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Dental composite resins may release bisphenol-A or similar molecules affecting patient health and the environment. This study measured bisphenol-A release from three commonly used in patients composite resins (Filtek™ Z350 XT, Filtek™ P60, Filtek™ Bulk Fill) immersed in three liquid mediums (artificial saliva, 0.001 M lactic acid and 15% ethanol) and assessed the changes in the surface micromorphology.The released BPA was measured by HPLC at basal time (t=0), 1 h, 1 d, 7 d and 30 d. Topographic analysis of specimens was performed by scanning electron microscopy (SEM). The data were analyzed using one-way ANOVA and Tukey post-hoc test (P < 0.05). BPA in solution increased significantly in the three DCRs immersed in 0.001 M lactic acid at all times. SEM micrographs of the specimen in 0.001 M lactic acid disclosed more structural defects than others. The surface of the three composite resins was morphologically affected by their immersion in all solutions. SEM evidenced that the dental materials underwent erosion and cracks with filler particles protruding from the surface. The morphological changes in tested dental materials produced by exposure to these solutions are potentially dangerous to patients by causing caries, infections, and partial loss of dental material.
Assuntos
Materiais Biomédicos e Odontológicos , Bis-Fenol A-Glicidil Metacrilato , Resinas CompostasRESUMO
(analítico) Los universitarios atraviesan una etapa evolutiva que los sitúa como una población propensa a presentar alteraciones de salud mental, afectando su calidad de vida general. Este trabajo analiza la relación entre salud mental, autoestima y satisfacción vital en estudiantes de una universidad del sur de Chile. Los 452 participantes, hombres y mujeres entre 18 y 24 años de distintas carreras de la universidad, respondieron cuatro instrumentos: cuestionario sociodemográfico, escala de depresión, ansiedad y estrés, escala de satisfacción con la vida y escala de autoestima. Los resultados mostraron que los estudiantes que puntuaron más alto en problemas de salud mental presentaban menor satisfacción con la vida y menor autoestima. Así mismo, se encontró que las mujeres presentan mayor prevalencia en problemas de salud mental que los hombres.
(analytical) University students experience an evolutionary stage that positions them as a population prone to mental health disorders, which affects their general quality of life. This paper analyzes the relationship between mental health, self-esteem and life satisfaction among students at a university in sout-hern Chile. The 452 participants, males and females aged between 18 and 24 studying different university degrees, answered 4 different questionnaires: Sociodemographic Questionnaire; Depression, Anxiety and Stress Scale; Life Satisfaction Scale; and Self-esteem Scale. The results showed that students who scored higher regarding mental health problems had lower life satisfaction and lower self-esteem scores. It was also identified that female students have a higher prevalence of mental health problems compared to male students.
(analítico) Os estudantes universitários passam por um estágio evolutivo que os coloca como uma população propensa a transtornos de saúde mental, afetando sua qualidade de vida geral. Este artigo analisa a relação entre saúde mental, autoestima e satisfação com a vida em estudantes de uma universidade no sul do Chile. 452 participantes, homens e mulheres entre 18 e 24 anos de diferentes carreiras universitárias, respondeu a 4 instrumentos: Questionário Sociodemográfico, Escala de Depressão, Ansiedade e Estresse, Escala de Satisfação com a Vida e Escala de Autoestima. Os resultados mostraram que os alunos que pontuaram mais em problemas de saúde mental apresentaram menor satisfação com a vida e menor autoestima. Assim, verificou-se também que as mulheres apresentam maior prevalência de problemas de saúde mental do que os homens.
RESUMO
Familism, also known in the literature as allocentrism, is the cultural propensity of a society to place the family at the center of its value system. Adherence to this value has been related to less depressive symptomatology in young people; however, these results are not conclusive, since it has also been found that the influence of familism on depressive symptoms is more indirect than direct. This study aimed to explore the direct relationships between familism (allocentrism and idiocentrism) and mental health (depression, anxiety, and stress). Methodologically, the study had a non-experimental, cross-sectional, descriptive, and correlational design. A sample of 451 Chilean university students responded to an instrument composed of the subscales allocentrism, idiocentrism, depression, anxiety, and stress during the COVID-19 pandemic. The results showed that family allocentrism was positively and significantly associated with depression (γ = 0.112, p < 0.05), anxiety (γ = 0.209, p < 0.001), and stress (γ = 0.212, p < 0.001), and family idiocentrism was negatively and significantly linked with depression (γ = -0.392, p < 0.001), anxiety (γ = -0.368, p < 0.001), and stress (γ = -0.408, p < 0.001). These findings contribute to supporting actions to reduce negative symptomatology and promote greater well-being in university students.
