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1.
Rev. Fac. Med. (Guatemala) ; 1(22 Segunda Época): 24-29, Ene - Jun.- 2017.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1140591

RESUMO

Introducción: Las infecciones por organismos multidroga resistentes (MDR) en pacientes oncológicos pediátricos se han convertido en una causa frecuente de morbilidad y mortalidad. Objetivos: El objetivo principal de este estudio fue determinar la incidencia y los factores de riesgo para estas infecciones en una muestra de pacientes de la UNOP. Métodos: Se realizó un estudio de tipo retrospectivo. Se incluyeron pacientes de la unidad de nosocomiales con infección por organismos MDR con cultivo positivo (hemocultivo, uro cultivo, aspirado oro traqueal cultivo de secreción). Se revisaron los registros comprendidos entre 1 de enero del 2015 al 31 de diciembre del 2015; obteniendo los registros médicos de 30 pacientes que cumplían con los criterios de inclusión. Resultados: Se observó que el 60% de los pacientes con infecciones por organismo MDR son del sexo femenino, el 70% poseen el diagnóstico de un tumor hematológico y el 37% tuvieron como diagnóstico bacteriemia/sepsis, siendo la incidencia de ésta de 3.49%. Palabras Claves: factores de riesgo, Infecciones por organismos multidroga resistentes, pacientes oncológicos pediátricos. A. baumannii, K. pneumonie; cancer pediátrico.


Introduction: Multidrug resistant (MDR) organism infections in pediatric oncology patients have become a frequent cause of morbidity and mortality. The main objective of the following study was to determine the incidence and risk factors associated to MDR organisms infections in a sample of patients from UNOP. Methods: Retrospective study. The inclusion criteria were documented MDR infection with positive culture (blood, urinary, tissue or endotracheal aspirate). We reviewed medical records between January 1st, 2015 to December 31st, 2015; obtaining the medical records of 30 patients who fulfilled the inclusion criteria. Results: Sixty percent (60%) of patients female; 70% had the diagnosis of hematologic malignancy; 37% of patients were diagnosed with clinical sepsis and the incidence of sepsis was 3.49%. Key words: risk factors, infections by multidrug-resistant organisms, pediatric cancer patients. A. baumannii, K. pneumonie; pediatric cancer

2.
Rev Panam Salud Publica ; 25(4): 328-36, 2009 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-19531321

RESUMO

OBJECTIVE: To understand the health needs of the population living in Mexico's marginalized urban areas. METHODS: A population-based survey of families residing in poor, urban neighborhoods, in five geographic areas in Mexico (northern, central, southern, south-east, and Mexico City), selected through multistage sampling. Interviews were conducted and anthropometric measurements were taken in the home, and included all members of the participating family. Analysis was carried out on positive health factors, nutrition, reproductive health, health problems, and mental health, and results were disaggregated by age and sex. RESULTS: In all, 24,707 individuals participated. The interviewees were found to have minimal schooling (6 years or less). Only 46.8% had health care coverage, be it public or private. Among the children, 19.8% were malnourished; overweight was prevalent from adolescence onwards. Of adolescents 12-19 years of age, 15.7% were sexually active, but only 57.7% of the males and 41.9% of the females in this age group were using some method of contraception. Of the adults, 5.9% suffered from diabetes and 11.5%, from high blood pressure. In the sample of adolescents, adults, and elderly adults, tobacco use was 21.2%; alcohol consumption, 36.0%; illicit drug use, 9.5%; and depression, 20.2%. CONCLUSIONS: The health needs of people living in Mexico's marginalized urban areas proliferate in the context of a young population with weak ties and little support from family and health services. They face crisis and disease--infant malnutrition, high-risk pregnancy, and addictions--the byproducts of disparities in social progress. The rate of chronic conditions was similar to that of the general population of Mexico.


