Relationship between Duration of Diabetes Mellitus and Gensini Score in Patients Undergoing Diagnostic Coronary Angiography

Background: Gensini (G score) is one of the most widely used scoring systems in cardiology. It is an objective method to determine the coronary artery disease severity according to angiographic findings. The aim of this work was to assess the relation between G score and the chronicity of diabetes mellitus (DM) in cases undergoing coronary angiography. Methods: This prospective cohort research was carried out on 300 cases with diabetes mellitus (DM) on antidiabetic treatment who were referred to diagnostic coronary angiography for suspected coronary artery disease. G score was calculated for measurement of the coronary artery disease severity. During the period from October 2020 to Aril 2022 Results: Age, smoking, chronicity of DM, cholesterol, triglycerides test, and electrocardiogram were statistically prominent positively related with G score, while female gender was statistically significant negative relation with it. Also. Mean G score was statistically prominent higher in cases with ischemic changes than in cases without ischemic changes. Therefore, the chronicity of DM was statistically significant predictor of G score. Conclusions: significant positive relation between the G score and the chronicity of DM.

Patrón inflamatorio de las vías aéreas en pacientes fumadores con enfermedad pulmonar obstructiva crónica / Inflammatory pattern of the airways in COPD smokers

Introducción: La enfermedad pulmonar obstructiva crónica cursa con un patrón inflamatorio en la vía aérea que incluye neutrófilos, macrófagos, linfocitos, los cuales se pueden obtener mediante un cepillado bronquial citológico. Objetivos: Identificar patrón inflamatorio según células inflamatorias presentes en la vía aérea, mediante el cepillado bronquial citológico e índice tabáquico de paquetes/año en pacientes con enfermedad pulmonar obstructiva crónica. Métodos: Se realizó un estudio descriptivo transversal en pacientes con enfermedad pulmonar obstructiva crónica, que concurrieron al Hospital Neumológico Benéfico-Jurídico, en el período comprendido de junio de 2018 a junio de 2019, con indicación para la realización de fibrobroncoscopía con cepillado bronquial. Resultados: El 53,1 por ciento de los pacientes corresponden al sexo masculino. Un 46,1 por ciento presentó un índice tabáquico de paquetes/año entre 21-40. Predominaron las criptas y estrías como hallazgos broncoscópicos con un 51 por ciento y 40,8 por ciento respectivamente en pacientes con índice paquetes/año mayor que 40. De los pacientes con índice paquetes/año mayor de 40 (13 para un 26,5 por ciento) presentaron hiperplasia de células basales. El 46,9 por ciento de los pacientes presentaron un patrón inflamatorio neutrofílica. Conclusiones: Se identificaron a los pacientes con EPOC que presentaron patrón inflamatorio neutrofílica en la vía aérea y elevado índice tabáquico y desde el punto de vista broncoscópico tienen varios hallazgos que sugieren cronicidad(AU)

Introduction: Chronic obstructive pulmonary disease presents with an inflammatory pattern in the airway that includes neutrophils, macrophages, and lymphocytes, which can be obtained by cytological bronchial brushing. Objectives: To identify inflammatory pattern according to inflammatory cells present in the airway, through cytological bronchial brushing and smoking rate of packs/year in patients with chronic obstructive pulmonary disease. Methods: A cross-sectional descriptive study was carried out in patients with chronic obstructive pulmonary disease, who attended Benefico-Jurídico Pneumological Hospital, from June 2018 to June 2019, with an indication for fiberoptic bronchoscopy with bronchial brushing. Results: 53.1percent of the patients correspond to the male sex. 46.1percent ad a smoking rate of packs/year between 21-40. Crypts and striae predominated as bronchoscopic findings with 51percent and 40.8percent respectively in patients with a pack/year index greater than 40. Patients with a pack/year index greater than 40 (13 for 26.5percent) showed basal cell hyperplasia. 46.9percent of the patients had a neutrophilic inflammatory pattern. Conclusions: Patients with COPD who had a neutrophilic inflammatory pattern in the airway and high smoking index were identified, and from the bronchoscopic point of view they have several findings that suggest chronicity(AU)

Group family psychotherapy during relapse. Case report of a novel intervention for severe and enduring anorexia nervosa / Psicoterapia familiar grupal durante la recaída. Caso clínico de una intervención novedosa para la anorexia nerviosa grave y duradera

Abstract Background Anorexia nervosa is a complex and highly variable disorder. Preventing patients from becoming resistant to treatments is fundamental since an important percentage develops a severe and enduring disorder; and because relapse is highly associated with psychiatric comorbidity, poor prognosis, and serious medical consequences due to malnutrition. Contemporary treatments for anorexia nervosa support the benefits of involving the family in treatment, and although the gold standard of family psychotherapy offers an excellent option for anorexia nervosa, that intervention is aimed at early stages, and therapeutic options for later stages of the disorder are reduced and not clearly established. Objective Expose the therapeutic effect of the protocol for severe and enduring cases of anorexia nervosa at relapse, used at the Clinic of Eating Behavior of the National Institute of Psychiatry, Ramón de la Fuente Muñiz, whose theoretical foundation is systemic therapy. Method To develop this case report, we carried out an in-depth review of the clinical records, and of the clinic attendance records of the case presented here. CARE clinical case report guidelines format were used. Results The case shows how a young woman, diagnosed with anorexia nervosa with clinical signs of severe and enduring anorexia nervosa (SE-AN), was able to achieve symptomatic remission after her parents, but not her, were administered the protocol for SE-AN. Discussion and conclusion Here we present an emblematic case showing the importance of getting the parents involved in the treatment of anorexia nervosa.

