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INTRODUCTION@#Probiotics such as Saccharomyces boulardii are now advocated for the treatment of diarrhea. The objective of this systematic review and meta-analysis was to determine the effectiveness of Saccharomyces boulardii in the treatment of diarrhea.@*METHODS@#MEDLINE, EBSCO, Clinical Key, and the Cochrane Library were searched for clinical trials which used Saccharomyces boulardii as primary or adjuvant treatment for diarrhea. Outcomes included were treatment success in the form of cessation of diarrhea, decrease in the duration of diarrhea, decrease in hospital days, and improvement of dehydration. The Centre for Evidence-Based Medicine Critical Appraisal tool together with the Cochrane Collaboration tool was used to assess the risk of bias, RevMan 5.4 for encoding, and the Mantel-Haenszel method for analysis to compute a pooled result. @*RESULTS@#Eleven clinical trials involving 1,541 participants were included in the systematic review and meta-analysis. Seven studies showed a non-significant overall decrease in the duration of diarrhea of 1.65 days (p = 0.25), five studies showed an overall significant beneficial response (RR = 1.68, p < 0.001) in the cessation of diarrhea. There was a statistically significant mean decrease (1.01 days, p < 0.001) in duration of hospitalization; and a statistically significant decrease (0.18 days or 4.32 hours, p = 0.04) in the duration of vomiting.@*CONCLUSION@#A systematic review and meta-analysis of 11 clinical trials favors the use of Saccharomyces boulardii in the treatment of diarrhea in terms of cessation of diarrhea, decrease in the duration of hospitalization and duration of vomiting.
Subject(s)
Saccharomyces boulardii , Probiotics , DiarrheaABSTRACT
Objetivo: Identificar factores asociados a calidad percibida de atención en la población adulta afiliada al Seguro Social en Salud (EsSalud). Material y métodos: Analizamos la Encuesta Nacional Socioeconómica de Acceso a la Salud de los Asegurados de EsSalud. La calidad percibida fue evaluada en consultorio externo, hospitalización y emergencias. Reportamos razones de medias ajustadas (RMa) estimadas mediante regresión de Poisson múltiple. Resultados: Estar empleado (RMa=0,98; IC95% 0,96-0,99), no conocer los servicios que brinda EsSalud (RMa=0,97; IC95% 0,95-1,00), no recibir información sobre los derechos como usuarios (RMa=0,95; IC95% 0,93-0,98), valorar como bajo el nivel de accesibilidad al EESS (RMa=0,97; IC95% 0,95-0,99) y no sentirse cómodo en el EESS al que acude (RM=0,92; IC95% 0,91-0,94) fueron factores asociados a menor puntaje de calidad percibida en consultorio externo. En hospitalización, tener entre 40-59 años (RMa=0,93; IC95% 0,88-0,97), contar con un índice de riqueza bajo (RMa=0,92; IC95% 0,87-0,97), no haber recibido información sobre los derechos como usuarios (RMa=0,90; IC95% 0,84-0,95) y no sentirse cómodos en el EESS (RMa=0,92; IC95% 0,89-0,96) se asociaron a menor puntuación de calidad. En emergencia, no sentirse cómodo en el EESS (RMa=0,89; IC95% 0,93-1,00) fue el único factor asociado a una menor puntuación de calidad percibida. Conclusiones: Identificamos factores relativos a los usuarios y a la oferta de servicios independientemente asociados a calidad percibida de atención, los cuales pueden ser considerados por los tomadores de decisiones para la mejor gestión de EsSalud.
Objetive: To identify factors associated with perceived quality of care in the adult population affiliated with Social Security Health (EsSalud) Material and methods: We analyzed the National Socioeconomic Survey of Access to Health of the EsSalud Insured. Perceived quality of health care was evaluated in ambulatory care, hospitalization and emergency medical services. We reported adjusted ratios of means (RMa) estimated by multiple Poisson regression. Results: Being employed (RMa=0.98; IC95% 0.96-0.99), not knowing the services provided by EsSalud (RMa=0.97; IC95% 0.95-1.00), not receiving information about right to health (RMa=0.95; IC95% 0.93-0.98), perceiving as low the level of accessibility to the health facility (RMa=0.97; IC95% 0.95-0.99) and not feeling comfortable in the health facility of EsSalud (RM=0.92;IC95% 0.91-0.94) were factors associated with lower scores of perceived quality in ambulatory care. In hospitalization, being between 40-59 years old (RMa=0.93; IC95% 0.88-0.97), having a low wealth index (RMa=0.92; IC95% 0.87-0.97), not having received information about right to health (RMa=0.90; IC95%0.84-0.95) and not feeling comfortable in the health facility of EsSalud (RMa=0.92; IC95% 0.89-0.96) were associated with lower quality score. In emergency, not feeling comfortable in the health facility of EsSalud (RMa=0.89; IC95% 0.93-1.00) was the only factor associated with a lower perceived quality score. Conclusions: We identified factors related to users and service offerings independently associated with perceived quality of care, which can be considered by decision makers for better management of EsSalud.
