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RESUMEN Introducción Las alteraciones metabólicas se vinculan a los ritmos biológicos, dado que es tos sistemas controlan aspectos fisiológicos como patrones de sueño/vigilia, temperatura corporal, presión arterial y liberación de hormonas endocrinas. Objetivo Identificar la relación entre los componentes del síndrome metabólico y disincro nía circadiana en personal de enfermería de un hospital público. Métodos Estudio correlacional. Muestra censal de 30 profesionales de enfermería de dos turnos. Para la recolección de datos se utilizaron tres cédulas: a) antecedentes biosociode mográficos y laborales; b) síndrome metabólico; c) ciclo circadiano. En el procesamiento de datos se utilizó pruebas Chi-cuadrada, R de Pearson y Rho de Spearman, se verificó el su puesto de normalidad con Shapiro-Wilk. Se contó con autorización del Comité de Ética de la institución de salud y con el consentimiento informado de participantes. Resultados 43.3 % del personal de enfermería cumplió con criterios diagnósticos de síndro me metabólico, 100 % del turno nocturno presentó disincronía circadiana con base en el indicador patrón de sueño. El consumo de alcohol y nivel alto de triglicéridos, mostraron relación positiva estadísticamente significativa con la presencia de insomnio (p ≤ 0.001; p ≤ 0.05). Conclusión El síndrome metabólico es un problema de salud con alta prevalencia entre el personal de enfermería, independientemente del nivel académico o del turno laboral. El peso y los triglicéridos fueron indicadores que mostraron relación con patrones de sueño afectados. Esto enfatiza la importancia de incidir en la prevención y tratamiento del sín drome metabólico como una prioridad en el personal de enfermería, desde la salud laboral.
ABSTRACT Introduction Metabolic alterations are linked to biologic rhythms because these cycles control physiologic patterns including sleep/awake, body temperature, blood pressure, and hormones release. Objective To identify the relationship between the metabolic syndrome components and the circadian alterations among nursing personnel in a public hospital in Mexico. Method This is a correlational study. The sample was constituted of 30 nursing professio nals working in 2 shifts. Data were collected using three registers: a) bio socio-demographic and labor-related backgrounds; b) metabolic syndrome; c) circadian cycle. Chi-square, Pearson's R, Spearman's Rho, and Shapiro-Wilk normality test were calculated. The study approval was granted by the Ethics Committee of the Health Institution. The corresponding informed consent was obtained from all participants. Results 43.3 % of the nursing personnel qualified for the metabolic syndrome diagnostic criteria. 100 % of the nurses working the night shift showed circadian alterations in terms of sleep patterns. Alcohol consumption and high levels of triglycerides were positively and significantly related to insomnia (p ≤ 0.001; p ≤ 0.05). Conclusion The metabolic syndrome is a health problem with a high prevalence in all kinds of nursing personnel. Bodyweight and triglyceride levels were indicators suggesting altered sleep patterns. This situation highlights the importance of designing and implementing strategies aimed at preventing and addressing metabolic syndrome among nursing person nel as a labor health priority.
RESUMO Introdução As alterações metabólicas estão ligadas aos ritmos biológicos, pois esses siste mas controlam aspectos fisiológicos como padrões de sono/vigília, temperatura corporal, pressão arterial e liberação de hormônios endócrinos. Objetivo Identificar a relação entre os componentes da síndrome metabólica e a dissincro nia circadiana na equipe de enfermagem de um hospital público. Métodos Estudo correlacional. Amostra censitária de 30 profissionais de enfermagem com dois turnos. Para a coleta de dados foram utilizados três cartões: a) antecedentes biossociodemográficos e laborais; b) síndrome metabólica; c) ciclo circadiano. No processa mento dos dados foram utilizados os testes Qui-quadrado, R de Pearson e Rho de Spearman, a suposição de normalidade foi verificada com Shapiro-Wilk. Contou-se com a autorização do Comitê de Ética da instituição de saúde e o termo de consentimento informado dos participantes. Resultados 43.3 % da equipe de enfermagem atendeu aos critérios diagnósticos para sín drome metabólica, 100 % do plantão noturno apresentou dissincronia circadiana com base no indicador padrão de sono. O consumo de álcool e o nível elevado de triglicerídeos mos traram relação positiva estatisticamente significativa com a presença de insônia (p ≤ 0.001; p ≤ 0.05). Conclusão A síndrome metabólica é um problema de saúde de alta prevalência entre a equipe de enfermagem, independentemente do nível acadêmico ou turno de trabalho. O peso e os triglicerídeos foram indicadores que mostraram relação com os padrões de sono afetados. Isto ressalta a importância de influenciar a prevenção e o tratamento da síndrome metabólica como prioridade na equipe de enfermagem, desde a saúde do trabalhador.
