RESUMO

INTRODUCTION: Hispanics report higher rates of problematic alcohol use compared to non-Hispanic Whites while also reporting lower rates of alcohol treatment utilization compared to non-Hispanics. The study employs Anderson's Behavioral Model of Healthcare Utilization Model to guide the exploration of alcohol use, help-seeking and healthcare utilization. METHODS: The present qualitative study explored help-seeking and alcohol treatment utilization for Hispanic men of Mexican ethnicity. A total of 27 participants (Mage = 35.7, SD = 10.82) completed a semi-structured interview that explored the treatment experiences and underlying psychological mechanisms that shaped their help-seeking. RESULTS: Through a thematic content analysis, the following themes emerged: 1) perceiving need with subthemes of familismo, role as protector and provider, and positive face; 2) predisposing beliefs on help-seeking; and 3) treatment experiences and elements of patient satisfaction with subthemes of monetized treatment, respect, and perceiving professional stigma. CONCLUSIONS: The findings in this article may assist in improving strategies for increasing alcohol treatment utilization among men of Mexican ethnicity. By exploring beliefs, values, and experiences health researchers can develop culturally informed intervention strategies.

Assuntos

Consumo de Bebidas Alcoólicas , Americanos Mexicanos , Aceitação pelo Paciente de Cuidados de Saúde , Humanos , Masculino , Adulto , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Consumo de Bebidas Alcoólicas/etnologia , Consumo de Bebidas Alcoólicas/psicologia , Consumo de Bebidas Alcoólicas/epidemiologia , Americanos Mexicanos/psicologia , Americanos Mexicanos/estatística & dados numéricos , Pesquisa Qualitativa , Pessoa de Meia-Idade , Comportamento de Busca de Ajuda , Alcoolismo/etnologia , Alcoolismo/psicologia , Alcoolismo/terapia , Satisfação do Paciente/etnologia

RESUMO

Despite the high incidence of urogenital carcinoma (UGC) in California sea lions stranded along California, no UGC has been reported in other areas of their distribution; however, cell morphologies typical of premalignant states have been found. Risk factors for UGC include high of organochlorines and infection with a gammaherpesvirus, OtHV-1, but the importance of the bacteriome for epithelial status remains unknown. We characterized the genital bacteriome of adult female California sea lions along their distribution in the Gulf of California and examined whether the diversity and abundance of the bacteriome varied spatially, whether there were detectable differences in the bacteriome between healthy and altered epithelia, and whether the bacteriome was different in California sea lions infected with OtHV-1 or papillomavirus. We detected 2270 ASVs in the genital samples, of which 35 met the criteria for inclusion in the core bacteriome. Fusobacteriia and Clostridia were present in all samples, at high abundances, and Actinobacteria, Alphaproteobacteria, and Campylobacteria were also well-represented. Alpha diversity and abundance of the California sea lion genital bacteriome varied geographically. The abundance of bacterial ASVs varied depending on the genital epithelial status and inflammation, with differences driven by classes Fusobacteriia, Clostridia, Campylobacteria and Alphaproteobacteria. Alpha diversity and abundance were lowest in samples in which OtHV-1 was detected, and highest those with papillomavirus. Our study is the first investigation of how the bacteriome is related to epithelial status in a wild marine species prone to developing cancer.

Assuntos

Gammaherpesvirinae , Leões-Marinhos , Neoplasias Urogenitais , Animais , Feminino , Leões-Marinhos/microbiologia , Disbiose/veterinária , Neoplasias Urogenitais/epidemiologia , Bactérias

