Research Progress on the Application of Intervention Mapping in Tertiary Prevention of Cancer / 中国医学科学院学报

Intervention mapping (IM) is a framework for formulating theory-and evidence-based health education projects with participatory approaches from ecological perspectives.The intervention program designed via IM plays a role in reducing the exposure of cancer risk factors,increasing cancer prevention behaviors,and promoting early cancer screening and rehabilitation of cancer patients.This study summarizes the characteristics,implementation steps,and application status of IM in tertiary prevention of cancer,aiming to provide reference for the application of IM in the health education projects for cancer in China.

Análise do perfil clínico e epidemiológico dos pacientes atendidos em um serviço terciário de dermatologia / Analysis of the clinico-epidemiological profile of patients attended in a tertiary dermatology service / Análisis del perfil clínico y epidemiológico de los pacientes atendidos en un servicio terciario de dermatología

OBJETIVO: Este artigo analisou o perfil epidemiológico e clínico dos pacientes atendidos em um serviço terciário de Dermatologia no município de Ponta Grossa-PR no período de 2016 a 2018. MÉTODOS: Trata-se de um estudo descritivo, exploratório, transversal e de abordagem quantitativa com dados coletados do prontuário médico. RESULTADOS: A maioria dos pacientes atendidos (I) era do sexo feminino; (II) com mais de 50 anos; (III) realizaram somente uma consulta, (IV) não foram submetidos a exames adicionais; e (V) apresentavam comorbidades, sobretudo, dermatológicas; o segmento corporal com maior número de lesões dermatológicas foi a cabeça; o grupo diagnóstico mais comum foi a afecção dos anexos cutâneos e o diagnóstico mais frequente foi a ceratose actínica. CONCLUSÃO: O estudo é fundamental para demonstrar quais são os pacientes e as doenças dermatológicas comumente encaminhadas para o serviço especializado, o que pode direcionar ações de prevenção primária, secundária e terciária.

OBJECTIVE: This article analyzed the epidemiological and clinical profile of patients treated at the outpatient Dermatology clinic, during 2016-2018, located in the municipality of Ponta Grossa-PR. METHODS: This is a descriptive exploratory, cross-sectional study with a quantitative approach, with data collected from the medical records. RESULTS: Most of the patients examinated: (I) were female; (II) over 50 years old; (III) attended to a single consultation; (IV) were not submitted to additional exams; and (V) had comorbidities, especially dermatological; the head was the most affected body segment; the most common diagnostic group was cutaneous annexes affections and the most frequent diagnosis was actinic keratosis. CONCLUSION: The study is fundamental to demonstrate who are the patients and which are the dermatological diseases commonly referred to the specialized service, which can guide primary, secondary and tertiary prevention actions.

OBJETIVO: Este artículo analizó el perfil epidemiológico y clínico de los pacientes atendidos en un servicio terciario de Dermatología en el municipio de Ponta Grossa-PR en el período de 2016 a 2018. MÉTODOS: Se trata de un estudio descriptivo, exploratorio y transversal con un enfoque cuantitativo con datos recogidos de las historias clínicas. RESULTADOS: La mayoría de los pacientes atendidos (I) eran mujeres; (II) tenían más de 50 años; (III) tenían una sola consulta, (IV) no se sometieron a exámenes adicionales; y (V) presentaban comorbilidades, principalmente, dermatológicas; el segmento corporal con mayor número de lesiones dermatológicas fue la cabeza; el grupo diagnóstico más común fue la afección de apéndices cutáneos y el diagnóstico más frecuente fue la queratosis actínica. CONCLUSIÓN: El estudio es fundamental para demostrar cuáles son los pacientes y las enfermedades dermatológicas que se derivan habitualmente al servicio especializado, lo que puede dirigir las acciones de prevención primaria, secundaria y terciaria.

