RESUMO
Chronic hyperglycemia increases the risk of developing severe COVID-19 symptoms, but the related mechanisms are unclear. A mean glucose level upon hospital admission >166 mg/dl correlates positively with acute respiratory distress syndrome in patients with hyperglycemia. The objective of this study was to evaluate the relationship between sustained hyperglycemia and the outcome of hospitalized patients with severe COVID-19. We also evaluated the effect of high glucose concentrations on the expression of angiotensin-converting enzyme 2 (ACE2). We carried out a case-control study with hospitalized patients with severe COVID-19 with and without sustained hyperglycemia. In a second stage, we performed in vitro assays evaluating the effects of high glucose concentrations on ACE2 gene expression. Fifty hospitalized patients with severe COVID-19 were included, of which 28 (56%) died and 22 (44%) recovered. Patients who died due to COVID-19 and COVID-19 survivors had a high prevalence of hyperglycemia (96.4% versus 90.9%), with elevated central glucose upon admission (197.7 mg/dl versus 155.9 mg/dl, p = 0.089) and at discharge (185.2 mg/dl versus 134 mg/dl, p = 0.038). The mean hypoxemia level upon hospital admission was 81% in patients who died due to COVID-19 complications and 88% in patients who survived (p = 0.026); at the time of discharge, hypoxemia levels were also different between the groups (68% versus 92%, p ≤ 0.001). In vitro assays showed that the viability of A549 cells decreased (76.41%) as the glucose concentration increased, and the ACE2 gene was overexpressed 9.91-fold after 72 h (p ≤ 0.001). The relationship between hyperglycemia and COVID-19 in hospitalized patients with COVID-19 plays an important role in COVID-19-related complications and the outcome for these patients. In patients with chronic and/or sustained hyperglycemia, the upregulation of ACE2, and its potential glycation and malfunction, could be related to complications observed in patients with COVID-19.
RESUMO
Background and Objectives. The importance of mitochondria in inflammatory pathologies, besides providing energy, is associated with the release of mitochondrial damage products, such as mitochondrial DNA (mt-DNA), which may perpetuate inflammation. In this review, we aimed to show the importance of mitochondria, as organelles that produce energy and intervene in multiple pathologies, focusing mainly in COVID-19 and using multiple molecular mechanisms that allow for the replication and maintenance of the viral genome, leading to the exacerbation and spread of the inflammatory response. The evidence suggests that mitochondria are implicated in the replication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which forms double-membrane vesicles and evades detection by the cell defense system. These mitochondrion-hijacking vesicles damage the integrity of the mitochondrion's membrane, releasing mt-DNA into circulation and triggering the activation of innate immunity, which may contribute to an exacerbation of the pro-inflammatory state. Conclusions. While mitochondrial dysfunction in COVID-19 continues to be studied, the use of mt-DNA as an indicator of prognosis and severity is a potential area yet to be explored.
Assuntos
COVID-19 , DNA Mitocondrial , DNA Mitocondrial/genética , Humanos , Imunidade Inata , Mitocôndrias/genética , SARS-CoV-2RESUMO
OBJECTIVES: To determine the percentage of positivity of close contacts of coronavirus disease 19 (COVID-19) patients to depict the importance of asymptomatic infections in the patient-to-patient transmission of COVID-19. METHODS: One hundred subjects were included. Nineteen index COVID-19 cases and 81 traced close contacts were screened for coronavirus 2 of severe acute respiratory syndrome (SARS-CoV-2) using real-time reverse transcription-polymerase chain reaction. Immunoglobulin M and G against SARS-CoV-2 were evaluated by rapid test. RESULTS: Thirty-four (42%) contacts in the study were positive for SARS-CoV-2. Twenty-three (67.6%) manifested less than 2 respiratory symptoms, and 5 (14.7%) remained asymptomatic. The average of positive contacts by index COVID-19 case (R0) was 4.3 and the mean of time of positive COVID-19 test at sampling time was 18.9 days. Positive antibody test against SARS-CoV-2 was observed in 16% of the participants. CONCLUSION: The proportion of close contacts of COVID-19 patients infected with SARS-CoV-2 (42%) and with less than 2 or with no respiratory symptoms (82.4%) was high in the study population. A low proportion of COVID-19 patients had a positive test for antibodies against SARS-CoV-2. The screening for SARS-CoV-2 in close contacts of COVID-19 positive patients should be encouraged to avoid spreading the infection and the expansion of the disease.
