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To assess our determination to continue transplant activity in Colombia during the coronavirus disease 2019 (COVID-19) pandemic, this study seeks to describe the risk of infection and mortality of transplanted patients vs those on the waiting list. Therefore, a descriptive study of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2)/COVID-19 infection in transplant recipients and patients on the waiting list was conducted. The data sources were the information systems of the Instituto Nacional de Salud of Colombia: National Donation and Transplant Information System, the National Public Health Surveillance System, and the National COVID-19 Data Repository. Characteristics of the patients who tested positive were analyzed, and the mortality rate was determined. An Real Time-PCR test for SARS-CoV-2/COVID-19 was performed in 7% of the transplant recipients included in this study, and 14.8% of those recipients tested positive. Among patients on the waiting list, 15.2% were tested, and 16.7% showed positive results. Overall, 1% (84/8108) of the transplant recipients and 2.5% (74/2926) of patients on the waiting list were infected with SARS-CoV-2/COVID-19. There were no differences in mortality between these groups (P = .8748). In conclusion, with the data obtained so far, the hospital availability, and the adoption of safety protocols in the institutions, our findings can support the continuity of the transplant activities in this country.
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COVID-19/diagnóstico , Transplante de Órgãos , Adulto , Idoso , COVID-19/epidemiologia , COVID-19/mortalidade , COVID-19/virologia , Colômbia/epidemiologia , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Sistema de Registros , SARS-CoV-2/isolamento & purificação , Listas de Espera/mortalidadeRESUMO
INTRODUCTION: Puerto Ricans, the second largest Latino group in the continental US, are underrepresented in genomic studies of Alzheimer disease (AD). To increase representation of this group in genomic studies of AD, we developed a multisource ascertainment approach to enroll AD patients, and their family members living in Puerto Rico (PR) as part of the Alzheimer's Disease Sequencing Project (ADSP), an international effort to advance broader personalized/precision medicine initiatives for AD across all populations. METHODS: The Puerto Rico Alzheimer Disease Initiative (PRADI) multisource ascertainment approach was developed to recruit and enroll Puerto Rican adults aged 50 years and older for a genetic research study of AD, including individuals with cognitive decline (AD, mild cognitive impairment), their similarly, aged family members, and cognitively healthy unrelated individuals age 50 and up. Emphasizing identification and relationship building with key stakeholders, we conducted ascertainment across the island. In addition to reporting on PRADI ascertainment, we detail admixture analysis for our cohort by region, group differences in age of onset, cognitive level by region, and ascertainment source. RESULTS: We report on 674 individuals who met standard eligibility criteria [282 AD-affected participants (42% of the sample), 115 individuals with mild cognitive impairment (MCI) (17% of the sample), and 277 cognitively healthy individuals (41% of the sample)]. There are 43 possible multiplex families (10 families with 4 or more AD-affected members and 3 families with 3 AD-affected members). Most individuals in our cohort were ascertained from the Metro, Bayamón, and Caguas health regions. Across health regions, we found differences in ancestral backgrounds, and select clinical traits. DISCUSSION: The multisource ascertainment approach used in the PRADI study highlights the importance of enlisting a broad range of community resources and providers. Preliminary results provide important information about our cohort that will be useful as we move forward with ascertainment. We expect that results from the PRADI study will lead to a better understanding of genetic risk for AD among this population.