La Psicología en la prevención y manejo del COVID-19: aportes desde la evidencia inicial / Psychology in the prevention and management of COVID-19: contributions from the initial evidence

Resumen En diciembre de 2019, se informaron casos de neumonía potencialmente mortal en Wuhan, provincia de Hubei, China (COVID-19). Esta enfermedad se ha extendido rápidamente por todo el mundo con miles de casos confirmados y muertes, transformándose en pandemia y desafiado los sistemas de salud pública. No existe aún vacuna ni tratamiento científicamente probado, sin embargo, se ha identificado los comportamientos exactos que pueden evitar el contagio y propagación. El presente artículo sistematiza información disponible inicial sobre psicología y COVID-19. Se discute que gran parte del problema de la enfermedad se puede evitar cambiando los comportamientos de las personas y que la psicología puede ayudar a explicar, prevenir e intervenir para su solución. La psicología cuenta con evidencia científica disponible que explica todos estos fenómenos, evidencia que debe ser puesta en relieve por los mismos actores de las disciplinas a disposición de otras áreas del conocimiento y sobre todo para los tomadores de decisión.

Abstract In December 2019, highly lethal cases of pneumonia were reported in Wuhan, Hubei Province, China (COVID-19). This disease has spread rapidly around the world with thousands of confirmed cases and deaths, becoming a pandemic and challenging public health systems. There is no vaccine or scientifically proven treatment yet, but the exact behaviours that can prevent transmission and spread have been identified. This article systematizes initial available information on psychology and COVID-19. It is discussed that much of the problem of the disease can be avoided by changing people's behaviors and that psychology can help explain, prevent and intervene to solve it. Psychology has scientific evidence available that explains all these phenomena, evidence that should be highlighted by the same actors in the disciplines available to other areas of knowledge and especially for decision makers.

Retos en la prevención del embarazo adolescente subsiguiente, un estudio desde la perspectiva de madres adolescentes / Challenges in preventing a subsequent pregnancy in adolescents: perspectives of adolescents' mothers

Resumen El presente artículo expone el resultado de una evaluación cualitativa sobre las acciones que los servicios públicos de salud desarrollan para la prevención de embarazos subsiguientes en adolescentes, en un estado en el centro-norte de México. El objetivo fue documentar los obstáculos percibidos para prevenir embarazos subsiguientes en madres adolescentes. La información se obtuvo entre 2016-2018, mediante entrevistas individuales en los domicilios de jóvenes usuarias de servicios públicos de salud. El análisis de la información se hizo a partir de la propuesta de Strauss y Corbin para teoría fundamentada. Las experiencias compartidas por las jóvenes madres fueron analizadas y clasificadas en dos categorías, obstáculos asociados a: (1) competencias profesionales, y (2) a imaginarios morales. Se concluye que las limitaciones más importantes tienen que ver con el hecho de que la estrategia de servicios amigables para adolescentes deja de implementarse en aquellas que han sido madres, sin considerar el impacto biológico y psicosocial que tienen los embarazos subsiguientes en la adolescencia y la necesidad de postergar la reproducción hasta la edad adulta.

Abstract This article presents the result of a qualitative evaluation of the actions that the public health services develop for the prevention of subsequent adolescent pregnancies in a state in north-central Mexico. The objective was to document the perceived obstacles to preventing subsequent teenage pregnancies in teenage mothers. The information was obtained in the period 2016-2018, by individual interviews in the homes of young users of public health services. The analysis of the information was based on Strauss and Corbin's proposal for the grounded theory. The experiences shared by the young mothers were analyzed and classified into two categories, obstacles associated with: (1) professional competences, and (2) with moral imagery. It is concluded that the most important limitations are related to the fact that the strategy of adolescent friendly services is no longer implemented in those who have been mothers, without considering the biological and psychosocial impact that subsequent pregnancies have in adolescence and the need to delay reproduction until adulthood.

Síndrome hemolítico urémico asociado a Shigatoxina: ¿Cómo prevenirlo? / Shiga-toxin associated hemolytic uremic syndrome: how to prevent it?

Resumen: El síndrome hemolítico urémico (SHU) asociado a infección intestinal por bacterias productoras de Shigatoxina, que afecta principalmente a población infantil, puede causar morbilidad aguda grave, secuelas crónicas en varios órganos, y la muerte prematura en algunos de ellos. Dado su carácter zoonótico, adecuadas medidas de manejo agropecuario y correcta higiene de lo que consumimos es indispensable a la hora de prevenir la infección. Actualmente, una vez gatillado el SHU el manejo es médico y, principalmente, de soporte. En los últimos años diversas estrategias terapéuticas se han ido desarrollando para evitar que esta enfermedad ocurra, o, al menos, que pueda ser atenuada en sus consecuencias de morbi-mortalidad. El presente artículo describe acciones específicas a diferentes niveles de prevención de esta patología.

