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1.
Cienc. Salud (St. Domingo) ; 7(3): [9], 2023.
Artigo em Espanhol | LILACS | ID: biblio-1525390

RESUMO

Objetivos: El propósito de esta investigación fue determinar el nivel de conocimiento, creencias, percepción y practicas asociadas al consumo de cigarrillos electrónicos en los estudiantes universitarios (UASD), recinto Santiago, República Dominicana. Cada estudiante firmó un consentimiento informado certificando que éste respondió cada pregunta realizada por el entrevistador de manera voluntaria. El método de recolección de los datos fue mediante entrevistas, las cuales fueron grabadas por los entrevistadores. La muestra fue de 53 entrevistas, 48 individuales y 5 grupos focales, la misma se tomó hasta alcanzar el punto de saturación de cada pregunta, es decir cuando todas las respuestas se tornaron repetitivas. Materiales y métodos: Se realizó un estudio cualitativo de tipo fenomenológico y de fuentes primarias en el período mayo-agosto del año 2019 en la universidad privada Pontificia Universidad Católica Madre y Maestra (PUCMM) y la universidad pública Universidad Autónoma de Santo Domingo. (UASD), campus Santiago, República Dominicana. El método de recolección de datos se realizó a través de entrevistas, las cuales fueron grabadas por los entrevistadores. Cada estudiante entrevistado firmó un consentimiento informado certificando que respondió voluntariamente a cada pregunta formulada por el entrevistador. La muestra estuvo compuesta por 53 entrevistas, 48 personas y cinco grupos focales. Las entrevistas se realizaron hasta llegar al punto de saturación de cada pregunta, que es cuando todas las respuestas se volvieron repetitivas. Resultados: El conocimiento que tiene los estudiantes universitarios sobre cigarrillo electrónico (CE), es pobre, desde su funcionamiento, partes, sustancias e incluso las posibles complicaciones que puede traer a la salud, tanto en la Pontificia Universidad Católica Madre y Maestra (PUCMM) como en la Universidad Autónoma de Santo Domingo (UASD), pero es más notable en la universidad pública. Por otro lado, muchos perciben el CE, como una alternativa del uso de tabaco, que posee diversidad de sabores, olor agradable, atractivo, práctico y capaz de ofrecer relajación. En cuanto a la actitud hacia el dispositivo, en PUCMM exhibe un mayor nivel de rechazo con respecto al uso. Es importante mencionar, que mayoría de los entrevistados son o alguna vez fueron usuarios de este, no obstante, no lo recomiendan en gran medida, ya que asumen que puede causar daño y ser adictivo, aunque en menor medida al cigarrillo convencional. La población más susceptible a su uso, son los jóvenes y el sexo masculino, aunque las féminas se han ido sumando de manera significativa. De igual modo, se logró apreciar las grandes influencias que mueven a los jóvenes a su consumo, incluyendo, las redes sociales, familia, amigos, en general el entorno en que se rodean. Conclusión: Concluimos que los estudiantes universitarios carecen de conocimiento con respecto al cigarrillo electrónico, tanto en el funcionamiento, sustancias y complicaciones para la salud. Muchos observan al cigarrillo electrónico como un dispositivo para fumar con un olor agradable, por lo cual puede ser muy atractivo para los usuarios. Se logró apreciar el importante papel que juegan las influencias sociales para el uso del dispositivo, promovido por las redes sociales y relaciones cercanas. Otro problema en la sociedad actual es el uso de CE en menores de edad. Según los resultados existe una gran necesidad de intervención y educación, principalmente en los jóvenes.


