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Drought is a major threat to plant growth in many parts of the world. During periods of drought, multiple aspects of plant physiology are negatively affected. For instance, water shortages induce osmotic imbalance, inhibit photosynthesis, decrease nutrient uptake, and increases the production of reactive oxygen species (ROS). In this context, it is necessary to develop sustainable strategies for crops that would help mitigate these conditions. In previous studies, endophytic Zopfiella erostrata strains were found to extensively colonize plant roots, forming a profuse melanized mycelium in the rhizosphere, which could be involved in improving water uptake and nutrient mineralization in plants. The aim of this study is to evaluate the effect of different strains of Z. erostrata on stress mitigation in wheat and tomato plants grown under water deficit conditions. General plant growth variables, as well as physiological and biochemical parameters, related to oxidative status were determined. Our data demonstrate that inoculation with both Zopfiella strains had a very significant effect on plant growth, even under water deficit conditions. However, we observed an even more pronounced impact, depending on the plant and strain involved, suggesting a certain degree of plant/strain compatibility. The biochemical aspects, the accumulation of proline, the oxidative damage to lipids, and the activity of antioxidant enzymes varied considerably depending on the endophyte and the plant evaluated.
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At present, drought and soil salinity are among the most severe environmental stresses that affect the growth of plants through marked reduction of water uptake which lowers water potential, leading to osmotic stress. In general, osmotic stress causes a series of morphological, physiological, biochemical, and molecular changes that affect plant performance. Several studies have found that diverse types of soil microorganisms improve plant growth, especially when plants are under stressful conditions. Most important are the arbuscular mycorrhizal fungi (AMF) which form arbuscular mycorrhizas (AM) with approximately 80% of plant species and are present in almost all terrestrial ecosystems. Beyond the well-known role of AM in improving plant nutrient uptake, the contributions of AM to plants coping with osmotic stress merit analysis. With this review, we describe the principal direct and indirect mechanisms by which AM modify plant responses to osmotic stress, highlighting the role of AM in photosynthetic activity, water use efficiency, osmoprotectant production, antioxidant activities, and gene expression. We also discuss the potential for using AMF to improve plant performance under osmotic stress conditions and the lines of research needed to optimize AM use in plant production.
Assuntos
Micorrizas/fisiologia , Pressão Osmótica , Fenômenos Fisiológicos Vegetais , Plantas/microbiologia , Água/metabolismo , Agricultura , Antioxidantes , Expressão Gênica , Fotossíntese , Plantas/genéticaRESUMO
El concepto de intersectorialidad, aplicado al campo de la salud en la región de las Américas, tiene sus bases en la Declaración Salud para Todos de Alma-Ata de 1978 (1). En ese documento, se enfatizó sobre la estrategia de atención primaria y la búsqueda de equidad en salud, resaltando que la intersectorialidad «entraña la participación, además del sector sanitario, de todos los sectores y campos de actividad conexos del desarrollo nacional y comunitario [ ]¼ (2). De esa manera 39 años después, el reto de la intersectorialidad sigue vigente tal y como se expresa en la estrategia de investigación para la salud de la Organización Mundial de la Salud (OMS), en la que se destaca la necesidad de incorporar los hallazgos de la investigación científica en las políticas públicas, la promoción y en la atención médica (1, 3). Siguiendo esa línea, la falta de implementación de medidas e intervenciones, cuya eficacia y costo-efectividad han sido demostradas, genera un impacto negativo en la salud y por ende en la economía de los países tanto con altos como bajos ingresos (4, 5). En ese sentido, se reconoce que la limitada comunicación entre los actores de los diferentes sectores constituye la barrera más importante para la implementación de los resultados de las investigaciones y su incorporación en el diseño de las políticas públicas (6- 8). En efecto, la interacción promovida por la intersectorialidad beneficia la comunicación y la generación de políticas de salud pública (8, 9).
