Falta de adherencia al control médico en pacientes pediátricos con antecedente de glomerulonefritis infecciosa

Introducción: La glomerulonefritis pos infecciosa (GNPI) en la infancia es un factor de riesgo para el desarrollo de enfermedad renal crónica a largo plazo. La adherencia al control médico permite realizar la nefroprevención secundaria. Objetivo: evaluar la relación entre los factores de riesgo relacionados a la falta de adherencia al control médico de pacientes con GNPI en una cohorte pediátrica. Metodología: estudio descriptivo de asociación cruzada de cohorte retrospectiva de pacientes internados entre enero de 2000 a diciembre de 2018 en un hospital de referencia. Se analizó la relación entre: hacinamiento, colecho, escolaridad materna y paterna, número de hermanos, de convivientes y procedencia, con la falta de adherencia al control médico. Se utilizaron la prueba de chi cuadrado y regresión logística a un nivel de significancia de 0,05. Resultados: Se incluyeron 148 pacientes (103 niños y 45 niñas) entre 2 a 16 años (edad promedio: 8,5± 3,4 años). La falta de adherencia fue encontrada en 73 pacientes (49,3%) que se asoció a procedencia rural (p= 0,012, RR: 1,50, IC95%: 1,10-2,06), baja escolaridad materna (p= 0,046, IC95%: 1,54:1,14-2,08), baja escolaridad paterna (p= 0,02; RR: 1,483, IC95%: 1,09-2,01), >3 convivientes (p=0,007, RR: 1,630, IC95%: 1,21-2,19), colecho (p=0,026; RR: 1,52, IC95%: 1,02-2,27) y hacinamiento (p<0,0001; RR: 1,92, IC95%: 1,39-2,65). Por regresión logística, el hacinamiento (p=0,005; OR= 4,8) y procedencia rural (p=0,022; OR: 2,4) se mantuvieron asociados a la falta de adherencia. Discusión: El hacinamiento y la procedencia rural se asociaron en forma independiente con la pérdida de seguimiento. Se recomienda mayor intervención de la atención primaria de salud.

Introduction: Post-infectious glomerulonephritis (PIGN) in childhood is a risk factor for the development of long-term chronic kidney disease. Adherence to medical control allows secondary nephroprevention to be carried out. Objective: to evaluate the relationship between risk factors related to non-adherence to medical control of patients with IPGN in a pediatric cohort. Methods: descriptive study, with an analytical component of a retrospective cohort of patients hospitalized between January 2000 and December 2018 in a reference hospital. The relationship between: overcrowding, co-sleeping, maternal and paternal education, number of siblings, cohabitants and origin, with lack of adherence to medical control was analyzed. The chi-square test and logistic regression were used at a significance level of 0.05. Results: a total of 148 patients (103 boys y 45 girls) between 2 and 16 years old (mean age: 8.5± 3.4 years) were included. The lack of adherence was found in 73 patients (49.3%) that was associated with rural origin (p= 0.012, RR: 1.50, 95% CI: 1.10-2.06), low maternal education (p= 0.046, 95%CI: 1.54:1.14-2.08), low paternal education (p= 0.02; RR: 1.483, 95%CI: 1.09-2.01), >3 cohabitants (p=0.007, RR: 1.630, 95% CI: 1.21-2.19), co-sleeping (p=0.026; RR: 1.52, 95% CI: 1.02-2.27) and overcrowding (p<0.0001; RR: 1.92, 95% CI: 1.39-2.65). By logistic regression, overcrowding (p=0.005; OR= 4.8) and rural origin (p=0.022; OR: 2.4) remained associated with lack of adherence. Discussion: Overcrowding and rural origin were independently associated with loss to follow-up. Greater intervention by primary health care is recommended.