Resumen Antecedentes La anorexia nervosa es un trastorno complejo y muy variable. Evitar que los pacientes se vuelvan resistentes a los tratamientos es fundamental, pues un porcentaje importante desarrolla un trastorno grave y duradero; adicionalmente, la recaída está muy asociada con una alta comorbilidad psiquiátrica, un mal pronóstico y graves consecuencias médicas debido a la desnutrición. El tratamiento actual de la anorexia nervosa respalda los beneficios de involucrar a la familia en el tratamiento, y, aunque el estándar de oro en psicoterapia familiar ofrece una excelente opción para la anorexia nervosa, dicha intervención está orientada a etapas tempranas y las opciones para las etapas tardías del trastorno son reducidas, además de no estar claramente establecidas. Objetivo Exponer el efecto terapéutico del protocolo para casos graves y duraderos de anorexia nervosa en recaída, de la Clínica de Trastornos de la Conducta Alimentaria (CTA) del Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, cuya base teórica es la terapia sistémica. Método Para integrar este caso, realizamos una revisión a fondo del expediente clínico y de los registros asistenciales del caso que aquí presentamos. Se utilizó el formato de reporte de caso de las guías CARE. Resultados El caso muestra cómo una joven, con signos clínicos de anorexia nervosa grave y duradera (AN-GD), pudo lograr remisión sintomatológica después de que sus padres, pero no ella, recibieran tratamiento con el protocolo para AN-GD. Discusión y conclusión Aquí presentamos un caso emblemático que muestra la importancia de involucrar a los padres en el tratamiento de la anorexia nervosa.

Cronicidad, violencia y longitud de trayectoria criminal. Hombres detenidos por violencia doméstica / Chronicity, violence and criminal trajectory length. Men arrested for domestic violence

Resumen Los delincuentes crónicos resultan ser los responsables de la mayor parte de la actividad criminal, además de ser los más persistentes y violentos. Existe escasa evidencia longitudinal que permita conocer cómo se manifiesta la cronicidad en agresores de violencia doméstica. El objetivo de esta investigación es identificar el criterio más adecuado para diferenciar a los hombres crónicos y establecer la relación que existe entre cronicidad, violencia, versatilidad y duración de la carrera criminal en 10 505 hombres chilenos detenidos por delitos de violencia en el ámbito familiar en el 2007, con base en todas las nuevas detenciones producidas los siguientes diez años. El diseño es longitudinal pseudoprospectivo, tal como si correspondiera a un estudio longitudinal prospectivo. Los resultados muestran que tres o más delitos bastan para identificar adecuadamente carreras criminales crónicas, y que un 12.7% del total de hombres pueden considerarse graves, violentos y crónicos, al presentar una trayectoria criminal de entre ocho y diez años, ser responsables de más del 37% del total de las reincidencias, alcanzar un promedio de delitos significativamente alto y versátiles, así como una elevada prevalencia en delitos violentos.

Abstract Chronical criminals turn out to be responsible of most of the criminal activity, in addition to being the most persistent and violent. There exists limited longitudinal evidence that allows knowing how chronicity manifests itself in domestic violence aggressors. The objective of this investigation is to identify the most appropriate criteria to differentiate chronic men and establish the relationship between chronicity, violence and duration of the criminal career in 10 505 Chilean men arrested for domestic violence crimes in 2007, based on all new arrests produced the next 10 years. The design is a longitudinal pseudo-prospective, as if it corresponded to a prospective longitudinal study. The results show that three or more crimes are enough to properly identify chronic criminal careers, and that 12.7% of all men can be considered as serious, violent and chronic, presenting a criminal trajectory between eight and ten years, being responsible for more than 37% of total recidivism, reach a significantly high average of crimes and high prevalence of violent crimes.

