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1.
Rev. chil. pediatr ; 91(5): 809-827, oct. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1144282

ABSTRACT

Resumen: Introducción: Las últimas guías clínicas conjuntas de NASPGHAN y ESPGHAN en relación a la infección por H. pylori publicadas el año 2016, contienen 20 afirmaciones que han sido cuestionadas en la práctica respecto a su aplicabilidad en Latinoamérica (LA); en particular en relación a la preven ción del cáncer gástrico. Métodos: Se realizó un análisis crítico de la literatura, con especial énfasis en datos de LA y se estableció el nivel de evidencia y nivel de recomendación de las afirmaciones mas controversiales de las Guías Conjuntas. Se realizaron 2 rondas de votación de acuerdo a la técnica Delfi de consenso y se utilizó escala de Likert (de 0 a 4) para establecer el "grado de acuerdo" entre un grupo de expertos de SLAGHNP. Resultados: Existen pocos estudios en relación a diagnóstico, efectividad de tratamiento y susceptibilidad a antibióticos de H. pylori en pacientes pediátricos de LA. En base a estos estudios, extrapolaciones de estudios de adultos y la experiencia clínica del panel de expertos participantes, se realizan las siguientes recomendaciones. Recomendamos la toma de biopsias para test rápido de ureasa e histología (y muestras para cultivo o técnicas moleculares, cuando estén disponibles) durante la endoscopia digestiva alta sólo si en caso de confirmar la infección por H. pylori, se indicará tratamiento de erradicación. Recomendamos que centros regionales seleccio nados realicen estudios de sensibilidad/resistencia antimicrobiana para H. pylori y así actúen como centros de referencia para toda LA. En caso de falla de erradicación de H. pylori con tratamiento de primera línea, recomendamos tratamiento empírico con terapia cuádruple con inhibidor de bomba de protones, amoxicilina, metronidazol y bismuto por 14 días. En caso de falla de erradicación con el esquema de segunda línea, se recomienda indicar un tratamiento individualizado considerando la edad del paciente, el esquema indicado previamente y la sensibilidad antibiótica de la cepa, lo que implica realizar una nueva endoscopía con extracción de muestra para cultivo y antibiograma o es tudio molecular de resistencia. En niños sintomáticos referidos a endoscopía que tengan antecedente de familiar de primer o segundo grado con cáncer gástrico, se recomienda considerar la búsqueda de H. pylori mediante técnica directa durante la endoscopia (y erradicarlo cuando es detectado). Con clusiones: La evidencia apoya mayoritariamente los conceptos generales de las Guías NASPGHAN/ ESPGHAN 2016, pero es necesario adaptarlas a la realidad de LA, con énfasis en el desarrollo de centros regionales para el estudio de sensibilidad a antibióticos y mejorar la correcta selección del tratamiento de erradicación. En niños sintomáticos con antecedente familiar de primer o segundo grado de cáncer gástrico, se debe considerar la búsqueda y erradicación de H. pylori.


Abstract: Introduction: The latest joint H. pylori NASPGHAN and ESPGHAN clinical guidelines published in 2016, contain 20 statements that have been questioned in practice regarding their applicability in Latin America (LA); in particular in relation to gastric cancer prevention. Methods: We conduc ted a critical analysis of the literature, with special emphasis on LA data and established the level of evidence and level of recommendation of the most controversial claims in the Joint Guidelines. Two rounds of voting were conducted according to the Delphi consensus technique and a Likert scale (from 0 to 4) was used to establish the "degree of agreement" among a panel of SLAGHNP ex perts. Results: There are few studies regarding diagnosis, treatment effectiveness and susceptibility to antibiotics of H. pylori in pediatric patients of LA. Based on these studies, extrapolations from adult studies, and the clinical experience of the participating expert panel, the following recom mendations are made. We recommend taking biopsies for rapid urease and histology testing (and samples for culture or molecular techniques, when available) during upper endoscopy only if in case of confirmed H. pylori infection, eradication treatment will be indicated. We recommend that selected regional centers conduct antimicrobial sensitivity/resistance studies for H. pylori and thus act as reference centers for all LA. In case of failure to eradicate H. pylori with first-line treatment, we recommend empirical treatment with quadruple therapy with proton pump inhibitor, amoxi cillin, metronidazole, and bismuth for 14 days. In case of eradication failure with the second line scheme, it is recommended to indicate an individualized treatment considering the age of the pa tient, the previously indicated scheme and the antibiotic sensitivity of the strain, which implies performing a new endoscopy with sample extraction for culture and antibiogram or molecular resistance study. In symptomatic children referred to endoscopy who have a history of first or se cond degree family members with gastric cancer, it is recommended to consider the search for H. pylori by direct technique during endoscopy (and eradicate it when detected). Conclusions: The evidence supports most of the general concepts of the NASPGHAN/ESPGHAN 2016 Guidelines, but it is necessary to adapt them to the reality of LA, with emphasis on the development of regional centers for the study of antibiotic sensitivity and to improve the correct selection of the eradication treatment. In symptomatic children with a family history of first or second degree gastric cancer, the search for and eradication of H. pylori should be considered.


