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Eating during the rest phase is associated with metabolic syndrome, proposed to result from a conflict between food consumption and the energy-saving state imposed by the circadian system. However, in nocturnal rodents, eating during the rest phase (day-feeding, DF) also implies food intake during light exposure. To investigate whether light exposure contributes to DF-induced metabolic impairments, animals receive food during the subjective day without light. A skeleton photoperiod (SP) is used to entrain rats to a 12:12 cycle with two short light pulses framing the subjective day. DF-induced adiposity is prevented by SP, suggesting that the conflict between light and feeding stimulates fat accumulation. However, all animals under SP conditions develop glucose intolerance regardless of their feeding schedule. Moreover, animals under SP with ad libitum or night-feeding have increased adiposity. SP animals show a delayed onset of the daily rise in body temperature and energy expenditure and shorter duration of nighttime activity, which may contribute to the metabolic disturbances. These data emphasize that metabolic homeostasis can only be achieved when all daily cycling variables are synchronized. Even small shifts in the alignment of different metabolic rhythms, such as those induced by SP, may predispose individuals to metabolic disease.
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Intolerância à Glucose , Fotoperíodo , Ratos , Animais , Adiposidade , Comportamento Alimentar , Ritmo Circadiano , Intolerância à Glucose/etiologia , Obesidade/etiologia , EsqueletoRESUMO
Microglia is considered the central nervous system (CNS) resident macrophages that establish an innate immune response against pathogens and toxins. However, the recent studies have shown that microglial gene and protein expression follows a circadian pattern; several immune activation markers and clock genes are expressed rhythmically without the need for an immune stimulus. Furthermore, microglia responds to an immune challenge with different magnitudes depending on the time of the day. This review examines the circadian control of microglia function and the possible physiological implications. For example, we discuss that synaptic prune is performed in the cortex at a certain moment of the day. We also consider the implications of daily microglial function for maintaining biological rhythms like general activity, body temperature, and food intake. We conclude that the developmental stage, brain region, and pathological state are not the only factors to consider for the evaluation of microglial functions; instead, emerging evidence indicates that circadian time as an essential aspect for a better understanding of the role of microglia in CNS physiology.
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Microglia , Fenômenos Fisiológicos , Microglia/fisiologia , Macrófagos , Sistema Nervoso Central , Encéfalo , Imunidade InataRESUMO
The rapid spread of COVID-19 on all continents and the mortality induced by SARS-CoV-2 virus, the cause of the pandemic coronavirus disease 2019 (COVID-19) has motivated an unprecedented effort for vaccine development. Inactivated viruses as well as vaccines focused on the partial or total sequence of the Spike protein using different novel platforms such us RNA, DNA, proteins, and non-replicating viral vectors have been developed. The high global need for vaccines, now and in the future, and the emergence of new variants of concern still requires development of accessible vaccines that can be adapted according to the most prevalent variants in the respective regions. Here, we describe the immunogenic properties of a group of theoretically predicted RBD peptides to be used as the first step towards the development of an effective, safe and low-cost epitope-focused vaccine. One of the tested peptides named P5, proved to be safe and immunogenic. Subcutaneous administration of the peptide, formulated with alumina, induced high levels of specific IgG antibodies in mice and hamsters, as well as an increase of IFN-γ expression by CD8+ T cells in C57 and BALB/c mice upon in vitro stimulation with P5. Neutralizing titers of anti-P5 antibodies, however, were disappointingly low, a deficiency that we will attempt to resolve by the inclusion of additional immunogenic epitopes to P5. The safety and immunogenicity data reported in this study support the use of this peptide as a starting point for the design of an epitope restricted vaccine.
