ABSTRACT
ABSTRACT Objective. To estimate the point prevalence and likely ranges of pregnancy-induced hypertension, pre-eclampsia, gestational diabetes, low birth weight and preterm delivery in Latin America and the Caribbean, and evaluate the heterogeneity of the estimates. Methods. We conducted a systematic review and meta-analysis of observational studies reporting the prevalence of maternal and perinatal adverse outcomes in populations in Latin American and the Caribbean published between 2000 and 2019 in English, Spanish, or Portuguese. We searched PubMed, Embase, and LILACS. We estimated the point prevalence and evaluated overall heterogeneity and, in sub-group analyses, heterogeneity by study design and level of bias. Results. Of 1087 records retrieved, 50 articles were included in the review: two on hypertensive disorders of pregnancy, 14 on pre-eclampsia, six on gestational diabetes, nine on low birth weight and 19 on preterm birth. No meta-analysis for hypertensive disorders of pregnancy could be done because of the small number of studies. Point prevalence estimates and 95% confidence intervals (CIs) for pre-eclampsia, gestational diabetes, low birth weight, and preterm birth were: 6.6% (95% CI: 4.9%, 8.6%), 8.5% (95% CI: 3.9%, 14.7%), 8.5% (95% CI: 7.2%, 9.8%), and 10.0% (95% CI: 8.0%, 12.0%), respectively. We observed substantial heterogeneity overall and by study design. No major differences in estimates were observed by level of bias. Conclusions. The results of this study provide updated estimates of some of the most prevalent adverse pregnancy and perinatal outcomes in Latin America and the Caribbean. They highlight that important heterogeneity exists in prevalence estimates, which may reflect the diversity of populations in the region.
RESUMEN Objetivo. Estimar la prevalencia puntual y los rangos probables de hipertensión provocada por embarazo, preeclampsia, diabetes gestacional, peso bajo al nacer y parto prematuro en América Latina y el Caribe, y evaluar la heterogeneidad de las estimaciones. Métodos. Se llevó a cabo una revisión sistemática y metanálisis de los estudios de observación que notificaron la prevalencia de resultados adversos perinatales y maternos en poblaciones de América Latina y el Caribe, publicados entre los años 2000 y 2019 en inglés, español o portugués. Se realizaron búsquedas en PubMed, Embase y LILACS. Se estimó la prevalencia puntual y se evaluó la heterogeneidad general y, en los análisis de subgrupos, la heterogeneidad según el diseño del estudio y nivel de sesgo. Resultados. De 1 087 registros recuperados, se incluyeron 50 artículos en la revisión: 2 sobre los trastornos hipertensivos en el embarazo, 14 sobre preeclampsia, 6 sobre la diabetes gestacional, 9 sobre peso bajo al nacer y 19 sobre parto prematuro. No se pudo realizar ningún metanálisis de los trastornos hipertensivos del embarazo debido al número reducido de estudios. Las estimaciones de prevalencia puntual y los intervalos de confianza (IC) del 95% para la preeclampsia, la diabetes gestacional, el peso bajo al nacer y el parto prematuro fueron: 6,6% (IC de 95%: 4,9%, 8,6%), 8,5% (IC de 95%: 3,9%, 14,7%), 8,5% (IC de 95%: 7,2%, 9,8%) y 10,0% (IC de 95%: 8,0%, 12,0%), respectivamente. Se observó una heterogeneidad significativa en general, así como según el diseño del estudio. No se advirtieron grandes diferencias en las estimaciones según el nivel del sesgo. Conclusiones. Los resultados de este estudio ofrecen cálculos actualizados de algunos de los resultados adversos perinatales y del embarazo con mayor prevalencia en América Latina y el Caribe. Estos resultados ponen de manifiesto que existe una gran heterogeneidad en las estimaciones de prevalencia, que podría reflejar la diversidad de la población de la región.