RESUMO

OBJETIVO: Evaluar el tiempo en rango de glucosa y su asociación con otras medidas del control glicémico establecidas por el consenso internacional del tiempo en rango en usuarios de vida real del sistema flash de monitorización de glucosa FreeStyle LibreTM en Chile. MÉTODOS: Se analizaron los datos provenientes de la base de datos Freestyle Libre™ entre diciembre de 2014 y enero de 2022. Las lecturas se dividieron en 10 grupos (deciles) del mismo tamaño (cada decil contenía aproximadamente 498 usuarios) en función del tiempo en rango. Para cada decil se calculó la media de determinaciones diarias, el promedio de glucosa, la HbA1c, la desviación estándar de glucosa, el coeficiente de variación de la glucosa, el tiempo en rango, el tiempo de glucosa (porcentaje) por encima de 250 mg/dL (TA250), el tiempo de glucosa (porcentaje) por encima de 180 mg/dL (TA180), el tiempo por debajo (porcentaje) de 70 mg/dL (TB70) y el tiempo por debajo (porcentaje) de 54 mg/dL (TB54). RESULTADOS: Desde diciembre de 2014 hasta enero de 2022 hubo 4984 lectores. El grupo con el mayor tiempo en rango mostró significativamente una menor glucosa promedio que el grupo con el tiempo en rango más bajo (decil 1: media 248,3 mg/dL, decil 10: media 113,2 mg/L, diferencia ­135,1 mg/dL, p<0.05). Asimismo, el mayor tiempo en rango se asoció con una menor desviación estándar (decil 1: media 93,7mg/dL, decil 10: media 26,7mg/L, diferencia: -67,0 mg/ dL, p<0,05), menor coeficiente de variación (decil 1: media 37,8%, decil 10: media 23,3%, diferencia: -14,5%, p<0,05), menor TA250 (decil 1: media 46,5%, decil 10: media 0,2%, diferencia: -46,3%, p<0.05), menor TA180 (decil 1: media 73,9%, decil 10: media 3,8%, diferencia: -70,1%, p<0.05), menor TB70 (decil 5: mediana 6,13%, decil 10: mediana 1,70%, diferencia: -4,43%, p<0.05) y menor TB54 (decil 5: mediana 1,79%, decil 10: mediana 0,12%, diferencia: -1,67%, p<0.05). El mayor tiempo en rango se asoció también significativamente con más determinaciones diarias (decil 1: media 11,4, decil 10: media 16,6, diferencia: 5,2, p<0,05). La frecuencia media de las determinaciones entre todos los lectores fue de 14,7 determinaciones diarias. CONCLUSIONES: En los pacientes con diabetes en Chile, el empleo del sistema flash de monitorización demuestra la asociación entre el mayor tiempo en rango, la reducción de la variabilidad de la glucosa y un menor riesgo de hiperglucemias e hipoglicemias y también con un mayor compromiso.

---

OBJECTIVE: To evaluate glucose time in range and its association with other metrics of glucose control established by the International Consensus on TIR amongst real-life patients using the Flash Glucose Monitoring system FreeStyle LibreTM in Chile. METHODS: Data from the Freestyle Libre™ database between December 2014 and January 2022 were analyzed. Readers were divided into 10 groups (deciles) of the same size (each decile had approximately 498 users) according to time in range. For each decile of time in range, the mean of daily scans, average glucose, estimated HbA1c, glucose standard deviation, glucose coefficient of variation, time in range, glucose time (percentage) above 250 mg/dL (TA250), and glucose time (percentage) above 180 mg/dL (TA180), and the median of glucose time (percentage) below 70 mg/dL (TB70) and glucose time (percentage) below 54 mg/dL (TB54), were calculated. RESULTS: From December 2014 to January 2022, there were 4984 readers. The group with the highest TIR showed significantly lower average glucose than the group with the lowest TIR (decile 1: mean 248.3 mg/dL, decile 10: mean 113.2 mg/L, difference: ­135.1 mg/dL, p<0.05). In addition, more time in range was associated with a lower glucose standard deviation (decile 1: mean 93.7 mg/dL, decile 10: mean 26.7 mg/L, difference: -67.0 mg/dL, p<0.05), lower glucose coefficient of variation (decile 1: mean 37.8%, decile 10: mean 23.3%, difference: -14.5%, p<0.05), lower TA250 (decile 1: mean 46.5%, decile 10: mean 0.2%, difference: -46.3%, p<0.05),lower TA180 (decile 1: mean 73.9%, decile 10: mean 3.8%, difference: -70.1%, p<0.05), lower TB70 (decile 5: median 6.13%, decile 10: median 1.70%, difference: -4.43%, p<0.05) and lower TB54 (decile 5: median 1.79%, decile 10: median 0.12%, difference: -1.67%, p<0.05). Greater TIR was also associated with significantly more daily scans (decile 1: mean 11.4, decile 10: mean 16.6, difference: 5.2, p<0.05). Mean scan frequency amongst all readers was 14.7 daily scans. CONCLUSIONS: In patients with diabetes from Chile, the use of the flash glucose monitoring system demonstrates the association between greater TIR, reduced glucose variability, and reduced risk of hyperglycemia and hypoglycemia, and also its association with greater engagement.

Assuntos

Humanos , Automonitorização da Glicemia/métodos , Diabetes Mellitus , Controle Glicêmico/métodos , Fatores de Tempo , Glicemia , Chile , Cooperação do Paciente , Líquido Extracelular , Confiabilidade dos Dados

