ABSTRACT
Point of care rapid diagnostic tests (POC-RDT) for Hepatitis C virus (HCV), Human Immunodeficiency virus (HIV) and Hepatitis B virus (HBV), are ideal for screening in non-clinical outreach settings as they can provide immediate results and facilitate diagnosis, allowing high risk population screening. The aim of this study was to compare POC-RDT with laboratory conventional tests. A total of 301 vulnerable evaluable subjects (drug users, migrants and homeless population) were recruited at a mobile screening unit in outreach settings in Madrid. Fingerprick whole blood capillary samples were tested using the SD BIOLINE HCV POC-RDT, Determine HIV Early Detect and Determine HBsAg 2, and the results were assessed against the LIAISON XL HCV, HIV and Murex-HBsAg-Quant, reference assays, respectively. The feasibility and user satisfaction of the POC-RDT were evaluated through a questionnaire. The resolved sensitivity and resolved specificity and their 95% confidence intervals (95% CI) were as follows, respectively: SD-BIOLINE-HCV: 98.8% (95% CI 93.4, 100.0) and 100.0% (95% CI 98.3, 100.0); Determine HIV Early Detect: 100% (95% CI 85.2, 100.0) and 100% (95% CI 98.7, 100); and Determine HBsAg 2: 66.7% (95% CI 9.4, 99.2) and 100.0% (95% CI 98.7, 100.0). As expected, the number of subjects with a confirmed positive result for HBsAg was very low (n = 4). Therefore, the analytical sensitivity has been evaluated in addition: The Determine HBsAg 2 test demonstrated 100% sensitivity for standard concentrations ≥ 0.125 IU/mL. The subject questionnaire yielded positive feedback for most subjects. The POC-RDT fingerprick blood collection method was well received, and the tests demonstrated a comparable clinical performance with conventional tests in outreach settings and vulnerable high-risk populations.
Subject(s)
HIV Infections , Hepatitis C , Humans , Hepacivirus , Hepatitis B virus , HIV , Hepatitis B Surface Antigens , Hepatitis C/diagnosis , HIV Infections/diagnosisABSTRACT
El objetivo del presente estuidio fue contrastar las condiciones bajo las cuales se ha dado el consumo de alcohol entre estudiantes universitarios y personas que han formado parte de programas de rehabilitación pro el consumo de alcohol y otras drogas. Se realizó un estudio de tipo no experimental, transeccional descriptivo, en el cual se aplicó un instrumento denominado Coval, diseñado para este estudio con el debido proceso de validación por jueces. Se trabajó con un grupo de 36 sujetos, de los cuales 20 fueron estudiantes de cualquiera de los cuatro primeros semestres de universidades privadas de Bogotá, entre los 17 y los 21 años, y 16 fueron adultos entre los 24 y 32 años que hubieran estado en un programa de rehabilitación por consumo de alcohol y otras drogas. Se encontraron similitudes, en cuanto al lugar y las personas con quiernes tomaban, donde la compañía de amigos y el consumo en casas y bares predomina. Igualmente, se encontró que la edad de inicio se ubica en los 15 años, en promedio, y que las bebidas consumidas con mayor frecuencia son la cerveza y los destilados. En cuanto a las diferencias encontradas, se vio que las personas que estuvieron en un proceseo de rehabilitación tenían antecedentes familiares de consumo en su amyoría, mientras que en los jóvenes no se encontraron datos de este tipo. También se halló que los índices altos en la frecuenica, la cantidad del consumo, las borracheras y las lagunas eran más frecuentes en los adultos con historia de rehabilitación que en los jóvenes, y que dichas condiciones se matuvieron en el tiempo...
The aim of this study was to compare the conditions under shich alcohol consumption takes place among college students and people who have been in rehabilitation programs for alcohol and other drugs. A nom-experimental, transectional descriptive study was conducted, applying an instrument called Coval, designed for this study with the due process of validation by judges. We worked with a group of 36 subjects, of whom 20 were freshmen and sophomores at private universities in Bogotá, between the ages of 17 and 21, and 16 were adults between 24 and 32 years of age who had been in a rehabilitation program for alcohol and other drugs. Similarities were found regarding the place and the people with whom they drank, with the company of friends and the consumption in households and bars being predominant in both groups. Likewise, we found the average age of onset to be 15, and the most frequently consumed beverages to be beer and spirits. As for the differences, it was found that most of those who entered a rehabilitation process had a family history of consumption, while for the young students there was no such data. It was also found that frequent and abundant consumption, as well as drunkenness and memory gaps, were more common in adults with a history of rehabilitation that in young people, and that those conditions were consitent over time...
