RESUMO
Introducción: La calidad de vida relacionada con la salud (CVRS) y los estados de ánimo son indicadores cruciales del bienestar en adolescentes, pero su relación con estudiantes de Antioquia, Colombia, no ha sido ampliamente estudiada. Objetivo: Determinar la CVRS y los estados de ánimo en escolares de Antioquia-Colombia. Materiales y métodos: Estudio transversal con 1957 escolares de 9 a 20 años. Se aplicaron mediciones de CVRS, ansiedad, depresión, hostilidad y alegría, actividad física, comportamiento sedentario, apoyo social de padres y nivel socioeconómico. Resultados: La calidad de vida alta (CVA) es más elevada en hombres, personas con alegría, estudiantes con apoyo de padres, activos físicamente y personas de nivel socioeconómico alto y medio. AL aumentar un año de edad, disminuye en un 15 % la CVA, y al aumentar la depresión, la ansiedad y el comportamiento sedentario disminuye la CVA. Además, los niveles de depresión y ansiedad son mayores en mujeres, estudiantes mayores, sin apoyo de los padres y personas sedentarias. Conclusiones: La CVRS se asocia con estados de ánimo, actividad física, comportamiento sedentario y apoyo de los padres; mientras que los estados de ánimo se asocian con el sexo, el apoyo de los padres, la CVS y el sedentarismo.
Introduction: Even though health-related quality of life (HRQL) and mood states are key indicators of the well-being of adolescents, their relationship has not been analyzed in students from Antioquia, Colombia. Objective: To determine HRQL and mood states in schoolchildren from Antioquia. Materials and methods: A cross-sectional study was conducted on 1,957 schoolchildren and adolescents aged between 9 and 20 years. Measurements of HRQL, anxiety, depression, hostility and happiness, physical activity, sedentary behavior, parental social support, and socioeconomic status were applied. Results: A high quality of life (HQL) was observed more frequently in male participants, students with parental support, physically active, and those belonging to medium and high socioeconomic status. HQL decreased 15% as their age increased by one year. Also, HQL was reduced when depression, anxiety, and sedentary behavior increased. Furthermore, depression and anxiety levels were higher in women, older students, as well as in those without parental control and with sedentary behavior. Conclusions: HRQL is associated with mood states, physical activity, sedentary behavior, and parental support. In contrast, mood states are related to gender, parental support, HQL, and sedentary lifestyle.
Introdução: A qualidade de vida relacionada à saúde (CVRS) e os estados de humor são indicadores cruciais de bem-estar em adolescentes, mas sua relação com estudantes de Antioquia, Colômbia, não foi amplamente estudada. Objetivo: Determinar a CVRS e os estados de humor em escolares de Antioquia-Colômbia. Materiais e métodos: Estudo transversal com 1.957 escolares de 9 a 20 anos. Foram aplicadas medidas de QVRS, ansiedade, depressão, hostilidade e felicidade, atividade física, comportamento sedentário, apoio social dos pais e nível socioeconômico. Resultados: A alta qualidade de vida (CVA) é maior em homens, pessoas com alegria, estudantes com apoio parental, fisicamente ativos e pessoas de nível socioeconômico alto e médio. À medida que a idade aumenta em um ano, diminui em 15% o CVA, e ao aumentar a depressão, a ansiedade e o comportamento sedentário aumentam, o CVA diminui. Além disso, os níveis de depressão e ansiedade são mais elevados nas mulheres, nos estudantes mais velhos, sem apoio dos pais e nas pessoas sedentárias. Conclusões: A QVRS está associada a estados de humor, atividade física, comportamento sedentário e apoio parental; enquanto os estados de humor estão associados ao sexo, apoio parental, CVS e estilo de vida sedentário.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Saúde , Emoções , Felicidade , HostilidadeRESUMO
La evaluación de la marcha en cinta caminadora puede resultar relevante para la toma de decisiones clínicas. No obstante, factores demográficos como la edad y el IMC pueden alterar la interpretación de los resultados. Nuestro objetivo fue obtener variables espacio- temporales, energéticas y costo de transporte durante la velocidad autoseleccionada en cinta caminadora para una muestra representativa de adultos uruguayos (n=28) y evaluar si diferentes rangos de edades e IMC pueden ser factores a tener en cuenta en pruebas clínicas donde se consideren dichas variables. Participaron 17 hombres y 11 mujeres (39,3 ± 14,8 años, 75,9 ± 12,5 kg, 1,74 ± 0,09 m, IMC 25,2 ± 4,06). Se realizó una reconstrucción 3D del movimiento en forma sincronizada con el consumo energético. Se obtuvieron valores de referencia y luego de agrupar los participantes según su IMC y rango de edad se compararon los datos mediante test de t (p≤0.05). Los resultados revelaron discrepancias significativas en las medidas espacio-temporales y energéticas de los adultos uruguayos al caminar en cinta con respecto a la literatura. La marcha difiere entre adultos jóvenes y de mediana edad en su velocidad autoseleccionada (p=0,03), longitud de zancada (p=0,01), trabajo mecánico externo (<0,001) y recuperación de energía mecánica (0,009), destacando la importancia de considerar la edad en evaluaciones clínicas. El IMC no influyó significativamente en estas variables. Estos hallazgos subrayan la necesidad de ajustar las interpretaciones de las pruebas clínicas de la marcha sobre cinta caminadora en adultos uruguayos de mediana edad (45 a 65 años).
