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Introducción: la diabetes mellitus tipo 2 (DM2) se define como un trastorno metabólico caracterizado por niveles de glucosa en sangre crónicamente elevados. La DM2 representa el paradigma de las enfermedades crónicas en las que existe una estrecha asociación entre factores familiares y ambientales. Por este motivo, este estudio tiene como finalidad determinar la asociación del riesgo a desarrollar DM2 y los hábitos tóxicos no ilícitos en pacientes que residen en una comunidad rural de Peravia, República Dominicana. Tales incluyen: alcohol, café y té. Metodología: Estudio observacional, transversal, analítico y prospectivo. Se aplicó cuestionario, recolectaron datos antropométricos y se determinó glucosa capilar a la muestra (n=304). Resultados: la prevalencia a presentar un alto riesgo a desarrollar DM2 en la población es de 35.5%, mientras que la prevalencia a presentar riesgo bajo es de 64.5%. En cuanto a hábitos tóxicos, no existió correlación positiva entre consumo de té y desarrollo de DM2. Sin embargo, sí entre el consumo de café y alcohol. Conclusiones: los habitantes de salinas presentan un bajo riesgo a desarrollar DM2, pero utilizan factores de riesgos modificables que aumentan la prevalencia a DM2.
Introduction: Type 2 diabetes mellitus (DM2) is defined as a metabolic disorder characterized by chronically elevated blood glucose levels. DM2 represents the paradigm of chronic diseases in which there is a close association between family and environmental factors. Therefore, the purpose of this study is to determine the association of the risk of developing DM2 and non-illicit toxic habits in patients residing in a rural community in Peravia, Dominican Republic. Such habits include alcohol, coffee and tea. Methodology: Observational, cross-sectional, analytical and prospective study. A questionnaire was applied, anthropometric data was collected, and capillary glucose was determined in the study sample (n=304). Results: the prevalence of presenting a high risk of developing DM2 in the population is 35.5%, while the prevalence of presenting low risk is 64.5%. Regarding toxic habits, there was no positive correlation between tea consumption and the development of DM2. However, this result differed between consumption of coffee and alcohol. Conclusions: the inhabitants of Salinas have a low risk of developing DM2 but are subject to modifiable risk factors that increase said prevalence.
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Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Diabetes Mellitus, Type 2 , Chronic Disease , Risk Factors , Dominican RepublicABSTRACT
O homem transgênero apresenta alta susceptibilidade às neoplasias de colo uterino devido à escassez de exames preventivos. O estudo objetiva levantar informações acerca dos desafios e estratégias para a promoção do rastreio e prevenção do câncer cervical em homens transgênero. Trata-se de uma revisão integrativa, desenvolvida em seis etapas a partir da pergunta norteadora: "Quais os desafios e estratégias atuais para a promoção do rastreio efetivo e prevenção de câncer de colo uterino em homens transgênero?". Utilizaram-se descritores combinados com operador booleano "cervical cancer" AND "transgender persons", e foram incluídos artigos completos de 2018 a 2022. Verificou-se que os desafios enfrentados incluem preconceito, despreparo profissional e susceptibilidade à disforia de gênero. Estudos mostraram benefícios relacionados ao uso de swabs vaginais autocolhidos para reduzir o impacto psicológico do exame Papanicolaou, com vistas a reduzir os desafios enfrentados por essa população, e a necessidade de implementar estratégias que aumentem a adesão aos serviços de saúde.
Transgender men are highly susceptible to cervical cancer due to the lack of preventive screening exams. This study aims to gather information about the challenges and strategies for promoting cervical cancer screening and prevention in transgender men. This is an integrative review, developed in six stages, based on the guiding question: "What are the current challenges and strategies for promoting effective screening and prevention of cervical cancer in transgender men?". Descriptors combined with Boolean operator "cervical cancer" AND "transgender persons" were used and full articles from 2018 to 2022 were included. It was found that the challenges faced include prejudice, professional unpreparedness and susceptibility to gender dysphoria. Studies have shown benefits related to the use of self-collected vaginal swabs to reduce the psychological impact of the Pap smear exam, aiming to reduce the challenges faced by this population and to implement strategies to increase adherence to health services.
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Humans , Male , Adult , Uterine Cervical Neoplasms/prevention & control , Healthcare Disparities , Barriers to Access of Health ServicesABSTRACT
In 2018, we reported an epidemiological study on disease-preventive effects of habitual hot spa-bathing in the elderly in Beppu city, which has the highest number of hot spring sources in the world. In this analysis, women with diabetes mellitus were observed more often as hot spa-bathers than non-spa-bathers [odds ratio (OR): 1.238, confidence interval (CI): 1.011-1.517]. To see whether there is an apparent harmful effect of spa-bathing, complicated background diseases of women with diabetes mellitus were investigated in this study. We compared background diseases of women complicated with diabetes mellitus in spa-bathers and non-spa-bathers. Compared with non-spa-bathers, female spa-bathers with diabetes mellitus revealed a higher occurrence of cancer history (OR: 2.626, CI 1.517-4.545). The occurrence of diabetes mellitus in women with no cancer history was not significantly different between habitual spa-bathers and non-spa-bathers (OR:1.041, CI 0.837-1.293). The observed odds ratios suggest that spa-bathing associated cancer surviving promotion leads to an increasing number of diabetic women with a past history of cancer and contributes to more women with diabetes mellitus in spa-bathers rather than habitual spa-bathing promoting the pathogenesis of diabetes mellitus.
