could somehow reflect the reality of a country with a public health policy that still has shortcomings and that it asistencialmente insufficient.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Automedicação , Paraguai/epidemiologia , Automedicação/estatística & dados numéricos , Prevalência , Estudos Transversais , Estudos Prospectivos , Inquéritos e Questionários , EscolaridadeRESUMO
Objetivo: Estudiar la relación entre la capacidad funcional y la calidad de vida relacionada (CVRS) con la salud en un grupo de trabajadores de una institución universitaria. Metodología: Estudio transversal que incluyó 146 trabajadores divididos en dos grupos: Grupo de Baja Capacidad funcional (< 9 METs) y Grupo de Alta Capacidad funcional (> 9,1 METs). Se evaluó la CVRS con el Cuestionario de Salud SF-12 y capacidad funcional con el Cuestionario PAR-PAF como indicadores del estado de salud. Resultados: De la población evaluada, 47,3% (69 sujetos) son hombres y 52,7% (78 sujetos), mujeres. La edad promedio de los grupos fue de 35,0 ± 9,7 años (rango 19,0-60,0 años), sin diferencias entre grupos. Para la CVRS, la media encontrada en la población evaluada fue de 45,2 ± 4,42 (rango 33,0-58,1) y 43,8 ± 6,87 (rango 19,8-43,8) en los componentes Physical Component Summary (PCS-12) y Mental Component Summary (MCS-12), respectivamente p=NS. Diferencias significativas fueron encontradas al comparar la capacidad funcional y el género, p<0,001, por grupos. De igual manera entre géneros y el componente mental MCS-12 (grupo de Baja Capacidad funcional) p=0,049, así como en las mujeres y el componente físico PCS-12, p=0,05, entre grupos. Por último, una mejor puntuación en la CVRS se observa en el grupo de Alta Capacidad funcional en ambos componentes y géneros OR 0.59 (0.25-1.38). Conclusiones: Los resultados de este trabajo demuestran la relación entre una alta capacidad funcional y una mejor CVRS en la población estudiada.
Aim: Examine the relationship between the functional capacity and the quality of life related to health in university workers. Methodology: Cross-sectional study in 146 subjects, divided in two groups: Low functional Capacity (< 9 METs) and High functional Capacity (> 9.1 METs). We evaluated quality of life related to health (HRQOL-Health Questionnaire SF-12) and functional capacity (Questionnaire PAR/PAF) as indicators of health status. Results: 47.3% (69 men) and 52.7% (78 women). The average age of the groups was 35.0 ± 9.7 years (range 19,0-60,0 years). For HRQOL, the average found in the population assessed was 45.2 ± 4.42 (range 33,0-58,1) and 43.8 ± 6.87 (range 19,8-43,8) in components Physical Component Summary (PCS-12) and Mental Component Summary (MCS-12), respectively p = NS. Significant differences were found when comparing functional ability and sex, p<0,001 in both groups. Similarly, sex and mental component MCS-12 (group of Lower Functional) p = 0,049 as well as women and the physical component PCS-12, p = 0,05 between groups. Finally, a better score in HRQL observed in the group of High Capacity and functional components in both sex OR 0.59 (0.25-1.38). Conclusions: The results of this study demonstrate the relationship between High functional Capacity and a better HRQOL in this population.
Objetivo. Estudar a relação entre a capacidade funcional e a qualidade de vida relacionada (CVRS) com a saúde em um grupo de trabalhadores de uma instituição universitária. Metodologia. Estudo transversal que incluiu 146 trabalhadores divididos em dois grupos: Grupo de Baixa Capacidade funcional (< 9 METs) e Grupo de Alta Capacidade funcional (> 9,1 METs). Avalio-se a CVRS com o Questionário de Saúde SF-12 e capacidade funcional com o Questionário PAR-PAF como indicadores do estado de saúde. Resultados. Da povoação avaliada, 47,3% (69 indivíduos) são homens e 52,7% (78 indivíduos), mulheres. A idade meia dos grupos foi de 35,0 ± 9,7 anos (rango 19,0-60,0 anos), sem diferenças entre grupos. Para a CVRS, a meia encontrada na povoação avaliada foi de 45,2 ± 4,42 (rango 33,0-58,1) e 43,8 ± 6,87 (rango 19,8-43,8) nos componentes Physical Component Summary (PCS-12) y Mental Component Summary (MCS-12), respectivamente p=NS. Diferenças significativas foram encontradas ao comparar a capacidade funcional e o gênero, p<0,001, por grupos. De igual maneira entre gêneros e o componente mental MCS-12 (grupo de Baixa Capacidade funcional) p=0,049, assim como nas mulheres e o componente físico PCS-12, p=0,05, entre grupos. Finalmente, uma melhor pontuação na CVRS se observa no grupo de Alta Capacidade funcional em ambos componentes e gêneros OR 0.59 (0.25-1.38). Conclusões. Os resultados deste trabalho demonstram a relação entre uma alta capacidade funcional e uma melhor CVRS na povoação estudada.
