RESUMO
Linking records of the same person from different sources makes it possible to build administrative cohorts and perform longitudinal analyzes, as an alternative to traditional cohort studies, and have important practical implications in producing knowledge in public health. We implemented the Fellegi-Sunter probabilistic linkage method to a sample of records from the Mexican Automated System for Hospital Discharges and the Statistical and Epidemiological System for Deaths and evaluated its performance. The records in each source were randomly divided into a training sample (25%) and a validation sample (75%). We evaluated different types of blocking in terms of complexity reduction and pairs completeness, and record linkage in terms of sensitivity and positive predictive value. In the validation sample, a blocking scheme based on trigrams of the full name achieved 95.76% pairs completeness and 99.9996% complexity reduction. After pairs classification, we achieved a sensitivity of 90.72% and a positive predictive value of 97.10% in the validation sample. Both values were about one percentage point higher than that obtained in the automatic classification without clerical review of potential pairs. We concluded that the linkage algorithm achieved a good performance in terms of sensitivity and positive predictive value and can be used to build administrative cohorts for the epidemiological analysis of populations with records in health information systems.
RESUMO
El propósito de este trabajo fue revisar la literatura científica que evalúa la eficacia y seguridad de las monoterapias de fexofenadina y montelukast, la terapia combinada (fija o en asociación) de montelukast - fexofenadina, así como de montelukast con otros antihistamínicos de segunda generación en el tratamiento de la rinitis alérgica. Se realizó una estrategia de búsqueda bibliográfica de múltiples etapas, en donde se identificaron estudios basados en ensayos clínicos y estudios no aleatorizados (ensayo controlado no aleatorizado, controlado antes-después, de series de tiempo interrumpidas, con controles históricos, de cohorte, de casos y controles, estudio transversal, y series de casos) en pacientes con rinitis alérgica, en las bases de datos MEDLINE/ PubMed, Scopus, Web of Science, Biblioteca Cochrane, Redalyc y Colección BVS y debido a la cantidad de resultados obtenidos se incluyó la búsqueda en Hinari. Con base en esta revisión se concluye que las combinaciones de antihistamínicos de segunda generación y antagonistas de leucotrienos y, en particular, la combinación fija de fexofenadina montelukast es eficaz, segura y favorece la adherencia al tratamiento, y a largo plazo también ayuda a alcanzar el objetivo terapéutico.
The purpose of this work was to review the scientific literature that evaluates the efficacy and safety of monotherapies of fexofenadine and montelukast, the combined therapy (fixed-dose or separate drug combinations) of montelukast-fexofenadine, as well as the use of montelukast together with other second-generation antihistamines in the treatment of allergic rhinitis. A multistage literature search strategy was designed, including clinical trials and non-randomized studies (non-randomized controlled trial, controlled before-after study, interrupted time series study, historical control study, cohort study, case-control study, crosssectional study, and case series) evaluating patients with allergic rhinitis. The databases MEDLINE/PubMed, Scopus, Web of Science, Cochrane Library, Redalyc, BVS Collection, and, due to the number of results obtained, Hinari were included. Based on this review, the conclusion is that the combinations of secondgeneration antihistamines with leukotriene antagonists and, in particular, the fixed combination of fexofenadine-montelukast are effective, safe and promote treatment adherence. In the long term, they also help achieve therapeutic goals.
Assuntos
Humanos , Segurança , Eficácia , Terapia Combinada , Antagonistas de Leucotrienos , Rinite Alérgica , Antagonistas dos Receptores Histamínicos , Pacientes , Terapêutica , MEDLINERESUMO
AIM OF THE STUDY: To examine mortality trends in children under 15 years of age due to HIV/AIDS in Mexico and describe their differences by insurance coverage. METHODS: Time series analysis of deaths from 1990-2019 through a Bayesian poisson regression model with linear splines and knots in 1994, 1997, and 2003. RESULTS: Overall, we observed a reduction in the mortality rate due to HIV from 2003 onwards, except in the group of 10-14 years. In the population covered with Social Security, mortality rates decreased in all age groups. However, in the group without Social Security or with Popular Security (subsidized system), mortality rates significantly decreased only for children below 5 years. of age. CONCLUSIONS: Health insurance through the contributory system is associated with faster and larger reductions in HIV related infant mortality. Universal access to health insurance was not sufficient to close the gap in HIV-mortality among children under 15 years of age in Mexico.
Assuntos
Síndrome da Imunodeficiência Adquirida , Transmissão Vertical de Doenças Infecciosas , Síndrome da Imunodeficiência Adquirida/epidemiologia , Teorema de Bayes , Feminino , Humanos , Lactente , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , México/epidemiologia , Previdência SocialRESUMO
The Female Sexual Function Index is one of the most common instruments used to evaluate the female sexual function. The present study aimed to analyze the test-retest reliability, internal consistency, and discriminant validity of the index in clinical samples and to determine a specific and sensitive cutoff point for the Spanish version of the Female Sexual Function Index. For that purpose, a sample consisting of 117 Colombian women was recruited to evaluate test-retest reliability, and a second sample, consisting of 185 women, was divided into diagnosis and no-diagnosis groups based on DSM-5 criteria. Results showed adequate test-retest reliability after four weeks, and satisfactory evidence of internal consistency was obtained for subscale and overall scores. The inventory was found to have an adequate criterion validity, and it confirmed the differences between diagnosis and no-diagnosis groups. The instrument's cutoff point was determined to be 26 points, with a specificity of 73.9%, a sensitivity of 87.7%, and an area under the curve of 85.9 (CI = 80.0-91.7). These results confirm that the Spanish version of the FSFI is an adequate tool for evaluating female sexual dysfunction based on DSM-5 criteria.