Abstract Hemolytic uremic syndrome (HUS) associated with intestinal infection by Shiga toxin-producing bacteria, which mainly affects children, can cause severe acute morbidity, chronic sequelae in seve ral organs, and premature death in some of them. Given its zoonotic nature, adequate measures of agricultural management and proper hygiene of what we consume are essential to prevent infection. Once the HUS is triggered, medical management is currently mainly supportive. In recent years, va rious therapeutic strategies have been developed to prevent this disease from occurring or, at least, to mitigate its morbidity and mortality consequences. This article describes specific actions at different levels of prevention of this pathology.

Evidence-based Nutritional Intervention Protocol for Korean Moderate-Severe Obese Children and Adolescents

Diet-related behavioral modification for healthy eating and lifestyle is required to improve childhood obesity. The present study aimed to develop customized nutritional intervention protocol and education program to find barriers to adhere healthy diet and lifestyle for moderate to severe obese children and adolescents and their families. Theoretical framework approaches can be used to change behavior and achieve goals. Previous studies that described the relationship between behavioral modification and nutrition education theory were reviewed. The social cognitive theory and transtheoretical model were employed with behavioral changes to target a healthful diet and lifestyle. The nutrition care process (NCP) model was adopted to customize nutrition care for the participants. Customized nutritional intervention protocol was developed following as the four steps of the NCP. Firstly, nutrition status of the participants was assessed by the nutrition expert. Nutrition problems were described as “inadequate energy intake,” “overweight/obesity,” or “food and nutrition-related knowledge deficit.” All nutrition sessions were designed for nutrition intervention to give nutritional knowledge and a practical mission in real life for individual goal setting and self-control. Meal planning, portion control, healthy snack selection and cooking with fruits and vegetables were consisted of five components of the nutrition education session. During each session, the participants and their families were interviewed by a nutrition expert for monitoring and evaluating diet-related goal setting and achievement. A theoretical and evidence-based nutritional intervention was developed for the secondary to tertiary prevention of childhood obesity. This nutrition intervention protocol and program might be helpful for the further research on childhood obesity. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0002111

Avances en la atención de salud a los pacientes con enfermedades reumáticas / Advances in health care in rheumatoid diseases

Introducción: Las enfermedades reumáticas, debido a su evolución natural, provocan afectaciones a la calidad de vida de las personas afectadas por eso es de vital importancia el diagnóstico temprano, el tratamiento oportuno y la prevención. El conocimiento de los adelantos contemporáneos en la atención de salud es una herramienta que ayuda a tomar decisiones clínicas en la práctica diaria, aunque la decisión final sobre el diagnóstico y el tratamiento de un paciente determinado dependerá de las características particulares de cada uno. Objetivo: Discutir algunos avances en la atención de salud a los pacientes con en enfermedades reumáticas. Desarrollo: Debido a que en la práctica clínica se encuentran con frecuencia resultados discordantes, la actualización de temas como este permite socializar los resultados obtenidos con profesionales del gremio, mostrar las estrategias más efectivas o los mejores métodos para el diagnóstico precoz, tratamiento y cuidado de estas enfermedades sobre la base de experiencias asistenciales e investigativas en varias regiones del mundo o en contextos diferentes. Conclusiones: Para controlar mejor las enfermedades reumáticas se necesita una estrategia organizativa en el marco de la cual se aprovechen las fortalezas de la prevención primaria, secundaria y terciaria y que los profesionales, de acuerdo con sus conocimientos y competencias, lleven a cabo acciones que prevengan las graves complicaciones de estas enfermedades. En varios estudios clínicos y ensayos terapéuticos se trabaja con novedosos fármacos biológicos, donde se evalúa su efectividad, se identifican los efectos adversos y se valora la relación riesgo-beneficio(AU)