RESUMO

Introducción. El asma es una enfermedad inflamatoria crónica con alta prevalencia en pacientes pediátricos. Existen resultados contradictorios respecto al efecto de esta enfermedad en los índices de caries dental. El objetivo del estudio fue determinar la prevalencia de caries dental en pacientes pediátricos asmáticos con medicación inhalatoria. Población y métodos. Estudio de casos y controles cuya muestra estuvo conformada por pacientes pediátricos que acudieron al Centro Médico Naval "Cirujano Mayor Santiago Távara" de diciembre de 2014 a marzo de 2015. Se dividieron en dos grupos: el primero (casos), integrado por pacientes asmáticos que utilizaban inhaladores en su tratamiento; el segundo (controles), por pacientes sanos del mismo nosocomio. Se realizó una evaluación médica para determinar tipo, tiempo y frecuencia del tratamiento y un examen oral para determinar la prevalencia de caries dental y el índice de dientes cariados, perdidos y obturados (CPOD). Resultados. Se encontró que la prevalencia de caries dental en el grupo control fue del 34,2 %, mientras, en el grupo casos, fue del 28,3 % (p = 0,094). Con respecto al índice de caries dental, el grupo control presentó CPOD de 4,73 ± 0,32, y el grupo casos, de 3,98 ± 0,31 (p = 0,08). Sin embargo, se evidenció que, a mayor tiempo de tratamiento con los inhaladores, el índice CPOD aumentaba significativamente (p = 0,04).Conclusiones. La medicación inhalatoria no incrementa la prevalencia de caries dental en pacientes pediátricos asmáticos. Sin embargo, existe una relación directa entre la duración del tratamiento y la prevalencia de caries dental

---

Introduction. Asthma is a chronic inflammatory disease that is highly prevalent among pediatric patients. The results about the effect of asthma on the rate of dental caries are contradictory. The objective of this study was to determine the prevalence of dental caries in asthma pediatric patients using inhaled drugs. Population and methods. Case-control study in a sample made up of pediatric patients who attended Centro Médico Naval "Cirujano Mayor Santiago Távara" between December 2014 and March 2015. Patients were divided into two groups: group A (cases) included asthma patients using inhalers as part of their treatment; group B (controls), healthy subjects who attended the same facility. A medical examination was done to determine the type, time, and frequency of treatment and an oral exam, to establish the prevalence of dental caries and the decayed, missing, and filled teeth (DMFT) index. Results. The prevalence of dental caries was 34.2 % in the control group and 28.3 % in the case group (p = 0.094). In relation to the rate of dental caries, the DMFT index in the control group was 4.73 ± 0.32, and 3.98 ± 0.31 in the case group (p = 0.08). However, it was evidenced that a longer duration of inhaler use led to a significantly higher DMFT index (p = 0.04).Conclusions. Inhaled drugs do not increase the prevalence of dental caries in asthma pediatric patients. However, there is a direct relationship between treatment duration and the prevalence of dental caries.

Assuntos

Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Asma/tratamento farmacológico , Suscetibilidade à Cárie Dentária , Inaladores Dosimetrados , Inaladores de Pó Seco , Broncodilatadores/administração & dosagem , Estudos de Casos e Controles , Epidemiologia Descritiva , Prevalência , Perda de Dente , Corticosteroides/administração & dosagem , Assistência Odontológica para Crianças

RESUMO

INTRODUCTION: Asthma is a chronic inflammatory disease that is highly prevalent among pediatric patients. The results about the effect of asthma on the rate of dental caries are contradictory. The objective of this study was to determine the prevalence of dental caries in asthma pediatric patients using inhaled drugs. POPULATION AND METHODS: Case-control study in a sample made up of pediatric patients who attended Centro Médico Naval "Cirujano Mayor Santiago Távara" between December 2014 and March 2015. Patients were divided into two groups: group A (cases) included asthma patients using inhalers as part of their treatment; group B (controls), healthy subjects who attended the same facility. A medical examination was done to determine the type, time, and frequency of treatment and an oral exam, to establish the prevalence of dental caries and the decayed, missing, and filled teeth (DMFT) index. RESULTS: The prevalence of dental caries was 34.2 % in the control group and 28.3 % in the case group (p = 0.094). In relation to the rate of dental caries, the DMFT index in the control group was 4.73 ± 0.32, and 3.98 ± 0.31 in the case group (p = 0.08). However, it was evidenced that a longer duration of inhaler use led to a significantly higher DMFT index (p = 0.04). CONCLUSIONS: Inhaled drugs do not increase the prevalence of dental caries in asthma pediatric patients. However, there is a direct relationship between treatment duration and the prevalence of dental caries.