Assuntos
Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , México , Pessoa de Meia-Idade , População Urbana , Adulto Jovem
3.
Fam Med ; 41(4): 277-84, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19343559

RESUMO

BACKGROUND AND OBJECTIVES: The Mexican Institute of Social Security (IMSS) is the largest public health care system in Mexico. IMSS family physicians' management of clinical problems is frequently not consistent with published evidence. This study aimed to evaluate the effects of a multifaceted educational intervention to improve management of acute respiratory infections (ARI) by IMSS family physicians. METHODS: A non-randomized pre-post intervention with comparison group design was conducted in eight IMSS family medicine clinics in which 106 family physicians practiced. An evidence-based clinical guideline for ARI management was developed, and clinical tutors were trained. The three-stage intervention comprised interactive workshops, individual tutorials, and round-table peer-review sessions. The main outcome was appropriate ARI case management. The intervention effect was calculated by using the differences-in-differences model, adjusting for cluster of physicians. RESULTS: In the intervention group, the difference in mean proportion of improvement compared with baseline evaluation was 22.6% (95% confidence interval [CI]=10.3 to 34.9) for appropriate prescription of antibiotics, 29.8% (95% CI=17.2 to 42.4) for indication of worsening signs, and 19.6% (95% CI=11.2 to 28.0) for overall appropriate case management. The comparison group showed no significant changes. CONCLUSIONS: The educational intervention improved ARI management. Further studies are needed to analyze organizational implications, cost, sustainability, and effects on health outcomes.


Assuntos
Administração de Caso/normas , Competência Clínica , Medicina de Família e Comunidade/educação , Avaliação de Resultados em Cuidados de Saúde , Infecções Respiratórias/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Criança , Pré-Escolar , Educação , Educação Médica Continuada/normas , Medicina de Família e Comunidade/normas , Feminino , Humanos , Lactente , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto , Programas Nacionais de Saúde/normas , Infecções Respiratórias/epidemiologia
4.
Rev. panam. salud pública ; 25(4): 328-336, abr. 2009. tab
Artigo em Espanhol | LILACS | ID: lil-515972

RESUMO

OBJETIVO: Evaluar las necesidades de salud de la población residente en áreas urbanas marginadas de México. MÉTODOS: Encuesta poblacional a familias residentes en colonias urbanas pobres de cinco regiones geográficas de México (Norte, Centro, Sur, Sureste y Ciudad de México), seleccionadas mediante un muestreo polietápico. Se realizaron entrevistas y mediciones antropométricas en sus domicilios a todos los integrantes de las familias seleccionadas y se analizaron las características de salud positiva, nutrición, salud reproductiva, daños a la salud y salud mental por grupos de análisis formados por edad y sexo. RESULTADOS: Participaron 24 707 personas. En los entrevistados se observó una baja escolaridad (6 años o menos) y solo 46,8 por ciento tuvo cobertura de servicios de salud, ya fuera en instituciones públicas o privadas. De los niños, 19,8 por ciento presentaba desmedro y el sobrepeso predominó a partir de la adolescencia. En los adolescentes de 12 a 19 años, 15,7 por ciento tenía vida sexual activa, pero solo 57,7 por ciento de los hombres y 41,9 por ciento de las mujeres de ese grupo de edad usaban algún método anticonceptivo. De los adultos, 5,9 por ciento padecía diabetes y 11,5 por ciento hipertensión arterial. En la muestra de adolescentes, adultos y adultos mayores, el tabaquismo fue de 21,2 por ciento, el consumo de alcohol de 36,0 por ciento, el uso de drogas de 9,5 por ciento y la depresión de 20,2 por ciento. CONCLUSIONES: La vulnerabilidad sanitaria de las personas que viven en las áreas urbanas marginadas de México se manifiesta en la existencia de una población joven, con pocas redes de apoyo familiar y de servicios de salud, que sufre trastornos y enfermedades, como la desnutrición infantil, el alto riesgo reproductivo y las adicciones en adolescentes y adultos, producto del rezago en el desarrollo social. La prevalencia de enfermedades crónicas fue similar a la de la población mexicana no marginada.


