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Introduction: Frailty is a geriatric syndrome frequently associated with executive dysfunction and white matter hyperintensities (WMH). But the relation between executive dysfunction and brain changes is poorly understood in frail subjects. Our hypothesis is that frontal-WMH mediates the association between frailty and executive dysfunction. Methods: A convenience sample of 113 subjects older than 65 years without dementia was studied with neuropsychological test, a structured clinical interview, physical examination and brain MRI. They were classified as robust or pre-frail and frail using the frailty phenotype score (0-5). The frontal WMH (F-WMH) were manually graduated (0-6) using the "Age-Related White Matter Changes score" from FLAIR sequences at a 3 Tesla brain MRI. A mediation analysis was done for testing whether F-WMH could act as a link factor between frailty phenotype score and executive dysfunction. Results: The group's mean age was 74 ± 6 years, subjects with higher frailty score had more depressive symptoms and worse performance in executive function tests. A regression analysis that explained 52% of the variability in executive functions, revealed a significant direct effect of frailty score (Standardized ßcoeff [95% CI] -0.201, [-0.319, -0.049], and F-WMH (-0.152[-0.269, -0.009]) on executive functions, while the F-WMH showed a small partial mediation effect between frailty and executive functions (-0.0395, [-0.09, -0.004]). Discussion: Frontal matter hyperintensities had a small mediation effect on the association between frailty and executive dysfunction, suggesting that other neuropathological and neurofunctional changes might also be associated with executive dysfunction in frail subjects.
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Introducción: El síndrome de cascanueces se considera una anomalía infrecuente y poco pensada en la práctica médica; su incidencia no está bien establecida debido a su sintomatología variada. La agenesia renal unilateral se estima entre 1/2500 y 1/4000 nacidos vivos. Objetivos: Describir una paciente de 18 años con sospecha prenatal de agenesia renal derecha confirmada por imágenes después del nacimiento, que ingresó por proteinuria. Presentación del caso: Paciente de 18 años con agenesia renal derecha conocida, en la que un examen de orina detectó proteinuria desde los 13 años. En su estudio se clasificó como proteinuria ortostática y evolutivamente refirió dolor lumbar izquierdo ligero y transitorio. En el ultrasonido renal, realizado para valorar crecimiento del riñón único, se detectó dilatación de la vena renal izquierda. Se repitió el estudio ecográfico para precisar ángulo aorto-mesentérico y dilatación de vena renal izquierda, y se confirmó el síndrome de cascanueces. Conclusiones: La asociación entre agenesia renal derecha y síndrome de cascanueces, resulta extremadamente rara, y, cuando se presenta con proteinuria ortostática y dolor lumbar ocasional, debe seguirse en forma expectante, pero no se necesita tratamiento quirúrgico en la mayoría de los casos(AU)
Introduction: Nutcracker syndrome is considered an infrequent and poorly thought out anomaly in medical practice; its incidence is not well established due to its varied symptomatology. Unilateral renal agenesis is estimated to be between 1/2500 and 1/4000 live births. Objectives: To describe an 18-year-old female patient with suspected pre-natal imaging-confirmed right renal agenesis after birth, who was admitted due to proteinuria. Case presentation: An 18-year-old female patient with known right renal agenesis, in whom a urine test detected proteinuria from the age of 13. In the study it was classified as orthostatic proteinuria and evolutionarily she referred mild and transient left low back pain. Renal ultrasound, performed to assess single kidney growth, showed dilation of the left renal vein. The ultrasound study was repeated to specify aorto-mesenteric angle and left renal vein dilation, and nutcracker syndrome was confirmed. Conclusions: The association between right renal agenesis and nutcracker syndrome is extremely rare, and, when it presents with orthostatic proteinuria and occasional low back pain, it should be followed expectantly, but surgical treatment is not needed in most cases(AU)
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Humanos , Feminino , Adolescente , Proteinúria/urina , Síndrome do Quebra-Nozes/diagnóstico por imagem , Rim Único/diagnóstico por imagem , Veias Renais , DilataçãoRESUMO