Assuntos
COVID-19 , Humanos , Adolescente , Saúde Mental , Universidades , Pandemias , Estudos Transversais , Depressão/psicologiaRESUMO
Chronic coronary syndromes are usually considered uncommon in young women, related to slower progression of atherosclerotic coronary artery disease, have atypical clinical presentations, and experience less diagnostic investigation. Non-atherosclerotic causes of coronary artery disease should be considered in young women experiencing angina. We report a 25-year-old woman who consulted for five months of moderate exertion angina. Physical examination revealed a right carotid bruit and asymmetrical upper extremity peripheral pulses. Initial work-up and imaging allowed to diagnose aortitis with bilateral coronary ostial stenosis secondary to Takayasu's arteritis. The patient experienced an apparent clinical response to initial medical therapy. However, follow-up evaluation revealed persistence of significant ischemia and requirement for myocardial revascularization. A percutaneous coronary intervention was performed.
Los síndromes coronaries crónicos son infrecuentes en mujeres jóvenes, quienes suelen presentar una lenta progresión de enfermedad coronaria aterosclerótica, tienen presentación clínica atípica y son menos sujetas a exploración diagnostica. Se deben considerar causas no ateroscleróticas de enfermedad coronaria en mujeres jóvenes con angina. Informamos una paciente de 25 años que consultó por cinco meses de angina con esfuerzos moderados. Al examen físico presentaba un soplo carotideo derecho y pulsos asimétricos de extremidades superiores. La exploración de laboratorio inicial y posterior evaluación multimodal permitió evidenciar la presencia de aortitis y estenosis de ambos ostium coronarios, concordante con el diagnóstico de una arteritis de Takayasu. Inició terapia medica con respuesta clínica aparentemente favorable. No obstante, la evaluación cardiológica no invasiva en el seguimiento permitió corroborar la persistencia de isquemia significativa y necesidad de revascularización miocárdica. Se realizó una intervención coronaria percutánea de ambos ostium, con una evolución favorable.
Assuntos
Humanos , Feminino , Adulto , Doença da Artéria Coronariana , Arterite de Takayasu/complicações , Arterite de Takayasu/diagnóstico por imagem , ArtériasRESUMO
Natural products have always played a significant role in the search for new drugs. One of the most relevant alkaloid-containing plant groups is the Amaryllidaceae family, a source of exclusive structures with a wide variety of pharmacological activities. The aim of this work was to determine the alkaloid composition and biological potential of an extract from the bulbs of an endemic Peruvian Amaryllidaceae species Ismene amancaes (Ker Gawl.) Herb. The alkaloid profiling was carried out by GC-MS, which revealed the presence of 13 compounds, 2 of them unidentified. The plant extract was found to contain high amounts of lycoramine, a galanthamine-type alkaloid. The extract also presented low inhibitory potential against the enzymes AChE and BuChE, with IC50 values of 14.6 ± 0.6 and 37.6 ± 1.4 µg·mL-1, respectively, and good to moderate inhibitory activity against the protozoan Plasmodium falciparum strain FCR-3 (chloroquine-resistant), with IC50 values of 3.78 ± 0.3 µg·mL-1. This is the first report of the alkaloid profile of a plant of the Ismene genus, which could be an interesting source of bioactive compounds.
RESUMO
Chronic coronary syndromes are usually considered uncommon in young women, related to slower progression of atherosclerotic coronary artery disease, have atypical clinical presentations, and experience less diagnostic investigation. Non-atherosclerotic causes of coronary artery disease should be considered in young women experiencing angina. We report a 25-year-old woman who consulted for five months of moderate exertion angina. Physical examination revealed a right carotid bruit and asymmetrical upper extremity peripheral pulses. Initial work-up and imaging allowed to diagnose aortitis with bilateral coronary ostial stenosis secondary to Takayasu's arteritis. The patient experienced an apparent clinical response to initial medical therapy. However, follow-up evaluation revealed persistence of significant ischemia and requirement for myocardial revascularization. A percutaneous coronary intervention was performed.