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Aim. To analyze clinical features, treatment, and results of patients with non-penetrating traumatic hyphema in an ophthalmological center in Colombia. Methods. A retrospective cohort study in which medical records of patients with traumatic hyphema were analyzed between 2013 and 2018. Results. 38 eyes of 37 patients (34 men, 3 women) were included. Average age was 30.6 ± 16.6 years. Sports-related (42.1%) and occupational accidents (34.2%) were the main causes. 67.5% of the eyes had grade I hyphema. 95% received topical corticosteroids, 92.1% topical mydriatics and 52.63% ocular hypotensive eyedrops. Two eyes with hyphema grade I did not receive steroids and resolved uneventfully. None of the eyes rebleeded, even without antifibrinolytics. One patient with grade IV hyphema required surgery. Mean hyphema's clearance time was 8.4 ± 3.2 days. The last mean corrected distance visual acuity was LogMAR 0.25. There were no complications directly related to the hyphema. Conclusions. Working related activities were the second cause of traumatic hyphema in our cohort, which might be attributable to poor awareness of the importance or ocular protection, or limited access to recommended protective devices. Outpatient management enabled adequate outcomes. Corticosteroids and mydriatics were the treatment cornerstone, though seemed not to be imperative when hyphema was grade I. We were not able to support the contributive role from antifibrinolytics, because none of our patients rebleeded in spite of the absence of them. Abbreviations: IOP = intraocular pressure, AC = anterior chamber, CDVA = corrected distance visual acuity.
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Traumatismos Oculares/etiologia , Hifema , Acuidade Visual/fisiologia , Ferimentos não Penetrantes/etiologia , Administração Oftálmica , Adolescente , Adulto , Anti-Hipertensivos/uso terapêutico , Colômbia , Feminino , Glucocorticoides/uso terapêutico , Humanos , Hifema/diagnóstico , Hifema/tratamento farmacológico , Hifema/etiologia , Hifema/fisiopatologia , Pressão Intraocular/fisiologia , Masculino , Pessoa de Meia-Idade , Midriáticos/uso terapêutico , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVES: To estimate the frequency of metabolic syndrome (MetS) in a daily urology practice and to determine its association with lower urinary tract symptoms (LUTS) and erectile dysfunction (ED). MATERIAL AND METHODS: A retrospective study was conducted. Data from all male patients aged ≥40 years who attended our outpatient urology clinic from 2010 to 2011 was collected. Prevalence of MetS was determined, and LUTS and ED were assessed. A logistic model was used to determine possible associations, controlling for confounders and interaction factors. RESULTS: A total of 616 patients were included. MetS was observed in 43.8% (95% CI 39.6-48.3). The bivariate model showed an association between MetS and LUTS (p<0.01), but not between MetS and ED. The logistic model showed an association between MetS and the International Prostate Symptom Score (IPSS), while controlling for other variables. Patients exhibiting moderate LUTS had a greater risk for MetS than patients with mild LUTS (OR 1.83, 95% CI 1.14-2.94). After analyzing for individual components of MetS, positive associations were found between diabetes and severe LUTS (OR 1.3, 95% CI 1.24-7.1), and between diabetes and ED (OR 2.57, 95% CI 1.12-5.8). CONCLUSION: This study was able to confirm an association between MetS and LUTS, but not for ED. Specific components such as diabetes were associated to both. Geographical differences previously reported in the literature might account for these findings. Given that MetS is frequent among urological patients, it is advisable that urologists actively screen for it.