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COVID-19 , Vacinas Virais , Cricetinae , Humanos , Camundongos , Animais , SARS-CoV-2 , Epitopos , Glicoproteína da Espícula de Coronavírus/genética , Vacinas contra COVID-19 , COVID-19/prevenção & controle , Anticorpos Antivirais , Imunoglobulina G , Peptídeos , RNA , Óxido de Alumínio , Anticorpos NeutralizantesRESUMO
Sleep has a major role in learning, memory consolidation, and metabolic function. Although it is known that sleep restriction increases the accumulation of amyloid ß peptide (Aß) and the risk to develop Alzheimer's disease (AD), the mechanism behind these effects remains unknown. In this review, we discuss how chronic sleep restriction induces metabolic and cognitive impairments that could result in the development of AD in late life. Here, we integrate evidence regarding mechanisms whereby metabolic signaling becomes disturbed after short or chronic sleep restriction in the context of cognitive impairment, particularly in the accumulation of Aß in the brain. We also discuss the role of the blood-brain barrier in sleep restriction with an emphasis on the transport of metabolic signals into the brain and Aß clearance. This review presents the unexplored possibility that the alteration of peripheral metabolic signals induced by sleep restriction, especially insulin resistance, is responsible for cognitive deficit and, subsequently, implicated in AD development.
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Purpose: To evaluate the cumulative incidence and progression of erosive tooth wear (ETW) and identify risk factors over 18 months in a cohort of 11- to 14-year-old schoolchildren in Mexico. Methods: The study was conducted in public schools located in northern Mexico City. Permanent teeth of 424 schoolchildren were examined using the basic erosive wear examination. The possible risk factors were included in the logistic models: the consumption of acidic food and beverages; habits related to the consumption of beverages; medication; gastroesophageal reflux; frequent vomiting; and characteristics of the saliva. Results: The prevalence of ETW was 62.5 percent (265 out of 424). The cumulative incidence was 35.2 percent (56 out of 159) and the progression was 72.8 percent (193 out of 265). The consumption of acidic beverages increased the relative risk (RR) of both the cumulative incidence (RR equals 1.09; 95 percent confidence interval [95% CI] 1.02 to 1.18; P=0.005) and the progression (RR equals 1.16; 95% CI 1.01 to 1.34; P=0.003). Conclusions: This population has a high risk of the development and progression of ETW, found in approximately one-third and approximately two-thirds of the schoolchildren, respectively. The most important risk factor was the consumption of acidic beverages.
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Erosão Dentária , Desgaste dos Dentes , Adolescente , Criança , Humanos , Incidência , México , Prevalência , Fatores de RiscoRESUMO
In mammals, time and metabolism are tightly coupled variables; this relationship can be illustrated by numerous examples, such as the circadian variation in food intake or the circadian response to a glucose bolus. We review evidence that the interaction between the suprachiasmatic nucleus and the arcuate nucleus plays a key role in the execution of these functions. The nuclei are reciprocally connected via different projections, and this interaction provides an ideal anatomical framework to modify the temporal output of the hypothalamus to metabolic organs as a consequence of the feedback from the periphery. The suprachiasmatic nucleus-arcuate nucleus relationship is essential to integrate metabolic information into the circadian system and thus adapt circadian rhythms in core body temperature, locomotor activity, food intake, and circulating molecules such as glucose and corticosterone. With the rise in obesity-associated diseases in the world population, gaining knowledge about this relationship, and the consequences of disturbing this liaison, is essential to understand the pathogenesis of obesity.