---

Introducción: El asma es una enfermedad inflamatoria crónica con alta prevalencia en pacientes pediátricos. Existen resultados contradictorios respecto al efecto de esta enfermedad en los índices de caries dental. El objetivo del estudio fue determinar la prevalencia de caries dental en pacientes pediátricos asmáticos con medicación inhalatoria. Población y Métodos: Estudio de casos y controles cuya muestra estuvo conformada por pacientes pediátricos que acudieron al Centro Médico Naval "Cirujano Mayor Santiago Távara" de diciembre de 2014 a marzo de 2015. Se dividieron en dos grupos: el primero (casos), integrado por pacientes asmáticos que utilizaban inhaladores en su tratamiento; el segundo (controles), por pacientes sanos del mismo nosocomio. Se realizó una evaluación médica para determinar tipo, tiempo y frecuencia del tratamiento y un examen oral para determinar la prevalencia de caries dental y el índice de dientes cariados, perdidos y obturados (CPOD). Resultados: Se encontró que la prevalencia de caries dental en el grupo control fue del 34,2 %, mientras, en el grupo casos, fue del 28,3 % (p = 0,094). Con respecto al índice de caries dental, el grupo control presentó CPOD de 4,73 ± 0,32, y el grupo casos, de 3,98 ± 0,31 (p = 0,08). Sin embargo, se evidenció que, a mayor tiempo de tratamiento con los inhaladores, el índice CPOD aumentaba significativamente (p = 0,04). Conclusiones: La medicación inhalatoria no incrementa la prevalencia de caries dental en pacientes pediátricos asmáticos. Sin embargo, existe una relación directa entre la duración del tratamiento y la prevalencia de caries dental.

Assuntos

Antiasmáticos/administração & dosagem , Asma/tratamento farmacológico , Cárie Dentária/epidemiologia , Antiasmáticos/efeitos adversos , Asma/complicações , Estudos de Casos e Controles , Criança , Pré-Escolar , Cárie Dentária/etiologia , Feminino , Humanos , Masculino , Nebulizadores e Vaporizadores , Prevalência

RESUMO

RESUMEN: Objetivo: Evaluar la influencia de la variación en la presión de oxígeno ambiental sobre la regeneración ósea guiada en cobayos. Material y método: Treinta y dos cobayos machos de 750±50g de peso fueron asignados en 2 grupos de 16 integrantes cada uno (grupo A: trabajado a 150msnm en la ciudad de Lima y a presión de oxígeno de 157mmHg; grupo B: trabajado a 3.230msnm en la ciudad de Jauja y a presión de oxígeno de 107mmHg). En ambos grupos se indujeron defectos óseos mandibulares de 5×6mm a través de un acceso quirúrgico extraoral; a 8 cobayos de cada grupo se les recubrió el defecto con una membrana de colágeno reabsorbible de origen porcino, mas al resto de animales no. Se evaluó el conteo celular de osteoblastos y osteocitos a los 15 y 30 días postoperatoriamente. Resultados: A los 15 y a los 30 días, en los grupos trabajados en altura y en los que se aplicó la membrana, la cantidad de osteoblastos fue 71±12,1 cél/camp y 83±7,2 cél/camp respectivamente, y la de osteocitos fue 34,5±6,6 cél/camp y 25±7,6 respectivamente; siendo estos grupos, en todas las comparaciones, los que tuvieron mayor cantidad de células óseas, aunque sin ser diferencias estadísticamente significativas (p>0,05). Conclusión: Se encontró tendencia a formar mayor cantidad de células óseas en las muestras tratadas con regeneración ósea y expuestas a la altitud comparados con el nivel del mar.

---

ABSTRACT: Objective: To evaluate the influence of the variation in ambient oxygen pressure on guided bone regeneration in guinea pigs. Material and method: A total of 32 male guinea pigs weighing 750±50g were assigned into two groups of 16 (group A: studied at 150 metres above sea level in the city of Lima and oxygen pressure of 157mmHg; group B: was at 3230 meters above sea level in the city of Jauja and an oxygen pressure of 107mmHg). Bone defects of 5×6mm were induced in the jaw in both groups through extra-oral surgical access. The defect in 8 guinea pigs of each group were covered with a porcine resorbable collagen membrane, but not in the other animals. The osteoblast and osteocyte cell counts were evaluated at 15 and 30 days post-operatively. Results: At 15 and 30 days, in the groups studied at height and with the membrane applied, the osteoblast count was 71±12.1 cells/field, and 83±7.2 cells/field, respectively, and an osteocyte count of 34.5±6.6 cells/field, and 25±7.6 cells/field, respectively. These groups had a higher number of bone cells in all the comparisons, but there were no statistically significant differences (P>.05). Conclusion: There was a tendency to form a greater amount of bone cells was found in the samples treated with bone regeneration and exposed to altitude compared to those at sea level.

Assuntos

Animais , Masculino , Cobaias , Oxigênio , Regeneração Óssea/fisiologia , Hipóxia Celular , Fator 1 Induzível por Hipóxia/fisiologia , Altitude , Osteoblastos , Pressão Atmosférica , Fatores de Tempo , Regeneração Tecidual Guiada