(1) Background: Due to the pandemic caused by COVID-19, mandatory confinement was declared, which generated a decrease in the practice of physical activity (PA). Based on this problem, it was proposed to study the associations between PA in relation to depressive symptoms, quality of sleep, and the quality of life of middle-aged people who work in the university context during compulsory confinement as a result of COVID-19. (2) Methods: A total of 336 middle-aged people (48 ± 6.67) participated in this analytical cross-sectional study. The variable levels of PA, quality of sleep, symptoms of depression, and quality of life were measured with the International Physical Activity Questionary (IPAQ), the Pittsburgh Sleep Quality Index (PSQI), the Zung Self-Rating Depression Scale (ZSDS), and the SF-12v2 questionnaire, respectively. (3) Results: A logistic regression model was used to analyze the relationships between the level of PA and depressive symptoms (OR = 2.053), total sleep duration (OR = 0.495), sleep disturbances (OR = 2.414), quality of sleep (OR = 2.471), use of sleep medication (OR = 0.348), daytime dysfunction (OR = 1.809), general health (OR = 0.949), and physical functioning (OR = 0.987). (4) Conclusions: In middle-aged people, during compulsory confinement, being insufficiently active is a risk for depressive symptoms and disturbances in sleep quality.
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During the COVID-19 pandemic, psychological disorders have been documented in the population, and their exacerbation in vulnerable populations such as those with Cardiometabolic Diseases (CD) might challenge health systems. This study determined psychological factors associated with CD in Colombian adults during the COVID-19 pandemic. For this purpose, 284 persons were evaluated, 142 without CD and 142 with CD. Sociodemographic data were collected, and the International Physical Activity Questionnaire (IPAQ), the SF-12v2, the Pittsburgh Sleep Quality Index (PSQI) and the Zung Self-Rating Depression Scale (ZSDS), which were integrated into an online form, were used. Through a simple and multiple logistic regression model, it was shown that CD was associated with low sleeping quality (LSQ) (OR = 3.51) and with depressive symptoms (DS) (OR = 1.98). In addition, in the group with CD, the presence of DS was related to BMI (OR = 2.45), and LSQ was related to living with persons at risk for COVID-19 (OR = 3.64) and BMI (OR = 5.88). In conclusion, this study showed that people with CD have a higher chance of presenting DS and LSQ. Furthermore, living with people at risk for COVID-19 was related to the presence of LSQ.
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Introducción: La infección neonatal constituye una de las enfermedades más comunes debido a la susceptibilidad de estos pacientes. Esta infección puede llegar a la sepsis neonatal e incrementar la mortalidad. Objetivo: Determinar las características clínicas y epidemiológicas de la infección neonatal tardía. Métodos: Estudio descriptivo retrospectivo y transversal de registros de neonatos ingresados en el servicio de neonatología del Hospital William Soler Ledea entre los años 2017-2019 con diagnóstico de infección. Se excluyeron aquellos registros de neonatos infectados intervenidos quirúrgicamente. Las variables estudiadas fueron: epidemiológicas, factores de riesgo, clínicas y paraclínicas. Se emplearon técnicas de estadísticas descriptivas como porcentajes, razón, media o promedio. Resultados: La muestra estuvo conformada por 1078 registros de pacientes para una tasa de infección de 59,4 × 100 ingresos. Los factores de riesgo prenatales y connatales obtuvieron razón de prevalencia < 1. Los factores de riesgo posnatales con mayor prevalencia fueron el sexo masculino (57,6 por ciento) y el cateterismo venoso central (53,6 por ciento). De 83 a 88 por ciento de los neonatos infectados presentaron alteraciones del perfil hematopoyético. Las infecciones respiratorias, de piel y de partes blandas se presentaron en 36 por ciento de los neonatos y fueron las bacterias grampositivas los principales microorganismos aislados. Hubo 11 pacientes fallecidos para una tasa de mortalidad del 22,9 por ciento. Conclusiones: La morbilidad por infección tardía es notable, predominan los factores de riesgo posnatales y el sexo masculino; la prematuridad y el bajo peso tuvieron la mayor representación en los fallecidos(AU)