RESUMO Objetivo. Estimar a prevalência pontual e os intervalos prováveis de hipertensão induzida pela gravidez, pré-eclâmpsia, diabetes gestacional, baixo peso ao nascer e parto prematuro na América Latina e no Caribe e avaliar a heterogeneidade das estimativas. Métodos. Realizou-se uma revisão sistemática com metanálise de estudos observacionais que relatam a prevalência de desfechos maternos e perinatais adversos em populações da América Latina e do Caribe, publicados entre 2000 e 2019 em inglês, espanhol ou português. Os bancos de dados PubMed, Embase e LILACS foram pesquisados. Estimou-se a prevalência pontual e avaliou-se a heterogeneidade geral, bem como, em análises de subgrupo, a heterogeneidade por delineamento do estudo e o nível de viés. Resultados. De 1 087 registros encontrados, 50 artigos foram incluídos na revisão: dois sobre distúrbios hipertensivos da gravidez, 14 sobre pré-eclâmpsia, seis sobre diabetes gestacional, nove sobre baixo peso ao nascer e 19 sobre parto prematuro. Não foi possível realizar metanálise para distúrbios hipertensivos da gravidez devido ao pequeno número de estudos. As estimativas de prevalência pontual e intervalos de confiança de 95% (IC) para pré-eclâmpsia, diabetes gestacional, baixo peso ao nascer e parto prematuro foram: 6,6%; (IC 95%: 4,9-8,6%), 8,5% (IC 95%: 3,9-14,7%), 8,5% (IC 95%: 7,2-9,8%) e 10,0% (IC 95%: 8,0-12,0%), respectivamente. Observou-se heterogeneidade considerável, tanto em geral como por delineamento de estudo. Não foram observadas diferenças importantes nas estimativas por nível de viés. Conclusões. Os resultados deste estudo fornecem estimativas atualizadas de alguns dos desfechos gestacionais e perinatais adversos mais prevalentes na América Latina e no Caribe. Destacam a existência de uma importante heterogeneidade nas estimativas de prevalência, o que pode refletir a diversidade das populações da região.
ABSTRACT
Objective: to describe and classify the main cultural practices used to relieve orodental pain in people who seek emergency dental care in vulnerable urban and rural areas of central Chile. methodology: a sample of 88 adults residing in urban and rural sectors, who received treatment at primary care emergency dental services in three districts of the central area of Chile was studied using a qualitative descriptive approach of sociocultural epidemiological orientation based on grounded theory. interviews were conducted in the waiting room of the emergency service or at the patient's home. empirical saturation and triangulation of temporal data were protected. results: practices of biomedical origin (self-medication and care received at dental emergency services) and socio-cultural practices were documented. they include the use of chemical products (iodine, phosphorus, battery acid, hydrogen peroxide, gasoline, and alcoholic drinks, among others), herbal infusions (buddleja globosa, aloe vera), mechanical-physical techniques (use of cold or heat, massage); subjects also perform the mechanical manipulation of the area with sharp objects, occasionally extracting the tooth itself. practices occur more frequently at home when the person feels the pain in the affected area, and end on the dental chair with the tooth extraction. conclusions: the coexistence of biomedical practices and alternative cultural strategies was observed. these practices complement each other and make people postpone seeking professional dental care, which may worsen their health condition.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Toothache/drug therapy , Pain Management/methods , Toothache/therapy , Chile , Epidemiology, Descriptive , Surveys and QuestionnairesABSTRACT
Background Cirrhosis is a serious public health problem worldwide. There are geographical, socioeconomic and demographic differences in mortality due to the disease. Aim To establish an association between mortality from cirrhosis and other chronic liver diseases and socioeconomic and demographic indicators in communes of the two largest regions of Chile, the Metropolitan Region (RM) and Bíobío. Material and Methods Analysis of the mortality data from the Chilean Ministry of Health. Multiple regression models of smoothed standardized mortality ratios at the community level between 2001 and 2008, were carried out for men and women in relation to socioeconomic and demographic indicators. Results Quite dissimilar phenomena were observed in these two regions. In RM, the risk of death is associated with urban communes of lower educational level (R2 = 53.6% in men, R2 = 62.3% in women). In men of the Bíobío Region, the risk decreases along with the percentage of population belonging to originary populations (R2 = 9.1%). In women, the model also includes a variable that represents the service sector (R2 = 15.0%), that represents a greater risk. Conclusions The association of mortality due to liver disease with other variables, changes according to the territory in which it is studied. Therefore, specific local studies are required to address this problem in depth. These studies will contribute to the design of locally relevant public policies, aimed at addressing health inequities and the prevention of liver diseases.
