ABSTRACT
Abstract Introduction: In Mexico, cardiac rehabilitation (CR) as an interdisciplinary intervention with therapeutic impact in patients with heart disease is growing. There is the need to know actual conditions of CR in our country. Objectives: The objective of this National Registry is to follow-up those existing and new CR units in Mexico through the comparison between the two previous registries, RENAPREC-2009 and RENAPREC II-2015 studies. This is a descriptive study focused on diverse CR activities such as assistance training, and certification of health professionals, barriers, reference, population attended, interdisciplinarity, permanence over time, growth prospects, regulations, post-pandemic condition, integrative characteristics, and scientific research. Results: Data were collected from 45 CR centers in the 32 states, 75.5% are private practice units, 67% are new, 33% were part of RENAPREC II-2015, and 17 have continued since 2009. With a better distribution of CR units along the territory, the median reference of candidates for CR programs is 9% with a significant reduction into tiempo of enrollment to Phase II admission (19 ± 11 days). Regarding to previous registries, the coverance of Phases I, II, and III is 71%, 100%, and 93%, respectively; and a coverance increases in evaluation, risk stratification, and prescription, more comprehensive attendance and prevention strategies. Conclusions: CR in Mexico has grown in the past 7 years. Even there is still low reference and heterogeneity in specific processes, there are strengths such as interdisciplinarity, scientific professionalization of specialists, national diversification, and an official society that are consolidated over time.
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ABSTRACT
Resumen Antecedentes: La obesidad es un trastorno multifactorial caracterizado por un aumento en la adiposidad corporal, de amplia prevalencia en nuestro país, a cualquier edad y ligada a grandes consecuencias adversas, incluyendo el desarrollo de cardiopatías. Los programas de rehabilitación cardiaca (RC) son intervenciones interdisciplinarias encaminadas no solo a restaurar la funcionalidad perdida de los pacientes que han sufrido un desenlace cardiovascular, sino también a corregir aquellos factores de riesgo que lo propiciaron y que interfieren en los resultados adaptativos del mismo. La obesidad contribuye a perpetuar el riesgo de cardiopatía y suele ser resistente a las modificaciones del estilo de vida de manera convencional. Objetivo: Establecer pautas en el reconocimiento de la obesidad con directrices de atención al paciente con cardiopatía dentro de los programas de RC y su abordaje interdisciplinario. Método: A través de una extensiva revisión bibliográfica y después de una discusión interdisciplinaria, se elaboró el presente documento para fijar una postura sobre el abordaje de la obesidad en el contexto de los programas de RC en pacientes con cardiopatía. Resultados y conclusiones: Nuestra Sociedad reconoce el abordaje interdisciplinario de los pacientes con obesidad y cardiopatía en su prevención primaria y secundaria, insta a la precisión en su diagnóstico y valoración, y recomienda que su eje primario debe estar basado en primera instancia en las modificaciones del estilo de vida (entrenamiento físico, atención nutricional e intervención psicoemocional), en tanto que la terapia farmacológica y la cirugía bariátrica pudieran ser coadyuvantes en la optimización de los resultados en pacientes selectos.
Abstract Background: Obesity is a multifactorial disorder characterized by increased body adiposity with a wide prevalence in our country, at any age, and linked to major adverse consequences, including the development of heart disease. Cardiac rehabilitation (CR) programs are interdisciplinary interventions aimed not only at restoring the lost functionality of patients who have suffered a cardiovascular outcome, but also at correcting those risk factors that led to it and that interfere with its adaptive results. Obesity contributes to perpetuating heart disease risk and is often resistant to conventional lifestyle modifications. Objective: Establish guidelines in the recognition of obesity with care guidelines for patients with heart disease within CR programs and their interdisciplinary approach. Method: Through an extensive bibliographical review and after an interdisciplinary discussion, this document was prepared to establish a position on the approach to obesity in the context of CR programs in patients with heart disease. Results and conclusions: Our Society recognizes the interdisciplinary approach of our patients with obesity and heart disease in its primary and secondary prevention, urges precision in its diagnosis and assessment, recommends that its primary axis must be based in the first instance on lifestyle modifications (physical training, nutritional care and psycho-emotional intervention), while pharmacological therapy and bariatric surgery could be coadjuvants in optimizing the results in selected patients.
ABSTRACT
La violencia intrafamiliar constituye una de las formas más frecuentes de violencia encontradas tanto a nivel nacional como internacional y dentro de estas el maltrato infantil presenta cifras alarmantes, y es el objeto de nuestra revisión. Los efectos de este problema repercuten notablemente en aquellos que sobreviven, ya que las consecuencias a largo plazo del maltrato infantil son más perjudiciales para las víctimas y sus familias, y más costoso para la sociedad, que las lesiones agudas inmediatas que puedan producir. Las consecuencias a largo plazo para estos niños varían desde efectos nocivos en su desarrollo hasta trastornos psicológicos, psiquiátricos y orgánicos. Es importante resaltar que aún con muy buenas intervenciones no todas tienen el éxito esperado si no se hacen de manera correcta. Es indispensable contar con estrategias de prevención que incluyan personal bien entrenado, una supervisión adecuada, los recursos necesarios, y un tiempo mínimo óptimo para enfrentar el problema y obtener los mejores resultados. [Alarcón LC, Araujo AP, Godoy AP, Vera ME. Maltrato infantil y sus consecuencias a largo plazo. MedUNAB 2010; 13:103-115]
Domestic violence is one of the most common forms of violence found both domestically and internationally. Within these, child abuse has alarming figures. This is the subject of this review. The effects of this problem significantly impact on those who survive; their long-term consequences are most severe and expensive for victimized child and his/her family than associated primary physical injuries. The long-term consequences for these children range from adverse effects on its psycholigical development to psychological, psychiatric organic disoders. It is important to note that good speeches are not enough to achieve success if any intervention are not done correctly. All prevention strategies include well-trained staff, appropriate supervision, resources, and a optimal time for addressing this problem to get the best results. [Alarcón LC, Araujo AP, Godoy AP, Vera ME. Child abuse and its long-term consequences. MedUNAB 2010, 13:103-115].
Subject(s)
Child Abuse , Therapeutics , Child , Domestic Violence , Impacts of Polution on HealthABSTRACT
Copper is an essential and toxic trace metal for bacteria and, therefore, must be tightly regulated in the cell. Enterococcus hirae is a broadly studied model for copper homeostasis. The intracellular copper levels in E. hirae are regulated by the cop operon, which is formed by four genes: copA and copB that encode ATPases for influx and efflux of copper, respectively; copZ that encodes a copper chaperone; and copY, a copper responsive repressor. Since the complete genome sequence for E. hirae is not available, it is possible that other genes may encode proteins involved in copper homeostasis. Here, we identified a cop-like operon in nine species of Lactobacillale order with a known genome sequence. All of them always encoded a CopY-like repressor and a copper ATPase. The alignment of the cop-like operon promoter region revealed two CopY binding sites, one of which was conserved in all strains, and the second was only present in species of Streptococcus genus and L. johnsonii. Additional proteins associated to copper metabolism, CutC and Cupredoxin, also were detected. This study allowed for the description of the structure and organization of the cop operon and discussion of a phylogenetic hypothesis based on the differences observed in this operon's organization and its regulation in Lactobacillale order.