Treadmill gait assessment can be relevant for clinical decision-making. However, demographic factors such as age and BMI may alter result interpretation. Our aim was to obtain spatiotemporal, energetic, and cost of transport variables during self-selected treadmill walking speed for a representative sample of Uruguayan adults (n=28) and to assess if different age ranges and BMI could be factors to consider in clinical tests involving these variables. Seventeen men and eleven women participated (39.3 ± 14.8 years, 75.9 ± 12.5 kg, 1.74 ± 0.09 m, BMI 25.2 ± 4.06). A synchronized 3D motion reconstruction was performed with energy consumption. Reference values were obtained and data were compared using t-tests (p≤0.05), after grouping participants by BMI and age range. Results revealed significant discrepancies in spatiotemporal and energetic measures of Uruguayan adults walking on the treadmill, compared to the literature. Gait differed between young and middle-aged adults in their self-selected speed (p=0.03), stride length (p=0.01), external mechanical work (p<0.001), and mechanical energy recovery (0.009), emphasizing the importance of considering age in clinical evaluations. BMI did not significantly influence these variables. These findings underscore the need to adjust interpretations of treadmill gait clinical tests in middle-aged Uruguayan adults (45 to 65 years).
A avaliação da marcha na esteira pode ser relevante para a tomada de decisões clínicas. No entanto, fatores demográficos como idade e IMC podem alterar a interpretação dos resultados. Nosso objetivo foi obter variáveis espaço-temporais, energéticas e custo de transporte durante a velocidade de caminhada autoselecionada na esteira para uma amostra representativa de adultos uruguaios (n = 28) e avaliar se diferentes faixas etárias e IMC podem ser fatores a serem considerados em testes clínicos que envolvam essas variáveis. Dezessete homens e onze mulheres participaram (39,3 ± 14,8 anos, 75,9 ± 12,5 kg, 1,74 ± 0,09 m, IMC 25,2 ± 4,06). Foi realizada uma reconstrução tridimensional do movimento sincronizada com o consumo de energia. Foram obtidos valores de referência e os dados foram comparados usando testes t (p≤0,05), após agrupar os participantes por IMC e faixa etária. Os resultados revelaram discrepâncias significativas nas medidas espaço-temporais e energéticas dos adultos uruguaios ao caminhar na esteira, em comparação com a literatura. A marcha diferiu entre adultos jovens e de meia-idade em sua velocidade autoselecionada (p=0,03), comprimento da passada (p=0,01), trabalho mecânico externo (<0,001) e recuperação de energia mecânica (0,009), destacando a importância de considerar a idade em avaliações clínicas. O IMC não influenciou significativamente essas variáveis. Esses achados destacam a necessidade de ajustar as interpretações dos testes clínicos de marcha na esteira em adultos uruguaios de meia- idade (45 a 65 anos).
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Composição Corporal/fisiologia , Caminhada/fisiologia , Teste de Esforço/estatística & dados numéricos , Índice de Massa Corporal , Distribuição por IdadeRESUMO
BACKGROUND: While traditional medicine (TM) is employed by a significant portion of the global population for managing health issues, clinical guidelines and state recommendations often overlook this practice. The aim of this study was to describe the frequency of use of TM to control 3 metabolic risk factors (MRF): hypertension, hypercholesterolemia, and hyperglycaemia; and the sociodemographic, economic, and clinical characteristics associated with the use of TM. METHODS: Cross-sectional descriptive study that analyses data obtained from a representative population survey in 2 health districts, one urban in the south of Quito and another in a forested rural area with diverse ethnic groups in Esmeraldas, Ecuador. We include 602 individuals with at least one MRF. We calculated the proportion of people reporting the regular use of TM (herbal or traditional remedy) to control their MRF and we assessed potential associations with sociodemographic, economic, and clinical characteristics with a multivariable logistic regression model. RESULTS: In two very different sociocultural contexts in Ecuador we found that use of TM to control MRF was frequent (39.4% in Esmeraldas, 31.1% in Quito), frequently in combination with CM. There is a notable percentage of people, 33.9% in Esmeraldas and 39.0% in Quito, who did not take any treatment for their MRF, and the remainder used CM alone. In both settings, an individual's education lever was significantly associated with TM use. Whereas in Quito individuals with higher education more frequently treated their MRF with TM (aOR 2.04, 95% CI 1.03-3.90), in the rural, hard-to-reach context of Esmeraldas, it was more frequent among people with no formal schooling (aOR: 3.76; 95%CI 1.59-8.88), as well as those of younger age (aOR by year: 0.97; 95% CI 0.95-0.99) and afro ethnicity (aOR: 2.13; 95%CI 1.02-4.45). CONCLUSION: Traditional medicine is used by a significant proportion of the population in Ecuador, highlighting the need for a more accessible and intercultural healthcare approach. The health system should ensure access to the necessary information and resources for the management of their metabolic risk factors.
Assuntos
Hipercolesterolemia , Hiperglicemia , Hipertensão , Medicina Tradicional , Humanos , Equador , Feminino , Masculino , Estudos Transversais , Pessoa de Meia-Idade , Adulto , Hipercolesterolemia/tratamento farmacológico , Hipercolesterolemia/epidemiologia , Prevalência , Hipertensão/tratamento farmacológico , Hiperglicemia/tratamento farmacológico , Idoso , Adulto Jovem , AdolescenteRESUMO
OBJECTIVE: To identify vulnerability factors associated with unsuccessful tuberculosis treatment outcomes between 2011 and 2021 in Manaus, Amazonas. METHOD: Ecological study using tuberculosis case notification data from the Notifiable Diseases Information System, from 2011 to 2021, of residents in Manaus. The variables refer to treatment outcomes and patient vulnerability, according to the theoretical model: individual, programmatic and social. The analysis tested the association between vulnerability and tuberculosis treatment non-success, measured by the occurrence of death, loss to follow-up or treatment default. The Odds Ratio estimate with confidence interval was obtained by logistic regression, according to a hierarchical model. RESULTS: The following factors were more likely to lead to unsuccessful tuberculosis treatment: individual vulnerability (age group 20 to 29 years and over 60 years, indigenous race, HIV+, drug use); programmatic vulnerability (not having an HIV test), social vulnerability (special population). CONCLUSION: Individual vulnerability was more strongly associated with non-success. Intervention is needed to explore the points of greatest individual vulnerability, enabling effective action to prevent unsuccessful tuberculosis treatment.