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Saúde Pública , Organização Mundial da SaúdeRESUMO
Background. An abnormally high incidence (44%) of bronchopulmonary dysplasia with variations in rates among cities was observed in Colombia among premature infants. Objective. To identify risk factors that could explain the observed high incidence and regional variations of bronchopulmonary dysplasia. Study Design. A case-control study was designed for testing the hypothesis that differences in the disease rates were not explained by differences in city-of-birth specific population characteristics or by differences in respiratory management practices in the first 7 days of life, among cities. Results. Multivariate analysis showed that premature rupture of membranes, exposure to mechanical ventilation after received nasal CPAP, no surfactant exposure, use of rescue surfactant (instead of early surfactant), PDA, sepsis and the median daily FIO(2), were associated with a higher risk of dysplasia. Significant differences between cases and controls were found among cities. Models exploring for associations between city of birth and dysplasia showed that being born in the highest altitude city (Bogotá) was associated with a higher risk of dysplasia (OR 1.82 95% CI 1.31-2.53). Conclusions. Bronchopulmonary dysplasia was manly explained by traditional risk factors. Findings suggest that altitude may play an important role in the development of this disease. Prenatal steroids did not appear to be protective at high altitude.
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Introducción: Los accidentes de tránsito ocasionados por conductores que se encuentran bajo el efecto del alcohol constituyen una de las principales causas de accidentalidad y mortalidad vial. Ante este problema, surge la necesidad de definir límites en cuanto al nivel de alcoholemia a partir del cual se pone en riesgo el estado de vigilia necesaria para la conducción. Objetivos: Determinar las concentraciones mínimas de alcohol en sangre con las que se altera el estado de vigilia o se genera algún grado de somnolencia que pone en riesgo la habilidad y la destreza al conducir. Métodos: Metanálisis de la literatura sobre los artículos publicados entre 1999 y 2009 que evaluaron la conducción en simuladores después de la ingesta de diferentes grados de alcohol y en los que se midió la somnolencia que estos grados producen en los conductores. Resultados: Se produce mayor somnolencia en los conductores que están bajo efecto de alcohol. Las diferencias medias estandarizadas (SMD) fueron de 0,81 (IC 95%: 0,54-1,09) para personas con niveles de concentraciones de alcohol en sangre (BAC) menores a 0,05 y de SMD = 1,16 (IC 95 %: 0,93-1,4) para las personas con niveles de BAC mayores a 0,05. En todas las escalas utilizadas para medir somnolencia se corroboró el efecto del alcohol. Conclusiones: En todos los desenlaces se evidenció que, independientemente de la cantidad de alcohol en la sangre (niveles mayores y menores de BAC = 0,05), la ingesta de alcohol está asociada con mayor somnolencia...
Introduction: Traffic accidents caused by drivers under the influence of alcohol are a major cause of road accidents and mortality. Faced with this problem, defining the limit of alcohol levels from which wakefulness for the purpose of driving is jeopardized is critical. Objectives: To determine the minimum concentration of alcohol in blood that alters wakefulness or generates some degree of drowsiness that compromises driving ability and skill. Method: Meta-analysis. Systematic review of eight databases, limited to publications between 1999 and 2009 in which the assessment was made through simulators and blood alcohol concentrations were measured. Results: In all the subgroups studied it was clear that people with some intake of alcohol tend to have some degree of drowsiness compared with those with a blood alcohol level of 0. Standardized mean differences in sleepiness were high. This means there was a great difference between those with blood alcohol concentrations and those without. Conclusions: In all outcomes it was evident that regardless of the amount of alcohol in blood, alcohol intake provoked in the drivers a tendency towards sleepiness. We observed that most simulator studies tend to favor zero alcohol intake while driving because of the high degree of drowsiness that occurs...
Assuntos
Consumo de Bebidas Alcoólicas , Metanálise como Assunto , AutomóveisRESUMO
The response of rice plants to inoculation with an arbuscular mycorrhizal (AM) fungus, Azospirillum brasilense, or combination of both microorganisms, was assayed under well-watered or drought stress conditions. Water deficit treatment was imposed by reducing the amount of water added, but AM plants, with a significantly higher biomass, received the same amount of water as non-AM plants, with a poor biomass. Thus, the water stress treatment was more severe for AM plants than for non-AM plants. The results showed that AM colonization significantly enhanced rice growth under both water conditions, although the greatest rice development was reached in plants dually inoculated under well-watered conditions. Water level did not affect the efficiency of photosystem II, but both AM and A. brasilense inoculations increased this value. AM colonization increased stomatal conductance, particularly when associated with A. brasilense, which enhanced this parameter by 80% under drought conditions and by 35% under well-watered conditions as compared to single AM plants. Exposure of AM rice to drought stress decreased the high levels of glutathione that AM plants exhibited under well-watered conditions, while drought had no effect on the ascorbate content. The decrease of glutathione content in AM plants under drought stress conditions led to enhance lipid peroxidation. On the other hand, inoculation with the AM fungus itself increased ascorbate and proline as protective compounds to cope with the harmful effects of water limitation. Inoculation with A. brasilense also enhanced ascorbate accumulation, reaching a similar level as in AM plants. These results showed that, in spite of the fact that drought stress imposed by AM treatments was considerably more severe than non-AM treatments, rice plants benefited not only from the AM symbiosis but also from A. brasilense root colonization, regardless of the watering level. However, the beneficial effects of A. brasilense on most of the physiological and biochemical traits of rice plants were only clearly visible when the plants were mycorrhized. This microbial consortium was effective for rice plants as an acceptable and ecofriendly technology to improve plant performance and development.