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OBJECTIVE@#This study aimed to investigate the association of ambient PM2.5 exposure with blood pressure (BP) at the population level in China.@*METHODS@#A total of 14,080 participants who had at least two valid blood pressure records were selected from the China Health and Retirement Longitudinal Survey during 2011-2015. Their long-term PM2.5 exposure was assessed at the geographical level, on the basis of a regular 0.1° × 0.1° grid over China. A mixed-effects regression model was used to assess associations.@*RESULTS@#Each decrease of 10 μg/m3 in the 1 year-mean PM2.5 concentration (FPM1Y) was associated with a decrease of 1.24 [95% confidence interval (CI): 0.84-1.64] mmHg systolic BP (SBP) and 0.50 (95% CI: 0.25-0.75) mmHg diastolic BP (DBP), respectively. A robust association was observed between the long-term decrease in PM2.5 and decreased BP in the middle-aged and older population. Using a generalized additive mixed model, we further found that SBP increased nonlinearly overall with FPM1Y but in an approximately linear range when the FPM1Y concentration was < 70 µg/m3; In contrast, DBP increased approximately linearly without a clear threshold.@*CONCLUSION@#Efficient control of PM2.5 air pollution may promote vascular health in China. Our study provides robust scientific support for making the related air pollution control policies.
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Middle Aged , Humans , Aged , Particulate Matter/analysis , Blood Pressure , Air Pollutants/analysis , Follow-Up Studies , Hypertension/etiology , East Asian People , Environmental Exposure/analysis , Air Pollution/analysis , China/epidemiologyABSTRACT
ABSTRACT Introduction: Ballroom dancing is a high-intensity sport. Exaggerated training plans and an overtraining range can easily cause sports injuries. Athletes should take the necessary protective measures when training or competing, including exercises with preventative intent. Objective: This research paper thoroughly investigates the current status of ballroom dance injuries in colleges and universities. Methods: This research selects 28 students who majored in ballroom dancing as experimental subjects. The volunteers were divided into a control group and an experimental group. The experimental group received an exercise prescription for 12 weeks of exercise. The control group did not do any exercise for 12 weeks. Injury statistics were performed after a 12-week comparative trial. The effect of exercise prescription on injury reduction in ballroom dancing was discussed. Results: The incidence of sports injuries in the experimental group decreased significantly after 12 weeks (P<0.01). Compared to the control group, the incidence of muscle, ligament and joint injuries in the experimental group was significantly lower (P<0.01). The waist and ankle injuries incidence in the experimental group was lower than in the control group, and the data had significant differences (P<0.01). Conclusion: Dance athletes who choose the appropriate exercise prescription can effectively reduce the likelihood of injuries during training. Training can effectively improve performance in athletic competitions. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
RESUMO Introdução: A dança de salão é um esporte de alta intensidade. Planos de treinamento exagerados e um leque de treinamento excessivo podem facilmente causar lesões esportivas. Os atletas devem tomar as medidas de proteção necessárias ao treinar ou competir, incluindo exercícios com intuito preventivo. Objetivo: Este artigo investiga minuciosamente a situação atual das lesões na dança de salão nas faculdades e universidades. Métodos: Esta pesquisa seleciona 28 estudantes que se especializaram em dança de salão como disciplinas experimentais. Os voluntários foram divididos em um grupo de controle e um grupo experimental. O grupo experimental recebeu uma prescrição de exercício durante 12 semanas de exercício físico. O grupo de controle não fez nenhum exercício durante 12 semanas. As estatísticas de lesões foram realizadas após um ensaio comparativo de 12 semanas. Foi discutido o efeito da prescrição de exercícios sobre a redução de lesões na dança de salão. Resultados: A incidência de lesões esportivas no grupo experimental diminuiu significativamente após 12 semanas (P<0,01). Em comparação com o grupo controle, a incidência de lesões nos músculos, ligamentos e articulações no grupo experimental foi significativamente menor (P<0,01). A incidência de lesões na cintura e tornozelo no grupo experimental foi menor do que no grupo controle, e os dados tiveram diferenças significativas (P<0,01). Conclusão: Os atletas de dança que escolhem a prescrição apropriada para o exercício podem efetivamente reduzir a probabilidade de lesões durante o treinamento. O treinamento pode efetivamente melhorar o desempenho em competições esportivas. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción: El baile de salón es un deporte de alta intensidad. Los planes de entrenamiento exagerados y el sobreentrenamiento pueden provocar fácilmente lesiones deportivas. Los deportistas deben tomar las medidas de protección necesarias cuando entrenen o compitan, incluyendo ejercicios con intención preventiva. Objetivo: Este documento investiga a fondo la situación actual de las lesiones en los bailes de salón en los colegios y universidades. Métodos: Esta investigación selecciona como sujetos experimentales a 28 estudiantes que se especializan en bailes de salón. Los voluntarios se dividieron en un grupo de control y un grupo experimental. El grupo experimental recibió una prescripción de ejercicio durante 12 semanas. El grupo de control no hizo ningún ejercicio durante 12 semanas. Las estadísticas de lesiones se realizaron tras un ensayo comparativo de 12 semanas. Se analizó el efecto de la prescripción de ejercicios en la reducción de lesiones en los bailes de salón. Resultados: La incidencia de lesiones deportivas en el grupo experimental disminuyó significativamente después de 12 semanas (P<0,01). En comparación con el grupo de control, la incidencia de lesiones musculares, ligamentosas y articulares en el grupo experimental fue significativamente menor (P<0,01). La incidencia de las lesiones de cintura y tobillo en el grupo experimental fue menor que en el grupo de control, y los datos presentaron diferencias significativas (P<0,01). Conclusión: Los atletas de danza que eligen la prescripción de ejercicios adecuada pueden reducir eficazmente la probabilidad de lesiones durante el entrenamiento. El entrenamiento puede mejorar eficazmente el rendimiento en las competiciones deportivas. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
