Estimativa de Produtividade Perdida Atribuída a Doenças Cardiovasculares na América do Sul / Estimated Loss of Productivity Attributed to Cardiovascular Diseases in South America

Resumo Fundamento: As doenças cardiovasculares (DCV) têm ônus sanitário e econômico significativos. Na América do Sul (AS), a perda de produtividade relacionada a estas enfermidades ainda não foi bem explorada. Objetivo: Estimar os anos de vida produtiva perdidos (AVPP) e a perda de produtividade relacionados a mortalidade prematura associada as DCV na AS, em 2019. Métodos: Empregou-se dados de mortalidade disponíveis no Global Burden of Disease Study 2019 na estimativa da carga de doença atribuível a DCV. Para os cálculos monetários da perda da produtividade usou-se uma proxy da abordagem de capital humano. Estratificou-se por sexo, nas faixas etárias de trabalho. Resultados: O número total de mortes por DCV na AS no ano de 2019 foi de 754.324 e os AVPP foram 2.040.973. A perda permanente de produtividade total foi de aproximadamente US$ 3,7 bilhões e US$ 7,8 bilhões em paridade do poder de compra, equivalente a 0,11% do produto interno bruto. O custo por morte foi de US$ 22.904, e a razão desse custo por óbito, entre homens e mulheres foi 1,45. A variação dos cenários aponta robustez nas estimativas, mesmo com diferenças importantes entre os países. Conclusões: As DCV impõem um ônus econômico significativo a este bloco de países. A caracterização deste fardo pode amparar os governos na alocação de recursos destinados ao planejamento e execução de políticas e intervenções sanitárias, sejam de promoção, prevenção ou recuperação.

Abstract Background: Cardiovascular diseases (CVD) have significant health and economic burdens. In South America, the loss of productivity related to these diseases has not yet been well explored. Objective: Estimate the potentially productive years of life lost (PPYLL) and loss of productivity related to premature mortality associated with CVD in South America, in 2019. Methods: Mortality data available from the 2019 Global Burden of Disease Study were used to estimate the burden of disease attributable to CVD. For monetary calculations of productivity loss, a proxy of the human capital approach was used. Data were stratified by sex, in working age groups. Results: The total number of deaths due to CVD in South America in 2019 was 754,324, and the total number of PPYLL was 2,040,973. The total permanent loss of productivity was approximately US$ 3.7 billion and US$ 7.8 billion in purchasing power parity, equivalent to 0.11% of the gross domestic product. The cost per death was US$ 22,904, and the ratio between men and women for the cost per death was 1.45. The variation in scenarios indicates that the estimates are robust, even with important differences between countries. Conclusions: CVD impose a significant economic burden on countries in South America. The characterization of this burden can support governments in the allocation of resources for the planning and execution of health policies and interventions in promotion, prevention, and recovery.

Obesity: Perceived Self-Efficacy, Emotional Regulation and Stress / Obesidade: Autoeficácia Percebida, Regulação Emocional e Estresse / Obesidad: Autoeficacia Percibida, Regulación Emocional y Estrés

Abstract Obesity increases the risk of non-transmissible chronic illnesses decreasing the quality of life and life expectancy. This investigation aims to define a psychological profile for the treatment of the target population evaluating the levels of self-efficacy perceived, difficulty in emotional regulation and stress. Eighty-six adults participated, including 63 women and 23 men who pertained to OBEMOB in Temuco. The results indicate that the level of stress, trust in problem solving skills, as well as ability to solve problems and unexpected situations differs according to the type of obesity (p<0.05). In addition, there is a negative relation between general self-efficacy and difficulty of emotional regulation (rho=-0.419) while stress and BMI demonstrate a positive relation (rho=0,380).

Resumo A obesidade aumenta os riscos de doenças crônicas não-transmissíveis, diminuindo a qualidade e a expectativa de vida. Esta investigação busca delinear o perfil psicológico da população-alvo, avaliando os níveis percebidos de autoeficácia, dificuldade da regulação emocional e estresse. Participaram 86 pessoas adultas, 63 mulheres e 23 homens da cidade de Temuco. Os resultados mostraram que os níveis de estresse, confiança, habilidade para resolução de problemas e para lidar com situações inesperadas variam segundo o tipo de obesidade (p<0,05). Ainda, existe uma relação negativa entre autoeficácia geral e dificuldade de regulação emocional (rho=-0.419) e uma relação positiva entre estresse e IMC (rho=0,380).