Características sociodemográficas en cuidadores principales de pacientes operados de cáncer de cerebro / Socio-demographic characteristics in primary caregivers of patients with brain cancer surgery

RESUMEN Introducción: la atención al enfermo es llevada a cabo por una secuencia específica de la familia, por lo que esta es considerada un cuidador principal. Objetivo: describir las características sociodemográficas en cuidadores principales de pacientes operados de cáncer de cerebro. Materiales y métodos : se realizó un estudio descriptivo, retrospectivo, en un universo de 128 cuidadores principales de pacientes operados de cáncer de cerebro en el Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, de Matanzas, entre 2016 y 2018. Criterio de inclusión: cuidadores que residían en la provincia y aceptación del consentimiento informado. Se excluyeron familiares de pacientes que fallecieron durante la investigación. Se aplicaron cuestionarios y entrevistas para caracterizar los resultados. Los mismos se analizaron en frecuencias absolutas, relativas, porcentual, en paquete estadístico de SPSS versión 20.0 en Windows. Resultados : predominó el sexo femenino (79,68 %). El 100 % de los cuidadores principales residían en casa del enfermo. Prevaleció el nivel de escolaridad de técnico medio (35,93 %); 88,28 % de los cuidadores mantenían vínculo laboral, y 41,40 % eran hermanas de los enfermos. Dentro de las necesidades de aprendizaje del cuidador, el déficit de conocimientos sobre la enfermedad constituyó el 73,43 %. Conclusiones: imperó el género femenino en los cuidadores con vínculo laboral, y con mayor incidencia las hermanas. Se evidenció la complejidad del cuidado en el hogar de los pacientes con secuelas, minusvalía progresiva producidas por la enfermedad, y que generalmente la mujer asume con más facilidad (AU).

ABSTRACT Introduction: the care of the patient is carried out by a specific sequence of the family, catalogued as a main caregiver. Objective: to describe the socio-demographic characteristics in main caregivers of patients who underwent a brain cancer surgery. Materials and methods: a retrospective, descriptive study was carried out in a universe of 128 main caregivers of patients who underwent brain cancer surgery in the University Hospital Faustino Perez Hernandez, of Matanzas, from 2016 until 2018. Inclusion criteria: caregivers living in the province of Matanzas and giving the informed consent. The relatives of patients who died during the research were excluded. Interviews were made and questionnaires applied to characterize the results. They were analyzed in absolute, relative, and percentage frequencies in statistical packet Windows SPSS, 20.0. Results: female sex predominated (79.68%). 100% of main caregivers lived in the house of the patient. The technician scholarship predominated (35.93%); 88.28% of the caregivers kept their employment bonds, and 41.40% were patients' sisters. The deficit of knowledge on the disease was 73.43% of the caregiver learning necessities. Conclusions: female genre prevailed in caregivers with employment bonds, with higher incidence of sisters. It was evidenced the complexity of home care of the patients with sequels, progressive disabilities caused by the disease, generally assumed more easily by women (AU).

Vulnerabilidad al estrés en pacientes adultos hipertensos / Vulnerability to the stress in hypertensive adult patients

RESUMEN Introducción: En la hipertensión, el estrés constituye un factor sicosocial de riesgo. Objetivo: establecer la relación entre vulnerabilidad al estrés con variables sociodemográficas y clínicas en pacientes hipertensos adultos del Policlínico Santa Cruz. Métodos: Estudio descriptivo, transversal. El universo lo conformaron 65 hipertensos, diagnosticados de enero a junio del 2019. La muestra intencional fue de 58 hipertensos. Para la recogida de información se emplearon: la Historia Clínica Individual y familiar y el Test de Vulnerabilidad al Estrés. Resultados: Predominio del 70,7 % de hipertensos en la tercera subetapa de la adultez, supremacía femenina (69,0 %); la mayoría con secundaria básica terminada (36,2 %); casados (44,8 %) y trabajadores estatales (51,7 %); predominaron los fumadores (81 %); prevaleció la hipertensión arterial grado II (69 %) y dieron cumplimiento al tratamiento el 53,4 %. La mayoría presentó vulnerabilidad al estrés (65,5%); mejor representado en la tercera subetapa de la adultez (81,6 %), mujeres (63,2 %), con secundaria básica terminada (39,5 %), casados (42,1 %), trabajador estatal (55,3 %), fumadores (76,3 %), con hipertensión arterial grado II el 76,3 %; cumplieron el tratamiento siempre el 55,3 %; presentaron nivel vulnerable al estrés el 68,4 % de los hipertensos. Existió asociación entre el nivel seriamente vulnerable al estrés y la escolaridad primaria (p= 0,007). La mayoría de los hipertensos presentaron vulnerabilidad al estrés. El nivel vulnerable al estrés predominó; mejor representado en la tercera subetapa de la adultez, en las mujeres, los fumadores, los hipertensos grado II y los que siempre cumplían con el tratamiento. Existió asociación entre el nivel seriamente vulnerable al estrés y la escolaridad primaria.