OBJECTIVE: To understand the health needs of the population living in Mexico's marginalized urban areas. METHODS: A population-based survey of families residing in poor, urban neighborhoods, in five geographic areas in Mexico (northern, central, southern, south-east, and Mexico City), selected through multistage sampling. Interviews were conducted and anthropometric measurements were taken in the home, and included all members of the participating family. Analysis was carried out on positive health factors, nutrition, reproductive health, health problems, and mental health, and results were disaggregated by age and sex. RESULTS: In all, 24 707 individuals participated. The interviewees were found to have minimal schooling (6 years or less). Only 46.8 percent had health care coverage, be it public or private. Among the children, 19.8 percent were malnourished; overweight was prevalent from adolescence onwards. Of adolescents 12-19 years of age, 15.7 percent were sexually active, but only 57.7 percent of the males and 41.9 percent of the females in this age group were using some method of contraception. Of the adults, 5.9 percent suffered from diabetes and 11.5 percent, from high blood pressure. In the sample of adolescents, adults, and elderly adults, tobacco use was 21.2 percent; alcohol consumption, 36.0 percent; illicit drug use, 9.5 percent; and depression, 20.2 percent. CONCLUSIONS: The health needs of people living in Mexico's marginalized urban areas proliferate in the context of a young population with weak ties and little support from family and health services. They face crisis and disease-infant malnutrition, high-risk pregnancy, and addictions-the byproducts of disparities in social progress. The rate of chronic conditions was similar to that of the general population of Mexico.


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , México , População Urbana , Adulto Jovem
5.
Rev Med Inst Mex Seguro Soc ; 47(Suppl 1): S81-S86, 2009 Dec 01.
Artigo em Espanhol | MEDLINE | ID: mdl-35960684

RESUMO

Background: adolescent population is an important age group, with vulnerability and health needs not well known, especially for those living in urban slums. Our objective was to identify health risks for adolescents living in poor urban areas in five geographical regions of Mexico. Methods: a secondary data analysis from a nationwide adolescents ́ survey was carried out from population living in poor urban areas of the north, center, DF, south and southeast of Mexico. Cigarette smoking, alcohol and drug consumption, as well as frequency of accidents and violence, age at sexual initiation and use of contraception methods were analyzed. Results: the highest frequencies of consumption were: 27.8 % for cigarette smoking and 35.2 % for alcohol, both in adolescents from 16 to 19 years; accidents (5 %) and violence (1.7 %); age (median) at sexual initiation was 16 years, about 50 % of adolescents with regular sexual activity reported use of a contraception method. Conclusions: comparing our data with National Health Surveys; in poor urban areas, most adolescents health risks are higher than those found for same group age in the general population, however, presentation of accidents and violence are similar.


Introducción: : los adolescentes son un grupo con vulnerabilidad y necesidades de salud poco conocidas en México, principalmente en áreas de pobreza urbana. El objetivo de esta investigación fue identificar los riesgos para la salud de los adolescentes en las áreas urbanas marginadas en cinco regiones del país. Métodos: análisis secundario de una encuesta de salud para adolescentes realizada en áreas urbanas marginadas del Distrito Federal y regiones norte, centro, sur y sureste del país; se analizó consumo de tabaco, alcohol y drogas; historia de accidentes y violencias, edad de inicio de vida sexual y uso de métodos anticonceptivos; se calcularon frecuencias absolutas y relativas. Resultados: los consumos más altos fueron para tabaco (27.8 %) y alcohol (35.2 %), ambos en el grupo de 16 a 19 años de edad; 5 % sufrió algún accidente y 1.7 %, violencia; el inicio de la vida sexual tuvo una mediana de 16 años y 50 % utilizaba algún método anticonceptivo. Conclusiones: al comparar nuestros datos con los de otras encuestas nacionales, se encontró que los riesgos para la salud son mayores en los adolescentes de áreas urbanas marginadas que en adolescentes de la población general, sin embargo, la frecuencia de accidentes y violencias fue similar.