Assuntos
COVID-19/transmissão , Portador Sadio/transmissão , Adulto , Idoso , COVID-19/epidemiologia , COVID-19/fisiopatologia , Teste de Ácido Nucleico para COVID-19 , Teste Sorológico para COVID-19 , Portador Sadio/epidemiologia , Busca de Comunicante , Feminino , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , SARS-CoV-2 , Doenças não Diagnosticadas , Adulto JovemRESUMO
Since the appearance of the severe acute respiratory syndrome coronavirus (SARS-CoV) in 2003 in China, diabetes mellitus (DM) and hyperglycemia in patients infected with SARS-CoV, represent independent predictors of mortality. Therefore, metabolic control has played a major role in the prognosis of these patients. In the current pandemic of coronavirus disease 19 (COVID-19), multiple studies have shown that DM is one of the main comorbidities associated with COVID-19 and higher risk of complications and death. The incidence and prevalence of COVID-19 complications and death related with hyperglycemia in patients with or without DM are high. There are many hypotheses related with worse prognosis and death related to COVID-19 and/or hyperglycemia. However, the information about the interplay between hyperglycemia and angiotensin-converting enzyme 2 (ACE2), the critical receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in the context of SARS-CoV-2 infection, is almost null, but there is enough information to consider the possible participation of hyperglycemia in the glycation of this protein, unleashing a pool of reactions leading to acute respiratory distress syndrome and death in patients with COVID-19. In this document we investigated the current evidence related with ACE2 as a key element within the pathophysiological mechanism related with hyperglycemia extrapolating it to context of SARS-CoV-2 infection and its relationship with worse prognosis and death for COVID-19.
RESUMO
Introduction: During severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the virus hijacks the mitochondria causing damage of its membrane and release of mt-DNA into the circulation which can trigger innate immunity and generate an inflammatory state. In this study, we explored the importance of peripheral blood mt-DNA as an early predictor of evolution in patients with COVID-19 and to evaluate the association between the concentration of mt-DNA and the severity of the disease and the patient's outcome. Methods: A total 102 patients (51 COVID-19 cases and 51 controls) were included in the study. mt-DNA obtained from peripheral blood was quantified by qRT-PCR using the NADH mitochondrial gene. Results: There were differences in peripheral blood mt-DNA between patients with COVID-19 (4.25 ng/µl ± 0.30) and controls (3.3 ng/µl ± 0.16) (p = 0.007). Lower mt-DNA concentrations were observed in patients with severe COVID-19 when compared with mild (p= 0.005) and moderate (p= 0.011) cases of COVID-19. In comparison with patients with severe COVID-19 who survived (3.74 ± 0.26 ng/µl) decreased levels of mt-DNA in patients with severe COVID-19 who died (2.4 ± 0.65 ng/µl) were also observed (p = 0.037). Conclusion: High levels of mt-DNA were associated with COVID-19 and its decrease could be used as a potential biomarker to establish a prognosis of severity and mortality of patients with COVID-19.