Objective: The purpose of this research was to determine the level of knowledge, beliefs, perception, and practices associated with consuming electronic cigarettes among university students. Materials and methods: A qualitative study of phenome-nological type and from primary sources was carried out in the period of May-August of the year 2019 at the private university Pontificia Universidad Católica Madre y Mae-stra (PUCMM) and the public university Universidad Autónoma de Santo Domingo (UASD), Santiago campus, Dominican Republic. The data collection method was done through interviews, which the interviewers recorded. Each student interviewed signed an informed consent cer-tifying that they answered voluntarily each question asked by the interviewer. The sample consisted of 53 interviews, 48 individuals, and five focus groups. Interviews were done until reaching the saturation point of each question, which is when all the answers became repetitive. Results: University students' knowledge regarding elec-tronic cigarettes (EC) is poor. Knowledge regarding its mechanism, parts, substances, and possible complications to one's health, is scarce both in PUCMM and the UASD, but this is more notable at the public university. Addition-ally, many perceive EC as an alternative to tobacco use, the former, as per our study population, having a variety of fla-vors, a pleasant smell, being attractive, practical, and capa-ble of offering relaxation. Regarding the attitude towards the device, PUCMM exhibits a higher level of rejection regarding its use. It is essential to mention that most inter-viewees were once users of EC. However, they do not rec-ommend it to a great extent since they assume that it can cause harm and be addictive, although to a lesser extent than conventional cigarettes. The population most suscep-tible to its use are young people, including minors and the male gender, although females have been significantly increasing its use. Similarly, it was possible to appreciate the influences that greatly evoke the younger population's consumption, including social networks, family, friends, and the surrounding environment. Conclusion: We concluded that university students have insufficient knowledge regarding electronic cigarettes, both in their mechanism, substances, and health compli-cations. Most see electronic cigarettes as smoking devices with a pleasant smell, which can be very attractive to users. It was possible to observe the critical role played by social influences on the use of the device, promoted by social networks and close relationships. Another problem in cur-rent society is the use of CE in minors. According to the results, there is a great need for intervention and educa-tion, mainly among the younger generation.


Assuntos
Humanos , Adolescente , Adulto , Sistemas Eletrônicos de Liberação de Nicotina , Vaping , Estudantes , República Dominicana , Produtos do Tabaco
2.
Nicotine Tob Res ; 24(6): 909-913, 2022 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-35084495

RESUMO

INTRODUCTION: Secondhand smoke (SHS) exposure poses risks to pregnant women and children. Though smoking among pregnant women in many low- and middle-income countries is low, exposure to SHS might be higher. We examined the prevalence and predictors of SHS among pregnant women from Costa Rica, the Dominican Republic, and Honduras. METHODS: Postpartum women 18+ years old who completed pregnancy in past 5 years were surveyed in health care and community settings. RESULTS: Data for 1,081 women indicated low tobacco use (1.0%-3.7%), frequent exposure to active smokers (29.0%-34.0%), often being close enough to breathe others' smoke (49.4%-66.5%), and most having smoke-free home policies (70.8%-76.2%). Women reporting unintended pregnancy (adjusted odds ratio [aOR]: 1.44, 95% confidence interval [CI] 1.03, 2.00) and alcohol consumption (aOR: 1.92, 95% CI 1.34, 2.77) were more likely to be close enough to breathe others' smoke. Women with health problems during pregnancy (aOR: 1.48 95% CI 1.07, 2.06) were more likely to have home smoking policies. Tobacco use was associated with all SHS exposure outcomes. CONCLUSIONS: SHS exposure was high during pregnancy; women with higher risk variables, that is, tobacco use, alcohol consumption, and unintended pregnancy were more likely to be exposed. Addressing SHS exposure in pregnancy in low- and middle-income countries can improve maternal health outcomes in vulnerable populations. IMPLICATIONS: The study results suggest a cluster of multiple risk factors associated with a high prevalence of exposure to SHS among pregnant women in LIMCs from Latin America and Caribbean Region. Interventions, regulations, and policies need to address specific high-risk factors to change behaviors and improve maternal and child health outcomes especially in vulnerable populations.