Introduction: Neonatal infection is one of the most common diseases due to the sensitivity of these patients. This infection can lead to neonatal sepsis and increase mortality. Objective: Determine the clinical and epidemiological characteristics of late neonatal infection. Methods: Retrospective and cross-sectional descriptive study of records on neonates admitted to the neonatology service of William Soler Ledea Hospital in the period 2017-2019 with a diagnosis of infection. Records of infected infants undergoing surgery were excluded. The variables studied were: epidemiological, risk factors, clinical and paraclinical. Descriptive statistical techniques such as percentages, ratio, mean or average were used. Results: The sample consisted of 1078 patient´s records, with an infection rate of 59.4 × 100 admissions. Prenatal and conatal risk factors obtained prevalence ratio < 1. The postnatal risk factors with the highest prevalence were male sex (57.6 percent) and central venous catheterization (53.6 percent). From 83 to 88 percent of infected neonates had alterations in the hematopoietic profile. Respiratory, skin and soft tissue infections occurred in 36 percent of the neonates and gram-positive bacteria were the main isolated microorganisms. There were 11 patients who died representing a mortality rate of 22.9 percent. Conclusions: Morbidity due to late infection is remarkable, postnatal risk factors predominate and male sex; prematurity and low weight had the highest representation in the deceased ones(AU)
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Humanos , Masculino , Recém-Nascido , Exame Físico/métodos , Fatores de Risco , Sepse Neonatal/mortalidade , Sepse Neonatal/epidemiologia , Cuidado Pré-Natal , Recém-Nascido Prematuro , Epidemiologia Descritiva , Estudos Transversais , Estudos RetrospectivosRESUMO
RESUMEN Introducción: La sepsis es una condición que genera alta morbilidad y mortalidad en donde la detección temprana de los microorganismos causantes es esencial para un manejo oportuno. Objetivo: determinar la frecuencia de detección y tipificación de los microorganismos por el PCR multiplex (Film Array) en pacientes pediátricos (menores de 18 años) ingresados al servicio de urgencias con el diagnóstico confirmado de sepsis. Materiales y Métodos: Se realizó un estudio observacional descriptivo retrospectivo. Fueron analizados los paneles positivos de hemocutivos de pacientes menores de 18 años, con diagnóstico de sepsis, por medio de la tecnología PCR multiplex (Film Array) en el Hospital Clínica Infantil Club Noel. Los resultados fueron comparados. Los datos fueron analizados con Microsof Excel, empleando estadísticas descriptivas. Resultados: De 101 hemocultivos positivos, el panel molecular Film Array detecto el 92 (91%). Hubo predominio de sepsis con puerta de entrada respiratoria y menores de 3 años de edad. Los gérmenes más frecuentemente detectados fueron los gram negativos tanto en el hemocultivo como en el panel molecular. Conclusiones: los hallazgos en cuanto a detección de bacteriemia, en nuestra población por PCR multiplex en tiempo real demuestran su capacidad de detección y su importancia en el diagnóstico temprano y tratamiento oportuno.
ABSTRACT Introduction: Sepsis is a condition that generates high morbidity and mortality: The early detection of the causative microorganisms is essential for timely management. Objective: to determine the frequency of detection and typing of microorganisms by multiplex PCR (Film Array) in pediatric patients (under 18 years of age) admitted to the emergency department with a confirmed diagnosis of sepsis. Materials and Methods: This was a retrospective, descriptive and observational study, Positive blood culture panels of patients under 18 years of age, diagnosed with sepsis, were analyzed using multiplex PCR technology (Film Array) at the Hospital Clínica Infantil Club Noel. The results were compared. The data was analyzed with Microsoft Excel, using descriptive statistics. Results: Of 101 positive blood cultures, the Film Array molecular panel detected 92 (91%). There was a predominance of sepsis from a respiratory source and children under 3 years of age. The most frequently detected germs were gram-negative organisms, both in the blood culture and in the molecular panel. Conclusions: the findings regarding the detection of bacteremia in our population, using multiplex real-time PCR, demonstrate its detection ability and its importance in early diagnosis and timely treatment.
