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1.
Biometals ; 37(3): 721-737, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38642266

RESUMO

BACKGROUND: In kidney damage, molecular changes can be used as early damage kidney biomarkers, such as Kidney Injury Molecule-1 and Neutrophil gelatinase-associated lipocalin. These biomarkers are associated with toxic metal exposure or disturbed homeostasis of trace elements, which might lead to serious health hazards. This study aimed to evaluate the relationship between exposure to trace elements and early damage kidney biomarkers in a pediatric population. METHODS: In Tlaxcala, a cross-sectional study was conducted on 914 healthy individuals. The participants underwent a medical review and a socio-environmental questionnaire. Five early damage kidney biomarkers were determined in the urine with Luminex, and molybdenum, copper, selenium, nickel, and iodine were measured with ICP-Mass. RESULTS: The eGFR showed a median of 103.75 mL/min/1.73 m2. The median levels for molybdenum, copper, selenium, nickel, and iodine were 24.73 ng/mL, 73.35 ng/mL, 4.78 ng/mL, 83.68 ng/mL, and 361.83 ng/mL, respectively. Except for molybdenum and nickel, the other trace elements had significant associations with the eGFR and the early kidney damage biomarkers. Additionally, we report the association of different exposure scenarios with renal parameters. DISCUSSION: and Conclusions. Among the explored metals, exposure to Cu and iodine impairs renal function. In contrast, Se may manifest as a beneficial metal. Interactions of Mo-Se and Mo-Iodine seem to alter the expression of NGAL; Mo-Cu for CLU; Mo-Cu, Mo-Se, and Mo-iodine for Cys-C and a-1MG; and Mo-Cu and Mo-iodine for KIM-1; were noticed. Our study could suggest that trace element interactions were associated with early kidney damage biomarkers.


Assuntos
Biomarcadores , Exposição Ambiental , Oligoelementos , Humanos , Biomarcadores/urina , Biomarcadores/metabolismo , Criança , Masculino , Feminino , Oligoelementos/análise , Oligoelementos/urina , Exposição Ambiental/efeitos adversos , Estudos Transversais , Adolescente , Lipocalina-2/urina , Taxa de Filtração Glomerular , Cobre/urina , Cobre/análise , Selênio/urina , Selênio/análise , Nefropatias/induzido quimicamente , Nefropatias/urina , Nefropatias/metabolismo , Rim/metabolismo , Pré-Escolar , Níquel/urina
2.
Egypt Heart J ; 76(1): 28, 2024 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-38407742

RESUMO

BACKGROUND: Nowadays, percutaneous procedures are expanding in use, and this comes with complications associated with the procedure itself. Cardiac tamponade is rare but may be life threatening since it can involve hemodynamic instability. It is known that after pleural effusion during a percutaneous procedure, pericardiocentesis should be used as drainage of the cavity. However, that does not achieve hemostasis in some cases, and in those patients who are hemodynamically unstable, a sealing agent to promote hemostasis might be useful, like thrombin. CASE PRESENTATION: We present a case report of 89-year-old patient with history of melanoma undergoing treatment with pembrolizumab, who attended the emergency department referring chest pain (intensity 5/10) and palpitations that have lasted hours. He had TnTUs 554/566 ng/L and an echocardiogram that showed dilated right chambers, hypertrophy and global hypokinesia of the left ventricle, increased filling pressures of the left ventricle and pulmonary hypertension. Myocarditis associated with pembrolizumab was suspected, so high dose steroids were initiated and endomyocardial biopsy was conducted, resulting in iatrogenic cardiac tamponade. To determine the etiology of the suspected myocarditis, an endomyocardial biopsy was performed. Unfortunately, an intraprocedural complication arose: pleural effusion resulting in iatrogenic cardiac tamponade, leading to hemodynamic instability. It required immediate pericardial drainage via subxiphoid puncture, obtaining a 550 mL hematic debit. Clinical manifestations raised suspicion of tamponade, prompting a bedside echocardiogram for a definitive diagnosis. Despite these efforts, the patient remained hemodynamically unstable, and due to the elevated surgical risk, intrapericardial thrombin was employed to achieve successful hemostasis. CONCLUSIONS: Cardiac tamponade is a life-threatening condition that can sometimes be induced iatrogenically, resulting from percutaneous interventions. Despite limited evidence regarding this therapeutic strategy, in patients experiencing iatrogenic cardiac tamponade with hemodynamic instability and high surgical risk, the administration of intra-pericardial thrombin could be contemplated.