Assuntos
Doença da Artéria Coronariana , Arterite de Takayasu , Feminino , Humanos , Adulto , Arterite de Takayasu/complicações , Arterite de Takayasu/diagnóstico por imagem , ArtériasRESUMO
RESUMEN Introducción. Las sustancias químicas son elementos altamente tóxicos por ingesta de humos metálicos. La Oroya es una ciudad minera que comprende un conjunto de fundiciones y refinerías, catalogada como la quinta más contaminada a nivel mundial, ocasionando efectos perjudiciales en la salud; sin embargo, existen profesionales de salud que trabajan en el hospital de dicha localidad. Objetivo. Identificar, analizar y comprender el significado que tiene la salud en los profesionales del hospital al vivir en una ciudad minera. Métodos. Estudio cualitativo, sustentado en el análisis de las representaciones sociales. Se seleccionó 13 profesionales de salud con un mínimo de 10 años laborando, divididos en foráneos y nativos arraigados. La técnica fue la entrevista en profundidad semiestructurada. Se aplicó una guía de preguntas construidas mediante el universo de creencias. Se utilizó el ATLASti como software de análisis textual. Resultados. Se identificó la categoría salud y bienestar, vinculada a dos sub categorías: psicosocial (objetivada en buenas relaciones interpersonales) y tranquilidad de vida. Y aspectos físicos, la cual comprende prácticas saludables y problemas de salud. Conclusiones. El significado de la salud fue enfrentar una nueva forma de vida desafiando la contaminación de una ciudad minera. Los foráneos presentaron más problemas de salud que los nativos arraigados y no tuvieron adecuada actividad física. Ambos grupos generaron nuevas costumbres, motivados por el beneficio económico mantener buenas relaciones con los pacientes y compañeros de trabajo y la vocación de servicio profesional.
ABSTRACT Introduction. Chemical substances are highly toxic elements due to the ingestion of metallic fumes. La Oroya is a mining city that comprises a set of smelters and refineries, ranked as the fifth most polluted worldwide, causing detrimental health effects; however, there are health professionals who work at the hospital in that locality. Objective. Identify, analyze and understand the meaning of health in hospital professionals when living in a mining city. Methods. Qualitative study, based on the analysis of social representations. Thirteen health professionals with a minimum of 10 years working were selected, divided into foreign and rooted natives. The technique was the semi-structured in-depth interview. A guide of questions constructed through the universe of beliefs was applied. ATLASti was used as textual analysis software. Results. The health and wellness category was identified, linked to two subcategories: psychosocial (objective in good interpersonal relationships) and tranquility of life. And physical aspects, which includes healthy practices and health problems. Conclusions. The meaning of health was to face a new way of life by defying pollution in a mining city. The foreigners presented more health problems than the rooted natives and did not have adequate physical activity. Both groups generated new customs, motivated by the economic benefit of maintaining good relationships with patients and coworkers and the vocation of professional service.
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ANTECEDENTES: El reemplazo protésico de la válvula tricúspide es un procedimiento infrecuente, con elevada mortalidad y morbilidad operatoria, independientemente de la etiología de la insuficiencia tricuspídea. Persiste aún una discusión respecto al tipo de prótesis a utilizar, mecánica o biológica. OBJETIVO: Analizar nuestros resultados perioperatorios y alejados en el reemplazo valvular tricuspídeo, comparando ambos tipos de prótesis. MÉTODO: Revisión de la Base de Datos de nuestro Servicio de Cirugía Cardiovascular para el periodo enero 1991 - diciembre 2017. Identificados los pacientes con reemplazo valvular tricuspídeo (RVT); se revisaron los protocolos operatorios y los ecocardiogramas. La supervivencia se certificó a través del Registro Civil e Identificación de Chile. RESULTADOS: Se identificaron 83 pacientes con RVT (76% mujeres), los que representaron el 0,7% del total de las cirugías con circulación extracorpórea y el 2,1% de las cirugías valvulares para el periodo en estudio. La edad promedio fue 49±16,5 años. Cuarenta y nueve casos (59%) correspondieron a reoperaciones y otros 49 tuvieron un procedimiento asociado. En 40 pacientes (48%) se utilizó una prótesis mecánica y en 43 (52%) una biológica. La mortalidad operatoria global fue 9,6% (8 pacientes, 4 con una prótesis mecánica y 4 con una biológica). El seguimiento se completó en el 100%, con un promedio de 7,1 años. Veintiocho pacientes fallecieron durante el seguimiento; la principal causa fue insuficiencia cardiaca. Así, la supervivencia a 5 años fue 70,3 ± 5,3% y a 10 años 58 ± 6,3%, sin diferencia significativa entre ambos tipos de prótesis. Siete pacientes se reoperaron durante el seguimiento (5 casos con prótesis biológica y 2 mecánica). CONCLUSIÓN: El RVT continúa siendo un procedimiento infrecuente, con mayor incidencia en mujeres, en la quinta década de la vida. La mayoría de los pacientes presentaba comorbilidad y había tenido cirugía cardiovascular previa. La mitad de estos recibió una prótesis mecánica y la otra, biológica. No hubo diferencias significativas entre ambos tipos de prótesis en cuanto a mortalidad operatoria, supervivencia alejada o reoperación.