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Disfunção Erétil/epidemiologia , Sintomas do Trato Urinário Inferior/epidemiologia , Síndrome Metabólica/epidemiologia , Adulto , Idoso , Causalidade , Colômbia/epidemiologia , Comorbidade , Fatores de Confusão Epidemiológicos , Diabetes Mellitus Tipo 2/epidemiologia , Disfunção Erétil/etiologia , Humanos , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Pessoa de Meia-Idade , Ambulatório Hospitalar/estatística & dados numéricos , Prevalência , Estudos Retrospectivos , Fumar/epidemiologia , UrologiaRESUMO
El principal objetivo de este trabajo es brindar las bases para un esfuerzo coordinado con el fin de crear capacidad de análisis de riesgos para la inocuidad de los alimentos en la región de América Latina y el Caribe (ALC) reuniendo a organizaciones internacionales (Organización Panamericana de la Salud-OPS, Organización de las Naciones Unidas para la Alimentación y la Agricultura -FAO e Instituto Interamericano de Cooperación para la Agricultura-IICA) y universidades (Universidad de Nebraska-Lincoln, Universidad de Maryland, Universidad de Minnesota y Universidad Tecnológica de Texas) mediante la Alianza Estratégica para la Creación de Capacidades en Análisis de Riesgos para la Inocuidad de los Alimentos (AECAR). Esperamos que este trabajo, creado por la alianza, logre: a) generar confianza y fortalecer la comunicación entre todas las organizaciones que trabajan en la región; b) proporcionar las bases para enfoques coordinados, consistentes y efectivos para crear capacidad y desarrollar programas de estudio; y c) facilitar la implementación del marco para análisis de riesgos en la región. Este trabajo presenta los recursos actuales de los autores, considera algunos ejemplos exitosos de implementación de análisis de riesgos en la región (de los sectores académicos y gubernamentales), los desafíos experimentados al implementar el análisis de riesgos, y una hoja de ruta para la creación de capacidad propuesta por esta alianza para ampliar la adopción de análisis de riesgos en la región.
The main goal of this paper is to provide the foundation for a coordinated effort for food safety risk analysis capacity building in the Latin American and Caribbean (LAC) region by bringing together international organizations (Panamerican Health Organization-PAHO, Food and Agriculture Organization of the United Nations-FAO and the Interamerican Institute for Cooperation in Agriculture-IICA) and universities (University of Nebraska-Lincoln, University of Maryland, University of Minnesota and Texas Tech University) through the Strategic Alliance in Risk Analysis Capacity Building (SARAC). We expect that this paper, authored by the alliance, will: a) build trust and strengthen communication among all the organizations that work in the region; b) provide the foundation for coordinated, consistent, and effective approaches to capacity building and curriculum development; and c) facilitate the implementation of the risk analysis framework within the region. This paper provides the current resources by the authors, discusses some successful examples of risk analysis implementation in the region (from academia and government sectors), the challenges experienced on implementing risk analysis and a capacity building roadmap proposed by this alliance to enhance the adoption of risk analysis in the region.
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Inocuidade dos Alimentos , Gestão de Riscos , Gestão de Riscos , Inocuidade dos Alimentos , AméricaRESUMO
INTRODUCTION: Epilepsy is a chronic neurological syndrome that is accompanied by abnormal, synchronic and exaggerated discharges in the cerebral cortex. Epilepsy is inversely related to health-related quality of life (HRQL), although little has been published on this relationship in children in Latin America. AIM: To examine the relation between epilepsy and HRQL in a group of schoolchildren aged 8-12 years who were treated in a paediatric hospital in Sonora, Mexico. PATIENTS AND METHODS: A cross-sectional study was conducted to compare the HRQL of children diagnosed with epilepsy with respect to the HRQL of two control groups. The validated questionnaire Paediatric Quality of Life Inventory was used to evaluate HRQL. Differences were examined by means of an ANOVA test and the association between epilepsy and HRQL was modelled by means of multiple logistic regression. RESULTS: The children with epilepsy displayed the lowest HRQL score (62.4 ± 14.8) of the subjects studied and had 5.2 times as much risk of their HRQL deteriorating (95% confidence interval = 2.43-11.06) compared to healthy children. Deterioration was greater on the cognitive (54.6 ± 15.0) and emotional scales (55.9 ± 23.6). Polypharmacy, i.e. the concomitant ingestion of three or more drugs (p < 0.001), and the chronological progression of suffering (p < 0.001) are factors that significantly deteriorate the HRQL of children with epilepsy. CONCLUSIONS: Epilepsy gives rise to an overall deterioration in the HRQL of children, specifically in the cognitive and emotional spheres, which is related with the chronological progression of the disease and polypharmacy.
