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1.
Rev. Inst. Med. Trop ; 19(1)jun. 2024.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1569559

ABSTRACT

Introducción : Se promueven iniciativas para mejorar la salud de las mujeres y niños siendo el denominador común disponer de un sistema de información con repercusión en la salud de esta población. En Paraguay el SIP PLUS es utilizado con diferente grado de cobertura en los servicios maternoinfantiles. Objetivo: analizar la calidad de los datos generados para la construcción de los indicadores de Eliminación de la Sífilis Congénita (SC). Metodología: Estudio nacionalmente representativo utilizando datos generados por el SIP PLUS. Resultados: 32.479 historias perinatales cargadas desde el 2018 a julio del 2021. La representación de la muestra 1,5% en 2018 al 23% en 2021. Mayores pérdidas de información en el 2020. Para las variables de contexto con menos pérdidas de información en comparación a las de prevención primaria, secundaria y salud reproductiva. La pérdida de datos para: porcentaje de mujeres embarazadas con cuidado prenatal (4 o más) en un promedio de 64,4%; porcentaje de mujeres embarazadas tamizadas 43,1 % en el 2020 y 33,4% en 2019; positividad de la prueba de sífilis 49% en el 2020. Lo que también se observa en el indicador de tratamiento. Se registraron 506 casos de SC. Tasa de SCx1000 nacidos vivos ( 10 x1000 nacidos vivos en los 4 años analizados. Edad adolescente (p: 0,040) como factor de riesgo para SC. Conclusiones: Pérdida de registros en lo referente a ETMI, por falta de carga de datos. Alta incidencia de SC en los años analizados. Adolescentes como factor de riesgo para SC.


Introduction: Initiatives are promoted to improve the health of women and children, the common denominator being having an information system with an impact on the health of this population. In Paraguay, the SIP PLUS is used with different degrees of coverage in maternal and child services. Objective: analyze the quality of the data generated for the construction of the indicators for the Elimination of Congenital Syphilis (CS). Methodology: Nationally representative study using data generated by the SIP PLUS. Results: 32,479 perinatal histories uploaded from 2018 to July 2021. The representation of the sample went from 1.5% in 2018 to 23% in 2021. Greater information losses in 2020. For the context variables with fewer information losses in comparison to those of primary, secondary prevention and reproductive health. Loss of data for: percentage of pregnant women with prenatal care (4 or more) averaged 64.4%; percentage of pregnant women screened 43.1% in 2020 and 33.4% in 2019; syphilis test positivity 49% in 2020. This is also observed in the treatment indicator. 506 cases of CS were recorded. Rate of SCx1000 live births  10 x1000 live births in the 4 years analyzed. Adolescent age (p: 0.040) as a risk factor for CS. Conclusions: Loss of records regarding ETMI, due to lack of data loading. High incidence of CS in the years analyzed. Adolescents as a risk factor for CS.

2.
Article in English | PAHO-IRIS | ID: phr-59188

ABSTRACT

[ABSTRACT]. Objective. To analyze temporal trends and inequalities in neonatal mortality between 2000 and 2020, and to set neonatal mortality targets for 2025 and 2030 in the Americas. Methods. A descriptive ecological study was conducted using 33 countries of the Americas as units of anal- ysis. Both the percentage change and average annual percentage change in neonatal mortality rates were estimated. Measurements of absolute and relative inequality based on adjusted regression models were used to assess cross-country social inequalities in neonatal mortality. Targets to reduce neonatal mortality and cross-country inequalities were set for 2025 and 2030. Results. The estimated regional neonatal mortality rate was 12.0 per 1 000 live births in 2000–2004 and 7.4 per 1 000 live births in 2020, representing a percentage change of –38.3% and an average annual per- centage change of –2.7%. National average annual percentage changes in neonatal mortality rates between 2000–2004 and 2020 ranged from –5.5 to 1.9 and were mostly negative. The estimated excess neonatal mor- tality in the 20% most socially disadvantaged countries, compared with the 20% least socially disadvantaged countries, was 17.1 and 9.8 deaths per 1 000 live births in 2000–2004 and 2020, respectively. Based on an extrapolation of recent trends, the regional neonatal mortality rate is projected to reach 7.0 and 6.6 neonatal deaths per 1 000 live births by 2025 and 2030, respectively. Conclusions. National and regional health authorities need to strengthen their efforts to reduce persistent social inequalities in neonatal mortality both within and between countries.


[RESUMEN]. Objetivo. Analizar las desigualdades en la mortalidad neonatal y las tendencias en el transcurso del tiempo entre el 2000 y el 2020, y establecer metas en materia de mortalidad neonatal para el 2025 y el 2030 en la Región de las Américas. Métodos. Se realizó un estudio ecológico descriptivo con información de 33 países de la Región de las Américas que se usaron como unidades de análisis. Se calculó tanto la variación porcentual como la varia- ción porcentual anual media de las tasas de mortalidad neonatal. Se utilizaron mediciones de la desigualdad absoluta y relativa basadas en modelos de regresión ajustados, para evaluar las desigualdades sociales en los diversos países en cuanto a la mortalidad neonatal. Se establecieron metas de reducción de la mortalidad neonatal y de las desigualdades en los diversos países para el 2025 y el 2030. Resultados. La tasa de mortalidad neonatal en la Región fue de 12,0 por 1 000 nacidos vivos en el período 2000-2004 y de 7,4 por 1 000 nacidos vivos en el 2020, lo que representa una variación porcentual del –38,3% y una variación porcentual anual media del –2,7%. Las variaciones porcentuales anuales medias de las tasas de mortalidad neonatal a nivel nacional entre el período 2000-2004 y el 2020 oscilaron entre –5,5 y 1,9, y fueron en su mayor parte negativas. El exceso de mortalidad neonatal estimado en el 20% de los países más desfavorecidos socialmente, en comparación con el 20% de los países menos desfavorecidos socialmente, fue de 17,1 muertes por 1 000 nacidos vivos en el período 2000-2004 y de 9,8 muertes por 1 000 nacidos vivos en el 2020. Al extrapolar las tendencias más recientes, se prevé que la tasa de mortalidad neonatal de la Región alcance valores de 7,0 y 6,6 muertes neonatales por 1 000 nacidos vivos en el 2025 y el 2030, respectivamente. Conclusiones. Las autoridades de salud nacionales y regionales deben fortalecer las medidas para reducir las desigualdades sociales que aún persisten en materia de mortalidad neonatal, tanto entre los distintos países como dentro de cada país.