Subject(s)
Humans , Male , Female , Socioeconomic Factors , Liver Cirrhosis/mortality , Chile/epidemiology , Residence Characteristics , Risk Factors , Liver Diseases/mortalityABSTRACT
El modelo de temperamento de Mary Rothbart, nos da un sustento teórico para comprender cómo el control esforzado favorece los procesos de regulación en los niños/niñas. Esta habilidad va marcando cómo el infante se va relacionando con el medio y con los diversos desafíos que éste le presenta. Por lo tanto, el presentar un desarrollo adecuado del control esforzado, le permitiría al infante adaptarse con mayor facilidad a los cambios que se van produciendo de manera constante en el contexto que se desarrolla. Dada la relevancia del control esforzado, es que el objetivo de este trabajo es mostrar una revisión teórica de este constructo, su desarrollo y sus implicancias en el desarrollo socioemocional de los niños.
Mary Rothbart's temperament model, gave as a theoretical background for the understanding of the effortful control implications in the regulatory process in children. This skill shapes the way infants relate to their environment and with different challenges that this present. For this reason, an adequate development of effortful control, allows the infants to adapt in a better way to the changes that emerges constantly in their context. Given the relevance of effortful control, is that the aim of this work is to present a theoretical review of this construct, its development and its implications in the children's socioemotional development.
Subject(s)
Humans , Child , Temperament , Child Development , Self-Control , AttentionABSTRACT
Background: Years of potential life lost (YPLL) is a parameter that allows to analyze premature deaths. Aim: To study the causes, differences by gender, geographic variations and the trend of premature deaths in the last decade in Chile. Material and Methods: Using death databases published by the Ministry of Health, YPLL were calculated for the decade 2001-2010, using the method proposed by the Organization for Economic Cooperation and Development. Results: The standardized annual average YPLL rate in Chile in the study period was 4.703 per 100,000 inhabitants. Trauma, cancer and cardiovascular diseases accounted for 68% of YPLL. The male/female YPLL ratio was 2.07; for trauma and mental disorders, the male/female ratio for YPLL was over 5; for cardiovascular and respiratory diseases the male/female ratio was over two. Regions with a higher proportion of rural areas had higher YPLL rates. Conclusions: The main causes of YPLL are potentially preventable. Further studies should be carried out to identify risk factors for premature death.
Subject(s)
Humans , Male , Female , Cause of Death , Mortality, Premature , Chile/epidemiology , Life Expectancy , Geography, MedicalABSTRACT
Background: Among women, breast cancer is the leading cause of death due to cancer worldwide. Aim: To describe the epidemiology of breast cancer mortality in Chilean women by age, time trend and explore its ecological association with socio-demographic variables. Material and Methods: Descriptive study of age specific death rates (2009-2013), and time trend analysis of crude mortality rates (1995-2013) using RiskDiff analysis. Additionally, time trend analysis of age specific death rates was done using Jointpoint regression. The relationship between county mortality risk and socio-demographic variables in the period 2001-2008 was done through an ecological analysis. Socio-demographic variables were: education, income, occupation, housing and living in rural areas. Results: Breast cancer mortality in Chilean women increases with age, with a sharp increase from 80 years old on. In the 1995-2013 period the increase in the crude death rate was 21.8%, this increment was due to changes in demographic structure (43.4%) and decrease in risk (21.7%). The county relative risk of breast cancer mortality is positively associated with education level and negatively associated with living in rural areas. Conclusions: The risk of dying from breast cancer in women has decreased in the period 1995-2013. Nonetheless, the crude death rate has increased in the same period. At an ecological level (counties), breast cancer mortality in Chile is associated with a higher socioeconomic status, measured by educational level and living in rural areas.
Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Breast Neoplasms/mortality , Chile/epidemiology , Risk Factors , Age DistributionABSTRACT
Abstract: to determine the relationship between caries and overall child development in three-year-old children in the cities of Linares and Talca, Chile, 2014-2015. Method: Cross-sectional study conducted in a sample of 170 preschool children attending daycare centers in Linares and Talca. Four dimensions of child development (language, cognition, motor skills and socio-emotional development) were qualitatively assessed using the child learning and development test (TADI, for its acronym in Spanish). Nutritional development was calculated with the weight/height index. Caries history was assessed by the dmft index and compromised tissue quantification. Statistical analysis was performed using Pearson's rho, ANOVA, Students t-test, Fishers exact test and Kruskal-Wallis. Results: A negative linear correlation was observed between dmft and total TADI score (r=-0.20, p=0.00), and the dimensions of language (r=-0.19, p=0.01), cognition (r=-0.18, p=0.02) and socio-emotional development (r=-0.21, p=0.01). Preschoolers with a dmft of >6.5 had a lower average TADI score than those with a dmft of <2.6 (p=0.009). There were no statistically significant differences in the level of compromised tissue quantification between preschool children with normal and altered development. No statistically significant association between dmft and nutritional development was found. Conclusion: A relationship between caries severity and overall child development in three-year-old preschool children was observed. Longitudinal studies are required to assess causality.