TITLE: Calidad de vida relacionada con la salud en niños con epilepsia de un hospital mexicano.Introduccion. La epilepsia es un sindrome neurologico cronico que cursa con descargas anormales, sincronicas y exageradas de la corteza cerebral. La epilepsia se relaciona inversamente con la calidad de vida relacionada con la salud de los pacientes (CVRS); sin embargo, esta relacion se ha documentado poco en niños de Latinoamerica. Objetivo. Examinar la relacion entre epilepsia y la CVRS en un grupo de niños escolares de 8-12 años atendidos en un hospital pediatrico de Sonora, Mexico. Pacientes y metodos. Se comparo transversalmente la CVRS de niños con diagnostico de epilepsia con respecto a la CVRS de dos grupos control. Se utilizo el cuestionario validado Pediatric Quality of Life Inventory para evaluar la CVRS. Las diferencias se examinaron mediante la prueba de ANOVA, y la asociacion entre epilepsia y CVRS se modelo mediante regresion logistica multiple. Resultados. Los niños con epilepsia mostraron la menor puntuacion de CVRS (62,4 ± 14,8) entre los sujetos estudiados, y tuvieron 5,2 veces mas riesgo de deterioro de su CVRS (intervalo de confianza al 95% = 2,43-11,06) en comparacion con el de niños sanos. El deterioro fue mayor en las escalas cognitiva (54,6 ± 15,0) y emocional (55,9 ± 23,6). La polifarmacia ingestion concomitante de tres o mas farmacos (p < 0,001) y la progresion cronologica de la enfermedad (p < 0,001) son factores que deterioran significativamente la CVRS de niños con epilepsia. Conclusiones. La epilepsia provoca un deterioro global en la CVRS de los niños, especificamente en las esferas cognitiva y emocional, lo que se relaciona con la progresion cronologica de la enfermedad y la polifarmacia.
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Epilepsia/psicologia , Sintomas Afetivos/etiologia , Sintomas Afetivos/psicologia , Anticonvulsivantes/efeitos adversos , Anticonvulsivantes/uso terapêutico , Criança , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/psicologia , Estudos Transversais , Progressão da Doença , Características da Família , Feminino , Hospitais Universitários/estatística & dados numéricos , Humanos , Relações Interpessoais , Masculino , México , Polimedicação , Qualidade de Vida , Autorrelato , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
This work evaluated HPV infection in the oral cavity (using oroscopy and exfoliative oral cytology) and its relation to genital infection in women with cytological diagnosis suggestive of HPV infection. The sample consisted of 60 patients who underwent oroscopy, cytology and viral determination in mouth and cervix by PCR using generic primers MY09/MY11 and MPCR. HPV DNA was detected in oral and genital mucosa in 48.33% and 73.3% of patients, respectively, yielding a concordance of 44.2% (k=0.44, moderate agreement). The most common viral types were low risk, especially type 6, found in 86.2% of oral samples and 65.9% of cervical specimens, alone or in combination with other types of low (11) or high oncogenic risk (16, 18, 33), with a concordance of 10.45% (k = 0.1, insignificant agreement). However, in relation to type 6, there was a concordance of 75.86% (k=0.7, high agreement). The cytology of the oral cavity had a sensitivity of 3.5% and a specificity of 93.6%. For oroscopy, sensitivity was 27.6% and specificity was 74.2%. The results indicate that HPV infection in the oral cavity of patients with genital infection could be frequent. The low concordance between HPV types suggests that HPV infection in the mouth and cervix has a different biological behavior.
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Colo do Útero/virologia , Doenças dos Genitais Femininos/virologia , Boca/virologia , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/virologia , Adulto , Feminino , Doenças dos Genitais Femininos/patologia , Humanos , Infecções por Papillomavirus/patologiaRESUMO
A prospective study was conducted on 72 patients of pulmonary tuberculosis (TB) and 201 healthy controls in a third level hospital. The HRQoL questionnaire (12-Item Short Form Health Survey, SF-12) was used to assess the QoL at the onset of treatment DOTS. Patients with TB had significantly lower mean scores than controls for overall QoL (51.1 +/- SD 22.6) versus 75.9 (+/- SD 17.6), p < 0.0001. The most affected domains were physical and psychological. Active TB patients shown difficulties in activities of daily living and alterations of the psychological state.