Assuntos
Falha de Tratamento , Tuberculose , Humanos , Adulto , Brasil , Masculino , Tuberculose/tratamento farmacológico , Adulto Jovem , Pessoa de Meia-Idade , Feminino , Adolescente , Populações Vulneráveis , Criança , Pré-Escolar , Lactente , Idoso , Fatores de RiscoRESUMO
AIMS: To investigate the association of CYP2C9 metabolic phenotypes with phenytoin plasma concentration ([PTH]) in neurosurgical patients from the Brazilian Public Health System. METHODS: Patients (nâ =â 170) were treated with phenytoin (300â mg/day) perioperatively as prophylaxis for postoperative seizures. Two to 10 days after surgery, a blood sample was collected for quantification of [PTH] and genotyping of CYP2C9*2 and *3 alleles. CYP2C9 metabolic phenotypes, NM (normal), IM (intermediate), and PM (poor) metabolizer, were inferred from CYP2C9 diplotypes. Linear regression modeling was applied to identify predictors of [PTH]. RESULTS: Wide (22-fold) interindividual variation in [PTH] was observed (2.2-47.5â mg/l). [PTH] associated significantly (Kruskal-Wallis Pâ <â 0.005) with CYP2C9 phenotypes and there was a significant trend (Jonckheere-Terpstra test, Pâ <â 0.0001) for [PTH] increase in the order NM < IM < PM. [PTH] was within the target therapeutic range (10-20â mg/l) in 34.7% of patients, while 39.4% and 25.9% had [PTH] below and above the range, respectively. CYP2C9 phenotypes associated significantly (chi-square Pâ =â 0.004) with the distribution of patients in [PHT] therapeutic categories and the Cramér's V test pointed to moderate magnitude of the effect of CYP2C9 phenotypes (Vâ =â 0.211). CONCLUSION: Diplotype-predicted CYP2C9 metabolic phenotypes are associated significantly with [PTH] in neurosurgical Brazilian patients receiving phenytoin for postsurgery seizure prophylaxis. [PHT] increased progressively in the phenotype order NM < IM < PM, and all PM patients had [PHT] above the target therapeutic range, consistent with the CPIC guideline 'strong' recommendation for phenytoin dosing adjustments in PMs.
Assuntos
Anticonvulsivantes , Citocromo P-450 CYP2C9 , Fenótipo , Fenitoína , Humanos , Citocromo P-450 CYP2C9/genética , Fenitoína/sangue , Fenitoína/administração & dosagem , Fenitoína/farmacocinética , Brasil , Feminino , Masculino , Adulto , Pessoa de Meia-Idade , Anticonvulsivantes/farmacocinética , Anticonvulsivantes/sangue , Anticonvulsivantes/administração & dosagem , Idoso , Convulsões/tratamento farmacológico , Convulsões/genética , Procedimentos Neurocirúrgicos/efeitos adversos , Adolescente , Genótipo , Adulto JovemRESUMO
OBJECTIVE: To estimate the prevalence of depressive symptoms in the population aged 18 to 24, according to socioeconomic and demographic aspects in Brazil, comparing its evolution between 2013 and 2019. METHODS: Cross-sectional study carried out with secondary data obtained from National Health Survey 2013 and 2019. It were included 7,823 young adulthood (aged 18 to 24) from 2013 and 8,047 from 2019. The instrument used to assess depression was the Patient Health Questionnaire-9 (PHQ-9). All estimates included population weights and complex sampling. RESULTS: The prevalence of depression almost doubled: 10.9% (95%CI 9.6-12.2) in 2019, compared to 5.6% (95%CI 4.8-6.4) in 2013, an absolute difference of 5.3% (4.5-6.0) greater. Women were the most affected in both surveys, with an increase between 2013 (8.3%; 95%CI 6.9-9.6) and 2019 (15.6%; 95%CI 13.5-17.6) higher than that of men (2013: 2.9%; 95%CI 2.0-3.8 and 2019: 6.2%; 95%CI 4.7-7.7). In both sexes, the pattern of increase was greater for the groups aged 18 to 20, not participating in religious activities, who were at the lowest levels of education and income, who lived with two or three or more people, who lived in the Northeast, Southeast, capitals and metropolitan areas of the country. CONCLUSION: There was a significant increase in the prevalence of depressive symptoms over the six years between the two surveys. However, this increase did not occur homogeneously among the characteristics analyzed, indicating population groups and locations in Brazil where the presence of these symptoms increased most in the period.
Assuntos
Depressão , Inquéritos Epidemiológicos , Fatores Socioeconômicos , Humanos , Brasil/epidemiologia , Feminino , Masculino , Adulto Jovem , Estudos Transversais , Prevalência , Adolescente , Depressão/epidemiologia , Distribuição por Sexo , Distribuição por Idade , Fatores SociodemográficosRESUMO
OBJECTIVE: To evaluate the frequency, reasons and factors associated with intentional nonadherence to drug therapy. METHODS: A population-based cross-sectional study was conducted with data from the National Survey on Access, Use and Promotion of Rational Use of Medicines (PNAUM). The questionnaire consisted of sociodemographic questions, presence of chronic diseases, medication use, self-rated health, and medication use behaviors. Data analysis included Poisson regression models adjusted for variance. RESULTS: A total of 31,573 individuals were included, most of whom were women (53.8%), with low level of education (57.7%), and self-rated good health (56.5%). Of those interviewed, 8.8% reported increasing the medication dose and 21.2% reported reducing it. The most common reason for dose reduction was the adverse effects of the medication. There were no differences in the reasons for increasing doses. Increasing or reducing doses were most commonly reported by younger people, with lower per capita income and worse self-rated health. CONCLUSION: A considerable portion of the respondents did not intentionally adhere to drug therapy. Understanding nonadherence and identifying those who practice it is crucial for creating effective strategies that promote adherence to treatment and prioritize patients' needs and perspectives.
