Association between Toxoplasma gondii exposure and abdominal pain: An age- and gender-matched case-control seroprevalence study.

Abdominal pain has been rarely reported in individuals infected with Toxoplasma gondii (T. gondii). The aim of this study was to determine the association between T. gondii infection and abdominal pain. Two hundred and ninety-nine patients with abdominal pain (cases) and 299 age- and gender-matched people without abdominal pain (controls) were tested for anti-T. gondii IgG and IgM antibodies. Twenty-four (8.0%) of the 299 cases and 12 (4.0%) of the 299 controls were positive for anti-T. gondii IgG antibodies (OR: 2.08; 95% CI: 1.02-4.25; P = 0.03). The seroprevalence of T. gondii infection was significantly higher in women with frequent abdominal pain than in women without this clinical feature (OR: 2.30; 95% CI: 1.06-4.96; P = 0.02). Twelve (4.0%) of the 299 cases and 7 (2.3%) of the 299 controls had high (>150 IU mL-1) anti-T. gondii IgG antibody levels (OR: 1.74; 95% CI: 0.67-4.49; P = 0.24). Seven (29.2%) of the 24 cases with anti-T. gondii IgG antibodies and 3 (25.0%) of the 12 controls with anti-T. gondii IgG antibodies were positive to anti-T. gondii IgM antibodies (OR: 1.23; 95% CI: 0.25-5.97; P = 1.00). Results suggest an association between T. gondii infection and frequent abdominal pain. Further research to confirm this association should be conducted.

Nivel de conocimiento sobre educación y autocuidado de los pies en pacientes con Diabetes Mellitus que reciben atención multidisciplinaria

Introducción: Educación y autocuidado son pilares en el tratamiento de la Diabetes Mellitus (DM) y prevención de complicaciones como la enfermedad del pie relacionada a la diabetes (EPRD). Objetivo: Determinar el nivel de conocimiento de DM y el autocuidado de los pies en pacientes con DM tipo 2. Materiales y métodos: Estudio observacional descriptivo, prospectivo, corte transversal; realizado en pacientes adultos con DM tipo 2, que acudieron a consulta endocrinológica y podológica en Hospital Central del Instituto de Previsión Social, en un periodo de 9 meses, desde setiembre 2022 a junio 2023. Tras al menos 2 consultas en cada especialidad, se solicitó el llenado de los cuestionarios DKQ24 y APD-UMA para evaluar conocimiento sobre DM y autocuidado de los pies respectivamente. Resultados: Se incluyó a 103 pacientes, 57% mujeres, 63±11 años de Diabetes, 14±8,45; 29% educación primaria, índice de masa corporal 30,56±5,31, hipertensión arterial 83,5%, 11,6% tabaquistas, retinopatía 35,9%, pérdida de la sensibilidad protectora (PSP) en pies 53,4%, enfermedad arterial periférica 20,4%, deformidades 49,5% y lesiones previas 27,2% en pies; amputación menor 2,9%, amputación mayor 1 %. HBA1c media 8% (±1,3), clearence de creatininia 78,2 mg/dL/m2 (±21,42). Niveles de conocimiento: bueno 68 (66%), regular 34 (33%) y escasos 1(1%). Autocuidado de los pies: promedio de respuestas entre muy adecuadas y adecuadas: 87,4 (84,8%), regular: 9,4 (9,2%); entre inadecuadas y muy inadecuadas 7 (6,8%). Conclusión: Los pacientes con DM2 que acuden a consulta multidisciplinaria tienen un alto conocimiento sobre su patología y autocuidado de los pies, lo que ayudaría a la prevención de complicaciones, teniendo en cuenta que son un grupo de riesgo para EPRD.