[RESUMO]. Objetivo. Analisar as tendências temporais e desigualdades em mortalidade neonatal entre 2000 e 2020 e estabelecer metas de mortalidade neonatal para 2025 e 2030 na Região das Américas. Métodos. Estudo ecológico descritivo examinando 33 países das Américas como unidades de análise. Foram estimadas a variação percentual e a variação percentual anual média das taxas de mortalidade neonatal. Foram usadas medidas de desigualdade absoluta e relativa baseadas em modelos de regressão ajustados para avaliar desigualdades sociais entre países em termos de mortalidade neonatal. Foram definidas metas de redução da mortalidade neonatal e das desigualdades entre países para 2025 e 2030. Resultados. A taxa regional estimada de mortalidade neonatal foi de 12,0 por mil nascidos vivos em 2000– 2004, e de 7,4 por mil nascidos vivos em 2020, representando uma variação percentual de -38,3%, e uma variação percentual anual média de -2,7%. As variações percentuais anuais médias nacionais das taxas de mortalidade neonatal entre 2000–2004 e 2020 variaram entre -5,5 e 1,9 e, em sua maioria, foram negativas. O excesso estimado de mortalidade neonatal nos países que estavam entre os 20% mais desfavorecidos socialmente, em comparação com os países entre os 20% menos desfavorecidos, foi de 17,1 e 9,8 mortes por mil nascidos vivos em 2000–2004 e 2020, respectivamente. Com base em extrapolação das tendências recentes, estima-se que a taxa de mortalidade neonatal regional deve atingir 7,0 e 6,6 mortes neonatais por mil nascidos vivos em 2025 e 2030, respectivamente. Conclusões. As autoridades de saúde nacionais e regionais precisam intensificar seus esforços para reduzir desigualdades sociais persistentes na mortalidade neonatal, tanto dentro dos países quanto entre eles.


Subject(s)
Infant Mortality , Perinatal Death , Health Inequities , Social Determinants of Health , Sustainable Development , Americas , Infant Mortality , Perinatal Death , Health Inequities , Social Determinants of Health , Sustainable Development , Americas , Infant Mortality , Perinatal Death , Health Inequities , Social Determinants of Health , Sustainable Development , Americas
3.
Article in English | MEDLINE | ID: mdl-38259254

ABSTRACT

Objective: To analyze temporal trends and inequalities in neonatal mortality between 2000 and 2020, and to set neonatal mortality targets for 2025 and 2030 in the Americas. Methods: A descriptive ecological study was conducted using 33 countries of the Americas as units of analysis. Both the percentage change and average annual percentage change in neonatal mortality rates were estimated. Measurements of absolute and relative inequality based on adjusted regression models were used to assess cross-country social inequalities in neonatal mortality. Targets to reduce neonatal mortality and cross-country inequalities were set for 2025 and 2030. Results: The estimated regional neonatal mortality rate was 12.0 per 1 000 live births in 2000-2004 and 7.4 per 1 000 live births in 2020, representing a percentage change of -38.3% and an average annual percentage change of -2.7%. National average annual percentage changes in neonatal mortality rates between 2000-2004 and 2020 ranged from -5.5 to 1.9 and were mostly negative. The estimated excess neonatal mortality in the 20% most socially disadvantaged countries, compared with the 20% least socially disadvantaged countries, was 17.1 and 9.8 deaths per 1 000 live births in 2000-2004 and 2020, respectively. Based on an extrapolation of recent trends, the regional neonatal mortality rate is projected to reach 7.0 and 6.6 neonatal deaths per 1 000 live births by 2025 and 2030, respectively. Conclusions: National and regional health authorities need to strengthen their efforts to reduce persistent social inequalities in neonatal mortality both within and between countries.

4.
Braz J Phys Ther ; 28(1): 100586, 2024.
Article in English | MEDLINE | ID: mdl-38219522

ABSTRACT

BACKGROUND: Shoulder pain related to pathology of the long head of the biceps tendon (LHBT) can be debilitating. Chronic LHBT tendinopathy is a common condition that is difficult to treat. Little consensus exists regarding the optimal approach to treating individuals with LHBT tendinopathy. OBJECTIVE: To systematically scope the literature to identify and present the available information regarding physical therapist interventions used for the management of individuals with LHBT tendinopathy including types of interventions used or recommended. METHODS: A scoping review of physical therapist interventions used to treat LHBT was conducted of the CINAHL, Embase, Medline, and SportDiscus databases. Full text records reporting physical therapist-based interventions in individuals with proximal LHBT pathology were included. Articles not written in English were excluded. RESULTS: Of the 4059 records identified, 14 articles met the inclusion criteria. Interventions used to treat LHBT tendinopathy identified in quantitative studies included: extracorporeal shock wave therapy, polarized light, ultrasound, low-level laser, iontophoresis, general exercise, eccentric training, stretching, dry needling, and joint mobilization. Interventions described in literature reviews, clinical commentaries, and a Delphi study included: therapeutic modalities, manual therapy, exercise, dry needling, and patient education. CONCLUSION: This scoping review reported interventions primarily based on therapeutic modalities in quantitative studies while literature reviews, clinical commentaries, and a Delphi study described the addition of manual therapy, patient education, exercise, and dry needling. Overall, there is a dearth of evidence detailing the conservative management of LHBT tendinopathy.


Subject(s)
Muscle, Skeletal , Tendinopathy , Humans , Physical Therapy Modalities , Tendons , Shoulder Pain/therapy , Tendinopathy/therapy
5.
J Wildl Dis ; 60(1): 14-25, 2024 Jan 01.
Article in English | MEDLINE | ID: mdl-37889940

ABSTRACT

Wildlife diseases have implications for ecology, conservation, human health, and health of domestic animals. They may impact wildlife health and population dynamics. Exposure rates of coyotes (Canis latrans) to pathogens such as Yersinia pestis, the cause of plague, may reflect prevalence rates in both rodent prey and human populations. We captured coyotes in north-central New Mexico during 2005-2008 and collected blood samples for serologic surveys. We tested for antibodies against canine distemper virus (CDV, Canine morbillivirus), canine parvovirus (CPV, Carnivore protoparvovirus), plague, tularemia (Francisella tularensis), and for canine heartworm (Dirofilaria immitis) antigen. Serum biochemistry variables that fell outside reference ranges were probably related to capture stress. We detected antibodies to parvovirus in 32/32 samples (100%), and to Y. pestis in 26/31 (84%). More than half 19/32 (59%) had antibodies against CDV, and 5/31 (39%) had antibodies against F. tularensis. We did not detect any heartworm antigens (n = 9). Pathogen prevalence was similar between sexes and among the three coyote packs in the study area. Parvovirus exposure appeared to happen early in life, and prevalence of antibodies against CDV increased with increasing age class. Exposure to Y. pestis and F. tularensis occurred across all age classes. The high coyote seroprevalence rates observed for CPV, Y. pestis, and CDV may indicate high prevalence in sympatric vertebrate populations, with implications for regional wildlife conservation as well as risk to humans via zoonotic transmission.