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Núcleo Arqueado do Hipotálamo/fisiologia , Ritmo Circadiano/fisiologia , Núcleo Supraquiasmático/fisiologia , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: Non-communicable diseases, such as obesity, diabetes, and hypertension, can be prevented and treated through a balanced nutrient-rich diet. Nutrition labels have been recognized as crucial to preventing obesity and non-communicable diseases through a healthier diet. OBJECTIVE: Our aim was to examine the association between nutrition label use and chronic conditions (overweight, obesity, previously diagnosed diabetes, and hypertension) among an adult Mexican population. DESIGN: This was a cross-sectional study that used data from the Mexican National Health and Nutrition Survey of 2016 (ENSANUT MC 2016). PARTICIPANTS/SETTING: The participants were 5,013 adults aged 20 to 70 years old. Older adults (>70 years), illiterate participants, pregnant women, and participants with implausible blood pressure data were excluded from the sample. The survey was conducted from May to August 2016 in the participants' households. MAIN OUTCOME MEASURES: We measured chronic conditions (overweight, obesity, previously diagnosed diabetes, and hypertension). STATISTICAL ANALYSES PERFORMED: Pearson χ2 test was used to examine the associations among the use of nutrition labels and sociodemographic characteristics and chronic conditions. Multiple logistic regression was used to determine the association between nutrition label use and chronic conditions adjusting for the effect of confounding variables like sex, age, body mass index, education level, marital status, ethnicity, residence area, region, and socioeconomic status. RESULTS: From the total sample, 40.9% (95% CI 38.4% to 43.8%) reported using nutrition labeling. Respondents with overweight or obesity were less likely to use nutrition labels (odds ratio 0.74; P<0.05). Participants who self-reported diabetes had significantly lower odds of nutrition label use than participants who did not report to have diabetes (odds ratio 0.66; P<0.05). Participants having 3 chronic conditions had lower odds of nutrition label use (odds ratio 0.34; P<0.01) relative to having zero chronic conditions. CONCLUSIONS: This study suggests an association between nutrition label use and chronic conditions (obesity and diabetes). These findings demonstrate that people with obesity, diabetes, and a combination of chronic conditions were less likely to use nutrition labels than people without these conditions.
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Doença Crônica/psicologia , Dieta Saudável/psicologia , Rotulagem de Alimentos/estatística & dados numéricos , Preferências Alimentares/psicologia , Comportamentos Relacionados com a Saúde/etnologia , Adulto , Idoso , Doença Crônica/epidemiologia , Doença Crônica/etnologia , Estudos Transversais , Diabetes Mellitus/etnologia , Diabetes Mellitus/psicologia , Dieta Saudável/etnologia , Feminino , Preferências Alimentares/etnologia , Humanos , Modelos Logísticos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Inquéritos Nutricionais , Obesidade/etnologia , Obesidade/psicologia , Razão de Chances , Sobrepeso/etnologia , Sobrepeso/psicologia , Adulto JovemRESUMO
Self-assembly of natural polymers constitute a powerful route for the development of functional materials. In particular, layer-by-layer (LBL) assembly constitutes a versatile technique for the nanostructuration of biobased polymers into multilayer films. Gelatin has gained much attention for its abundance, biodegradability, and excellent gel-forming properties. However, gelatin gels melt at low temperature, thus limiting its practical application. With respect to the above considerations, here, we explored the potential application of gelatin gels as a matrix for protein delivery at physiological temperature. A model protein, bovine serum albumin (BSA), was encapsulated within gelatin gels and then coated with a different number of bilayers of alginate and chitosan (10, 25, 50) in order to modify the diffusion barrier. The coated gel samples were analyzed by means of Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) and confocal Raman spectroscopy, and it was found that the multilayer coatings onto polymer film were interpenetrated to some extent within the gelatin. The obtained results inferred that the coating of gelatin gels with polysaccharide multilayer film increased the thermal stability of gelatin gels and modulated the BSA release. Finally, the influence of a number of bilayers onto the drug release mechanism was determined. The Ritger-Peppas model was found to be the most accurate to describe the diffusion mechanism.