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Qualidade de Vida , Tuberculose , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
Lipid oxidation is known to occur rather rapidly in cooked chicken meat containing relatively high amounts of polyunsaturated fatty acids. To assess the lipid oxidation stability of sous vide chicken meat enriched with n-3 and conjugated linoleic acid (CLA) fatty acids, 624 Cobb × Ross broilers were raised during a 6-wk feeding period. The birds were fed diets containing CLA (50% cis-9, trans-11 and 50% trans-10, cis-12 isomers), flaxseed oil (FSO), or menhaden fish oil (MFO), each supplemented with 42 or 200 mg/kg of vitamin E (dl-α-tocopheryl acetate). Breast or thigh meat was vacuum-packed, cooked (74°C), cooled in ice water, and stored at 4.4°C for 0, 5, 10, 15, and 30 d. The lipid oxidation development of the meat was estimated by quantification of malonaldehyde (MDA) values, using the 2-thiobarbituric acid reactive substances analysis. Fatty acid, nonheme iron, moisture, and fat analyses were performed as well. Results showed that dietary CLA induced deposition of cis-9, trans-11 and trans-10, cis-12 CLA isomers, increased the proportion of saturated fatty acids, and decreased the proportions of monounsaturated and polyunsaturated fatty acids. Flaxseed oil induced higher deposition of C18:1, C18:2, C18:3, and C20:4 fatty acids, whereas MFO induced higher deposition of n-3 fatty acids, eicosapentaenoic acid (C20:5), and docosahexaenoic acid (C22:6; P < 0.05). Meat lipid oxidation stability was affected by the interaction of either dietary oil or vitamin E with storage day. Lower (P < 0.05) MDA values were found in the CLA treatment than in the MFO and FSO treatments. Lower (P < 0.05) MDA values were detected in meat samples from the 200 mg/kg of vitamin E than in meat samples from the 42 mg/kg of vitamin E. Nonheme iron values did not affect (P > 0.05) lipid oxidation development. In conclusion, dietary CLA, FSO, and MFO influenced the fatty acid composition of chicken muscle and the lipid oxidation stability of meat over the storage time. Supranutritional supplementation of vitamin E enhanced the lipid oxidation stability of sous vide chicken meat.
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Ácidos Graxos Ômega-3/química , Ácidos Linoleicos Conjugados/química , Peroxidação de Lipídeos , Carne/análise , Ração Animal/análise , Animais , Galinhas , Culinária , Dieta/veterinária , Suplementos Nutricionais , Ácidos Graxos Ômega-3/metabolismo , Óleos de Peixe/química , Ácidos Linoleicos Conjugados/metabolismo , Óleo de Semente do Linho/química , Carne/normasRESUMO
The fatty acid composition of chicken muscle may affect the lipid oxidation stability of the meat, particularly when subjecting the meat to thermal processing and storage. The objective of this study was to evaluate the diet effect on lipid oxidation stability of fresh and cooked chicken meat. Six hundred broilers were raised for a 6-wk feeding period and were assigned to 8 treatments with 3 repetitions. Broilers were fed a basal corn-soybean meal diet, including 5% of either animal-vegetable, lard, palm kernel, or soybean (SB) oil, each supplemented with a low (33 mg/kg) or high (200 to 400 mg/kg) level of vitamin E. Fresh breast and thigh meat and skin were packaged and refrigerated (4°C) for 15 d. Breast and thigh meat were frozen (-20°C) and stored for ~6 mo and then thawed, deboned, ground, and formed into patties of 150 g each. Patties were cooked (74°C), cooled, packaged, and stored in refrigeration for 6 d. The lipid oxidation development of the products was determined using the TBA reactive substances analysis. The results showed that the lipid oxidation development, in both fresh chicken parts and cooked meat patties, was influenced by the interaction of either dietary lipid source or vitamin E level with storage time. Fresh breast meat showed no susceptibility to lipid oxidation, but thigh meat and skin presented higher (P < 0.05) malonaldehyde values in the SB oil treatment, starting at d 10 of storage. In cooked patties, during the entire storage time, the SB oil showed the highest (P < 0.05) lipid oxidation development compared with the other treatments. Regarding vitamin E, in both fresh parts and cooked meat patties, in most sampling days the high supplemented level showed lower (P < 0.05) malonaldehyde values than the control treatment. In conclusion, the lipid oxidation stability of chicken meat is influenced by the lipid source and vitamin E level included in the diet upon storage time and processing of the meat.