Introduction: Education and self-care are pillars in the treatment of Diabetes Mellitus (DM) and prevention of complications such as diabetes-related foot disease (DPERD). Objetive: Determine the level of knowledge of DM and foot self-care in patients with type 2 DM. Materials and methods: Descriptive, prospective, cross-sectional observational study; performed in adult patients with type 2 DM, who attended an endocrinological and podiatric consultation at the Central Hospital of the Institute of Social Security, in a period of 9 months, from September 2022 to June 2023. After at least 2 consultations in each specialty, a filling out the DKQ24 and APD-UMA questionnaires to evaluate knowledge about DM and foot self-care respectively. Results: 103 patients were included, 57% women, 63±11 years of Diabetes, 14±8.45; 29% primary education, body mass index 30.56±5.31, high blood pressure 83.5%, 11.6% smokers, retinopathy 35.9%, loss of protective sensitivity (PSP) in feet 53.4%, peripheral arterial disease 20.4%, deformities 49.5% and previous injuries 27.2% in the feet; minor amputation 2.9%, major amputation 1%. HBA1c mean 8% (±1.3), creatinine clearance 78.2 mg/dL/m2 (±21.42). Knowledge levels: good 68 (66%), regular 34 (33%) and poor 1 (1%). Foot self-care: average of responses between very adequate and adequate: 87.4 (84.8%), regular: 9.4 (9.2%); between inadequate and very inadequate 7 (6.8%). Conclusion: Patients with DM2 who attend multidisciplinary consultation have an elevated level of knowledge about their foot pathology and self-care, which would help prevent complications, considering that they are a risk group for EPRD.

Association between ABO and Rh blood groups and Toxoplasma gondii infection: A cross sectional study.

We aimed to determine the association between the seropositivity to Toxoplasma gondii and the ABO and Rh blood groups in 2,053 people. ABO and Rhesus blood groups and anti-T. gondii IgG and IgM antibodies were determined using commercially available assays. Of the 2,053 people studied, 171 (8.3%) were positive for anti-T. gondii IgG antibodies. Sixty-five (38.0%) and 36 (21.1%) of these 171 individuals had high anti-T. gondii IgG antibody levels (≥150 IU mL-1) and anti-T. gondii IgM antibodies, respectively. We found the following prevalences of T. gondii infection among the ABO groups: 8.5% in group A, 4.3% in group B, 4.7% in group AB, and 8.9% in group O (P = 0.19). The prevalences of T. gondii infection among Rh groups were: 8.4% in the Rh-positive group and 7.1% in the Rh-negative group (P = 0.58). Logistic regression analysis showed that the frequencies of ABO and Rh blood groups were similar (P > 0.05) among people with positive and negative serology for anti-T. gondii IgG antibodies, with high (≥150 IU mL-1) and lower (<150 IU mL-1) levels of anti-T. gondii IgG antibodies, and with positive and negative serology for anti-T. gondii IgM antibodies. Results does not support an association between T. gondii infection and ABO and Rh blood groups.

The osteoarthritis prevention study (TOPS) - A randomized controlled trial of diet and exercise to prevent Knee Osteoarthritis: Design and rationale.

Background: Osteoarthritis (OA), the leading cause of disability among adults, has no cure and is associated with significant comorbidities. The premise of this randomized clinical trial is that, in a population at risk, a 48-month program of dietary weight loss and exercise will result in less incident structural knee OA compared to control. Methods/design: The Osteoarthritis Prevention Study (TOPS) is a Phase III, assessor-blinded, 48-month, parallel 2 arm, multicenter randomized clinical trial designed to reduce the incidence of structural knee OA. The study objective is to assess the effects of a dietary weight loss, exercise, and weight-loss maintenance program in preventing the development of structural knee OA in females at risk for the disease. TOPS will recruit 1230 ambulatory, community dwelling females with obesity (Body Mass Index (BMI) â€‹≥ â€‹30 â€‹kg/m2) and aged ≥50 years with no radiographic (Kellgren-Lawrence grade ≤1) and no magnetic resonance imaging (MRI) evidence of OA in the eligible knee, with no or infrequent knee pain. Incident structural knee OA (defined as tibiofemoral and/or patellofemoral OA on MRI) assessed at 48-months from intervention initiation using the MRI Osteoarthritis Knee Score (MOAKS) is the primary outcome. Secondary outcomes include knee pain, 6-min walk distance, health-related quality of life, knee joint loading during gait, inflammatory biomarkers, and self-efficacy. Cost effectiveness and budgetary impact analyses will determine the value and affordability of this intervention. Discussion: This study will assess the efficacy and cost effectiveness of a dietary weight loss, exercise, and weight-loss maintenance program designed to reduce incident knee OA. Trial registration: ClinicalTrials.gov Identifier: NCT05946044.

The Use of Medical Crowdfunding to Mitigate the Personal Costs of Serious Chronic Illness: Scoping Review.