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UNLABELLED: This study investigates three common factor mechanisms that could affect outcome in clinical practice: response expectancy, the affective expectation model and motivational concordance. Clients attending a gestalt therapy clinic (30 clients), a sophrology (therapeutic technique) clinic (33 clients) and a homeopathy clinic (31 clients) completed measures of expectancy and the Positive Affect and Negative Affect Schedule (PANAS) before their first session. After 1 month, they completed PANAS and measures of intrinsic motivation, perceived effort and empowerment. Expectancy was not associated with better outcome and was no different between treatments. Although some of the 54 clients who endorsed highest expectations showed substantial improvement, others did not: 19 had no change or deteriorated in positive affect, and 18 had the same result for negative affect. Intrinsic motivation independently predicted changes in negative affect (ß = -0.23). Intrinsic motivation (ß = 0.24), effort (ß = 0.23) and empowerment (ß = 0.20) independently predicted positive affect change. Expectancy (ß = -0.17) negatively affected changes in positive affect. Clients found gestalt and sophrology to be more intrinsically motivating, empowering and effortful compared with homeopathy. Greater improvement in mood was found for sophrology and gestalt than for homeopathy clients. These findings are inconsistent with response expectancy as a common factor mechanism in clinical practice. The results support motivational concordance (outcome influenced by the intrinsic enjoyment of the therapy) and the affective expectation model (high expectations can lead for some clients to worse outcome). When expectancy correlates with outcome in some other studies, this may be due to confound between expectancy and intrinsic enjoyment. KEY PRACTITIONER MESSAGE: Common factors play an important role in outcome. Intrinsic enjoyment of a therapeutic treatment is associated with better outcome. Active engagement with a therapeutic treatment improves outcome. Unrealistic expectations about a therapeutic treatment can have a negative impact on outcome.
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Afeto , Cultura , Motivação , Avaliação de Processos e Resultados em Cuidados de Saúde , Processos Psicoterapêuticos , Adolescente , Adulto , Idoso , Instituições de Assistência Ambulatorial , Feminino , Terapia Gestalt , Homeopatia , Humanos , Masculino , México , Pessoa de Meia-Idade , Relações Metafísicas Mente-Corpo , Poder Psicológico , Inquéritos e Questionários , Adulto JovemRESUMO
Introducción: en otros países se han descrito ciertos factores relacionados con el desarrollo de queratosis actínica (QA). Objetivo: describir las características clínicas, epidemiológicas e histopatológicas de pacientes institucionales de Medellín, con diagnóstico de QA. Metodología: estudio descriptivo de pacientes con QA. Se aplicó una encuesta estructurada tomando datos demográficos, clínicos y relacionados con el desarrollo de la QA. Resultados: se incluyeron 153 pacientes (58 hombres [37,9%] y 95 mujeres [62,1%]), con edad promedio de 70 años. Tenían 75 años o más 64 pacientes (41,8%). Ciento ocho pacientes (70,6%) refirieron haber tenido un grado alto de exposición solar en la niñez; 76 (49,7%) tenían el antecedente de fumar y 16 de estos (21,1%) aún fumaban; 46 (30,1%) informaron el antecedente de un familiar con cáncer de piel. Setenta y tres (47,7%) realizaban las actividades tanto bajo techo como al aire libre; 80 (52,3%) informaron que se aplicaban protector solar y 37 (24,4%) usaban gorra o sombrero por la época en que fueron encuestados. Predominó el fototipo II (101 pacientes; 66%) y había daño actínico moderado en 76 (49,7%). Cuando hubo un solo patrón histológico predominó el atrófico (12%) y cuando hubo dos, el atróficohiperqueratósico (18,7%). Conclusiones: las características fenotípicas y de exposición de los pacientes con QA estudiados en Medellín (Colombia) son similares a las reportadas en la literatura.
Introduction: Several factors related with the development of actinic keratosis (AK) have been reported in other countries. Objective: To describe the clinical, epidemiological and histopathological characteristics of patients with diagnosis of AK in Medellín, Colombia. Methodology: This was a descriptive study of patients with AK. A structured survey including demographic, clinical and epidemiological information was applied. Results: 153 patients were included (58 men [37.9%] and 95 women [62.1%]) with an average age of 70 years. Sixty four patients (41.8%) were aged 75 years or more. With regard to their personal history, 108 individuals (70.6%) had a high degree of solar exposure during childhood; 76 (49.7%) reported the habit of smoking and 16 out of these (21.1%) still smoked. In 46 (30.1%) there was a family history of skin cancer. Regarding individual habits, 73 (47.7%) carried out both indoor and outdoor activities, 80 (52.3%) reported the use of sunscreen and 37 (24.4%) used hat or cap at the time of the study. Fitzpatrick´s type II phototype predominated (101 patients; 66%) and 76 (49.7%) had moderate actinic damage. The predominant single histologic subtype corresponded to the atrophic type (12%) and the main mixed subtype was the atrophichyperkeratotic subtype (18.7%). Conclusions: Clinical, epidemiological and histopathological features found among two institutional populations with AK in Medellin (Colombia) were similar to those reported in the literature.