Rheumatic diseases, due to their natural evolution, bring with them effects on the quality of life of the people carrying this conditions, which is why their early diagnosis, timely treatment and prevention are of vital importance. The knowledge of contemporary advances in health care is a tool to help when making clinical decisions in daily practice, although the final decision on the diagnostic or therapeutic approach of a specific patient will depend on the characteristics of the same. Objective: to discuss some advances in health care in rheumatoid diseases. Development: due to the fact that in clinical practice discordant results are frequently found, the updating of topics such as these allows to socialize the results obtained with professionals of the guild, to show the most effective strategies or the best methods for the early diagnosis, treatment and management of these diseases, on the basis of assistance and research experiences in various regions of the world or in different contexts. Conclusions: for a better control of rheumatic diseases requires a strategy of articulation where the strengths of primary, secondary and tertiary prevention are exploited, where the professionals in accordance with their competence execute actions that prevent the serious complications of these diseases and where properly treat infectious processes in particular, those produced by Streptococcus A, among others. Results of several clinical trials and therapeutic trials work with novel biological drugs, assessing their effectiveness, identifying adverse effects, assessing the risk-benefit ratio and the convenience of these forming part of the treatment scheme against various targets(AU)

National dementia research and development project

The Ministry of Science and ICT and the Ministry of Health and Welfare of the Republic of Korea have organized the first National Committee for Dementia Research, to which all domestic experts in the field have been invited as they endeavor to achieve ‘national dementia liability’, which is one of the core national agenda items of the current Korean government. To make this initiative sustainable and bring dementia under control, we should not focus only on providing care and economic support to the family of patients with dementia. Instead, a large-scale, long-term research and development (R&D) strategy for dementia prevention, diagnosis, and therapy is warranted. This R&D project comprises several parts: 1) elucidation of the etiology and prevention of dementia, 2) innovative diagnostics for dementia, 3) tailored therapies for dementia, and 4) tangible and effective care for dementia. Given the fact that dementia is a very heterogeneous condition involving multiple pathogenic factors and typically having a chronic disease course, comprehensive and integrated approaches across various disciplines should be explored for primary, secondary, and tertiary prevention of this disease. With the success of this R&D project, the national dementia liability system will gain momentum and come into its own. Integrated efforts in terms of both policyrelated and scientific initiatives would allow us to take a step closer to realizing our shared goal of living in a world of dementia carefree.

Caracterización de los servicios de promoción de la salud y prevención de la enfermedad en cuatro instituciones de salud del municipio de Medellín, 2015 / Characterization of Health Promotion and Disease Prevention Services in Four Health Institutions in the Municipality of Medellin, 2015 / Caracterização dos serviços de promoção da saúde e prevenção de doença em quatro instituições de saúde do município de Medellín, 2015

Resumen Estudio descriptivo que permitió caracterizar los programas y las actividades de promoción de la salud y prevención de la enfermedad en cuatro instituciones de salud de alta complejidad de Medellín. Por medio de un estudio descriptivo de serie de casos, se aplicaron dos instrumentos semiestructurados tipo encuesta donde se recolectó información sobre: estructura y funcionamiento, enfoque, públicos beneficiarios, metodologías y equipos de trabajo. Se encontró que las cuatro instituciones desarrollan actividades de este tipo, con un enfoque hacia la prevención terciaria congruente con su nivel de complejidad; están orientadas esencialmente al paciente y a las familias, y, a veces, a la comunidad; los empleados también se benefician desde salud ocupacional; son desarrolladas por profesionales de diferentes disciplinas; su funcionamiento depende generalmente de las direcciones científicas; no se identifica un área en particular que las gestione articuladamente. Se considera importante que las instituciones se declaren a favor de modelos de atención en salud integrales donde se trabaje de manera articulada las actividades de promoción y prevención con la atención clínica.

Abstract This is a descriptive study that allowed for the characterization of the health promotion and disease prevention programs and activities in four high-complexity health institutions in Medellín. By means of a descriptive study of a series of cases, two semi-structured survey instruments were applied through which information was collected on: structure and functioning, approach, beneficiary communities, methodologies, and work teams. We found that all four institutions develop activities of this type, with a focus on tertiary prevention consistent with their level of complexity; they are essentially oriented to the patient and their families, and, sometimes, to the community; employees also benefit from occupational health; the activities are developed by professionals from different disciplines; their operation depends in general terms on scientific management; and no particular area was identified to manage the activities articulately. We considered important that the institutions manifest to be in favor of integral health care models where the promotion and prevention activities are coordinated with clinical care.