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Introducción: las afecciones periodontales están catalogadas entre las más comunes del género humano, y como la causa más frecuente de la morbilidad y mortalidad dentarias. Objetivo: caracterizar las enfermedades periodontales crónicas en pacientes diabéticos. Métodos: se realizó un estudio transversal sobre la epidemiología de las enfermedades periodontales crónicas en pacientes diabéticos, del Consultorio Médico Popular Colinas, del Área de Salud Integral Comunitaria (ASIC) La Unidad, municipio de Caroní, estado de Bolívar, Venezuela, entre septiembre del 2014 a diciembre del 2015. El universo lo integraron 61 pacientes diabéticos de 19 a 60 años, y la muestra quedó constituida por 52 pacientes que cumplieron con los criterios de inclusión. Se utilizó el Índice Periodontal de Russell, conforme a la Organización Mundial de la Salud (OMS); revisado para determinar la prevalencia y gravedad de la enfermedad periodontal. Resultados: en el grupo de 41 a 60 años predominó 40,4% de pacientes con periodontitis. El sexo masculino fue el más afectado por la enfermedad periodontal crónica, con 51,9%. Tanto la gingivitis como la periodontitis se presentaron en su forma leve con mayor frecuencia, con el 57,9%. Conclusiones: elevada prevalencia de enfermedades periodontales crónicas, según la edad y el sexo, con mayor intensidad y frecuencia en las periodontitis en su forma leve, donde el sexo masculino resultó ser el más afectado.
Introduction: periodontal affections are, among most common mankind jaws´ morbility and mortality causes. Objective: to characterize diabetic patients´chronic periodontal diseases. Methods: a traverse study on diabetic patients´ chronic periodontal diseases epidemiology, was carried out at Colinas doctor's office, from the Community Integral Health Area (CIHA) La Unidad, Caroni municipality, Bolivar state, Venezuela; from September 2014 to December 2015. The universe was composed by 61 from 19 to 60 years old diabetic patients, and the sample was formed by 52 patients which fulfill inclusion expectatations. Periodontal Russell index was used by the World Health Organization (WHO), in order to find periodontal diseases´graveness and prevalence. Results: the 40.4 % of the 41 to 60 year-old periodontitis patients, prevailed. The 51.9% of males were the most affected by periodontal chronic diseases. Gingivitis and periodontitis showed in their light form, up to 57.9%. Conclusions: the elevated chronic periodontal diseases prevalence. Light periodontitis intensity and frequency, according to age and sex, showed males as the most affected group.
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PURPOSE: Obesity and high body fat are related to diabetes and metabolic syndrome (MetS) in all ethnic groups. Based on the International Diabetes Federation (IDF) definition of MetS, the aim of the present study was to compare body adiposity indexes (BAIs) and to assess their various cutoff values for the prediction of MetS in university students from Colombia. METHODS: A cross-sectional study was conducted on 886 volunteers (51.9% woman; age mean 21.4 years). Anthropometric characteristics (height, weight, waist circumference [WC], and hip circumference [HC]) were measured, and body composition was assessed by bioelectrical impedance analysis. MetS was defined as including ≥3 of the metabolic abnormalities (WC, high-density lipoprotein cholesterol [HDL-C], triglycerides, fasting glucose, and systolic and diastolic blood pressure [BP]) in the definition provided by the IDF. The BAIs (i.e., BAI-HC [BAI], BAI-WC [BAI-w], and [BAI-p]) were calculated from formulas taking into account, height, weight, and WC, and for the visceral adiposity indexes, a formula, including WC, HDL-C, and triglycerides, was used. RESULTS: The overall prevalence of MetS was 5.9%, higher in men than in women. The most prevalent components were low HDL-C, high triglyceride levels, WC, and BP levels. The receiver operating characteristic curves analysis showed that BAI, BAI-w, and BAI-p could be useful tools to predict MetS in this population. CONCLUSION: For women, the optimal MetS threshold was found to be 30.34 (area under curve [AUC] = 0.720-0.863), 19.10 (AUC = 0.799-0.925), and 29.68 (AUC = 0.779-0.901), for BAI, BAI-w, and BAI-p, respectively. For men, the optimal MetS threshold was found to be 27.83 (AUC = 0.726-0.873), 21.48 (AUC = 0.755-0.906), and 26.18 (AUC = 0.766-0.894), for BAI, BAI-w, and BAI-p, respectively. The three indexes can be useful tools to predict MetS according to the IDF criteria in university students from Colombia. Data on larger samples are needed.