Assuntos
Política Antifumo , Poluição por Fumaça de Tabaco , Adolescente , Criança , Costa Rica/epidemiologia , República Dominicana/epidemiologia , Feminino , Honduras/epidemiologia , Humanos , Masculino , Gravidez , Poluição por Fumaça de Tabaco/efeitos adversos
3.
Infectio ; 25(2): 79-83, abr.-jun. 2021. tab, graf
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1250071

RESUMO

Abstract Objective: To evaluate the relationship between tobacco use and viral load and CD4+ T cell count in HIV patients. Results: The research conducted was a descriptive study of 317 patients on highly active antiretroviral therapy (HAART), 18 years old and above, who attended the "Unidad de Atención Integral" (UAI) at the Hospital Regional Universitario José María Cabral y Báez, in Santiago, Dominican Republic. Of those 317 patients, 172 were included in the data analysis. It was found that a 77.3% of smokers had a CD4+ T cell count equal to or below 250 cells/mm3. 75% of smokers had a viral load equal to or greater than 400 copies/ml. In addition, 82.9% of nonsmokers presented with a viral load below 400 copies/ml. The smokers were more likely to have a viral load equal to or greater than 400 copies/ml (OR = 6.285, P < 0.001), in comparison with nonsmokers. Patients younger than 45 years old were more likely to have a viral load equal to or above 400 copies/ml compared to older patients (OR = 3.313, P = 0.024).


Resumen Objetivo: Evaluar la relación entre el consumo de tabaco, la carga viral y el recuento de linfocitos T CD4+ en pacientes con VIH. Resultados: La investigación fue realizada mediante un estudio descriptivo a 317 pacientes en terapia antirretroviral de alta actividad (TARGA), de 18 años o ma yores, que asistían a la Unidad de Atención Integral (UAI) del Hospital Regional Universitario José María Cabral y Báez, en Santiago, República Dominicana. De esos 317 pacientes, 172 se incluyeron en el análisis de datos. Se encontró que un 77,3% de los fumadores tenían un recuento de células T CD4 + igual o inferior a 250 células / mm3. El 75% de los fumadores tenían una carga viral igual o superior a 400 copias / ml. Además, el 82,9% de los no fumadores presentaba una carga viral inferior a 400 copias / ml. Los fumadores tenían más probabilidades de tener una carga viral igual o superior a 400 copias / ml (OR = 6.285, P <0.001), en comparación con los no fumadores. Los pacientes menores de 45 años tenían más probabilidades de tener una carga viral igual o superior a 400 copias / ml en comparación con los pacientes mayores (OR = 3,313, P = 0,024).


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Tabagismo , Antígenos CD4 , HIV , Carga Viral , Terapia Antirretroviral de Alta Atividade , República Dominicana , Uso de Tabaco , Fumantes
4.
Rev Panam Salud Publica ; 44: e36, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32973895

RESUMO

OBJECTIVE: To define the antimicrobial resistance profiles of the microorganisms most commonly isolated from hospitalized adult patients in Dominican Republic (DR). METHODS: A retrospective, cross-sectional study of phenotypic antimicrobial susceptibility patterns was conducted using data from 3 802 clinical microbiology reports specifying positive bacterial cultures in samples collected from patients admitted to the clinical, surgery, and intensive care units (ICU) at three tertiary-level care hospitals in the city of Santiago de los Caballeros from 1 January 2016 - 31 December 2017. Descriptive statistics and chi-square test (P ≤ 0.05) were used to analyze the qualitative variables. RESULTS: At the three hospitals, there were 932, 1 090, and 1 780 microbiology reports analyzed. Of the total, 1274 were from the ICU, 1 042 from the surgery unit, and 1 486 from the clinical unit. Methicillin resistance was found in 57.3% of the Staphylococcus aureus isolates and 75.3% of the coagulase-negative staphylococci. Third-generation cephalosporin resistance was detected in 54.4% of isolates identified as members of the Enterobacteriaceae family, 67.3% of the Acinetobacter spp., and 91.7% of the Pseudomonas, while carbapenem resistance was shown by 8.0%, 23.8%, and 51.0% of these, respectively. Most of the resistant Acinetobacter spp. isolates were found in just one hospital and the prevalence of Enterobacteriaceae resistant to carbapenems was highest in the ICU. CONCLUSION: Antimicrobial resistance levels are high among hospitalized patients in Dominican Republic and may cause enhanced risk factors that impact clinical outcomes. Urgent measures are needed to address antimicrobial resistance in DR.