Resumo Estudo descritivo que permitiu caracterizar os programas e atividades de promoção da saúde e prevenção de doença em quatro instituições de saúde de alta complexidade de Medellín. Por meio de estudo descritivo de série de casos, aplicaram-se dois instrumentos semiestruturados tipo inquérito onde foi coletada informação sobre: estrutura e funcionamento, enfoque, públicos beneficiários, metodologias e equipes de trabalho. Verificou-se que as quatro instituições desenvolvem atividades deste tipo, com enfoque para a prevenção terciária congruente com o seu nível de complexidade; são orientadas essencialmente ao paciente e as famílias, e, às vezes, à comunidade; os empregados também são beneficiados desde saúde ocupacional; são desenvolvidas por profissionais de diferentes disciplinas; o seu funcionamento depende geralmente das direções científicas; não se identifica uma área em particular que as gere articuladamente. Considera-se importante as instituições se declararem em favor de modelos de atenção em saúde integrais onde se trabalharem de maneira articulada as atividades de promoção e prevenção com a atenção clínica.

Cuestionario PAR-Q & YOU y antecedentes cardiovasculares frente a la práctica de la actividad física en adultos mayores en diálisis / PAR-Q & YOU Questionnaire and cardiovascular history of elderly patients on dialysis engaged in physical activity

INTRODUCCIÓN: La actividad física se ha convertido en los últimos años en una herramienta terapéutica y mecanismo protector en el adulto mayor para disminuir el riesgo cardiovascular en usuarios con diversos tipos de diálisis que se encuentran en su fase paliativa. OBJETIVO: El presente trabajo buscó determinar la evaluación de ingreso a un programa de actividad física terapéutica por medio de la aplicación del Cuestionario PARQ & YOU en un grupo de participantes adultos mayores con diversos tipos de hemodiálisis, y su relación con los factores de riesgo cardiovascular. MATERIAL Y MÉTODOS: Se utilizó una prueba chi cuadrado de Pearson con el fin de determinar la posible asociación de las variables en relación a los antecedentes médicos y el disconfort, frente a la práctica de actividad física versus el resultado del PAR-Q & YOU. Se realizó una regresión logística binaria con las variables que en el análisis mediante prueba chi cuadrado. CONCLUSIONES: En la regresión logística se evidenció que los antecedentes cardiovasculares tienen 10.44 más veces influencia sobre la pertinencia de la aplicación del PAR-Q & YOU, como un instrumento básico para el ingreso a programas de actividad física en la rehabilitación renal desde la fisioterapia

INTRODUCTION: During the last few years, physical activity has become a therapeutic tool and a protective mechanism for the elderly; it reduces cardiovascular risk in patients undergoing different types of dialysis and receiving palliative care. OBJECTIVE: The aim of this study was to establish the inclusion criteria for a therapeutic physical activity program through the use of the PAR-Q & YOU Questionnaire with elderly patients treated with different types of hemodialysis, and to relate it with cardiovascular risk factors. METHODS:Pearson's chi-squared test was used to determine the possible association among variables, considering the medical history and discomfort caused by physical activity against the results of PAR-Q & YOU. Binary logistic regression was used with the variables in the chi-squared test. CONCLUSIONS: Through logistic regression, we found that cardiovascular history was 10.44 times more significant to establish the relevance of the PAR-Q & YOU as a basic assessment instrument for the inclusion in a physical activity program which is part of a physiotherapy-led renal rehabilitation

Características de los ámbitos de aplicación de la prevención del consumo de SPA / Characteristics of the areas of application of SPA prevention

En el presente artículo se aborda un fenómeno que se ha convertido en un problema de salud pública, el consumo de sustancias psicoactivas (SPA), centrándose esencialmente en el tema de la prevención. Se hará una contextualización de los conceptos más significativos en materia preventiva hasta llegar a los ámbitos de prevención más destacados en la literatura, siendo estos: el familiar, escolar, comunitario, laboral y penitenciario. Además, expone de manera sustancial la importancia y características que marcan el camino para lograr una efectiva intervención preventiva, de acuerdo a las peculiaridades del contexto donde se realice, poniéndose en evidencia la importancia de conocer las particularidades de la población.