Assuntos
Adesão à Medicação , Humanos , Feminino , Masculino , Estudos Transversais , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Adulto , Adulto Jovem , Adolescente , Idoso , Brasil , Fatores Socioeconômicos , Prevalência , Medicamentos sob Prescrição/administração & dosagemRESUMO
OBJECTIVE: This study aimed to verify the association between adherence to school meals provided by the National School Feeding Program and dietary patterns in adolescents from Brazilian public schools. METHODS: Data from the 2019 National School Health Survey were used, with a nationally representative sample of Brazilian school adolescents (n=53,477; 13-17 years old). Food consumption of healthy and unhealthy food markers was obtained from a food consumption questionnaire. Regular consumption was considered ≥5 times/week. Latent class analysis was used to identify dietary patterns whose association with adherence to school meals was evaluated by multinomial logistic regression models, with adjustment for sociodemographic and eating behavior variables. RESULTS: Three dietary patterns were identified: "unhealthy" - higher consumption of soft drinks and sweets (9.2% of adolescents); "healthy" - higher consumption of beans, vegetables, and fruits (27.1%); and "monotonous" - higher consumption of beans (63.7%). High adherence to school meals (every day) and unsatisfactory adherence (1-4 times/week) were positively associated with the healthy pattern even after adjustment for possible potential confounders (OR 1.37, 95%CI 1.23-1.52; OR 1.20, 95%CI 1.10-1.30, respectively). CONCLUSION: The results showed that the consumption of school meals offered by the National School Feeding Program can contribute to healthy eating habits among Brazilian adolescents.
Assuntos
Dieta Saudável , Comportamento Alimentar , Serviços de Alimentação , Instituições Acadêmicas , Humanos , Adolescente , Brasil , Masculino , Feminino , Instituições Acadêmicas/estatística & dados numéricos , Dieta Saudável/estatística & dados numéricos , Serviços de Alimentação/estatística & dados numéricos , Estudos Transversais , Refeições , Fatores Socioeconômicos , Padrões DietéticosRESUMO
OBJECTIVE: To identify in the literature the factors associated with the inconsistent use of conservation by the young population. METHOD: Systematic review that searched for studies in six data sources in June 2023, with no publication date or language restrictions. Materials were selected by two independent reviewers who individually screened observational studies by reading the title and abstract of the articles. The studies were assessed for methodological quality and narrative synthesis. RESULTS: Of the 15,783 publications retrieved, nine were included. It was found that anal sex, not carrying a condom, low education, shame about buying condoms, drug use, early sexual debut and difficulties in negotiating condom use were factors associated with inconsistent condom use among the young population. CONCLUSION: Multidimensional factors are associated with inconsistent condom use, permeated by sociodemographic, cultural and behavioral elements that challenge practices and policies aimed at promoting sexual and reproductive health, including the control of sexually transmitted infections.
Assuntos
Preservativos , Comportamento Sexual , Humanos , Preservativos/estatística & dados numéricos , Adolescente , Adulto Jovem , Feminino , Infecções Sexualmente Transmissíveis/prevenção & controle , Masculino , Sexo Seguro/psicologiaRESUMO
OBJECTIVES: Identify the frequency of recurrent violence in cases reported in Espírito Santo and the associated factors. METHODS: Cross-sectional study. Which included data on violence in Espírito Santo from 2011 to 2018, from the Notifiable Diseases Information System, and, Statistical analyzes were performed using the chi-square test and Poisson regression. RESULTS: 54.2% (N:14.966) of reported cases of violence are repeated, and higher prevalences were associated with female sex (PR:1.54), child (PR: 1.29) or elderly victims (PR: 1.25), the presence of disabilities/disorders (PR:1.42) and occurrence in urban/peri-urban areas (PR: 1.10). Furthermore, there is a greater frequency of injuries caused by a single aggressor (PR: 1.20), man (PR: 1.28), aged 25 or over (PR: 1.09), known to the victim (PR: 2.81) and at home (PR: 1.69). CONCLUSION: The reported cases of violence showed a high frequency of recurrence, and were associated with the studied characteristics of the victim, the aggressor and the event.
Assuntos
Recidiva , Violência , Humanos , Masculino , Estudos Transversais , Feminino , Adulto , Violência/estatística & dados numéricos , Criança , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Adolescente , Brasil/epidemiologia , Pré-Escolar , Lactente , Prevalência , Ferimentos e Lesões/epidemiologiaRESUMO
The etiology of tinea capitis changes over time, mainly due to trends in migration. We report 19 cases of tinea capitis caused by Microsporum audouinii, an uncommon agent in South America, all of them confirmed by molecular methods. All patients were male. The average age was 6.1 years. Fifteen patients were residents of Rio de Janeiro city and four were from neighboring cities. Among the patients submitted to follow-up, griseofulvin was prescribed for eight of them. Due to medication shortages, terbinafine was prescribed for five patients, needing to be switched in three cases, with a bigger total average time until clinical improvement. The study reaffirms the emergence of a new etiological agent in Rio de Janeiro, Brazil.
The etiology of tinea capitis changes over time, mainly due to migratory flows. We report 19 cases of tinea capitis caused by Microsporum audouinii, an uncommon agent in South America, all of them confirmed by molecular methods. The study reaffirms the emergence of a new etiological agent in Rio de Janeiro, Brazil.