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Alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid glutamate receptors have been shown to modulate the morphology of the lamelar processes of Bergmann glia cells in the molecular layer of the cerebellum. Here we suggest that reorganization of F-actin may underlay the changes in the morphology of the lamelar processes. Using the fluorescent staining of F-actin with Phalloidin and the quantification of RhoA activation through immunoprecipitation or pull-down assays, we show that RhoA is activated after stimulation of alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid receptors and leads to the reorganization of the actin cytoskeleton of Bergmann fibers. This reorganization of the actin cytoskeleton is reflected in the form of an increase in the intensity of the F-actin staining as well as in the loss of the number of Bergmann fibers stained with Phalloidin. Moreover, using a pharmacological approach, we show that activation of RhoA and the change in the intensity of the F-actin staining depends on the activation of PI3-K, focal adhesion kinase, and protein kinase C, whereas changes in the number of Bergmann fibers depend on external calcium in a RhoA independent manner. Our findings show that glutamate may induce a form of structural plasticity in Bergmann glia cells through the reorganization of the actin cytoskeleton. This may have implications in the way the synaptic transmission is processed in the cerebellum.
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Actinas/metabolismo , Ácido Glutâmico/metabolismo , Neuroglia/metabolismo , Receptores de AMPA/metabolismo , Proteína rhoA de Ligação ao GTP/metabolismo , Citoesqueleto de Actina/metabolismo , Animais , Cerebelo/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Transdução de Sinais/fisiologiaRESUMO
INTRODUCTION: Cognitive and/or memory impairment are the main clinical markers currently used to identify subjects at risk of developing dementia. This study aimed to explore the relationship between the presence of neuropsychiatric symptoms and dementia incidence. METHODS: We analyzed the association between neuropsychiatric symptoms and incident dementia in a cohort of 1355 Mexican older adults from the general population over 3 years of follow-up, modeling cumulative incidence ratios using Poisson models. RESULTS: Five neuropsychiatric symptoms were associated with incident dementia: delusions, hallucinations, anxiety, aberrant motor behavior, and depression. The simultaneous presence of two symptoms had a relative risk, adjusted for mild cognitive impairment, diabetes, indicators of cognitive function, and sociodemographic factors, of 1.9 (95% confidence interval, 1.2-2.9), whereas the presence of three to five, similarly adjusted, had a relative risk of 3.0 (95% confidence interval, 1.9-4.8). DISCUSSION: Neuropsychiatric symptoms are common in predementia states and may independently contribute as risk factors for developing dementia.
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Demência/epidemiologia , Transtornos Mentais/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Masculino , México/epidemiologia , Fatores de Risco , Fatores SocioeconômicosRESUMO
The possibility of combining more than one stimulus-responsive property into a single material holds interesting potential for the creation of adaptive devices to be used in diverse fields such as drug delivery, nanomedicine and tissue engineering. This paper describes a novel material based on thermo-responsive PNIPAm nanopillars with amplified surface properties through the incorporation of Fe3O4 nanoparticles. The incorporation of magnetic nanoparticles into the nanopillars, prepared via surface-initiated atom-transfer radical polymerization in anodized aluminum oxide templates, sharply increased their stiffness and hydrophobicity when increasing the temperature above the volume phase transition temperature. Furthermore, their magnetic response turned out to be proportional to the amount of the incorporated nanoparticles. The possibility of sharply increasing the stiffness with a temperature variation close to the human body temperature paves the way to the application of these substrates as "smart" scaffolds for cell culture. Additionally, the presence of superparamagnetic nanoparticles in the nanopillars offers the possibility of using these nanostructured systems for magnetic hyperthermia.