This article is addresses a phenomenon that has become a public health problem, the consumption of psychoactive substances, focusing essentially on the subject of prevention. Will be made a contextualization of the most significant concepts in preventive matters until arrive to the most important areas of prevention in the literature, being these: family, school, community, labor and penitentiary. Also it exposes in a substantial way the importance and characteristics that mark the road to achieve an effective preventive intervention, according to the peculiarities of the context where it takes place, becoming evident the importance of knowing the peculiarities of the population.

Cancer detection ratio in a population participating in cancer screening programs at a tertiary care cancer center in São Paulo

Background: Tertiary care cancer centers can act as reference units for prevention and early detection programs. The purpose of this study was to describe the profile of the Cancer Prevention Campaign (CPC) participants at the A.C. Camargo Cancer Center in Sao Paulo, Brazil. Methods: A cross-sectional, quantitative study was carried out to analyze data of the CPC participants at the A.C. Camargo Cancer Center. Participants were recruited from the general public during lectures delivered by CPC members in selected parts of the city of São Paulo. Data included gender analysis, number of cancer cases diagnosed, topography and tumor/node/metastasis (TNM) stage, in the period 2008­2012. Results: Sixty-two thousand nine hundred one people participated in CPC during the 5-years period (2008­2012). A total of 65 cancer cases were diagnosed, which represents 0,1% of detection rate: 25 cases were identified in men and 40 in women. The most frequent neoplasms in men were thyroid, prostate and oral cavity cancers while in women, thyroid and breast cancers were more frequent. Conclusions: Cancer prevention activities in tertiary care cancer centers raise awareness in its employees and in the general population, increasing early diagnosis (AU)

Nuevos términos clínicos, prevención y tratamiento del trastorno cognitivo vascular: revisión de literatura basada en la evidencia / New clinical terms, prevention and treatment of vascular cognitive impairment: a review of evidence-based literature

El trastorno cognitivo vascular agrupa todas las instancias donde el compromiso cognitivo puede ser atribuidoa enfermedad vascular cerebral, es mayor que el esperado para el envejecimiento normal y que, cuando llega aafectar las actividades de la vida diaria, se denomina demencia vascular. En esta revisión, se actualizan los términos relacionados a trastorno cognitivo vascular y se plantean estrategias de prevención y tratamiento basadas en revisiones sistemáticas y meta-análisis. En la primera parte se definen diversos términos relacionados a trastorno cognitivo vascular; en la segunda, se plantea el tratamiento del trastorno cognitivo vascular/demencia vascular, que incluyeun manejo orientado a prevención primaria, controlando los factores de riesgo; un tratamiento secundario paraprevenir la exacerbación o la extensión de las lesiones producidas por la injuria vascular cerebral y, finalmente, untratamiento terciario o sintomático de los problemas cognitivos y/o conductuales. Damos especial énfasis y se fundamenta la conveniencia y beneficios de los tratamientos primario y secundario.

Vascular cognitive impairment is a label ascribed to cases in which the cognitive impairment can be attributed to cerebral vascular disease, is greater than the expected for normal aging and, when affecting the activities of daily life, is called vascular dementia. In this review, the terms related to vascular cognitive impairment, are updated, and strategies for prevention and treatment, based on systematic reviews and meta-analyses are outlined. In the first part, various vascular cognitive impairment-related terms are defined; in the second part, the treatment of vascular cognitive impairment / vascular dementia is described: it includes, management steps oriented towards primary prevention, controlling risk factors; a secondary treatment aimed at the prevention of exacerbation or extension of lesions produced by the vascular brain injuries and, finally, the tertiary or symptomatic treatment of cognitive and / or behavioral manifestations. Special emphasis is placed on, and the convenience and benefits of the primary and secondary treatments are substantiated.