La promoción de salud en la escuela como estrategia para el abordaje de la cronicidad en España / Health promotion in schools as a strategy for addressing chronic disease in Spain / A promoção da saúde na escola como estratégia para controlar a cronicidade em Espanha / La promotion de la santé à l'école comme stratégie pour faire face á la chronicité en Espagne

Resumen Objetivo: Este artículo aborda los temas que sirvieron de referencia teórica de una disertación de tesis doctoral. Se pretende analizar las principales conductas y factores de patologías crónicas que avalan la necesidad del enfoque promocional de salud en la escuela y a lo del todo el curso de vida, así como su impacto en la mejora de la salud global de la población y la reducción del gasto público en España. Material y métodos: Se ha utilizado una perspectiva crítica desde la que se hace una revisión reflexiva sobre dichos factores en el contexto español, estudiando la necesidad de abordaje temprano. Los factores analizados han estado relacionados con la alimentación y actividad física, salud bucodental, consumo de sustancias tóxicas, seguridad vial, sexualidad y bienestar emocional. Resultados: Se observa un descenso de actividad física en la etapa escolar. Tres de cada diez niños/as tienen sobrepeso u obesidad. La prevalencia de afecciones bucodentales ronda el 40% a los 6 años. El cannabis es la tercera droga más consumidas por los escolares de 14-18 años, después del tabaco y el alcohol. Más de la mitad de los fallecimientos por accidente de tráfico entre los jóvenes (18-24 años) fue durante la noche y fin de semana. España se consolida como tercer país de la Unión Europea con mayor número de abortos. Las infecciones de transmisión sexual afectan de forma desproporcionada a las adolescentes. Los trastornos de salud mental están entre los cuatro problemas más prevalentes de los niños/as menores de 15 años Conclusiones: Se concluye que las acciones educativas realizadas en la escuela desde las edades más tempranas sobre los factores y conductas pueden reducir considerablemente los costes individuales, económicos y sociales que acarrean las enfermedades crónicas, convirtiéndose en una necesidad estratégica para el abordaje de la cronicidad, que es uno de los mayores retos a los que se enfrenta el sistema sanitario español.

Abstract Object: This article focuses on the topics that served as theoretical reference of a doctoral dissertation. The aim is to analyze the main behaviors and factors of chronic pathologies that support the need of the promotional approach of health in the school and the whole life course, as well as its impact in the improvement of the global health of the population and the reduction of the public spending in Spain. Materials and methods: A critical perspective has been used from which a reflexive review of these factors in the Spanish context has been carried out, studying the need of an early approach. Factors related to diet and physical activity, oral health, toxic substance use, road safety, sexuality and emotional well-being have been analyzed. Results: There was a decrease in physical activity in the school stage. Three out of ten children are overweight or obese. The prevalence of oral diseases is around 40% at 6 years. Cannabis is the third most consumed drug by schoolchildren aged 14-18, after tobacco and alcohol. More than half of the deaths due to traffic accidents among young people (18-24 years old) occurred during the night and weekend. Spain is consolidated as the third country in the European Union with the highest number of abortions. Sexually transmitted infections disproportionately affect teenagers. Mental health disorders are among the four most prevalent problems of children under 15 years of age. Conclusions: It is concluded that educational actions carried out in schools from the earliest ages on behavioral risk factors can considerably reduce the individual, economic and social costs of chronic diseases, becoming a strategic necessity for dealing with chronic diseases, which is one of the greatest challenges facing the Spanish health system.

Resumo Objetivo: Este artigo aborda os temas que foram usados como referência teórica numa tese de doutoramento. Pretendeu-se analisar os principais comportamentos e fatores relacionados com as patologias crónicas que suportam a necessidade de uma abordagem de promoção de saúde na escola e em todo o ciclo de vida, bem como o seu impacto na melhoria da saúde global da população e na redução das despesas públicas em Espanha. Materiais e métodos: Utilizou-se uma perspectiva crítica a partir de uma revisão reflexiva sobre esses fatores no contexto espanhol, estudando a necessidade de intervenção precoce. Os fatores analisados foram relacionados com a alimentação, a atividade física, a saúde bucal, o consumo de substâncias tóxicas, a segurança rodoviária, a sexualidade e o bem-estar emocional Resultados: Observou-se uma diminuição da atividade física em crianças de idade escolar. Três em cada dez crianças sofrem excesso de peso ou obesidade. A prevalencia de doenjas bucais é de cerca de 40% aos 6 anos. A Cannabis é a terceira droga mais consumida por alunos dos 14 a 18 anos, depois do consumo de tabaco e álcool. Mais da metade das mortes por acidentes rodoviários dos jovens entre os 18 e 24 anos ocorreram durante a noite e no fim-de-semana. A Espanha é o terceiro país da Uniao Europeia com mais número de abortos. As infecções sexualmente transmissíveis afetam desproporcionalmente as adolescentes. Os transtornos mentais estao entre os quatro problemas mais prevalentes em crianças menores de 15 anos de idade. Conclusões: Conclui-se que as ações educativas realizadas na escola, em idades precoces, sobre os fatores de risco comportamentais, podem reduzir consideravelmente os custos individuais, económicos e sociais que as doenjas crónicas acarretam, transformando-se numa necessidade estratégica para a abordagem da cronicidade, que é um dos maiores desafios que o sistema de saúde espanhol enfrenta.