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ABSTRACT Introduction The acceleration of the aging process causes the number of elderly patients with chronic diseases to increase every year, causing hypertension, diabetes, cerebral infarction, and chronic respiratory diseases. This situation considerably threatens the health of the elderly, affecting their quality of life. Objective Improve the health awareness of the elderly as well as modify unhealthy lifestyles. Methods Changes in blood glucose, blood pressure, blood lipids, uric acid, blood oxygen saturation, body mass index (BMI) and other indicators in elderly patients with chronic diseases before and after aerobic exercise were compared and analyzed. Symptoms and common self-management efficacy scores in elderly patients with chronic diseases were compared and analyzed before and after aerobic exercise. Results The detection rate of liver steatosis, overweight and obesity significantly decreased after aerobic exercise. Symptom scores and common self-management efficacy were significantly higher than those collected before the intervention (p<0.05). Conclusion The actual measured and predicted theoretical value of vital capacity, and other vital indicators were significantly improved. Level of evidence II; Therapeutic studies - investigating treatment outcomes.
RESUMO Introdução A aceleração do processo de envelhecimento faz com que o número de pacientes idosos com doenças crônicas, aumente todos os anos, provocando hipertensão, diabetes, infarto cerebral e doenças respiratórias crônicas. Esta situação ameaça consideravelmente a saúde do idoso afetando sua qualidade de vida. Objetivo Melhorar a conscientização sobre a saúde do idoso bem como modificar o estilo de vida pouco saudável. Métodos foram comparadas e analisadas as alterações da glicemia, pressão arterial, lipídios sanguíneos, ácido úrico, saturação de oxigênio no sangue, índice de massa corporal (IMC) e outros indicadores em pacientes idosos com doenças crônicas antes e depois do exercício aeróbico. Foram comparados e analisados os sintomas e escores comuns de eficácia de autogestão em pacientes idosos com doenças crônicas antes e depois do exercício aeróbico. Resultados A taxa de detecção de esteatose hepática, excesso de peso e obesidade diminuiu significativamente depois do exercício aeróbico. Os escores de sintomas e a eficácia comum de autogestão foram significativamente superiores aos coletados antes da intervenção (p<0,05). Conclusão O valor real medido e teórico previsto da capacidade vital, e outros indicadores vitais foram aprimorados significativamente. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción La aceleración del proceso de envejecimiento hace que el número de pacientes ancianos con enfermedades crónicas aumente cada año, provocando hipertensión, diabetes, infarto cerebral y enfermedades respiratorias crónicas. Esta situación amenaza considerablemente la salud de las personas mayores, afectando a su calidad de vida. Objetivo mejorar la concienciación sobre la salud de las personas mayores, así como modificar los estilos de vida poco saludables. Métodos se compararon y analizaron los cambios en la glucemia, la presión arterial, los lípidos sanguíneos, el ácido úrico, la saturación de oxígeno en sangre, el índice de masa corporal (IMC) y otros indicadores en pacientes ancianos con enfermedades crónicas antes y después del ejercicio aeróbico. Se compararon y analizaron los síntomas y las puntuaciones comunes de eficacia de autogestión en pacientes ancianos con enfermedades crónicas antes y después del ejercicio aeróbico. Resultados La tasa de detección de esteatosis hepática, sobrepeso y obesidad disminuyó significativamente tras el ejercicio aeróbico. Las puntuaciones de los síntomas y la eficacia común de autocontrol fueron significativamente superiores a las recogidas antes de la intervención (p<0,05). Conclusión El valor real medido y el valor teórico previsto de la capacidad vital, así como otros indicadores vitales, mejoraron significativamente. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
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ABSTRACT Introduction Many athletes suffer sports injuries during exercise and are susceptible to sequelae due to a variety of post-injury complications that occur in the process of sports activities. Preventing these injuries in physical training, impacts positively on the athletes' physique. Objective Study the sports habit and regional physical fitness, exploring the prevention strategies in the main sports injuries. Methods This paper elaborates targeted questionnaires (n=568) including proportion of gender, fitness, exercise frequency, duration and intensity of current regional fitness, as well as athletes' motivations in a Chinese city. Results Current urban residents' enthusiasm for fitness is high, however due to lack of conditions, athletes tend to choose some sports with lower complexity (circuits, 65.06%; running, 48.84%; walking, 40.46%). Most of the injuries caused by these types of sports are skin abrasions. The severity of these injuries is not high. Conclusion Providing effective exercise guidance to its practitioners can improve their sports cognition, build a foundation for the professional sports system, and provide relevant knowledge about emergency treatments. Level of evidence II; Therapeutic studies - investigation of treatment results.