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BACKGROUND: The rising Filipino population results in a proportionate increase in the aging population and its health care needs.OBJECTIVE: In order to determine the demographic characteristics and needs of palliative and hospice patients in southern Metro Manila and surrounding provinces seeking care in a non-institutionalized setting, a chart review of 399 patients from 2 community-based hospice and palliative care programs was undertaken.RESULTS: Results show that the usual demographic profile of a patient seeking hospice and palliative care in the community setting of southern Metro Manila and neighboring provinces is female, 51-60 years old, with a diagnosis of cancer, breast cancer being the most common. Majority had undergone prior chemotherapy or radiation therapy. Hypertension was the most common co-morbidity associated with the primary diagnosis, and pain was the most common symptom reported. The children were the primary caregivers of these patients at home, and written advance care directives were unavailable or initial consultation. The most common spiritual concern of patients was not the fear of death, but being a burden to their family members. Complementary services may be needed in order to help patients and their families cope with the terminal illness. These may include social work to help connect the family to other institutions that provide free medicines, counselling sessions both for the patient and family, respite care or providing a day off for the caregivers, and skills training for the primary care givers.
Subject(s)
Humans , Female , Middle Aged , Respite Care , Caregivers , Palliative Care , Hospice Care , Advance Directives , Adaptation, Psychological , Breast Neoplasms , Hypertension , Primary Health CareABSTRACT
@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> The rising Filipino population results in a proportionate increase in the aging population and its health care needs.<br /><strong>OBJECTIVE:</strong> In order to determine the demographic characteristics and needs of palliative and hospice patients in southern Metro Manila and surrounding provinces seeking care in a non-institutionalized setting, a chart review of 399 patients from 2 community-based hospice and palliative care programs was undertaken.<br /><strong>RESULTS:</strong> Results show that the usual demographic profile of a patient seeking hospice and palliative care in the community setting of southern Metro Manila and neighboring provinces is female, 51-60 years old, with a diagnosis of cancer, breast cancer being the most common. Majority had undergone prior chemotherapy or radiation therapy. Hypertension was the most common co-morbidity associated with the primary diagnosis, and pain was the most common symptom reported. The children were the primary caregivers of these patients at home, and written advance care directives were unavailable or initial consultation. The most common spiritual concern of patients was not the fear of death, but being a burden to their family members. Complementary services may be needed in order to help patients and their families cope with the terminal illness. These may include social work to help connect the family to other institutions that provide free medicines, counselling sessions both for the patient and family, respite care or providing a day off for the caregivers, and skills training for the primary care givers.</p>
Subject(s)
Humans , Female , Middle Aged , Respite Care , Caregivers , Palliative Care , Hospice Care , Advance Directives , Adaptation, Psychological , Breast Neoplasms , Hypertension , Primary Health CareABSTRACT
Abstract: Rosenberg's self-esteem scale has been extensively used in all areas of psychology to assess global self-esteem (Rosenberg, 1965, 1979). Its construct validity, and specifically its factor structure, has almost from the beginning been under debate. More than four decades after its creation the cumulated evidence points that the scale measures a single trait (self-esteem) but confounded by a method factor associated to negatively worded items. The aim of the study is to examine the measurement invariance of the RSES by gender and test potential gender differences at the latent (trait and method) variable level, while controlling for method effects, in a sample of Spanish students. A series of completely a priori structural models were specified, with a standard invariance routine implemented for male and female samples. The results lead to several conclusions. Conclusions: a) the scale seem gender invariant for both trait and method factors; b) there were small but significant differences between males and females in self-esteem, differences that favored male respondents; and c) there were statistically non-significant differences between men and women in the method factor's latent means.