Assuntos
Azospirillum/fisiologia , Micorrizas/fisiologia , Oryza/microbiologia , Oryza/fisiologia , Simbiose/fisiologia , Água/fisiologia , Antioxidantes/metabolismo , Biomassa , Desidratação/microbiologia , Oryza/crescimento & desenvolvimento , Estresse Oxidativo/fisiologia , Fotossíntese/fisiologia , Folhas de Planta/crescimento & desenvolvimento , Raízes de Plantas/microbiologia , Transpiração Vegetal/fisiologia , Prolina/metabolismo , Distribuição Aleatória , Solo , Luz SolarRESUMO
Introducción: Conducir bajo los efectos del alcohol aumenta el riesgo de sufrir accidentes de tránsito y la tasa de accidentalidad vial tiende a incrementarse. Sin embargo, no es claro en qué grado la presencia de alcohol en la sangre logra desviar al conductor de su carril. Objetivos: Determinar las concentraciones mínimas de alcohol en la sangre que se deben alcanzar para alterar la habilidad de conducción en las personas y definir qué habilidades se ven afectadas con mayor rapidez en la desviación del carril. Método: Revisión sistemática de la literatura en ocho bases de datos. Se limitó a publicaciones de los últimos diez años (1999-2009) y a artículos en los que se hizo la evaluación a través de simuladores y donde se midieron las concentraciones de alcohol en la sangre. Resultados: De todos los subgrupos estudiados es evidente que las personas con algún consumo de alcohol tienden a desviarse más de la línea que las personas que no lo han consumido. Entre los conductores que presentaron alcohol en la sangre, sólo se encontró una pequeña diferencia entre las desviaciones de la línea de aquellos con cifras mayores o menores a 0,05 (0,65 vs. 0,78). Conclusiones: En todos los desenlaces se evidenció que, independientemente de la cantidad de alcohol en la sangre, el haber consumido hace que el conductor tienda a desviarse de su carril. En términos generales se puede decir que la desviación de la línea se convierte en una medida muy sensible al consumo de alcohol...
Introduction: Driving under the influence of alcohol increases the risk of traffic accidents and road accident. However, it is not clear to what extent the presence of alcohol in the blood can divert a driver of the lane. Objectives: To determine the minimum concentration of alcohol in the blood that must be reached to alter the driving ability in people and define what skills are affected more quickly in the deviation of the lane test. Method: Systematic review of the literature in eight databases, limited to publications of the last ten years (1999-2009) and articles in which the assessment was made through simulators and concentrations of alcohol in the blood were measured. Results: Of all the subgroups studied, it is clear that persons with any alcohol consumption tend to drift over the line more than people who have not consumed. Among the drivers who had alcohol in the blood, there was only a slight difference between the deviations from the line of those with levels greater or less than 0.05 (0.65 vs. 0.78). Conclusions: In all the endpoints was demonstrated that, regardless of the amount of alcohol in the blood, a driver with any alcohol use tend to deviate from the lane. Overall we can say that the deviation of the line becomes a very sensitive evidence of alcohol use...