Subject(s)
Coyotes , Distemper Virus, Canine , Distemper , Dog Diseases , Parvoviridae Infections , Parvovirus, Canine , Plague , Tularemia , Yersinia pestis , Animals , Dogs , Humans , Plague/epidemiology , Plague/veterinary , Tularemia/epidemiology , Tularemia/veterinary , Distemper/epidemiology , Seroepidemiologic Studies , New Mexico , Antibodies, Viral , Parvoviridae Infections/epidemiology , Parvoviridae Infections/veterinary , Animals, Wild
6.
Rev. panam. salud pública ; 48: e4, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1536671

ABSTRACT

ABSTRACT Objective. To analyze temporal trends and inequalities in neonatal mortality between 2000 and 2020, and to set neonatal mortality targets for 2025 and 2030 in the Americas. Methods. A descriptive ecological study was conducted using 33 countries of the Americas as units of analysis. Both the percentage change and average annual percentage change in neonatal mortality rates were estimated. Measurements of absolute and relative inequality based on adjusted regression models were used to assess cross-country social inequalities in neonatal mortality. Targets to reduce neonatal mortality and cross-country inequalities were set for 2025 and 2030. Results. The estimated regional neonatal mortality rate was 12.0 per 1 000 live births in 2000-2004 and 7.4 per 1 000 live births in 2020, representing a percentage change of -38.3% and an average annual percentage change of -2.7%. National average annual percentage changes in neonatal mortality rates between 2000-2004 and 2020 ranged from -5.5 to 1.9 and were mostly negative. The estimated excess neonatal mortality in the 20% most socially disadvantaged countries, compared with the 20% least socially disadvantaged countries, was 17.1 and 9.8 deaths per 1 000 live births in 2000-2004 and 2020, respectively. Based on an extrapolation of recent trends, the regional neonatal mortality rate is projected to reach 7.0 and 6.6 neonatal deaths per 1 000 live births by 2025 and 2030, respectively. Conclusions. National and regional health authorities need to strengthen their efforts to reduce persistent social inequalities in neonatal mortality both within and between countries.


RESUMEN Objetivo. Analizar las desigualdades en la mortalidad neonatal y las tendencias en el transcurso del tiempo entre el 2000 y el 2020, y establecer metas en materia de mortalidad neonatal para el 2025 y el 2030 en la Región de las Américas. Métodos. Se realizó un estudio ecológico descriptivo con información de 33 países de la Región de las Américas que se usaron como unidades de análisis. Se calculó tanto la variación porcentual como la variación porcentual anual media de las tasas de mortalidad neonatal. Se utilizaron mediciones de la desigualdad absoluta y relativa basadas en modelos de regresión ajustados, para evaluar las desigualdades sociales en los diversos países en cuanto a la mortalidad neonatal. Se establecieron metas de reducción de la mortalidad neonatal y de las desigualdades en los diversos países para el 2025 y el 2030. Resultados. La tasa de mortalidad neonatal en la Región fue de 12,0 por 1 000 nacidos vivos en el período 2000-2004 y de 7,4 por 1 000 nacidos vivos en el 2020, lo que representa una variación porcentual del -38,3% y una variación porcentual anual media del -2,7%. Las variaciones porcentuales anuales medias de las tasas de mortalidad neonatal a nivel nacional entre el período 2000-2004 y el 2020 oscilaron entre -5,5 y 1,9, y fueron en su mayor parte negativas. El exceso de mortalidad neonatal estimado en el 20% de los países más desfavorecidos socialmente, en comparación con el 20% de los países menos desfavorecidos socialmente, fue de 17,1 muertes por 1 000 nacidos vivos en el período 2000-2004 y de 9,8 muertes por 1 000 nacidos vivos en el 2020. Al extrapolar las tendencias más recientes, se prevé que la tasa de mortalidad neonatal de la Región alcance valores de 7,0 y 6,6 muertes neonatales por 1 000 nacidos vivos en el 2025 y el 2030, respectivamente. Conclusiones. Las autoridades de salud nacionales y regionales deben fortalecer las medidas para reducir las desigualdades sociales que aún persisten en materia de mortalidad neonatal, tanto entre los distintos países como dentro de cada país.


RESUMO Objetivo. Analisar as tendências temporais e desigualdades em mortalidade neonatal entre 2000 e 2020 e estabelecer metas de mortalidade neonatal para 2025 e 2030 na Região das Américas. Métodos. Estudo ecológico descritivo examinando 33 países das Américas como unidades de análise. Foram estimadas a variação percentual e a variação percentual anual média das taxas de mortalidade neonatal. Foram usadas medidas de desigualdade absoluta e relativa baseadas em modelos de regressão ajustados para avaliar desigualdades sociais entre países em termos de mortalidade neonatal. Foram definidas metas de redução da mortalidade neonatal e das desigualdades entre países para 2025 e 2030. Resultados. A taxa regional estimada de mortalidade neonatal foi de 12,0 por mil nascidos vivos em 2000-2004, e de 7,4 por mil nascidos vivos em 2020, representando uma variação percentual de -38,3%, e uma variação percentual anual média de -2,7%. As variações percentuais anuais médias nacionais das taxas de mortalidade neonatal entre 2000-2004 e 2020 variaram entre -5,5 e 1,9 e, em sua maioria, foram negativas. O excesso estimado de mortalidade neonatal nos países que estavam entre os 20% mais desfavorecidos socialmente, em comparação com os países entre os 20% menos desfavorecidos, foi de 17,1 e 9,8 mortes por mil nascidos vivos em 2000-2004 e 2020, respectivamente. Com base em extrapolação das tendências recentes, estima-se que a taxa de mortalidade neonatal regional deve atingir 7,0 e 6,6 mortes neonatais por mil nascidos vivos em 2025 e 2030, respectivamente. Conclusões. As autoridades de saúde nacionais e regionais precisam intensificar seus esforços para reduzir desigualdades sociais persistentes na mortalidade neonatal, tanto dentro dos países quanto entre eles.

7.
Animals (Basel) ; 13(24)2023 Dec 15.
Article in English | MEDLINE | ID: mdl-38136895

ABSTRACT

Increasing the efficiency of rumen fermentation is one of the main ways to maximize the production of ruminants. It is therefore important to understand the ruminal microbiome, as well as environmental influences on that community. However, there are no studies that describe the ruminal microbiota in buffaloes in the Amazon. The objective of this study was to characterize the rumen microbiome of the water buffalo (Bubalus bubalis) in the eastern Amazon in the dry and rainy seasons in three grazing ecosystems: Baixo Amazonas (BA), Continente do Pará (CP), Ilha do Marajó (IM), and in a confinement system: Tomé-Açu (TA). Seventy-one crossbred male buffaloes (Murrah × Mediterranean) were used, aged between 24 and 36 months, with an average weight of 432 kg in the rainy season and 409 kg in the dry season, and fed on native or cultivated pastures. In the confinement system, the feed consisted of sorghum silage, soybean meal, wet sorghum premix, and commercial feed. Samples of the diet from each ecosystem were collected for bromatological analysis. The collections of ruminal content were carried out in slaughterhouses, with the rumen completely emptied and homogenized, the solid and liquid fractions separated, and the ruminal pH measured. DNA was extracted from the rumen samples, then sequenced using Restriction Enzyme Reduced Representation Sequencing. The taxonomic composition was largely similar between ecosystems. All 61 genera in the reference database were recognized, including members of the domains Bacteria and Archaea. The abundance of 23 bacterial genera differed significantly (p < 0.01) between the Tomé-Açu confinement and other ecosystems. Bacillus, Ruminococcus, and Bacteroides had lower abundance in samples from the Tomé-Açu system. Among the Archaea, the genus Methanomicrobium was less abundant in Tomé-Açu, while Methanosarcina was more abundant. There was a difference caused by all evaluated factors, but the diet (available or offered) was what most influenced the ruminal microbiota.