Assuntos
Disfunções Sexuais Fisiológicas , Disfunções Sexuais Psicogênicas , Feminino , Humanos , Psicometria , Reprodutibilidade dos Testes , Disfunções Sexuais Fisiológicas/diagnóstico , Disfunções Sexuais Psicogênicas/diagnóstico , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Dengue fever is a major public health problem in Colombia. A fever surveillance study was conducted for evaluation of the clinical, epidemiological, and molecular patterns of dengue, prior to Chikungunya and Zika epidemics. METHODS: In November 2011-February 2014, a passive facility-based surveillance was implemented in Santa Cruz Hospital, Medellin, and enrolled eligible febrile patients between 1 and 65 years-of-age. Acute and convalescent blood samples were collected 10-21 days apart and tested for dengue using IgM/IgG ELISA. RNA was extracted for serotyping using RT-PCR on acute samples and genotyping was performed by sequencing. RESULTS: Among 537 febrile patients enrolled during the study period, 29% (n = 155) were identified to be dengue-positive. Only 7% of dengue cases were hospitalized, but dengue-positive patients were 2.6 times more likely to be hospitalized, compared to non-dengue cases, based on a logistic regression. From those tested with RT-PCR (n = 173), 17 were dengue-confirmed based on PCR and/or virus isolation showing mostly DENV-3 (n = 9) and DENV-4 (n = 7) with 1 DENV-1. Genotyping results showed that: DENV-1 isolate belongs to the genotype V or American/African genotype; DENV-3 isolates belong to genotype III; and DENV-4 isolates belong to the II genotype and specifically to the IIb sub-genotype or linage. CONCLUSIONS: Our surveillance documented considerable dengue burden in Santa Cruz comuna during non-epidemic years, and genetic diversity of circulating DENV isolates, captured prior to Chikungunya epidemic in 2014 and Zika epidemic in 2015. Our study findings underscore the need for continued surveillance and monitoring of dengue and other arboviruses and serve as epidemiological and molecular evidence base for future studies to assess changes in DENV transmission in Medellin, given emerging and re-emerging arboviral diseases in the region.
Assuntos
Vírus da Dengue/genética , Vírus da Dengue/imunologia , Dengue/epidemiologia , Febre/epidemiologia , Variação Genética , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Colômbia/epidemiologia , Dengue/virologia , Vírus da Dengue/isolamento & purificação , Doenças Endêmicas , Ensaio de Imunoadsorção Enzimática , Feminino , Febre/virologia , Genótipo , Humanos , Incidência , Lactente , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Multiplex , Filogenia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Adulto JovemRESUMO
OBJECTIVE: To estimate malnutrition prevalence of preschool children at the level of municipality in Mexico, describe prevalence heterogeneity and its relationship with the Programa Nacional México Sin Hambre´s coverage. MATERIALS AND METHODS: Using the 2012 Mexican National Survey of Health and Nutrition, municipal income inequality and marginality, we applied a generalized normal model to obtain municipal distributions of nutrition status indicators from which we estimated malnutrition prevalence. RESULTS: Stunting prevalence ranged from 7.8% (95%CI: 5.9-8.9) to 64.2% (49.2-72.5), low weight prevalence ranged from 0.6% (0.005- 1.7) to 22.2% (13.5-34.9) and overweight-obesity prevalencem ranged from 2.6% (0.2-3.9) to 14.4% (11.9-27.7). A total of 275 out of 554 municipalities with stunting prevalence above 25% were covered by the Programa Nacional México Sin Hambre. CONCLUSIONS: Municipal malnutrition prevalence estimation showed wide differences within Mexico; this knowledge could assist public policy.
OBJETIVO: Estimar las prevalencias municipales de mala nutrición en población preescolar en México, y describir su variabilidad y su relación con la cobertura del Programa Nacional México Sin Hambre. MATERIAL Y MÉTODOS: A partir de datos de la Encuesta Nacional de Salud y Nutrición de 2012, la desigualdad del ingreso y marginación municipal se aplicó un modelo normal generalizado para obtener las distribuciones municipales de los indicadores de nutrición y estimar las prevalencias de mala nutrición. RESULTADOS: Las prevalencias de talla baja variaron de 7.8% (IC95%: 5.9-8.9) a 64.2% (49.2-72.5), las de bajo peso de 0.6% (0.005-1.7) a 22.2% (13.5-34.9) y de sobrepeso u obesidad de 2.6% (0.2- 3.9) a 14.4% (11.9-27.7). De los 554 municipios con prevalencias de talla baja mayor que 25%, 275 fueron cubiertos por el programa México Sin Hambre. CONCLUSIONES: La estimación de prevalencias municipales de mala nutrición evidenció grandes diferencias al interior del país, mismas que podrían asistir la política pública.