BACKGROUND: Tricuspid valve replacement (TVR) is an uncommon surgical procedure, associated with high mortality and morbidity. The use of biological or mechanical prostheses in TVR has advantages and disadvantages and, therefore, there persists a debate regarding the choice of one or other type of prostheses. AIM: To analyze our operative and long-term surgical results, comparing both types of prosthetic valves. METHODS: The Data Base of the Cardiovascular Surgery Service was reviewed for the period between January 1991 and December 2017. 83 patients with TVR were identified, the operative notes and echocardiogram reports were analyzed. Survival was obtained from the Chilean Civil Identification Service. RESULTS: 83 patients (76% women) had TVR. They represented 0.7% of the total cases operated on with extracorporeal circulation and 2.1% of all valve disease cases, for the study period. Mean age was 49±16.5 years. 49 cases (59%) were reoperations and another 49 had an associated procedure. In 40 patients (48%) a mechanical prosthesis was used and in 43 (52%) a biological one was implanted. Operative mortality rate was 9.6% (8 patients, had a mechanical valve and the other 8, a biological one). Follow-up was 100% completed, with an average of 7.1 years. 28 patients died during follow-up; the main cause of death was heart failure. Five-year survival rate was 70.3 ± 5.3% and at 10 years it was 58 ± 6.3%, without significant difference the type of prostheses. Seven patients were re-operated during follow-up (5 cases corresponded to a biological prostheses and 2 to a mechanical one). CONCLUSION: TVR is still an infrequent surgical procedure, more commonly performed in women, on the fifth decade of life. Most patients presented comorbidities and had a previous cardiovascular surgical operation. Half of them received a mechanical prosthesis and half a biological one. There was no significant difference between both types of prostheses related to surgical mortality, long-term survival or reoperation.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Valva Tricúspide/cirurgia , Insuficiência da Valva Tricúspide/cirurgia , Próteses Valvulares Cardíacas , Implante de Prótese de Valva Cardíaca/métodos , Circulação Extracorpórea , Reoperação , Insuficiência da Valva Tricúspide/etiologia , Insuficiência da Valva Tricúspide/mortalidade , Bioprótese , Comorbidade , Análise de Sobrevida , Seguimentos , Resultado do Tratamento , Implante de Prótese de Valva Cardíaca/estatística & dados numéricosRESUMO
ABSTRACT: Background: Hyposalivation is an objective decrease in salivary flow and it can produce xerostomia; which is a subjective sensation of dry mouth, common condition in senior population. Objectives: To identify the association between xerostomia and hyposalivation and its risk factors in people aged 60 years and older, and to investigate the association with medications, habits and other oral complications. Methods: 211 participants were included. Xerostomia data was collected using a validated Spanish-Xerostomia Inventory (XI-sp). Unstimulated whole-salivary flow rates were measured to detect hyposalivation. Results were analyzed using Chi-square, Fisher tests and multivariate logistic regression analysis. p <.05. Results: No significant association was detected between Xerostomia and Hyposalivation (p=.0666). Xerostomia 84.3%(p=.036) and hyposalivation 81.4%(p=.004) occur more frequently in women. A significant association was found between hyposalivation with the female gender (OR = 2.46, 95% confidence interval (CI): 1.19-5.11, p=0.015); denture stomatitis (OR=3.71, 95% CI:1.03-13.3, p=0.045) and atrophic glossitis (OR=3.72, 95% CI:1.78-8.1, p=0.001). Only female gender (OR=2.54; 95% CI:1.19-5.43, p=0.016) was significantly associated with xerostomia. Conclusions: No statistically significant association was found between hyposalivation and xerostomia. A significant association was found between oral candidiasis, denture stomatitis and the atrophic tongue with hyposalivation. Being woman was a risk factor for xerostomia and hyposalivation.