BACKGROUND: Persons diagnosed with serious chronic illnesses and their caretakers experience multiple types of financial costs that strain their income and generate financial distress. Many turn to medical crowdfunding (MCF) to mitigate the harms of these costs on their health and quality of life. OBJECTIVE: This scoping review aims to summarize the research on MCF for persons diagnosed with serious chronic illness regarding study designs and methods; the responsible conduct of research practices; and study foci as they relate to stress, stress appraisals, and the coping processes. METHODS: This review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Eligible studies were conducted in countries designated as high income by the World Bank and focused on beneficiaries diagnosed with serious chronic illness. The findings of the included studies were summarized as they related to the key concepts in a conceptual framework derived from an established stress, appraisal, and coping framework and a conceptual model of financial toxicity in pediatric oncology. RESULTS: Overall, 26 studies were eligible for inclusion in the review. The main findings included a lack of integration of qualitative and quantitative approaches and the inconsistent reporting of the responsible conduct of research practices. The included studies focused on financial stressors that contributed to financial burden, such as out-of-pocket payments of medical bills, basic living expenses, medical travel expenses, and lost income owing to illness-related work disruptions. Few studies addressed stress appraisals as threatening or the adequacy of available financial resources. When mentioned, appraisals related to the global financial struggle during the COVID-19 pandemic or the capacity of social network members to donate funds. The consequences of MCF included the receipt of 3 forms of social support (tangible, informational, and emotional), privacy loss, embarrassment, and the propagation of scientifically unsupported information. Studies found that friends and family tended to manage MCF campaigns. Although most of the studies (21/26, 81%) focused on monetary outcomes, a few (5/26, 19%) concentrated on peoples' experiences with MCF. CONCLUSIONS: The identified methodological gaps highlight the need for more robust and reproducible approaches to using the copious data available on public MCF platforms. The integration of quantitative and qualitative methods will allow for nuanced explorations of the MCF experience. A more consistent elaboration of strategies to promote the responsible conduct of research is warranted to minimize risk to populations that are vulnerable and express concerns regarding the loss of privacy. Finally, an examination of the unanticipated consequences of MCF is critical for the development of future interventions to optimize existing supports while providing needed supports, financial and nonfinancial, that are lacking.

Taxonomic identification accuracy from BOLD and GenBank databases using over a thousand insect DNA barcodes from Colombia.

Recent declines of insect populations at high rates have resulted in the need to develop a quick method to determine their diversity and to process massive data for the identification of species of highly diverse groups. A short sequence of DNA from COI is widely used for insect identification by comparing it against sequences of known species. Repositories of sequences are available online with tools that facilitate matching of the sequences of interest to a known individual. However, the performance of these tools can differ. Here we aim to assess the accuracy in identification of insect taxonomic categories from two repositories, BOLD Systems and GenBank. This was done by comparing the sequence matches between the taxonomist identification and the suggested identification from the platforms. We used 1,160 COI sequences representing eight orders of insects from Colombia. After the comparison, we reanalyzed the results from a representative subset of the data from the subfamily Scarabaeinae (Coleoptera). Overall, BOLD systems outperformed GenBank, and the performance of both engines differed by orders and other taxonomic categories (species, genus and family). Higher rates of accurate identification were obtained at family and genus levels. The accuracy was higher in BOLD for the order Coleoptera at family level, for Coleoptera and Lepidoptera at genus and species level. Other orders performed similarly in both repositories. Moreover, the Scarabaeinae subset showed that species were correctly identified only when BOLD match percentage was above 93.4% and a total of 85% of the samples were correctly assigned to a taxonomic category. These results accentuate the great potential of the identification engines to place insects accurately into their respective taxonomic categories based on DNA barcodes and highlight the reliability of BOLD Systems for insect identification in the absence of a large reference database for a highly diverse country.

Women's perspectives on the acceptability and feasibility of an HPV screen-and-treat approach to cervical cancer prevention in Iquitos, Peru: a qualitative study.