Resumen: La Escala de Autoestima de Rosenberg (EAR) ha sido utilizada extensamente en todas las áreas de la Psicología para evaluar la autoestima (Rosenberg, 1965, 1979). Su validez de constructo, y particularmente su estructura factorial, ha estado en debate casi desde que fue construida. Más de cuatro décadas después de su creación, la evidencia acumulada señala que la escala evalúa un solo rasgo (autoestima), aunque se confunde con un método factorial asociado de manera negative con reactivos verbales. El objetivo de este estudio fue evaluar la estabilidad de la medición de la EAR entre sexos y poner a prueba potenciales diferencias entre los mismos en un nivel latente de la variable (rasgo y estado), controlando efectos de método, en una muestra de estudiantes españoles. Se especificaron una serie de modelos estructurales a priori, con rutinas implementadas de invarianza estándar para muestras de hombres y mujeres. Los resultados llevan a diferentes conclusiones: a) La escala parece ser invariable ante el sexo tanto para factores de rasgo como de estado; b) existieron diferencias pequeñas, pero significativas, entre hombres y mujeres en autoestima, favoreciendo ligeramente a los hombres; y, c) no existieron diferencias estadísticamente significativas entre hombres y mujeres en las medias de la variable latente del factor.
ABSTRACT
AIM: To investigate whether oral motor performance is determinant for the hydration status and the effect of a supplemental oral fluid supply on salivary osmolality. METHODS: The sample consisted of 99 children with cerebral palsy aged 6 to 13 years old. In this study, children participated in 2-day evaluations: 1st day - baseline: saliva collection, caries experience and oral motor performance evaluations; and 2nd day: saliva collection after supplemental fluid supply. Prior to each evaluation, the participants were trained for saliva collection. Unstimulated whole saliva was collected using cotton roll at baseline, with the amount of fluid usually offered by caregivers, and 48 h after baseline, with as much as twice the normal daily fluid intake previously offered. Salivary osmolality was measured using a freezing point depression osmometer. Caries experience index for decayed, missed and filled teeth (DMFT) was evaluated. According to the Oral Motor Assessment Scale, the children were classified into subfunctional or functional groups. Chi-square, Student's t test and Pearson's correlation coefficient were used. RESULTS: The subfunctional group presented a higher percentage of quadriplegic children (p<0.001), with significantly higher values for caries experience (p<0.001) and salivary osmolality (p<0.001), which did not diminish when supplemental fluid supply was offered, compared with the functional group (p=0.001). CONCLUSIONS: The effectiveness of oral motor performance plays an important role in the hydration status of children with cerebral palsy and those with worse oral motor performance may be at higher risk of oral diseases...
Subject(s)
Humans , Male , Female , Child , Cerebral Palsy , Fluid Therapy , Motor Skills Disorders , Muscle Spasticity , Osmolar ConcentrationABSTRACT
A DPOC é uma doença sistêmica que está associada com alteração da função pulmonar e disfunção dos músculos esqueléticos, que contribuem para a redução da tolerância ao exercício. Vários fatores contribuem para a redução da tolerância ao exercício, como inatividade física, uso de corticosteroides, tabagismo, desnutrição, deficiência de anabolizantes, inflamação sistêmica, estresse oxidativo e hipóxia. O cuidado ideal aos pacientes com DPOC geralmente requer a combinação de tratamentos farmacológicos e não farmacológicos. A reabilitação pulmonar é um tratamento abrangente e inclui treinamento físico,educação do paciente, oxigenoterapia, apoio psicossocial e intervenção nutricional. A reabilitação pulmonar tem demonstrado eficácia para melhorar a dispneia, a capacidade de exercício e a qualidade de vida. Devido ao elevado número de pacientes com DPOC e ao baixo número de centros de reabilitação pulmonar, um programa de reabilitação domiciliar temsido estudado e desenvolvido para aumentar o número de pacientes a serem tratados
Having recently been classified as a systemic disease, COPD is associated with impaired pulmonary function and skeletal muscle dysfunction, the combination of which results in low exercise tolerance. Many other factors also contribute to the reduction in exercise tolerance in COPD, including physical inactivity, corticosteroid use, smoking, malnutrition, deficienciesin anabolic hormones, systemic inflammation, hypoxia, and oxidative stress. The optimal care of patients with COPD typically requires a combination of pharmacological and non-pharmacological treatment. Pulmonary rehabilitation is a comprehensive treatment that includes exercise training, patient education, psychosocial supportand nutritional intervention. Pulmo-nary rehabilitation has proven effective in reducing dyspnea, as well as in improving exercise capacity and health-related quality of life. Due to the high number of COPD patients and to the low number of pulmonary rehabilitation centers, a home based rehabilitation program has been developed in order to increase the number of patients receiving such treatment
Subject(s)
Humans , Pulmonary Disease, Chronic Obstructive/rehabilitation , Pulmonary Disease, Chronic Obstructive/therapy , Exercise Therapy , Quality of LifeABSTRACT
Few studies have been conducted to determine the prevalence of chronic diseases and its impact in individuals aged 40 years or over in Brazil. The objective of this study is to evaluate the prevalence of some common chronic diseases in the Brazilian subgroup assessed by the PLATINO study using a self-reported survey. A total of 918 individuals (55% women) with a mean age of 54.6 ± 10.9 years were evaluated. The most prevalent diseases were obesity (62.5%), hypertension (39.2%) and gastritis (30.9%). We conclude from this study that there is a high prevalence of chronic diseases in the population over 40 years of age: 88% of the population suffers from a minimum of one disease and 26% of the sample suffers from at least three diseases. We also observed that the number of comorbidities increases with age.