Assuntos
Transtornos do Crescimento/epidemiologia , Desnutrição/epidemiologia , Estado Nutricional , Obesidade Infantil/epidemiologia , Pré-Escolar , Cidades/epidemiologia , Feminino , Humanos , Renda , Lactente , Recém-Nascido , Masculino , México/epidemiologia , Programas Nacionais de Saúde/estatística & dados numéricos , Inquéritos Nutricionais , Prevalência , Magreza/epidemiologiaRESUMO
Resumen: Objetivo: Estimar las prevalencias municipales de mala nutrición en población preescolar en México, y describir su variabilidad y su relación con la cobertura del Programa Nacional México Sin Hambre. Material y métodos: A partir de datos de la Encuesta Nacional de Salud y Nutrición de 2012, la desigualdad del ingreso y marginación municipal se aplicó un modelo normal generalizado para obtener las distribuciones municipales de los indicadores de nutrición y estimar las prevalencias de mala nutrición. Resultados: Las prevalencias de talla baja variaron de 7.8% (IC95%: 5.9-8.9) a 64.2% (49.2-72.5), las de bajo peso de 0.6% (0.005-1.7) a 22.2% (13.5-34.9) y de sobrepeso u obesidad de 2.6% (0.2-3.9) a 14.4% (11.9-27.7). De los 554 municipios con prevalencias de talla baja mayor que 25%, 275 fueron cubiertos por el programa México Sin Hambre. Conclusiones: La estimación de prevalencias municipales de mala nutrición evidenció grandes diferencias al interior del país, mismas que podrían asistir la política pública.
Abstract: Objective: To estimate malnutrition prevalence of preschool children at the level of municipality in Mexico, describe prevalence heterogeneity and its relationship with the Programa Nacional México Sin Hambre´s coverage. Materials and methods: Using the 2012 Mexican National Survey of Health and Nutrition, municipal income inequality and marginality, we applied a generalized normal model to obtain municipal distributions of nutrition status indicators from which we estimated malnutrition prevalence. Results: Stunting prevalence ranged from 7.8% (95%CI: 5.9-8.9) to 64.2% (49.2-72.5), low weight prevalence ranged from 0.6% (0.005-1.7) to 22.2% (13.5-34.9) and overweight-obesity prevalence ranged from 2.6% (0.2-3.9) to 14.4% (11.9-27.7). A total of 275 out of 554 municipalities with stunting prevalence above 25% were covered by the Programa Nacional México Sin Hambre. Conclusions: Municipal malnutrition prevalence estimation showed wide differences within Mexico; this knowledge could assist public policy.
Assuntos
Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estado Nutricional , Desnutrição/epidemiologia , Obesidade Infantil/epidemiologia , Transtornos do Crescimento/epidemiologia , Magreza/epidemiologia , Inquéritos Nutricionais , Prevalência , Cidades/epidemiologia , Renda , México/epidemiologia , Programas Nacionais de Saúde/estatística & dados numéricosRESUMO
Abstract: Objective: To provide an overview of morbidity and mortality due to acute diarrheal disease in Mexico in order to understand its magnitude, distribution, and evolution from 2000 to 2016. Materials and methods: We carried out a longitudinal ecological study with secondary sources of information. We used data from epidemiological surveillance, health services, and vital statistics. We calculated and mapped measures of utilization of health services rates and mortality due to diarrheal diseases. Results: Diarrhea morbidity decreased by 42.1% across the period. However, emergency department attendances increased by 50.7% in the Ministry of Health. The hospitalization rate and mortality among the general population decreased by 37.6 and 39.7%, respectively, and the infant mortality rate decreased by 72.3% among children under five years of age. Chiapas and Oaxaca had the highest mortality among the states of Mexico. Conclusions: Cases of diarrhea, including rotavirus, have decreased in Mexico. However, in 2016, 3.4 per 100 000 people died due to diarrhea, which could have been avoided with health promotion.
Resumen: Objetivo: Ofrecer un panorama de la morbimortalidad por enfermedad diarreica aguda (EDA) entre 2000 y 2016 en México, para entender su magnitud, distribución y evolución. Material y métodos: Estudio ecológico longitudinal, con fuentes de información secundarias. Se analizaron datos de vigilancia epidemiológica, prestación de servicios y estadísticas vitales. Se calcularon tasas de utilización de servicios y mortalidad. Resultados: La morbilidad por EDA disminuyó 42.1% en el periodo, sin embargo, la atención por urgencias aumentó 50.7% en SS. La tasa de hospitalización descendió 37.6% y la mortalidad 39.7% en población general y 72.3% en menores de cinco años. Chiapas y Oaxaca fueron los estados con mayor tasa de mortalidad. Conclusiones: Los casos de diarrea, incluyendo los de rotavirus, han disminuido en el país. Sin embargo, en 2016 se encontró una tasa de 3.4 por 100 000 personas que mueren por EDA, lo cual podría evitarse con promoción de la salud.