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Ração Animal/classificação , Galinhas/fisiologia , Gorduras na Dieta/farmacologia , Peroxidação de Lipídeos/efeitos dos fármacos , Carne/normas , Vitamina E/farmacologia , Animais , Culinária , Ácidos Graxos/análise , Carne/análise , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/fisiologia , Vitamina E/sangueRESUMO
There is an increasing demand in precooked chicken meat products for restaurants and catering services. Because cooked chicken meat develops lipid oxidation relatively fast, sous vide chicken meat was studied to assess its shelf-life. Six hundred Cobb x Ross broilers were fed for 6 wk with a basal corn-soybean meal diet including soybean, palm kernel, or animal-vegetable oil, each supplemented with 33 or 200 mg/kg of dl-alpha-tocopheryl acetate. Broilers were randomly assigned into 6 treatments and 4 repetitions with 25 birds each. Boneless breast or thigh muscle pieces were dissected into 5 x 5 x 5 cm cubes, vacuum-packed, cooked in water bath (until 74 degrees C internal temperature), chilled, and stored at 4 degrees C for 1, 5, 10, 25, and 40 d. For each storage day, each pouch contained 3 pieces of meat, either breast or thigh. Thiobarbituric acid reactive substances analysis, to quantify malonaldehyde (MDA) values, was conducted to estimate the lipid oxidation development. Nonheme iron values of cooked meat were analyzed. Fatty acid methyl esters analysis was performed in chicken muscle to determine its fatty acid composition. There was no interaction between dietary fat and vitamin E level in all of the variables studied except in nonheme iron. Dietary fat significantly influenced the fatty acid composition of the muscle (P < 0.01), but it did not affect the MDA values, regardless of differences in the muscle fatty acid composition between treatments. Supplementation of the high level of vitamin E significantly reduced the MDA values in both breast and thigh meat (P < 0.01). The maximum MDA values were observed at d 40 of storage in thigh and breast meat in animal-vegetable and soybean oil treatments with the low levels of vitamin E, 0.91 and 0.70 mg/kg, respectively. Nonheme iron values in thigh meat differed between treatments at 1 or 25 d of storage but not in breast meat. In conclusion, refrigerated sous vide chicken meat has a prolonged shelf-life, which is enhanced by dietary supranutritional supplementation of vitamin E.
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Galinhas , Glycine max , Peroxidação de Lipídeos/efeitos dos fármacos , Carne/análise , Tocoferóis/farmacologia , Vitamina E/farmacologia , Animais , Culinária , Suplementos Nutricionais , Ácidos Graxos/análise , Óleos de Peixe/farmacologia , Ferro/análise , Lipídeos/análise , Músculo Esquelético/química , Óleos de Plantas/farmacologia , alfa-Tocoferol/análiseRESUMO
Emergency contraception (EC), an intervention within 72 h of unprotected intercourse, dates back approximately 30 years, to the Yuzpe method. Recent development of a second generation of 'morning after,' better called 'emergency' contraceptives, has raised claims that they are abortifacient. These claims are largely rejected in medical, legal and much religious reasoning. Pregnancy is usually ascribed to the postimplantation period; means to prevent completion of implantation do not terminate pregnancy. An alternative attack on EC has arisen under South American laws that protect human life 'from conception.' The chance of conception from a single act of unprotected intercourse is very low, in view of limited times of fertility during menstrual cycles. The protection of a woman's life is not suspended during pregnancy. Risks to women's interests are more credible than the chance of conception having occurred. The claim to prohibit EC to protect embryonic life from conception is therefore problematic.