Assuntos
Humanos , Capacidade Residual Funcional , Qualidade de Vida , Exercício Físico , Nível de Saúde , Estudos Transversais , Saúde Ocupacional , ColômbiaRESUMO
We report the use of transition metal nanoparticles (Ni or Co) to longitudinally cut open multiwalled carbon nanotubes in order to create graphitic nanoribbons. The process consists of catalytic hydrogenation of carbon, in which the metal particles cut sp(2) hybridized carbon atoms along nanotubes that results in the liberation of hydrocarbon species. Observations reveal the presence of unzipped nanotubes that were cut by the nanoparticles. We also report the presence of partially open carbon nanotubes, which have been predicted to have novel magnetoresistance properties.(1) The nanoribbons produced are typically 15-40 nm wide and 100-500 nm long. This method offers an alternative approach for making graphene nanoribbons, compared to the chemical methods reported recently in the literature.
Assuntos
Nanocompostos/química , Nanotecnologia/métodos , Nanotubos de Carbono/química , Catálise , Cobalto/química , Desenho de Equipamento , Grafite/química , Microscopia de Força Atômica/métodos , Microscopia Eletrônica de Varredura/métodos , Microscopia Eletrônica de Transmissão/métodos , Níquel/químicaRESUMO
Neutralizing activity of secretory immunoglobulin A (S-IgA) directed against the V1/V2 domain of HIV-1 was studied in parotid saliva of HIV-1- infected patients in Colombian and French cohorts. Purified V1/V2-specific S-IgA antibodies were found to neutralize clades A, B and C primary isolates in five out 76 and 82 patients from each cohort, respectively. These results suggest that neutralizing S-IgA antibodies targeting the V1/V2 domain may provide protection against HIV-1 infection in vivo and may be beneficial in mucosal vaccines.
Assuntos
Anticorpos Neutralizantes/imunologia , Infecções por HIV/imunologia , HIV-1/imunologia , Imunoglobulina A Secretora/imunologia , Saliva/imunologia , Estudos de Coortes , Colômbia , Feminino , França , Proteína gp120 do Envelope de HIV/imunologia , Humanos , Masculino , Fragmentos de Peptídeos/imunologia , Saliva/virologiaRESUMO
Antecedentes: Al menos un 50 por ciento de los pacientes quirúrgicos presentan algún grado de hipotermia. Esta se ha asociado a diversos efectos adversos metabólicos, hematológicos, cardiovasculares y farmacológicos, entre otros. Objetivo: conocer el efecto del calentamiento durante el periodo perioperatorio en pacientes adultos. Metodología: revisión de literatura que recopila 22 investigaciones randomizadas controladas, 11 revisiones bibliográficas, 3 estudios prospectivos, 1 metanálisis, 1 revisión sistemática y 1 guía clínica, publicadas entre enero de 1996 y octubre de 2006, obtenidos desde distintas bases de datos y revistas científicas. Resultados: existen diversos sistemas de calentamiento, siendo el más utilizado y efectivo el aire caliente forzado. El calentamiento es utilizado en todo tipo de cirugías (excepto en las neurológicas y cardiacas), principalmente durante el intraoperatorio. Los principales efectos en la etapa preoperatoria son el aumento de la temperatura corporal y la facilitación de la canulación venosa. En la etapa intraoperatoria produce mantención de la normotermia y disminución en el sangramiento durante la cirugía, ambos efectos se mantienen durante la etapa postoperatoria. En la última fase del perioperatorio, es posible observar una reducción de la infección de la herida operatoria, escalofríos, vasoconstricción, presión arterial, eventos mórbidos cardíacos, tiempo de ventilación mecánica, uso de vasodilatadores, morfina y antibióticos, y un aumento del confort térmico. Conclusiones: se respalda la aplicación del calentamiento como un método efectivo, ya sea previniendo o tratando la hipotermia perioperatoria inadvertida y sus complicaciones, lo que reduce el tiempo de recuperación, los costos de la hospitalización y aumenta el confort térmico.
Background: At least 50 percent surgical patients have some hypothermia degree. In Addition, hypothermia may have several metabolic, haematologic, cardiovascular and pharmacological adverse consequences, between other things. Aim: it is to know the warming effects during perioperative in surgical adults patients. Methods: literature review of twenty two randomized controlled trials, eleven literature review, three prospective trials, one meta-analysis, one systematic review, and one clinical guideline, published between January 1996 and October 2006, all this evidence have been got of different data bases and scientific magazine. Results: randomized controlled trials show the application of several warming systems, the most used and effective is air forced. Warming used in all types of surgery (except neurological and cardiac surgery), mainly during intraoperative. The principal effects of warming in the preoperative are: increase patient temperature, and facilitate venous cannulation. During intraoperative mantains normothermia and decrease blood loss during surgery, both effects remain in the postoperative. Furthermore in the last perioperative phase is possible found a reduce of wound infection, hospital stay, shivering, vasoconstriction, blood pressure, morbid cardiac events, mechanical ventilation time, vasodilators, morphine and antibiotics use, pain, and increase thermal comfort. Conclusion: this evidence review provide support that warming is an effective method, preventing or treatment unplanned perioperative hypothermia and its adverse consequences, reducing recuperation time, hospitalization costs and increasing thermal comfort.