ABSTRACT Introduction: In the hypertension, the stress constitutes a psychosocial risk factor. Objective: To establish the relation between vulnerability to the stress with socio-demographics and clinical variables in adult hypertensive patients of the General hospital Santa Cruz. Methods: Descriptive, transverse study. The universe was constituted of 65 hypertensive patients, diagnosed from January until June, 2019. The intentional sample was 58 hypertensive patients. For the information collection, it was used: the Individual and familiar Case history and the Test of Vulnerability to the Stress. Results: Predominance 70.7 % of hypertensive patients in the third sub-stage of the adulthood, feminine supremacy (69.0 %); the majority with secondary school finished (36.2 %); married (44.8 %) and state workpeople (51.7 %); there prevailed the smokers (81 %); the arterial hypertension grade II prevailed (69 %) and they fulfilled the treatment 53.4 %. The majority presented vulnerability to the stress (65.5 %); better represented in the third sub-stage of the adulthood (81.6 %), women (63.2 %), with secondary school finished (39.5 %), married (42.1 %), state worker (55.3 %), smokers (76.3 %), with arterial hypertension grade II 76.3 %; they always fulfilled the treatment 55.3 %; they presented vulnerable level to the stress 68.4 % of the hypertensive patients. Association existed between the level seriously vulnerably to the stress and the primary schooling (p = 0.007). Discussion: Most of the hypertensive patients presented vulnerability to the stress. The vulnerable level to the stress prevailed; better represented in the third sub-stage of the adulthood, in the women, the smokers, hypertensive grade II and those who were always fulfilled with the treatment. Association existed between the level seriously vulnerably to the stress and the primary schooling.

Gender perspectives and health literacy proficiencies of In-school adolescents in Osun State, Nigeria

Health literacy proficiency has been linked with positive adolescent health outcomes. Strategies aimed towards improving health literacy have been suggested as a major way of achieving adolescent health and wellbeing. Previous research has identified a nexus between socio-demographics, education and health literacy proficiency. This study therefore, explores existing relationships between gender, socio-economic class and the health literacy proficiency levels of in-school adolescents in Osun State.Mixed method involving questionnaire survey and Focus group discussion were used to obtain data from 1,200 randomly selected in-school adolescents from 12 high schools in Osun State, Nigeria. The survey instrument was an adaptation of the electronic health literacy scale (eHEALS). Results show only 1,186 (98.8%) questionnaire were found analysable. Mean age of respondents was 15 + 0.6 with 616(51.1%) being female. Overall health literacy proficiency was low with only 447(37.7%) having a high level of health literacy proficiency. Quantitative survey shows that both gender and socio-economic background have negative statistically significant relationship with health literacy proficiency. Similarly, FGD revealed that females generally have lower health literacy proficiency when compared with males. The study concludes that gender based interventions for female adolescents could reduce health and educational disparities which will contribute to the achievement of Sustainable Development Goals 3, 4 and 5.