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Adulto , Epidemiologia , Ceratose Actínica , Neoplasias Cutâneas , BiópsiaRESUMO
La psoriasis es una de las enfermedades cutáneas más frecuentes pues afecta al 2-3% de la población mundial. Es autoinmune, específica de órgano, crónica y recurrente, desencadenada por factores externos en individuos con predisposición genética. En su inmunopatogénesis se ha descrito unafalla en la regulación de la respuesta inmune frente a antígenos aún no bien identificados. Tiene diversas presentaciones clínicas e influye desfavorablemente en la calidad de vida de los pacientes. La comprensión de sus fundamentos inmunopatogénicos ha permitido poner en práctica nuevas estrategias de tratamiento como la terapia biológica. En este artículo se revisan los aspectos fundamentales de la inmunopatogénesis de la psoriasis y sus características epidemiológicas, clínicas e histopatológicas, así como las varias opciones terapéuticas.
Psoriasis is one of the most frequent skin diseases. Worldwide, it affects 2 to 3% of the population. It is an organ-specific, chronic, recurrent, autoimmune disease, triggered by external factors in individuals with a genetic predisposition. In its immunopathogenesis a lack of regulation of the immune response to unidentified antigens has been described. Psoriasis has many different clinical presentations and produces an important decrease in the quality of life. Understanding itsimmunopathogenetic bases has led to new therapeutic strategies such as the biological approaches. This review includes basic immunopathogenetic aspects of psoriasis, as well as the epidemiological, clinical and histopathological characteristics of the disease. Therapeutic options are also included.
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Adulto , Imunidade Inata , Imunidade/genética , PsoríaseRESUMO
La malaria es una de las enfermedades parasitarias más comunes en el mundo; anualmente afecta entre 200 y 300 millones de personas, con uno a dos millones de muertes debidas entre otras causas a las complicaciones agregadas, como malaria cerebral, disfunción hepática y renal, alteraciones metabólicas, hematológicas y pulmonares (1). Dentro de estas últimas, el síndrome de dificultad respiratoria aguda y el edema pulmonar, son manifestaciones que se presentan con una frecuencia de 3 por ciento a 10 por ciento en malaria por P. falciparum y por P. vivax, con una mortalidad que puede ascender al 40 por ciento (2). Se presentan dos casos de Síndrome de Dificultad Respiratoria Aguda y uno de edema pulmonar secundarios a malaria por P. falciparum y se revisan las complicaciones pulmonares en malaria, su definición, epidemiología, patogenia, criterios diagnósticos y su tratamiento
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Edema Pulmonar , Malária/complicações , Pneumopatias , Síndrome do Desconforto Respiratório , Malária Falciparum/complicações , Plasmodium falciparumRESUMO
Antecedentes: El 95 por ciento de los trastornos de la alimentación se presenta en mujeres, siendo más frecuente en estudiantes de secundaria y universitarias, Su prevalencia en el mundo es el 0.5 al 1 por cinto para anorexia nerviosa y del 1 al 10 por ciento para bulimia. En Colombia es del 2.3 por ciento y 0.1 por ciento respectivamente, y no se conoce la prevalencia real para el trastorno de alimentación compulsiva. Dentro de la etiología, factores culturales como los medios de comunicación, presión social, estrés académico y otros desordenes mentales como depresión y ansiedad están fuertemente asociados."Objetivo": Calcular la prevalencia de los trastornos de alimentación y estimar su asociación con presión familiar, influencia de los medios de comunicación, estrés académico, depresión y ansiedad. Materiales y métodos: Estudio descriptivo realizado en 196 estudiantes universitarias de primer y segundo año en cuatro programas de pregrado del CES. Se aplicó un cuestionario con preguntas dirigidas a evaluar cada trastorno y factor de riesgo mencionado...