Assuntos
Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Diarreia/epidemiologia , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Vigilância da População , Doença Aguda , Estudos Longitudinais , Morbidade , Conglomerados Espaço-Temporais , Diarreia/mortalidade , Serviços Médicos de Emergência/estatística & dados numéricos , Assistência Ambulatorial/estatística & dados numéricos , Hospitalização/tendências , Hospitalização/estatística & dados numéricos , México/epidemiologiaRESUMO
OBJECTIVE: To provide an overview of morbidity and mortality due to acute diarrheal disease in Mexico in order to understand its magnitude, distribution, and evolution from 2000 to 2016. MATERIALS AND METHODS: We carried out a longitudinal ecological study with secondary sources of information. We used data from epidemiological surveillance, health services, and vital statistics. We calculated and mapped measures of utilization of health services rates and mortality due to diarrheal diseases. RESULTS: Diarrhea morbidity decreased by 42.1% across the period. However, emergency department attendances increased by 50.7% in the Ministry of Health. The hospitalization rate and mortality among the general population decreased by 37.6 and 39.7%, respectively, and the infant mortality rate decreased by 72.3% among children under five years of age. Chiapas and Oaxaca had the highest mortality among the states of Mexico. CONCLUSIONS: Cases of diarrhea, including rotavirus, have decreased in Mexico. However, in 2016, 3.4 per 100 000 people died due to diarrhea, which could have been avoided with health promotion.
OBJETIVO: Ofrecer un panorama de la morbimortalidad por enfermedad diarreica aguda (EDA) entre 2000 y 2016 en México, para entender su magnitud, distribución y evolución. MATERIAL Y MÉTODOS: Estudio ecológico longitudinal, con fuentes de información secundarias. Se analizaron datos de vigilancia epidemiológica, prestación de servicios y estadísticas vitales. Se calcularon tasas de utilización de servicios y mortalidad. RESULTADOS: La morbilidad por EDA disminuyó 42.1% en el periodo, sin embargo, la atención por urgencias aumentó 50.7% en SS. La tasa de hospitalización descendió 37.6% y la mortalidad 39.7% en población general y 72.3% en menores de cinco años. Chiapas y Oaxaca fueron los estados con mayor tasa de mortalidad. CONCLUSIONES: Los casos de diarrea, incluyendo los de rotavirus, han disminuido en el país. Sin embargo, en 2016 se encontró una tasa de 3.4 por 100 000 personas que mueren por EDA, lo cual podría evitarse con promoción de la salud.
Assuntos
Diarreia/epidemiologia , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Doença Aguda , Adolescente , Adulto , Idoso , Assistência Ambulatorial/estatística & dados numéricos , Criança , Pré-Escolar , Diarreia/mortalidade , Serviços Médicos de Emergência/estatística & dados numéricos , Feminino , Hospitalização/estatística & dados numéricos , Hospitalização/tendências , Humanos , Lactente , Estudos Longitudinais , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Morbidade , Vigilância da População , Conglomerados Espaço-Temporais , Adulto JovemAssuntos
Fármacos Anti-HIV , Infecções por HIV/tratamento farmacológico , Fármacos Anti-HIV/administração & dosagem , Fármacos Anti-HIV/economia , Fármacos Anti-HIV/provisão & distribuição , Infecções por HIV/epidemiologia , Humanos , Assistência Médica/organização & administração , Assistência Médica/estatística & dados numéricos , México , Educação de Pacientes como Assunto , Vigilância da População , Avaliação de Programas e Projetos de Saúde , Previdência Social/organização & administração , Previdência Social/estatística & dados numéricosRESUMO
Resumen La depresión, la ansiedad y la ira rasgo han evidenciado ser factores asociados a un peor pronóstico de los pacientes con enfermedad cardiovascular. En el presente estudio se evaluó una muestra de 168 pacientes con cardiopatía isquémica que habían tenido un evento cardíaco en el último mes (edad media = 64 años, DT = 11; 66.7 % hombres) para contrastar la existencia del afecto negativo como factor común entre la depresión, la ansiedad y la ira rasgo. Los instrumentos utilizados fueron las escalas rasgo de los cuestionarios de depresión, ansiedad e ira de Spielberger. Como resultado, los análisis factoriales exploratorios realizados confirmaron la estructura factorial de todas escalas, y el análisis factorial confirmatorio corroboró la existencia del afecto negativo como factor de orden superior (X2 = 3.42, p > .05; CFI > .95, TLI > .95, SRMS < .05). Los resultados de este estudio señalan la importancia de considerar modelos dimensionales para el abordaje de la emoción en esta población.