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Endoscopy, Digestive System/standards , Helicobacter pylori/isolation & purification , Helicobacter Infections/diagnosis , Helicobacter Infections/pathology , Helicobacter Infections/prevention & control , Helicobacter Infections/drug therapy , Proton Pump Inhibitors/therapeutic use , Anti-Bacterial Agents/therapeutic use , Pediatrics/methods , Pediatrics/standards , Stomach/pathology , Stomach/diagnostic imaging , Biopsy , Microbial Sensitivity Tests/standards , Endoscopy, Digestive System/methods , Delphi Technique , Treatment Outcome , Drug Therapy, Combination , Latin America
4.
Article | IMSEAR | ID: sea-201760

ABSTRACT

Background: Working in the healthcare sector is generally regarded as stress inductive, which hampers performance, yet one demanding constant accuracy. This dichotomy has led to numerous investigations on the impact from perceived stress on hospital workers but focused primarily on employing psychological methods to determine perceived stress. This study sought to employ an arguably more objective measure of chronic stress on female healthcare professionals in Saudi Arabia, by assaying the concentration of hair cortisol (HCC) in parallel with stress questionnaires.Methods: Pharmacists, nurses and lab workers participated in providing hair samples. Cortisol levels were subsequently quantified using immunoassay methods. Investigations considered the variables of age, gender, and smoking, hair coloring or bleaching or working in shifts on both stress perception and HCC.Results: On average chronic stress was perceived comparably between the different healthcare professions and not differ significantly against the female control group. However, chronic stress differed significantly between genders within the healthcare profession. In contrast, HCC levels showed no direct relation to stress perception with respect to either gender or profession. HCC did, however, show steady decreases with respect to age, as an indirect measure of experience, that contrasted against the identical scores for stress perception. Finally, night shifts, smoking or hair colouring did not produce a significant change on HCC in the healthcare cohorts.Conclusions: Women in the healthcare profession perceive stress higher irrespective of profession compared to men. Also show a pattern of decreasing levels of cortisol with increasing age despite reporting similar stress perception against younger participants.

6.
Gastroenterol. latinoam ; 30(supl.1): S13-S17, 2019. graf, ilus
Article in Spanish | LILACS | ID: biblio-1116166

ABSTRACT

Over the last decades, modern lifestyle and environment have contributed to a shift in gut microbial colonization patterns and composition. Not only intestinal but also extraintestinal disorders have been proposed to be linked to changes in the gut microbiome. There is increasing evidence from clinical, epidemiologic and animal studies exploring associations between the dysbiotic microbiome and an increased risk of allergic, inflammatory, autoimmune, and metabolic diseases. The fetus is essentially sterile until the amniotic sac ruptures. After that, the maternal microbiota of the mouth, intestine, vagina and urinary tract contribute to the initial seeding of neonatal microbiota. Newborns are mainly inoculated at birth in the passage through the birth canal (vertical transmission). A number of exposure events occur afterwards (horizontal transmission), and by age 2, an infant's microbiota composition becomes indistinguishable from that of an adult. In mammalian evolution, the potential loss or change in vertical transmission of microbiota from mother to offspring could be compensated through horizontally transmitted microbiota (fecally contaminated drinking and bathing water, frequent physical contact, social crowding, and large families). However, the progressive loss of vertically transmitted microbiota without horizontal replacement represents a cumulative birth cohort phenomenon. Events that decrease microbiota diversity have been classically associated with risk of disease