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Adiposidade , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Adolescente , Adulto , Antropometria , Área Sob a Curva , Glicemia/análise , Composição Corporal , HDL-Colesterol/sangue , Colômbia , Estudos Transversais , Diástole , Feminino , Humanos , Inflamação , Gordura Intra-Abdominal/patologia , Masculino , Obesidade/sangue , Curva ROC , Estudantes , Inquéritos e Questionários , Sístole , Triglicerídeos/sangue , Universidades , Circunferência da Cintura , Relação Cintura-Quadril , Adulto JovemRESUMO
Introducción: la rehabilitación protésica se extiende más allá del diente individual o del área desdentada única, comprende la restauración de la normalidad de las relaciones de los músculos y dientes, de modo que se devuelva la salud bucal, tiene como objetivo la sustitución de los dientes, cuando se encuentran perdidos o ausentes, por medios artificiales capaces de restablecer la función masticatoria, estética y fonética. Objetivos: identificar la necesidad real y sentida de prótesis estomatológica en pacientes mayores de 15 años del Policlínico Universitario III René Vallejo Ortiz. Métodos: se realizó un estudio descriptivo transversal donde del universo de 19 760 personas se examinaron 500 personas que representaron la muestra la cual se escogió de forma aleatoria; se realizó el examen bucal y formulario, se contó con el consentimiento de todos los pacientes seleccionados. Resultados: el sexo femenino representó el 60% de los examinados y el grupo de 35-59 años el 45%. El 56% de los examinados necesitó tratamiento, las prótesis parciales fueron las más necesitadas con 62,5%, el sexo femenino mostró una necesidad real del 64,3% y la necesidad sentida de prótesis estomatológica fue del 51,8%, mayor en el sexo femenino con el 68,9% y en el grupo de edad de 35-59 años con el 56,7%. Conclusiones: más de la mitad de la población examinada necesitó tratamiento protésico de tipo parcial, la necesidad real y sentida de tratamiento fue más notoria en el sexo femenino y en el grupo de edad de 35 a 59 años.
Introduction: prosthetic rehabilitation extends beyond the individual tooth or the single area without teeth, which includes restoring the normality of the relations of muscles and teeth, as well as the proper oral health, substituting the teeth absent by artificial means and achieving the masticatory, aesthetics and phonetics function. Objective: to identify the real need for stomatology prosthesis in patients older than 15 years of René Vallejo Ortiz University Polyclinic III Method: a cross-sectional descriptive study was done. Of a total of 19.760 individuals, 500 of them were randomly selected, representing the sample. The oral examination was performed considering the informed consent of all patients. Results: the female sex represented 60% and the group of 35-59 years 45%; 56% of the patients needed treatment, partial dentures were the most needed with 62.5%, the female sex showed a real need of 64.3% and the felt need for the prosthesis represented 51.8%, higher in the female sex with 68.9% and in the age group between 35-59 (56.7%). Conclusions: more than half of the population required partial-type prosthetic treatment, the real and felt need for treatment was more evident in the female sex and in the age group between 35-59.