8.
PLoS One ; 18(12): e0296002, 2023.
Article in English | MEDLINE | ID: mdl-38134193

ABSTRACT

OBJECTIVE: To determine stillbirth ratio and its association with maternal, perinatal, and delivery characteristics, as well as geographic differences in Latin American countries (LAC). METHODS: We analysed data from the Perinatal Information System of the Latin American Center for Perinatology and Human Development (CLAP) between January 2018 and June 2021 in 8 health facilities from five LAC countries (Bolivia, Guatemala, Honduras, Nicaragua, and the Dominican Republic). Maternal, pregnancy, and delivery characteristics, in addition to pregnancy outcomes were reported. Estimates of association were tested using chi-square tests, and P < 0.05 was regarded as significant. Bivariate analysis was conducted to estimate stillbirth risk. Prevalence ratios (PR) with their 95% confidence intervals (CI) for each predictor were reported. RESULTS: In total, 101,852 childbirths comprised the SIP database. For this analysis, we included 99,712 childbirths. There were 762 stillbirths during the study period; the Stillbirth ratio of 7.7/1,000 live births (ranged from 3.8 to 18.2/1,000 live births across the different maternities); 586 (76.9%) were antepartum stillbirths, 150 (19.7%) were intrapartum stillbirths and 26 (3.4%) with an ignored time of death. Stillbirth was significantly associated with women with diabetes (PRadj 2.36; 95%CI [1.25-4.46]), preeclampsia (PRadj 2.01; 95%CI [1.26-3.19]), maternal age (PRadj 1.04; 95%CI [1.02-1.05]), any medical condition (PRadj 1.48; 95%CI [1.24-1.76, and severe maternal outcome (PRadj 3.27; 95%CI [3.27-11.66]). CONCLUSIONS: Pregnancy complications and maternal morbidity were significantly associated with stillbirths. The stillbirth ratios varied across the maternity hospitals, which highlights the importance for individual surveillance. Specialized antenatal and intrapartum care remains a priority, particularly for women who are at a higher risk of stillbirth.


Subject(s)
Resource-Limited Settings , Stillbirth , Pregnancy , Female , Humans , Stillbirth/epidemiology , Latin America/epidemiology , Risk Factors , Electronics
9.
Glob Health Action ; 16(1): 2269736, 2023 12 31.
Article in English | MEDLINE | ID: mdl-37886828

ABSTRACT

BACKGROUND: The burden of maternal morbidity in neonatal outcomes can vary with the adequacy of healthcare provision and tool implementation to improve monitoring. Such information is lacking in Latin American countries, where the decrease in severe maternal morbidity and maternal death remains challenging. OBJECTIVES: To determine neonatal outcomes according to maternal characteristics, including different degrees of maternal morbidity in Latin American health facilities. METHODS: This is a secondary cross-sectional analysis of the Perinatal Information System (SIP) database from eight health facilities in five Latin American and Caribbean countries. Participants were all women delivering from August 2018 to June 2021, excluding cases of abortion, multiple pregnancies and missing information on perinatal outcomes. As primary and secondary outcome measures, neonatal near miss and neonatal death were measured according to maternal/pregnancy characteristics and degrees of maternal morbidity. Estimated adjusted prevalence ratios (PRadj) with their respective 95% CIs were reported. RESULTS: In total 85,863 live births were included, with 1,250 neonatal near miss (NNM) cases and 695 identified neonatal deaths. NNM and neonatal mortality ratios were 14.6 and 8.1 per 1,000 live births, respectively. Conditions independently associated with a NNM or neonatal death were the need for neonatal resuscitation (PRadj 16.73, 95% CI [13.29-21.05]), being single (PRadj 1.45, 95% CI [1.32-1.59]), maternal near miss or death (PRadj 1.64, 95% CI [1.14-2.37]), preeclampsia (PRadj 3.02, 95% CI [1.70-5.35]), eclampsia/HELPP (PRadj 1.50, 95% CI [1.16-1.94]), maternal age (years) (PRadj 1.01, 95% CI [<1.01-1.02]), major congenital anomalies (PRadj 3.21, 95% CI [1.43-7.23]), diabetes (PRadj 1.49, 95% CI [1.11-1.98]) and cardiac disease (PRadj 1.65, 95% CI [1.14-2.37]). CONCLUSION: Maternal morbidity leads to worse neonatal outcomes, especially in women suffering maternal near miss or death. Based on SIP/PAHO database all these indicators may be helpful for routine situation monitoring in Latin America with the purpose of policy changes and improvement of maternal and neonatal health.


Subject(s)
Perinatal Death , Pregnancy Complications , Pregnancy , Infant, Newborn , Female , Humans , Cross-Sectional Studies , Resuscitation , Infant Mortality , Maternal Mortality , Information Systems , Pregnancy Complications/epidemiology
10.
Glob Health Action ; 16(1): 2249771, 2023 12 31.
Article in English | MEDLINE | ID: mdl-37722922

ABSTRACT

The sustained reduction in maternal mortality in America underlines the need to analyse women who survived a complication that could have been fatal if appropriate and timely care had not been taken. Analysis of maternal near-miss (MNM) cases, as well as potentially life-threatening conditions (PLTC), are considered indicators for monitoring the quality of maternal care. The specific objective of this study protocol is to develop a surveillance system for PLTC, MNM and maternal mortality, as primary outcomes, in Latin American and Caribbean maternal healthcare institutions. Secondarily, the study was designed to identify factors associated with these conditions and estimate how often key evidence-based interventions were used for managing severe maternal morbidity. This is a multicenter cross-sectional study with prospective data collection. The target population consists of all women admitted to health centres participating in the network during pregnancy, childbirth, or the postpartum period. Variables describing the sequence of events that may result in a PLTC, MNM or maternal death are recorded. Relevant quality control is carried out to ensure the quality of the database and confidentiality. Centres with approximately 2,500 annual deliveries will be included to achieve a sufficient number of cases for calculation of indicators. The frequency of outcome measures for PLTC, MNM and maternal mortality and their confidence intervals and differences between groups will be calculated using the most appropriate statistical tests. Similar procedures will be performed with variables describing the use of evidence-based practices. Networking creates additional possibilities for global information management and interaction between different research groups. Lessons can be learned and shared, generating scientific knowledge to address relevant health problems throughout the region with provision of efficient data management.