Assuntos
COVID-19 , DNA Mitocondrial/genética , Humanos , Imunidade Inata , Mitocôndrias/genética , SARS-CoV-2RESUMO
RESUMEN: Objetivo: Conocer mediante el análisis del estado del conocimiento, el impacto de polifarmacia en calidad de vida de adultos mayores y cuál ha sido el rol de enfermería frente a esta problemática de salud. Métodos: Revisión descriptiva de 62 artículos originales de diversos diseños metodológicos, en bases de datos: EBSCO, PubMed, Web of Science, SciELO, Elsevier, SCOPUS y Dialnet. Resultados: La polifarmacia en adultos mayores se presenta con mayor frecuencia en el sexo femenino, en personas con bajo nivel de escolaridad, sumados a factores socioeconómico. Un gran porcentaje de adultos mayores presenta efecto cascada en consumo de fármacos, por cantidad de medicamentos consumidos y número de médicos consultados, produciendo interacciones farmacológicas, afectando funcionalidad y calidad de vida. Conclusiones: Es necesario mayor control de medicamentos consumidos por adultos mayores, para evitar efectos nocivos. Los profesionales de enfermería deben tener un rol educativo en este grupo etario, para disminuir polifarmacia e impulsar estilos de vida que fomenten el envejecimiento saludable.(AU)
ABSTRACT: Objective: To know, by analyzing the state of knowledge, the impact of the polypharmacy on the quality of life of older adults and the role of nursing when dealing with this health problem. Materials and Methods: Descriptive review of 62 original articles with multiple methodological designs, in the databases EBSCO, PubMed, Web of Science, SciELO, Elsevier, SCOPUS and Dialnet. Results: Polypharmacy in older adults is more frequent in the female sex and people with low level of education, and is associated with socioeconomic factors. A large percentage of older adults present with prescription cascade due to the amount of drugs consumed and the number of doctors consulted, leading to pharmacological interactions that affect functionality and quality of life. Conclusions: More control of drugs consumed by older adults is needed to avoid harmful effects. Nursing professionals should have an educational role in this age group to reduce polypharmacy and promote lifestyles that foster healthy ageing.(AU)
RESUMO: Objetivo: Conhecer, através da análise do estado do conhecimento, o impacto da polifarmácia na qualidade de vida do idoso e qual o papel da enfermagem diante desse problema de saúde. Métodos: Revisão descritiva de 62 artigos originais de vários desenhos metodológicos, nas bases de dados: EBSCO, PubMed, Web of Science, SciELO, Elsevier, SCOPUS e Dialnet. Resultados: A polifarmácia em idosos ocorre mais frequentemente no sexo feminino, em pessoas com baixa escolaridade, somada a fatores socioeconômicos. Uma grande porcentagem de idosos apresenta efeito cascata no consumo de medicamentos, pela quantidade de medicamentos consumidos e número de médicos consultados, produzindo interações farmacológicas, afetando a funcionalidade e a qualidade de vida. Conclusões: É necessário um maior controle dos medicamentos consumidos por idosos para evitar efeitos nocivos. Os profissionais de enfermagem devem ter papel educativo nessa faixa etária, para diminuir a polifarmácia e promover estilos de vida que promovam o envelhecimento saudável.(AU)
Assuntos
Saúde do Idoso , Polimedicação , Expectativa de Vida Ajustada à Qualidade de Vida , Cuidados de Enfermagem/organização & administração , Uso Indevido de Medicamentos sob Prescrição/efeitos adversosRESUMO
OBJECTIVE: To know, by analyzing the state of knowledge, the impact of the polypharmacy on the quality of life of older adults and the role of nursing when dealing with this health problem. MATERIALS AND METHODS: Descriptive review of 62 original articles with multiple methodological designs, in the databases EBSCO, PubMed, Web of Science, SciELO, Elsevier, SCOPUS and Dialnet. RESULTS: Polypharmacy in older adults is more frequent in the female sex and people with low level of education, and is associated with socioeconomic factors. A large percentage of older adults present with prescription cascade due to the amount of drugs consumed and the number of doctors consulted, leading to pharmacological interactions that affect functionality and quality of life. CONCLUSIONS: More control of drugs consumed by older adults is needed to avoid harmful effects. Nursing professionals should have an educational role in this age group to reduce polypharmacy and promote lifestyles that foster healthy ageing.
OBJETIVO: Conocer mediante el análisis del estado del conocimiento, el impacto de polifarmacia en calidad de vida de adultos mayores y cuál ha sido el rol de enfermería frente a esta problemática de salud. MÉTODOS: Revisión descriptiva de 62 artículos originales de diversos diseños metodológicos, en bases de datos: EBSCO, PubMed, Web of Science, SciELO, Elsevier, SCOPUS y Dialnet. RESULTADOS: La polifarmacia en adultos mayores se presenta con mayor frecuencia en el sexo femenino, en personas con bajo nivel de escolaridad, sumados a factores socioeconómico. Un gran porcentaje de adultos mayores presenta efecto cascada en consumo de fármacos, por cantidad de medicamentos consumidos y número de médicos consultados, produciendo interacciones farmacológicas, afectando funcionalidad y calidad de vida. CONCLUSIONES: Es necesario mayor control de medicamentos consumidos por adultos mayores, para evitar efectos nocivos. Los profesionales de enfermería deben tener un rol educativo en este grupo etario, para disminuir polifarmacia e impulsar estilos de vida que fomenten el envejecimiento saludable.
