RESUMO

OBJECTIVE: To estimate the baseline to measure one of the three indicators of the World Health Organization (WHO) End TB strategy (2015-2035), measure the costs incurred by patients affected by tuberculosis (TB) during a treatment episode and estimate the proportion of households facing catastrophic costs (CC) and associated risk factors, in Colombia, 2021. MATERIAL AND METHODS: A nationally representative cross-sectional survey was conducted among participants on TB treatment in Colombia, using telephone interviews due to the exceptional context of the COVID-19 pandemic. The survey collected household costs (direct [medical and non-medical out-of-pocket expenses] and indirect) over an episode of TB, loss of time, coping measures, self-reported income, and asset ownership. Total costs were expressed as a proportion of annual household income and analyzed for risk factors of CC (defined as costs above 20% annual household income). RESULTS: The proportion of TB-affected households incurring in costs above 20% annual household income (CC) was 51.7% (95%CI: 45.4-58.0) overall, 51.3% (95%CI: 44.9-57.7) among patients with drug-sensitive (DS) TB, and 65.0% (95%CI: 48.0-82.0) among drug-resistant (DR). The average patient cost of a TB case in Colombia was $1,218 (95%CI 1,106-1,330) including $860.9 (95%CI 776.1-945.7) for non-medical costs, $339 (95%CI 257-421) for the indirect costs, and $18.1 (95%CI 11.9-24.4) for the medical costs. The factors that influenced the probability of facing CC were income quintile, job loss, DR-TB patient, and TB type. CONCLUSION: Main cost drivers for CC were non-medical out-of-pocket expenses and income loss (indirect costs). Current social protection programs ought to be expanded to mitigate the proportion of TB-affected households facing CC in Colombia, especially those with lower income levels.

Assuntos

RESUMO

The transformation of cooking oils and their waste into polyesters is a challenge for circular chemistry. Herein, we have used epoxidized olive oil (EOO), obtained from cooking olive oil (COO), and various cyclic anhydrides (such as phthalic anhydride PA, maleic anhydride MA, and succinic anhydride SA) as raw materials for the preparation of new bio-based polyesters. For the synthesis of these materials, we have used the bis(guanidine) organocatalyst 1 and tetrabutylammonium iodide (Bu4NI) as cocatalyst. The optimal reaction conditions for the preparation of poly(EOO-co-PA) and poly(EOO-co-MA) were 80 °C for 5 h using toluene as solvent; however, the synthesis of poly(EOO-co-SA) required more extreme reaction conditions. Furthermore, we have exclusively succeeded in obtaining the trans isomer for MA-polyester. The obtained biopolyesters were characterized by NMR, Fourier transform infrared, thermogravimetric analysis, and scanning electron microscopy analyses. Since there are few examples of functionalized and defined compounds based on olive oil, it is innovative and challenging to transform these natural-based compounds into products with high added value.

RESUMO

As a highly contaminated waterway flowing through a densely populated urban area, microbiological pollution associated with the Choqueyapu River and the absence of a wastewater treatment plant in La Paz city threatens public health. We collected air samples adjacent to this river using impingement. Laboratory analyses identified the presence of Enterobacteriaceae, reporting a maximum concentration of 86,11 CFU/m3 of sampled air. Positive samples were tested for antibiotic susceptibility against the antibiotics amoxicillin-clavulanic acid, ciprofloxacin, gentamicin, meropenem, sulfamethoxazole-trimethoprim and tetracycline via disk diffusion. The highest percentages of antibiotic resistance were registered for tetracycline (50% of isolates) and sulfamethoxazole-trimethoprim (38,9%), while the lowest resistance profile was reported for meropenem (5,6%). A comparison of results obtained on the pilot studies [elaborated during the wet season of 2018 by Chavez, 2019 and Salazar et al., 2020] and the present study has been done, highlighting seasonal effects over airborne Enterobacteriaceae concentration. Also, it was determined an increase of antibiotic resistance for tetracycline, gentamicin and ciprofloxacin; and a reduction for sulfamethoxazole-trimethoprim, meropenem and amoxicillin-clavulanic acid.