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Humanos , Masculino , Feminino , Xerostomia , Fatores de Risco , Boca , ChileRESUMO
Background: The APGAR-family scale is used for the assessment of family functioning in primary health care. Aim: To examine the psychometric properties of the family functioning scale APGAR-family, in a multi-ethnic sample of older Chilean adults. Material and Methods: The scale was applied to 800 participants aged more than 60 years, residing in rural areas of the regions of Arica and Parinacota and La Araucanía. Results: The Cronbach's alpha obtained was 0,992 for the scale composed of five items. The confirmatory factor analysis determined a unifactorial model, whose goodness of fit indices were satisfactory. Namely, weighted least square mean and variance adjusted-χ2 was 20.097 (p < 0.01), comparative fit index was 0.997, Tucker-Lewis index was 0.995 and Root Mean Square Error of Approximation was 0.079 (90% confidence intervals 0.049-0.091). Conclusions: The APGAR-family is a reliable and appropriate instrument to be applied in older people in Chile, specifically in elderly people residing in rural areas who belong to the Aymara and Mapuche indigenous communities.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Inquéritos e Questionários/estatística & dados numéricos , Relações Familiares/psicologia , Psicometria , Qualidade de Vida/psicologia , Padrões de Referência , Fatores Socioeconômicos , Chile , Reprodutibilidade dos Testes , Análise Fatorial , Relações Familiares/etnologia , Solidão/psicologiaRESUMO
Resumen Este artículo identifica y analiza la relación entre la sustentabilidad financiera y la excelencia de la atención hospitalaria de la salud pública chilena. Los datos se obtienen directamente del Cuadro de Mando Integral de los 57 hospitales chilenos de mayor complejidad. Se realiza un análisis univariado, para determinar el comportamiento tendencial de los indicadores que componen las estrategias de sustentabilidad financiera y excelencia de la atención; luego un análisis bivariado para establecer asociaciones entre indicadores y variables relevantes, y analizar el funcionamiento de los establecimientos; y finalmente un análisis multivariado, donde se utiliza la técnica de análisis factorial confirmatoria. Demuestra que existe una relación negativa entre los resultados de ambas estrategias en estudio, por lo que se concluye que mejoras en los resultados de la sustentabilidad financiera no se traducen directamente en los resultados de excelencia de la atención hospitalaria, ya que no existe una canalización efectiva entre ambas estrategias.
Abstract Objective: To determine. This article identifies and analyzes the relationship between financial sustainability and the excellence of hospital care in Chilean public health. The data is obtained directly from the Balanced Scorecard of the 57 most complex Chilean hospitals. A univariate analysis is carried out to determine the trend behavior of the indicators that make up the strategies of financial sustainability and excellence of care; then a bivariate analysis to establish associations between indicators and relevant variables, and analyze the operation of the establishments; and finally a multivariate analysis, where the technique of confirmatory factor analysis is used. It shows that there is a negative relationship between the results of both strategies under study, so it is concluded that improvements in the results of financial sustainability do not translate directly into the results of excellence in hospital care, since there is no effective channeling between both strategies.
Assuntos
Qualidade da Assistência à Saúde/organização & administração , Reforma dos Serviços de Saúde/economia , Indicadores de Desenvolvimento , Assistência Hospitalar/economia , Indicadores de Gestão/políticas , Chile , Saúde PúblicaRESUMO
BACKGROUND: The APGAR-family scale is used for the assessment of family functioning in primary health care. AIM: To examine the psychometric properties of the family functioning scale APGAR-family, in a multi-ethnic sample of older Chilean adults. MATERIAL AND METHODS: The scale was applied to 800 participants aged more than 60 years, residing in rural areas of the regions of Arica and Parinacota and La Araucanía. RESULTS: The Cronbach's alpha obtained was 0,992 for the scale composed of five items. The confirmatory factor analysis determined a unifactorial model, whose goodness of fit indices were satisfactory. Namely, weighted least square mean and variance adjusted-χ2 was 20.097 (p < 0.01), comparative fit index was 0.997, Tucker-Lewis index was 0.995 and Root Mean Square Error of Approximation was 0.079 (90% confidence intervals 0.049-0.091). CONCLUSIONS: The APGAR-family is a reliable and appropriate instrument to be applied in older people in Chile, specifically in elderly people residing in rural areas who belong to the Aymara and Mapuche indigenous communities.