RESUMO
Resumen Objetivo: Presentar una serie de reconstrucciones con colgajos perforantes en pacientes con casos severos de hidradenitis supurativa y sus resultados. Pacientes y métodos: Se realizaron 7 reconstrucciones axilares y un caso de reconstrucción esternal en 5 pacientes. Todos los pacientes correspondieron a la clasificación II o III de Hurley, y fueron derivados a nuestro servicio después de por lo menos un año de tratamiento médico sin obtener resultados. El equipo de cirugía plástica realizó tanto la resección como la reconstrucción en todos los casos. Los vasos perforantes fueron marcados con un dispositivo Doppler sonido. Resultados: Se obtuvo cobertura en todos los casos, con solo una pérdida parcial de colgajo que fue resuelta con curaciones. Tras un seguimiento de 26 meses, no hubo recidiva de hidradenitis supurativa. Todas las reconstrucciones evolucionaron con resultados funcionales óptimos. Conclusión: Los colgajos perforantes son una buena alternativa para el tratamiento de casos severos de hidradenitis supurativa, tanto esternal como axilar. Por esta razón, debe ser considerado en el armamento de cirujanos plásticos que traten esta enfermedad, una vez que el tratamiento médico haya fallado.
Abstract Aim: To present a brief series of reconstructions with perforator flaps in severe cases of hidradenitis suppurativa patients and results. Patients and methods: Seven axillary and one sternal case in five patients were operated on. All patients were in stage II or III according to Hurley classification, and were referred after at least one year of medical treatment with no satisfactory result. The plastic surgery team performed both, resection and reconstruction in all cases. Perforator vessels were marked using a handheld Doppler device. Results: One partial flap failure occurred, which healed with standard wound care. After a median follow up of 26 months, no relapse of hidradenitis suppurativa occurred. All reconstructions evolved with full functional results. Conclusion: Perforator flaps are a good choice in the treatment of severe cases of hidradenitis suppurativa, both sternal and axillary. It should be considered in the armamentarium of any plastic surgeon treating patients with this condition, once the medical treatment has failed.
Assuntos
Humanos , Masculino , Feminino , Adulto , Axila/cirurgia , Hidradenite Supurativa/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Retalho Perfurante , Esterno/cirurgia , Resultado do TratamentoRESUMO
BACKGROUND: Currently, there are no valid training programs based solely on nonliving models. The authors aimed to develop and validate a microsurgery training program based on nonliving models and assess the transfer of skills to a live rat model. METHODS: Postgraduate year-3 general surgery residents were assessed in a 17-session program, performing arterial and venous end-to-end anastomosis on ex vivo chicken models. Procedures were recorded and rated by two blinded experts using validated global and specific scales (objective structured assessment of technical skills) and a validated checklist. Operating times and patency rates were assessed. Hand-motion analysis was used to measure economy of movements. After training, residents performed an arterial and venous end-to-end anastomosis on live rats. Results were compared to six experienced surgeons in the same models. Values of p < 0.05 were considered statistically significant. RESULTS: Learning curves were achieved. Ten residents improved their median global and specific objective structured assessment of technical skills scores for artery [10 (range, 8 to 10) versus 28 (range, 27 to 29), p < 0.05; and 8 (range, 7 to 9) versus 28 (range, 27 to 28), p < 0.05] and vein [8 (range, 8 to 11) versus 28 (range, 27 to 28), p < 0.05; and 8 (range, 7 to 9) versus 28 (range, 27 to 29), p < 0.05]. Checklist scores also improved for both procedures (p < 0.05). Trainees were slower and less efficient than experienced surgeons (p < 0.05). In the living rat, patency rates at 30 minutes were 100 percent and 50 percent for artery and vein, respectively. CONCLUSIONS: Significant acquisition of microsurgical skills was achieved by trainees to a level similar to that of experienced surgeons. Acquired skills were transferred to a more complex live model.