Assuntos

RESUMO

Listeria monocytogenes is a pathogen difficult to control, due to its resistance to extreme conditions. The antimicrobial activity of a mixture of metabolites produced by lactic acid bacteria was evaluated against L. monocytogenes. Bacterial combined cultures in 1:1 ratio of Lactobacillus plantarum and Weissella cibaria (treatment LP + WC) and mixtures in ratio 1:1:1 of Lactobacillus brevis, L. plantarum, and W. cibaria, (treatment (LB + LP + WC) were grown by discontinuous fermentation, at 32 °C for 48 h. At 1, 2, 6, 12, 24 and 48 h of fermentation, samples were taken, the biomass was separated from the metabolites, and the antimicrobial activity of the metabolites was measured in vitro against L. monocytogenes. For comparison, experimental data published in the literature corresponding to monocultures of L. brevis (L.B), L. plantarum (LP) and W. cibaria (WC) were used. The antimicrobial activity was measured by a surface diffusion technique using absorbent paper discs impregnated with 60 µl from each metabolite and placed on the TSA agar surface (36 °C, 24 h). The metabolites from the microbial mixtures showed statistical differences with respect to their respective monocultures. With the treatment (LP + WC) an inhibition diameter of 2.54 cm was obtained at 12 h of fermentation, this value was higher than those obtained in the monoculture LP (2.19 cm), and WC (2.44 cm), during the same period. In the mixture (LB + LP + WC) during the first 12 h of fermentation, the antimicrobial activity was higher (2.12-2.28 cm) than the antimicrobial activity of the monoculture LB (1.66-2.23 cm). The use of metabolites from the co-culture of L brevis, L. plantarum and W. cibaria under the evaluated conditions, potentiate the antimicrobial activity of L. brevis against L. monocytogenes, therefore, they are promising in bio-preservation.

RESUMO

INTRODUCTION: Intestinal parasite infections and polyparasitism are highly prevalent in the most vulnerable populations of developing countries due to environmental, biological and social determinants common in the transmission of parasites. Children between 1 and 15 years of age are the most affected population. OBJECTIVE: To describe the prevalence and profiles of intestinal polyparasitism in 1 to 15 year-old children from native communities in the Colombian Amazon region. MATERIALS AND METHODS: We used a non-probability sampling of 300 children between 1 and 15 years of age from several rural settlements and the main urban area of Puerto Nariño, Amazonas, Colombia, who participated voluntarily in the study. We obtained fecal samples that were analyzed by the direct method (0.85% saline solution-lugol) and the Kato-Katz technique. The most prevalent polyparasitism profiles were identified using Cohen's kappa coefficient with a 95% confidence interval. RESULTS: The prevalence of polyparasitism, defined as the presence of at least two intestinal pathogenic parasites, was 84% (95 % CI: 79.35-87.96). Polyparasitism by two or three of the following parasites: Ascaris lumbricoides, Trichuris trichiura, Blastocystis sp., Ancylostoma duodenale and Necator americanus from the Ancylostomatidae family, and Entamoeba histolytica, E. dispar and E. moshkovskii of the Entamoeba complex, had the highest prevalence. CONCLUSION: Several intestinal polyparasitism profiles were found, although in most cases fewer than six parasites were involved. Better prevalence estimations and identification of determinant factors will allow to priorize and direct resources to control these infections.