En las últimas décadas, el estilo de vida y el ambiente moderno, han contribuido a un cambio en los patrones y la composición de colonización microbiana intestinal. No sólo se ha propuesto que los trastornos intestinales, sino también los extraintestinales, estarían relacionados con cambios en la microbioma intestinal. Cada vez hay más evidencias de estudios clínicos, epidemiológicos y en animales que exploran las asociaciones entre el microbioma disbiótico y un mayor riesgo de enfermedades alérgicas, inflamatorias, autoinmunes y metabólicas. El feto es esencialmente estéril hasta que el saco amniótico se rompe. Después de eso, la microbiota materna de la boca, el intestino, la vagina y el tracto urinario contribuye a la siembra inicial de la microbiota neonatal. Los recién nacidos se inoculan principalmente al nacer en el pasaje a través del canal de parto (transmisión vertical). Después de una serie de eventos de exposición (transmisión horizontal), a los 2 años, la composición de microbiota de un bebé se vuelve indistinguible de la de un adulto. En la evolución de los mamíferos, la pérdida o cambio potencial en la transmisión vertical de la microbiota de la madre a la descendencia podría compensarse mediante la microbiota transmitida horizontalmente (agua potable y de baño contaminada con heces, contacto físico frecuente, aglomeración social y familias numerosas). Sin embargo, la pérdida progresiva de microbiota transmitida verticalmente sin reemplazo horizontal representa un fenómeno de cohorte de nacimiento acumulativo. Los eventos que disminuyen la diversidad de la microbiota se han asociado clásicamente con el riesgo de enfermedad.


Subject(s)
Humans , Gastrointestinal Tract/microbiology , Gastrointestinal Microbiome , Aging , Age Factors , Microbiota
7.
Rev. chil. pediatr ; 89(5): 630-637, oct. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-978135

ABSTRACT

Resumen: Introducción: La proctocolitis alérgica inducida por proteína alimentaria (PCA) es la forma más fre cuente de alergia alimentaria no mediada por IgE. El diagnóstico se realiza por prueba de provocación oral, sin embargo, no existe una prueba diagnóstica no invasiva para su diagnóstico. Frecuentemente en Chile se utiliza la prueba de hemorragia oculta fecal (PHOF) para confirmar PCA, pero no hay estudios que respalden su indicación. Objetivo: Determinar la validez diagnóstica de la PHOF en la evaluación de lactantes con PCA. Pacientes y Método: Estudio de casos y controles con recluta miento prospectivo de lactantes con rectorragia y sospecha de PCA y lactantes sanos, en quienes se realizó una PHOF. Se indicó dieta de exclusión a los casos y luego se confirmó diagnóstico de PCA mediante contraprueba. Resultados: Se incluyó a 25 casos y 29 controles sin diferencias signi ficativas en edad, sexo, tipo de parto, alimentación o edad materna. Los casos presentaron con mayor frecuencia comorbilidades alérgicas, uso de medicamentos y antecedentes familiares de alergia. La PHOF fue positiva en 84% de casos y en 34% de controles (p<0,001). La sensibilidad de la PHOF para diagnosticar PCA fue 84%, especificidad 66%, valor predictivo positivo 68% y valor predictivo nega tivo 83%. El área bajo la curva ROC fue de 0,75 (IC 95% 0,61-0,88). Conclusiones: Si bien la PHOF tiene sensibilidad adecuada para detectar PCA en lactantes con rectorragia, resulta alterada en más de un tercio de lactantes sanos por lo que no se recomienda su uso habitual para el diagnóstico de PCA.