RESUMO Introdução Muitos atletas sofrem lesões esportivas durante o exercício e estão propensos a sequelas por uma variedade de complicações do pós-acidente que ocorre no processo das atividades esportivas. Prevenir essas lesões no treinamento físico, impacta positivamente no físico dos atletas. Objetivo Estudar o hábito esportivo e a aptidão física regional, explorando as estratégias de prevenção nas principais lesões desportivas. Métodos Este artigo elabora questionários direcionados (n=568) incluindo proporção de gênero, aptidão, frequência, duração e intensidade do exercício da aptidão regional atual, bem como as motivações dos atletas em uma cidade chinesa. Resultados O entusiasmo dos atuais moradores urbanos pela aptidão física é alto, porém devido à falta de condições, os atletas tendem a optar por alguns esportes com menor complexidade (circuitos, 65,06%; corrida, 48,84%; caminhada, 40,46%). A maioria das lesões causadas por esse tipo de esportes são abrasões de pele. A gravidade dessas lesões não é alta. Conclusão Fornecer a orientação efetiva dos exercícios para seus praticantes pode melhorar sua cognição esportiva, construir uma base para o sistema esportivo profissional e proporcionar conhecimentos relevantes sobre os tratamentos emergenciais. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.
RESUMEN Introducción Muchos atletas sufren lesiones deportivas durante el ejercicio y son propensos a sufrir secuelas debido a una variedad de complicaciones posteriores a la lesión que se producen en el proceso de las actividades deportivas. Prevenir estas lesiones en el entrenamiento físico, repercute positivamente en el físico de los deportistas. Objetivo Estudiar el hábito deportivo y la aptitud física regional, explorando las estrategias de prevención en las principales lesiones deportivas. Métodos Este trabajo elabora cuestionarios específicos (n=568) que incluyen la proporción de género, la condición física, la frecuencia de ejercicio, la duración y la intensidad de la condición física regional actual, así como las motivaciones de los deportistas en una ciudad china. Resultados El entusiasmo de los residentes urbanos actuales por la aptitud física es alto, sin embargo, debido a la falta de condiciones, los atletas tienden a elegir algunos deportes de menor complejidad (circuitos, 65,06%; correr, 48,84%; caminar, 40,46%). La mayoría de las lesiones causadas por este tipo de deportes son abrasiones de la piel. La gravedad de estas lesiones no es elevada. Conclusión Proporcionar una orientación eficaz sobre el ejercicio a sus practicantes puede mejorar su cognición deportiva, construir una base para el sistema deportivo profesional y proporcionar conocimientos relevantes sobre los tratamientos de emergencia. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.
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Objective:To explore the source of students and the way to understand the policy of public and non-public undergraduate students majoring in preventive medicine.Methods:Using cluster random sampling, a total of 205 students from the first batch of public funded undergraduates and the same batch of non-public funded undergraduates of preventive medicine from Batch 2020 of two medical colleges in Shandong Province were selected as research objects. Questionnaires were issued on the platform of Sojump to investigate the source of students and the way to understand the policy. SPSS 22.0 statistical software was used to analyze the data, and the relative number and composition ratio were used to describe the counting data. Chi-square test was used to compare the characteristics of students and the understanding degree of the policy between government-funded undergraduates and non-government-funded undergraduates. Multiple responses were used to analyze students' understanding of the policy.Results:There were significant differences in the gender ( χ2=10.29, P<0.001), place of household registration ( χ2=5.61, P=0.018), father's educational level ( χ2=9.78, P=0.044) and the way to understand the policy ( χ2=17.19, P<0.001) of the public and non-public funded undergraduates majoring in preventive medicine. And 88.4% of the students knew about the policy of public medical students through their teachers, classmates and family members. Conclusion:There are more female government-funded undergraduates in preventive medicine than male students, and more rural students than urban students, with the spreading way of from mouth to mouth as the main approach to know this policy.
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Based on the information of China Postgraduate Admissions Information Network and the official website of the enrollment unit, this study statistically analyzed the enrollment of master's and doctoral students in the first-level discipline of public health and preventive medicine in China in 2022. The results showed a regional imbalance in the enrollment of postgraduate students of public health and preventive medicine, research fields to be further expanded, a lack of international top colleges or institutions for public health and preventive medicine postgraduate cultivation, a weakening phenomenon in the cultivation of postgraduates related to infectious disease prevention and control, and the interdiscipline to be further strengthened. It is suggested to pay attention to the regional balance in the enrollment of public health and preventive medicine postgraduate students; the research field of postgraduate enrollment in public health and preventive medicine should be further expanded; the high-level public health colleges constructed needs to attach importance to postgraduate enrollment and cultivation, and to balance infectious and non-infectious disease research; public health and preventive medicine should be combined with life science, biosafety/biosecurity, and social sciences.