Assuntos

RESUMO

Resumen Introducción. Las infecciones parasitarias y el poliparasitismo intestinal son muy prevalentes en las poblaciones más vulnerables de los países en desarrollo debido a la existencia de factores ambientales, biológicos y sociales determinantes en la transmisión de parásitos. La población entre uno y 15 años de edad es la más afectada por dicha situación. Objetivo. Describir las prevalencias y los perfiles del poliparasitismo intestinal en la población de uno a 15 años de edad de comunidades indígenas de la Amazonia colombiana. Materiales y métodos. Se hizo un muestreo no probabilístico de 300 niños entre uno y 15 años de edad, procedentes de varios asentamientos rurales y de la cabecera urbana de Puerto Nariño, Amazonas, quienes participaron voluntariamente en el estudio. Las muestras de materia fecal se analizaron mediante el método directo (solución salina al 0,85 % y lugol) y la técnica de Kato-Katz. Se determinaron los perfiles más prevalentes de poliparasitismo intestinal con el coeficiente kappa de Cohen y un intervalo de confianza de 95 %. Resultados. La prevalencia de poliparasitismo, definida como la presencia de, por lo menos, dos parásitos intestinales patógenos, fue de 84 % (IC95 %: 79,35-87,96). Los casos con presencia de dos o tres agentes incluyeron los parásitos Ascaris lumbricoides, Trichuris trichiura, Blastocystis sp., los ancilostomídeos Ancylostoma duodenale yNecator americanus, así como Entamoeba histolytica,E. dispar y E. moshkovskii del complejo Entamoeba, y fueron los de mayor prevalencia. Conclusión. Se encontraron varios perfiles de poliparasitismo intestinal, aunque la mayoría de los casos involucraron menos de seis especies. Una mejor estimación de la prevalencia y los factores determinantes del poliparasitismo intestinal permitirían priorizar y orientar los recursos para su control.

Abstract Introduction: Intestinal parasite infections and polyparasitism are highly prevalent in the most vulnerable populations of developing countries due to environmental, biological and social determinants common in the transmission of parasites. Children between 1 and 15 years of age are the most affected population. Objective: To describe the prevalence and profiles of intestinal polyparasitism in 1 to 15 year-old children from native communities in the Colombian Amazon region. Materials and methods: We used a non-probability sampling of 300 children between 1 and 15 years of age from several rural settlements and the main urban area of Puerto Nariño, Amazonas, Colombia, who participated voluntarily in the study. We obtained fecal samples that were analyzed by the direct method (0.85% saline solution-lugol) and the Kato-Katz technique. The most prevalent polyparasitism profiles were identified using Cohen's kappa coefficient with a 95% confidence interval. Results: The prevalence of polyparasitism, defined as the presence of at least two intestinal pathogenic parasites, was 84% (95 % CI: 79.35-87.96). Polyparasitism by two or three of the following parasites: Ascaris lumbricoides,Trichuris trichiura, Blastocystis sp., Ancylostoma duodenale and Necator americanus from the Ancylostomatidae family, and Entamoeba histolytica,E. dispar and E. moshkovskii of the Entamoeba complex, had the highest prevalence. Conclusion: Several intestinal polyparasitism profiles were found, although in most cases fewer than six parasites were involved. Better prevalence estimations and identification of determinant factors will allow to priorize and direct resources to control these infections.

Assuntos

RESUMO

Resumen Introducción. La técnica de Kato Katz es el método recomendado para realizar el recuento de huevos en materia fecal y determinar la intensidad parasitaria por helmintos. La calidad de los resultados se ve afectada por la tardanza en el procesamiento de la muestra, por lo que se requiere de preservantes que faciliten la lectura posterior a las 24 horas de recolección de la muestra. Objetivo. Demostrar validez de la solución con acetato de sodio-ácido acético-formalina (SAF) como preservante de huevos de Necator americanus por medio del estudio de un caso clinico. Materiales y métodos. Descripción de caso clínico con diagnóstico de parásitos intestinales por coprológico, intensidad de la infección por la técnica de Kato Katz, evaluación de la presencia de huevos N. americanus por la técnica de Kato Katz durante 10 meses en muestra preservada en SAF y determinación de especie de Uncinaria sp. por qPCR. Resultados. Los huevos de N. americanus se conservan de manera adecuada en morfología durante los primeros cinco meses. Conclusiones. A fin de ejecutar la técnica de Kato Katz, la fijación con SAF demostró ser adecuada para el mantenimiento de la intensidad parasitaria y morfología de los huevos de N. americanus en un período de hasta cinco meses.