Resumen: determinar la relación entre la severidad de caries y el desarrollo infantil integral en preescolares de tres años de las ciudades Linares y Talca durante el período 2014- 2015. Método: Estudio transversal con una muestra de 170 preescolares asistentes a jardines infantiles de Linares y Talca. El test de aprendizaje y desarrollo infantil (TADI) evaluó el desarrollo en cuatro dimensiones (lenguaje, cognición, motricidad y socioemocionalidad). El desarrollo nutricional se calculó con el índice peso/talla. Se evaluó la historia de caries mediante ceod y compromiso del tejido dentario. Se realizó análisis estadístico con rho de Pearson, ANOVA, t de student, test exacto de Fisher y Kruskall Wallis. Resultados: Se observó una correlación lineal negativa entre ceod y el puntaje total del TADI (r=-0,20, p=0,00), y las dimensiones de lenguaje (r=-0,19, p=0,01), cognición (r=-0,18, p=0,02) y socioemocionalidad (r=-0,21, p=0,01). Los preescolares con ceod >6,5 tuvieron un promedio TADI menor que aquellos con ceod <2,6 (p=0,009). No hubo diferencias estadísticamente significativas entre el compromiso del tejido dentario entre preescolares con desarrollo normal y alterado. No se observó asociación estadísticamente significativa entre ceod y desarrollo nutricional. Conclusión: Se observó una relación entre la severidad de caries y el desarrollo infantil integral en preescolares de tres años. Se requiere de estudios longitudinales para evaluar su causalidad.
Subject(s)
Male , Female , Humans , Child, Preschool , Child Development , Dental Caries/epidemiology , Analysis of Variance , Chile , Cross-Sectional Studies , DMF Index , Severity of Illness IndexABSTRACT
El objetivo fue analizar la tendencia de la tasa de mortalidad por cáncer de pulmón en Chile, durante el periodo 1990-2009 y proyectar estas tasas a seis años. La información de mortalidad fue obtenida del Ministerio de Salud de Chile. Para calcular las tasas se utilizaron las proyecciones de población según el Censo de 2002. Las tasas se estandarizaron usando la población mundial como referencia. Se ajustaron modelos lineales dinámicos bayesianos para estimar la tendencia entre 1990-2009 y proyectar el periodo 2010-2015. Durante el periodo se observa una reducción del 19,9% de la tasa de mortalidad en hombres, mientras que en mujeres, la tendencia es creciente con aumento de 28,4%. El modelo de segundo orden entregó un mejor ajuste en hombres y el de primer orden en mujeres. Entre 2010 y 2015, se mantiene la tendencia decreciente en hombres, en cambio se proyecta una estabilización en la tendencia de mortalidad por cáncer pulmonar en mujeres en Chile. Este tipo de análisis es útil para implementar sistemas de vigilancia epidemiológica y evaluar estrategias.
O objetivo foi analisar a tendência da taxa de mortalidade por câncer de pulmão no Chile, durante 1990-2009 e projetar estas taxas em seis anos. As informações sobre a mortalidade foram obtidas no Ministério da Saúde do Chile. Para calcular as taxas foram utilizadas projeções da população de acordo com o Censo de 2002. As taxas foram padronizadas utilizando-se a população mundial como referência. Modelos lineares dinâmicos bayesianos foram ajustados para estimar a tendência entre 1990-2009 e projetar o período 2010-2015. Durante o período, observa-se uma redução da taxa de mortalidade de 19,9% nos homens, entretanto nas mulheres a tendência é de crescimento, com o aumento de 28,4%. O modelo de segunda ordem deu um melhor ajuste para os homens e mulheres de primeira ordem. Entre 2010 e 2015, a tendência descendente é mantida entre os homens, no entanto, projetando uma tendência de estabilização da mortalidade por câncer de pulmão em mulheres no Chile. Este tipo de análise pode ser útil para implementar sistemas de vigilância epidemiológica e avaliar estratégias.