Assuntos
Antifúngicos , Griseofulvina , Microsporum , Terbinafina , Tinha do Couro Cabeludo , Humanos , Tinha do Couro Cabeludo/microbiologia , Tinha do Couro Cabeludo/tratamento farmacológico , Tinha do Couro Cabeludo/epidemiologia , Brasil/epidemiologia , Microsporum/isolamento & purificação , Masculino , Antifúngicos/uso terapêutico , Criança , Pré-Escolar , Griseofulvina/uso terapêutico , Terbinafina/uso terapêutico , Adolescente , LactenteRESUMO
INTRODUCTION: The increase in the production of substances to enhance the quality of life, the biodiversity of the different ecosystems in Mexico, and the unique characteristics of pediatric patients, contribute to intoxications within this population. METHOD: Analytical retrospective study of admissions to pediatric emergency care due to poisoning in < 16-year-old (2016 to 2020). Included variables were age, gender, type of toxic substance, exposure characteristics, and the season of the year. Frequencies, percentages, range, average and standard deviation were obteined. In the bivariate análisis, the Chi square test was used. A p-value < 0.05 was considered statistically significant. RESULTS: Over 5 years, there were 459 cases, with a prevalence of 3.16%. No gender predominance was observed. The most common was caused by venomous animals (28.5%), followed by medication ingestion (27.6%). Only 5% of cases were suicide attempts, the rest were accidental (95%). Children up to 5 years old were more commonly by medication ingestion, hydrocarbons, or household products (p = 0.03, p = 0.0001), while the causes in older children were contact with venomous animals and ingestion of stimulants drugs (alcohol, amphetamines, cannabis, cocaine) (p = 0.0001, p = 0.006). Intoxication with quaternary ammonium herbicides was lethal in all cases. CONCLUSIONS: Children under the age of 5 are more susceptible to intoxication from common household products. Older kids tend to be more frequently a combination of stimulants drugs.
INTRODUCCIÓN: El aumento en la producción de sustancias para mejorar la calidad de vida, la biodiversidad de los diferentes ecosistemas en México, así como las características propias de los pacientes pediátricos, contribuyen a la intoxicación dentro de esta población. MÉTODO: Estudio retrospectivo analítico de los ingresos por envenenamiento en niños menores de 16 años en urgencias pediátricas (2016 a 2020). Se analizaron la edad, el sexo, el tipo de xenobiótico, las características de exposición y la estación del año. Se obtuvieron frecuencias, porcentajes, rango, promedio y desviación estándar. En el análisis bivariado se utilizó la prueba chi al cuadrado, considerando estadísticamente significativo un valor p < 0.05. RESULTADOS: En el periodo de 5 años se atendieron 459 casos, con una prevalencia del 3.16%. No se observó predominio de sexo. La intoxicación más frecuente fue por animales venenosos (28.5%), seguida de la ingesta de medicamentos (27.6%). El 95% de los casos fueron accidentales y el 5% por intento de suicidio. En los menores de 5 años, lo más frecuente fue la ingesta de medicamentos, hidrocarburos o productos de uso doméstico (p = 0.03, p = 0.0001), mientras que en los mayores de 6 años fue por contacto con animales venenosos e ingesta de drogas estimulantes (alcohol, anfetaminas, cannabis, cocaína) (p = 0.0001, p = 0.006). El 100% de los intoxicados por herbicida cuaternario de amonio fallecieron. CONCLUSIONES: Los menores de 5 años son más propensos a la intoxicación con productos que se utilizan en sus propios domicilios. En los mayores de 6 años es más frecuente la combinación de drogas estimulantes.
Assuntos
Intoxicação , Humanos , México/epidemiologia , Masculino , Feminino , Estudos Retrospectivos , Criança , Pré-Escolar , Intoxicação/epidemiologia , Adolescente , Lactente , Prevalência , Tentativa de Suicídio/estatística & dados numéricos , Estações do Ano , Emergências , Serviço Hospitalar de Emergência/estatística & dados numéricosRESUMO
INTRODUCTION: Epstein-Barr virus (EBV) infection, with a global prevalence exceeding 95%, typically manifests in children as infectious mononucleosis. However, clinical practice frequently encounters diverse atypical presentations characterized by multisystem involvement, often resulting in an unfavorable clinical course. Our objective is to describe the clinical manifestations and results of EBV infection in a tertiary pediatric hospital in Mexico. METHOD: An observational, transversal, retrospective, and descriptive study that included a systematic review of medical records (2012-2022) of patients under 18 years of age with detectable EBV particles in peripheral blood. RESULTS: The study included 26 patients with a median age of 5 years and a male predominance of 53.8%. Predominant symptoms were fever (85%) and lymphadenopathy (35%). Sixty-five percent had severe and atypical manifestations, including pneumonia and hepatic, hematologic-oncologic, and autoimmune diseases. Anemia, thrombocytopenia and leukopenia were common, with lymphocytosis in 19% of cases. The median EBV viral load was 2816 copies/mL (range: 555-355,500 copies/mL). Four deaths related to EBV infection were reported. Viral load in these cases also varied widely from 594 to 121,000 copies/mL. Supportive care was administered to 85% of patients, while others received antiviral treatment, steroids, and rituximab. CONCLUSION: Atypical manifestations were common, especially in children with multisystem involvement. EBV should be considered as a potential contributor to a diverse spectrum of clinical presentations, emphasizing the need for comprehensive evaluation and awareness in clinical diagnosis.