5.
Rev Panam Salud Publica ; 44, sept. 2020
Artigo em Inglês | PAHO-IRIS | ID: phr-52270

RESUMO

[ABSTRACT]. Objective. To define the antimicrobial resistance profiles of the microorganisms most commonly isolated from hospitalized adult patients in Dominican Republic (DR). Methods. A retrospective, cross-sectional study of phenotypic antimicrobial susceptibility patterns was conducted using data from 3 802 clinical microbiology reports specifying positive bacterial cultures in samples collected from patients admitted to the clinical, surgery, and intensive care units (ICU) at three tertiary-level care hospitals in the city of Santiago de los Caballeros from 1 January 2016 – 31 December 2017. Descriptive statistics and chi-square test (P ≤ 0.05) were used to analyze the qualitative variables. Results. At the three hospitals, there were 932, 1 090, and 1 780 microbiology reports analyzed. Of the total, 1274 were from the ICU, 1 042 from the surgery unit, and 1 486 from the clinical unit. Methicillin resistance was found in 57.3% of the Staphylococcus aureus isolates and 75.3% of the coagulase-negative staphylococci. Third-generation cephalosporin resistance was detected in 54.4% of isolates identified as members of the Enterobacteriaceae family, 67.3% of the Acinetobacter spp., and 91.7% of the Pseudomonas, while carbapenem resistance was shown by 8.0%, 23.8%, and 51.0% of these, respectively. Most of the resistant Acinetobacter spp. isolates were found in just one hospital and the prevalence of Enterobacteriaceae resistant to carbapenems was highest in the ICU. Conclusion. Antimicrobial resistance levels are high among hospitalized patients in Dominican Republic and may cause enhanced risk factors that impact clinical outcomes. Urgent measures are needed to address antimicrobial resistance in DR.


[RESUMEN]. Objetivo. Determinar cuáles son los perfiles de resistencia a los antimicrobianos de los microorganismos aislados con mayor frecuencia en los pacientes adultos hospitalizados en República Dominicana. Métodos. Se llevó a cabo un estudio retrospectivo y transversal de los patrones de fenotipos de sensibilidad a los antimicrobianos mediante el uso de los datos obtenidos en 3802 antibiogramas. Este estudio detalla cultivos de bacteria positivos en las muestras de pacientes ingresados en las unidades clínicas, quirúrgicas y de cuidados intensivos (UCI) de cada uno de los tres hospitales de atención especializada de la ciudad de Santiago de los Caballeros. El estudio se llevó a cabo del 1 de enero del 2016 al 31 de diciembre del 2017. Se recurrió a la estadística descriptiva y la prueba de la c² (P ≤ 0,05) para analizar las variables cualitativas. Resultados. Se analizaron 932 antibiogramas del hospital A, 1090 del hospital B y 1780 del hospital C. Del total, 1274 resultados corresponden a las UCI, 1042 a las unidades quirúrgicas y 1486 a las unidades clínicas. El 57,3% de las cepas aisladas de Staphylococcus aureus y el 75,3% de los estafilococos coagulasa-negativos resultó resistente a la meticilina. Se detectó que el 54,5% de las cepas aisladas de la familia Enterobacteriaceae resultó resistente a la cefalosporina de tercera generación; en este caso, el 67,3% del género Acinetobacter y el 91,7% del género Pseudomonas resultaron resistentes a la cefalosporina. Asimismo, se detectó que son resistentes a los fármacos carbapenémicos y se obtuvieron los resultados siguientes: 8,0%, 23,8% y 51,0%, respectivamente. La mayoría de las cepas del género Cursiva resistentes fueron identificadas en un solo hospital, mientras que en las UCI se evidenció mayor predominio de las cepas de Cursiva resistentes a los fármacos carbapenémicos. Conclusiones. Los niveles de resistencia a los antimicrobianos demuestran ser más elevados en los pacientes hospitalizados de República Dominicana. Esto puede causar factores de riesgo intensificados que se traduzcan en consecuencias clínicas. Asimismo, es necesario establecer medidas inmediatas para abordar los casos de resistencia a los antimicrobianos en República Dominicana.