Résumé Objectif: Cet article se centre sur les sujets qui ont servi de référence théorique pour une thése de doctorat. L'objectif est d'analyser les principaux comportements et facteurs de pathologies chroniques qui supportent le besoin de l'approche promotionnelle de la santé á l'école et tout au long de la vie, ainsi que son impact sur l'amélioration de la santé globale de la population et la réduction du dépenses publiques en Espagne. Matériaux et méthodes: Une perspective critique a été utilisée á partir de laquelle une revue réflexive est faite sur ces facteurs dans le contexte espagnol, en étudiant la nécessité d'une approche précoce. Les facteurs analysés ont été liés á l'alimentation et á l'activité physique, á la santé bucco-dentaire, á la consommation de substances toxiques, á la sécurité routiére, á la sexualité et au bien-etre émotionnel. Résultats: Il y a une diminution de l'activité physique au stade scolaire. Trois enfants sur dix sont en surpoids ou obéses. La prévalence des maladies buccales est d'environ 40% á 6 ans. Le cannabis est la troisiéme drogue la plus consommé par les écoliers agés de 14 á 18 ans, aprés le tabac et l'alcool. Plus de la moitié des décés dus aux accidents de la circulation chez les jeunes (18-24 ans) ont eu lieu pendant la nuit et le week-end. L'Espagne est consolidée comme le troisiéme pays de l'Union européenne avec le plus grand nombre d'avortements. Les infections sexuellement transmissibles touchent de maniére disproportionnée les adolescentes. Les troubles de santé mentale sont parmi les quatre problémes les plus courantes chez les enfants de moins de 15 ans. Conclusion: Les actions éducatives menées á l'école dés le plus jeune age sur les facteurs et les comportements peuvent réduire considérablement les coúts individuels, économiques et sociaux qu'apportent les maladies chroniques, devenant une nécessité stratégique pour l'approche de la chronicité, qui est l'un des plus grands défis du systéme de santé espagnol.

Study of tumor necrosis factor receptor superfamily 1B gene polymorphism in relation to the outcomes of HCV infection / 中华肝脏病杂志

Objective@#To investigate the tumor necrosis factor receptor superfamily 1B gene (TNFRSF1B) polymorphism in relation to the outcomes of hepatitis C virus (HCV) infection.@*Methods@#One thousand six hundred and forty-five cases without HCV infection, 545 cases with HCV clearance, and 783 cases with chronic HCV infection were enrolled. TaqMan probe method was used to investigate genotype rs1061622 (T > G) and rs1061624 (G > A). Two single nucleotide polymorphisms (SNPs) sites were genotyped and haplotypes were constructed to evaluate their relation with the outcome of HCV infection.@*Results@#Logistic regression analysis showed that there was no relation to the two SNPs with HCV infection susceptibility and chronicity (P > 0.05). Haplotype analysis showed that carrier TA had an increased susceptibility to HCV infection [adjusted odds ratio (OR) = 1.15, 95% confidence interval (CI): 1.01 to 1.30, P = 0.038)]. Carrier TA and GG haplotypes were conducive to chronic HCV infection (adjusted OR = 1.28, 95% CI: 1.08 to 1.53, P = 0.006; OR = 1.31, 95% CI: 1.03 to 1.66, P = 0.026).@*Conclusion@#The combinational effects of rs1061622 and rs1061624 in TNFRSF1B gene may increase the risk of HCV chronicity and infection.

Metabolomic screening for diagnostic biomarkers of drug-induced chronic liver injury related cirrhosis / 药学学报

About 15%-20% of drug-induced liver injury (DILI) will progress to chronic manifestation (CH-DILI), which sometimes advances rapidly to liver cirrhosis (LC-DILI) within 0.5-1 year with deteriorative clinical prognosis. Therefore, it is important to find a non-invasive diagnosis for early detection of liver cirrhosis. In this study, the metabolomic profiles revealed significant differences in the metabolites from the plasma of LC-DILI versus CH-DILI. We found 35 differential metabolites through principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA). Through pathway enrichment analysis, some up-regulated metabolic pathways reflected impaired liver functions such as bile acid, lipid synthesis and decomposition during cirrhosis. Five biomarkers were found to exhibit effective diagnosis value (AUC > 0.6), including phosphatidylcholine, lysoPC (18:1 (9Z)), creatine, taurochenodeoxycholic acid and taurocholic acid. Furthermore, we found that the relative content ratio between phosphatidylcholine and lysoPC (18:1 (9Z)) had a better distinguishing ability (AUC = 0.867). The relative content ratio also had the feature to reduce systematic errors of sample processing and instrument detection, therefore having a greater value for clinical application.