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Consumo de Bebidas Alcoólicas , Metanálise como Assunto , AutomóveisRESUMO
Introducción: La accidentalidad vial debe una importante cuota al alcohol. El alcohol no sólo altera la capacidad para conducir y reaccionar al tráfico, sino que incrementa los riesgos de daños a otros pasajeros y a otros vehículos, los daños en propiedades, las pérdidas en horas laborables, la calidad de vida y las reparaciones. Método: Revisión sistemática de la literatura para evaluar los estudios descriptivos y experimentales que miden el impacto del consumo, la efectividad de las diferentes medidas de limitación al consumo y las alteraciones producidas por el alcohol en el conductor. Resultados: Los accidentes de tráfico asociados con el alcohol (ATRA) son la causa aislada más importante de muertes relacionadas con alcohol en muchos países. Cada aumento de 0,02% en las concentraciones de alcohol duplica el riesgo de un accidente fatal. La mayoría de accidentes en Colombia ocurren en áreas urbanas (75%) y el 53,3% de los muertos son peatones. Se ha mostrado que, adicionalmente, la educación tiene un impacto enorme en la prevención de accidentes. Conclusiones: Para reducir la accidentalidad relacionada con el alcohol es claro que las restricciones legales tienen impacto, así como los programas de educación e información. Debe generalizarse el concepto de alteración en la capacidad para conducir de manera segura y debe pedirse a las autoridades que busquen implementar los conceptos de limitación legal a la conducción bajo efectos del alcohol...
Introduction: Alcohol consumption plays an important role in road accidents. Alcohol not only alters the ability to drive and react to traffic, but it also increases the drivers riskof injuries and death, the risk of injuries to other passengers and pedestrians, increases damages to other vehicles and properties, quality of life, losses of labor hours. Method: Systematic review of literature to descriptive and experimental studies were evaluated for impact of alcohol consumption, for effectiveness of different strategies to reduce driving under the influence, and for effects of alcohol on driving performance. Results: Road accidents associated with driving under the influence are the isolated most important cause of deaths related to alcohol in m ny countries. For each increase in 0.02% in Blood Alcohol Concentration (BAC) the risk of a fatal accident duplicates. Most of the accidents in Colombia occur in the cities (75%) and 53.3% of deaths occur in pedestrians. It has been shown that education offers additional benefits. Conclusions: It is clear now that legal restrictions in the use of alcohol while driving produce reduction in road accidents, even more if accompanied by information and education programs. The knowledge of driving abilities impairment associated with alcohol consumption should be generalized, and the authorities asked to implement legal limits to driving under the effects of alcohol...
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Acidentes de Trânsito , Consumo de Bebidas Alcoólicas , Intoxicação AlcoólicaRESUMO
Con el estudio de los extractos de Peltostigma guatemalense, algunas fracciones sin purificar y metabolitos aislados, se determinó la actividad antimicrobiana frente a bacterias gram positivas (Staphylococcus aureus ATCC 6538 y Enterococcus faecalis ATCC 29212) y gram negativas (Salmonella typhimurium ATCC 14028s y MS 7953) así como la actividad antiparasitaria frente Plasmodium falciparum. Los metabolitos aislados de los extractos de hojas y extracto etanólico de madera fueron: siete alcaloides, skimmianina, γ-fagarina, anhidroevoxina, evoxina, 7-isopentiloxi-γ-fagarina, kokusaginina y 4-metoxi-1-metil-2-quinolona, una cumarina, escopoletina, un flavonoide, gardenina B, un lignano, siringaresinol, un terpeno, Lupeol, un esterol, sitosterol y dos derivados del ácido benzoico: p-hidroxibenzoato metilo y ácido fenilacético, los cuales fueron identificados por métodos espectroscópicos y por comparación con los datos reportados en la literatura. Los compuestos alcaloidales, anhidroevoxina, kokusaginina y 4-metoxi-1-metil-2-quinolona, mostraron una fuerte actividad anti Plasmodium y el compuesto p-hidroxibenzoato de metilo presentó la actividad antimicrobiana más promisoria comparada con los demás compuestos ensayados.