Assuntos
Humanos , Adulto , Temperatura Corporal , Hipotermia , Enfermagem Perioperatória/métodosRESUMO
The involvement of neurotensin (NT) within the nucleus accumbens core (NAC) in behavior has been sparsely investigated. Moreover, little is known of what role NT within the ventral striatum has on spatial learning. The present study investigated whether NT receptors in the NAC are implicated in learning of spatial information. Male Long-Evans rats were trained on a food search spatial learning task. Rats were microinfused with either NT antagonist SR 48692 (50 nM/0.5 =L) or saline in the NAC before each training session. Rats treated with SR 48692 made more reference and working memory errors during the acquisition of spatial learning than did rats infused with saline. These results suggest that NT receptors contribute to NAC-mediated spatial learning.
Assuntos
Comportamento Apetitivo/efeitos dos fármacos , Neurotensina/antagonistas & inibidores , Núcleo Accumbens/efeitos dos fármacos , Orientação/efeitos dos fármacos , Pirazóis/farmacologia , Quinolinas/farmacologia , Animais , Ingestão de Alimentos/efeitos dos fármacos , Masculino , Memória de Curto Prazo/efeitos dos fármacos , Atividade Motora/efeitos dos fármacos , Ratos , Ratos Long-Evans , Receptores de Neurotensina/antagonistas & inibidoresRESUMO
Esta revisión bibliográfica tiene como propósito exponer la relación que se ha encontrado entre la enfermedad periodontal y algunas alteraciones del embarazo como la preeclampsia, el retardo en el crecimiento fetal, la ruptura prematura de membranas, el parto a pretérmino, y el bajo peso al nacer, cuando se tienen en cuenta la manifestación clínicas de las enfermedades periodontales en las embarazadas, los hallazgos microbiológicos y las hipótesis propuestas sobre la etiopatogénesis de las complicaciones del embarazo, sugeridas a partir de los hallazgos de estudios realizados en animales y en humanos.
The aim of this bibliographic revision is to show the existing relationship between periodontal disease and some adverse pregnancy outcomes such as preeclampsia, pre-labor rupture of membranes, fetal growth restriction, preterm birth and low birth weight; by taking in account some aspects of the periodontal disease like clinical manifestations during pregnancy, microbiological findings, and the different results found in animal and human casecontrol studies.
Assuntos
Gravidez , Doenças Periodontais , Complicações na Gravidez , Dinoprostona , Periodontite , Pré-Eclâmpsia , Fator de Necrose Tumoral alfaRESUMO
Diarrhetic shellfish poisoning (DSP) is a gastrointestinal disease caused by fat-soluble polyether toxins produced by dinoflagellates and accumulated in shellfish. Up to the present, only four fat-soluble polyethers have been known as diarrhetic shellfish toxins. Among them,*** Okadaic acid, Dinophysistoxin-1, Dinophysistoxin-2 and Dinophysistoxin-3. Outbreaks associated with DSP have occurred in the Chilean Patagonia fjords since 1970. Native people, who live in small communities close to the southern fjords, smoke fresh shellfish. During this popular smoking procedure, they impregnate the shellfish with polycyclic aromatic hydrocarbons, as incomplete combustion products, which are potent carcinogenic compounds, this product is sold in local markets without phycotoxins analysis or inclusion in any monitoring program. The present paper shows, DSP phycotoxins quantitation, using high performance liquid chromatography with fluorescent and mass spectrometric detection and the measurements of polycyclic aromatic hydrocarbons by gas chromatography with mass detection, in smoked shellfish samples. The presence of Dinophysistoxin-3, the Dinophysistoxin-1 ester (7-O-acyl-derivatives of dinophysistoxin-1), was assessed in all shellfish samples analyzed. The 7-OH in Dinophysistoxin-1 was esterified with palmitic fatty acid. The shellfish meat contains seven polycyclic aromatic hydrocarbons, among them fluoranthene, phenanthrene, anthracene, pyrene and benzo[a]pyrene. The gas chromatography-mass spectrometry analysis showed four of the six most frequent carcinogenic polycyclic aromatic hydrocarbons reported. The content of benzo[a]pyrene in the Razor Clam and Ribbed Mussel were 78.61 and 4.94 ng/g of shellfish dry weight, respectively. In both cases the benzo[a]pyrene amounts were greater than the acceptable tolerance limits of 1 microg/kg of sample. The Razor Clam samples also show amount further above the maximum label regulated by FAO/WHO (10 microg/kg). The presence of both type of compounds in the smoked shellfish samples analyzed, correspond to a dangerous combination, where the polycyclic aromatic hydrocarbons are carcinogenic compounds by themselves and DTX-1, is a potent tumor promoter.