BACKGROUND: The objective of this study was to explore women's experiences of a screen-and-treat approach with ablative therapy (referred to by the Spanish acronym TVT-TA) as a method of treatment following a positive HPV test in Iquitos, Peru. METHODS: A total of 111 in-depth interviews were conducted with 47 HPV positive women who attended the TVT-TA procedure at a primary-level healthcare facility. Interviews were conducted immediately before, immediately after, and six-weeks after TVT-TA. RESULTS: Most interviewed women reported experiencing moderate pain during ablative therapy and minimal pain immediately after and six weeks after ablative therapy. Women also stated that the pain was less intense than they had expected. The most common physical after-effects of treatment were bleeding and vaginal odor. Women experienced oscillating emotions with fear upon receiving a positive HPV result, calming after hearing about ablative therapy treatment, worry about pain from the treatment itself, relaxation with counseling about the procedure, and relief following treatment. CONCLUSIONS: Nearly all participants emphasized that they were pleased with the TVT-TA process even if they had experienced pain during TVT-TA, recommended that TVT-TA be expanded and available to more women, and stated that TVT-TA was faster and easier than expected. This study found that TVT-TA is a feasible and acceptable means of treating HPV according to the women receiving the treatment.

Qualitative Exploration of Dyadic Influence on Physical Activity Between Latina Patients With Osteoarthritis and a Supporter of Their Physical Activity.

OBJECTIVE: Research indicates that social support may promote physical activity; however, most Latina individuals with osteoarthritis (OA) are not sufficiently active. The purpose of this qualitative dyadic study was to explore how Latina patients with OA and a self-selected physical activity "supporter" motivate each other to be more active. Furthermore, perceptions of how OA symptoms impact support and physical activity were examined. METHODS: Semistructured dyadic interviews were conducted with Latina patients with OA and a member of their social network age ≥16 years who supports their physical activity (n = 14 dyads). We used framework analysis to reduce qualitative data to themes and subthemes. RESULTS: Daughters (n = 5), spouses (n = 4), sons (n = 2), a granddaughter (n = 1), a nephew (n = 1), and a friend (n = 1) provided support for the target behavior. In many cases, members of dyads said the motivation to engage in physical activity was reciprocated rather than focused solely on Latina patients with OA. Support was often reciprocated by engaging in physical activity together, using pressure, talking about being active, modeling physical activity, and helping with household responsibilities. Although participants agreed that physical activity was beneficial and Latina patients desired additional support when experiencing OA symptoms, there was concern about the safety of activity in the presence of symptoms. Several adult daughters indicated that their mothers' OA symptoms motivated their own physical activity. CONCLUSION: Dyadic strategies for promoting physical activity among Latina patients with OA and how support may be reciprocated were identified.

Partner and Relationship Predictors of Longitudinal Physical Activity Trajectories Among Individuals with Osteoarthritis Using Latent Class Growth Analysis.

BACKGROUND: Physical activity reduces osteoarthritis symptoms, yet many individuals with the disease are insufficiently active. PURPOSE: We identified physical activity trajectories over 12 months of individuals with osteoarthritis and examined how their cohabiting spouses'/partners' baseline physical activity and relationship factors affected trajectory membership. METHODS: In this longitudinal observational study, we collected data from 168 adults with knee/hip osteoarthritis. We used latent class growth curve analysis to identify physical activity trajectories and logistic regression to predict trajectory membership using partners' physical activity, relationship satisfaction, and communal coping (belief that both partners are responsible for osteoarthritis management). Measures, including objectively assessed physical activity, were collected at baseline from the couple, who then received an educational class on physical activity and social support. Objectively assessed physical activity was also collected from individuals with osteoarthritis at 1 week, 3 months, 6 months, and 12 months post-baseline. RESULTS: Three trajectories were identified: stable active, increaser, and stable sedentary (24%, 40%, 37% of participants, respectively). Individuals with osteoarthritis with partners who were more active and who believed they alone were responsible for their osteoarthritis were more likely to follow the stable active (versus stable sedentary) trajectory. Those with partners who were less active and had higher relationship satisfaction were more likely to follow the increaser (vs. stable active) trajectory. CONCLUSIONS: Findings demonstrate the importance of considering partner and relationship factors in physical activity interventions for couples.