With the study of extracts Peltostigma guatemalense, some fraction without purify and isolated metabolites were found antimicrobial activity against Gram-positive bacteria Staphylococcus aureus ATCC 6538 and Enterococcus faecalis ATCC 29212 and Gram-negative Salmonella typhimurium ATCC 14028s and MS 7953 and as antiparasitic activity against Plasmodium falciparum. The metabolites isolated from extracts of ethanol extract of leaves and wood were: seven alkaloids γ-fagarine, anhidroevoxyn, evoxyn, skimmianine, 7-isopenthyloxi-γ-fagarina, kokusaginina and 4-methoxy-1-methyl-2- quinolone one coumarin, escopoletina, one flavonoid, gardenine B, one Lignan, syringaresinol, one terpene, lupeol, one sterol, sitosterol and two derivatives of benzoic acid: methyl-p-hydroxybenzoate, phenylacetic acid which were identified by spectroscopic methods and by comparison with the data reported in the literature. The alkaloid compounds, anhidroevoxyn, kokusaginine and 4-methoxy-1-methyl-2-quinolone, showed a strong anti Plasmodium activity and the compound p-hydroxybenzoate presented the most promising antimicrobial activity compared with the other compound tested.
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Alcaloides/farmacologia , Antimaláricos/farmacologia , Flavonoides , Rutaceae , Infecções Bacterianas/patologia , Plasmodium falciparumRESUMO
To improve the outcome of children with acute lymphoblastic leukemia (ALL) treated at the National Cancer Institute, Bogota, Colombia, a protocol based on the BFM-90 (Berlin, Frankfurt, Munster study) and the LSA2L2 regimens was implemented in the year 1993. The patients were classified as being standard risk (SR) or high risk (HR) according to clinical criteria, to which cytogenetic information and day-8 prednisone response were also added. A 123-patient cohort entered the study, 18 of them being considered SR and 105 HR. There was a 94% 10 years' event-free-survival rate for the SR group and 36% for the HR group. Decreased induction death rate (7% vs. 14%), increased complete remission (CR) rate (81% vs. 75%), and continuous CR (45% vs. 33%) were found in comparison with the previous study. A significant improvement was achieved in relapse rate, 44% to 28% (P=0.029), mainly due to reduced central nervous system relapse rate from 16% to 6% (P=0.037), whereas the number of patients receiving cranial radiation was reduced to 55%. A major problem concerned the increased CR mortality rate, 5% to 14% (P=0.06). Improved supportive care therapy and socioeconomic conditions will hopefully reduce the CR mortality rate in the future.
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Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Neoplasias do Sistema Nervoso Central/prevenção & controle , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Adolescente , Neoplasias do Sistema Nervoso Central/etiologia , Criança , Pré-Escolar , Estudos de Coortes , Colômbia , Irradiação Craniana , Análise Citogenética , Humanos , Lactente , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , Prednisona , Indução de Remissão , Risco , Prevenção Secundária , Taxa de SobrevidaRESUMO
In a double blind trial, 319 fully immunized children received two doses of either placebo or 10(6.7) focus-forming units of the attenuated RIX4414 human rotavirus (RV) vaccine ("all-in-one" formulation). Plasma RV-specific IgA (RV IgA), stool RV IgA, and circulating total and RV memory B cells (CD19+ IgD+/- CD27+) with an intestinal homing phenotype (alpha4beta7+ CCR9+/-) were measured, after the first and second doses, as potential correlates of protection. After the first and/or second dose, 54% of vaccinees and 13% of placebo recipients had plasma RV IgA. Before vaccination, most (95%) of the children (of both study groups) were breast-fed and had stool RV IgA (68.64%). Coproconversion (4-fold increase) after the first and/or second dose was observed in 32.7% of vaccinees and 17.4% of placebo recipients. No significant difference was seen when comparing the frequencies of any subset of memory B cells between vaccinees and placebo recipients. Statistically significant weak correlations were found between plasma RV IgA titers and coproconversion, and several subsets of memory B cells. The vaccine provided 74.8% protection (95% confidence interval, 30.93-92.62) against any RV gastroenteritis and 100% protection (95% confidence interval, 14.53-100) against severe RV gastroenteritis. When vaccinees and placebo recipients were considered together, a correlation was found between protection from disease and plasma RV IgA measured after dose 2 and RV memory (IgD- CD27+ alpha4beta7+ CCR9+) circulating B cells measured after dose 1. However, the correlation coefficients for both tests were low (<0.2), suggesting that other factors are important in explaining protection from disease.