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Introducción: Las comunidades indígenas presentan un mayor riesgo de inseguridad alimentaria y malnutrición, menor disponibilidad de recursos, y una creciente dependencia de alimentos más baratos aunque con un alto grado de procesamiento. Objetivo: Identificar el estado nutricional y aspectos alimentarios en mujeres indígenas de tres comunidades del Departamento de Presidente Hayes, Chaco Paraguayo. Metodología: Estudio observacional de diseño transversal con componente analítico, que incluyó a 81 mujeres de 15 a 44 años de edad, de las etnias Maká y Toba Qom. Previo consentimiento informado, se realizó la valoración nutricional y la entrevista para obtener los datos sociodemográficos y alimentarios. Resultados: Las mujeres indígenas presentaron una frecuencia de sobrepeso de 30,8% y obesidad del 21,0%, mientras que el 1,2 % presentó desnutrición. No encontramos diferencia significativa entre las etnias, en relación al sobrepeso y obesidad, (p>0,05). Observamos que las indígenas tenían una alta ingesta de frutas, azúcares y mieles. El 87 y 88% de las mujeres indígenas de ambas etnias estudiadas refirieron no consumir lácteos y derivados y entre 65 y 69% refirieron no consumir verduras. Conclusiones: Observamos un elevado porcentaje de obesidad y sobrepeso, un bajo consumo de lácteos y verduras y un alto consumo de azúcares, relacionados posiblemente a cambios en los aspectos alimentarios y sus costumbres, influenciados por la cercanía a las zonas urbanas y el acceso a alimentos de menor precio y mayor contenido energético.
Introduction: Indigenous communities present higher risk of food insecurity and malnutrition, lower availability of resources and growing dependence on cheaper food but with high degree of processing. Objective: To identify the nutritional state and food aspects in indigenous women from three communities of Presidente Hayes Department, Paraguayan Chaco. Methodology: Cross-sectional observational study with analytical component including 81 women who were 15 to 44 years old from the Maká and Toba Qom ethnic groups. After giving their informed consent, the nutritional assessment and the interview to collect socio-demographic and food data were carried out. Results: The indigenous women presented an overweight frequency of 30.8 % and obesity of 21.0%, while malnutrition was observed in 1.2%. No significant differences were found between ethnic groups in relation to overweight and obesity (p>0.05). High ingestion of fruits, sugar and honey was observed and 87% and 88% of the indigenous women from both ethnic groups referred that they did not consume dairy products and derivatives and 65% and 69% referred that they did not consume vegetables. Conclusions: High percentages of obesity and overweight were observed. Low consumption of dairy products, its by products and vegetables and a high consumption of sugar were observed, related probably to changes in food aspects and the habits of these groups, influenced by the proximity to urban areas and the access to low prices food with high energetic content.
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Humanos , Feminino , Estado Nutricional , Dieta , Paraguai , Mulheres , Povos IndígenasRESUMO
The majority of abortions in Colombia continue to take place outside the formal health system under a range of conditions, with the majority of women obtaining misoprostol from a thriving black market for the drug and self-administering the medication. We conducted a cost analysis to compare the costs to the health system of three approaches to the provision of abortion care in Colombia: post-abortion care for complications of unsafe abortions, and for legal abortions in a health facility, misoprostol-only medical abortion and vacuum aspiration abortion. Hospital billing records from three institutions, two large maternity hospitals and one specialist reproductive health clinic, were analysed for procedure and complication rates, and costs by diagnosis. The majority of visits (94%) were to the two hospitals for post-abortion care; the other 6% were for legal abortions. Only one minor complication was found among the women having legal abortions, a complication rate of less than 1%. Among the women presenting for post-abortion care, 5% had complications during their treatment, mainly from infection or haemorrhage. Legal abortions were associated not only with far fewer complications for women, but also lower costs for the health system than for post-abortion care. We calculated based on our findings that for every 1,000 women receiving post-abortion care instead of a legal abortion within the health system, 16 women experienced avoidable complications, and the health system spent US $48,000 managing them. Increasing women's access to safe abortion care would not only reduce complications for women, but would also be a cost-saving strategy for the health system.