Assuntos
Currículo , Cirurgia Geral/educação , Internato e Residência/métodos , Microcirurgia/educação , Modelos Anatômicos , Modelos Educacionais , Treinamento por Simulação/métodos , Anastomose Cirúrgica/educação , Animais , Artérias/cirurgia , Galinhas , Chile , Competência Clínica , Masculino , Modelos Animais , Ratos , Ratos Sprague-Dawley , Método Simples-Cego , Veias/cirurgiaRESUMO
INTRODUCTION: Living animal models are frequently used for perforator flap dissection training, but no ex vivo models have been described. The aim of this study is to present a novel nonliving model for perforator flap training based on a constant perforator in the chicken leg. METHODS: A total of 15 chicken legs were used in this study. Anatomical dissection of the perforator was performed after its identification using ink injection, and in four of these specimens a perforator-based flap was raised. RESULTS: The anatomical dissection revealed a constant intramuscular perforator with a median length of 5.7 cm. Median proximal and distal vessel diameters were 0.93 and 0.4 mm, respectively. The median dissection time was 77.5 minutes. CONCLUSION: This study introduces a novel, affordable, and reproducible model for the intramuscular dissection of a perforator-based flap using an ex vivo animal model. Its consistent perforator and appropriate-sized vessels make it useful for training.
RESUMO
Background Supermicrosurgery is a technique used for dissection and anastomosis of submillimeter diameter vessels. This technique requires precise hand movements and superb eye-hand coordination, making continuous training necessary. Biological in vivo and ex vivo models have been described for this purpose, the latter being more accessible and cost-effective. The aim of this study is to present a new ex vivo training model using a chicken leg. Methods In 28 chicken legs, an anatomical study was performed. An intramuscular perforator vessel was identified and dissected. Arterial diameters of 0.7, 0.5, and 0.3 mm were identified and consistency of the perforator was assessed. In additional 10 chicken legs, 25 submillimeter arteries were anastomosed using this perforator vessel. Five arteries of 0.3 and 10 of 0.5 mm were anastomosed with nylon 11-0 and 12-0 sutures. Intravascular stent (IVaS) technique and open guide (OG) technique were used in 0.5-mm arteries. A total of 10 arteries of 0.7 mm were anastomosed using 10-0 sutures in a conventional fashion. Dissection and anastomosis time were recorded and patency was tested. Results We were able to identify 0.7 to 0.3 mm diameter arteries in all the specimens and confirm the consistency of the perforator. The median time for dissection was 13.4 minutes. The median time for anastomosis was 32.3 minutes for 0.3-mm arteries, 24.3 minutes for 0.5-mm arteries using IVaS, 29.5 minutes for the OG technique, and 20.9 minutes for the 0.7 mm diameter arteries. All the anastomoses were permeable. Conclusion Due to its consistent and adequate diameter vessels, this model is adequate for training supermicrosurgical skills.
Assuntos
Anastomose Cirúrgica/educação , Dissecação/educação , Extremidade Inferior/cirurgia , Microcirurgia/educação , Microvasos/cirurgia , Modelos Animais , Procedimentos Cirúrgicos Vasculares/educação , Anastomose Cirúrgica/métodos , Animais , Galinhas , Competência Clínica , Dissecação/métodos , Educação de Pós-Graduação em Medicina , Extremidade Inferior/anatomia & histologia , Microvasos/anatomia & histologia , Duração da CirurgiaRESUMO
Soldier suicide rates, unfortunately, continue to rise in our military services. It is well known that military personnel are highly vulnerable to multiple psychopathologies due to a lack of social support system, traumatizing life events and deprived sense of control. Serious psychopathologies such as post-traumatic stress disorders, other anxiety disorders (i.e., generalized anxiety disorder) and depression may increase the risk of suicide. In addition, malingering may be a serious problem that can affect valid treatment due to an intentional production of false or grossly exaggerated physical or psychological symptoms, motivated by external incentive such as avoiding military duty or obtaining financial compensation. Moreover, Hispanic soldiers may be at a higher risk for such psychopathologies due to extreme marginalization conditions by military peers, lack of bilingual language management and discrimination that can severely affect their quality of life. Thus, it is important to recognize those problems in order to prevent them. Literature demonstrate that Primary Preventive Interventions (PPI) can help to reduce the incidence of psychiatric disorders due to an early identification of the mental conditions associate to serious outcome, such as suicide. Taking the previous factors into consideration, the relevant literature pertaining suicidality in service members and the mental disorders associated with it is reviewed. Furthermore, emphasis is made in the importance to develop and validate a battery of screening instruments that address the previous conditions in the military personnel, especially in the Hispanic/Latino soldier and/or veteran as future plans of interventions. This implies the creation, adaptation and administration of a Psychological Battery that will be culturally sensitive for Hispanic/Latino soldiers in which the screening of the previously mentioned pathologies and conditions can be identified. This may help to prevent serious psychological situations and extreme irreversible damage, such as suicide.