[RESUMO]. Objetivo. Definir os perfis de resistência antimicrobiana dos microrganismos isolados com mais frequência em pacientes adultos hospitalizados na República Dominicana. Métodos. Realizamos um estudo transversal retrospectivo dos padrões fenotípicos de suscetibilidade antimicrobiana utilizando dados de 3802 laudos de microbiologia clínica que especificavam culturas bacterianas positivas em amostras coletadas de pacientes internados em unidades clínicas, cirúrgicas e de terapia intensiva (UTIs) de três hospitais terciários da cidade de Santiago de los Caballeros, de 1 de janeiro de 2016 a 31 de dezembro de 2017. Para a análise das variáveis qualitativas, utilizamos estatísticas descritivas e o teste do qui-quadrado (p≤0,05). Resultados. Nos três hospitais, foram analisados 932, 1090 e 1780 laudos de microbiologia. Do total, 1274 foram de UTIs, 1042 de unidades cirúrgicas e 1486 de unidades clínicas. A resistência à meticilina foi encontrada em 57,3% dos isolados de Staphylococcus aureus e 75,3% dos estafilococos coagulase negativos. A resistência a cefalosporinas de terceira geração foi detectada em 54,4% dos isolados identificados como membros da família Enterobacteriaceae, 67,3% de Acinetobacter spp. e 91,7% de Pseudomonas, enquanto a resistência ao carbapenem foi observada em 8,0%, 23,8% e 51,0% destes isolados, respectivamente. A maioria dos isolados resistentes de Acinetobacter spp. foi encontrada em apenas um hospital, e a prevalência de Enterobacteriaceae resistentes a carbapenem foi maior nas UTIs. Conclusão. Os níveis de resistência antimicrobiana são elevados em pacientes hospitalizados na República Dominicana e podem aumentar os fatores de risco que afetam os resultados clínicos. São necessárias medidas urgentes para abordar a resistência antimicrobiana na República Dominicana.


Assuntos
Resistência Microbiana a Medicamentos , Staphylococcus aureus Resistente à Meticilina , Enterobacteriaceae , Pseudomonas , Acinetobacter , República Dominicana , Resistência Microbiana a Medicamentos , Staphylococcus aureus Resistente à Meticilina , República Dominicana , Resistência Microbiana a Medicamentos , Staphylococcus aureus Resistente à Meticilina
6.
Infectio ; 24(2): 66-70, abr.-jun. 2020. tab, graf
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1114842

RESUMO

Objectives: The Dominican Republic lacks reliable information on antimicrobial resistance (AMR), which would allow physicians to prescribe the best treatment for common infectious diseases. This study aimed to define the antimicrobial resistance profiles of the more common pathogens from pediatric services, where data is even more important due to the vulnerability of the population. Methods: We collected data from patients admitted in the pediatric unit of three third level hospitals in the city of Santiago de los Caballeros, Dominican Republic, showing positive bacterial cultures, during a period of two years. Results: Half of the Gram negative pathogens exhibited third generation cephalosporins (3GC) resistance, 17% were resistant to carbapenems. Serratia marcescens presented an exceptionally high proportion of resistance to 3GC (95.9%). Staphylococcus aureus showed elevated resistance to methicillin (58.4%) and even to clindamycin (35.8%). Conclusion: There are elevated levels of antimicrobial resistance among the Enterobacteriaceae family and the Staphylococcus genus isolated from the pediatric population. Necessary measures should be taken to tackle AMR in the country.


Objetivos: La República Dominicana carece de información confiable sobre las resistencias antimicrobianas en el país, lo que permitiría al personal médico prescribir los mejores tratamientos para infecciones comunes. El objetivo de este estudio es definir los perfiles de resistencia antimicrobiana de los patógenos más comunes en servicios pediátricos, donde esta información es esencial, debido a la vulnerabilidad de la población. Métodos: Se tomaron los datos de reportes microbiológicos con cultivo bacteriano positivo procedentes de pacientes admitidos en la unidad pediátrica de tres hospitales de tercer nivel en la ciudad de Santiago de los Caballeros, República Dominicana, durante un periodo de dos años. Resultados: La mitad de los patógenos Gram negativos mostraron resistencia a cefalosporinas de tercera generación (3GC), 17% eran resistentes a carbapenémicos. Serratia marcescens presentó una resistencia excepcionalmente elevada a 3GC (95.9%). Staphylococcus aureus mostró alta resistencia a meticilina (58.4%) e incluso a clindamicina (35.8%). Conclusión: Existen elevados niveles de resistencia antimicrobiana entre las enterobacterias y los estafilococos en la población pediátrica dominicana. Es necesario tomar medidas para abordar este problema en el país.