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Aborto Induzido , Aborto Legal , Custos de Cuidados de Saúde , Abortivos não Esteroides/uso terapêutico , Aborto Induzido/economia , Aborto Induzido/métodos , Aborto Induzido/estatística & dados numéricos , Aborto Legal/economia , Aborto Legal/métodos , Aborto Legal/estatística & dados numéricos , Adulto , Instituições de Assistência Ambulatorial , Colômbia , Técnicas de Apoio para a Decisão , Feminino , Custos de Cuidados de Saúde/estatística & dados numéricos , Reforma dos Serviços de Saúde , Maternidades , Humanos , Misoprostol/uso terapêutico , Gravidez , Curetagem a Vácuo , Saúde da MulherAssuntos
Agricultura , Agroquímicos/intoxicação , Poluentes Ambientais/intoxicação , Falência Renal Crônica/mortalidade , Causalidade , Causas de Morte/tendências , América Central/epidemiologia , Desidratação/complicações , Desidratação/etiologia , Feminino , Mortalidade Hospitalar/tendências , Humanos , Falência Renal Crônica/etiologia , Masculino , Prevalência , Distribuição por SexoRESUMO
In April 2013, a consortium of regional health ministries, nongovernmental organizations, aid agencies, clinical specialists and researchers from diverse sectors convened in San Salvador to discuss the epidemic of chronic kidney disease of unknown or non-traditional causes (CKDu) plaguing agricultural communities in Central America and beyond. The three-day meeting, where presentation of research on the clinical and epidemiological characteristics of CKDu roused significant debate, led the Pan American Health Organization to declare CKDu "a pressing and serious health problem [which] represents a burden for families, communities, health systems and society as a whole."[1] This High-level Meeting on Chronic Kidney Disease of Non-Traditional Causes in Central America (24-26 April) followed several international meetings at which Dr María Isabel Rodríguez, El Salvador's Minister of Health, presented studies on the disease burden in her country, where end-stage renal disease is the leading cause of hospital deaths. She outlined results of original scientific research by Dr Carlos Orantes (first published in MEDICC Review), that described an "elevated prevalence of chronic kidney disease, chronic renal failure and risk factors" among the patients studied, noting that "the most common [form] was chronic kidney disease of unknown cause, associated with neither diabetes nor hypertension."[2] In this interview with MEDICC Review, Dr Rodríguez discussed the gravity of the problem in Salvadoran agricultural communities; the importance of CKDu research in other countries; and the urgent need for intersectoral action and active community participation to confront and control the epidemic.
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Agricultura , Doenças Profissionais/etiologia , Insuficiência Renal Crônica/etiologia , América Central/epidemiologia , El Salvador/epidemiologia , Epidemias/estatística & dados numéricos , Humanos , Doenças Profissionais/epidemiologia , Insuficiência Renal Crônica/epidemiologiaRESUMO
Cervical cancer is the most frequent malignant tumour of women in Latin America being human papillomavirus (HPV) the main cause. The aim of this study was to increase the knowledge about the cervical infections with oncogenic HPV types (HR-HPV) in Asuncion, Paraguay. Two hundred and seventy-two cervical samples were analyzed using hybrid capture II assay (HCA II) for HR-HPV. The frequency of HR-HPV in the study group was 44 percent. HR-HPV was detected in 25 percent of the women negative for squamous intraepithelial lesions (NSIL), 72 percent with atypical squamous cells of undetermined significance (ASCUS), 68 percent with low SIL and 78 percent with high SIL. A moderate concordance was observed between HCA II assay and cytology (kappa: 0.43 IC95 percent 0.3 - 0.5). It was detected a high frequency of HR-HPV in women from 11 to 30 years old and in those over 60 years old. The data obtained in this study showed a high frequency of HR-HPV in woman with NSIL and ASCUS, which corroborate that the use of cytology together with HCA II assay for HR-HPV could improve remarkably the efficiency of screening programs of cervical cancer in Paraguay. Furthermore, these findings point out the need for the periodical follow-up of HR-HPV infections in older women.