Evolución terapéutica de la hepatitis crónica por virus C / Therapeutic evolution of chronic hepatitis C virus

Escasas áreas geográficas escapan a la pandemia que representa la infección viral por virus C. Los porcentajes de evolución a la cronicidad son altos: entre 20-30 por ciento desarrollan cirrosis hepática y sus complicaciones dentro de 30 años. Se revisa el camino recorrido en la práctica asistencial hasta llegar a la era de los antivirales de acción directa, los pacientes pueden obtener una sustancial erradicación del virus de la hepatitis C (VHC) con una combinación de drogas que elevan las tasas de respuesta virológica sostenida (RVS). La erradicación de este virus está asociada a mejor calidad de vida, baja morbilidad y mortalidad(AU)

Few geographical areas escape the pandemic that represents the viral infection by virus C. The percentage of evolution to chronicity are high. Between 20-30 percent develop liver cirrhosis and its complications within 30 years. The foot path traveled in the healthcare practice is reviewed until reaching the era of direct action antivirals, when patients can obtain a substantial eradication of the hepatitis C virus (HCV) with a combination of drugs that raises the rates of sustained virological response (RVS). The eradication of this virus is associated with better quality of life, low morbidity and mortality(AU)

Clinical types and features of chronicity of drug-induced liver injury / 临床肝胆病杂志

ObjectiveTo investigate the clinical types and features of chronicity of drug-induced liver injury (DILI). MethodsThe patients who were diagnosed with DILI in Beijing You′An Hospital, Capital Medical University from January 2011 to December 2013 were screened, and a retrospective analysis was performed for 84 patients with chronic DILI. The case report form was filled out for each patient, and the data were entered into a database, including demographic features, underlying diseases, types of drugs, cardinal symptoms and signs, and laboratory examinations. ResultsOf all patients, 63 (75.0%) were female. The chronicity of DILI could be divided into six clinical types according to disease progression and recovery of liver function; of all patients, 64 (762%) had a recurrent type, 4 (4.8%) had a delayed recovery type, 4 (4.8%) had a recurrent fluctuation type, 6 (7.1%) had a chronic cholestasis type, 5 (6.0%) had a type of rapid progression to liver cirrhosis, and 1 (1.2%) had a type of drug-induced autoimmune hepatitis. Among all the 84 patients, 56 (66.7%) had underlying diseases; 51 (60.7%) had DILI induced by a single drug, mainly traditional Chinese medicine (47.0%), antipyretics and analgesics (10.6%), and antitubercular agents (9.1%); as for the type of liver injury, 52 (61.9%) had hepatocyte injury, 8 (9.5%) had cholestasis, and 5 (6.0%) had a mixed type. Liver biochemistries showed abnormal results in 19 patients (22.6%). ConclusionThe chronicity of DILI can be divided into six clinical types, of which the most common type is the recurrent type, and the other clinical types include delayed recovery type, recurrent fluctuation type, chronic cholestasis type, rapid progression to liver cirrhosis, and drug-induced autoimmune hepatitis.

El paciente experto 2. 0 VIH: molecularización, regímenes de vitalidad y nuevos ciudadanos crónicos. / HIV 2. 0 Expert Patient: Molecularization, Regimes of Vitality and New Chronic Citizenship.

La introducción de los tratamientos antirretrovirales de gran actividad (TARGA), generó una profunda transformación en la vida de las personas diagnosticadas con VIH: habitan un nuevo espacio vital, la enfermedad crónica caracterizada por un envejecimiento prematuro causado por la inflamación crónica del sistema inmune. Se plantea que la condición crónica del paciente VIH desborda el efecto puramente biológico o biomédico y se define por el establecimiento de lo que se denomina régimen de vitalidad. A partir de metodología cualitativa, se analiza la producción de un nuevo tipo de ciudadano crónico que, conducido por la norma biomédica y el dato biológico, se autogobierna en relación con representaciones del VIH.

The appearance of highly active antiretroviral treatments (HAART) marked a deep transformation in the lives of those diagnosed with HIV, as the retrovirus was no longer associated with fast and lethal immune system decay. These people inhabit a new vital space: the chronic disease, characterized by early ageing caused by chronic inflammation of the immune system. This paper puts forward the hypothesis that the chronic condition of HIV patients transcends the mere biological or biomedical realms to be defined in terms of what we will be call a regime of vitality. The production of a new type of citizen, the chronic ones, will be analyzed using a qualitative methodology. Citizens whose understanding of themselves and the world is shaped by biomedical norms and biological data related to HIV representations

Condições de vida e saúde de usuários idosos do programa de saúde da família / Living and health conditions of elderly users in the family health program

Esta pesquisa tem como objetivo conhecer e descrever as condições de vida e saúde da população idosa cadastrada e atendida no Programa Saúde da Família (PSF). Consiste em um estudo descritivo, analítico e transversal com abordagem quantitativa utilizando o teste do qui-quadrado, o valor de significância adotado de 5%. Sua amostra foi composta por 441 idosos usuários do PSF do município de Benevides, Pará, aplicando-lhes a caderneta do idoso do Ministério da Saúde. Os resultados revelaram que a maior parte dos idosos está entre 60 a 64 anos, é do sexo feminino, casada, católica e com renda familiar de 1 a 3 salários mínimos. A maioria não ingeria bebida alcoólica e não possuía o hábito de fumar, mas não praticava atividade física nem se alimentava adequadamente. A hipertensão arterial (HÁ) prevalece como a doença crônica, seguida por diabetes mellitus (DM) e também hábitos de vida pouco saudáveis, o que leva os PSF a buscarem estratégias especialmente dirigidas a favor do extrato idoso com enfoque na prevenção precoce da instalação da cronicidade e seus agravos entre seus usuários adultos maduros.