Subject(s)
Hospitals, Maternity , Maternal Mortality , Pregnancy , Female , Humans , Cross-Sectional Studies , Latin America/epidemiology , Caribbean Region/epidemiology , Multicenter Studies as Topic
11.
BMC Pregnancy Childbirth ; 23(1): 605, 2023 Aug 24.
Article in English | MEDLINE | ID: mdl-37620835

ABSTRACT

BACKGROUND: Latin America has the highest Cesarean Section Rates (CSR) in the world. Robson's Ten Group Classification System (RTGCS) was developed to enable understanding the CSR in different groups of women, classified according to obstetric characteristics into one of ten groups. The size of each CS group may provide helpful data on quality of care in a determined region or setting. Data can potentially be used to compare the impact of conditions such as maternal morbidity on CSR. The objective of this study is to understand the impact of Severe Maternal Morbidity (SMM) on CSR in ten different groups of RTGCS. METHODS: Secondary analysis of childbirth information from 2018 to 2021, including 8 health facilities from 5 Latin American and Caribbean countries (Bolivia, Guatemala, Honduras, Nicaragua, and the Dominican Republic), using a surveillance database (SIP-Perinatal Information System, in Spanish) implemented in different settings across Latin America. Women were classified into one of RTGCS. The frequency of each group and its respective CSR were described. Furthermore, the sample was divided into two groups, according to maternal outcomes: women without SMM and those who experienced SMM, considering Potentially Life-threatening Conditions, Maternal Near Miss and Maternal Death as the continuum of morbidity. RESULTS: Available data were obtained from 92,688 deliveries using the Robson Classification. Overall CSR was around 38%. Group 5 was responsible for almost one-third of cesarean sections. SMM occurred in 6.7% of cases. Among these cases, the overall CSR was almost 70% in this group. Group 10 had a major role (preterm deliveries). Group 5 (previous Cesarean section) had a very high CSR within the group, regardless of the occurrence of maternal morbidity (over 80%). CONCLUSION: Cesarean section rate was higher in women experiencing SMM than in those without SMM in Latin America. SMM was associated with higher Cesarean section rates, especially in groups 1 and 3. Nevertheless, group 5 was the major contributor to the overall CSR.


Subject(s)
Cesarean Section , Pentaerythritol Tetranitrate , Pregnancy , Infant, Newborn , Female , Humans , Latin America/epidemiology , Racial Groups , Parturition , Family
12.
BMC pregnancy childbirth ; BMC pregnancy childbirth;23(1): 605, 2023.
Article in English | LILACS, BNUY, MMyP, UY-BNMED | ID: biblio-1518570

ABSTRACT

Background: Latin America has the highest Cesarean Section Rates (CSR) in the world. Robson's Ten Group Classification System (RTGCS) was developed to enable understanding the CSR in different groups of women, classified according to obstetric characteristics into one of ten groups. The size of each CS group may provide helpful data on quality of care in a determined region or setting. Data can potentially be used to compare the impact of conditions such as maternal morbidity on CSR. The objective of this study is to understand the impact of Severe Maternal Morbidity (SMM) on CSR in ten different groups of RTGCS. Methods: Secondary analysis of childbirth information from 2018 to 2021, including 8 health facilities from 5 Latin American and Caribbean countries (Bolivia, Guatemala, Honduras, Nicaragua, and the Dominican Republic), using a surveillance database (SIP-Perinatal Information System, in Spanish) implemented in different settings across Latin America. Women were classified into one of RTGCS. The frequency of each group and its respective CSR were described. Furthermore, the sample was divided into two groups, according to maternal outcomes: women without SMM and those who experienced SMM, considering Potentially Life-threatening Conditions, Maternal Near Miss and Maternal Death as the continuum of morbidity. Results: Available data were obtained from 92,688 deliveries using the Robson Classification. Overall CSR was around 38%. Group 5 was responsible for almost one-third of cesarean sections. SMM occurred in 6.7% of cases. Among these cases, the overall CSR was almost 70% in this group. Group 10 had a major role (preterm deliveries). Group 5 (previous Cesarean section) had a very high CSR within the group, regardless of the occurrence of maternal morbidity (over 80%). Conclusion: Cesarean section rate was higher in women experiencing SMM than in those without SMM in Latin America. SMM was associated with higher Cesarean section rates, especially in groups 1 and 3. Nevertheless, group 5 was the major contributor to the overall CSR. (AU)


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Cesarean Section , Pentaerythritol Tetranitrate , Parturition , Latin America/epidemiology
13.
Article in English | PAHO-IRIS | ID: phr-56536

ABSTRACT

[ABSTRACT]. Objectives. This systematic review aimed at assessing the associations between sexual health and subjective well-being in older age groups (i.e. people aged between 40 and ≥90 years). Methods. A systematic search was conducted of the Web of Science, MEDLINE, EBSCO, Scopus, SciELO and LILACS (Latin American and Caribbean Health Sciences Literature) databases for studies published until September 2021. Search strings included a combination of terms such as “sexual health” or “sexuality” and “well-being” and terms related to the measures that assess the constructs of interest. This systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results were grouped into four categories that assess the interplay between sexual health and subjective well-being: cognitive and attitudinal factors, sexual behavior, sexual function and sexual satisfaction. The subjective well-being domains that were analyzed were life satisfaction, positive and negative affect, and psychological well-being. Results. A total of 15 quantitative studies were reviewed, of which 14 were articles and 1 was a doctoral dis- sertation. Findings suggest that living a fulfilling sexual life is an essential part of subjective well-being. Conclusions. This review suggests that programs aiming to promote well-being in older age groups should also encourage a fulfilling sexual life.


[RESUMEN]. Objetivos. El objetivo de esta revisión sistemática es evaluar las asociaciones entre salud sexual y bienestar subjetivo en grupos de mayor edad (es decir, personas entre 40 y 90 años o más). Métodos. Se realizó una búsqueda sistemática en las bases de datos Web of Science, MEDLINE, EBSCO, Scopus, SciELO y LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud) de estudios publicados hasta septiembre del 2021. Las cadenas de búsqueda incluyeron una combinación de términos como “salud sexual” o “sexualidad” y “bienestar” y términos relacionados con las medidas que evalúan los constructos de interés. Esta revisión sistemática siguió las directrices PRISMA (sigla en inglés de elementos de referencia para publicar revisiones sistemáticas y metaanálisis). Los resultados se agruparon en cuatro categorías que evalúan la interacción entre la salud sexual y el bienestar subjetivo: factores cognitivos y acti- tudinales, comportamiento sexual, función sexual y satisfacción sexual. Los dominios de bienestar subjetivo analizados fueron la satisfacción vital, el afecto positivo y negativo y el bienestar psicológico. Resultados. Se revisaron 15 estudios cuantitativos en total: 14 artículos y 1 tesis doctoral. Los resultados indican que experimentar una vida sexual satisfactoria es una parte esencial del bienestar subjetivo. Conclusiones. Esta revisión sugiere que los programas destinados a promover el bienestar en los grupos de mayor edad también deben fomentar una vida sexual satisfactoria.