Resumo A depressão-traço, a ansiedade-traço e a ira-traço mostraram evidências de que são fatores associados a um prognóstico pior dos pacientes com doença cardiovascular. No presente estudo, avaliou-se uma amostra de 168 pacientes com cardiopatia isquêmica que tinham sofrido um evento cardíaco no último mês (idade média = 64 anos, DP = 11; 66.7 % homens) para contrastar a existência do efeito negativo como fator comum entre a depressão, a ansiedade e a ira-traço. Os instrumentos utilizados foram as escalas traço dos questionários de depressão, ansiedade e ira de Spielberger. Como resultado, as análises fatoriais exploratórias realizadas confirmaram a estrutura fatorial de todas as escalas, e a análise fatorial confirmatória corroborou a existência o efeito negativo como fator de ordem superior (X2 = 3.42, p > .05; CFI > .95, TLI > .95, SRMS < .05 ). Os resultados deste estudo assinalam a importância de considerar modelos dimensionais para a abordagem da emoção nessa população.
Abstract Depression, anxiety and anger trait have been shown to be factors related to poor prognosis in patients with cardiovascular disease. A sample of 168 patients with ischemic heart disease that have had a cardiac event in the last month (age: Mean = 64 years, SD = 11; 66.7 % men) was evaluated to verify the existence of negative affect as a common factor among the previous emotions in these patients. Patients answered the Spielberger depression, anxiety and anger trait questionnaires. Exploratory factorial analyses were carried out to confirm the factorial structure of the scales. Confirmatory factor analysis confirmed the existence of negative affect as a higher order factor (X 2 = 3.42, p > .05; CFI > .95, TLI > .95, SRMS < .05). These results suggest that it is important to consider dimensional models for the treatment of emotions in this population.
Assuntos
Humanos , Masculino , Feminino , Idoso , Ansiedade , Isquemia Miocárdica , Depressão , IraAssuntos
Humanos , Infecções por HIV/tratamento farmacológico , Fármacos Anti-HIV , Fármacos Anti-HIV/administração & dosagem , Fármacos Anti-HIV/economia , Previdência Social/organização & administração , Previdência Social/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Infecções por HIV/epidemiologia , Vigilância da População , Educação de Pacientes como Assunto , Assistência Médica/organização & administração , Assistência Médica/estatística & dados numéricos , MéxicoRESUMO
OBJECTIVE: To assess the magnitude of the Mexican epidemic of Zika virus infection and the associated risk of microcephaly. METHODS: From the reported number of laboratory-confirmed symptomatic infections among pregnant women and the relevant birth rate, we estimated the number of symptomatic cases of infection that occurred in Mexico between 25 November 2015, when the first confirmed Mexican case was reported, and 20 August 2016. We used data from the birth certificates to compare mean monthly incidences of congenital microcephaly before (1 January 2010-30 November 2015) and after (1 December 2015-30 September 2017) the introduction of Zika virus, stratifying the data according to whether the mother's place of residence was at an altitude of at least 2200 m above sea level. We used Poisson interrupted time series, statistical modelling and graphical analyses. FINDINGS: Our estimated number of symptomatic cases of infection that may have occurred in the general population of Mexico between 25 November 2015 and 20 August 2016, 60 172, was 7.3-fold higher than the corresponding number of reported cases. The monthly numbers of microcephaly cases per 100 000 live births were significantly higher after the introduction of the virus than before (incidence rate ratio, IRR: 2.9; 95% confidence interval, CI: 2.3 to 3.6), especially among the babies of women living at altitudes below 2200 m (IRR: 3.4; 95% CI: 2.9 to 3.9). CONCLUSION: The Mexican epidemic appears to be much larger than indicated by estimates based solely on counts of laboratory-confirmed cases, and to be associated with significantly increased risk of microcephaly.
Assuntos
Complicações Infecciosas na Gravidez/epidemiologia , Infecção por Zika virus/epidemiologia , Zika virus , Adolescente , Adulto , Animais , Feminino , Humanos , México/epidemiologia , Microcefalia/epidemiologia , Pessoa de Meia-Idade , Mosquitos Vetores , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Adulto Jovem , Infecção por Zika virus/diagnósticoRESUMO
BACKGROUND: Dengue is an important public health problem worldwide. A vaccine has recently been licensed in some countries of Latin America and Asia. Recommendations for dengue vaccine introduction include endemicity and a high serological prevalence of dengue in the territories considering its introduction. METHODS: A community-based survey was conducted to estimate dengue seroprevalence and age-specific seroconversion rates in a community in Medellin, Colombia, using a dengue serological test (IgG indirect ELISA). Residents were selected at random and were first screened for dengue infection; they were then followed over 2.5 years. RESULTS: A total of 3684 individuals aged between 1 and 65 years participated in at least one survey. The overall dengue seroprevalence was 61%, and only 3.3% of seropositive subjects self-reported a past history of dengue. Among dengue virus (DENV)-naïve subjects with more than two visits (n=1002), the overall seroconversion rate was 8.7% (95% confidence interval 7.3-10.4) per 1000 person-months, over the study period. Overall, the mean age of DENV prevalent subjects was significantly higher than the mean age of seroconverted subjects. Specifically, DENV seropositivity over 70% was observed in participants over 21 years old. Serotype-specific plaque-reduction neutralization tests (PRNT) revealed that all four dengue serotypes were circulating, with DENV4 being most prevalent. CONCLUSIONS: These laboratory-based findings could inform dengue vaccine decisions, as they provide age-specific seroprevalence and seroconversion data, evidencing permanent and ongoing dengue transmission in the study area. This study provides evidence for the existing rates of secondary and heterotypic responses, presenting a challenge that must be addressed adequately by the new vaccine candidates.