3.
Int J Gynaecol Obstet ; 164 Suppl 1: 67-80, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38360029

RESUMO

Forty-seven of the 203 countries with abortion laws detailed by the Center for Reproductive Rights have a health exception (HE) clause, inconsistent in both wording and implementation, even within countries. This narrative review sought to determine the understanding and implementation of the legally permissible HE in different countries, or states, to provide clarification and guidance for strategies that will maximize permitted access to safe abortion within the law and avoid undue delays that harm the lives and health of women and their families. A multimethod approach was used. The literature search for countries with HE laws, including physical, mental, and social health, and exceptions for threat to life, rape, incest, and fetal anomaly, returned sparse results. The review of emblematic cases that had reached regional courts on the grounds of human rights violation for failure to obtain legal abortion under the country's HE clause included some examples qualifying on multiple grounds. We interviewed 15 physician advocates from 14 countries about use of the HE in their countries. Informants from Latin America interpreted the HE to refer to physical, psychological, and social health. HE laws are common but confusing, with significant opportunities to improve access through clarification and implementation. Where multiple grounds permit ending a pregnancy, the least onerous exception for the patient is the most ethical. Examples of progress in Colombia and Ghana demonstrate successful approaches to broader HE implementation.


Assuntos
Aborto Induzido , Estupro , Gravidez , Feminino , Humanos , Aborto Legal , Direitos Humanos , América Latina
4.
Exp Biol Med (Maywood) ; 248(20): 1754-1767, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37916410

RESUMO

Even though smoking has been scarcely studied in osteoarthritis (OA) etiology, it is considered a controversial risk factor for the disease. Exposure to tobacco smoke has been reported to promote oxidative stress (OS) as part of the damage mechanism. The aim of this study was to assess whether smoking increases cartilage damage through the generation of OS. Peripheral blood (PB) and synovial fluid (SF) samples from patients with OA were analyzed. The samples were stratified according to smoking habit, Kellgren-Lawrence score, pain, and cotinine concentrations in PB. Malondialdehyde (MDA), methylglyoxal (MGO), advanced protein oxidation products (APOPs), and myeloperoxidase (MPO) were assessed; the activity of antioxidant enzymes such as gamma-glutamyl transferase (GGT), glutathione S-transferase (GST) and catalase (CAT), as well as the activity of arginase, which favors the destruction of cartilage, was determined. When stratified by age, for individuals <60 years, the levels of MDA and APOPs and the activity of MPO and GST were higher, as well as antioxidant system activity in the smoking group (OA-S). A greater degree of pain in the OA-S group increased the concentrations of APOPs and arginase activity (P < 0.01 and P < 0.05, respectively). Arginase activity increased significantly with a higher degree of pain (P < 0.01). Active smoking can be an important risk factor for the development of OA by inducing systemic OS in young adults, in addition to reducing antioxidant enzymes in older adults and enhancing the degree of pain and loss of cartilage.


Assuntos
Osteoartrite do Joelho , Adulto Jovem , Humanos , Idoso , Pessoa de Meia-Idade , Osteoartrite do Joelho/metabolismo , Antioxidantes/metabolismo , Fumar/efeitos adversos , Arginase/metabolismo , Oxirredução , Dor
5.
J Clin Med ; 12(17)2023 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-37685527

RESUMO

This article presents three cases of Descemet's membrane detachment (DMD) occurring during 'ab externo' phacocanaloplasty procedures in three patients with uncontrolled primary open-angle glaucoma (OAG) and discusses the management of this condition by reviewing the available literature. Following a successful 360° cannulation of Schlemm's canal (SC), the microcatheter was withdrawn while an ophthalmic viscosurgical device (OVD) was injected into the canal. During passage through the inferonasal quadrant, a spontaneous separation of the posterior layer of the cornea was observed. Each case was managed differently after diagnosis, with the third case being drained intraoperatively based on experience gained from the previous cases. On the first postoperative day, slit-lamp biomicroscopy (BMC) revealed multiple DMDs in case one and a hyphema in the lower third of a deep anterior chamber. In the other two cases, a single DMD was observed. The second case developed hemorrhagic Descemet membrane detachment (HDMD), while the other two were non-hemorrhagic. In all three cases, anterior segment optical coherence tomography (AS-OCT) revealed the presence of retrocorneal hyperreflective membranes indicative of DMDs. These membranes were located in the periphery of the cornea and did not impact the visual axis. After evaluation, a small incision was made in the inferotemporal DMD of the first case. However, for the two remaining cases, a strategy of watchful waiting was deemed appropriate due to the location and size of the DMDs, as they did not affect the best-corrected visual acuity (BCVA). Over time, the patients demonstrated progressive improvement with a gradual reduction in the size of the DMDs.