Assuntos
Subpopulações de Linfócitos B/imunologia , Imunoglobulina A/imunologia , Infecções por Rotavirus/imunologia , Infecções por Rotavirus/prevenção & controle , Vacinas contra Rotavirus/imunologia , Rotavirus/imunologia , Vacinas Atenuadas/imunologia , Subpopulações de Linfócitos B/metabolismo , Colômbia , Método Duplo-Cego , Feminino , Humanos , Imunoglobulina A/sangue , Imunoglobulina A/metabolismo , Memória Imunológica , Lactente , Masculino , Vacinas Atenuadas/uso terapêuticoRESUMO
Si, en la B. Pero no en la segunda división del fútbol profesional colombiano sino en la categoría B del Sistema Nacional de Indexación de Publicaciones Especializadas de Ciencia, Tecnología e Innovación, y en su producto más visible, el Índice Bibliográfico Nacional Publindex ¿Por qué es importante que una revista como Infectio figure en este o en otros índices? La respuesta tiene al menos dos componentes. El primero es simple: para que los interesados puedan encontrar los artículos publicados en ella. La generación cada vez más acelerada de nueva información, producto de la investigación científica, conlleva retos para quienes quieren acceder a los nuevos hallazgos. ¿Cómo puede un lector interesado encontrar lo que busca? Los índices de publicaciones científicas, tales como PubMed la Biblioteca Nacional de Medicina de los Estados Unidos, Embase de Elsevier o la Biblioteca de la Colaboración Cochrane" la Colaboración Cochrane son uno de los principales medios para ello.
Yes, in the B division. But not in the second division of Colombian professional football, but in category B of the National Indexing System for Specialised Publications in Science, Technology and Innovation, and in its most visible product, the Publindex National Bibliographic Index. Why is it important for a journal like Infectio to appear in this or other indexes? The answer has at least two components. The first is simple: so that interested parties can find the articles published in it. The ever-accelerating generation of new information from scientific research brings challenges for those who want to access new findings. How can an interested reader find what he or she is looking for? Indexes of scientific publications, such as the US National Library of Medicine's PubMed, Elsevier's Embase or the Cochrane Collaboration's "Cochrane Collaboration Library" are one of the main means of doing so.
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Humanos , Publicações Seriadas , Sistemas de Avaliação das Publicações , Acesso à Informação , Indicadores (Estatística)RESUMO
INTRODUCTION: Bronchiolitis is the most common lower respiratory tract infection in infants, occurring in a seasonal pattern, with highest incidence in the winter in temperate climates, and in the rainy season in warmer countries. Bronchiolitis is a common reason for attendance at and admission to hospital. METHODS AND OBJECTIVES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of prophylactic interventions for bronchiolitis in high-risk children? What are the effects of measures to prevent transmission of bronchiolitis in hospital? What are the effects of treatments for children with bronchiolitis? We searched: Medline, Embase, The Cochrane Library and other important databases up to October 2006 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 40 systematic reviews, RCTs, or observational studies that met our inclusion criteria. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: bronchodilators (oral, inhaled salbutamol, inhaled adrenaline [epinephrine]), chest physiotherapy, corticosteroids, montelukast, nursing interventions (cohort segregation, hand washing, gowns, masks, gloves, and goggles), respiratory syncytial virus immunoglobulins, pooled immunoglobulins, or palivizumab (monoclonal antibody), ribavirin, or surfactants.
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Albuterol , Bronquiolite , Administração por Inalação , Albuterol/administração & dosagem , Bronquiolite/tratamento farmacológico , Broncodilatadores/uso terapêutico , Epinefrina/administração & dosagem , Hospitalização , Humanos , Lactente , Infecções por Vírus Respiratório Sincicial/tratamento farmacológicoAssuntos
Bronquiolite/tratamento farmacológico , Corticosteroides/efeitos adversos , Corticosteroides/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Anticorpos Monoclonais Humanizados , Bronquiolite/prevenção & controle , Broncodilatadores/efeitos adversos , Broncodilatadores/uso terapêutico , Criança , Infecção Hospitalar/prevenção & controle , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Palivizumab , Vírus Sinciciais Respiratórios/imunologia , Ribavirina/efeitos adversos , Ribavirina/uso terapêuticoAssuntos
Bronquiolite/tratamento farmacológico , Corticosteroides/efeitos adversos , Corticosteroides/uso terapêutico , Bronquiolite/prevenção & controle , Broncodilatadores/efeitos adversos , Broncodilatadores/uso terapêutico , Criança , Infecção Hospitalar/prevenção & controle , Humanos , Ribavirina/efeitos adversos , Ribavirina/uso terapêuticoRESUMO
A University-based hospital in Bogotá, Colombia, developed and implemented an educational intervention to complement a new structured antibiotic order form. This intervention was performed after assessing the appropriateness of the observed antibiotic prescribing practices using a quasi-experimental study. An application of interrupted time series intervention analysis was conducted in three antibiotic groups (aminoglycosides, cephradine/cephalothin, and ceftazidime/cefotaxime) and their hospital weekly rate of incorrect prescriptions before and after the intervention. A fourth time series was defined on prophylactic antibiotic use in elective surgery. Preintervention models were used in the postintervention series to test for pre-post series level differences. An abrupt constant change was significant in the first, third, and fourth time series indicating a 47, 7.3, and 20% reduction of incorrect prescriptions after the intervention. We conclude that a structured antibiotic order form, coupled with graphic and educational interventions can improve antibiotic use in a university hospital.