[RESUMO]. Objetivos. Esta revisão sistemática teve como objetivo avaliar as associações entre saúde sexual e bem-estar subjetivo em faixas etárias mais velhas (ou seja, pessoas com idade entre 40 e 90 anos ou mais). Métodos. Foi realizada uma pesquisa sistemática nas bases de dados Web of Science, MEDLINE, EBSCO, Scopus, SciELO e LILACS (Latin American and Caribbean Health Sciences Literature) para estudos publica- dos até setembro de 2021. Os termos de busca incluíram uma combinação de termos como “saúde sexual” ou sexualidade” e ”bem-estar”, e termos relacionados às medidas que avaliam os construtos de interesse. A revisão sistemática seguiu as diretrizes PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Os resultados foram agrupados em quatro categorias de avaliação da interação entre saúde sexual e bem-estar subjetivo: fatores cognitivos e atitudinais, comportamento sexual, função sexual e satis- fação sexual. Os domínios de bem-estar subjetivo analisados foram satisfação com a vida, afeto positivo e negativo, e bem-estar psicológico. Resultados. Foram revisados 15 estudos quantitativos, sendo 14 artigos e uma tese de doutorado. Os resul- tados sugerem que viver uma vida sexual plena é uma parte essencial do bem-estar subjetivo. Conclusões. Esta revisão sugere que os programas destinados a promover bem-estar nas faixas etárias mais velhas também devem incentivar uma vida sexual plena.


Subject(s)
Aging , Sexuality , Sexual Health , Personal Satisfaction , Aging , Sexuality , Sexual Health , Personal Satisfaction , Aging , Sexuality , Sexual Health , Personal Satisfaction
14.
Rev Panam Salud Publica ; 46: e41, 2022.
Article in English | MEDLINE | ID: mdl-35677216

ABSTRACT

Objectives: To estimate inequalities in demand for family planning satisfied with modern methods among women in Latin America and the Caribbean, with an emphasis on Brazil and Mexico, and to calculate the scenario for recovery of modern contraceptive coverage by expanding access to long-acting contraceptives (LARC) after the COVID-19 pandemic. Methods: National health surveys from 2006 to 2018 were used to estimate the demand for family planning satisfied with modern methods and how it was affected by the COVID-19 pandemic. The scenario included three variables: coverage, health outcomes, and costs. Considering coverage, United Nations Population Fund data were used to estimate the impact of COVID-19 on access to contraception in Latin America and the Caribbean. Health outcomes were assessed with the Impact 2 tool. Direct investment was used to evaluate cost-effectiveness. Results: Substantial inequalities were found in the use of modern contraceptive methods before the pandemic. We showed the potential cost-effectiveness of avoiding maternal deaths by introducing LARCs. Conclusions: In the scenario predicted for Brazil and Mexico, the costs of modern family planning and averted disability-adjusted life years are modest. Governments in Latin America and the Caribbean should consider promoting LARCs as a highly efficient and cost-effective intervention.

15.
Article in English | PAHO-IRIS | ID: phr-56017

ABSTRACT

[ABSTRACT]. Objectives. To estimate inequalities in demand for family planning satisfied with modern methods among women in Latin America and the Caribbean, with an emphasis on Brazil and Mexico, and to calculate the scenario for recovery of modern contraceptive coverage by expanding access to long-acting contraceptives (LARC) after the COVID-19 pandemic. Methods. National health surveys from 2006 to 2018 were used to estimate the demand for family planning satisfied with modern methods and how it was affected by the COVID-19 pandemic. The scenario included three variables: coverage, health outcomes, and costs. Considering coverage, United Nations Population Fund data were used to estimate the impact of COVID-19 on access to contraception in Latin America and the Caribbean. Health outcomes were assessed with the Impact 2 tool. Direct investment was used to evaluate cost-effectiveness. Results. Substantial inequalities were found in the use of modern contraceptive methods before the pandemic. We showed the potential cost-effectiveness of avoiding maternal deaths by introducing LARCs. Conclusions. In the scenario predicted for Brazil and Mexico, the costs of modern family planning and averted disability-adjusted life years are modest. Governments in Latin America and the Caribbean should consider promoting LARCs as a highly efficient and cost-effective intervention.


[RESUMEN]. Objetivos. Estimar las desigualdades en la demanda de planificación familiar satisfecha con métodos anticonceptivos modernos entre las mujeres de América Latina y el Caribe, especialmente en Brasil y México, y analizar el escenario de recuperación de la cobertura de los anticonceptivos modernos mediante la ampliación del acceso a los anticonceptivos de acción prolongada tras la pandemia de COVID-19. Métodos. Se emplearon encuestas nacionales de salud desde el año 2006 hasta el año 2018 para estimar la demanda de planificación familiar satisfecha con métodos modernos y el impacto de la pandemia de COVID-19. El escenario comprendía tres variables: cobertura, resultados en materia de salud y costos. En lo respectivo a la cobertura, se emplearon datos del Fondo de Población de las Naciones Unidas para evaluar la repercusión de la COVID-19 en el acceso a los anticonceptivos en América Latina y el Caribe. Los resultados en materia de salud se examinaron con la herramienta Impact 2. Se empleó la inversión directa para evaluar la costo-efectividad. Resultados. Se encontraron desigualdades sustanciales en el uso de métodos anticonceptivos modernos antes de la pandemia. Se demostró la posible costo-efectividad de evitar muertes maternas mediante la introducción de anticonceptivos de acción prolongada. Conclusiones. De acuerdo con el escenario previsto para Brasil y México, los costos de la planificación familiar moderna y los años de vida ajustados en función de la discapacidad evitados son moderados. Los gobiernos de América Latina y el Caribe deberían considerar la posibilidad de p


[RESUMO]. Objetivos. Estimar as desigualdades na demanda por planejamento familiar atendida por métodos contraceptivos modernos em mulheres da América Latina e do Caribe, com ênfase no Brasil e no México, e calcular o cenário de recuperação da cobertura por métodos contraceptivos modernos por meio da ampliação do acesso a métodos contraceptivos reversíveis de longa duração (LARC) após a pandemia de COVID-19. Métodos. Foram usadas pesquisas nacionais de saúde de 2006 a 2018 para estimar a demanda por planejamento familiar atendida por métodos contraceptivos modernos e como ela foi afetada pela pandemia de COVID-19. O cenário incluiu três variáveis: cobertura, desfechos de saúde e custos. Para cobertura, os dados do Fundo de População das Nações Unidas foram usados para estimar o impacto da COVID-19 no acesso à contracepção na América Latina e no Caribe. Desfechos de saúde foram avaliados com a ferramenta Impact 2. O investimento direto foi usado para avaliar a relação custo-benefício. Resultados. Foram constatadas desigualdades importantes no uso de métodos contraceptivos modernos antes da pandemia. Demonstramos a potencial relação custo-benefício de evitar mortes maternas mediante a introdução de LARC. Conclusões. No cenário previsto para o Brasil e o México, os custos do planejamento familiar moderno e dos anos de vida ajustados por incapacidade por ele evitados são modestos. Os governos da América Latina e do Caribe devem considerar a promoção dos LARC como uma intervenção altamente eficiente e custo-efetiva.