Abstract Introduction: The Kato Katz technique is the recommended method for fecal egg counts and determining the intensity of parasitic helminths. The quality of the results is affected by the delay in the analysis of the sample. Therefore, fixatives are necessary to make the reading easier 24 hours after sample collection. Objective: To prove the usefulness of sodium acetate-acetic acid-formalin (SAF) solution as a fixative for Necator americanus eggs by means of a clinical case study. Materials and methods: Clinical case description and intestinal parasites diagnosis by direct stool microscopic analysis and parasite infection intensity by means of the Kato Katz technique. N. americanus eggs were detected by Kato Katz method for 10 months on a SAF-fixed stool sample. Identification of Uncinaria sp. by qPCR. Results: N. americanus eggs are adequately preserved in SAF during the first five months. Conclusions: SAF fixative is suitable for Kato Katz method and proved to be capable of maintaining parasite intensity and N. americanus egg morphology over a period of up to five months.

RESUMO

PREMISE OF THE STUDY: A prevailing hypothesis in forest succession is that shade-tolerant species grow more slowly than shade-intolerant species, across light conditions, because they prioritize carbon (C) allocation to storage. We examined this hypothesis in a confamilial pair of species, including one of the fastest-growing tree species in the world (Eucalyptus globulus) and a shade-tolerant, slow-growing species (Luma apiculata). METHODS: Seedlings were subjected to one out of four combinations of light (high vs. low) and initial defoliation (90% defoliated vs. nondefoliated) for four months. Growth, C storage concentration in different organs, leaf shedding, and lateral shoot formation were measured at the end of the experiment. KEY RESULTS: Eucalyptus globulus grew faster than L. apiculata in high light, but not in low light. Both species had lower C storage concentration in low than in high light, but similar C storage concentrations in each light condition. Defoliation had no effect on C storage, except in the case of the old leaves of both species, which showed lower C storage levels in response to defoliation. Across treatments, leaf shedding was 96% higher in E. globulus than in L. apiculata while, in contrast, lateral shoot formation was 87% higher in L. apiculata. CONCLUSIONS: In low light, E. globulus prioritized C storage instead of growth, whereas L. apiculata prioritized growth and lateral branching. Our results suggest that shade tolerance depends on efficient light capture rather than C conservation traits.

Assuntos

RESUMO

The incidence and prevalence of intestinal parasites in children is most likely due to lack of natural or acquired resistance and differences in behavior and habits closely related to environmental and socioeconomic determinants. The most important protozoa that parasitize humans are Giardia, Entamoeba, Blastocystis, and Cryptosporidium. These parasites present wide intraspecific genetic diversity and subsequently classified into assemblages and subtypes. The Amazon basin is the largest in the world and is the fifth freshwater reserve on the planet. Contradictorily, people living in these areas (Indigenous populations) have poor quality of life, which favors the infection of diseases of fecal-oral transmission. The aim of this work was to unravel the molecular epidemiology of Giardia, Blastocystis and Cryptosporidium across four communities (Puerto Nariño, San Juan del Soco, Villa Andrea and Nuevo Paraíso). We obtained 284 fecal samples from children under 15 years old that were analyzed by direct microscopy (261 samples) and Real Time PCR (qPCR) (284 samples). The positive samples for these protozoa were further characterized by several molecular markers to depict assemblages and subtypes. We observed a frequency of Giardia infection by microscopy of 23.7% (62 samples) and by qPCR of 64.8% (184 samples); for Blastocystis by microscopy of 35.2% (92 samples) and by qPCR of 88.7% (252 samples) and for Cryptosporidium only 1.9% (5 samples) were positive by microscopy and qPCR 1.8% (5 samples). Regarding the Giardia assemblages, using the glutamate dehydrogenase (gdh) marker we observed AI, BIII and BIV assemblages and when using triose phosphate isomerase (tpi) we observed assemblages AI, AII, BIII and BIV. In contrast, Blastocystis STs detected were 1, 2, 3, 4, and 6. Lastly, the species C. viatorum, C. hominis (with the subtypes IdA19 and IaA12R8) and C. parvum (with the subtype IIcA5G3c) were identified. We observed a high profile of zoonotic transmission regarding the Giardia assemblages and Blastocystis STs/alleles. Also, we highlight the elevated frequency of infection by these two protozoans suggesting an active transmission in the area. Our findings reinforces the need to deploy better epidemiological surveillance systems for enteric pathogens in the area.