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Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Displasia do Colo do Útero/diagnóstico , DNA Viral/análise , Papillomaviridae/genética , Infecções por Papillomavirus/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Displasia do Colo do Útero/virologia , Hibridização de Ácido Nucleico , Paraguai , Infecções por Papillomavirus/virologia , Neoplasias do Colo do Útero/virologia , Esfregaço Vaginal , Carga Viral , Adulto JovemRESUMO
Cervical cancer is the most frequent malignant tumour of women in Latin America being human papillomavirus (HPV) the main cause. The aim of this study was to increase the knowledge about the cervical infections with oncogenic HPV types (HR-HPV) in Asuncion, Paraguay. Two hundred and seventy-two cervical samples were analyzed using hybrid capture II assay (HCA II) for HR-HPV. The frequency of HR-HPV in the study group was 44%. HR-HPV was detected in 25% of the women negative for squamous intraepithelial lesions (NSIL), 72% with atypical squamous cells of undetermined significance (ASCUS), 68% with low SIL and 78% with high SIL. A moderate concordance was observed between HCA II assay and cytology (kappa: 0.43 IC(95% 0.3-0.5)). It was detected a high frequency of HR-HPV in women from 11 to 30 years old and in those over 60 years old. The data obtained in this study showed a high frequency of HR-HPV in woman with NSIL and ASCUS, which corroborate that the use of cytology together with HCA II assay for HR-HPV could improve remarkably the efficiency of screening programs of cervical cancer in Paraguay. Furthermore, these findings point out the need for the periodical follow-up of HR-HPV infections in older women.
Assuntos
DNA Viral/análise , Papillomaviridae/genética , Infecções por Papillomavirus/diagnóstico , Displasia do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/diagnóstico , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Pessoa de Meia-Idade , Hibridização de Ácido Nucleico , Infecções por Papillomavirus/virologia , Paraguai , Neoplasias do Colo do Útero/virologia , Esfregaço Vaginal , Carga Viral , Adulto Jovem , Displasia do Colo do Útero/virologiaRESUMO
Se realizó un estudio en las gestantes de menos de 14 semanas de embarazo, pertenecientes al Policlínico Carlos J Finlay de Santiago de Cuba, en el período entre enero y marzo del 2002, con el propósito de indagar acerca de sus conocimientos en la esfera de la salud bucal. El universo constituido por 45 embarazadas. Para el estudio se formaron 2 grupos de edades teniendo en cuenta la madurez físico-mental de las embarazadas: menores de 20 años y mayores de 20 años. Para la recopilación de la información se elaboró un cuestionario con el objetivo de facilitar los resultados. Se observó que el nivel de conocimientos sobre los temas evaluados fue incorrecto en ambos grupos de estudio, pero las embarazadas pertenecientes al grupo menores de 20 años, mostraron menor nivel de conocimientos, por lo que se recomienda una intervención educativa, así como llevar a cabo estudios similares en las diferentes entidades del municipio(AU)
He/she was carried out a study in the gestantes of less than 14 weeks of pregnancy, belonging to the Policlínico Carlos J. Finlay of Santiago from Cuba, in the period between January and March of the 2002, with the purpose of investigating about their knowledge in the sphere of the buccal health. The universe constituted by 45 pregnant. For the study they were formed 2 groups of ages keeping in mind the physical-mental maturity of the pregnant ones: smaller than 20 years and bigger than 20 years. For the summary of the information a questionnaire was elaborated with the objective of facilitating the results. It was observed that the level of knowledge on the evaluated topics was incorrect in both study groups, but the pregnant belonging to the group smaller than 20 years, they showed smaller level of knowledge, for what an educational intervention is recommended, as well as to carry out similar studies in the different entities of the municipality(AU)