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NEW FINDINGS: What is the central question of this study? What are the factors influencing day-night variations in postprandial triglycerides? What is the main finding and its importance? Rats show low postprandial plasma triglyceride concentrations early in the active period that are attributable to a higher uptake by skeletal muscle and brown adipose tissue. We show that these day-night variations in uptake are driven by the suprachiasmatic nucleus, probably via a Rev-erbα-mediated mechanism and independent of locomotor activity. These findings highlight that the suprachiasmatic nucleus has a major role in day-night variations in plasma triglycerides and that disturbances in our biological clock might be an important risk factor contributing to development of postprandial hyperlipidaemia. Energy metabolism follows a diurnal pattern, mainly driven by the suprachiasmatic nucleus (SCN), and disruption of circadian regulation has been linked to metabolic abnormalities. Indeed, epidemiological evidence shows that night work is a risk factor for cardiovascular disease, and postprandial hyperlipidaemia is an important contributor. Therefore, the aim of this work was to investigate the factors that drive day-night variations in postprandial triglycerides (TGs). Intact and SCN-lesioned male Wistar rats were subjected to an oral fat challenge during the beginning of the rest phase (day) or the beginning of the active phase (night). The plasma TG profile was evaluated and tissue TG uptake assayed. After the fat challenge, intact rats showed lower postprandial plasma TG concentrations early in the night when compared with the day. However, no differences were observed in the rate of intestinal TG secretion between day and night. Instead, there was a higher uptake of TG by skeletal muscle and brown adipose tissue early in the active phase (night) when compared with the rest phase (day), and these variations were abolished in rats bearing bilateral SCN lesions. Rev-erbα gene expression suggests this as a possible mediator of the mechanism linking the SCN and day-night variations in TG uptake. These findings show that the SCN has a major role in day-night variations in plasma TGs by promoting TG uptake into skeletal muscle and brown adipose tissue. Consequently, disturbance of the biological clock might be an important risk factor contributing to the development of hyperlipidaemia.
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Tecido Adiposo Marrom/metabolismo , Relógios Biológicos/fisiologia , Ritmo Circadiano , Gorduras na Dieta/sangue , Metabolismo Energético , Músculo Esquelético/metabolismo , Período Pós-Prandial , Núcleo Supraquiasmático/fisiologia , Triglicerídeos/sangue , Ciclos de Atividade , Animais , Gorduras na Dieta/administração & dosagem , Regulação da Expressão Gênica , Masculino , Atividade Motora , Membro 1 do Grupo D da Subfamília 1 de Receptores Nucleares/genética , Membro 1 do Grupo D da Subfamília 1 de Receptores Nucleares/metabolismo , Fotoperíodo , Ratos Wistar , Transdução de Sinais , Núcleo Supraquiasmático/metabolismo , Fatores de TempoRESUMO
PURPOSE: To study the levels of pathogenic and non-pathogenic Th17 and Th22 cells in autoimmune thyroid disorders patients. Although Th17 cells seem to play an important role in the pathogenesis of thyroid autoimmune disorders, the specific subsets of these lymphocytes have not been analyzed in this condition. METHODS: We assessed the levels of Th17 (pathogenic and non-pathogenic) and Th22 cells in peripheral blood and thyroid glands of autoimmune thyroid disorders patients (n = 26, 16 with Graves' disease and 10 with Hashimoto's thyroiditis) and 15 healthy controls by multi-parametric flow cytometry and immunofluorescence microscopy. RESULTS: We found increased levels of pathogenic Th17 lymphocytes and Th22 cells in peripheral blood from autoimmune thyroid disorders patients. In addition, these cells were detected in thyroid glands from HT patients. Furthermore, we found significant correlations between the levels of these cells and disease activity, disease duration, and the presence of ophthalmopathy. CONCLUSIONS: The increased levels of pathogenic Th17 lymphocytes and Th22 cells in autoimmune thyroid disorders suggest their involvement in the pathogenesis of this condition.