INTRODUCCIÓN: La infección por el virus de Epstein-Barr (VEB) tiene una prevalencia mundial superior al 95%. Se considera que en los niños se manifiesta principalmente como mononucleosis infecciosa; sin embargo, en la práctica clínica, a menudo encontramos numerosas manifestaciones atípicas con compromiso multisistémico que llevan a un curso desfavorable. Nuestro objetivo es describir las manifestaciones clínicas y los resultados de la infección por VEB en un hospital pediátrico de tercer nivel en México. MÉTODO: Estudio observacional, transversal, retrospectivo y descriptivo, en el cual se revisaron sistemáticamente los expedientes médicos de pacientes menores de 18 años con una detección positiva de partículas de VEB en sangre periférica en el periodo 2012-2022. RESULTADOS: Se incluyeron 26 pacientes con una mediana de edad de 5 años y predominio de varones (53.8%). El 65% presentaron manifestaciones graves y atípicas, incluyendo enfermedades respiratorias, hepáticas, hematooncológicas y autoinmunitarias. Los síntomas más frecuentes fueron fiebre (85%) y linfadenopatía (35%). El 54% presentaron manifestaciones atípicas, incluyendo linfohistiocitosis hemofagocítica, neumonía y neoplasia. La anemia, la trombocitopenia y la leucocitopenia fueron comunes, mientras que el 19% presentaron linfocitosis. La media de la carga viral fue de 2816 copias/ml (555-355,500). Se informaron cuatro muertes atribuidas a la infección por VEB, con valores de carga viral de 594 a 121,000 copias/ml. El 85% de los pacientes recibieron solo tratamiento sintomático, mientras que otros recibieron antivirales, esteroides y rituximab. CONCLUSIÓN: Las manifestaciones atípicas se observaron comúnmente, en especial en niños con compromiso multisistémico. El VEB debe considerarse como un potencial factor contribuyente en el diagnóstico de una amplia gama de manifestaciones clínicas.
Assuntos
Infecções por Vírus Epstein-Barr , Centros de Atenção Terciária , Humanos , México/epidemiologia , Masculino , Feminino , Infecções por Vírus Epstein-Barr/epidemiologia , Infecções por Vírus Epstein-Barr/diagnóstico , Criança , Estudos Retrospectivos , Pré-Escolar , Adolescente , Lactente , Estudos Transversais , Carga Viral , Hospitalização/estatística & dados numéricos , Herpesvirus Humano 4/isolamento & purificação , Herpesvirus Humano 4/genética , Febre/virologia , Linfadenopatia/virologiaRESUMO
BACKGROUND: Intramuscular vascular malformations (IVMs) are rare developmental congenital structural abnormalities. Their clinical diagnosis is difficult, and imaging studies are essential to determine the type and extent of vessels involved. Treatment can be challenging and must be managed by a multidisciplinary team. METHODS: A descriptive, observational, retrospective, longitudinal study of clinical records of patients diagnosed with IVMs who were evaluated at the vascular anomalies clinic from January 2011 to December 2021 was performed. Demographic, clinical, imaging, diagnosis, treatment, and response data were collected. RESULTS: Seven patients (five females and two males) with a mean age of 13.66 years (standard deviation 5.82 years) were included in the study. In all cases, the clinical diagnosis was venous and lymphatic malformation. The radiological findings were dilated and tortuous vascular structures or multilobulated lesions with septa inside, with or without vascular flow; these findings allowed diagnosis in all cases. Treatment modalities included sclerotherapy in five patients, surgical resection in two, medical treatment with sirolimus in three, and surveillance in one. Subsequent clinical evolution was favorable in all patients, with decreased pain in six (partial in four and total in two) and size reduction in one patient. CONCLUSION: IVMs in our pediatric population most frequently affect the lower extremities. The main symptoms and signs were pain on exertion and volume increase. Treatment can be challenging given the extension and depth of the malformations, so a combination of therapeutic modalities may be necessary to obtain the best outcome.
INTRODUCCIÓN: Las malformaciones vasculares intramusculares (MVI) son anomalías estructurales congénitas del desarrollo raras. Su diagnóstico clínico es difícil y los estudios de imagen son fundamentales para determinar su tipo y extensión. Su tratamiento puede ser un desafío y debe ser dirigido por un equipo multidisciplinario. MÉTODOS: Se realizó un estudio descriptivo, observacional, retrospectivo y longitudinal de los expedientes clínicos de pacientes con diagnóstico de MVI que fueron valorados en la Clínica de Anomalías Vasculares desde enero 2011 a diciembre 2021. Se recolectaron datos demográficos, clínicos, imagenológicos, diagnóstico, tratamiento y respuesta al mismo. RESULTADOS: Se incluyeron 7 pacientes (5 mujeres y 2 hombres) con una edad media de 13.66 años (DE 5.82 años). En todos, el diagnóstico clínico fue malformación venosa y/o linfática. Los hallazgos radiológicos mediante ultrasonido y/o resonancia magnética nuclear fueron estructuras vasculares dilatadas y tortuosas o lesiones multilobuladas con septos en su interior, con o sin flujo vascular; y en todos los casos permitieron hacer el diagnóstico. El tratamiento fue escleroterapia en 5 pacientes, resección quirúrgica en 2, tratamiento con Sirolimus en 3 y vigilancia en 1. La evolución clínica posterior fue favorable en todos, con disminución del dolor en 6 (parcial en 4 y total en 2) y reducción del tamaño en 1 paciente. CONCLUSIÓN: Las MVI en nuestra población pediátrica, afectan con mayor frecuencia las extremidades inferiores. Los principales síntomas fueron dolor de esfuerzo y aumento de volumen. Su tratamiento puede ser un reto dada su extensión y profundidad, por lo que la combinación de modalidades terapéuticas puede ser necesarias para obtener el mejor desenlace.
Assuntos
Escleroterapia , Malformações Vasculares , Humanos , Estudos Retrospectivos , Feminino , Masculino , Criança , Adolescente , Malformações Vasculares/terapia , Malformações Vasculares/diagnóstico , Estudos Longitudinais , Escleroterapia/métodos , Sirolimo/administração & dosagem , Anormalidades Linfáticas/terapia , Anormalidades Linfáticas/diagnóstico , Anormalidades Linfáticas/patologia , Pré-Escolar , Músculo Esquelético/irrigação sanguínea , Resultado do TratamentoRESUMO
BACKGROUND: Pilomatricoma is a common benign adnexal neoplasm in children. There are few epidemiological studies on this subject, with most relying solely on descriptive statistics. METHODS: A cross-sectional study conducted in two tertiary hospitals in Mexico City from January 2017 to December 2023. Clinical and electronic records of patients with histopathological diagnosis of pilomatricoma, both sexes, under 18 years old, with any type of present comorbidity were selected. Records of patients with diagnosis not confirmed by histopathology or incomplete records were not included in the study. RESULTS: Fifty-two cases with pilomatrixoma were included in the study, showing a total of 74 lesions. About 23.1% of the cases had multiple pilomatrixomas. 40.4% of the cases experienced pain; this symptom was associated with lesions > 15 mm in diameter and with multiple pilomatrixomas. Risk factors for lesions > 15 mm included age under 8 years, positive tent sign, tumor evolution longer than a year, and a non-classical clinical variety. The head and neck were the most commonly affected areas. The left upper extremity presented larger pilomatrixomas (median 18.5 mm) and occurred more frequently in adolescent patients (mean age 12.1 years) compared to other body areas. CONCLUSIONS: Pilomatrixoma in children shows clinical diversity, with specific findings based on size, number, and anatomical location.