Assessment of Dietary Diversity Score, Nutritional Status and Socio-demographic Characteristics of Under-5 Children in Some Rural Areas of Imo State, Nigeria

Introduction: The study assessed dietary diversity score (DDS) of rural under-five children and the relationship with their nutritional status and socio-demographic characteristics of their mothers/caregivers. Methods: The study was a descriptive cross-sectional survey involving 226 mothers and their under-five children selected at random from rural communities in Imo state, Nigeria. A pre-tested questionnaire was used to obtain information on socio-demographics. Qualitative recall of the child’s food consumption during the previous 24-h was used to calculate individual dietary diversity score (DDS=representing the number of food groups, based on a scale of 12 groups) and the scores were divided into terciles low= =4, medium=5 - 8, and high= 9 - 12). Weight-for-age (WAZ), height-for-age (HAZ) and weight-for-height (WHZ) Z-scores were used to determine nutritional status of the children. Descriptive statistics, Chi square and linear regression analyses were performed. Results: Average age of the children was 4.2±0.7years, with 51.8% being males, and 48.2% females. Stunting, wasting and underweight were 11.5%, 5.4% and 2.7%, respectively. Mean DDS for all food groups was 6.04±4.18. Cereals and vegetables had higher mean values (0.78±0.29 and 0.78±0.30, respectively), while eggs had the least value (0.15±0.25). The prevalence of low, medium and high DDS (in terciles) was 73.5%, 25.2% and 1.3%, respectively. DDS was significantly associated with HAZ (?2 =10.63;p=0.03), while total family income remained significantly and positively associated with dietary diversity score (p<0.05) in the linear regression model. Conclusion: Children with low DDS were more likely to be stunted. Therefore, efforts aimed at increasing diversity in meals, both at home and in schools, are likely to benefit children at nutritional risk.

Consumo de ansiolíticos benzodiazepínicos: uma correlação entre dados do SNGPC e indicadores sociodemográficos nas capitais brasileiras / Consumption of anxiolytic benzodiazepines: a correlation between SNGPC data and sociodemographic indicators in Brazilian capitals

Resumo O objetivo do artigo é conhecer a distribuição e a frequência de consumo de ansiolíticos benzodiazepínicos, bem como avaliar a correlação entre consumo e características demográficas, epidemiológicas, econômicas e sociais. Estudo ecológico tendo como unidade amostral as 27 capitais brasileiras. A coleta de dados foi executada através do banco da Anvisa, para a dispensação do Alprazolam, Bromazepam, Clonazepam, Diazepam e Lorazepam, de 2010 a 2012, do Censo Demográfico 2010 (IBGE), Datasus e da pesquisa Demografia Médica. A análise estatística descritiva e a de regressão linear múltipla foram realizadas para análise dos dados. A região Norte possui as capitais com menores médias de consumo desses medicamentos e o Sudeste as mais elevadas. O consumo médio para a população de todas as capitais foi de 3,60 DHD. O Alprazolam é o mais dispensado pelas farmácias e drogarias particulares, com média de 2,00 DHD para as capitais. A análise de regressão linear múltipla demonstrou que 76% da variância do consumo foi explicada pela variação da densidade demográfica (β = 0,310 p = 0,045) e percentual de médicos (β = 0,507 p = 0,016). O consumo de ansiolíticos de meia vida curta vem crescendo ao longo dos anos, principalmente nas capitais de maior densidade demográfica e concentração de médicos.

Abstract The scope of this article is to determine the distribution and frequency of consumption of anxiolytic benzodiazepines and the correlation between consumption and demographic, epidemiological, economic and social characteristics. It is an ecological study with a sample of 27 state capitals. Data collection was performed through the ANVISA database for the dispensation of Alprazolam, Bromazepam, Clonazepam, Diazepam and Lorazepam in 2010-2012, the 2010 Demographic Census (IBGE), DATASUS and Medical Demographic Research. Descriptive statistical analysis and multiple linear regression analyses were performed for data analysis. The northern region has capitals with the lowest and the southeast has capitals with the highest average consumption of these products. The average consumption for the population of all capitals was 3.60 DHD. Alprazolam is the drug most dispensed by pharmacies and private drugstores with average 2.00 DHD for the capitals. Multiple linear regression analysis showed that 76% of the variation was explained by population density (β = 0.310 p = 0.045) and percentage of physicians (β = 0.507 p = 0.016). The consumption of short half-life anxiolytics has been on the increase, mainly in the cities of greater population density and concentration of physicians.