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Objective:To carry out opening experiments on occupational health and occupational medicine for students majoring in preventive medicine, reform the experimental teaching mode, and explore the teaching methods to improve students' professional quality and scientific research ability.Methods:Opening experiments were carried out in the experimental course of occupational health and occupational medicine for students of preventive medicine major. A total of 147 students majoring in preventive medicine of Batch 2016 were classified as the control group, and the routine confirmatory experiment was carried out in the group; 176 students majoring in preventive medicine of Batch 2017 were classified as the experimental group, and this group carried out opening experiment. The evaluation was made from three aspects: comprehensive evaluation results, teacher self-evaluation and student satisfaction survey. SPSS 22.0 software was used for analysis and comparison by independent-samples t-test and Chi-square test. Results:The theoretical scores of the experimental group and the control group students were (84.37±10.45) vs. (81.44±9.22) ( t=2.68, P=0.008), and the experimental skills scores were (93.66±3.89) vs. (88.41±5.67) ( t=9.51, P<0.001). Questionnaire investigation showed that the students in the opening experimental group were more satisfied with the courses arrangement ( χ2=8.31, P=0.004), group cooperation ( χ2=21.10, P<0.001), assessment form ( χ2 =7.92, P=0.005), improvement of the writing ability of scientific research papers ( χ2 =17.56, P<0.001), improvement of practical skills ( χ2=11.70, P=0.001), logical thinking, language organization and expression ability ( χ2=10.33, P=0.001). They considered the opening experiment was helpful to cultivate innovative thinking and ability, but it had limited effect on the cultivation of employment advantages. And the students considered the opening experiments of setting up professional courses was sufficient and necessary. Conclusion:Carrying out opening experiments for students majoring in preventive medicine is helpful to improve students' professional quality and cultivate their practical ability and scientific research ability.
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There are still some shortcomings in the training of preventive medicine undergraduates in China, such as outdated education mode, disjointed theory/practice, and lack of multi-dimensional integration. This paper proposes an attempt to reform the cultivation mode of preventive medicine undergraduates by combining student research training programs. However, many problems have been exposed during the implementation of the reform, and it has not achieved satisfactory results, especially in emergency management and solving practical problems. In order to cultivate practical preventive medicine talents in line with the needs of the times, the training mode based on student research training projects still needs considerable efforts in many aspects, including project approval, project guidance, project evaluation and so on.
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Abstract Background Migraine affects 1 billion people worldwide and > 30 million Brazilians; besides, it is an underdiagnosed and undertreated disorder. Objective The need to disseminate knowledge about the prophylactic treatment of migraine is known, so the Brazilian Headache Society (SBCe, in the Portuguese acronym) appointed a committee of authors with the objective of establishing a consensus with recommendations on the prophylactic treatment of episodic migraine based on articles from the world literature as well as from personal experience. Methods Meetings were held entirely online, with the participation of 12 groups that reviewed and wrote about the pharmacological categories of drugs and, at the end, met to read and finish the document. The drug classes studied in part II of this Consensus were: antihypertensives, selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, calcium channel blockers, other drugs, and rational polytherapy. Results From this list of drugs, only candesartan has been established as effective in controlling episodic migraine. Flunarizine, venlafaxine, duloxetine, and pizotifen were defined as likely to be effective, while lisinopril, enalapril, escitalopram, fluvoxamine, quetiapine, atorvastatin, simvastatin, cyproheptadine, and melatonin were possibly effective in prophylaxis of the disease. Conclusions Despite an effort by the scientific community to find really effective drugs in the treatment of migraine, given the large number of drugs tested for this purpose, we still have few therapeutic options.
Resumo Antecedentes Migrânea afeta um bilhão de pessoas em todo o mundo e mais de 30 milhões de brasileiros; além disso, é um distúrbio subdiagnosticado e subtratado. Objetivo Sabe-se sobre a necessidade de difundir o conhecimento sobre o tratamento profilático da migrânea; por isso, a Sociedade Brasileira de Cefaleias (SBCe) nomeou um comitê de autores com o objetivo de estabelecer um consenso com recomendações sobre o tratamento profilático da migrânea episódica com base em artigos da literatura mundial, assim como da experiência pessoal. Métodos As reuniões foram realizadas inteiramente online, com a participação de 12 grupos que revisaram e escreveram sobre as categorias farmacológicas dos medicamentos e, ao final, reuniram-se para a leitura e conclusão do documento. As classes de medicamentos estudadas na parte II deste Consenso foram: anti-hipertensivos, inibidores seletivos de recaptação de serotonina, inibidores de recaptação de serotonina e noradrenalina, bloqueadores dos canais de cálcio, outros medicamentos e politerapia racional. Resultados Desta lista de medicamentos, apenas o candesartan foi estabelecido como eficaz no controle da migrânea episódica. Flunarizina, venlafaxina, duloxetina e pizotifeno foram definidos como provavelmente eficazes, enquanto lisinopril, enalapril, escitalopram, fluvoxamina, quetiapina, atorvastatina, sinvastatina, ciproheptadina e melatonina foram possivelmente eficazes na profilaxia da doença. Conclusões Apesar do esforço da comunidade científica em encontrarmedicamentos realmente eficazes no tratamento da migrânea, dado o grande número de medicamentos testados para este fim, ainda dispomos de poucas opções terapêuticas.
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Objetivo Identificar barreras en el acceso a control preventivo de la Atención Primaria en padres migrantes de lactantes y preescolares en Santiago, Chile, en el año 2018. Métodos Estudio observacional, descriptivo, transversal, en una muestra no probabilística de 108 padres migrantes de lactantes y preescolares entre 0-4 años, 11 meses, 29 días, que asisten a jardines infantiles de la comuna de Santiago, en quienes se autoaplicó un cuestionario en español y creole, diseñado y validado en contenido y traducción de forma piloto, previa autorización de Comité de Ética, entre julio y octubre de 2018. Se midieron variables de caracterización sociodemográfica, asistencia a control preventivo y barreras. Resultados Un 7,8% de padres manifestó que su hijo no asistía a control, y 48,5% de los padres indicó que tenía dificultades para asistir. Las barreras para asistir a control fueron en un 63% horario y tiempos de espera, en un 39,8% desconocimiento del funcionamiento del sistema y en un 11,1% transporte. Conclusiones Son necesarias estrategias para mejorar el acceso a salud con una mirada desde los determinantes sociales de la salud.