The study’s objectives were to know and describe living conditions and health of the elderly population enrolled and attended in the Family Health Program. It is a descriptive, analytical and cross-sectional research of a quantitative approach using the chi-square test with a signifi cance value of 5%. The study’s sample consisted of 441 elderly members of the Family Health Program (PSF) of the municipality of Benevides, Pará with the utilization of the protocol for elderly from the Ministry of Health. Results showed most of the elderly people is 60-64 years old; they are female, married, Catholic and with a family income from one to three minimum wages. Most of them did not drink alcohol beverages and did not have smoking habits; however, they did not practice physical activities or had an adequate diet. Arterial hypertension (AH) was the most prevalent chronic disease and was followed by Diabetes Mellitus (DM). PSFs are induced to search for strategies specifi cally targeted to assist the elderly stratum, addressing an early approach for chronicity prevention and its grievances among mature adult users.

Study on Chronic Nephrotoxicity of Penthorum chinense / 医药导报

Objective To study chronic nephrotoxicity of Penthorum chinense. To provide a scientific evidence for the development and application of Penthorum chinense in food and drug. Methods 48 SD rats were randomly divided into 4 groups (n=12), 0. 9% sodium chloride solution saline group and three Penthorum chinense treat groups. The Penthorum chinense groups were treated by intragastric administration with 5,10,20 g·kg-1 crude drug once a day for 3 months. The levels of Urea, UA, Cre in serum were detected, and the HE dyeing was chosen to observe the kidney morphology. Results The body weight, nephritic organ quotiety, and the level of Urea, UA, and Cre in each exposure group have no statistically significant difference compared with 0. 9% sodium chloride solution group (P>0. 05). There were no obvious kidney morphology changes in the Penthorum chinense group(F=1. 37,P=0. 268). Conclusion The kidney morphology and function of rat shows no apparente injury after long-term intragastric administration of Penthorum chinense.

Prediction of Chronicity of Anterior Cruciate Ligament Tear Using MRI Findings

BACKGROUND: The estimation of anterior cruciate ligament (ACL) tear is required in certain cases involving legal and financial administration, such as the worker's compensation and/or insurance. The aim of this study is to propose and evaluate a quantitative evaluation instrument to estimate the chronicity of the ACL tear, based on the four magnetic resonance imaging (MRI) findings. METHODS: One hundred and fifty one cases of complete ACL tear confirmed by arthroscopy were divided into 4 groups according to the time from ACL injury to MRI acquisition: acute ( 1 year). The four MRI findings including ACL morphology, joint effusion, posterior cruciate ligament angle, and bone bruise were analyzed for temporal changes among the 4 groups. Binary logistic regression equations were formulated using the MRI findings to estimate the chronicity of ACL tear in a quantitative manner, and the accuracy of the formulated regression equations was evaluated. RESULTS: The four MRI findings showed substantial temporal correlation with the time-limits of ACL injury to be included in the estimation model. Three predictive binary logistic equations estimated the probability of the ACL injury for the three cutoff time-limits of 6 weeks, 3 months, and 1 year with accuracies of 82.1%, 89.4%, and 89.4%, respectively. CONCLUSIONS: A series of predictive logistic equations were formulated to estimate the chronicity of ACL tear using 4 MRI findings with chronological significance.

Association between the BDNF Val66Met Polymorphism and Chronicity of Depression

OBJECTIVE: Both clinical and biological factors influence the course of depressive disorders. This study tested for associations between the brain-derived neurotrophic factor (BDNF) gene at the Val66Met locus and the course of major depressive disorder (MDD). METHODS: Three hundred ten Korean subjects (209 patients, 101 controls) were genotyped for rs6265 at nucleotide 196 (G/A), which produces an amino acid substitution at codon 66 (Val66Met) of the gene for BDNF. Course of illness was evaluated both by chronicity of current episode (episode duration >24 months) and by the lifetime history of recurrences. RESULTS: Patients with the Met/Met BDNF genotype had a significantly higher rate of chronic depression than all others. There was a significant dose effect of the Met allele on chronicity. Compared with the Val/Val genotype, the relative risk of chronicity was 1.67 for the Val/Met genotype, and 2.58 for the Met/Met genotype. Lifetime history of recurrent episodes was not related to BDNF genotypes but was significantly associated with younger age of onset and with a history of depression in first degree relatives. CONCLUSION: BDNF genotyping may be informative for anticipating chronicity in major depression.