RESUMO

Waterlogging decreases a plant's metabolism, stomatal conductance (gs) and photosynthetic rate (A); however, some evergreen species show acclimation to waterlogging. By studying both the physiological and morphological responses to waterlogging, the objective of this study was to assess the acclimation capacity of four swamp forest species that reside in different microhabitats. We proposed that species (Luma apiculata [D.C.] Burret. and Drimys winteri J.R. et G. Forster.) abundant in seasonally and intermittently waterlogged areas (SIWA) would have a higher acclimation capacity than species abundant in the inner swamp (Blepharocalyx cruckshanksii [H et A.] Mied. and Myrceugenia exsucca [D.C.] Berg.) where permanent waterlogging occurs (PWA); it was expected that the species from SIWA would maintain leaf expansion and gas exchange rates during intermittent waterlogging treatments. Conversely, we expected that PWA species would have higher constitutive waterlogging tolerance, and this would be reflected in the formation of lenticels and adventitious roots. Over the course of 2 months, we subjected seedlings to different waterlogging treatments: (i) permanent (sudden, SW), (ii) intermittent (gradual) or (iii) control (field capacity, C). Survival after waterlogging was high (≥80%) for all species and treatments, and only the growth rate of D. winteri subjected to SW was affected. Drimys winteri plants had low, but constant A and g during both waterlogging treatments. Conversely, L. apiculata had the highest A and g values, and g increased significantly during the first several days of waterlogging. In general, seedlings of all species subjected to waterlogging produced more adventitious roots and fully expanded leaves and had higher specific leaf area (SLA) and stomatal density (StD) than seedlings in the C treatment. From the results gathered here, we partially accept our hypothesis as all species showed high tolerance to waterlogging, maintained growth, and had increased A or g during different time points of waterlogging. Differences in leaf (SLA) and stomata functioning (gs, StD) plasticity likely allows plants to maintain positive carbon gains when waterlogging occurs. The species-specific differences found here were not entirely related to microhabitat distribution.

Assuntos

RESUMO

The molecular structures of (E)-1-(4-{[1-(4-fluorophenyl)-3,5-dimethyl-1H-pyrazol-4-yl]diazenyl}phenyl)ethanone, C19H17FN4O, (III), and (E)-1-(4-chlorophenyl)-3,5-dimethyl-4-[2-(2-nitrophenyl)diazenyl]-1H-pyrazole, C17H14ClN5O2, (IV), prepared by reaction of the corresponding ß-diketohydrazones with substituted arylhydrazines in acid media, are nonplanar, with the planes of the lateral phenyl rings forming dihedral angles with that of the central pyrazole ring varying from 2.71 (7) to 45.22 (7)°. The crystal structures are supported by C-H...O, C-H...π and π-π weak intermolecular interactions together with some unusual trifurcated C-Cl...Cl-C contacts, which are discussed in detail.

RESUMO

Introducción: La verificación y seguimiento de la presencia de microrganismos indicadores de la calidaddel agua es imprescindible debido al riesgo que representan para la población que la utiliza para consumo, recreación o deporte. Los reservorios acuíferos de Corrales de San Luis Beltrán, Atlántico, Colombia, son fuente de sustento de las comunidades campesinas aledañas, animales y plantas de la reserva; sin embargo, su calidad microbiológica no ha sido estudiada. Objetivo: Evaluar la calidad sanitaria del agua de reservorios acuíferos de Corrales de San Luis Beltrán. Materiales y métodos: Se realizaron muestreos de aguas superficiales y sedimento de reservorios acuíferos de Corrales de San Luis Beltrán, y se midieron in situ algunos parámetros fisicoquímicos (temperatura, pH, y oxígeno disuelto), y la calidad microbiológica (coliformes totales, coliformes fecales y bacterias reductoras de sulfato). Resultados: Se presentaron concentraciones bajas de oxígeno disuelto (2,71 mg/L), temperatura promedio de 26 °C y pH ligeramente básico (8,1). Los coliformes totales oscilaron entre 1,0x104 y 1,3x107 UFC/100 mL y los fecales entre 0 y 1,3x105 UFC/100 mL. Se encontró una correlación negativa entre el pH y los coliformes totales, y entre el oxígeno disuelto y los coliformes fecales; y una correlación positiva entre los coliformes fecales y la temperatura. Los recuentos de bacterias reductoras de sulfato fueron superiores a 103 UFC/100 g...