Assuntos
Militares , Prevenção do Suicídio , Suicídio , Adolescente , Adulto , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Hispânico ou Latino/psicologia , Humanos , Simulação de Doença , Programas de Rastreamento , Transtornos Mentais/epidemiologia , Militares/psicologia , Militares/estatística & dados numéricos , Preconceito , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia , Suicídio/etnologia , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Guerra , Adulto JovemRESUMO
PURPOSE: The prevalence of diabetes mellitus in Puerto Ricans has been identified and reported as being disproportionately higher as compared to other metabolic pathologies. Recently, diabetes has been identified as the third cause of mortality in Puerto Rico (Puerto Rico Health Department, Vital Statistics Annual Report, 1999-2001). The Research Center, Education and Medical Services for Diabetes in Puerto Rico (also known as the "Centro de Diabetes para Puerto Rico" [CDPR]) is a public corporation in the island created by the government to reduce diabetes prevalence, mortality and morbidity. METHOD: The CDPR offers Diabetes Self Management Educational Training Program Schools for patients (DSMETPS) island wide. The research design was an ex-post facto. As part of the process, patients are administered an extensive sociodemographic and health information questionnaire, which also includes the CES-D (a symptomatology depressive scale). This study pretends to describe the diabetic patient profiles (n=27) using information from the DSMETPS of the CDPR and explore the association with the CES-D. Variables such as patients' needs, knowledge and understanding of the condition (i.e., pathology management, type and medications utilized and exercise and nutritional patterns), patient attitudes to diabetes and their relations with the CES-D were explored. RESULTS: Results show a negative association, controlling for age and gender, between patients diabetic education/knowledge and CES-D score. CONCLUSIONS: Diabetes educators in Puerto Rico need to identify depressive symptomatology in order to prevent mental health complications in their patients since this may affect their future treatment and prognosis. An interdisciplinary team is recommended to improve the effectivity of the intervention.
Assuntos
Depressão/diagnóstico , Depressão/etiologia , Diabetes Mellitus Tipo 2/psicologia , Testes Psicológicos , Humanos , Porto RicoRESUMO
This investigation presents the development and validation process of a scale whose principal purpose is to identify those areas in which one is required to achieve improved functioning and adequate emotional health resulting in improved sports performance with adolescent athletes. The "Hechavarria Wellness Scale for Adolescent Athletes" (HWSAA) was developed. The concept of wellness was measured utilizing the following 4 sub-scales measuring; depressive symptomatology, trait anxiety, self-esteem and social relations. A pilot study was undertaken with a universe of 149 adolescent athletes from both sexes with an average of 15.6 years old and residing within the different municipalities of Puerto Rico. The alpha coefficient reliability of the HWSAA and its' subscales fluctuated between 0.71 and 0.82. The results suggest that the HWSAA and its' subscales possess a psychometrically adequate internal consistency. This means that the instrument is valid and reliable for the sample utilized. We suggest further research with the HWSAA.