Assuntos
Humanos , Masculino , Feminino , Criança , Farmacorresistência Bacteriana , Pediatria , Atenção Terciária à Saúde , Clindamicina , Carbapenêmicos , República Dominicana , Meticilina
7.
J Smok Cessat ; 11(4): 239-249, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28025600

RESUMO

INTRODUCTION: Tobacco use and harm continue to increase in low- and middle income countries (LMICs) globally. Smoking cessation is the most effective means of reducing morbidity and mortality from tobacco use. Increasing the prevalence of ex-users is an indicator of population cessation. AIMS: This study provides the first examination of factors associated with ex-tobacco use status in the Dominican Republic (DR), a LMIC in the Latin America and Caribbean region. METHODS: Baseline surveillance was conducted for 1177 randomly selected households in 7 economically disadvantaged DR communities (total N=2680 adult household members). RESULTS: Ex-user prevalence was 10.6% (1.0%-18.5% across communities), 14.8% were current users (9.1-20.4), and quit ratios were 41.7% (9.7%-52.7%). Among ever-users, females (OR 2.02, 95% CI 1.41, 2.90), older adults (45-64: OR 1.75, 95% CI 1.12, 2.74; 65+: OR 2.09, 95% CI 1.29, 3.39), and those who could read/write (OR 1.64, 95% CI 1.08, 2.50), had health conditions (OR 1.63, 95% CI 1.11, 2.41), and lived with ex-users (OR 1.70, 95% CI 1.12, 2.58) were over 60% to two times as likely to be ex-users. Those from remote communities (OR 0.52, 95% CI 0.36, 0.74), using chewed tobacco (OR 0.14, 95% CI 0.04, 0.48) and living with tobacco users (OR 0.55, 95% CI 0.37, 0.81) were less likely to be ex-users. CONCLUSIONS: Ex-user prevalence and quit ratios were lower than for high income countries. Implementing broad tobacco control measures, combined with clinically targeting vulnerable groups, may increase tobacco cessation to most effectively reduce this public health crisis.

8.
J Smok Cessat ; 11(2): 99-107, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29104673

RESUMO

Engaging partners for tobacco control within low and middle income countries (LMICs) at early stages of tobacco control presents both challenges and opportunities in the global effort to avert the one billion premature tobacco caused deaths projected for this century. The Dominican Republic (DR) is one such early stage country. The current paper reports on lessons learned from 12 years of partnered United States (US)-DR tobacco cessation research conducted through two NIH trials (Proyecto Doble T, PDT1 and 2). The projects began with a grassroots approach of working with interested communities to develop and test interventions for cessation and secondhand smoke reduction that could benefit the communities, while concurrently building local capacity and providing resources, data, and models of implementation that could be used to ripple upward to expand partnerships and tobacco intervention efforts nationally. Lessons learned are discussed in four key areas: partnering for research, logistical issues in setting up the research project, disseminating and national networking, and mentoring. Effectively addressing the global tobacco epidemic will require sustained focus on supporting LMIC infrastructures for tobacco control, drawing on lessons learned across partnered trials such as those reported here, to provide feasible and innovative approaches for addressing this modifiable public health crisis.