Introduction: The verification and monitoring of indicator microorganisms of water quality is essential.A low water quality may represent a risk for human health, because human populations frequently use it for consumption, recreation, or sport. Water reservoirs situated in Corrales de San Luis Beltran, Atlantico, Colombia, are source of sustenance to local peasant communities, animals, and plants around the village. However, the microbiological quality has not been established. Objective: To assess the sanitary water quality from Corrales de San Luis Beltran. Materials and methods: Surface water and sediment were sampled and some physicochemical parameters (temperature, pH, and dissolved oxygen), and the microbiological quality (total coliforms, fecal coliforms, and sulfate-reducing bacteria) were measured in situ. Results: The analysis showed low dissolved oxygen levels (2,71 mg/L), an average temperature of 26 °C and a slightly basic pH (8,1). Total coliform counts ranged from 1,0x104 and 1,3 x 107 CFU/100 mL and fecal coliform between 0 and 1,3 x 105 CFU/100 g. A negative correlation occurred between pH and total coliform as well as between dissolved oxygen and fecal coliforms. In addition, a positive correlation occurred between fecal coliform and temperature. The number of sulfate-reducing bacteria was more than 103 CFU/100 mL...

Assuntos

RESUMO

Objective. To interpret the experience of being un conscious or alert from a group of patients during the surgical act and appreciations from the members of the nursing team on the same context. Methodology. Qualitative study focusing on grounded theory.Information was collected through a) observation and b) interviewsto 20 patients, 19 nursing aides, and 8 nursing professionals whowork in level II surgical centers in Valle de Aburrá, Colombia.Results. From being aware of everything to being at the mercyof another, during el intraoperative, the patient goes through different states of conscience, which means being subjected tototal care. Instead, for the nursing personnel the same contextimplies different behavior going between two environments: theôscenarioõ ûwhen in front of the patient awake, which involves measured and diplomatic behavior; or, ôbehind the scenesõ û withthe person under the effects of anesthesia û the behavior is more free and uninhibited. Conclusion. The intraoperative surgical context is different for patients and for the nursing team. However, it is necessary to bear in mind that they are caring for a human being who requires respect, dignified treatment, and that care must be promoted under an ethical perspective.

Objetivo. Interpretar la experiencia de un grupo de pacientes con respecto al estar inconsciente o alerta durante el acto quirúrgico y las apreciaciones de los miembros del equipo de enfermería sobre el mismo contexto. Metodología. Estudio cualitativo con enfoque en la teoría fundamentada. La información se recolectó mediante a) observación y, b) entrevistas a 20 pacientes, 19 auxiliares de enfermería y 8 enfermeras, quienes laboran en centros quirúrgicos de segundo nivel del vallede Aburrá, Antioquia (Colombia). Resultados. Desde dándome cuenta de todo hasta estando a merced del otro, durante el transoperatorio, el paciente transita por diferentes estados de consciencia que le significa sujetetarse al cuidado total. En cambio, para el personal de enfermería el mismo contexto le implica un comportamiento diferente que se mueve entre dos ambientes: por una parte, el ôescenarioõ -cuando se está en frente del paciente despierto-, que involucra un comportamiento mesurado y diplomático; por otra, ôtrasbastidoresõûcon la persona bajo los efectos de la anestesia- por el contrario, el comportamiento es más libre y desinhibido. Conclusión. El contexto quirúrgico transoperatorio es diferente tanto para los pacientes como para el equipo de enfermería. Sin embargo, es necesario tener presente que están al cuidado de un ser humano que requiere respeto y un trato digno. Por consiguiente, se debe promover un cuidado bajo una perspectiva ética.