Abstract: Introduction: Food protein-induced allergic proctocolitis (FPIAP) is the most frequent presenta tion of non-IgE mediated food allergy (FA). The diagnosis is made by oral food challenge, however, non-invasive diagnostic tests are not available. In Chile, the fecal occult blood test (FOBT) is fre quently used to confirm FPIAP, however, there are no studies that support this practice. Objective: To establish the diagnostic validity of FOBT in the evaluation of infants with FPIAP. Patients and Method: Case-control study with prospective recruitment of infants with rectal bleeding and suspicion of FPIAP, and controls were healthy infants, in whom the FOBT was conducted. All cases underwent an elimination diet, after which the diagnosis of FPIAP was confirmed by oral food cha llenge. Results: 25 cases and 29 controls were included without significant differences in age, gen der, type of delivery, feeding, and maternal age. The cases had higher rates of allergic comorbidities, medication use, and family history of allergy. The FOBT was positive in 84% of cases and in 34% of controls (p < 0.001). The sensitivity of the FOBT for the diagnosis of FPIAP was 84%, specificity was 66%, positive predictive value 68%, and the negative predictive value 83%. The area under the ROC curve was 0.75 (CI 95% 0.61-0.88). Conclusions: Although the FOBT has an adequate sensitivity to diagnose FPIAP in infants with rectal bleeding, this test had abnormal results in more than a third of healthy infants. Therefore, the routine use of FOBT is not recommended for the diagnosis of FPIAP.


Subject(s)
Humans , Male , Female , Infant , Proctocolitis/etiology , Food Hypersensitivity/blood , Gastrointestinal Hemorrhage/etiology , Occult Blood , Case-Control Studies , Prospective Studies , Sensitivity and Specificity , Food Hypersensitivity/complications
8.
J. inborn errors metab. screen ; 6: 170022, 2018. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1090953

ABSTRACT

Abstract The mucopolysaccharidosis (MPS) disorders are a group of rare, inherited lysosomal storage disorders. In each of the 11 MPS (sub)types, deficiency in a specific lysosomal enzyme (1 of 11 identified enzymes) leads to accumulation of glycosaminoglycans, resulting in cell, tissue, and multi-organ dysfunction. There is great heterogeneity in the clinical manifestations both between and within each MPS type. Somatic signs and symptoms include short stature, coarse facial features, skeletal and joint abnormalities, cardiorespiratory dysfunction, hepatosplenomegaly, and vision and hearing problems. In addition, patients with MPS I, II, III, and VII can have significant neurological manifestations, including impaired cognitive, language, and speech abilities, behavioral abnormalities, sleep problems, and/or epileptic seizures. Hydrocephalus is a frequent finding in patients with MPS I, II, and VI. Spinal cord compression can develop in almost all MPS disorders. Effective management and development of therapies that target these neurological manifestations warrant a profound understanding of their pathophysiology and progression in the different MPS types and best practices for evaluation and treatment. In order to obtain expert opinion addressing these topics we performed an online survey among an international group of experts with extensive experience in managing and treating MPS disorders. The results of this survey provide important insights into the management of neurological manifestations of MPS in clinical practice and are a valuable addition to current evidence.

9.
J. inborn errors metab. screen ; 6: e170025, 2018. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1090972

ABSTRACT

Abstract Mucopolysaccharidosis VI (MPS VI) is a progressive lysosomal storage disorder with multiorgan and multisystemic pathology. Currently, galsulfase enzyme replacement therapy (ERT) is the only approved treatment for MPS VI. A crosssectional survey study of 121 patients with MPS VI conducted in 2001 to 2002 and a 10-year follow-up study of the same patients (resurvey study; ClinicalTrials.gov NCT01387854) found that those receiving galsulfase at any time showed physical improvements and a lower mortality rate (16.5%) versus treatment-naive patients (50%). After *15 years, galsulfasetreated patients (n » 104) continue to have a survival advantage over treatment-naive patients (n » 14), as demonstrated by a 24% versus 57% mortality rate. This survival advantage is further supported by data from the commercial use of galsulfase (2005-2016), which show a 5-year mortality rate for galsulfase-treated patients of 12.5%. Together, these findings suggest that galsulfase ERT can increase life expectancies for patients with MPS VI over a period of at least 15 years.