INTRODUCCIÓN: El pilomatricoma es una neoplasia anexial benigna frecuente en la infancia. Hay muy pocos estudios epidemiológicos al respecto y la mayoría solo han utilizado estadística descriptiva. MÉTODOS: Estudio transversal realizado en dos hospitales de concentración de la Ciudad de México de enero de 2017 a diciembre de 2023. Se seleccionaron expedientes clínicos y electrónicos de pacientes con diagnóstico histopatológico de pilomatricoma, ambos sexos, menores de 18 años, con cualquier tipo de comorbilidad presente. No se incluyeron los expedientes de pacientes con diagnóstico no confirmado por histopatología o expediente incompleto. RESULTADOS: Se incluyeron 52 casos con diagnóstico de pilomatricoma que mostraron un total de 74 lesiones. El 23.1% de los pacientes tuvieron pilomatricomas múltiples. El 40.4% experimentaron dolor; este signo se asoció con lesiones de diámetro superior a 15 mm y pilomatricomas múltiples. La edad menor de 8 años, el signo de la tienda de campaña positivo, un tiempo de evolución mayor de 1 año y una variedad clínica no clásica son factores de riesgo asociados con las lesiones mayores de 15 mm. La cabeza y el cuello fueron las áreas más comúnmente afectadas por estos tumores. La extremidad superior izquierda presento pilomatricomas de mayor tamaño (mediana 18.5 mm), y ocurrieron más en pacientes adolescentes (media 12.1 años), en comparación con otras áreas del cuerpo. CONCLUSIONES: El pilomatricoma en niños muestra diversidad clínica. Presenta hallazgos y asociaciones específicas según el tamaño, el número y la ubicación anatómica.
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Doenças do Cabelo , Pilomatrixoma , Neoplasias Cutâneas , Humanos , Pilomatrixoma/patologia , Pilomatrixoma/epidemiologia , Pilomatrixoma/diagnóstico , México/epidemiologia , Masculino , Criança , Feminino , Estudos Transversais , Adolescente , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/epidemiologia , Pré-Escolar , Doenças do Cabelo/epidemiologia , Doenças do Cabelo/patologia , Fatores de Risco , Lactente , Dor/epidemiologia , Dor/etiologiaRESUMO
Rats are major reservoirs for pathogenic Leptospira, the bacteria causing leptospirosis, particularly in urban informal settlements. However, the impact of variation in rat abundance and pathogen shedding rates on spillover transmission to humans remains unclear. This study aimed to investigate how spatial variation in reservoir abundance and pathogen pressure affect Leptospira spillover transmission to humans in a Brazilian urban informal settlement. A longitudinal eco-epidemiological study was conducted from 2013 to 2014 to characterize the spatial distribution of rat abundance and Leptospira shedding rates in rats and determine the association with human infection risk in a cohort of 2,206 community residents. Tracking plates and live-trapping were used to measure rat abundance and quantify rat shedding status and load. In parallel, four sequential biannual serosurveys were used to identify human Leptospira infections. To evaluate the role of shedding on human risk, we built three statistical models for: (1) the relative abundance of rats, (2) the shedding rate by individual rats, and (3) human Leptospira infection, in which "total shedding", obtained by multiplying the predictions from those two models, was used as a risk factor. We found that Leptospira shedding was associated with older and sexually mature rats and varied spatially and temporally-higher at valley bottoms and with seasonal rainfall (December to March). The point estimate for "total shedding" by rat populations was positive, i.e., Leptospira infection risk increased with total shedding, but the association was not significant [odds ratio (OR) = 1.1; 95% confidence interval (CI): 0.9, 1.4]. This positive trend was mainly driven by rat abundance, rather than individual rat shedding (OR = 1.8; 95% CI: 0.6, 5.4 vs. OR = 1.0; 95% CI: 0.7, 1.4]. Infection risk was higher in areas with more vegetative land cover (OR = 2.4; 95% CI: 1.2, 4.8), and when floodwater entered the house (OR = 2.4; 95% CI: 1.6, 3.4). Our findings indicate that environmental and hydrological factors play a more significant role in Leptospira spillover than rat associated factors. Furthermore, we developed a novel approach combining several models to elucidate complex links between animal reservoir abundance, pathogen shedding and environmental factors on zoonotic spillover in humans that can be extended to other environmentally transmitted diseases.