Subject(s)
Long-Acting Reversible Contraception , Health Services Accessibility , COVID-19 , Latin America , Caribbean Region , Brazil , Mexico , Long-Acting Reversible Contraception , Health Services Accessibility , Latin America , Caribbean Region , Brazil , Mexico , Long-Acting Reversible Contraception , Health Services Accessibility , Caribbean Region
16.
Rev. panam. salud pública ; 46: e179, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1450259

ABSTRACT

ABSTRACT Objectives. This systematic review aimed at assessing the associations between sexual health and subjective well-being in older age groups (i.e. people aged between 40 and ≥90 years). Methods. A systematic search was conducted of the Web of Science, MEDLINE, EBSCO, Scopus, SciELO and LILACS (Latin American and Caribbean Health Sciences Literature) databases for studies published until September 2021. Search strings included a combination of terms such as "sexual health" or "sexuality" and "well-being" and terms related to the measures that assess the constructs of interest. This systematic review followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results were grouped into four categories that assess the interplay between sexual health and subjective well-being: cognitive and attitudinal factors, sexual behavior, sexual function and sexual satisfaction. The subjective well-being domains that were analyzed were life satisfaction, positive and negative affect, and psychological well-being. Results. A total of 15 quantitative studies were reviewed, of which 14 were articles and 1 was a doctoral dissertation. Findings suggest that living a fulfilling sexual life is an essential part of subjective well-being. Conclusions. This review suggests that programs aiming to promote well-being in older age groups should also encourage a fulfilling sexual life.


RESUMEN Objetivos. El objetivo de esta revisión sistemática es evaluar las asociaciones entre salud sexual y bienestar subjetivo en grupos de mayor edad (es decir, personas entre 40 y 90 años o más). Métodos. Se realizó una búsqueda sistemática en las bases de datos Web of Science, MEDLINE, EBSCO, Scopus, SciELO y LILACS (Literatura Latinoamericana y del Caribe en Ciencias de la Salud) de estudios publicados hasta septiembre del 2021. Las cadenas de búsqueda incluyeron una combinación de términos como "salud sexual" o "sexualidad" y "bienestar" y términos relacionados con las medidas que evalúan los constructos de interés. Esta revisión sistemática siguió las directrices PRISMA (sigla en inglés de elementos de referencia para publicar revisiones sistemáticas y metaanálisis). Los resultados se agruparon en cuatro categorías que evalúan la interacción entre la salud sexual y el bienestar subjetivo: factores cognitivos y actitudinales, comportamiento sexual, función sexual y satisfacción sexual. Los dominios de bienestar subjetivo analizados fueron la satisfacción vital, el afecto positivo y negativo y el bienestar psicológico. Resultados. Se revisaron 15 estudios cuantitativos en total: 14 artículos y 1 tesis doctoral. Los resultados indican que experimentar una vida sexual satisfactoria es una parte esencial del bienestar subjetivo. Conclusiones. Esta revisión sugiere que los programas destinados a promover el bienestar en los grupos de mayor edad también deben fomentar una vida sexual satisfactoria.


RESUMO Objetivos. Esta revisão sistemática teve como objetivo avaliar as associações entre saúde sexual e bem-estar subjetivo em faixas etárias mais velhas (ou seja, pessoas com idade entre 40 e 90 anos ou mais). Métodos. Foi realizada uma pesquisa sistemática nas bases de dados Web of Science, MEDLINE, EBSCO, Scopus, SciELO e LILACS (Latin American and Caribbean Health Sciences Literature) para estudos publicados até setembro de 2021. Os termos de busca incluíram uma combinação de termos como "saúde sexual" ou sexualidade" e "bem-estar", e termos relacionados às medidas que avaliam os construtos de interesse. A revisão sistemática seguiu as diretrizes PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Os resultados foram agrupados em quatro categorias de avaliação da interação entre saúde sexual e bem-estar subjetivo: fatores cognitivos e atitudinais, comportamento sexual, função sexual e satisfação sexual. Os domínios de bem-estar subjetivo analisados foram satisfação com a vida, afeto positivo e negativo, e bem-estar psicológico. Resultados. Foram revisados 15 estudos quantitativos, sendo 14 artigos e uma tese de doutorado. Os resultados sugerem que viver uma vida sexual plena é uma parte essencial do bem-estar subjetivo. Conclusões. Esta revisão sugere que os programas destinados a promover bem-estar nas faixas etárias mais velhas também devem incentivar uma vida sexual plena.

17.
Rev. panam. salud pública ; 46: e41, 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1432003

ABSTRACT

ABSTRACT Objectives. To estimate inequalities in demand for family planning satisfied with modern methods among women in Latin America and the Caribbean, with an emphasis on Brazil and Mexico, and to calculate the scenario for recovery of modern contraceptive coverage by expanding access to long-acting contraceptives (LARC) after the COVID-19 pandemic. Methods. National health surveys from 2006 to 2018 were used to estimate the demand for family planning satisfied with modern methods and how it was affected by the COVID-19 pandemic. The scenario included three variables: coverage, health outcomes, and costs. Considering coverage, United Nations Population Fund data were used to estimate the impact of COVID-19 on access to contraception in Latin America and the Caribbean. Health outcomes were assessed with the Impact 2 tool. Direct investment was used to evaluate cost-effectiveness. Results. Substantial inequalities were found in the use of modern contraceptive methods before the pandemic. We showed the potential cost-effectiveness of avoiding maternal deaths by introducing LARCs. Conclusions. In the scenario predicted for Brazil and Mexico, the costs of modern family planning and averted disability-adjusted life years are modest. Governments in Latin America and the Caribbean should consider promoting LARCs as a highly efficient and cost-effective intervention.