RESUMO

An unusually high prevalence of metastatic urogenital carcinoma has been observed in free-ranging California sea lions stranded off the coast of California in the past two decades. No cases have been reported for sea lions in the relatively unpolluted Gulf of California. We investigated occurrence of genital epithelial transformation in 60 sea lions (n=57 pups and 3 adult females) from the Gulf of California and examined whether infection by a viral pathogen previously found to be associated with urogenital carcinoma accounted for such alterations. We also explored the contribution of MHC class II gene expression on transformation. Cellular alterations, such as squamous cell atypia (ASC), atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions were observed in 42% of the pups and in 67% of the adult females. Normal genital epithelium was more common in male than female pups. ASC was five times more likely to occur in older pups. Epithelial alterations were unrelated to infection by the potentially oncogenic otarine type I gammaherpesvirus (OtHV-1), but ASCUS was more common in pups with marked and severe inflammation. Expression of MHC class II DRB loci (Zaca DRB-D) by peripheral antigen-presenting leucocytes showed a slightly 'protective' effect for ASC. We propose that transformation of the California sea lion genital epithelium is relatively common in young animals, increases with age and is probably the result of infection by an unidentified pathogen. Expression of a specific MHC class II gene, suggestive of presentation of specific antigenic peptides to immune effectors, appears to lower the risk of transformation. Our study provides the first evidence that epithelial transformation of the California sea lion genital tract is relatively common, even from an early age, and raises questions regarding differences in sea lion cancer-detection and -repair success between geographical regions.

RESUMO

La coartación aórtica crítica del recién nacido es una de las cardiopatías congénitas con mayor mortalidad. Se presenta el caso de un paciente diagnosticado de coartación aortica a las dos semanas de vida, operado de coartectomía y anastomosis termino terminal. A los tres meses de edad evoluciona desfavorablemente, con deterioro hemodinámico, confirmándose una recoartación aórtica crítica, por lo que se decide realizar una aortoplastía con balón por vía percutánea, que resulta exitosa y sin complicaciones inmediatas. La aortoplastía con balón constituye una opción terapéutica aceptablemente segura y mínimamente invasiva en pacientes pediátricos con recoartación aórtica.

---

Aortic coarctation of the newborn is a congenital heart disease with increased mortality. We report the case of an aortic coarctation diagnosed at two weeks old patient, surgery was indicated, the procedure was coarctectomy with end-to-end anastomosis. At three months of age evolves unfavorably, with hemodynamic compromise, confirming critical aortic recoarctation, so it was decided to make a balloon aortoplasty percutaneously, which is successful without immediate complications. The balloon aortoplasty is an acceptably safe and minimally invasive therapeutic option in pediatric patients with aortic coarctation.

RESUMO

OBJECTIVE: To investigate the risk effects of poverty and exposure to collective violence attributed to organized crime on the mental health of children living on the United States-Mexico border. METHODS: A repeated, cross-sectional study measured risk effects by comparing scores of psychosocial and behavioral problems among children and adolescents living on the border in the United States or Mexico in 2007 and 2010. Patients living in poverty who responded once to the Pictorial Child Behavior Checklist (P+CBCL) in Spanish were randomly selected from clinics in El Paso, Texas, United States (poverty alone group), and Ciudad Juarez, Chihuahua, Mexico (poverty plus violence group). Only children of Hispanic origin (Mexican-American or Mexican) living below the poverty level and presenting at the clinic for nonemergency visits with no history of diagnosed mental, neurological, or life-threatening disease or disability were included. RESULTS: Exposure to collective violence and poverty seemed to have an additive effect on children's mental health. Children exposed to both poverty and collective violence had higher problem scores, as measured by the P+CBCL, than those exposed to poverty alone. CONCLUSIONS: It is important to consider that children and adolescents exposed to collective violence and poverty also have fewer chances to receive treatment. Untreated mental health problems predict violence, antisocial behaviors, and delinquency and affect families, communities, and individuals. It is crucial to address the mental health of children on the border to counteract the devastating effects this setting will have in the short term and the near future.

Assuntos

Proteção da Criança/psicologia , Internacionalidade , Saúde Mental , Estresse Psicológico , Violência/psicologia , Adaptação Psicológica , Adolescente , Análise de Variância , Criança , Estudos Transversais , Feminino , Disparidades nos Níveis de Saúde , Humanos , Masculino , México , Pobreza , Psicometria , Medição de Risco , Fatores de Risco , Estados Unidos

Assuntos

Comportamento Infantil , Saúde do Adolescente , Violência , Saúde Mental , Comportamento Infantil , Saúde do Adolescente , Violência , Saúde Mental , Pobreza , Crime , Saúde na Fronteira , Estados Unidos , México , Pobreza , Crime , Saúde na Fronteira , Estados Unidos , Saúde da Criança , Internacionalidade , Estresse Psicológico , Análise de Variância , Psicometria , Saúde Mental , Violência , Adaptação Psicológica , Estudos Transversais , Disparidades nos Níveis de Saúde , Medição de Risco , Fatores de Risco