10.
Article | IMSEAR | ID: sea-183506

ABSTRACT

The incidence of sepsis is increasing globally, with high morbidity and mortality. Diagnosis of neonatal sepsis is still a clinical and laboratory challenge. Though blood culture is gold standard, it sometimes gives false negative result. So, judgement of clinical condition along with various investigations is important

11.
J. inborn errors metab. screen ; 5: e170008, 2017. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1090939

ABSTRACT

Abstract Patients with mucopolysaccharidosis (MPS), and Morquio A syndrome (MPS IVA) in particular, often report substantial pain burden. MOR-008 was a randomized, double-blind, pilot study assessing the safety and efficacy, including impact on patient-reported pain, of 52 weeks of treatment with elosulfase alfa (at a dose of 2.0 or 4.0 mg/kg/week) in patients with Morquio A syndrome (?7 years old). Assessment of pain at baseline revealed that patients (N = 25) had a mean number of pain locations of 5.7, mean pain intensity score of 4.6 (indicative of medium pain), and a mean number of selected pain descriptors of 7.4 words. Treatment with elosulfase alfa improved subjective pain score (reduced to 3.2), pain locations (reduced by a mean of 1 location), and pain descriptor words (reduced to 4.9 words) over 1 year (52 weeks), suggesting that elosulfase alfa can reduce pain in some patients with Morquio A.

12.
Article in English | WPRIM | ID: wpr-198947

ABSTRACT

Adverse events after endoscopic retrograde cholangiopancreatography (ERCP) are not uncommon and can be associated with tragic outcomes. Bleeding, perforation, and post-ERCP pancreatitis are the most common complications. Some events are unavoidable; others are associated with well described risk factors so that they can be either anticipated and/or measures can be taken for prevention or at least risk reduction. This review will focus on the more common complications after ERCP, their risk factors, and potential strategies for risk reduction. Additionally, recommendations for management of ERCP complications will be presented.


Subject(s)
Cholangiopancreatography, Endoscopic Retrograde , Hemorrhage , Intestinal Perforation , Pancreatitis , Risk Factors , Risk Reduction Behavior
13.
Rev. chil. pediatr ; 87(6): 474-479, Dec. 2016. tab
Article in Spanish | LILACS | ID: biblio-844568

ABSTRACT

Introducción: La infección por H. pylori se adquiere tempranamente en la infancia. Sin embargo, existe escasa información acerca del rol de la lactancia materna y la adquisición de la bacteria en la etapa neonatal/lactante. Objetivo: Evaluar algunos factores que afectan la adquisición de H. pylori en recién nacidos y lactantes hijos de madres infectadas. Pacientes y método: Reclutamiento consecutivo de binomios madre-hijo en maternidad, inmediatamente posparto. Luego de la firma de consentimiento informado, se obtuvo una muestra de deposición de la madre, previo al alta. Posteriormente se obtuvieron 3 muestras de deposición de los recién nacidos/lactantes a los 15, 60 y 90 días de vida, para la detección de antígeno en deposición de H. pylori (HpSAg monoclonal, sensibilidad 94% y especificidad 97%). Además se registraron variables socio-epidemiológicas y biomédicas. Resultados: Se reclutaron 32 binomios madre-hijo, 64 sujetos. Promedio de edad materna de 30,1 ± 5,1 años, 53% parto eutócico, 85% con lactancia materna exclusiva al final del seguimiento. Se encontró 13 madres (40%) infectadas por H. pylori. No hubo infección por H. pylori en los recién nacidos y lactantes a los 3 meses de seguimiento. No hubo diferencia significativa en el nivel socioeconómico entre madres infectadas versus no infectadas (ambos grupos en nivel socioeconómico muy alto: 28% y 32% respectivamente, p = 0,15), ni en el número de habitantes por domicilio entre madres infectadas y no infectadas (3,8 ± 0,8 vs 4,2 ± 1,8 personas, p = 0,18). Conclusión: A pesar de tener un alto porcentaje de madres infectadas por H. pylori, no hubo recién nacidos/lactantes infectados al tercer mes de vida. El rol protector de la lactancia maternal no se puede descartar.