The objectives were to analyze lung cancer mortality trends in Chile from 1990 to 2009, and to project the rates six years forward. Lung cancer mortality data were obtained from the Chilean Ministry of Health. To obtain mortality rates, population projections were used, based on the 2002 National Census. Rates were adjusted using the world standard population as reference. Bayesian dynamic linear models were fitted to estimate trends from 1990 to 2009 and to obtain projections for 2010-2015. During the period under study, there was a 19.9% reduction in the lung cancer mortality rate in men. In women, there was increase of 28.4%. The second-order model showed a better fit for men, and the first-order model a better fit for women. Between 2010 and 2015 the downward trend continued in men, while a trend to stabilization was projected for lung cancer mortality in women in Chile. This analytical approach could be useful implement surveillance systems for chronic non-communicable disease and to evaluate preventive strategies.
Subject(s)
Female , Humans , Male , Lung Neoplasms/mortality , Bayes Theorem , Chile/epidemiology , Models, Theoretical , Mortality/trends , Prevalence , Sex Distribution , Sex FactorsABSTRACT
Un aumento de las enfermedades cardiovasculares (ECV) mundialmente, la existencia de un porcentaje más alto que el promedio nacional de éstas para la región de Maule (Chile), y una atención incrementada en el análisis de factores psicológicos, motivan el análisis del Patrón de Comportamiento Tipo A (PCTA) y la ira respecto de las ECV. Se trabajó con 1007 participantes de 18 a 74 años (ciudadanos de Talca, Chile), mayoritariamente mujeres, quienes respondieron un cuestionario (información socio demográfica, hábitos alimentarios y de estilo de vida), la Escala Retiro de Patrón de Conducta tipo A (ERCTAa), y el Inventario de Ira de Novaco. Se les midió peso, masa corporal, presión arterial y sangre, como factores de riesgo cardiovascular. Los participantes son altamente sedentarios (79.9%), tabáquicos (53.6%), hipercolesterolémicos (44.5%), con sobrepeso (40.7%) y obesidad (32.6%), un cuarto de los cuales presenta hiperglicemia e hipertensión y con PCTA equirepartido según sexo. Es la ausencia de PCTA (ó presencia de PCTB) la que aparece asociada a factores tradicionales de riesgo cardiovascular (FRCV). La ira alta se presenta más en mujeres que en hombres (2.1% vs. 0.3%; c²(3) = 27.99, p<.0001), disminuyendo para ambos sexos con la edad, pero los infartos acaecen igualmente según sexo.
A worldwide raise in the number of cardiovascular disease (CVD) and the existence of a higher percentage in Maule (Chile) than the national media, and increased attention in the analysis of psychological factors motivate to analyze the Type A Behavior Pattern (TABP) and anger in relation to CVD. The sample was 1007 adults between 18 and 74 years old (citizens of Talca, Chile), mostly women. They provided information about their demographic details, eating habits and lifestyle, answered the Novaco's Anger Inventory and the Retiro Scale of Type A Behavior (RSTAB), and also were taken measurements like weight, body mass index and blood pressure and blood tests related to risk factors to traditional cardiovascular diseases. The results show Overall, that the participants appear highly sedentary (79.9%) with relatively high levels of tabaquism (53.6%), and hypercholesterolemia (44.5%), overweight (40.7%) and obesity (32.6%). A quarter of the sample also presents hyperglycemic indexes, hypertension and TABP unequally distributed by sex. The absence of PCTA (or PCTB presence) appeared mostly associated with traditional cardiovascular risk factors (CRF). Regarding anger, women present more high than men (2.1% against 0.3%; c²(3) = 27.99, p<.0001), decreasing for both sexes with age, while also befall stroke by sex.
ABSTRACT
Background: Cardiovascular disease is the leading cause of morbidity and mortality in Chile and worldwide. Framingham functions were developed to calculate overall coronary heart disease risk However these functions overestimate the risk in some countries ¡ike Chile. Aim To develop Chilean risk tables to assess the overall 10-year risk of coronary heart disease. Material and methods: The Framingham function was adapted for a population aged 35 to 74 years, based on an estimate of Chilean incidence of coronary heart disease and the prevalence of coronary heart disease risk factors such as age, sex, total cholesterol, high-density lipoprotein cholesterol, blood pressure, diabetes and smoking. Results: The 10-year incidence of coronary heart disease in Chile (2.7 percent in men, 1.096 in women) was lower than the incidence in the United States (10.096/3.896) and Spain (4.996/2.296), but higher than China (1.196/0.496). Framingham tables have more than 50 percent of cells in the risk category of 10 percent or greater. In contrast, Chilean tables have less than 10 percent of cells in the same risk category. Conclusions: Adapted tables use local information to calculate overall coronary heart disease risk. A validation study should be conducted to assess their predictive power.