7.
Rev Saude Publica ; 42(4): 679-83, 2008 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-18709244

RESUMO

OBJECTIVE: To estimate seroprevalence of Bordetella pertussis in students and their community. METHODS: A total of 12,273 adolescent students aged 12 to 15 years from 14 public high schools in Mexico City were studied from September 2002 to March 2003. Nasopharyngeal samples were collected from those adolescents with whooping cough for more than 14 days. Infection was confirmed using polymerase chain reaction (PCR). All students, school staff and family exposed to PCR-confirmed cases were tested. RESULTS: Whooping cough rate was 5 to 1,000 students. Of those students (61) who were identified with whooping cough for more than 14 days, 20 (32.8%) were positive to Bordetella pertussis. Of 152 people exposed (contacts) to these cases, 16 (10.6%) were positive and only eight (50%) had whooping cough. One of these exposed (contacts) was the principal of a school that had more than 60% positive cases (12/20) and who was also a teacher of 10 infected students. Of 29 family members tested, eight (27.6%) were positive and from three different families. CONCLUSIONS: The study results show a similar rate of whooping cough in adolescents as seen in other countries. Since persistent cough is not always clinically seen in all infected individuals, there may be asymptomatic cases of Bordetella infection.


Assuntos
Bordetella pertussis , Busca de Comunicante , Coqueluche/epidemiologia , Adolescente , Anticorpos Antibacterianos/sangue , Bordetella pertussis/imunologia , Criança , Intervalos de Confiança , Feminino , Humanos , Masculino , México/epidemiologia , Mucosa Nasal/microbiologia , Reação em Cadeia da Polimerase , Estudos Soroepidemiológicos , Coqueluche/imunologia , Coqueluche/microbiologia
8.
Rev. saúde pública ; Rev. saúde pública;42(4): 679-683, ago. 2008. tab
Artigo em Espanhol | LILACS | ID: lil-488992

RESUMO

OBJETIVO: Estimar la seroprevalencia a Bordetella pertussis en escolares y sus contactos escolares y familiares. MÉTODOS: Un total de 12.273 estudiantes de 12 a 15 años de edad, de 14 escuelas secundarias públicas de la Ciudad de México fueron estudiados durante los meses de Septiembre 2002 a Marzo 2003. Se tomó muestra de exudado nasofaríngeo en adolescentes con tos de más de 14 días de evolución. La infección fue confirmada por la técnica de reacción en cadena de polimerasa. Se realizó estudio de contactos escolares y familiares. RESULTADOS: La incidencia de tos fue de 5 para 1.000 estudiantes. De los 61 estudiantes con tos incluidos en la muestra, 20 (32,8 por ciento) fueron positivos para Bordetella. De los 152 contactos escolares, 16 (10,6 por ciento) resultaron positivos, y ocho tenían tos. Uno de esos contactos fue el director de una de las escuelas responsable de más del 60 por ciento de los casos positivos (12/20), quien también dio lecciones a diez de los estudiantes infectados. De los 29 familiares, ocho (27,6 por ciento) fueron positivos, pertenecientes a tres familias. CONCLUSIONES: Los resultados muestran que la frecuencia de la enfermedad fue similar al comunicado en la población adolescente de otros países. Sin embargo, este trastorno no tiene necesariamente signos clínicos de la tos persistente y está sujeto a la existencia de infectados asintomáticos con Bordetella.


OBJECTIVE: To estimate seroprevalence of Bordetella pertussis in students and their community. METHODS: A total of 12,273 adolescent students aged 12 to 15 years from 14 public high schools in Mexico City were studied from September 2002 to March 2003. Nasopharyngeal samples were collected from those adolescents with whooping cough for more than 14 days. Infection was confirmed using polymerase chain reaction (PCR). All students, school staff and family exposed to PCR-confirmed cases were tested. RESULTS: Whooping cough rate was 5 to 1,000 students. Of those students (61) who were identified with whooping cough for more than 14 days, 20 (32.8 percent) were positive to Bordetella pertussis. Of 152 people exposed (contacts) to these cases, 16 (10.6 percent) were positive and only eight (50 percent) had whooping cough. One of these exposed (contacts) was the principal of a school that had more than 60 percent positive cases (12/20) and who was also a teacher of 10 infected students. Of 29 family members tested, eight (27.6 percent) were positive and from three different families. CONCLUSIONS: The study results show a similar rate of whooping cough in adolescents as seen in other countries. Since persistent cough is not always clinically seen in all infected individuals, there may be asymptomatic cases of Bordetella infection.