Correlación entre el Cuestionario Respiratorio de Saint George, la Escala de Severidad de la Fatiga y la Escala de Actividades de la Vida Diaria London Chest en pacientes que se recuperaron de COVID-19 e ingresaron a un programa de rehabilitación pulmonar / Correlation between the Saint George's Respiratory Questionnaire, the Fatigue Severity Scale and the London Chest Activities of Daily Living Scale in patients who recovered from COVID-19 and entered a pulmonary rehabilitation program

Introducción. Una vez declarada la pandemia por COVID-19, los servicios de rehabilitación empezaron a prepararse para la atención, mediante diferentes abordajes, de los pacientes que se recuperaran de esta enfermedad. Objetivo. Correlacionar los resultados obtenidos en el Cuestionario Respiratorio de Saint George (CRSG), la Escala de Severidad de la Fatiga (FSS) y la Escala de Actividades de la Vida Diaria London Chest (LCADL) aplicados en pacientes recuperados de COVID-19 para medir su calidad de vida y la fatiga. Métodos. Estudio descriptivo retrospectivo realizado en 60 pacientes recuperados de COVID-19, moderado o grave, que ingresaron al programa de rehabilitación pulmonar de un hospital de tercer nivel de Bogotá, Colombia, entre el primero de octubre de 2020 y el 30 de junio de 2021. Se analizaron variables demográficas y para caracterizar la calidad de vida y la fatiga de los participantes se utilizó el cuestionario CRSG, la escala FSS y la escala LCADL, cuyos resultados se compararon mediante correlación de Spearman. Para el análisis estadístico se utilizó el programa de SPSS versión 28. Resultados. La fatiga está correlacionada con la calidad de vida, y al ser identificada se puede intervenir mediante los ejercicios terapéuticos de los programas de rehabilitación pulmonar, lo cual optimiza los resultados esperados. Conclusiones. Existe una adecuada correlación entre las escalas CRSG y LCADL; esto es importante porque aplicar escalas de calidad de vida en pacientes con SARS-CoV-2 permite conocer las áreas que pueden ser intervenidas mediante programas de rehabilitación pulmonar para lograr una intervención adecuada

Introduction. Once the COVID-19 pandemic was declared, rehabilitation services began to prepare for the care, through different approaches, of patients recovering from this disease. Objective. To correlate the results obtained in the Saint George's Respiratory Questionnaire (CRSG), the Fatigue Severity Scale (FSS) and the London Chest Activities of Daily Living Scale (LCADL) applied in patients recovered from COVID-19 to measure their quality of life and fatigue. Methods. Retrospective descriptive study conducted in 60 patients recovered from COVID-19, moderate or severe, who were admitted to the pulmonary rehabilitation program of a third level hospital in Bogota, Colombia, between October 1, 2020 and June 30, 2021. Demographic variables were analyzed and the CRSG questionnaire, the FSS scale and the LCADL scale were used to characterize the quality of life and fatigue of the participants, whose results were compared by Spearman correlation. SPSS version 28 was used for statistical analysis. Results. Fatigue is correlated with quality of life, and when identified, it can be intervened by means of therapeutic exercises in pulmonary rehabilitation programs, which optimizes the expected results. Conclusions. There is an adequate correlation between the CRSG and LCADL scales; this is important because applying quality of life scales in patients with SARS-CoV-2 allows us to know the areas that can be intervened through pulmonary rehabilitation programs to achieve an adequate intervention.

Is Toxoplasma gondii Infection Associated with Sexual Promiscuity? A Cross-Sectional Study.

We determined the association between T. gondii seropositivity and a history of sexual promiscuity. The study included 3933 people (mean age: 41.81 ± 14.31 years) who attended public health facilities. Face-to-face interviews were used to collect data. Enzyme immunoassays were used to determine anti-T. gondii IgG and IgM antibodies. Anti-T. gondii IgG antibodies were found in 57 (18.1%) of 315 individuals with sexual promiscuity and in 374 (10.3%) of 3618 individuals without this practice (OR: 1.91; 95% CI: 1.41-2.60; p < 0.0001). High (>150 IU/mL) levels of anti-T. gondii IgG antibodies were found in 29 (9.2%) of the 315 participants with sexual promiscuity and in 167 (4.6%) of the 3618 participants without this history (OR: 2.09; 95% CI: 1.38-3.16; p = 0.0003). The association of sexual promiscuity with T. gondii seropositivity and serointensity was observed in men but not in women. Sexual promiscuity was associated with T. gondii seropositivity in all age groups studied (≤30 years, 31-50 years, and >50 years) and with T. gondii serointensity in two age groups (≤30 years, and >50 years). No difference in the frequencies of anti-T. gondii IgM antibodies among the groups was found. Our findings indicate that T. gondii seropositivity and serointensity are associated with sexual promiscuity.