Objective To identify barriers to preventive healthcare access in migrant parents of Infants and young children in Santiago, Chile, 2018. Methods An observational, descriptive, cross-sectional study, in a non-probability sample from 108 migrant parents of 0-4 years old children, attending at pre-primary schools in Santiago was designed. A self-administered questionnaire was used to determine variables, which was designed and validated through pilot tested after approval by an Ethics Committee. Sociodemographic characterization, preventive healthcare attendance, and barriers were measured. Results 7.8% of parents said their child was not attendant to healthcare and 48.5% of parents had difficulties to attend. The barriers were appointment and waiting time (63%), unknowledge (39.8%), and transport (11.1%). Conclusions The design of strategies to improve access to preventive healthcare in children considering determinants of health is needed.
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Abstract The Brazilian Headache Society (Sociedade Brasileira de Cefaleia, SBCe, in Portuguese) nominated a Committee of Authors with the aim of establishing a consensus with recommendations regarding prophylactic treatment for episodic migraine based on articles published in the worldwide literature, as well as personal experience. Migraine affects 1 billion people around the world and more than 30 million Brazilians. In addition, it is an underdiagnosed and undertreated disorder. It is well known within the medical community of neurologists, and especially among headache specialists, that there is a need to disseminate knowledge about prophylactic treatment for migraine. For this purpose, together with the need for drug updates and to expand knowledge of the disease itself (frequency, intensity, duration, impact and perhaps the progression of migraine), this Consensus was developed, following a full online methodology, by 12 groups who reviewed and wrote about the pharmacological categories of the drugs used and, at the end of the process, met to read and establish conclusions for this document. The drug classes studied were: anticonvulsants, tricyclic antidepressants, monoclonal anti-calcitonin gene-related peptide (anti-CGRP) antibodies, beta-blockers, antihypertensives, calcium channel inhibitors, other antidepressants (selective serotonin reuptake inhibitors, SSRIs, and dual-action antidepressants), other drugs, and polytherapy. Hormonal treatment and anti-inflammatories and triptans in minimum prophylaxis schemes (miniprophylaxis) will be covered in a specific chapter. The drug classes studied for part I of the Consensus were: anticonvulsants, tricyclic antidepressants, monoclonal anti-CGRP antibodies, and beta-blockers.
Resumo A Sociedade Brasileira de Cefaleia (SBCe) nomeou um Comitê de Autores com o objetivo de estabelecer um consenso com recomendações sobre o tratamento profilático da enxaqueca episódica com base em artigos da literatura mundial e da experiência pessoal. A enxaqueca é um distúrbio subdiagnosticado e subtratado que acomete um bilhão de pessoas no mundo e mais de 30 milhões de brasileiros. É conhecido na comunidade médica de neurologistas e, sobretudo, dos especialistas em cefaleia, a necessidade de se divulgar o conhecimento sobre o tratamento profilático da enxaqueca. Com esta finalidade, aliada às necessidades de atualizações de drogas e de se aumentar o conhecimento sobre a doença em si (frequência, intensidade, duração, impacto e talvez a progressão da enxaqueca), foi elaborado este Consenso, com metodologia totalmente on-line, por 12 grupos que revisaram e escreveram sobre as categorias farmacológicas das drogas e, ao final, reuniram-se para a leitura e conclusão do documento. As classes de drogas estudadas para este Consenso foram: anticonvulsivantes, antidepressivos tricíclicos, anticorpos monoclonais do antipeptídeo relacionado ao gene da calcitonina (peptídeo relacionado ao gene da calcitonina — anti-CGRP), betabloqueadores, anti-hipertensivos, inibidores dos canais de cálcio, outros antidepressivos (inibidores seletivos de recaptação de serotonina, ISRSs, e antidepressivos de ação dual), outras drogas, e politerapia. O tratamento hormonal, bem como anti-inflamatórios e triptanas em esquema de profilaxia mínima (miniprofilaxia), será abordado em um capítulo próprio. As classes de drogas estudadas na parte I do Consenso foram: anticonvulsivantes, antidepressivos tricíclicos, anticorpos monoclonais anti-CGRP, e betabloqueadores.
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Resumen A lo largo de su historia, México ha sido afectado por diversas epidemias, así como pandemias, y el sistema de salud de cada época ha tenido que desarrollar, adoptar y perpetuar múltiples acciones y medidas de seguridad sanitarias, entre las que destacan las siguientes: vacunación, higiene personal, sana alimentación, cloración del agua, suspensión de actividades, desinfección de lugares públicos y casas, cuarentena, confinamiento o aislamiento, uso de cubrebocas, evitar lugares concurridos, prohibición de reuniones colectivas, por mencionar las más relevantes. Todo lo anterior se ha implementado con la intención de mitigar y erradicar su propagación; así como disminuir su morbilidad y mortalidad. La pandemia por COVID-19, al igual que todas las epidemias y pandemias que se han presentado en México, ha trastocado diversos aspectos como el económico, social, político y sanitario. En cada época se ha hecho evidente la crisis por la que atraviesa el sector salud, lo cual ha implicado que las autoridades sanitarias realicen múltiples esfuerzos para hacerles frente y tratar de sobrellevarlas. En este escrito hacemos un breve recuento de las epidemias y pandemias que han afectado a México, desde el año 1450 hasta el 2020, la evolución histórica de las autoridades sanitarias y los aspectos generales del Derecho Sanitario.