Resumen La obesidad aumenta el riesgo de enfermedades crónicas no transmisibles, disminuye la expectativa y calidad de vida. Esta investigación busca establecer un perfil psicológico para el tratamiento de la población objetivo, realizar evaluaciones sobre los niveles de autoeficacia percibida, dificultad de la regulación emocional y estrés. Participaron 86 personas adultas, 63 mujeres y 23 hombres pertenecientes a OBEMOB de la ciudad de Temuco. Los resultados señalan que el nivel de estrés, confianza en la resolución de problemas, capacidad de resolución de problemas y resolución de situaciones inesperadas, difiere según el tipo de obesidad (p<0,05). Además, existe una relación negativa entre la autoeficacia general y la dificultad de la regulación emocional (rho=-0,419) y una relación positiva entre el estrés y el IMC (rho=0,380).

Exostosis múltiple hereditaria y síndrome de Down / Multiple hereditary exostoses and Down's syndrome

Introducción. La exostosis múltiple hereditaria es un trastorno autosómico dominante caracterizada por excrecencias cartilaginosas múltiples, fundamentalmente, en huesos de las extremidades, y en la que se han descrito como asociados el síndrome de Langer Giedion, la leucemia mieloide aguda y la espondilitis anquilosante. Objetivo: describir el caso de un niño de 10 años de edad en el cual coexisten la exostosis múltiple hereditaria y síndrome de Down. Caso clínico. Paciente masculino de 10 años, con edad aparente mayor a la real, braquicefalia, fisuras palpebrales oblicuas, epicanto, puente nasal aplanado, retardo mental, con presencia de tumoraciones de 3 x 2 cm aproximados, localizadas en extremidades, cintura escapular y pélvica, con marcha claudicante y complemento cromosómico de 47, XY, +21. Conclusión. Parece tratarse del primer caso en donde coexisten el síndrome de Down y la exostosis múltiple.

Introduction. Multiple hereditary exostoses is an autosomal dominant disorder characterized by multiple osteochondromas, fundamentally in bones of the extremities, and in which they have been described like the associates the syndrome of Langer Giedion, the acute myeloid leukemia and the ankylosing spondylitis. Objective: to describe the case of 10-year-old boy in which coexist multiple hereditary exostoses and Down's syndrome. Case report. Male patient with greater apparent age to the real one, brachycephaly, up slanting palpebral fissures, low nasal bridge, mental deficiency, and tumors presence of approximate 3 x 2 cm, located in extremities waist scapular and pelvic, with failing march and complement chromosomal of 47, XY, + 21. Conclusion. We report appears to be the first case of Down's syndrome with the coexistence of multiple exostoses.

Síndrome de Pfeiffer tipo 2 con expresividad variable

Introducción. Objetivo: presentar un caso clínico de síndrome de Pfeiffer, de 5 años de edad, con cráneo en trébol, proptosis ocular severa, y aparentemente sin retardo mental Caso clínico. Niño de 5 años de edad, producto de segunda gesta, embarazo normoevolutivo de término; padres de 19 años de edad al momento de nacer el propositus, sin antecedentes teratogénicos, ni consanguinidad o de otro padecimiento similar en miembros de la familia. A la exploración física: cráneo en trébol, frente amplia y prominente, proptosis ocular (antecedente de salida del globo ocular derecho en dos ocasiones), aplanamiento medio facial, pabellones auriculares con hélix de configuraciones en cruz horizontal, primer dedo de manos y pies anchos de su falange distal, sindactilia parcial en manos y pies. El cariotipo en linfocitos de sangre periférica mostró un complemento cromosómico normal 46, XY. Radiológicamente se observó cráneo en trébol, con múltiples impresiones digitales. Conclusión. El caso presentado aquí corresponde clínica y radiológicamente a un síndrome de Pfeiffer tipo 2, sin complicaciones viscerales y con desarrollo neurológico de acuerdo a su edad cronológica.