Assuntos
Serviços de Saúde do Adolescente/estatística & dados numéricos , Indicadores Básicos de Saúde , Qualidade de Vida , Esportes/psicologia , Adolescente , Feminino , Humanos , Masculino , Projetos Piloto , Porto Rico , Reprodutibilidade dos Testes , Esportes/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
The use of alternative/complementary medicine has been increasing considerably. Conventional medicine must begin to address issues related to the use, safety, regulation, research and education of alternative/complementary medicine. Integrative medicine combines conventional medicine and alternative complementary practices. Integrative medicine is an innovative approach to medicine and medical education. It involves the understanding of the interaction of the mind, body and spirit and how to interpret this relationship in the dynamics of health and disease. Integrative medicine shifts the orientation of the medical practice from disease based approach to a healing based approach. It does not reject conventional medicine nor uncritically accepts unconventional practices. Integrative medicine is an effective, more fulfilling human approach to medicine based on the benefit of the patient by following good medicine practices in a scientific manner.
Assuntos
Humanos , Terapias Complementares , Educação Médica/tendências , Prestação Integrada de Cuidados de Saúde/tendências , Saúde Holística , Porto RicoRESUMO
Se realizó estudio descriptivo longitudinal, sobre la influencia de la Educación para Salud en la adquisición de conocimientos y cambios de actitud y control de la enfermedad en ancianos hipertensos de 2 consultorios del Policlínico California, en el año 1977. El universo lo constituyeron 126 ancianos, a los que se les aplicó MINI-MENTAL-TEST, resultando aptos para la investigación 92 gerontes, a éstos se le realizó encuesta y resultó que el mayor porcentaje tenía conocimientos sobre su enfermedad evaluados de regular, al igual que la actitud ante la misma. Estos aspectos mejoraron después de la técnica educativa, incrementándose también el número de pacientes controlados de su enfermedad. Se formularon recomendaciones
Assuntos
Humanos , Idoso , Educação em Saúde , Saúde do Idoso , HipertensãoRESUMO
Folate deficiency is one of today's most common vitamin deficiencies in women. Women who consume a low level of folate during pregnancy are at risk for poor pregnancy outcomes including neural tube defects (NTD). However, other factors such as heredity, social class, maternal age, birth order, maternal diet, length of time between pregnancies, maternal zinc deficiency, use of anticonvulsant drugs, abnormal homocysteine metabolism and the use of oral contraceptives, have also been implicated as causes of NTD. Animal studies have shown that fetuses are highly dependent on the folate status of the mother. In addition, several retrospective and prospective human studies have provided evidence that folate lowers the incidence of NTD
Assuntos
Humanos , Animais , Feminino , Gravidez , Ácido Fólico/administração & dosagem , Complicações na Gravidez/prevenção & controle , Deficiência de Ácido Fólico/prevenção & controle , Defeitos do Tubo Neural , Cebus , Ensaios Clínicos Controlados como Assunto , Deficiência de Ácido Fólico/complicações , Ensaios Clínicos Controlados Aleatórios como Assunto , Defeitos do Tubo Neural/etiologia , Estudos Prospectivos , Estudos Retrospectivos , Fatores de RiscoRESUMO
El alto consumo de grasa ha sido ligado en forma consistente al cáncer de las mamas en estudios epidemiológicos y experimentales. Esta comunicación revisa los posibles mecanismos envueltos en esta relación. Además revisaremos los efecto de distintas grasas sobre el crecimiento del cáncer mamario en recientes estudios experimentales
Assuntos
Neoplasias da Mama/etiologia , Gorduras na Dieta/efeitos adversos , Neoplasias Mamárias Animais/etiologia , Camundongos NusRESUMO
La incidencia de las complicaciones pulmonares de neumonía ha disminuido en proporción con la introducción de nuevos y más eficaces agentes antimicrobianos. En los últimos 20 años se han informado solamente 60 casos nuevos de abscesos pulmonares en niños. Es probable que muchos de los casos no se estén informado. Los enfermos, de cualquier edad, que sufren de neumonía pueden desarrollar complicaciones tales como abscesos y empiema. Como ejemplo, presentamos el caso de un infante de 10 meses de edad con un absceso pulmonar primario debido a Staphylococcus aureus con una respuesta satisfactoria a los agentes antimicrobianos