Introduction: H. pylori infection is acquired early in childhood. However, there is little information available regarding the role of breastfeeding and neonatal acquisition of the infection. Objective: To evaluate factors affecting the acquisition of H. pylori in newborns and infants from infected mothers. Patients and method: Consecutive mothers and their newborns were recruited into the study from the maternity unit, immediately after delivery. After signing informed consent, one stool sample from the mother was obtained before hospital discharge. Three stool samples of the newborns were then collected at home at 15, 60, and 90 days of life, for the detection of H. pylori antigen (Monoclonal HpSAg, sensitivity 94% and specificity 97%). The socio-epidemiological and biomedical variables were also analysed using a questionnaire. Results: A total of 32 mother-child pairs (64 subjects) were enrolled. The mean maternal age was 30.1 ± 5.1 years, with 53% vaginal delivery, and 85% exclusively breastfed. There were 13 (40%) infected mothers. No H. pylori infection was detected in newborns and infants up to 3 months of follow-up. No significant differences were found in socioeconomic level between infected versus non-infected mothers (both groups mostly in the very high socioeconomic category: 28% and 32%, respectively, P = .15) and in the number of family members between infected versus non-infected mothers (3.8 ± 0.8 vs 4.2 ± 1.8 persons, P = .18). Conclusion: Despite having a significant percentage of H. pylori-infected mothers, no newborn was infected at the third month of life. The protective role of breastfeeding cannot be ruled out.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Adult , Breast Feeding , Helicobacter pylori/isolation & purification , Helicobacter Infections/prevention & control , Infectious Disease Transmission, Vertical/prevention & control , Socioeconomic Factors , Time Factors , Surveys and Questionnaires , Follow-Up Studies , Helicobacter Infections/transmission , Helicobacter Infections/epidemiology , Sensitivity and Specificity
15.
Rev. salud pública ; 18(4): 1-1, jul.-ago. 2016. ilus, tab
Article in Spanish | LILACS | ID: lil-794080

ABSTRACT

Objetivo Evaluar la concordancia en talla para la edad entre referencias antropométricas de crecimiento en niños indígenas colombianos estudiados en la Encuesta Nacional de la Situación Nutricional de Colombia 2010 -ENSIN 2010-. Métodos Análisis secundario de 2 598 datos de indígenas colombianos menores de cinco años evaluados en la ENSIN 2010. Las variables fueron talla para la edad, se-xo, altitud, lugar de residencia, departamento y estrato socioeconómico. La clasificación del déficit en talla con las referencias del Centro Nacional de Estadísticas en Salud de Estados Unidos (NCHS) y de la Organización Mundial de la Salud (OMS) se hizo mediante puntaje Z <-2 con el software Anthro. Se estimó el coeficiente kappa para evaluar concordancia entre las categorías antropométricas y se clasificó con la propuesta de Altman DG. Resultados Más de uno de cada cuatro menores presentó déficit de talla con ambas referencias antropométricas. La prevalencia de déficit de talla fue superior al usar el patrón de la OMS, aumentó con la edad y fue mayor en los niños y quienes residían en baja altitud (m.s.n.m.). La concordancia entre las dos referencias fue buena (kappa ≥0,688, p=0,000) en los niños de ambos sexos y en todas las edades. La excepción fue para los de 2 años, pues fue moderada (kappa 0,601, p=0,000). El mayor desacuerdo en la clasificación se observó en la categoría de altos. Conclusión Según la concordancia estadística encontrada entre las dos referencias antropométricas (OMS vs NCHS) podría usarse cualquiera en la evaluación de la talla para la edad.


Objective To evaluate the correlation of size, according to age, of the anthropometric growth references of Colombian indigenous children studied in Encuesta Nacional de la Situación Nutricional de Colombia 2010 -ENSIN 2010 (National Survey of Nutrition in Colombia - 2010). Method A secondary analysis of 2598 data of indigenous Colombian children under five years of age, evaluated by ENSIN in 2010, was performed. The considered variables were size according to age, gender, height, place of residence, department and socioeconomic position. The classification of the deficit in size, based on the references of the National Center for Health Statistics (NCHS) and the World Health Organization (WHO), was made by using the Z <-2 score and the Anthro software. The Kappa coefficient was estimated to assess the correlation between anthropometric categories and was classified taking into account the proposal of Altman DG. Results One in four children had a deficit in size in the light of both anthropometric references. The prevalence of the deficit was higher when using the WHO standard, increased with age and was higher in children who resided in low altitude (m). The correlation between the two references was good (kappa ≥0,688, p=0,000) for children of both genders and all ages; the exception corresponded to children of age two, since it was moderate (kappa=0,601, p=0,000). The greatest disagreement in the classification was observed in the category "tall". Conclusion According to the statistical correlation found between the two anthropometric references (WHO vs. NCHS), any reference could be used for assessment of size according to for age.