RESUMEN Objetivos. Estimar las desigualdades en la demanda de planificación familiar satisfecha con métodos anticonceptivos modernos entre las mujeres de América Latina y el Caribe, especialmente en Brasil y México, y analizar el escenario de recuperación de la cobertura de los anticonceptivos modernos mediante la ampliación del acceso a los anticonceptivos de acción prolongada tras la pandemia de COVID-19. Métodos. Se emplearon encuestas nacionales de salud desde el año 2006 hasta el año 2018 para estimar la demanda de planificación familiar satisfecha con métodos modernos y el impacto de la pandemia de COVID-19. El escenario comprendía tres variables: cobertura, resultados en materia de salud y costos. En lo respectivo a la cobertura, se emplearon datos del Fondo de Población de las Naciones Unidas para evaluar la repercusión de la COVID-19 en el acceso a los anticonceptivos en América Latina y el Caribe. Los resultados en materia de salud se examinaron con la herramienta Impact 2. Se empleó la inversión directa para evaluar la costo-efectividad. Resultados. Se encontraron desigualdades sustanciales en el uso de métodos anticonceptivos modernos antes de la pandemia. Se demostró la posible costo-efectividad de evitar muertes maternas mediante la introducción de anticonceptivos de acción prolongada. Conclusiones. De acuerdo con el escenario previsto para Brasil y México, los costos de la planificación familiar moderna y los años de vida ajustados en función de la discapacidad evitados son moderados. Los gobiernos de América Latina y el Caribe deberían considerar la posibilidad de promover los anticonceptivos de acción prolongada como intervención sumamente eficiente y costo-efectiva.


RESUMO Objetivos. Estimar as desigualdades na demanda por planejamento familiar atendida por métodos contraceptivos modernos em mulheres da América Latina e do Caribe, com ênfase no Brasil e no México, e calcular o cenário de recuperação da cobertura por métodos contraceptivos modernos por meio da ampliação do acesso a métodos contraceptivos reversíveis de longa duração (LARC) após a pandemia de COVID-19. Métodos. Foram usadas pesquisas nacionais de saúde de 2006 a 2018 para estimar a demanda por planejamento familiar atendida por métodos contraceptivos modernos e como ela foi afetada pela pandemia de COVID-19. O cenário incluiu três variáveis: cobertura, desfechos de saúde e custos. Para cobertura, os dados do Fundo de População das Nações Unidas foram usados para estimar o impacto da COVID-19 no acesso à contracepção na América Latina e no Caribe. Desfechos de saúde foram avaliados com a ferramenta Impact 2. O investimento direto foi usado para avaliar a relação custo-benefício. Resultados. Foram constatadas desigualdades importantes no uso de métodos contraceptivos modernos antes da pandemia. Demonstramos a potencial relação custo-benefício de evitar mortes maternas mediante a introdução de LARC. Conclusões. No cenário previsto para o Brasil e o México, os custos do planejamento familiar moderno e dos anos de vida ajustados por incapacidade por ele evitados são modestos. Os governos da América Latina e do Caribe devem considerar a promoção dos LARC como uma intervenção altamente eficiente e custo-efetiva.

18.
Biochim Biophys Acta Gen Subj ; 1865(1): 129754, 2021 01.
Article in English | MEDLINE | ID: mdl-33010352

ABSTRACT

BACKGROUND: Ubiquitously eXpressed Transcript isoform 2 (UXTV2) is a prefoldin-like protein involved in NF-κB signaling, apoptosis, and the androgen and estrogen response. UXT-V2 is a cofactor in the NF-κB transcriptional enhanceosome, and its knockdown inhibits TNF-α -induced NF-κB activation. Fbxo7 is an F-box protein that interacts with SKP1, Cullin1 and RBX1 proteins to form an SCF(Fbxo7) E3 ubiquitin ligase complex. Fbxo7 negatively regulates NF-κB signaling through TRAF2 and cIAP1 ubiquitination. METHODS: We combine co-immunoprecipitation, ubiquitination in vitro and in vivo, cycloheximide chase assay, ubiquitin chain restriction analysis and microscopy to investigate interaction between Fbxo7 and overexpressed UXT-V2-HA. RESULTS: The Ubl domain of Fbxo7 contributes to interaction with UXTV2. This substrate is polyubiquitinated by SCF(Fbxo7) with K48 and K63 ubiquitin chain linkages in vitro and in vivo. This post-translational modification decreases UXT-V2 stability and promotes its proteasomal degradation. We further show that UXTV1, an alternatively spliced isoform of UXT, containing 12 additional amino acids at the N-terminus as compared to UXTV2, also interacts with and is ubiquitinated by Fbxo7. Moreover, FBXO7 knockdown promotes UXT-V2 accumulation, and the overexpression of Fbxo7-ΔF-box protects UXT-V2 from proteasomal degradation and enhances the responsiveness of NF-κB reporter. We find that UXT-V2 colocalizes with Fbxo7 in the cell nucleus. CONCLUSIONS: Together, our study reveals that SCF(Fbxo7) mediates the proteasomal degradation of UXT-V2 causing the inhibition of the NF-κB signaling pathway. GENERAL SIGNIFICANCE: Discovering new substrates of E3 ubiquitin-ligase SCF(Fbxo7) contributes to understand its function in different diseases such as cancer and Parkinson.


Subject(s)
Cell Cycle Proteins/metabolism , F-Box Proteins/metabolism , Molecular Chaperones/metabolism , NF-kappa B/metabolism , SKP Cullin F-Box Protein Ligases/metabolism , Signal Transduction , Cell Line, Tumor , HEK293 Cells , Humans , Proteasome Endopeptidase Complex/metabolism , Protein Isoforms/metabolism , Proteolysis , Ubiquitination
19.
Glob Health Action ; 13(1): 1811482, 2020 12 31.
Article in English | MEDLINE | ID: mdl-32867629

ABSTRACT

Maternal mortality is unacceptably high in our region. In 2015, the Latin American Center for Perinatology and Women´s Reproductive Health (CLAP) created a regional network of institutions including 16 countries, committed to improving epidemiological surveillance and healthcare of women in a situation of abortion or near miss event, using a common platform, the Perinatal Information System (SIP). The objective of the current pilot project was to test a new method of study called EviSIP (Evidence from SIP), a method of generating information on maternal near miss and abortion for the region. We describe the implementation of this initiative in reproductive healthcare facilities using SIP. Junior researchers/clinicians from these countries were included, along with expert researchers in reproductive health from across the world. Articles were produced with data on maternal near miss and abortion gathered from the SIP of each participating sentinel center; and recommendations from experts. EviSIP was the first joint workspace to discuss patient outcomes after treatment of abortion or near miss cases, with data analysis of each Sentinel Center; discuss and analyze data among centers, at a country and regional level; discuss the main outcomes and their impact on changing procedures and policies; strengthen the operational research capacity of the centers; develop and encourage the publication of scientific articles. The EviSIP initiative also promoted training of healthcare professionals in research. EviSIP provided a unique opportunity to train for research and mentorship and was pivotal to the production of scientific knowledge of reproductive health in the region.


Subject(s)
Mentors , Reproductive Health , Abortion, Induced , Adult , Caribbean Region , Delivery of Health Care , Female , Health Services , Humans , Latin America , Maternal Mortality , Pilot Projects , Pregnancy
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