Association between Toxoplasma gondii Exposure and Suicidal Behavior in Patients Attending Primary Health Care Clinics.

This study aimed to determine the association between suicidal behavior and T. gondii seroreactivity in 2045 patients attending primary care clinics. IgG antibodies against T. gondii were found in 37 (12.1%) out of 306 individuals with a history of suicidal ideation and in 134 (7.7%) of 1739 individuals without this history (OR: 1.64; 95% CI: 1.11-2.42; p = 0.01). Seropositivity to T. gondii was associated with suicidal ideation in women (OR: 1.56; 95% CI: 1.01-2.42; p = 0.03) and individuals aged ≤30 years (OR: 3.25; 95% CI: 1.53-6.88; p = 0.001). No association between the rates of high (>150 IU/mL) levels of anti-T. gondii IgG antibodies and suicidal ideation or suicide attempts was found. IgG antibodies against T. gondii were found in 22 of 185 (11.9%) individuals with a history of suicide attempts and in 149 (8.0%) of 1860 individuals without this history (OR: 1.54; 95% CI: 0.96-2.49; p = 0.06). The seroprevalence of T. gondii infection was associated with suicide attempts in individuals aged 31-50 years (OR: 2.01; 95% CI: 1.09-3.71; p = 0.02), and with more than three suicide attempts (OR: 4.02; 95% CI: 1.34-12.03; p = 0.008). Our results indicate that T. gondii exposure is associated with suicidal behavior among patients attending primary care clinics.

Leptospira infection in people in the city of Durango, Mexico: a cross sectional study.

OBJECTIVE: To determine the seroprevalence of Leptospira immunoglobulin (Ig)G and IgM antibodies and its association with the characteristics of the study population from the northern Mexican city of Durango, Mexico. METHODS: Through a cross-sectional study design, inhabitants of Durango City, Mexico were surveyed between June 2018 and November 2018. Serum samples from the subjects were analysed for anti-Leptospira IgG and IgM antibodies using commercially available enzyme-linked immunosorbent assays. Sociodemographic, clinical, behavioural and housing characteristics were recorded. Data were analysed by bivariate and multivariate analyses. RESULTS: The study enrolled 413 people, of which 124 (30.0%) and 137 (33.2%) were positive for anti-Leptospira IgG antibodies and anti-Leptospira IgM antibodies, respectively. Multivariate analysis showed that Leptospira seropositivity was associated with professional occupation, alcohol consumption, ill clinical status, memory impairment and a history of surgery. CONCLUSIONS: This is the first study to report the seroepidemiology of Leptospira infection in an urban general population in the north of Mexico. The seroprevalence of Leptospira infection found was higher than those previously reported in Mexican studies.

Características y factores asociados al maltrato percibido en internos de medicina en Perú / Characteristics and associated factors with mistreatment perception in medical interns in Peru

RESUMEN Objetivo: Determinar las características y factores asociados a la percepción de maltrato en internos de medicina del Perú. Materiales y métodos : Estudio multicéntrico, transversal y analítico. Se encuestaron a internos de medicina de dieciocho hospitales del Perú. Se aplicó una encuesta entre marzo y abril del 2016 que incluían características sociodemográficas y una escala que media la percepción de maltrato psicológico, físico y sexual. Se realizaron modelos lineales generalizados y se estimaron razones de prevalencia crudas y ajustadas (RPa) con intervalos de confianza al 95%. Resultados : Participaron 418 internos de medicina. El maltrato psicológico, físico y sexual percibido fue de 91,9%; 55,5% y 34%, respectivamente. Los factores asociados con el maltrato psicológico fueron proceder de una universidad privada (RPa:1,07; IC95%:1,01- 1,13), respecto al maltrato físico fueron la edad (RPa: 1,08; IC95%: 1,05-1,12), realizar internado en un hospital de la selva (RPa: 1,27; IC95%: 1,03-1,56) y en un hospital del Seguro Social (RPa:0,66; IC95%:0,44-0,94) y para el maltrato sexual el ser mujer (RPa:1,52; IC95%:1,15-2,01). Conclusiones : Existe una alta percepción de maltrato reportado por los internos de medicina siendo el psicológico el más frecuente. Existen diferencias en la percepción de maltrato psicológico y físico según el tipo de financiamiento de la universidad de procedencia y del hospital donde se realiza el internado. Una alta frecuencia de maltrato sexual fue reportada por mujeres luego de los tres primeros meses del internado hospitalario.