Impacto da cronicidade do transtorno distímico na qualidade de vida / Impact of dysthymic disorder cronicity on quality of life

A distimia diferencia-se da depressão por sua cronicidade e menor severidade sintomatológica. A cronicidade acarreta sérios prejuízos na rotina dos pacientes, atividades laborais, relacionamentos sociais e qualidade de vida. O objetivo deste estudo foi explorar o impacto do transtorno distímico na qualidade de vida dos pacientes. Utilizou-se uma entrevista semiestruturada com 24 pacientes distímicos, sendo os dados analisados pelo software Alceste. Neste artigo, discutiu-se a classe sobre o Tratamento da Distimia e Qualidade de Vida. Observou-se um ciclo de tristeza que interfere no dia a dia, acarretando insatisfação e frustração, retroalimentando a baixa autoestima, que induziria à continuidade dos sintomas, passando a fazer parte da experiência cotidiana do indivíduo e aparecendo, por fim, como um modo de ser. A partir desses dados, sugere-se que o transtorno possa ser interpretado por novos parâmetros, baseados na compreensão dessa sucessão de processos, que deveria ser o foco da intervenção com tais pacientes.

Dysthymia is differentiated from depression by its chronicity and less symptomatic severity. Chronicity causes severe harm in the routine of patients, work activities, social relationships and quality of life. The aim of this study was to explore the impact of dysthymic disorder on patients' quality of life. A semi-structured interview was held with 24 dysthymic patients and the data were analyzed by the Alceste software. In this article, the lexical class in the Treatment of dysthymia and Quality of Life was discussed. There was a cycle: sadness that interferes with day-to-day life, causing frustration and dissatisfaction, with feedback to low self-esteem, which would lead to continuity of symptoms, becoming part of the individual's everyday experience, and finally, appearing to be a way of being. From these data, it is suggested that the disorder may be interpreted by new parameters, based on the understanding of this succession of processes, which should be the focus of intervention in these patients.

Urinary Hypoxia-Inducible Factor-1alpha Levels Are Associated with Histologic Chronicity Changes and Renal Function in Patients with Lupus Nephritis

PURPOSE: Tubulointerstitial hypoxia in the kidney is considered a hallmark of injury and a mediator of the progression of tubulointerstitial fibrosis. Hypoxia-inducible factor-1alpha (HIF-1alpha), a master transcription factor in cellular adaptation to hypoxia, regulates a wide variety of genes, some of which are closely associated with tissue fibrosis. The present study set out to characterize urinary HIF-1alpha expressions in patients with lupus nephritis (LN) and to explore whether urinary HIF-1alpha expressions are associated with histologic chronicity changes and renal function. MATERIALS AND METHODS: Urinary HIF-1alpha levels were measured by enzyme-linked immunosorbent assays in 42 patients with LN and in 30 healthy controls. Activity and chronicity indexes as well as tubular HIF-1alpha expressions were analyzed for each specimen. RESULTS: Urinary HIF-1alpha levels were higher in LN patients than in healthy controls (3.977+/-1.696 vs. 2.153+/-0.554 ng/mL, p0.05). CONCLUSION: Urinary HIF-1alpha levels were elevated in LN patients and were associated with histologic chronicity changes and renal function, indicating that HIF-1alpha might contribute to histologic chronicity in LN.

Desafios para os Centros de Atenção Psicossocial como serviços substitutivos: a nova cronicidade em questão / Challenges for Psychosocial Care Centers as alternative services: the new chronicity in question

Este artigo advém de uma pesquisa exploratória, de base qualitativa, realizada em um Centro de Atenção Psicossocial (Caps) do Rio de Janeiro, com o objetivo de compreender a produção da nova cronicidade. Além da observação participante, foram realizadas entrevistas semiestruturadas com técnicos, usuários e familiares, tendo como base para análise dos dados a teoria do construcionismo social. Os resultados mostram que os entrevistados têm perspectivas que vão ao encontro da ideia de nova cronicidade, expressão que colaborou para uma análise do funcionamento, dos avanços e desafios encontrados nesse serviço.

This paper is part of a qualitativelyoriented research project conducted in a Psychosocial Care Center (Caps) in Rio de Janeiro, Brazil. The goal of this work was to analyze the risks of a new chronicity in this service. The research was based on semi-structured interviews with professionals, patients and relatives, analyzing the data from a social constructionist perspective. The main conclusion of this study is that the people interviewed agree with the tendency of a new chronicity, an expression that was useful to analyze the operations, advances and challenges of this service.

Is There Any Relationship between the Chronicity of Chronic Anal Fissure and Endothelin-1?