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Antibacterianos/administração & dosagem , Competência Clínica , Prescrições de Medicamentos/normas , Revisão de Uso de Medicamentos/métodos , Hospitais de Ensino/normas , Aminoglicosídeos/administração & dosagem , Antibioticoprofilaxia/normas , Cefazolina/administração & dosagem , Cefradina/administração & dosagem , Colômbia , Países em Desenvolvimento , Educação Médica Continuada , Grupos Focais , Formulários de Hospitais como Assunto/normas , Humanos , Corpo Clínico Hospitalar/educação , Modelos EstatísticosAssuntos
Bronquiolite/tratamento farmacológico , Corticosteroides/efeitos adversos , Corticosteroides/uso terapêutico , Antibacterianos/efeitos adversos , Antibacterianos/uso terapêutico , Antivirais/efeitos adversos , Antivirais/uso terapêutico , Bronquiolite/prevenção & controle , Broncodilatadores/efeitos adversos , Broncodilatadores/uso terapêutico , Criança , Pré-Escolar , Infecção Hospitalar/prevenção & controle , Humanos , Imunização Passiva , Ribavirina/efeitos adversos , Ribavirina/uso terapêuticoRESUMO
El objetivo de este estudio fue identificar una posible asociación entre el consumo de pasta básica de cocaína o basuco entre mujeres embarazadas y el crecimiento intrauterino de sus productos vivos en dos hospitales de tercer nivel en Bogotá, Colombia. con un diseño de cohorte retrospectiva, se encuestaron 1878 mujeres en el puerperio mediato para indagar, en otras variables, la historia sobre el consumo de drogas ilícitas. Tanto a las madres como a sus recién nacidos se les realizaron mediciones antropométricas estandarizadas. Se comparó la prevalencia de bajo peso al nacer (BPN), parto prematuro (PP) y retardo del crecimiento intrauterino (RCIU) con la historia de consumo de drogas ilícitas durante el embarazo por medio de modelos de regresión lineal múltiple y regresión logística múltiple, para ajustar el efecto de posibles confusores como edad materna, estado nutricional y patologías maternas, nivel socioeconómico, escolaridad y tabaquismo, entre otros. Los resultados mostraron que unda de cada 189 mujeres consumió sustancias ilegales durante el embarazo, comúnmente Cannabis sativa o pasta básica de cocaína. Las consumidoras de estos productos típicamente tenían menor escolaridad, eran de nivel socioeconómico más bajo, eran más delgadas, con una historia de control prenatal inadecuado, primigestantes o multigestantes y, con frecuencia, también fumaban tabaco y bebían alcohol. Se halló una asociación ente el consumo de la sustancias ilegales con RCIU (cociente de suertes de prevalencia de 5,24, IC95 por ciento: 1,3-21,0 y un d{eficit de 0,7 desv{ios est{andares del peso para la edad gestacional (p=0,03). Además, se encontró un cociente de suertes ajustado de 7,78 con IC95 por ciento: 1,0-62, entre el consumo de pasta básica de cocaína y RCIU. Aunque es probable que a través de entrevistas se subestime la prevalencia de consumo de drogas y a pesar del limitado poder del estudio, éste fue capaz de identificar un efecto importante del consumo de pasta básica de cocaína en el RCIU. Estos hallazgos tienen importancia para la salud pública dada la magnitud de proporciones epidémicas que ha cobrado el uso de esta forma de cocaína en las Américas