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Autoimunidade , Doença de Graves/imunologia , Doença de Hashimoto/imunologia , Linfocitose/etiologia , Linfócitos T Auxiliares-Indutores/imunologia , Células Th17/imunologia , Glândula Tireoide/imunologia , Adulto , Autoanticorpos/análise , Células Cultivadas , Feminino , Citometria de Fluxo , Doença de Graves/metabolismo , Doença de Graves/patologia , Doença de Graves/fisiopatologia , Oftalmopatia de Graves/etiologia , Doença de Hashimoto/metabolismo , Doença de Hashimoto/patologia , Doença de Hashimoto/fisiopatologia , Humanos , Iodo/urina , Ativação Linfocitária , Contagem de Linfócitos , Masculino , Microscopia de Fluorescência , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Linfócitos T Auxiliares-Indutores/metabolismo , Linfócitos T Auxiliares-Indutores/patologia , Células Th17/metabolismo , Células Th17/patologia , Glândula Tireoide/metabolismo , Glândula Tireoide/patologia , Glândula Tireoide/fisiopatologia , Hormônios Tireóideos/sangueRESUMO
Research on factors associated with poor adherence to self-care focuses primarily on psychiatric emotional disorders such as depression and anxiety, whereas non-psychiatric chronic-disease-related emotional distress has received little attention in hypertensive patients. The objective of this study was to evaluate the association of hypertension-related distress with the lack of self-care including low adherence to pharmacological treatment, lack of regular physical activity, low intake of fruits and vegetables and frequent intake of high-salt foods. A cross-sectional survey was conducted in 2014 in two family medical units affiliated with the Mexican Institute of Social Security. The study included 487 hypertensive patients >19 years of age. The conceptual framework for the study was based on the Health Promotion Model. The analysis included multiple Poisson regression models. We found that 21.1% of participants had hypertension-related distress. Low adherence to pharmacological treatment was identified in 45.8% of patients, whereas 46.8% lacked regular physical activity, 30.8% reported a low consumption of fruits and vegetables, and 54.6% frequently consumed foods high in salt content. Hypertension-related distress was associated with lack of regular physical activity and low intake of fruits and vegetables. These findings highlight the importance of addressing distress in order to improve self-care of hypertensive patients.
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Comportamentos Relacionados com a Saúde , Hipertensão/psicologia , Hipertensão/terapia , Cooperação do Paciente/psicologia , Autocuidado , Estresse Psicológico/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
The crystallization and morphology of PLA-mb-PBS copolymers and their corresponding stereocomplexes were studied. The effect of flexible blocks (i.e., polybutylene succinate, PBS) on the crystallization of the copolymers and stereocomplex formation were investigated using polarized light optical microscopy (PLOM), differential scanning calorimetry (DSC), infrared spectroscopy (FTIR), and carbon-13 nuclear magnetic resonance spectroscopy (13C-NMR). The PLA and PBS multiple blocks were miscible in the melt and in the glassy state. When the PLA-mb-PBS copolymers are cooled from the melt, the PLA component crystallizes first creating superstructures, such as spherulites or axialites, which constitute a template within which the PBS component has to crystallize when the sample is further cooled down. The Avrami theory was able to fit the overall crystallization kinetics of both semi-crystalline components, and the n values for both blocks in all the samples had a correspondence with the superstructural morphology observed by PLOM. Solution mixtures of PLLA-mb-PBS and PLDA-mb-PBS copolymers were prepared, as well as copolymer/homopolymer blends with the aim to study the stereocomplexation of PLLA and PDLA chain segments. A lower amount of stereocomplex formation was observed in copolymer mixtures as compared to neat L100/D100 stereocomplexes. The results show that PBS chain segments perturb the formation of stereocomplexes and this perturbation increases with the amount of PBS in the samples. However, when relatively low amounts of PBS in the copolymer blends are present, the rate of stereocomplex formation is enhanced. This effect dissappears when higher amounts of PBS are present. The stereocomplexation was confirmed by FTIR and solid state 13C-NMR analyses.