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Reservatórios de Doenças , Leptospira , Leptospirose , Zoonoses , Animais , Humanos , Leptospirose/epidemiologia , Leptospirose/microbiologia , Leptospirose/transmissão , Leptospira/isolamento & purificação , Reservatórios de Doenças/microbiologia , Brasil/epidemiologia , Ratos , Zoonoses/microbiologia , Masculino , Feminino , Adulto , Derrame de Bactérias , Estudos Longitudinais , Pessoa de Meia-Idade , Fatores de Risco , População Urbana/estatística & dados numéricos , Adolescente , Adulto JovemRESUMO
Influenza circulation was significantly affected in 2020-21 by the COVID-19 pandemic. During this time, few influenza cases were recorded. However, in the summer of 2021-22, an increase in atypical influenza cases was observed, leading to the resurgence of influenza in the southernmost state of Brazil, Rio Grande do Sul (RS). The present study aimed to identify the circulation of FLUAV, FLUBV and SARS-CoV-2 and characterize the influenza genomes in respiratory samples using high-throughput sequencing technology (HTS). Respiratory samples (n = 694) from patients in RS were selected between July 2021 and August 2022. The samples were typed using reverse transcriptase real-time PCR (RT-qPCR) and showed 32% (223/694) of the samples to be positive for SARS-CoV-2, 7% for FLUAV (H3) (49/694). FLUBV was not detected. RT-qPCR data also resulted in FLUAV and SARS-CoV-2 co-infections in 1.7% (4/223) of samples tested. Whole genome sequencing of FLUAV produced 15 complete genomes of the H3N2 subtype, phylogenetically classified in the 3C.2a1b.2a.2a.3 subclade and revealing the dominance of viruses in the southern region of Brazil. Mutation analysis identified 72 amino acid substitutions in all genes, highlighting ongoing genetic evolution with potential implications for vaccine effectiveness, viral fitness, and pathogenicity. This study underscores limitations in current surveillance systems, advocating for comprehensive data inclusion to enhance understanding of influenza epidemiology in southern Brazil. These findings contribute valuable insights to inform more effective public health responses and underscore the critical need for continuous genomic surveillance.
Assuntos
COVID-19 , Genoma Viral , Influenza Humana , Filogenia , SARS-CoV-2 , Humanos , Brasil/epidemiologia , COVID-19/epidemiologia , COVID-19/virologia , SARS-CoV-2/genética , SARS-CoV-2/classificação , SARS-CoV-2/isolamento & purificação , Influenza Humana/epidemiologia , Influenza Humana/virologia , Pessoa de Meia-Idade , Adulto , Feminino , Genoma Viral/genética , Masculino , Adulto Jovem , Idoso , Adolescente , Surtos de Doenças , Sequenciamento Completo do Genoma , Criança , Pré-Escolar , Lactente , Coinfecção/epidemiologia , Coinfecção/virologia , Sequenciamento de Nucleotídeos em Larga Escala , Idoso de 80 Anos ou mais , GenômicaRESUMO
This cross-sectional study examines treatment received for falls from a section of the US-Mexico border wall with a focus on emergency medical services activation and type of treatment.
Assuntos
Acidentes por Quedas , Humanos , Masculino , México/epidemiologia , Acidentes por Quedas/estatística & dados numéricos , Feminino , Adulto , Pessoa de Meia-Idade , Serviços Médicos de Emergência/estatística & dados numéricos , Estados Unidos/epidemiologia , Idoso , Adolescente , Adulto Jovem , Ferimentos e Lesões/epidemiologiaRESUMO
BACKGROUND: This study aims to verify the relationship between screen and sleep time, body mass index (BMI) and immunological factors with telomere length according to leisure-time physical activity (PA) in children and adolescents. METHODS: A cross-sectional study involving a sample of 476 schoolchildren of both sexes, aged seven to 17 years, from a community in southern Brazil. Behavioral variables (PA, sleep time, and screen time) were self-reported using a questionnaire. PA was classified as inactive and any PA (doing some physical activity). The associations of screen time, sleep time, BMI, and immunologic factors with telomere length were tested using multiple linear regression models, with the sample divided according to the schoolchildren's leisure-time physical activity practices. RESULTS: An inverse association between BMI and telomere length (ß: -0.239; 95% CI: -0.468; -0.010) and a direct association of leukocytes (ß: 0.151; 95% CI: 0.029; 0.278) and neutrophils (ß: 0.131; 95% CI: 0.008; 0.254) with telomeres were found in the inactive students. No association was found between screen time and sleep time and telomeres. No association was found among students who engaged in any PA. CONCLUSION: The associations between telomeres, BMI, and immunologic factors were found only in inactive students. These results suggest that the association between BMI and immunological factors and telomere length may be influenced by physical activity.
Assuntos
Índice de Massa Corporal , Exercício Físico , Sono , Telômero , Humanos , Masculino , Feminino , Estudos Transversais , Criança , Adolescente , Brasil , Tempo de Tela , Atividades de Lazer , Fatores Imunológicos , Modelos LinearesRESUMO
INTRODUCTION: Odontogenic keratocyst (OKC) and unicystic ameloblastoma (UA) are lesions of odontogenic origin. Both lesions are morphologically cysts. However, they are classified as developmental cysts and epithelial odontogenic tumours, respectively. Cyclin D1 (CCD1) dysregulation is associated with oncogenic activity and malignancies, while tumour protein p63 (p63) alterations are associated with tumourigenesis. AIM: To evaluate and compare the protein expression of CCD1 and p63 in sporadic OKC (OKC-sp), syndromic OKC (OKC-sy), and UA. MATERIAL AND METHODS: 45 cases from the Anatomical Pathology Department, Faculty of Dentistry, University of Chile were analysed and divided into groups: OKC-sp (n=15), OKC-sy (n=15) and UA (n=15), the latter categorised into intraluminal and/or luminal (n=7) and mural (n=8). Immunohistochemical staining for CCD1 and p63 proteins was performed from paraffin-embedded sections. Statistical analysis included the Shapiro-Wilk test, one-way ANOVA with Tukey's multiple comparisons, and Spearman's correlation coefficient (p<0.05). RESULTS: There was an involvement mainly in women in the mandibular area, and a high frequency of jaw expansion, especially in the mural UA. P63 protein expression was higher than CCD1 in all cystic lesions, particularly in mural UA (p<0.001). No correlation was found between CCD1 and p63 expression. CONCLUSION: P63 may serve as a valuable marker for evaluating cell proliferative activity in odontogenic cystic lesions, providing insights into the aggressive behaviour of mural UA.