Introduction. Since 1964, about 30 cases of Pfeiffer syndrome type 2 have been informed; this variant is characterized by cloverleaf skull, prominent forehead, severe ocular proptosis, severe central nervous system damage, elbow synostosis, and early death. Case report. A 5 years old male withouth antecedents of consanguinity, teratogenic exposure of his parents (of 19 years of age at the time of the bird of patient), or familial malformation, was admitted. On physical examination a cloverleaf skull, wide forehead, ocular proptosis (in 2 previous occasions the right eye exited), mid facial flattening, horizontal cross configuration of ear helix, widening of the first finger of hand and feet, and partial syndactyly of hands and feet were observed. A normal 46 XY cariotype, and a normal neural development were found. Discussion. We present a case of Pfeiffer syndrome type 2 without visceral complications and normal neurologic development.

Enfermedad de lafora: una forma poco frecuente de epilepsia mioclónica: aspectos clínicos, histológicos, inmunohistoquímicos y ultraestructurales de un caso: revisión de la literatura / Lafora's disease: an form little frequent of myclonus epilepsies: aspect clinic histological inmunohistochemical and ultrastructural: revision of a case and of the literature

Los cuerpos de poliglucosán (CPG), se encuentran en diversas entidades patológicas e incluso en condiciones normales. Su hallazgo en biopsia, cerebrales de pacientes con epilepsia mioclónica progresiva es diagnóstico de enfermedad de Lafora, siendo también encontrados en hígado, músculo esquelético, músculo cardíaco y piel. Presentamos los hallazgos clínicos, gistoquímicos, inmunohistoquímicos y ultraestructurales de la biopsia cerebral de un paciente masculino de 18 años de edad, en el que clínicamente se sospechó la enfermedad

Neurotuberculosis: lesiones expansivas del sistema nervioso central / Neurotuberculosis: expansives injuries of the central nervous system

La tuberculosis (TBC) del sistema nervioso central (SNC), rara vez se manifiesta como una lesión ocupante del espacio (LOE), siendo los tuberculomas más frecuentes que los abscesos tuberculosos. Presentamos los hallazgos clínicos, imagenológicos e histopatológicos de tres tuberculomas y un absceso tuberculoso. En todos los casos se realizaron coloraciones para bacterias, hongos y bacilos ácido alcohol resistentes (BAAR). Todos los pacientes presentaron manifestaciones clínicas e imagenológicas de LOE. El diagnóstico de neurotuberculosis fue establecido por estudios histopatológicos. Las LOE por TBC en el SNC pueden presentar problemas en el diagnóstico diferencial, por lo que es necesario correlacionar la información clínica y los hallazgos anatomopatológicos, para establecer un diagnóstico y tratamiento temprano

Cambios clinicos y hematologicos en becerros infectados con Anaplasma marginale / Clinical and hematological change in calves infected with Anaplasma marginale

Clinical and hematological changes of six Anaplasma marginale(isolated Zulia) inoculated calves (experimental group) and four healthy calves (control group) were studied during twenty and eighty days before and after infection, respectively. The behavior of the four calves used as control group was stable and no significant changes in the parameters analyzed was observed. The experimental group developed the three typical phases of illness. During the prepatent phase, which lasted a mean of 21.2 + /- 2.56 days, the animals were asymptomatic and no significant changes in the hematological values occurred, but a remarkable transitory decrease in number of lymphocytes from 6.5 x 10(6) to 3.3 x 10(6) cells/ml. The infection during the acute phase produced a highly severe effect in two animals, a severe effect in three animals and a mild effect in one. The effects observed were the following: 1) a fast decrease in haematocrite, ranging from 6 to 10 percent; 2) values of parasitaemia varied from 15 to 48 percent 3) a greater body temperature than the control animals (40.5 vs. 38.5 degrees C); 4) a elevated heart frequency, from 60 to 110 beats/min; 5) an increase in the concentration of neotrophiles from 10 x 10(6) to 13 x 10(6) cells/ml; 6) The number of monocytes also augmented from 3 x 10(6) to 6 x 10(6) cells/ml; and 7) an important decrease of weight gain. The natural course of infection was interrupted with oxytetracycline when the haematocrite of the animal lowered to values less or equal to 10 percent. Then, the animals showed a rapid recovery with an undetectable parasitaemia and concomitant return to basal line of the rest of the parameters