ABSTRACT Objective: To determine the characteristics and factors associated with the perception of abuse in medicine interns of Peru. Material and Methods : This is a cross-sectional multicenter and analytical study. Medicine interns from eighteen Peruvian hospitals were interviewed. A survey was administered between March and April 2016, which included socio-demographic characteristics and a scale measuring psychological and physical abuse, as well as sexual harassment perception. Generalized linear models were used and crude and adjusted prevalence rates (aPR) were estimated, with 95% confidence intervals (CI). Results: 418 medical interns participated in the study. Psychological and physical abuses were perceived by 91,9% and 55,5% of the studied population. Sexual harassment was perceived by 34% of all interviewed interns. Associated factors with psychological abuse were studied in a private university (aPR: 1.07; 95% CI: 1.01-1.13). Factors associated with physical abuse were age (aPR: 1.08; 95% IC: 1.05-1.12), performing internship in an Amazonian area hospital (aPR: 1,27; 95% CI: 1,03-1,56), and in a Social Security Hospital (aPR: 0,66; 95% CI: 0,44-0,94); and for sexual harassment, being female was the main associated factor (aPR: 1,52; 95% CI: 1,15-2,01). Conclusions: There is a high perception of abuse experienced by medicine interns, being psychological abuse the most frequent condition. There are some differences in the perception of psychological and physical abuse, according to the medical school the interns come from, as well as with respect to the healthcare facility where internship is performed. A high frequency of sexual harassment was reported by female interns after three months of having started their training period.

Uso de mapas conceptuales en Razonamiento Clínico como herramienta para favorecer el rendimiento académico / The Usage of Conceptual Maps in the Subject Clinical Reasoning as a Tool for Improving Academic Performance

Introducción: Las dificultades presentes en la educación en ciencias de la salud son experimentadas por docentes y estudiantes en las asignaturas disciplinares. Los profesores requieren entregar y evaluar gran volumen de contenidos y los alumnos deben asimilar estos rápidamente para obtener un adecuado rendimiento. Objetivo: Evaluar la efectividad de la creación de mapas conceptuales sobre el rendimiento, en la asignatura Razonamiento Clínico de la carrera de kinesiología de una universidad privada de la V región, Chile. Métodos: Estudio cuasi experimental, en el que participaron dos grupos: control y experimental. En el grupo experimental se aplicó la intervención con la incorporación de la herramienta de creación de mapas conceptuales en dos unidades temáticas. Se evaluó el rendimiento pre- y posintervención. La población de estudio estuvo constituida por dos grupos de estudiantes de Kinesiología (n = 55), que cursaron la asignatura Razonamiento Clínico del séptimo semestre, correspondiente al primer semestre de 2017 de la malla curricular en la carrera de kinesiología, en una universidad privada de la ciudad de la V región, Chile. Resultados: El rendimiento pre- y posintervención indicó una diferencia significativa en las calificaciones correspondientes a las unidades II y III en el grupo experimental (t-test pareado p < 0,0001). Al comparar el desempeño entre ambos grupos: control y experimental, este último obtuvo un promedio de notas significativamente superior al grupo control en las unidades II y III (t-test, p < 0,0001). La unidad I no presentó diferencias notables entre el grupo control con respecto al experimental (ANOVA/Bonferroni post hoc test, p > 0,05). Conclusiones: La estrategia de crear mapas conceptuales incrementa el rendimiento en la asignatura Razonamiento Crítico para abordar problemas clínicos. La creación de mapas conceptuales favorece el aprendizaje y permite identificar habilidades que denotan mayor dificultad en los estudiantes. Se propone la incorporación de estos mapas en formación sistemática como herramienta de enseñanza y evaluación(AU)