Assuntos
Relações Familiares/psicologia , Inquéritos e Questionários/normas , Idoso , Idoso de 80 Anos ou mais , Chile , Análise Fatorial , Relações Familiares/etnologia , Feminino , Humanos , Solidão/psicologia , Masculino , Pessoa de Meia-Idade , Psicometria , Qualidade de Vida/psicologia , Padrões de Referência , Reprodutibilidade dos Testes , Fatores SocioeconômicosRESUMO
Resumen: El compromiso simultáneo del arco aórtico y aorta descendente proximal, ya sea por disección o aterosclerosis, constituye uno de los mayores desafíos que puede enfrentar un cirujano cardiovascular. La prótesis híbrida Thoraflex, introducida en los últimos años, ha resultado ser una importante ayuda para el tratamiento quirúrgico de esta compleja y grave patología. Esta consiste en un tubo protésico de Dacron con 4 ramas, para el reemplazo del arco aórtico y sus troncos braquiocefálicos y perfusión corporal distal, y una endoprótesis que queda como "trompa de elefante suspendida" en la aorta descendente proximal. Presentamos en esta oportunidad nuestra experiencia inicial en 4 pacientes, 3 con disección aórtica crónica y una con un aneurisma aterosclerótico, usando la prótesis híbrida Thoraflex.
Abstract: Atherosclerotic aneurysm or dissection of the aortic arch and proximal descending thoracic aorta is one of the major challenges for a cardiovascular surgeon. The new hybrid prosthesis Thoraflex has become an important devise to simplify the surgical treatment of this very complex and technically demanding aortic pathology. This hybrid prosthesis consists of a 4-branched arch graft with a stent-graft at the distal end. The proximal part is a gelatin-coated woven polyester prosthesis. The stented section is a self-expanding endoprosthesis constructed of thin-walled polyester and nitinol ring stents that is left in the proximal descending aorta as a "frozen elephant trunk". We present our initial experience with the Thoraflex prosthesis in four patients, three of them with chronic aortic dissection and one with an atherosclerotic aneurysm.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Aneurisma da Aorta Torácica/cirurgia , Implante de Prótese Vascular/métodos , Procedimentos Endovasculares/métodos , Dissecção Aórtica/cirurgia , Aorta Torácica/cirurgia , Aorta Torácica/diagnóstico por imagem , Aneurisma da Aorta Torácica/diagnóstico por imagem , Angiografia por Tomografia Computadorizada , Dissecção Aórtica/diagnóstico por imagemRESUMO
The Ministry of Health of Chile, aiming to improve the quality of clinical practice guidelines, gradually incorporated the GRADE system (Grading of Recommendations, Assessment, Development and Evaluation) to develop evidence based recommendations. This system summarizes and evaluates the certainty of the available evidence. It moves from evidence to decision in a systematic and transparent manner, based on four main dimensions: balance between benefits and harms, certainty of evidence, patient's values and preferences and use of resources. The GRADE system produces strong and conditional recommendations. Strong recommendations provide confidence that the favorable consequences of an intervention clearly outweigh the adverse consequences, or vice versa. These recommendations apply to a broad range of patients and circumstances. Conditional recommendations, however, indicate that there is a close balance between favorable and unfavorable consequences of the intervention, there is uncertainty in the magnitude of benefits or adverse effects, there is uncertainty or variability in values and preferences of individuals or costs are not justified. These recommendations apply to many patients, but not all of them: ideally they should be discussed with each person. To achieve a better implementation of the recommendations made with GRADE methodology, health professionals should know the meaning of strong and conditional recommendations and they should be able to critically assess of them.
Assuntos
Humanos , Adulto , Guias de Prática Clínica como Assunto/normas , Medicina Baseada em Evidências/instrumentação , Antivirais/uso terapêutico , Pessoal de Saúde , Tomada de Decisões , Influenza Humana/tratamento farmacológico , Oseltamivir/uso terapêuticoRESUMO
Violence against women is considered a public health problem that affects women worldwide. Recently, the Directing Council of the Pan American Health Organization declared its serious socioeconomic impact in the Region of the Americas and committed to undertaking actions in the health services to address this problem. Within that framework, this paper describes the steps of a participatory action research (PAR) approach that is being implemented in the Wenteche Territory of the La Araucanía region of Chile, which aims to strengthen community bonds, rekindle opportunities for dialogue with and among the people of the territory, foster social participation and democracy in the generation of pertinent, participatory knowledge regarding this problem, and obtain information to support design of an intervention model adapted to local characteristics.