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OBJECTIVES: To assess the epidemiologic and microbiologic profile and in vitro fluconazole susceptibility of yeasts isolated from the oral mucosa colonization/infection of elderly patients. BACKGROUND: It has been reported that in older adults increases the oral colonization by Candida particularly C. non-albicans, showing a decreased response to fluconazole, which increases the risk of recalcitrant local and disseminated candidiasis. MATERIALS AND METHODS: This was a prospective cross-sectional study conducted in 120 elderly patients. Oral samples were obtained of mucosal Candida colonization or infection by swabbing. Each sample was plated on CHROMagar(®)Candida and incubated (36±1.5°C) for two days. The yeast species were identified using the API(®)ID32-C-AUX. Fluconazole susceptibility was tested using a broth microdilution assay according to the CLSI methods. RESULTS: The yeast colonization/infection frequency in the total population was 65.8%. The frequency of the highest Candida carriers was 67.4% in the 70-79-year-old-group. Oral candidiasis was present in 20%, with a tendency to increase with age (33.3% of adults aged>80years), it was determined that the use of prosthesis is associated with a higher colonization rate (Chi2, p=0.011). The frequency of colonization/infection cases with more than one species showed a tendency to increase with age; 18.9% in the 60-69 year-old-group, 20.9% in the 70-79-year-old-group and 29.2% in the ≥80 year-old-group. About fluconazole susceptibility: for C. albicans, 20.3%, about Candida non-albicans species 15.3% were dose dependently susceptible (DDS) and 17.9% were resistant. CONCLUSIONS: After 80 years of age, there is a considerable increase in Candida non-albicans species and a reduced susceptibility to fluconazole.
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Antifúngicos/uso terapêutico , Candidíase Bucal/diagnóstico , Fluconazol/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Candida/isolamento & purificação , Candidíase Bucal/tratamento farmacológico , Estudos Transversais , Farmacorresistência Fúngica , Feminino , Humanos , Masculino , México , Mucosa Bucal/microbiologia , Estudos ProspectivosRESUMO
OBJECTIVES: The aim of this study was to adapt and validate the Distress Scale for Mexican patients with type 2 diabetes and hypertension (DSDH17M). SETTING: Two family medicine clinics affiliated with the Mexican Institute of Social Security. PARTICIPANTS: 722 patients with type 2 diabetes and/or hypertension (235 patients with diabetes, 233 patients with hypertension and 254 patients with both diseases). DESIGN: A cross-sectional survey. METHODS: The validation procedures included: (1) content validity using a group of experts, (2) construct validity from exploratory factor analysis, (3) internal consistency using Cronbach's α, (4) convergent validity between DSDH17M and anxiety and depression using the Spearman correlation coefficient, (5) discriminative validity through the Wilcoxon rank-sum test and (6) test-retest reliability using intraclass correlation coefficient. RESULTS: The DSDH17M has 17 items and three factors explaining 67% of the total variance. Cronbach α ranged from 0.83 to 0.91 among factors. The first factor of 'Regime-related Distress and Emotional Burden' moderately correlated with anxiety and depression scores. Discriminative validity revealed that patients with obesity, those with stressful events and those who did not adhere to pharmacological treatment had significantly higher distress scores in all DSDH17M domains. Test-retest intraclass correlation coefficient for DSDH17M ranged from 0.92 to 0.97 among factors. CONCLUSIONS: DSDH17M is a valid and reliable tool to identify distress of patients with type 2 diabetes and hypertension.