Objetivo. Interpretar a experiência de estar inconsciente ou alerta de um grupo de pacientes durante o ato cirúrgico e as apreciações dos membros da equipe de enfermaria sobre o mesmo contexto. Metodologia.Estudo qualitativo com enfoque na teoria fundamentada. A informação se coletou mediante a) observação e,b) entrevistas a 20 pacientes, 19 auxiliares de enfermaria e 8 enfermeiras que laboram em centros cirúrgicos de segundo nível do Vale de Aburrá, Colômbia. Resultados. Desde dando-me conta de tudo até estando agraça do outro, durante o transoperatório, o paciente transita por diferentes estados de consciência que lhe significa estar sujeito ao cuidado total. Em mudança, para o pessoal de enfermaria o mesmo contexto lhe implica um comportamento diferente que se move entre dois ambientes: o ôpalcoõ -quando se está em frente do paciente desperto-, que envolve um comportamento mesurado e diplomático; em mudança,ôdepois de bastidoresõûcom a pessoa sob os efeitos da anestesia- o comportamento é mais livre e desinibido.Conclusão. O contexto cirúrgico transoperatório é diferente para os pacientes e para a equipe de enfermaria. No entanto, é necessário ter presente que estão cuidando a um ser humano que requer respeito, trato digno e se deve promover um cuidado sob uma perspectiva ética.

Assuntos

RESUMO

Este artículo describe la primera fase de una intervención preventiva incorporada en las accionesde monitoreo y evaluación de un proyecto de desarrollo alternativo para población rural de regiones afectadas por cultivos ilícitos y/o presencia de grupos armados irregulares. Presenta el análisis de una encuesta de conocimientos, actitudes y prácticas sexuales, cuyos resultadosevidencian la persistencia de conceptos erróneos, actitudes negativas hacia personas con Virus de Inmunodeficiencia Humana (VIH) y baja frecuencia de prácticas sexuales protegidas. El nivel de conocimientos y el uso del condón son mucho menores en este grupo poblacional que en otros grupos de alta vulnerabilidad que viven en contextos urbanos. Esta intervención constituye la primera experiencia exitosa de tranversalización de la prevención del VIH en proyectos dedesarrollo apoyados por el Sistema de Naciones Unidas (UN) en Colombia.

This article describes the first phase of a Human Inmunodeficiency Virus HIV/AIDS related preventive intervention mainstreamed in the monitoring and evaluation activities conducted within the frame of an alternative development project aimed at rural populations living in regions affected by illegal crops and/or presence of irregular armed forces. It also analyses results of the knowledge, attitudes and sex behaviour survey, which evidences persistence ofmisconceptions around ways of viral transmission, negative attitudes towards people living with HIV, and low frequency of protected sex practices. Level of knowledge and consistencyof condom use are much lower among this population group than in other highly vulnerable population groups living in urban contexts. This intervention constituted the first successful experience in mainstreaming HIV/AIDS prevention in development projects supported by United Nations (UN) in Colombia.

Este artigo descreve a primeira fase de uma intervenção preventiva incorporada nas ações de monitorização e avaliação de um projeto de desenvolvimento alternativo para população ruralde regiões afetadas por cultivos ilícitos e/ou presença de grupos armados ilegais. Apresenta a analise de uma pesquisa de conhecimentos, atitudes e práticas sexuais, cujos resultados evidenciam a persistência de conceitos errôneos, atitudes negativas para pessoas com Virus da Inmunodeficiência humana (VIH) baixa frequência de práticas sexuais protegidas. O nível deconhecimentos e o uso do preservativo são muito menores neste grupo populacional que em outros grupos de alta vulnerabilidade que vivem em contextos urbanos. Esta intervenção constitui a primeira experiência bem sucedida de tranversalização e prevenção do HIV em projetos dedesenvolvimento apoiados pelo Sistema das Nações Unidas na Colômbia.