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Anticoncepcionais Pós-Coito , Serviços Médicos de Emergência/legislação & jurisprudência , Ética Médica , Desenvolvimento Embrionário , Feminino , Fertilização , Humanos , Gravidez , Religião , África do Sul , América do Sul , Saúde da MulherRESUMO
Amparada por sus derechos a la libertad de pensamiento y de conciencia en en ejercicio de su autonomía reproductiva es la mujer a quien corresponde en su fuero interno decidir si evita o no un embarazo, acudiendo por ejemplo a la anticoncepción de emergencia
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Colômbia , Anticoncepcionais Pós-Coito , Legislação como AssuntoRESUMO
OBJECTIVES: The origin of the elevation of serum immunoglobulin A1 (IgA1) in Type 2 diabetes mellitus (DM) is unsettled. The aim of this study was to address the carbohydrate changes of serum IgA1 from patients with Type 2 diabetes mellitus, as a possible cause of the elevation. DESIGN AND METHODS: IgA1 was purified from sera of 6 DM patients and 4 healthy matched controls by using highly acetylated-Sepharose 6B, anti-IgA-agarose, and jacalin-agarose columns, and further separated into jacalin low-affinity, medium, and high-affinity fractions. Hinge and Fc fragments from native IgA1 were obtained and analyzed by using Sambucus nigra, Maackia amurensis, Arachis hypogaea, Erythrina cristagalli, and Ricinus communis lectins. RESULTS: The jacalin high-affinity fraction, mostly constituted by macromolecular IgA1, was more abundant in DM patients than in controls and also more reactive to Sambucus nigra, and Maackia amurensis lectins. CONCLUSIONS: Macromolecular serum IgA1 from DM patients is hypersialylated and this probably contributes to the high level of IgA1 in DM patients.
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Diabetes Mellitus Tipo 2/sangue , Imunoglobulina A/sangue , Idoso , Carboidratos/sangue , Estudos de Casos e Controles , Cromatografia em Agarose , Eletroforese em Gel de Poliacrilamida , Feminino , Humanos , Imunoglobulina A/química , Imunoglobulina A/isolamento & purificação , Lectinas/metabolismo , Masculino , Pessoa de Meia-Idade , Ligação Proteica , Fatores de TempoRESUMO
PIP: The objective of the 'safe motherhood' initiative is to reduce maternal mortality by 50% by the year 2000. A strong policy is needed to permit development of national and international programs. The lifetime risk of death from causes related to complications of pregnancy is estimated at 1/16 in Africa, 1/65 in Asia, 1/130 in Latin America and the Caribbean, 1/1400 in Europe, and 1/3700 in North America. A minimum of 585,000 women die of maternal causes each year, with nearly 90% of the deaths occurring in Asia and Africa. Approximately 50 million women suffer from illnesses related to childbearing. A principal cause of maternal mortality is lack of medical care during labor, delivery, and the postpartum period. Motherhood will become safe if governments, multilateral and bilateral funding agencies, and nongovernmental organizations give it the high priority it requires. Women also die because they lack rights. Their reduced decision-making power and inequitable access to family and social resources prevents them from overcoming barriers to health care. Women die when they begin childbearing at a very young age, yet an estimated 11% of births throughout the world each year are to adolescents. Adolescents have very limited access to family planning, either through legal restrictions or obstacles created by family planning workers. Maternal deaths would be avoided if all births were attended by trained health workers; an estimated 60 million births annually are not. Prevention of unwanted pregnancy and, thus, of the 50 million abortions estimated to take place each year would avoid over 200 maternal deaths each day. Unsafe abortions account for 13% of maternal deaths. The evidence demonstrates that rates of unsafe abortion and abortion mortality are higher where laws are more restrictive.^ieng
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Países em Desenvolvimento , Mortalidade Materna , Política , Direitos da Mulher , Demografia , Economia , América Latina , Mortalidade , População , Dinâmica Populacional , Fatores SocioeconômicosRESUMO
OBJECTIVE: To analyze the experience of the Fundación Santa Fe de Bogotá with radical prostatectomy in the treatment of localized prostatic cancer. METHODS: A retrospective study was conducted on 108 patients with localized carcinoma of the prostate stage T1-T2NxM0 submitted to radical prostatectomy from 1989 to 1994. RESULTS: Preoperatively, 50% of the patients had a PSA < 10 ng/ml and 14% had values that fell within the normal ranges of 0-4 mg/ml. A family history of prostate cancer was detected in 9.3% of the patients. The prostate cancer was clinically understaged in 75% of the patients, particularly those with stages T2a and T2b, and less significantly in those with stage T2c. Considering only those patients in whom the pathological staging had disclosed the cancer was not localized, this incidence accounted for 52% (n = 57). The presence of surgical margins was approximately 36%. The tumor recurrence rate was 26.9% and the complication rate was 6.8%. CONCLUSION: The relatively low complication rate in the present series shows that radical prostatectomy is a safe procedure that achieves good results if the cases are carefully selected and the diagnostic test are widely utilized.