Abstract Throughout history, Mexico has been affected by major epidemics and pandemics, for this reason the health system of each era has had to develop, adopt and perpetuate multiple actions and health security measures, in which the following measures stand out: vaccination, adequate personal hygiene, a balanced diet, water chlorination, suspension of some activities, adequate disinfection of public places, preventive and disinfection measures in homes, quarantine, isolation or confinement, correct use of face masks, avoid crowded places, prohibit or avoid collective meetings, this just to mention the most relevant. The aforementioned cares have been implemented with the intention of mitigating and eradicating its spread, as well as reducing its morbidity and mortality from it. The COVID-19 pandemic, like other pandemics that have arisen over time in México, have affected various aspects such as economic, social, political and especially sanitary health. As time has passed, the crisis that the health sector is going through has become evident, which has forced the corresponding health authorities to make multiple efforts to face it and try to cope with these epidemics and pandemics. In this article we make a brief account of the epidemics and pandemics that have affected Mexico from the year 1450 to 2020, as well as the historical evolution of the pertinent health authorities and the general aspects of health law.
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Introdução: O SARS-CoV-2 é um novo tipo de coronavírus capaz de infectar humanos e causar a Coronavirus Disease (COVID-19), enfermidade que tem causado enormes impactos no Brasil e no mundo. A doença, devido às suas altas taxas de disseminação e letalidade, foi declarada pandêmica pela Organização Mundial da Saúde no primeiro semestre de 2020. Vários estudos têm frequentemente indicado a detecção de fragmentos de RNA do SARS-CoV-2 em amostras de redes de esgoto, estações de tratamento e águas naturais. A presença do SARS-CoV-2 nesses ambientes tem levantado a possibilidade de transmissão pelo contato com águas contaminadas e aerossóis gerados durante seus fluxos ou tratamentos. Objetivo: Descrever relatos de detecção do novo coronavírus em amostras obtidas em redes de esgotos, em lodos residuais de plantas de tratamento e em corpos d'água naturais, e apresentar a viabilidade desse vírus quando inoculado artificialmente nesses ambientes. Método: Revisão integrativa de literatura fundamentada em artigos científicos escritos em inglês ou português, indexados nas bases de dados do Web of Science, Scopus, PubMed, ScienceDirect, Google Scholar e MedRxiv. Resultados: Foi possível destacar os riscos que o SARS-CoV-2 proporciona às populações de humanos e de animais selvagens quando presente nas águas residuais, estratégias cabíveis de serem utilizadas para limitar a propagação desse patógeno nas matrizes aquáticas, e a importância da implementação de sistemas de monitoramento epidemiológico nesses locais. Conclusões: A fim de reduzir os riscos de surtos emergentes e reemergentes da COVID-19 por meio de matrizes aquosas, abordagens preventivas em relação à presença do SARS-CoV-2 nesses ambientes têm sido fortemente recomendadas.
Introduction: SARS-CoV-2 is a new type of coronavirus capable of infecting humans and cause the Coronavirus Disease (COVID-19), an illness that has causing enormous impacts in Brazil and worldwide. The disease, due to its high-level dissemination and lethality rates, was declared pandemic by the World Health Organization in the first half of 2020. Several studies have frequently indicated the detection of SARS-CoV-2 RNA fragments in samples from sewage networks, treatment plants and natural waters. The presence of SARS-CoV-2 in those environments has raised the possibility of transmission through the contact with contaminated waters and aerosols generated during their flow or treatment. Objective: Describe detection reports of the new coronavius in samples obtained from sewage networks, from waste sludges of treatment plants and from natural water bodies, and present the viability of this virus when artificially inoculated in those environments. Method: Integrative literature review based on scientific articles written in English or Portuguese, indexed in the Web of Science, Scopus, PubMed, ScienceDirect, Google Scholar and MedRxiv databases. Results: It was possible to highlight the risks that the SARS-CoV-2 poses to human and wildlife populations when present in wastewater, appropriate strategies to be used to limit the spread of this pathogen in aquatic matrices, and the importance of implementing epidemiological monitoring systems in those places. Conclusions: In order to reduce the risks of emerging and re- emerging outbreaks of COVID-19 through aqueous matrices, precautionary approaches regarding the presence of SARS-CoV-2 in those environments have been strongly recommended.