RESUMO

Objetivo. Investigar los efectos del riesgo de pobreza y la exposición a la violenciacolectiva atribuida al crimen organizado sobre la salud mental de los niños que vivenen la frontera entre México y los Estados Unidos.Métodos. En este estudio transversal seriado se midieron los efectos del riesgo mediantela comparación de las puntuaciones de problemas psicosociales y conductualesen los niños y adolescentes que viven en la frontera entre México y los Estados Unidosen el 2007 y el 2010. Se seleccionó aleatoriamente a pacientes que viven en la pobrezaque habían respondido en una oportunidad anterior el Cuestionario de ComportamientoInfantil basado en Pictogramas (P+CBCL) en español a partir de consultoriosen El Paso, Texas, Estados Unidos (grupo afectado solamente por la pobreza), yCiudad Juárez, Chihuahua, México (grupo afectado por la pobreza y la violencia). Seincluyeron solamente niños de origen hispano (estadounidenses de origen mexicanoo mexicanos) que vivían en la pobreza, que consultaron por motivos que no eran urgenciasy que no presentaban antecedentes de enfermedades neurológicas, mentaleso potencialmente mortales, ni discapacidad.Resultados. La exposición a la violencia colectiva y la pobreza parecieron tenerun efecto aditivo sobre la salud mental de los niños. Los niños expuestos tanto a lapobreza como a la violencia colectiva tuvieron puntuaciones mayores de problemasconductuales y psicosociales según las mediciones del P+CBCL que aquellos expuestossolamente a la pobreza.Conclusiones. Es importante considerar que los niños y los adolescentes expuestosa la violencia colectiva y la pobreza también tienen menos oportunidades de recibirtratamiento. Los problemas de salud mental no tratados son factores predictivos de laviolencia, los comportamientos antisociales y la delincuencia y afectan a las familias,a las comunidades y a los individuos. Es crucial abordar el tema de la salud mentalde los niños en la región de la frontera a fin de contrarrestar los efectos devastadoresque esta situación ocasionará a corto plazo y en el futuro cercano.

---

Objective. To investigate the risk effects of poverty and exposure to collective violenceattributed to organized crime on the mental health of children living on the United States–Mexico border.Methods. A repeated, cross-sectional study measured risk effects by comparing scores ofpsychosocial and behavioral problems among children and adolescents living on the border inthe United States or Mexico in 2007 and 2010. Patients living in poverty who responded onceto the Pictorial Child Behavior Checklist (P+CBCL) in Spanish were randomly selected fromclinics in El Paso, Texas, United States (poverty alone group), and Ciudad Juarez, Chihuahua,Mexico (poverty plus violence group). Only children of Hispanic origin (Mexican–Americanor Mexican) living below the poverty level and presenting at the clinic for nonemergency visitswith no history of diagnosed mental, neurological, or life-threatening disease or disability wereincluded.Results. Exposure to collective violence and poverty seemed to have an additive effect onchildren’s mental health. Children exposed to both poverty and collective violence had higherproblem scores, as measured by the P+CBCL, than those exposed to poverty alone.Conclusions. It is important to consider that children and adolescents exposed to collectiveviolence and poverty also have fewer chances to receive treatment. Untreated mentalhealth problems predict violence, antisocial behaviors, and delinquency and affect families,communities, and individuals. It is crucial to address the mental health of children on the borderto counteract the devastating effects this setting will have in the short term and the near future.

Assuntos

Humanos , Masculino , Feminino , Criança , Adolescente , Proteção da Criança/psicologia , Internacionalidade , Saúde Mental , Estresse Psicológico , Violência/psicologia , Adaptação Psicológica , Análise de Variância , Estudos Transversais , Disparidades nos Níveis de Saúde , México , Pobreza , Psicometria , Medição de Risco , Fatores de Risco , Estados Unidos

RESUMO

Leprosy offers a broad spectrum of altered immunological sceneries, ranging from strong cell-mediated immune responses seen in tuberculoid leprosy (TT), through borderline leprosy (BB), to the virtual absence of T cell responses characteristic in lepromatous leprosy (LL). The exact mechanism of autoantibodies production remains unknown in leprosy and other chronic inflammatory diseases and also the contribution of these antibodies to the pathogenesis of the disease. The aim of this study is to evaluate the frequency and profiles of serum anti-cyclic citrullinated peptide antibodies (a-CCP), rheumatoid factor (RF) and its relationship with leprosy spectrum. Serum samples from 67 leprosy patients (54 LL, 5 TT and 8 BB) and 46 clinically healthy subjects (CHS) from the same endemic region were investigated. The clinical chart and questionnaire were used to obtain clinical information. Anti-cyclic citrullinated peptide antibodies (a-CCP) were measured by enzyme-linked immunosorbent assay, whereas the rheumatoid factor (RF) levels were measured by nephelometric method. The mean age of patients was 51.5 ± 13 years. Sera levels of a-CCP where higher in leprosy patients than in CHS (5.9 ± 11.6 vs. 0.3 ± 0.29) (P < 0.0001); the same pattern was found for RF sera titers without reaching statistical significance (16.8 ± 22.5 vs. 9.9 ± 3) (P = NS). We did not find a correlation between a-CCP and RF Rho =0.02786 (IC 95%) P = 0.8229. However, LL patients had higher a-CCP and RF levels than TT patients. Although an absence in correlation was observed, the serum levels of a-CCP antibodies and RF appeared to be useful in distinguishing LL from TT patients with a limited significance in detecting reactional leprosy patients.