Assuntos
Participação da Comunidade , Violência de Gênero/prevenção & controle , Modelos Teóricos , Chile , Feminino , HumanosRESUMO
La violencia contra la mujer se considera un problema de salud pública que afecta a las mujeres en todo el mundo. Recientemente, el Consejo Directivo de la Organización Panamericana de la Salud declaró sus graves repercusiones sociales y económicas en la Región de las Américas y se comprometió a emprender acciones en los servicios de salud para afrontar el problema. En ese marco, se presentan los pasos de una investigación-acción-participativa (IAP), que se está desarrollando en el territorio wenteche de la región de La Araucanía de Chile, que apuesta por fortalecer los vínculos comunitarios, revalorizar los espacios de diálogo con y entre las personas del territorio, la participación social y la democracia en la generación de conocimientos pertinentes y participativos sobre este problema, y obtener información para diseñar un modelo de intervención que se adecúe a las características locales.
Violence against women is considered a public health problem that affects women worldwide. Recently, the Directing Council of the Pan American Health Organization declared its serious socioeconomic impact in the Region of the Americas and committed to undertaking actions in the health services to address this problem. Within that framework, this paper describes the steps of a participatory action research (PAR) approach that is being implemented in the Wenteche Territory of the La Araucanía region of Chile, which aims to strengthen community bonds, rekindle opportunities for dialogue with and among the people of the territory, foster social participation and democracy in the generation of pertinent, participatory knowledge regarding this problem, and obtain information to support design of an intervention model adapted to local characteristics.
A violência contra a mulher é um problema de saúde pública que atinge mulheres em todo o mundo. Recentemente, o Conselho Diretor da Organização Pan-Americana da Saúde reconheceu as sérias repercussões socioeconômicas do problema na Região das Américas e se comprometeu a realizar ações nos serviços de saúde para combatê-lo. Como parte deste enquadramento, são apresentadas as etapas de uma pesquisa-ação participativa sendo desenvolvida no território wenteche da região de La Araucanía, no Chile, que visa reforçar os vínculos na comunidade, revalorizar os espaços de diálogo com e entre os habitantes locais, a participação social e a democracia na geração de conhecimento pertinente e participativo sobre esta problemática e obter dados para a elaboração de um modelo de intervenção adequado às características locais.
Assuntos
Violência Doméstica , Pesquisa Participativa Baseada na Comunidade , Organização Comunitária , Saúde Pública , Chile , Violência Doméstica , Pesquisa Participativa Baseada na Comunidade , Organização Comunitária , Saúde Pública , Pesquisa Participativa Baseada na Comunidade , Violência Doméstica , Saúde PúblicaRESUMO
The Ministry of Health of Chile, aiming to improve the quality of clinical practice guidelines, gradually incorporated the GRADE system (Grading of Recommendations, Assessment, Development and Evaluation) to develop evidence based recommendations. This system summarizes and evaluates the certainty of the available evidence. It moves from evidence to decision in a systematic and transparent manner, based on four main dimensions: balance between benefits and harms, certainty of evidence, patient's values and preferences and use of resources. The GRADE system produces strong and conditional recommendations. Strong recommendations provide confidence that the favorable consequences of an intervention clearly outweigh the adverse consequences, or vice versa. These recommendations apply to a broad range of patients and circumstances. Conditional recommendations, however, indicate that there is a close balance between favorable and unfavorable consequences of the intervention, there is uncertainty in the magnitude of benefits or adverse effects, there is uncertainty or variability in values and preferences of individuals or costs are not justified. These recommendations apply to many patients, but not all of them: ideally they should be discussed with each person. To achieve a better implementation of the recommendations made with GRADE methodology, health professionals should know the meaning of strong and conditional recommendations and they should be able to critically assess of them.
Assuntos
Medicina Baseada em Evidências/instrumentação , Guias de Prática Clínica como Assunto/normas , Adulto , Antivirais/uso terapêutico , Tomada de Decisões , Pessoal de Saúde , Humanos , Influenza Humana/tratamento farmacológico , Oseltamivir/uso terapêuticoRESUMO
La infección del virus de inmunodeficiencia humana (VIH) se adquiere principalmente a través del contagio sexual y los pacientes infectados siguen aumentando en el mundo. El tratamiento antirretroviral (TARV) moderno es capaz de suprimir la replicación viral y mejorar el recuento de linfocitos T CD4+, aumentando la supervivencia de los pacientes. De esta manera, aumenta el riesgo de presentar enfermedades crónicas siendo las cardiovasculares las más frecuentes. Objetivo: Comunicar nuestra experiencia en pacientes con infección por VIH sometidos a cirugía cardiovascular. Pacientes y Método: Estudio retrospectivo en que se revisó la base de datos del Servicio de Cirugía Cardiovascular entre los años 2009 y 2015. Identificamos a los pacientes con infección por VIH sometidos a cirugía cardiovascular. Resultados: Catorce pacientes presentaban esa condición. La mayoría estaba en control y con TARV (11 casos) logrando que la carga viral fuera indetecta-ble. La principal vía de infección fue la sexual (13/14 casos). Durante la cirugía se tomaron las precauciones universales de protección para el equipo quirúrgico, las que fueron efectivas en todos los casos. La enfermedad más frecuentemente tratada fue la cardiopatía coronaria (9 casos), seguido de valvulopatías severas (4 casos) en que solo uno presentaba Endocarditis Infecciosa. No hubo mortalidad asociada al procedimiento ni en el seguimiento a tres años de la cirugía. Conclusión: Los pacientes con infección por VIH están expuestos a desarrollar enfermedades cardiovasculares que requieren de tratamiento quirúrgico. Estos pueden ser realizados en forma segura con gran beneficio en su calidad de vida y de su supervivencia.
