RESUMO
OBJECTIVE: This study analyzes the effects of the Pedernales earthquake (April 2016) on Ecuador's health care system. METHODS: A research was carried out in Chone Canton, which combined documentary, quantitative, and qualitative techniques. Epidemiological and service production information taken from official documents was analyzed systematically. In-depth interviews and surveys were conducted with health care program directors and technicians from the Health Centres of the Ministry of Public Health and the users. RESULTS: Deficiencies in the health care system were already observed in Chone Canton prior to the earthquake mainly due to the lack of doctors, nurses, and hospital beds. According to the interviewees, the health district was not prepared for an emergency like the earthquake. Some buildings fell after the earthquake, and Chone Hospital was disabled. These problems coupled with preventive action failures at the community level led to an increase in diseases after the earthquake. CONCLUSIONS: The shortage of personnel and physical infrastructure, weaknesses in primary health care in the Ecuadorian health system, the lack of preparation, and limited availability of information on health indicators were the causes of the sharp increase in pre-existing diseases in the area, and of new epidemic outbreaks after the earthquake.
Assuntos
Terremotos , Atenção à Saúde , Equador , Humanos , Saúde Pública , Pesquisa QualitativaRESUMO
During an apnea, changes in PaO2 activate peripheral chemoreceptors to increase respiratory drive. Athletes with continuous apnea, such as breath-hold divers, have shown a decrease in hypoxic ventilatory response (HVR), which could explain the long apnea times; however, this has not been studied in swimmers. We hypothesize that the long periods of voluntary apnea in swimmers is related to a decreased HVR. Therefore, we sought to determine the HVR and cardiovascular adjustments during a maximum voluntary apnea in young-trained swimmers. In fifteen trained swimmers and twenty-seven controls we studied minute ventilation (V E ), arterial saturation (SpO2), heart rate (HR), and autonomic response [through heart rate variability (HRV) analysis], during acute chemoreflex activation (five inhalations of pure N2) and maximum voluntary apnea test. In apnea tests, the maximum voluntary apnea time and the end-apnea HR were higher in swimmers than in controls (p < 0.05), as well as a higher low frequency component of HRV (p < 0.05), than controls. Swimmers showed lower HVR than controls (p < 0.01) without differences in cardiac hypoxic response (CHR). We conclude that swimmers had a reduced HVR response and greater maximal voluntary apnea duration, probably due to decreased HVR.
RESUMO
Daily glucose variability is higher in diabetic mellitus (DM) patients which has been related to the severity of the disease. However, it is unclear whether glycemic variability displays a specific pattern oscillation or if it is completely random. Thus, to determine glycemic variability pattern, we measured and analyzed continuous glucose monitoring (CGM) data, in control subjects and patients with DM type-1 (T1D). CGM data was assessed for 6 days (day: 08:00-20:00-h; and night: 20:00-08:00-h). Participants (n = 172; age = 18-80 years) were assigned to T1D (n = 144, females = 65) and Control (i.e., healthy; n = 28, females = 22) groups. Anthropometry, pharmacologic treatments, glycosylated hemoglobin (HbA1c) and years of evolution were determined. T1D females displayed a higher glycemia at 10:00-14:00-h vs. T1D males and Control females. DM patients displays mainly stationary oscillations (deterministic), with circadian rhythm characteristics. The glycemia oscillated between 2 and 6 days. The predictive model of glycemia showed that it is possible to predict hyper and hypoglycemia (R2 = 0.94 and 0.98, respectively) in DM patients independent of their etiology. Our data showed that glycemic variability had a specific oscillation pattern with circadian characteristics, with episodes of hypoglycemia and hyperglycemia at day phases, which could help therapeutic action for this population.
Assuntos
Diabetes Mellitus Tipo 1/sangue , Controle Glicêmico , Adulto , Glicemia/metabolismo , Estudos de Casos e Controles , Ritmo Circadiano , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Hiperglicemia/sangue , Hipoglicemia/sangue , Masculino , Pessoa de Meia-Idade , Modelos BiológicosRESUMO
El objetivo del presente estudio fue conocer las propiedades psicométricas del Inventario Psicológico de Ejecución Deportiva (IPED) en nadadores federados de Chile. Para ello se evaluaron 99 sujetos de los cuales 41 son damas (41,4%) y 58 son varones (58,6%). Los resultados muestran que las sub-escalas de autoconfianza, control de afrontamiento negativo, control visuo-imaginativo y nivel emocional estaban compuestas por un solo factor que explicaba entre el 37% y 42% de la varianza, en tanto, las sub-escalas de control atencional, control de afrontamiento positivo y control actitudinal estaban compuestas por dos factores que explicaban entre el 57% y 67% de la varianza total. La consistencia interna de cada sub-escala fue aceptable. Los resultados muestran que este inventario es confiable y valido en la muestra utilizada. Son necesarias futuras investigaciones en una muestra más amplia que abarque nadadores de todo el país.