Assuntos
Vacinas contra Dengue , Vírus da Dengue/imunologia , Dengue/epidemiologia , Soroconversão , Adolescente , Adulto , Anticorpos Antivirais , Criança , Pré-Escolar , Colômbia/epidemiologia , Dengue/virologia , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Testes de Neutralização , Prevalência , Estudos Soroepidemiológicos , Sorogrupo , Adulto JovemRESUMO
The prevalence of posttraumatic stress disorder (PTSD) in ex-combatants from illegal armed groups in Colombia has been estimated at 37.4%. This high prevalence indicates a need to explore alternative and adjunctive therapies in the treatment of PTSD. A randomized controlled trial was undertaken to evaluate the efficacy and safety of a protocol based on Satyananda Yoga® in PTSD-diagnosed reintegrating adults in Colombia. One hundred reintegrating adults (n = 50 for each of the yoga and control arms) from Bogota and Medellin participated in this study. Yoga participants engaged in a Satyananda Yoga intervention for 16 weeks while the control group continued the regular demobilization program. The Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C) was used to evaluate the effects of the applied therapy. Outcomes were assessed before entry and after the treatment. T-tests revealed a treatment effect of d = 1.15 for the yoga group and a between-groups effect size of d = .73. The difference in improvement in PCL-C scores between both groups was 18.91% (p < 0.05). The highest percentage of improvement was observed in the re-experiencing symptom cluster (23.71%; p < 0.05), with a treatment effect of d = 1.40 for the yoga group and a between-groups effect size of d = 1.15. The data suggest that Satyananda Yoga methodology is an effective therapy for reintegrating adults diagnosed with PTSD. Further research is needed in order to evaluate prolonged effects of this alternative therapy.
RESUMO
Numerosos estudios han encontrado una asociación robusta entre los síntomas depresivos o la depresión mayor y un incremento en la morbilidad y la mortalidad cardiaca posterior a un síndrome coronario agudo (SCA); sin embargo, también se ha reportado evidencia en contra. Debido a esta divergencia, la depresión aún no ha sido aceptada por la Asociación Americana del Corazón como un factor de riesgo para un mal pronóstico en pacientes con enfermedades cardiovasculares. En este artículo se aborda el tema de la depresión en pacientes que han tenido un SCA y los factores que pueden influir en la divergencia de los resultados mencionada. Se concluye que la depresión se relaciona con un peor pronóstico en estos pacientes, específicamente cuando su presencia es posterior al evento o se trata de un cuadro resistente al tratamiento. Los síntomas cognitivos y somáticos son indicadores de mal pronóstico, así como la presencia de ansiedad comórbida.
Studies have found a strong association between depressive symptoms and major depression and cardiac morbidity and mortality increased after acute coronary syndrome (ACS); however it has also been reported evidence against this association. This difference in results may explain why depression has not yet been accepted by the American Heart Association as a risk factor for poor prognosis in patients with CVD. In this article depression is discussed as a risk factor of poor prognosis in patients who have had ACS and the factors that may influence the divergence of results in the studies. Our conclusions show that depression is related with a worse prognosis in ACS patients specifically when the symptomatology occurred after the event or when it is a treatment-resistant disorder. Cognitive and somatic symptoms and also comorbid anxiety are bad prognosis indicators.
RESUMO
Introducción: El Cryptosporidium spp. (C. spp.) es uno de los principales agentes causales de diarrea enniños. En Colombia, hay pocos estudios de prevalencia en niños sanos. Objetivo: Determinar la prevalencia de C. spp. mediante ELISA en niños de Cali, Colombia. Materiales y métodos: Estudio descriptivo observacional de corte transversal en 107 niños sanos < 10 años, de la Comuna 18 de Cali, Colombia, quienes consultaron al Programa de Crecimiento y Desarrollo del Centro de Salud Lourdes. El análisis estadístico incluyó medidas de tendencia central, de dispersión y pruebas de asociación. Se incluyeron datos como edad, género, signos y síntomas, peso (P) y talla (T), y condiciones ambientales. Según las tablas de la NCHS fueron clasificados según grado de desnutrición (DNT). La identificación del C. spp., se realizó en materia fecal mediante la técnica de ELISA. Resultados: Fueron analizados 100 niños, 66% estrato 1, con edad = 4 años ± 2 meses, 50 niños, 30% en hacinamiento, 95% con agua potable, 85% con disposición de excretas, 52% con animales intradomiciliares, y 63% asisten a guardería o colegio. Ninguno de los niños C. spp. positivos, presentó síntomas. Tuvieron P = 16±6 kg y T = 97±18 cm, 40% con algún tipo de DNT. La prevalencia fue del 4% (IC 95% 0,1-7,89) sin diferencias significativas (p>0.05). Conclusiones: La prevalencia para C. spp. fue del 4% sin posibles asociaciones demográficas, ambientales o clínicas.