Assuntos
Prostatectomia/métodos , Neoplasias da Próstata/cirurgia , Distribuição por Idade , Fatores Etários , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Prostatectomia/efeitos adversos , Neoplasias da Próstata/patologia , Estudos RetrospectivosRESUMO
UNLABELLED: The scope of this work is to analyze the usefulness and indications of preoperative evaluation. PATIENTS AND METHODS: 791 consecutive patients candidate for surgical treatment, were studied prospectively under the next inclusion criteria: 40 years old or less than 40 years old. Blood count cell, glucose, urea, creatinine, sodium, potassium, prothrombin time, partial thromboplastin time, platelets count, liver function tests, chest x-ray and electrocardiograph made before entry. In the the post liver, lung, bleeding, infectious or metabolic complications was done, while visiting the patients every day until discharge. Relative risk (RR) was calculated for every variable, analyzing differences with X2 and Fisher's Test. Those variables with statistical significance value were analyzed with logistic regression. Only 751 patients were studied, there were 335 male (44%) and 416 female (56%), with mean age of 63.9 years. Metabolic disorders (16.9%) and postoperative infections (7.0%) were the more frequent complications. Hemorrhage during of after surgery occurred in 2.2% of the patients. There were seventeen deaths (2.2%) related directly with surgery, with systemic illness or with postoperative complications. Selection of auxiliary tests for preoperative evaluation must be agree with clinical evaluation. The major objective of clinical evaluation is to estimate risk factors for surgery.
Assuntos
Diagnóstico , Cuidados Pré-Operatórios , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
PIP: Profamilia, the Colombian family planning association and the country's largest family planning provider, began diversifying its services in 1982 to offer prenatal care services as well as general medical consultations. The organization has since attempted to integrate quality assurance at all levels of operation. Specifically, Profamilia is aiming to provide care which is of sustainably high quality to satisfy present clients and attract new ones without overtaxing available organization resources, thereby prompting the eventual financial collapse of the programs and the failure to increase coverage especially among the middle and lower classes of the country. Drawing from the credo of modern corporate enterprise, "the client is always right," Profamilia listens and responds to clients' needs with the goal of making their satisfaction the ultimate objective. Moreover, organization staff receive regular training to motivate their receptiveness to client needs, while the pursuit of quality exists as a major goal at the managerial level. Profamilia regards quality maintenance and improvement as indispensable in program sustainability.^ieng
Assuntos
Agentes Comunitários de Saúde , Planejamento em Saúde , Necessidades e Demandas de Serviços de Saúde , Motivação , Pacientes , Gestão de Recursos Humanos , Relações Públicas , Qualidade da Assistência à Saúde , América , Comportamento , Colômbia , Países em Desenvolvimento , Economia , Serviços de Planejamento Familiar , Pesquisa sobre Serviços de Saúde , Relações Interpessoais , América Latina , Avaliação de Programas e Projetos de Saúde , Psicologia , América do SulRESUMO
94 patients with renal allograft from a living related donor were studied in three different groups: 1 Patients with identical histocompatibility (n-32), treated with prednisone (PDN) and azathioprine (Aza); 2 Haploidentical patients (34) who received PDN, Aza and cyclosporine (CsA); 3 Haploidentical patients (28) who previous to the transplantation received specific donor blood transfusions and Aza/PDN after the transplantation. The survival for the patient and the graft after five years was 100% and 96% in group 1; 97% y 89% in group 2 and 82% and 72% in group 3. Five patients in group 1 received CsA also. There was no mortality in group 1, while there were one death in group 2 and two more in group 3. There was no significant difference between CsA and Blood transfusions in the patients and grafts survival.