The aim of the present study was to understand the psychometric properties of the Psychological Inventory of Sports Execution (IPED) in national swimmers of Chile. There were 99 subjects evaluated, of which 41 were ladies (41,4%) and 58 were males (58,6%). The results show that the sub-scales of self-confidence, negative confrontation control, visual-imaginative control and emotional level were composed by an alone factor that was explaining between 37% and 42% of the variance, while, the sub-scales of attentional control, positive confrontation control and attitudinal control were composed by them by two factors they were explaining between 57% and 67% of the total variance. The internal consistency of every sub-scale was acceptable. The results show that this inventory is reliable and valid in the used sample. Future investigations are necessary with a bigger sample that includes swimmers from the entire country.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Inventário de Personalidade , Natação , Desempenho Atlético/psicologia , Atletas/psicologia , Psicometria , Inquéritos e Questionários , Análise Fatorial , Análise de Componente PrincipalRESUMO
El objetivo del presente estudio fue conocer las propiedades psicométricas del Inventario de Estilos de Aprendizaje de Kolb y del Cuestionario de Felder-Silverman en una muestra de estudiantes de educación física de Chile. Para ello se aplicó ambos instrumentos a 141 estudiantes de dicha carrera de la Universidad Católica Silva Henríquez, siendo el 34,8% mujeres y el 65,2% hombres. Los resultados muestran que las cuatro subescalas del inventario de Kolb y las 4 subescalas del cuestionario de Felder-Silverman poseen índices adecuados de validez, sin embargo, los índices de confiabilidad obtenidos con alfa de Cronbach se ubican bajo los niveles aceptables en todas las subescalas. Se recomiendan más estudios con muestras de diversas universidades para confirmar las propiedades psicométricas de estos instrumentos en este tipo de población.
The aim of the present study was to know the psychometric properties of the learning styles inventory of Kolb and Felder-Silverman's questionnaire in a students' sample of physical education of Chile. For it both instruments were applied to 141 students of the above mentioned career of the Universidad Católica Silva Henríquez, being 34,8% ladies and 65,2 % males. The results show that four sub-scales of Kolb's inventory and 4 sub-scales of Felder-Silverman's questionnaire possess suitable indexes of validity, nevertheless, the indexes of reliability obtained with Cronbach's alpha are located under the acceptable levels in all the subscales. More studies are recommended by samples of diverse universi-ties to confirm the psychometric properties of these instruments in this type of population.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Educação Física e Treinamento , Psicometria , Estudantes , Inquéritos e Questionários , Aprendizagem , Chile , Análise Fatorial , Análise de Componente PrincipalRESUMO
Reportamos 1 caso de una patología infrecuentemente diagnosticada, en un varón de 57 años de edad, diabéticos, procedente de Iquitos, que inicia con una enfermedad de 1 mes de evolución caracterizada por tos productiva y esputo hemoptoico, fiebre, edema de miembros inferiores e ictericia de piel y mucosas, además de pérdida de 10 kilos de peso. Recibió tratamiento antibiótico diverso sin resultados favorables. Paciente mal estado general. Rx Tórax una consolidación cavitada de tercio medio de hemitórax derecho. Velocidad sedimentación 51 mm/h. glucosa 118. BK esputo (-). Cultivo de hongos negativo: Prueba de función respiratoria: severo defecto restrictivo. Rx senos paranasales: opacidad circunscrita en seno maxilar derecho. Broncofibroscopía: traquea desviada a la derecha y signos inflamatorios crónicos del lóbulo superior derecho. Biopsia transbronquial informada por patología como Mucormicosis. Tratamiento Anfotericina más cirugía. Pronóstico malo.
Assuntos
Humanos , Masculino , Adulto , Biópsia , Mucormicose/diagnóstico , Mucormicose/terapia , DiagnósticoRESUMO
La broncofibroscopa y la biopsia bronquial y/o transbronquial son herramientas útiles para el diagnóstico de enfermedades pulmonares, sin embargo existen factores que van a influier sobre el rendimiento diagnóstico. Sobre un total de 153 muestras de biopsias realizadas entre 1996 y 1999, se obtuvo un diagnóstico definitivo en 46 casos y corresponde a un 30 por ciento; 92 resultados fueron descriptivos 60 por ciento y 15 muestras fueron insuficientes 10 por ciento. Se observo la influencia del número de muestras, requiriendose como mínimo 3 muestras, así mismo el tamaño mayor de 0.2 cm. Por otro lado es importante la comunicación que debe haber entre el neumológo y el patológo en cuanto a la patología a diagnosticar y otro factor no desdeñable es el manejo adecuado de las muestras por parte del personal paramédico
Assuntos
Brônquios , PneumologiaRESUMO
Estudio prospectivo descriptivo, para determinar el comportamiento del Antígeno Prostático Específico (APE) posterior a prostatectomía retropúbica por Hiperplasia Prostática Benigna (HPB). Incluyó 7 pacientes atendidos en el Servicio de Urología del Hospital Universitario de Caracas (noviembre 1997-julio 1998). Se determinó APE total, libre y relación APE libre/total séricos preoperatorios, y en los días 7,30 y 90 postoperatorios, procesados mediante el Ensayo Monoclonal Delfia ProStatus Wallac. El APE total preoperatorio (media 12,69 ñ 7,87 ng/ml) disminuyó significativamente a un promedio de 1,19 ñ 0,98 ng/ml (90 días). El APE libre se pudo establecer relación entre el volumen del adenoma y la variación de APE total. Concluimos que el APE sérico disminuye posterior a una adenomectomía, requiriéndose evaluación a largo plazo para determinar los niveles de APE base a considerar en estos pacientes
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Prostatectomia , Antígeno Prostático Específico/biossínteseRESUMO
La duplicación vesical es una rara anomalía congénita. A continuación se reporta un caso en el cual se presentó una duplicación vesical acompañada de hipoplasia renal y útero bicorne