Poucos estudos foram desenvolvidos para determinar a prevalência de doenças crônicas e suas associações em indivíduos com mais de 40 anos de idade no Brasil. O objetivo deste trabalho foi avaliar a prevalência de algumas doenças crônicas altamente prevalentes no país, de modo autorreferido, avaliadas no Estudo PLATINO em São Paulo, em uma amostra de base populacional. Novecentos e dezoito indivíduos (55% mulheres) com média de idade de 54,6 ± 10,9 anos foram avaliados. As três doenças mais prevalentes foram obesidade (62,5%), hipertensão (39,2%) e gastrite (30,9%). Há uma alta prevalência de doenças crônicas na população acima de 40 anos: 88% da amostra apresentaram pelo menos uma doença e 26%, pelo menos, três doenças; e o número de doenças apresentava tendência a aumentar com a idade.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Chronic Disease/epidemiology , Self Report , Age Factors , Brazil/epidemiology , Comorbidity , Health Surveys , Hypertension/epidemiology , Obesity/epidemiology , Prevalence , Pulmonary Disease, Chronic Obstructive/epidemiologyABSTRACT
Se realizó un estudio descriptivo, retrospectivo y de corte transversal durante el período enero-julio del año 2005, con el fin de evaluar los costos de atención médica de los recién nacidos pretérminos ingresados al servicio de neonatología del Hospital Fernando Vélez Paiz (H.F.V.P)la muestra fue no probalistica por conveniencia que incluyó 18 neonatos nacidos antes de las 37 semanas de gestación. Para la evaluación de los costos se utilizaron los precios establecidos por el SAD-MINSA en el tiempo que se realizó el estudio. Para el costo de la atención médica se tomó como referencia lo establecido por el servicio del privado del(H.F.V.P). Para estimar el costo de algunos farmacos que no se encontraron en la lista SAD-MINSA, se tomo un precio promedio en referencia al valor ofertado en diversas farmacias. En cuanto a la determinación de los costos directos de la atención de los recién nacidos pretérminos en el servicio de neonatología se encontró que el 40 porciento de los costos se utilizaron para pago de planilla del personal médico y para medico; hotelería representó el 30 porciento, procedimientos un 20 porciento, para lo medios de diagnósticos 6 porciento y un 4 porciento para medicamentos. Dentro de los medicamentos los antibióticos constituyeron el 53 porciento de los costos, líquidos y electrólitos 33 porciento, hemoderivados un 6 porciento y el uso de diuréteicos 0.4 porciento, otros medicamentos como xantinas, vitaminas y raniditina
Subject(s)
Health Care Costs , Health Expenditures , Infant, Newborn , Medical CareABSTRACT
We have previously shown the feasibility of lung procurement from nom-heart-beating donors in a porcine survival movel. Pulmonary function is now evaluated transplanted lungs subjected to 1 hour of normothermic ischemia in a similiar experimental model. Eight adult swine underwent left lung allotransplantation. Controls received lungs procured from heart-beating donors, and study group pigs received lungs harvest 1 hour after death from asphyxiation. Pulmonary function studies were undertaken 3 days after lung transplantation. Pulmonary vascular hemodynamics, pulmonary venous partial pressure of oxygen, dynamic airway compliance and resistence were equivalent in both grups. We conclude that transplanted lungs from non-heart-beating donors with 1 hour of warm ischemia are functionally viable