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Anthropometry/methods , Failure to Thrive/epidemiology , Indigenous Peoples , Reference Standards , Reproducibility of Results , Colombia/epidemiology
17.
Rev. bras. med. fam. comunidade ; 11(38): 1-13, jan./dez. 2016. tab
Article in Portuguese | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-877813

ABSTRACT

Objetivo: O objetivo deste trabalho foi verificar a relação entre a satisfação conjugal e a depressão pós-parto e o impacto destas variáveis nos níveis de satisfação conjugal e depressão futuros, em uma amostra brasileira. Estudos revelam que o conflito conjugal é um antecedente importante no desenvolvimento da depressão e que a depressão pós-parto influencia significativamente a satisfação conjugal. Métodos: Este estudo longitudinal com 99 mulheres brasileiras utilizou análises de regressão múltipla para verificar a associação entre a satisfação conjugal e a depressão. A sintomatologia depressiva foi avaliada pelo instrumento Self-Reporting Questionnaire (SRQ-20). A satisfação conjugal foi verificada a partir de itens sobre a percepção de satisfação conjugal das participantes. Os dados foram coletados 4 meses e 2 anos após o parto. Os dados longitudinais possibilitaram a análise cronológica da interação entre as duas variáveis. Resultados e Conclusões: Os resultados indicam que o modelo teórico que estabelece a relação entre conflito conjugal e depressão é também apropriado para casais brasileiros, sugerindo a utilização potencial da terapia de casal no tratamento da depressão pós-parto no Brasil.


Objective: This study examined the relationship between marital satisfaction and postpartum depression as well as the impact of postpartum depression and marital satisfaction on later relational characteristics among Brazilian couples. Studies have shown that marital satisfaction is an important antecedent to depression and that postpartum depression has an influence on marital satisfaction. Methods: A longitudinal study using multiple regression to test the association between marital satisfaction and depression was conducted among Brazilian women. Depressive symptomatology was assessed using the Self-Reporting Questionnaire 20 and marital satisfaction using an instrument developed by the researchers to test the individuals' perception of their marital quality. Data were collected at 4 months and 2 years after childbirth. The longitudinal data allowed researchers to chronologically analyze the interaction of key variables. Results and Conclusions: Results showed that the model established between marital satisfaction and depression is appropriate for Brazilian couples as well as for postpartum women. This study highlights the potential impact of marital treatment on postpartum depression in Brazil.


Objetivo: El objetivo de este trabajo fué verificar la relación existente entre la satisfacción con la relación de pareja y la depresión pos-parto y el impacto de esas variables en los niveles de satisfacción con la relación de pareja y depresión futuros, en una muestra brasileña. Estudios revelan que el conflicto de pareja és un antecedente importante en el desarollo de depresión y que la depresión pos-parto provoca influencia significativa en la relación de pareja. Métodos: Este estudio longitudinal con 99 mujeres brasileñas hizo uso de análisis de regresión multiple para estudiar la asociación entre la satisfacción en la relación de pareja y la depresión. Los sintomas depresivos fueron evaluados por el instrumento Self-Reporting Questionnaire (SRQ-20). La satisfacción con la relación de pareja fué verificada utilizando datos sobre la percepción de satisfacción de las participantes. Los datos fueron obtenidos 4 meses y 2 años después del parto. Resultados y Conclusiones: Los resultados indican que el modelo teórico que establece la relación entre conflicto de pareja y depresión és tambien apropriado para parejas brasileña s y sugiere la posibilidad de utilización de la terapia de pareja en el tratamiento de la depresión pos-parto en Brasil.