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Ansiedade/diagnóstico , Depressão/diagnóstico , Diabetes Mellitus Tipo 2/psicologia , Hipertensão/psicologia , Escalas de Graduação Psiquiátrica/normas , Psicometria/métodos , Idoso , Estudos Transversais , Análise Fatorial , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Qualidade de Vida , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Inquéritos e QuestionáriosRESUMO
El análisis de la situación de salud como proceso, tiene como característica principal la interrelación de variables pertenecientes al aspecto político, socioeconómico y ecológico de la comunidad, que permite generar una descripción y explicación del proceso salud enfermedad. Objetivo: Identificar las características de la estructura poblacional y los factores de riesgo de las personas del área urbana del municipio de Guaimaca, Francisco Morazán, de noviembre 2012 a noviembre de 2013. Material y Métodos: Estudio descriptivo de corte transversal. La población fue de 12,442 personas de ambos sexos de todas las edades. Se utilizó para la recolección de datos la ficha familiar conformada por 43 ítems y se elaboró un instructivo que facilitó el llenado de la ficha. Resultados: La morbilidad mayor de 15 días de duración presente en la población, mostró que las primeras causas de enfermedad son: hipertensión arterial 5.2%; diabetes mellitus 1.7% y asma bronquial 1.3%. En el grupo de personas aparentemente sanas no se encontró diferencia por sexo; en el grupo de población con riesgo predominó el sexo masculino 21%. En el grupo población enferma predominó el femenino con 11.6%; en las personas con deficiencia, incapacidad o secuela no se encontró diferencia porcentual. Conclusión. En el área urbana del municipio de Guaimaca la mayoríade las personas resultaron estar aparentemente sana. Los grupos dispensariales II, III y IV estaban presentes en la población en menor frecuencia...(AU)
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Humanos , Doença Crônica/economia , Serviços de Saúde Comunitária , Dados Estatísticos , Grupos Populacionais , Atenção Primária à SaúdeRESUMO
PURPOSE: The purpose of this study was to validate the Mexican version of the Support Person Unmet Needs Survey (SPUNS-SFM). METHODS: A cross-sectional survey that included 826 primary caregivers of cancer patients was conducted from June to December 2013 at the Oncology Hospital of the Mexican Institute of Social Security in Mexico City. The validation procedure comprised (1) content validity through a group of experts; (2) construct validity through an exploratory factor analysis based on the polychoric correlation matrix; (3) internal consistency using Cronbach's alpha; (4) convergent validity between SPUNS-SFM and quality of life, anxiety-and-depression scales by calculating Spearman's rank correlation coefficient;( 5) discriminative validity through the Wilcoxon rank-sum test; and (6) test-retest reliability using intraclass correlation coefficient. RESULTS: SPUNS-SFM has 23 items with six factors accounting for 65 % of the total variance. The domains were concerns about the future, access and continuity of healthcare, information, work and finance, and personal and emotional needs. Cronbach's alpha values ranged from 0.70 to 0.88 among factors. SPUNS-SFM had moderate convergent validity compared with quality of life and depression-and-anxiety scales and good discriminative validity, revealing high needs for younger caregivers and more emotional needs for caregivers of patients with advanced cancer stages. Intraclass correlation coefficient between SPUNS-SFM measurements was 0.78. CONCLUSION: SPUNS-SFM is a valid and reliable tool to identify needs of caregivers of cancer patients.
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Cuidadores/psicologia , Neoplasias/psicologia , Psicometria/métodos , Estudos Transversais , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Inquéritos e QuestionáriosRESUMO
PURPOSE: The purpose of this study is to validate the Mexican version of the Short-Form Supportive Care Needs survey (SCNS-SFM). METHODS: A cross-sectional survey was conducted from June to December 2013 at the Oncology Hospital of the Mexican Institute of Social Security in Mexico City. The study included 825 subsequent cancer patients >20 years of age with all forms of solid cancer. Patients had prior surgical removal of histologically confirmed cancer and attended outpatient consultations. Validation of SCNS-SFM included the following: (1) content validity through a group of experts; (2) construct validity through an exploratory factor analysis based on the polychoric correlation matrix; (3) internal consistency using Cronbach's alpha; (4) convergent validity between SCNS-SFM and quality of life, anxiety, and depression scales by calculating Pearson's correlation coefficient; (5) discriminative validity through analysis of MANOVAs; and (6) test-retest reliability using intraclass correlation coefficient calculations. RESULTS: SCNS-SFM has 33 items with five factors accounting for 59 % of total variance. Cronbach's alpha values ranged from 0.78 to 0.90 among factors. SCNS-SFM has good convergent validity compared with quality of life and depression and anxiety scales and good discriminative validity, revealing great information, psychological support, and physical daily living needs for women, patients <60 years, and high physical daily living needs for those with <1 year since cancer diagnosis, with advanced disease stages and current chemo- or radiotherapy. Intraclass correlation coefficient between SCNS-SFM measurements was 0.9. CONCLUSION: SCNS-SFM has acceptable psychometric properties and is suitable to evaluate supportive care needs of cancer patients.