Assuntos

Artrite Reumatoide/diagnóstico , Autoanticorpos/sangue , Hanseníase/imunologia , Peptídeos Cíclicos/imunologia , Fator Reumatoide/sangue , Adulto , Idoso , Artrite Reumatoide/sangue , Artrite Reumatoide/imunologia , Autoanticorpos/imunologia , Estudos Transversais , Feminino , Humanos , Hanseníase/sangue , Masculino , México , Pessoa de Meia-Idade , Estudos Retrospectivos , Fator Reumatoide/imunologia

RESUMO

Leprosy is a chronic infectious disease caused by Mycobacterium leprae. IL-12 participates in the immune response against M. leprae by regulating T cell differentiation into the Th1-type response. Several single nucleotide polymorphisms have been identified in the IL-12 gene such as 3'UTR 1188 A/C polymorphism, which is associated with different diseases. However, the relationship of this polymorphism with the immune response in leprosy has not been explored. In this case-control study, we evaluated 44 patients with lepromatous leprosy (LL) and 51 healthy subjects (HS). We aimed to determine the relationship between 3'UTR 1188 A/C polymorphism of IL-12 p40, mRNA expression, and soluble IL-12 concentration in LL patients and HS. Genotype frequencies were 41% A/A, 36% A/C, and 23% C/C in LL patients, and 47% A/A, 49% A/C, and 4% C/C in HS (p<0.05). LL patients had a lower mRNA expression of IL-12 p40 gene, whereas HS had a higher expression level. Soluble IL-12 p40 concentration was higher in LL patients than in HS (p<0.05). IL-12 p70 concentration did not differ between groups, and IL-12 p40 concentration was not significantly correlated with mRNA expression in either group. These data suggest that IL-12 p40 3'UTR 1188 A/C polymorphism is associated with greater susceptibility to lepromatous leprosy in patients from western Mexico, independently of IL-12 p40 and p70 expression levels.

Assuntos

Regiões 3' não Traduzidas/genética , Subunidade p40 da Interleucina-12/genética , Hanseníase Virchowiana/genética , Polimorfismo Genético , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Regulação da Expressão Gênica , Frequência do Gene , Predisposição Genética para Doença , Genótipo , Humanos , Interleucina-12/sangue , Subunidade p40 da Interleucina-12/sangue , Masculino , México , Pessoa de Meia-Idade , RNA Mensageiro/metabolismo

RESUMO

BACKGROUND: Thrombophilia is defined as an altered hemostasis that predisposes to thrombosis. It can be primary when there is a family clustering of the disease or secondary, when it is associated to an acquired risk factor. AIM: To report clinical features in a series of patients with primary thrombophilia. MATERIAL AND METHODS: Review of clinical records of patients with thrombotic episodes that lead to the suspicions of primary thrombophilia. Analysis of asymptomatic adult close relatives of these patients. RESULTS: We report 93 subjects (56 females, age range 14-77 years) with repeated episodes of thrombosis and a family history of thrombosis and 12 asymptomatic close relatives. Seventy one percent had the first thrombotic episode before the age of 40 years, 62% had more than one thrombotic episode and 37% had a family history of thrombosis. Twenty four percent had protein C deficiency, 24% had antithrombin III deficiency, 18% had resistance to activated C protein by factor V Leiden, 10% had protein S deficiency, and 10% had the G20210 mutation of prothrombin gene. Among acquired defects studied simultaneously, 30% had lupus anticoagulant and 11% had hyperhomocysteinemia. Twenty four percent of cases had more than one thrombophilic risk factor. Among asymptomatic relatives, five had factor V Leiden, four had protein C deficiency and three had the G20210 mutation of prothrombin gene. CONCLUSIONS: Thrombophilia must be suspected in young subjects with thrombotic episodes and a family history. The type of coagulation defect will determine prognosis, and the type of treatment.

Assuntos

Predisposição Genética para Doença , Trombofilia , Adolescente , Adulto , Idoso , Deficiência de Antitrombina III/genética , Ecocardiografia Doppler , Ensaio de Imunoadsorção Enzimática , Métodos Epidemiológicos , Fator V/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Deficiência de Proteína C/genética , Deficiência de Proteína S/genética , Trombofilia/diagnóstico , Trombofilia/genética

RESUMO

La hipocolesterolemia es un fenómeno frecuente en pacientes que reciben soporte nutricional parenteral. Los motivos de este hallazgo pueden ser la carencia de esta grasa en las fórmulas parenterales y a que estos pacientes frecuentemente sufren de algún grado de reacción inflamatoria sistémica debido a su padecimiento de fondo. En el presente estudio no se demostró que la hipocolesterolemia como variable única posea sensibilidad y especificidad significativa para predecir mortalidad en pacientes que reciben nutrición parenteral. Se requieren estudios posteriores para determinar si el nivel de hipocolesterolemia pueda ser usado como marcador de la magnitud de la reacción inflamatoria.