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RESUMEN Objetivo. Diseñar y analizar las evidencias de validez de contenido, estructura interna y fiabilidad de un cuestionario de prácticas preventivas de hantavirus en una comunidad endémica en el contexto panameño. Materiales y métodos. Estudio cuantitativo de diseño instrumental. Esta investigación se desarrolló en cuatro etapas: revisión de literatura, validez de contenido a través de juicio de expertos con el método de agregados individuales y el cálculo de la V de Aiken; prueba piloto y validación psicométrica, a través del análisis factorial exploratorio (AFE) y análisis de fiabilidad de las puntuaciones del instrumento con el alfa ordinal. Resultados. Se evidenció validez de contenido y se reportó valores de V de Aiken superiores a 0,70 en el límite inferior del intervalo de confianza al 95%. En la estructura interna se identificó que los 8 ítems subyacen a un solo factor que explica el 60,70% de la varianza total de la prueba y con cargas factoriales superiores a 0,40; en el análisis de fiabilidad se obtuvo un valor de alfa ordinal de 0,84, valor considerado como bueno. Conclusiones. El cuestionario de práctica preventivas de hantavirus es un instrumento breve que muestra propiedades psicométricas aceptables para medir las actividades o conductas que realizan las personas para prevenir el hantavirus.
ABSTRACT Objective. To design and analyze the evidence of content validity, internal structure, and reliability of a questionnaire of preventive practices for hantavirus in an endemic community in the Panamanian context. Material and methods. Quantitative study of instrumental design. This research was conducted in four phases: Literature review, content validity through expert judgment with the individual aggregate method and the calculation of the V Aiken, pilot test and psychometric validation, through exploratory factor analysis (EFA) and reliability analysis of instrument scores with ordinal alpha. Results. Content validity was evidenced and V Aiken values higher than 0.70 were reported in the lower limit of 95% CI. In the internal structure we identified that the 8 items underlie a single factor that explains 60.70% of the total variance of the test and with factor loadings greater than 0.40; during the reliability analysis, we obtained an ordinal alpha value of 0.84, which is considered good. Conclusions. The Hantavirus preventive practical questionnaire is a brief instrument that shows acceptable psychometric properties to measure the activities or behaviors that people carry out to prevent hantavirus.
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Preventive Medicine , Orthohantavirus , Surveys and Questionnaires , Validation StudyABSTRACT
Objetivo: Com o presente estudo, buscou-se verificar a quantidade de exames de colpocitologia oncótica coletados em Unidade Básica de Saúde (UBS) escolhida, determinar quantas e quais são as alterações encontradas nesses exames e quais foram as condutas e acompanhamentos realizados em pacientes com exames alterados. Métodos: Foram analisados 446 exames de colpocitologia oncótica realizados em uma UBS do centro-oeste do Paraná. As pacientes com exame alterado foram selecionadas e foi feita uma análise desses prontuários a fim de verificar a conduta e o acompanhamento dessas pacientes. Resultados: Foram encontrados 32 exames com alterações, sendo três de uma mesma paciente. Dessas 30 pacientes, a grande maioria correspondia a células escamosas atípicas de significado indeterminado (ASC-US), possivelmente não neoplásicas, e 28 pacientes retornaram para receber uma conduta inicial, sendo principalmente o encaminhamento para a coleta de novo preventivo em seis meses ao serviço de oncologia clínica. Conclusão: O presente estudo concluiu que a hipótese principal foi verdadeira, a qual foi descrita como prevalência significativa de lesões intraepiteliais de alto grau, embora não seja a mais frequente, e descontinuidade por parte das pacientes que obtiveram esse resultado. Além disso, notou-se grande encaminhamento à atenção terciária, o que não é indicado pelo Ministério da Saúde.(AU)
Objective: With the present study, we sought to verify the amount of cytopathological tests collected in the chosen basic health unit, to determine how many and what are the alterations found in these tests and what were the conducts and follow-ups performed in patients with altered exams. Methods: We analyzed 446 preventive tests performed in a basic health unit in the Midwest of Paraná, and patients with altered examination were selected and an analysis of these medical records was made in order to verify the conduct and follow-up of the patients. Results: Thirty-two tests with alterations were performed, 3 of which were the same patient. Of these 30 patients, the vast majority corresponded to atypical cells of squamous meaning possibly non-neoplastic (ASC-US), and 28 patients returned to receive an initial approach, mainly being referred to the collection of preventive new in 6 months and to the clinical oncology service. Conclusion: The present study concluded that the main hypothesis was true, which was described as a significant prevalence of high-grade intraepithelial lesions (HSIL), although not the most frequent, and discontinuity on the part of the patients who obtained this result. In addition, there was a large referral to tertiary care, which is not indicated by the Ministry of Health.(AU)
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Humans , Female , Papanicolaou Test/statistics & numerical data , Atypical Squamous Cells of the Cervix/pathology , Squamous Intraepithelial Lesions of the Cervix/diagnosis , Squamous Intraepithelial Lesions of the Cervix/epidemiology , Outpatients , Brazil/epidemiology , Health Centers , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/prevention & control , Medical Records , Preventive Medicine/methods , Prevalence , Monitoring, Physiologic/methodsABSTRACT
A vigilância ativa é a solução encontrada pela urologia para a condução de tumores prostáticos com características de pouca agressividade. Desenvolvida especialmente após as polêmicas que envolveram a validade do rastreamento, essa abordagem vem sendo consolidada como a melhor maneira de se evitar o tratamento desnecessário do câncer de próstata e precisa ser compreendida por todos os médicos que lidam com a saúde do homem.
Active surveillance is the solution found by urology to deal with low-aggressivity prostate tumours. Having been developed following controversies over screening strategies, this has been considered the best approach to avoid unnecessary treatment of prostate cancer and such a concept needs to be well understood by every medical doctor who deals with men's health.