Introduction: Cryptosporidium spp. (C. spp.) is a major causative agents of diarrea in children. In Colombia, there are few prevalence studies in healthy children. Objective: To determine the prevalence ofC. spp. by ELISA in children of Cali, Colombia. Materials and methods: A cross-sectional observational in 107 healthy children < 10 years from the Commune 18 in Cali, Colombia, who consulted the Growth and Development Program of Centro de Salud Lourdes. Statistical analysis included measures of central tendency, dispersión and association tests. Data included age, gender,signs and symptoms, weight (W) and height (H), and environmental conditions. According to the NCHS tables were classified by degree of malnutrition (MNT). The identification of C. spp. was held in stool by ELISA. Results: 100 children were analyzed, 66% stratum 1, age = 4 years ± 2 months, 50 boys, 30% overcrowding, 95% with wáter, 85% with waste disposal, 52% with home animals, and 63% attend daycare or school. None of the children C. spp. positive had symptoms. The W were 16±6 kg and H were 97±18 cm, 40% were some form of MNT. The prevalence was 4% (95% CI 0.1 to 7,89) without significant differences (p>0.05). Conclusions: The prevalence of C. spp. was 4% without any demographic, environmental or clinics associations.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Cryptosporidium/isolamento & purificação , Cryptosporidium/classificação , Cryptosporidium/imunologia , Cryptosporidium/parasitologia , Cryptosporidium/patogenicidade , Prevalência , Infecções por Protozoários/classificação , Infecções por Protozoários/diagnóstico , Infecções por Protozoários/epidemiologia , Infecções por Protozoários/parasitologia , Infecções por Protozoários/patologiaRESUMO
La percepción de enfermedad y los estilos de afrontamiento se relacionan con la percepción de calidad de vida en la enfermedad crónica. El presente estudio tuvo como objetivo la identificación de las creencias sobre la enfermedad y las estrategias de afrontamiento predictoras de la calidad de vida relacionada con la salud en una muestra de 80 pacientes (68.6% hombres y 31.3% mujeres) asistentes al programa de rehabilitación cardiovascular de la Fundación Cardiovascular de Colombia, con sede en Bucaramanga. Para ello se aplicaron el Illness Behavior Questionnaire (IBQ), la Escala de Estrategias de Coping Modificada (EEC-M) y el Cuestionario de Calidad de Vida Relacionada con la Salud SF-36. Los resultados estadísticos evidencian la influencia del empleo de las estrategias de afrontamiento pasivas sobre la baja calidad de vida en la muestra valorada, así como de las creencias focalizadas en las limitaciones que conlleva la patología; asimismo, muestra a la religión como una estrategia protectora en el afrontamiento de la enfermedad cardiovascular.
Illness perception and coping styles are related to the perceived quality of life in chronic illness. This study aimed at identifying beliefs about illness and coping strategies as predictors of health related quality of life in a sample of 80 patients (68.6% men and 31.3% women) who were attending the cardiac rehabilitation program at the Fundación Cardiovascular de Colombia, based in Bucaramanga. In order to achieve this objective, the Illness Behavior Questionnaire (IBQ), the Coping Strategies Scale- Modified (CSS-M) and the Health Related Quality of Life Questionnaire SF-36 were administered to the participants. The statistical results show the influence of passive coping strategies and of beliefs focused on the constraints inherent to their pathology on the poor quality of life of the assessed sample. They also show religion as a protective strategy for coping with cardiovascular disease.
A percepção da doença e os estilos de enfrentá-la estão relacionados à qualidade de vida percebida em doenças crônicas. Neste estudo se identificaram as crenças sobre a doença e as estratégias predictoras da qualidade de vida relacionada à saúde em uma amostra de 80 pacientes (68,6% homens e 31,3% mulheres) participarem do programa de reabilitação cardíaca na Fundação Cardiovascular da Colômbia, com sede em Bucaramanga. Se aplicaram o Questionário de Comportamento Doença (IBQ), a Escala de Estratégias de Enfrentamento Modificada (CSE-M) e o Questionário de Qualidade de Vida Relacionada à Saúde SF-36. Os resultados estatísticos mostram a influência do uso de estratégias de enfrentamento passivo na má qualidade de vida nos valores da amostra e as crenças focadas nos constrangimentos inerentes à patologia. Também mostra a religião como uma estratégia de proteção ao lidar com a doença cardiovascular.