PURPOSE: Many kinds of substances are produced on vascular endothelial activation. The aim of this study is to confirm an increase in Endothelin-1 (ET-1), the most potent vasoconstrictor, which is produced by endothelial activation, in patients with chronic anal fissure and to infer the relationship between ET-1 and anal fissure chronicity. METHODS: The study groups are divided into three different groups with 30 subjects each. Group 1 is comprised of healthy volunteers, group 2 of chronic anal fissure patients, and Group 3 of patients with higher than 3rd degree hemorrhoids. Blood samples were taken to measure the ET-1 levels in subject's serum and to compare the results with those for the control groups. RESULTS: Among the 90 subjects, 38 were male, and 52 were female. The average age was 36.8. The average ET-1 level marked 1.47 +/- 0.78 pg/mL for male subjects and 1.16 +/- 0.47 pg/mL for female subjects (P = 0.02). The average ET-1 level in the patient groups is as follow: 1.21 +/- 0.44 pg/mL in group 1, 1.46 +/- 0.83 pg/mL in group 2, and 1.20 +/- 0.56 pg/mL in group 3 (P = 0.14). CONCLUSION: Group 2, the chronic anal fissure patient group, showed a higher ET-1 level than groups 1 and 3, the control group and the hemorrhoid patient group, but this difference had no statistical significance.

Cronicidade e vulnerabilidade em saúde de grupos populacionais: implicações para o cuidado / Crónica y vulnerabilidad en salud de grupos de población: implicaciones para el cuidado / Vulnerability and chronic health population groups: implications for care

Este artigo objetivou classificar as vulnerabilidades em saúde dos sujeitos com agravos crônicos, analisando suas suscetibilidades e as implicações para o cuidado de enfermagem. Desenvolveu-se uma pesquisa exploratória, na Universidade do Estado do Rio de Janeiro, em 2008, com 122 participantes de eventos de saúde. O referencial baseou-se em conceitos da área da saúde coletiva e os resultados foram avaliados à luz das análises estatística e temática. Percebe-se que a distribuição das variáveis, correlacionadas com o contexto geral de saúde e as questões socioeconômicas, de trabalho e moradia, fortaleceu a classificação das vulnerabilidades. Esse contexto comprovou as chances de exposição dos sujeitos ao adoecimento como resultante de um conjunto de variáveis, e que também auxiliou na definição das vulnerabilidades. Cabe destacar que as implicações para o cuidado direcionam para práticas de saúde baseadas no modelo construtivista, envolvendo os sujeitos de tal forma que os fazem refletir sobre a sua vida e criar maneiras de se proteger de agravos em defesa de sua saúde e para o alcance de melhor qualidade de vida.

This article aims at classifying health vulnerability in health care practices of subjects in chronic conditions, analyzing the susceptibility of those subjects and the implications for nursing care. It was developed an exploratory analysis, at the Rio de Janeiro State University, in 2008, with 122 participants of health events. Theoretical framework resorted to concepts found in Public Health, and results were evaluated under the light of thematic analysis. It was observed that the percentage of variables, against the general context of health and socio-economic issues, employment, and housing strengthened the classification of vulnerabilities. That context confirmed the likeliness of exposure of individuals to illness as a result of a number of aspects, on the one hand, but, on the other hand, it also helped classifying vulnerabilities. It should be noted that the implications for direct care to health care practices based on the constructivist model cause the subjects to reflect on their attitudes, to create ways to avoid injuries in defense of their health, and to improve quality of life.

Este artículo tuvo por objetivo clasificar las vulnerabilidades en salud de los sujetos con agravios crónicos, analizando sus susceptibilidades y las implicaciones para el cuidado de enfermería. Se ha desarrollado una investigación exploratoria, en la Universidad del Estado de Rio de Janeiro, en 2008, con 122 participantes de eventos de salud. El referencial se ha basado en conceptos del área de salud colectiva y los resultados fueron evaluados a la luz del análisis estadístico y temático. Se observó que la distribución de las variables, correlacionadas con el contexto general de la salud y con las cuestiones socioeconómicas de trabajo y morada, fortaleció la clasificación de las vulnerabilidades. Esto demostró las posibilidades de exposición de las personas a la enfermedad como resultado de una serie de aspectos, y que también ayudó en la definición de las vulnerabilidades. Cabe señalar que las implicaciones para el cuidado apuntan para prácticas de salud basadas en el modelo constructivista, con la participación de los sujetos de tal manera que los hacen reflexionar sobre sus vidas, crear formas de protegerse de las lesiones en defensa de su salud y alcanzar la calidad de vida.

Análisis computarizado y comparativo del discurso en pacientes orgánicos crónicos / Computerized and comparative analysis of discourse in chronic organic patients

El trabajo comienza describiendo los resultados obtenidos en una investigación previa donde a partir del discurso de pacientes con psoriasis y asma se detectaron los deseos y defensas dominantes que aparecían en sus relatos y actos del habla. Estos resultados se estudiaron en relación a cada afección en particular para finalmente investigar qué vinculación guardan con la respuesta desigual que presentaban los pacientes respecto a la medicación indicada para sus respectivos tratamientos.

The study describes, in the first place, the results obtained in a previous research in which the discourse of patients with psoriasis and asthma leads to detect the main wishes and defenses that surfaced in their narrations and speech acts. These results were studied in relation to each particular ailment so as to finally research the link to the dissimilar response the patients presented regarding the indicated medication fortheir respective treatments.