9.
Int J Environ Res Public Health ; 12(4): 4060-75, 2015 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-25872018

RESUMO

Tobacco use is increasing globally, particularly in low and middle-income countries like the Dominican Republic (DR) where data have been lacking. Health care worker (HCW) interventions improve quit rates; asking patients about tobacco use at each visit is an evidence-based first step. This study provides the first quantitative examination of knowledge, attitudes and practices of DR HCWs regarding tobacco use. All HCWs (N = 153) in 7 economically disadvantaged DR communities were targeted with anonymous surveys. Approximately 70% (N = 107) completed the primary outcome item, asking about tobacco use at each encounter. Despite >85% strongly agreeing that they should ask about tobacco use at each encounter, only 48.6% reported doing so. While most (94.39%) strongly agreed that smoking is harmful, knowledge of specific health consequences varied from 98.13% for lung cancer to 41.12% for otitis media. Few received training in tobacco intervention (38.32%). Exploratory analyses revealed that always asking even if patients are healthy, strongly agreeing that tobacco causes cardiac disease, and always advising smoke-free homes were associated with always asking. Overall, results demonstrate a disconnect between HCW belief and practice. Though most agreed that always asking about tobacco was important, fewer than half did so. Gaps in HCW knowledge and practices suggest a need for education and policy/infrastructure support. To our knowledge, this is the first reported survey of DR HCWs regarding tobacco, and provides a foundation for future tobacco control in the DR.


Assuntos
Atitude do Pessoal de Saúde , Competência Clínica/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Áreas de Pobreza , Atenção Primária à Saúde/normas , Abandono do Hábito de Fumar , Tabagismo/diagnóstico , Países em Desenvolvimento , República Dominicana , Feminino , Pessoal de Saúde/psicologia , Pessoal de Saúde/normas , Humanos , Masculino , Atenção Primária à Saúde/estatística & dados numéricos , Fumar/efeitos adversos , Tabagismo/complicações , Tabagismo/terapia
10.
Clin Transl Oncol ; 13(9): 677-85, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21865140

RESUMO

INTRODUCTION: Methylation of the promoter of the MGMT gene and MGMT protein expression are recognized as predictive markers for response to alkylating chemotherapy in glioblastoma (GB). MATERIAL AND METHODS: We have assessed MGMT methylation with the methylation-specific polymerase chain reaction (MSP) in tumor samples from 70 GB patients and in serum samples from 37 of these patients. We have also assessed MGMT protein expression by immunohistochemical (IHC) analysis in tissue samples from 63 of these patients. RESULTS: We found concordance between MGMT methylation status in tissue and serum (Cohen's Kappa = 0.586; p<0.0001). MSP for detection of non-methylated MGMT promoter in serum showed a sensitivity of 95.4% and a specificity of 60%, while the IHC methylation test showed a low specificity (8.9%). Patients whose MGMT promoter was methylated in tissue attained longer progression-free and overall survival. In the multivariate analysis, serum MGMT promoter methylation emerged as an independent factor for longer progression-free and overall survival. CONCLUSION: Serum-based MGMT methylation analysis offers a promising alternative to tumor-based MGMT analysis in cases where tissue samples are unavailable.


Assuntos
Neoplasias Encefálicas/genética , Neoplasias Encefálicas/metabolismo , Metilases de Modificação do DNA/genética , Metilases de Modificação do DNA/metabolismo , Enzimas Reparadoras do DNA/genética , Enzimas Reparadoras do DNA/metabolismo , Glioblastoma/genética , Glioblastoma/metabolismo , Proteínas Supressoras de Tumor/genética , Proteínas Supressoras de Tumor/metabolismo , Adulto , Idoso , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Análise Química do Sangue , Neoplasias Encefálicas/sangue , Neoplasias Encefálicas/mortalidade , Metilação de DNA/fisiologia , Metilases de Modificação do DNA/análise , Metilases de Modificação do DNA/sangue , Enzimas Reparadoras do DNA/análise , Enzimas Reparadoras do DNA/sangue , Feminino , Glioblastoma/sangue , Glioblastoma/mortalidade , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Neoplasias/sangue , Neoplasias/genética , Neoplasias/metabolismo , Regiões Promotoras Genéticas/fisiologia , Estudos Retrospectivos , Soro/química , Soro/metabolismo , Análise de Sobrevida , Análise Serial de Tecidos , Proteínas Supressoras de Tumor/análise , Proteínas Supressoras de Tumor/sangue
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