Assuntos

Colesterol , Nutrição Parenteral/mortalidade

RESUMO

El soporte nutricional es actualmente considerado como parte fundamental del tratamiento de prácticamente cualquier enfermedad que tratamos en el hospital. Esto justifica la necesidad de establecer equipos expertos para la administración de este recurso. Por esto se propone estudio que permita mostrar la cantidad de pacientes que han sido atendidos en el Hospital R.A. Calderón Guardia por el Comité de Nutrición Enteral y Parenteral durante los años 1995-2000 con nutrición parenteral. Además, se evalúa la encuesta de opinión para conocer la imagen que tienen los usuarios del papel del Comité de Nutrición Enteral y Parenteral del Hospital R.A Calderón Guardia después de 10 años de funcionamiento. Como resultados se obtuvo que fueron atendidos 726 pacientes para soporte parenteral en el lapso estudiado y fueron preparadas 10663 fórmulas. La encuesta de opinión reveló un conocimiento difuso de la existencia y educación en servicio es reconocido por los encuestados como las principales debilidades del comité.

Assuntos

Inquéritos Nutricionais , Apoio Nutricional , Distúrbios Nutricionais , Necessidades Nutricionais , Educação Alimentar e Nutricional , Ciências da Nutrição , Nutrição Enteral , Nutrição Parenteral , Programas de Nutrição , Programas de Nutrição Aplicada , Coleta de Dados , Serviço Hospitalar de Nutrição , Costa Rica

RESUMO

Patterns of production of specific cytokines are accepted as standards for T-lymphocyte subsets in diseases caused by intracellular parasites. These lymphocyte subsets (Th1 and Th2) have been associated with the different poles of the leprosy spectrum. Lepromatous leprosy (LL) onset correlates with cytokines produced by Th2 cells on the grounds of the patient's poor cellular immune response, i.e., interleukin 2 (IL-2) and gamma interferon (IFN-gamma) deficiency. On the other hand, tuberculoid leprosy (TL) has been associated with a Th1 response. Moreover, pro-inflammatory cytokines like IL-1 beta and tumor necrosis factor-alpha (TNF-alpha) play a major role in chronic inflammatory pathologies being IL-1ra and TNF-alpha soluble receptors, natural counterbalancing inhibitors. In light of this background, we decided to measure serum levels of IL-1 beta, IL-1ra, TNF-alpha and IL-6 in LL and TL patients, and we also studied the production in vitro of Th1 (IFN-gamma, IL-2), Th2 (IL-4, IL-10) and TNF-alpha cytokines. Our data showed that IL-1ra is highly elevated in sera from LL patients; there were no differences in Th2 cytokine levels and there were diminished levels in Th1 cytokines.

Assuntos

Hanseníase Virchowiana/genética , Hanseníase Virchowiana/imunologia

Assuntos

Anticorpos Monoclonais/uso terapêutico , /imunologia , /imunologia , Divisão Celular/imunologia , Fito-Hemaglutininas/farmacologia , Hanseníase Virchowiana/metabolismo , Hanseníase Virchowiana/patologia , Hanseníase Virchowiana/terapia , Interferon gama/biossíntese , Leucócitos Mononucleares/imunologia , Leucócitos Mononucleares/patologia , Linfócitos B/imunologia , Linfócitos T/imunologia

RESUMO

Lime juice killed millions of Vibrio cholerae O1, El Tor, Inaba, present on cabbage and lettuce contaminated in the laboratory. The lethal effect was evident within 5 min of exposure to lime juice. No vibrios could be recovered at dilution 1:10 using alkaline peptone water (APW) and thiosulfate-citrate-bile salts-saccharose agar (TCBS). More than 99.9 per cent of the initial inoculum was effectively destroyed. The number of vibrios killed by lime juice was 2 to 6 logarithms greater than the maximum infecting dose, and 4 to 8 logs greater than the minimum infecting dose for cholera El Tor. The time interval needed for killing was smaller than the usual waiting time for serving food in homes and restaurants. The addition of lime juice to non-acidic foods, beverages and water, is strongly recommended to prevent infection with cholera vibrios and other acid-sensitive microorganisms. This measure is particularly important for rural and slum populations in the tropics and subtropics

Assuntos

Citrus , Cólera/prevenção & controle , Microbiologia de Alimentos , Lactuca , Manipulação de Alimentos/métodos , Plantas , Vibrio cholerae