OBJETIVO: Estimar a soroprevalência a Bordetella pertussis em escolares e seus contatos. MÉTODOS: Foram examinados 12.273 alunos entre 12 e 15 anos de idade, de 14 escolas secundárias públicas da Cidade do México, de setembro de 2002 a março de 2003. Amostras de exudado nasofaríngeo foram coletadas de adolescentes com tosse por mais de 14 dias. A infecção foi confirmada por reação em cadeia da polimerase. Todos os alunos e funcionários dos colégios dos casos confirmados por reação em cadeia da polimerase e seus familiares foram testados. RESULTADOS: A incidência de tosse foi de 5 para 1.000 alunos. Dos 61 alunos com tosse amostrados, 20 (32,8 por cento) foram positivos para Bordetella. Dos 152 contatos desses alunos, 16 (10,6 por cento) foram positivos, dos quais oito apresentavam tosse. Um desses contatos foi a diretora de uma das escolas responsável por mais de 60 por cento dos casos positivos (12/20), que também deu aulas a dez desses alunos infectados. Dos 29 familiares testados, oito (27,6 por cento) foram positivos, pertencentes a três famílias. CONCLUSÕES: Os resultados mostram que a freqüência do agravo foi semelhante à reportada na população adolescente em outros países. Todavia, este agravo não tem necessariamente manifestações clínicas de tosse persistente, sendo possível a existência de sujeitos assintomáticos infectados com Bordetella.


Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Bordetella pertussis , Busca de Comunicante , Coqueluche/epidemiologia , Anticorpos Antibacterianos/sangue , Bordetella pertussis/imunologia , Intervalos de Confiança , México/epidemiologia , Mucosa Nasal/microbiologia , Reação em Cadeia da Polimerase , Estudos Soroepidemiológicos , Coqueluche/imunologia , Coqueluche/microbiologia
9.
Rev Med Inst Mex Seguro Soc ; 45(6): 623-7, 2007.
Artigo em Espanhol | MEDLINE | ID: mdl-18593546

RESUMO

OBJECTIVE: To describe an epidemiological study of one case of pertusis. CLINICAL CASE: a five-year old boy was diagnosed with pneumonia and he had incomplete DPT vaccination scheme; pertusis was diagnosed by using the PCR technique and culture. An epidemiological study with family contacts was carried out, in which 20 samples for both tests were obtained. These were taken twice. RESULTS: The average age of the family members was 26.5 years, 50 % were women, 62 % did not have social security and 30 % had three doses of DPT. 35 % were positive to PCR and, 20 % out of these had positive cultures. CONCLUSIONS: In children smaller than five years suffering from pneumonia, is relevant to ascertain about DPT vaccination status and to consider the possibility of carrying out an epidemiological study with the family.-


Assuntos
Coqueluche/diagnóstico , Coqueluche/epidemiologia , Adolescente , Adulto , Idoso , Pré-Escolar , Saúde da Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
10.
Rev. enfermedades infecc. ped ; 14(56): 117-118, abr.-jun. 2001.
Artigo em Espanhol | LILACS | ID: lil-314273

RESUMO

Es de gran relevancia el logro de una separación eficiente y adecuada de los residuos peligrosos biológico-infecciosos, porque contribuye a proteger y preservar la salud del personal y de los usuarios en todas las unidades médicas, de cualquier nivel de atención del sistema nacional de salud en el país, consecuentemente, favorece la protección del medio ambiente y el cuidado de la salud pública; lo anterior, con el propósito de alcanzar un mundo mejor para nosotros, nuestras familias y para quienes heredarán este planeta.