Infection with human immunodeficiency virus (HIV+) is primarily acquired through sexual transmission and the number of infected people continues to increase. Anti-retroviral therapy (HAART) suppress viral replication and improves CD4 T cell count, increasing survival and the risk of developing chronic diseases. Cardiovascular disease is prevalent among these patients. Objective: To report our experience in patients positive for HIV undergoing cardiovascular surgery. Patients and Methods: We reviewed the Cardiovascular Surgery Service database from 2009 to 2015 to identify HIV-infected patients that underwent cardiovascular surgery. Results: There were 14 HIV positive patients. Most of them were receiving HAART and the viral load was undetectable in 11 patients Thee main route of infection was sexual (13/14 cases). Universal precautions to protect the surgical team were taken during surgery. These were effective in all cases. Coronary artery disease was the most common condition treated (9 cases), followed by severe valve disease (4). Only one patients had infective endocarditis. There was no mortality associated with the procedure. Al patients were alive and asymptomatic 3 years after surgery. Conclusion: Patients with HIV infection are likely to develop cardiovascular diseases requiring surgical treatment. These can be performed safely with great benefit in quality of life and survival.
Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Idoso , Procedimentos Cirúrgicos Cardíacos , Cardiopatias/cirurgia , Infecções por HIV , Estudos Retrospectivos , Resultado do TratamentoRESUMO
RESUMEN La violencia contra la mujer se considera un problema de salud pública que afecta a las mujeres en todo el mundo. Recientemente, el Consejo Directivo de la Organización Panamericana de la Salud declaró sus graves repercusiones sociales y económicas en la Región de las Américas y se comprometió a emprender acciones en los servicios de salud para afrontar el problema. En ese marco, se presentan los pasos de una investigación-acción-participativa (IAP), que se está desarrollando en el territorio wenteche de la región de La Araucanía de Chile, que apuesta por fortalecer los vínculos comunitarios, revalorizar los espacios de diálogo con y entre las personas del territorio, la participación social y la democracia en la generación de conocimientos pertinentes y participativos sobre este problema, y obtener información para diseñar un modelo de intervención que se adecúe a las características locales.(AU)
ABSTRACT Violence against women is considered a public health problem that affects women worldwide. Recently, the Directing Council of the Pan American Health Organization declared its serious socioeconomic impact in the Region of the Americas and committed to undertaking actions in the health services to address this problem. Within that framework, this paper describes the steps of a participatory action research (PAR) approach that is being implemented in the Wenteche Territory of the La Araucanía region of Chile, which aims to strengthen community bonds, rekindle opportunities for dialogue with and among the people of the territory, foster social participation and democracy in the generation of pertinent, participatory knowledge regarding this problem, and obtain information to support design of an intervention model adapted to local characteristics.(AU)
RESUMO A violência contra a mulher é um problema de saúde pública que atinge mulheres em todo o mundo. Recentemente, o Conselho Diretor da Organização Pan-Americana da Saúde reconheceu as sérias repercussões socioeconômicas do problema na Região das Américas e se comprometeu a realizar ações nos serviços de saúde para combatê-lo. Como parte deste enquadramento, são apresentadas as etapas de uma pesquisa-ação participativa sendo desenvolvida no território wenteche da região de La Araucanía, no Chile, que visa reforçar os vínculos na comunidade, revalorizar os espaços de diálogo com e entre os habitantes locais, a participação social e a democracia na geração de conhecimento pertinente e participativo sobre esta problemática e obter dados para a elaboração de um modelo de intervenção adequado às características locais.(AU)