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Depression, Postpartum , Family Conflict , Family Therapy , Marital Therapy
18.
J. inborn errors metab. screen ; 4: e160029, 2016. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1090890

ABSTRACT

Abstract The mucopolysaccharidosis (MPS) disorders are rare genetic diseases caused by deficiencies in lysosomal enzymes involved in the degradation of glycosaminoglycans, leading to pulmonary, cardiac and neurological dysfunctions, skeletal anomalies, impaired vision, and/or hearing and shortened life spans. Whereas in the past, few individuals with MPS reached adulthood, better diagnosis, multidisciplinary care, and new therapies have led to an increasing number of adult patients with MPS. Therefore, fertility and pregnancy questions in this patient population are becoming more important. Management of fertility issues and pregnancy in patients with MPS is challenging due to the lack of documented cases and a dearth in the literature on this topic. This review presents multidisciplinary expert opinions on managing fertility and pregnancy based on case studies and clinical experience presented at a meeting of MPS specialists held in Berlin, Germany, in April 2015. An overview of the existing literature on this subject is also included.

19.
ARS med. (Santiago, En línea) ; 41(1): 35-43, 2016. ilus
Article in Spanish | LILACS | ID: biblio-1015654

ABSTRACT

Durante la última década, con la aparición de técnicas de secuenciación de última generación basadas en la filogenia del gen ARN ribosomal 16S y complejas plataformas bioinformáticas, la composición del microbioma y su rol en salud y enfermedad ha sido sujeto de investigación activa. Existe una evidencia creciente que relaciona la disbiosis microbiana y un aumento del riesgo de desarrollar enfermedades de tipo inflamatorio, autoinmune, y metabólico tales como asma, diabetes, obesidad y enfermedades gastrointestinales crónicas. El ensamblaje de la microbiota intestinal en los humanos comienza antes y durante el proceso de parto y evoluciona con la alimentación durante la infancia y debe ser entendido en profunda relación con el microbioma de su madre. La comprensión del impacto de la microbiota en la morbilidad en seres humanos necesariamente requiere de una etapa previa como es el conocimiento del desarrollo y ensamblaje precoz de la microbiota en recién nacidos, y como las intervenciones médicas como la elección en la ruta de parto (parto cesárea versus parto vaginal), uso precoz de antibióticos, selección de fórmula láctea (lactancia materna versus fórmulas artificiales), entre otros, pueden modificar en forma sustancial su conformación y a través de cambios en el desarrollo del sistema inmune, ejercer un impacto en salud y enfermedad en neonatos, lactantes y posteriormente a lo largo de la vida de un ser humano.(AU)


In the last years, with the development of massive last generation sequencing techniques based on the phylogeny of 16S rRNA gene and complex bioinformatics platforms, the composition of the human microbiome and its role in health and disease has been an active subject of research. There is growing evidence that associate the intestinal disbiosis with an increase risk to develop chronic inflammatory, autoimmune, and metabolic diseases such as asthma, diabetes, obesity and chronic gastrointestinal conditions. The assembly of the intestinal microbiome in human begins before and during the birth process, progressing with the feeding duringm infancy and it must be understood in a close relationship with the microbiome of their mothers. The comprehension of the impact of microbiome in human morbidity will require of a previous stage, the knowledge of the development and early assembly of the microbiome in newborns, and to understand how early medical intervention such as delivery route (C-section versus vaginal delivery), early use and abuse of antibiotics, selection of formula patterns (human milk versus formula bottle milk) among others, may substantially modify the microbiome conformation and to have a profound impact in the development of the immune system, affecting later in life the development of disease in neonates, infants and adults.(AU)


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Microbiota , Infant , Health , Dysbiosis , Environmental Chemistry
20.
Indian J Med Microbiol ; 2015 Jan-Mar ; 33 (1): 129-131
Article in English | IMSEAR | ID: sea-157003

ABSTRACT

Bio-medical waste has a higher potential of infection and injury to the healthcare worker, patient and the surrounding community. Awareness programmes on their proper handling and management to healthcare workers can prevent the spread of infectious diseases and epidemics. This study was conducted in a tertiary care hospital to assess the impact of training, audits and education/implementations from 2009 to 2012 on awareness and practice of biomedical waste segregation. Our study reveals focused training, strict supervision, daily surveillance, audits inspections, involvement of hospital administrators and regular appraisals are essential to optimise the segregation of biomedical waste.

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