O objetivo do presente estudo foi contrastar as condicóes sob as quais se tem dado o consumo de àlcool entre estudantes universitarios e pessoas que tenham sido parte de programas de reabilitacáo pelo consumo de àlcool e outras drogas. Realizouse um estudo de tipo nao experimental, transversal descritivo, no qual foi aplicado um instrumento denominado Covai, desenliado para este estudo com o devido processo de validacáo por juízes. Trabalhou-se com um grupo de 36 sujeitos, dos quais 20 eram estudantes de qualquer dos quatro primeiros semestres de universidades particulares de Bogotá, entre 17 e 21 anos, e 16 foram adultos entre 24 e 32 anos que estiveram em um programa de reabilitacáo pelo consumo de àlcool e outras drogas. Encontraram-se semelhancas, quanto ao lugar e as pessoas com que bebiam, onde a companhia de amigos e o consumo ñas casas e bares predominam. Da mesmaforma, encontrou-se que a idade de inicio é de 15 anos, em mèdia, e que as bebidas consumidas com maior frequència sào a cerveja e os destilados. Quanto às diferencas encontradas, observou-se que as pessoas que estiveram em um processo de reabilitacáo tinham antecedentes familiares de consumo em sua maioria, enquanto que nos jovens nao foram encontrados dados desse tipo. Também foi encontrado que os altos índices na frequència, quantidade do consumo, bebedeiras e os brancos eram mais frequentes nos adultos com historia de reabilitacáo que nos jovens, e quetais condicóes se mantiveram com o tempo...
Subject(s)
Alcoholism/psychology , Rehabilitation/psychologyABSTRACT
BACKGROUND: There are multiple therapeutic options for the management of constipation, from lifestyle modifications to the use of laxatives and in extreme cases surgery. OBJECTIVES AND METHODS: To establish the clinical guidelines for diagnosis and treatment of chronic constipation in Mexico we conducted a review of the literature regarding medical and surgical treatments for chronic constipation and have made recommendations based on evidence. RESULTS: Low water consumption, physical inactivity and low intake of fiber are conditions associated with chronic constipation, but the evidence to prove these associations is scarce. Bolus forming agents are useful in the management of constipation with normal colonic transit and defecation without dissynergia. Evidence supports the use of lactulose (IB) and polyethylene glycol (IA) as the most safe and effective agents in the long term in adults. The use of stimulant laxatives (docusate, picosulfate, senna) is recommended only for short periods. Tegaserod is an agonist of 5-HT4 receptors and there are many clinical trials supporting its effectiveness in the management of functional constipation (IA). However "their cardiovascular safety has been questioned recently. Biofeedback therapy is the gold standard in the management of constipation associated with pelvic floor dyssynergia. Surgical treatment is reserved for extreme cases of colonic inertia. CONCLUSIONS: The treatment of constipation should be based on the underlying pathophysiological mechanisms and the selection of drugs must be made according to the scientific evidence.
Subject(s)
Constipation/therapy , Chronic Disease , Constipation/diagnosis , Constipation/drug therapy , Constipation/surgery , Electric Stimulation Therapy , Evidence-Based Medicine , Feedback, Physiological , Humans , Laxatives/therapeutic use , Life Style , MexicoABSTRACT
BACKGROUND: Essential hypertension and symptoms of depression such as unexplained fatigue and tiredness are frequently encountered in primary medical care clinics. Although, exhaustive evaluation rarely detects unsuspected underlying disorders, obstructive sleep apnea (OSA) is commonly associated with each of these conditions. We tested the hypothesis that therapy with antihypertensive and antidepressant medications predicts the increased likelihood of OSA. METHODS: We analyzed the computer archive of 212,972 patients for prescriptions for antihypertensive medications, antidepressant medications, and International Classification of Diseases, Ninth Revision codes for OSA. Prevalence, prevalence odds ratio (POR), and confidence intervals (CIs) were calculated correcting for gender and age group. RESULTS: The prevalence rates of OSA were 0.8%, 2.8%, and 3.2% for men and 0.4%, 1.4%, and 1.8% for women aged 20 to 39 years, 40 to 59 years, and >or= 60 years, respectively. Compared to groups of corresponding age and gender who had not received prescriptions for either hypertension or depression, the highest PORs were found in patients receiving medications from both categories: 18.30 (95% CI, 10.69 to 25.66), 5.72 (95% CI, 4.10 to 6.70), and 4.47 (95% CI, 2.45 to 7.01) for men, and 17.43 (95% CI, 9.54 to 28.67), 7.29 (95% CI, 5.20 to 9.29), and 2.72 (95% CI, 1.48 to 4.73) for women. CONCLUSIONS: We found that the likelihood of having a diagnosis of OSA increases when either antihypertensive or antidepressant medications have been prescribed. The probability is highest in the young and middle-age groups receiving prescriptions for both medications. The possibility of OSA should be considered in any patient with hypertension and depression or unexplained fatigue who is receiving antihypertensive and antidepressant medications.