Introduction: The difficulties present in health sciences education are experienced by teachers and students in disciplinary subjects. Teachers need to deliver and evaluate large volumes of content and students must assimilate these quickly in order to obtain adequate performance. Objective: To evaluate the effectiveness of creating conceptual maps on performance, in the subject Clinical Reasoning of the Kinesiology major of a private university of the V Region, Chile. Methods: Quasiexperimental study with the participation of two groups, a control group and an experimental group. In the experimental group, the intervention was applied with the incorporation of the tool for creating conceptual maps in two thematic units. Pre- and post-intervention performance was evaluated. The study population consisted of two groups of students of Kinesiology (n=55), who attended the subject Clinical Reasoning of the seventh semester, corresponding to the first semester of 2017, of the curriculum in the Kinesiology major at a private university in the city of the V region, Chile. Results: The pre- and post-intervention performance indicated a significant difference in the qualifications corresponding to units II and III in the experimental group (paired t-test p<0.0001). When comparing the performance between both groups, control and experimental, the latter obtained an average of significantly higher scores than the control group in units II and III (t-test, p < 0.0001). Unit I did not show notable differences between the control group and the experimental group (ANOVA/Bonferroni post hoc test, p > 0.05). Conclusions: The strategy of creating conceptual maps increases the performance in the subject Critical Reasoning, for the addressing of clinical problems. The creation of conceptual maps favors learning and allows the identification of skills that denote greater difficulty in students. The incorporation of these maps in systematic training is proposed as a teaching and evaluation tool(AU)

Association between Toxoplasma gondii infection and thyroid dysfunction: a case-control seroprevalence study.

BACKGROUND: The association between Toxoplasma gondii infection and thyroid disease has been poorly studied. Therefore, we sought to determine the association between T. gondii seropositivity and thyroid dysfunction. METHODS: We performed an age- and gender-matched case-control study of 176 patients suffering from hypothyroidism (n = 161) or hyperthyroidism (n = 15) and 528 control subjects without these diseases in a public hospital in Durango City, Mexico. Anti-Toxoplasma IgG antibodies were determined in sera from cases and controls using a commercially available enzyme-linked immunoassay. RESULTS: Anti-T. gondii IgG antibodies were found in 11 (6.3%) of 176 patients suffering from thyroid dysfunction and in 48 (9.1%) of 528 control subjects (OR = 0.66; 95% CI: 0.33-1.31; P = 0.23). Stratification by two groups of age (50 years and younger, and 51 year and older) showed that the youngest group of patients with thyroid dysfunction had a significantly lower seroprevalence of T. gondii infection than its age- and gender-matched control group (1/83: 1.2% vs 23/257: 8.6%; OR = 0.12; 95% CI: 0.01-0.93; P = 0.01). This stratification also showed that the youngest group of patients with hypothyroidism had a significantly lower seroprevalence of T. gondii infection than its age- and gender matched control group (0/75: 0% vs 21/233: 9.0%; P = 0.003). CONCLUSIONS: Our results suggest that thyroid dysfunction is not associated with seropositivity to T. gondii in general; however, in young (50 years or less) patients, a negative association between infection and thyroid dysfunction and hypothyroidism was found. Further research to confirm this negative association is needed.

The Role of Cohabitating Partner and Relationship Characteristics on Physical Activity among Individuals with Osteoarthritis.

BACKGROUND: Most individuals with knee or hip osteoarthritis do not meet recommendations for physical activity. The Social Cognitive Theory suggests that the social environment (e.g., spouses/partners) may influence the physical activity of individuals with osteoarthritis. The purpose of this study was to examine whether the physical activity of insufficiently active, coupled adults with osteoarthritis was associated with received partner support for physical activity, partner's engagement in physical activity, and relationship satisfaction. METHODS: Cross-sectional data from 169 couples were collected. Accelerometers estimated moderate-to-vigorous physical activity and daily steps for participants with osteoarthritis and their partners. Participants with osteoarthritis reported total received partner support for physical activity and relationship satisfaction. RESULTS: Participants with osteoarthritis were on average 65 years old, 65% female, 86% non-Hispanic white, and 47% retired. Receiving total partner support more frequently was associated with more minutes of moderate-to-vigorous physical activity but not with steps. Relationship satisfaction moderated the association of partner's physical activity on the daily steps of individuals with osteoarthritis such that having a partner who accomplished more daily steps was associated with participants with osteoarthritis accomplishing more daily steps themselves when they reported greater relationship satisfaction. CONCLUSIONS: Partners and relationship satisfaction may play an important role in the physical activity of individuals with osteoarthritis. Interventions seeking to increase physical activity in this population may be enhanced by promoting partner support. Additional research is needed to further explain these associations within the context of relationship satisfaction.