Conocimientos y actitudes del paciente sobre entrenamiento físico y control de factores de riesgo cardiovascular en el Programa de Rehabilitación Cardiaca Hospital Nacional Guillermo Almenara Irigoyen EsSalud / Knowledge and attitudes of the patient about physical training and control of factors of risk cardiovascular in the Cardiac Rehabilitation Program at the National Hospital Guillermo Almenara Irigoyen EsSalud

El Objetivo fue determinar los Conocimientos y Actitudes del Paciente sobre Entrenamiento Físico y Control de Factores de Riesgo Cardiovascular en el Programa de Rehabilitación Cardiaca. Hospital Nacional Guillermo Almenara Irigoyen Es Salud. Lima-Perú 2015. Material y Método. El estudio fue de nivel aplicativo, tipo cuantitativo, método descriptivo de corte transversal. La población estuvo conformada por 20. La técnica fue la encuesta y los instrumentos fueron un cuestionario y una escala de actitud aplicados previo consentimiento informado. Resultados: Del 100 por ciento (20), 60 por ciento (12) conocen, 40 por ciento (8) no conocen; y en cuanto a las actitudes 65 por ciento (13) eran desfavorables y 35 por ciento (7) favorables. Los ítems que conocen está referido al beneficio del entrenamiento físico orientada a mejorar la tolerancia al ejercicio, disminuir el colesterol y mejorar los síntomas de enfermedad del corazón, que la dieta del paciente con diabetes consiste en restringir alimentos ricos en azúcares, disminuir el consumo de harinas, carbohidratos y grasas, y para evitar el incremento de la presión arterial debe realizar ejercicios, evitar el consumo de tabaco, ingerir alimentos libre de grasas, sin exceso de azúcar; seguido de ítems que no conocen que 1a obesidad se puede evitar mediante 1a ingesta de una dieta saludable a base de pescado, pollo, alimentos bajo en grasa y azúcar, ingerir abundantes verduras y realizar ejercicios, y el efecto del tabaco en las arterias del corazón; en cuanto a las actitudes favorables los pacientes acuden a las sesiones, algunas veces incumplen los ejercicios porque le da pereza, y asisten a las sesiones de charla educativa; mientras que los ítems con actitud desfavorable está dado porque omiten el control de la presión arterial, faltan a las sesiones, les resulta imposible dejar los gustos alimentarios y no cumplen con la dieta restringida en grasas. Conclusiones: El mayor porcentaje conocen que el objetivo del...

The objective was to determine the Patient Knowledge and Attitudes about Physical Training and Control of Cardiovascular Risk Factors in Cardiac Rehabilitation Program. Guillermo Almenara Irigoyen National Hospital's Health. Lima-Peru 2015. Material and Methods: The study was applicative level, quantitative type, descriptive method of cross section. The population consisted of 20. The technique was the survey and the instruments were a questionnaire and attitude scale applied prior informed consent. Results: 100 per cent (20), 60 per cent (12) known, 40 per cent (8) do not know; and attitudes regarding 65 per cent (13) were unfavorable and 35 per cent (7) favorable. The items they know is based on the benefit of physical training aimed at improving exercise tolerance, lower cholesterol and improve symptoms of heart disease, the diet of patients with diabetes is to restrict foods high in sugar, reduce consumption flours, carbohydrates and fats, and to avoid increasing blood pressure should perform exercises, avoid eating snuff, eating fat-free foods, without excess sugar; followed by items that do not know that obesity can be prevented by eating a healthy diet of fish, chicken, low-fat foods and sugar, eating plenty of vegetables and exercise, and the effect of snuff in the heart arteries ; as to the favorable attitudes patients attend meetings, sometimes violate the exercises because you get lazy, and attend educational talk sessions; whereas items with unfavorable attitude is given because they omit the control of blood pressure, missing sessions, they find it impossible to leave food tastes and do not meet the fat-restricted diet. Conclusions: The highest percentage know that the goal of physical training is to keep the heart healthy and strong, and items that do not know is that being a smoker is considered when the person smokes 1 cigarette a week. The highest percentage have an unfavorable attitude as they find it impossible to leave the food tastes and...