Assuntos
Eliminação de Resíduos de Serviços de Saúde/métodos , Resíduos de Serviços de Saúde , Controle de Infecções , Vacinas de Produtos Inativados
11.
Rev. méd. IMSS ; 33(4): 391-5, jul.-ago. 1995. tab
Artigo em Espanhol | LILACS | ID: lil-174165

RESUMO

Se estudiaron 71 madres de niños menores de un año con diarrea aguda atendidos en un Centro Docente Asistencial (CDA) interinstitucional en la ciudad de Tlaxcala, para evaluar el cumplimiento en el hogar de las indicaciones de hidratación oral y dieta otorgadas por el médico. Los casos se captaron en la sala de espera del CDA, se observó el desarrollo de la consulta y se registraron las características clínicas del padecimiento. Tres a siete días posteriores se efectuó visita domiciliaria donde se obtuvo información acerca de la evolución de la enfermedad, de los conceptos y comprensión de la madre acerca de las indicaciones recibidas y de su cumplimiento. Hubo correcta comprensión de las indicaciones de alimentación en casi todas las madres, pero solamente 38 por ciento entendió la indicación de hidratación oral. Se encontró una frecuencia de uso de terapia de hidratación oral de 84.5 por ciento, de Vida Suero Oral 66.2 por ciento, continuación de alimentación normal 90.5 por ciento y continuación del seno materno 100 por ciento. Menos de 15 por ciento de los casos recibió líquidos no recomendados en el CDA. Cuando las indicaciones médicas dadas en un CDA sobre hidratación oral y dieta son proporcionadas adecuadamente y por personal convencido, es posible lograr un cumplimiento satisfactorio. Sin embargo, la administración de Vida Suero oral debe mejorarse en base a lograr una mejor comprensión de su uso por parte de la madre


Assuntos
Recém-Nascido , Lactente , Humanos , Masculino , Feminino , Fatores de Risco , Centros Comunitários de Saúde/estatística & dados numéricos , Diarreia Infantil/terapia , Dieta , Hidratação , Hidratação , Educação em Saúde/tendências
12.
Rev. méd. IMSS ; 32(4): 359-62, jul.-ago. 1994. tab
Artigo em Espanhol | LILACS | ID: lil-176902

RESUMO

Los aspectos emocionales intervienen en los trastornos de las parejas estériles, pero generalmente el médico los minimiza y esto condiciona o agrava alteraciones conductuales y afectivas, agregándose en consecuencia otros problemas en el curso del tratamiento. Se acepta que el factor piscológico está presente en la mayoría de las parejas con trastornos de la fertilidad hasta en 5 por ciento de ellas. En este trabajo se presenta una prueba para la evaluación psicológica de las mujeres con alteración de la fertilidad, con el propósito de que el médico pueda determinar más objetivamente cuáles necesitan asistir a consulta con psicólogo. Para facilitar la detección de ansiedad, depresión y disfunción sexual, se ideó un cuestionario de ocho preguntas abiertas que se aplicaron a 50 mujeres, con el fin de identificar a las pacientes con algunos problemas no manifiestos. Con esta prueba, la reacción psicológica más frecuente fue la ansiedad, detectada claramente en 16 pacientes y en forma dudosa en 28. La ansiedad se asoció a la disfunción sexual en 23 mujeres. La interpretación global de la respuesta reveló que 14 pacientes necesitaban asistencia psicológica, diez requerían una entrevista inicial diagnóstica y 26 no ameritaban dicha evaluación. Los resultados preliminares de este protocolo indican que estos criterios permiten al médico una selección más objetiva de las parejas con problemas picológicos, los cuales generalmente pasan inadvertidos


Assuntos
Ansiedade/etiologia , Disfunções Sexuais Psicogênicas/psicologia , Transtorno Depressivo/complicações , Fertilidade/fisiologia , Infertilidade Feminina/psicologia , Infertilidade Masculina/psicologia , Testes Psicológicos/métodos
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