Assuntos

RESUMO

Introducción. El síndrome de Guillain Barré tiene una incidencia de 1,2 a 1,7 por 100.000 hab en Colombia. Además de la mortalidad, esta entidad cuenta con un alto impacto social y económico en razón a la probabilidad importante de generar discapacidad. Presentamos los datos correspondientes al grupo de pacientes diagnosticados en un hospital colombiano de cuarto nivel durante un periodo de cinco años, haciendo énfasis en las características clínicas y de pronóstico. Objetivo. Describir las características y la evolución con la inmunoterapia de los pacientes con síndrome de Guillain Barré que ingresaron al Hospital San Vicente de Paúl, de Medellín, entre 2001 y 2005. Materiales y métodos. Estudio observacional descriptivo entre enero de 2001 y diciembre de 2005. Resultados. Se obtuvo información en 46 pacientes, 54,3% mujeres, con edad promedio de 39,4 años (+17,6). Predominaron los pacientes con las formas ascendente y desmielinizante. Quienes tenían las formas axonales permanecieron más tiempo hospitalizados. Recibieron inmunoterapia 50%, plasmaféresis 47,8%, inmunoglobulina 52,2%. Requirieron ventilación mecánica 50% de quienes recibieron plasmaféresis y 75% de quienes recibieron inmunoglobulina; el puntaje de Hughes fue más alto para el grupo de inmunoglobulina. Fallecieron 3 pacientes. Se recolectó información al año de egreso en 67,4% de los pacientes, 23,3% de ellos tenían secuelas. Conclusiones. La principal complicación fue la neumonía. Las características clínicas difieren entre este grupo de pacientes y las publicadas en el mundo. Se requiere reforzar los conocimientos de los médicos generales para evitar retraso en la atención, y nuevos estudios para aclarar el comportamiento de esta enfermedad en nuestro medio.

Assuntos

RESUMO

Introducción: la epilepsia es la tercera enfermedad neurológica más frecuente. Su diagnóstico es esencialmente clínico y se hace teniendo en cuenta las manifestaciones descritas por el paciente y sus familiares. El electroencefalograma y los estudios de neuroimagen sirven para respaldar una etiología, el pronóstico y la selección de un manejo medico o quirúrgico. La Liga Internacional contra la Epilepsia (ILAE) recientemente propuso una clasifi cación de las crisis que tiene en cuenta factores como fi siopatología de las crisis, sustrato neuronal, respuesta a los anticonvulsivos, entre otros. Objetivo: servir de actualización para los psiquiatras y tratar temas relacionados con la clínica, el diagnóstico y el tratamiento de la epilepsia. Método: se presenta cómo la elección del medicamento anticonvulsivo está determinada por el tipo de crisis, la edad del paciente, el sexo, la presencia de efectos adversos, el uso previo de otros anticonvulsivos y la respuesta a éstos. Conclusión: el manejo farmacológico es la principal forma de terapia para la epilepsia y la monoterapia consigue controlar las crisis entre un 60% y 80% de los casos.

Introduction: Epilepsy is the third most frequent neurological disease. The diagnosis of epilepsy is clinical and it is based on the descriptions made by the patients and relatives. Other strategies, like EEG and neuroimaging, are used to assess a possible etiology, prognosis and can infl uence the decision between medical or surgical treatment. The International League against Epilepsy has recently proposed a modifi ed classifi cation that takes into account factors like the physiopathology of seizures, neural substrate and response to treatment, among others. Objective: This article is meant to serve as a general update for psychiatrists and deals with clinical, diagnostic and therapeutic issues in epilepsy. Method: It shows how the selection of treatment is infl uenced by age, type of seizures, previous use and response to anticonvulsants. Conclusion: Pharmacological treatment is the main intervention and anticonvulsant monotherapy improves patients in 60% to 80% of cases.

RESUMO

El objetivo del trabajo que aquí se reporta fue estudiar en una muestra masculina residente en Bogotá, Colombia, la relación entre el riesgo cardiovascular y el ambiente laboral en el que se desempeñan, basándose en el modelo de tensión laboral. Se Obtuvo información del ambiente laboral (demandas, control y apoyo social), nivel de colesterol, HDL, LDL de 279 hombres trabajadores de diferentes ocupaciones (operarios, asistentes, médicos y ejecutivos). Los resultados mostraron que en la muestra se presenta un riesgo cardiovascular moderado, pero a nivel general no se relaciona con el ambiente laboral. Entre los grupos ocupacionales sólo hubo diferencias en control y demandas laborales. En los operarios, mayor control se relacionó con mayor riesgo. En médicos, a mayor apoyo social se identificó menor riesgo, lo cual puede deberse a las condiciones de alta tensión en su trabajo. Se discuten algunas explicaciones para estos resultados inesperados

Assuntos