Trauma en pediatría: Estudio epidemiológico en pacientes internados en el Hospital de Niños "Ricardo Gutiérrez" / Pediatric trauma: Epidemiological study among patients admitted to Hospital de Niños "Ricardo Gutiérrez"

Introducción. En Argentina, el trauma es la causa más frecuente de muerte en niños mayores de 1 año, con una elevada morbilidad y un alto costo para el sistema de salud. Objetivo. Identificar las causas de las lesiones en los pacientes internados por trauma y analizar la asociación entre los factores epidemiológicos y el trauma grave. Población y métodos. Estudio prospectivo. Se incluyeron los niños de 0-18 años internados por trauma no intencional entre abril de 2012 y marzo de 2013. Se dividieron en dos grupos según el índice de trauma pediátrico grave (8 o menor) para identificar factores de riesgo mediante un modelo de regresión logística. Variables predictivas: características demográficas del paciente y sus padres, factores socioeconómicos, datos del incidente, asistencia inicial, evolución y factores de riesgo. Se estratificaron en tres grupos etarios para el análisis de la topografía de la lesión. Resultados. Se incluyeron 237 pacientes. En menores de 3 años, predominó el traumatismo craneoencefálico y, en mayores de 3 años, las fracturas de miembros. En el análisis bivariado, padres extranjeros, indigencia o pobreza, causa inmediata prevenible, altura peligrosa y calefacción insegura resultaron estadísticamente significativos. Por regresión múltiple, quedaron incluidas las variables padres extranjeros, residencia en asentamiento, causa inmediata prevenible y calefacción insegura. Conclusiones. La principal causa de trauma fue la caída de altura y algunos de los factores socioeconómicos explorados se asociaron a mayor riesgo de trauma. Esto podría ser utilizado para elaborar medidas de prevención.

Introduction.In Argentina, trauma is the most common cause of death among children older than 1 year old, has a high morbidity rate, and results in large costs for the health system. Objective.To identify causes of injuries in patients admitted to the hospital due to a trauma, and to analyze the relationship between epidemiological factors and severe trauma. Population and Methods.Prospective study. Children and adolescents aged 0 to 18 years old admitted to the hospital due to unintentional trauma between April 2012 and March 2013 were included. They were divided into two groups based on severity according to the pediatric trauma score (8 or lower) to identify risk factors by means of a logistic regression model. Predictive outcome measures: patients' and parents' demographic characteristics, socioeconomic factors, event data, initial care, course, and risk factors. Patients were stratified into three age groups for the analysis of the type of injury and the anatomic location. Results.Two hundred and thirty-seven patients were included. Traumatic brain injuries were predominant among children younger than 3 years old, while limb fractures were most common among children older than 3 years old. In the bivariate analysis, foreign parents, a state of poverty or destitution, an immediate preventable cause, dangerous heights, and an unsafe heating system were statistically significant outcome measures. Based on multiple regression, outcome measures included were foreign parents, living in a slum area, an immediate preventable cause, and an unsafe heating system. Conclusions.The main cause of trauma was related to falls from heights, and some of the studied socioeconomic factors were associated with a higher risk of trauma. This information may be useful to develop prevention measures.

French good practice guidelines for medical and occupational surveillance of the low back pain risk among workers exposed to manual handling of loads

Several clinical practice guidelines related to the assessment and management of low back pain (LBP) have been published with varied scopes and methods. This paper summarises the first French occupational guidelines for management of work-related LBP (October 2013). There main originality is to treat all the three stages of primary, secondary and tertiary prevention of work-related LBP. The guidelines were written by a multidisciplinary working group of 24 experts, according to the Clinical Practice Guidelines method proposed by French National Health Authority, and reviewed by a multidisciplinary peer review committee of 50 experts. Recommendations were based on a large systematic review of the literature carried out from 1990 to 2012 and rated as strong (Level A), moderate (B), limited (C) or based on expert consensus (D) according to their level of evidence. It is recommended to deliver reassuring and consistent information concerning LBP prognosis (Level B); to perform a clinical examination looking for medical signs of severity related to LBP (Level A), encourage continuation or resumption of physical activity (Level A), identify any changes in working conditions and evaluate the occupational impact of LBP (Level D). In case of persistent/recurrent LBP, assess prognostic factors likely to influence progression to chronic LBP, prolonged disability and delayed return to work (Level A). In case of prolonged/repeated sick leave, evaluate the pain, functional disability and their impact and main risk factors for prolonged work disability (Level A), promote return to work measures and inter professional coordination (Level D). These good practice guidelines are primarily intended for professionals of occupational health but also for treating physicians and paramedical personnel participating in the management of LBP, workers and employers.

Book Review: Primary, secondary, and tertiary prevention of cervical cancer / 부인종양

No abstract available.