Assuntos
Humanos , Masculino , Feminino , Qualidade de Vida , Adaptação Psicológica , Comportamento de Doença , Reabilitação CardíacaRESUMO
El creciente interés por crear y disponer de herramientas de apoyo diagnóstico, adaptadas a lascondiciones del entorno, hace necesario llevar a cabo procedimientos de validación que cumplancon los criterios internacionales. Para el caso de la depresión, las distintas revisiones indican que haylimitaciones en los instrumentos, debidas a la confusión de medidas de intensidad y frecuencia, asícomo de síntomas característicos de esta entidad clínica.El objetivo del presente estudio es presentar las propiedades psicométricas del IDER con muestras deadolescentes y universitarios de la ciudad de Bucaramanga.Se trata de un estudio instrumental, llevado a cabo con 298 adolescentes (71.04 por ciento mujeres y 28.95 por ciento,hombres), con edades entre los 12 y los 17 años (Media: 15.05 años; DT: 1.03). La muestra deuniversitarios fue de 278 participantes (62.4 por ciento mujeres y 37.3 por ciento hombres) entre los16 y 28 años(media: 19.9 años; DT: 3.05).Los resultados permiten identificar las adecuadas propiedades psicométricas de la prueba con valoresde confiabilidad, altos, mayores para los universitarios frente a los adolescentes, evidencias de lavalidez convergente y discriminante y adecuados niveles de consistencia interna...
The growing interest in creating and using diagnostic support tools which are adapted to environmentalconditions makes it necessary to carry out some validation procedures which satisfy internationalcriteria. In the case of depression, the various reviews show that there are limitations in instruments,due to confusion in the measurements of intensity and frequency, as well as characteristic symptomsof this clinic. The purpose of this study is to present the psychometric properties of the State-Trait DepressionInventory with samples of adolescents and university students in the city of Bucaramanga.This is an instrumental study, carried out with 298 adolescents (71.04 percent female and 28.95 percent male)aged between 12 and los 17 (Average: 15.05 years; DT: 1.03). The sample of university studentsconsisted of 278 participants (62.4 percent female and 37.3 percent male) between 16 and 28. (Average: 19.9;DT: 3.05).The results permitted the identification of the suitable psychometric properties of the test with highlevels of reliability, more for the university students than for the adolescents, which gives evidence ofconvergent and discriminant validity, and sufficient levels of internal consistency...
O crescente interesse por criar e dispor de ferramentas de apoio diagnóstico adaptadas às condiçõesdo ambiente há necessário levar a cabo procedimentos de validação que cumpram com os critériosinternacionais. Para o caso da depressão as diferentes revisões indicam que há limitações nosinstrumentos devidas à confusão de medidas de intensidade e freqüência, assim como de sintomascaracterísticos desta entidade clínica. O objetivo do presente estudo é apresentar as propriedadespsicométricas o IDER com amostras de adolescentes e universitários da cidade de Bucaramanga.Tratase de um estudo instrumental, levado a cabo com 298 adolescentes (71.04 por cento mulheres e 28.95 por cento,homens) com idades entre os 12 e os 17 anos (Meia: 15.05 anos; DT: 1.03). A mostra de universitáriosfoi de 278 participantes (62.4 por cento mulheres e 37.3 por cento homens) entre os 16 e 28 anos (meia: 19.9 anos;DT: 3.05). Os resultados permitem identificar as adequadas propriedades psicométricas da prova comvalores de confiabilidade, altos, maiores para os universitários frente aos adolescentes, evidências davalidade convergente e discriminante e adequados níveis de consistência interna...
Assuntos
Adolescente , Depressão , PsicometriaRESUMO
La ansiedad y la depresión constituyen importantes problemas de salud, dadas las altas tasas de prevalencia tanto en población normal como en población clínica. El presente estudio no experimental pretende identificar el perfil cognitivo mediante el modelo de los esquemas maladaptativos tempranos presentes en estudiantes de la Universidad Pontificia Bolivariana Bucaramanga-UPB, relacionados con las puntuaciones obtenidas en ansiedad y depresión; todo con el fin de aportar a la identificación de características cognitivas que puedan ayudar en la prevención de estos trastornos. Se evaluaron 259 estudiantes de psicología de primero a séptimo semestre de la UPB mediante los cuestionarios BDI, ST/DEP, STAI y YSQ-L2. Los resultados no indican la presencia de esquemas diferenciales en función de la presencia de depresión Estado/Rasgo y de ansiedad Estado/Rasgo, lo cual podría sugerir, desde el paradigma dimensional, la presencia de cierto patrón cognitivo para un trastorno mixto de ansiedad y depresión. No obstante se sugiere realizar nuevos estudios con otras muestras, incluida población clínica.
Anxiety and depression are important health problems, because of the high prevalence rates in normal population and in clinical population. Thisnon-experimental study intends to identify the cognitive profile, throughthe early maladaptive schemes in students from the Universidad PontificiaBolivariana Bucaramanga, related with depression and anxiety scores. Thegoal is to contribute to the identification of cognitive characteristics thatcould help in the prevention of these disorders. 259 psychology students of the first seven semesters were evaluated by means from the followingquestionnaires: BDI, ST/DEP, STAI and YSQ-L2. The results dont show the presence of specific schemes as a function of the presence of State/Trait depression or State/Trait anxiety, which might suggest, through thedimensional paradigm, the presence of a cognitive pattern for an anxiety and depression mix disorder. It is suggested that further research should be carried out with other samples, including clinical population.