6.
J Nephrol ; 36(5): 1383-1393, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37253904

RESUMO

BACKGROUND: In recent years, chronic kidney disease has increased in the pediatric population and has been related to environmental factors. In the diagnosis of kidney damage, in addition to the traditional parameters, early kidney damage biomarkers, such as kidney injury molecule 1, cystatin C, and osteopontin, among others, have been implemented as predictors of early pathological processes. OBJECTIVE: This study aimed to evaluate the relationship between exposure to environmental pollutants and early kidney damage biomarkers. METHODS: A cross-sectional pilot study was conducted in February 2016 and involved 115 apparently healthy children aged 6-15 residing in Apizaco, Tlaxcala. Participant selection was carried out randomly from among 16,472 children from the municipality of Apizaco. A socio-demographic questionnaire included  age, sex, education, duration of residence in the area, occupation, water consumption and dietary habits, pathological history, and some non-specific symptoms. Physical examination included blood pressure, weight, and height. The urine concentrations of urinary aluminum, total arsenic, boron, calcium, chromium, copper, mercury, potassium, sodium, magnesium, manganese, molybdenum, lead, selenium, silicon, thallium, vanadium, uranium, and zinc, were measured. Four of the 115 participants selected for the study were excluded due to an incomplete questionnaire or lack of a medical examination, leaving a final sample population of 111 participants. RESULTS: The results showed a mean estimated glomerular filtration rate of 89.1 ± 9.98 mL/min/1.73m2 and a mean albumin/creatinine ratio of 12.9 ± 16.7 mg/g urinary creatinine. We observed a positive and significant correlation between estimated glomerular filtration rate with fluoride, total arsenic and lead, and a correlation of albumin/creatinine ratio with fluoride, vanadium, and total arsenic. There was also a significant correlation between the early kidney damage biomarkers and fluoride, vanadium, and total arsenic, except for cystatin C. CONCLUSION: In conclusion, our results show that four urinary biomarkers: α1-microglobulin, cystatin C, kidney injury molecule 1, and neutrophil gelatinase-associated lipocalin are related to environmental exposure to urinary fluoride, vanadium, and total arsenic in our pediatric population.


Assuntos
Arsênio , Insuficiência Renal Crônica , Humanos , Criança , Arsênio/efeitos adversos , Arsênio/análise , Cistatina C , Fluoretos , Vanádio , México/epidemiologia , Estudos Transversais , Creatinina , Projetos Piloto , Rim , Biomarcadores , Albuminas , Taxa de Filtração Glomerular , Lipocalina-2
7.
Chem Biol Interact ; 379: 110519, 2023 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-37121298

RESUMO

The proximal tubule is a target of subchronic exposure to fluoride (F) in the kidney. Early markers are used to classify kidney damage, stage, and prognosis. MicroRNAs (miRNAs) are small sequences of non-coding single-stranded RNA that regulate gene expression and play an essential role in developing many pathologies, including renal diseases. This study aimed to evaluate the expression of Cytokine-Chemokine molecules (IL-1α/1ß/4/6/10, INF-γ, MIP-1α, MCP-1, RANTES, and TGF ß1/2/3) and inflammation-related miRNAs to evidence the possible renal mechanisms involved in subchronic exposure to F. Total protein and miRNAs were obtained from the renal cortex of male Wistar rats exposed to 0, 15 and 50 mg NaF/L through drinking water during 40 and 80 days. In addition, cytokines-chemokines were analyzed by multiplexing assay, and a panel of 77 sequences of inflammatory-related miRNAs was analyzed by qPCR. The results show that cytokines-chemokines expression was concentration- and time-dependent with F, where the 50 mg NaF/L were the main altered groups. The miRNAs expression resulted in statistically significant differences in thirty-four miRNAs in the 50 mg NaF/L groups at 40 and 80 days. Furthermore, a molecular interaction network analysis was performed. The relevant pathways modified by subchronic exposure to fluoride were related to extracellular matrix-receptor interaction, Mucin type O-glycan biosynthesis, Gap junction, and miRNAs involved with renal cell carcinoma. Thus, F-induced cytokines-chemokines suggest subchronic inflammation; detecting miRNAs related to cancer and proliferation indicates a transition from renal epithelium to pathologic tissue after fluoride exposure.


Assuntos
MicroRNAs , Neoplasias , Ratos , Masculino , Animais , Fluoretos/toxicidade , MicroRNAs/genética , MicroRNAs/metabolismo , Ratos Wistar , Citocinas/metabolismo , Quimiocinas/genética , Quimiocinas/metabolismo , Inflamação/induzido quimicamente
8.
J Clin Pharmacol ; 63(4): 383-396, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-36433678

RESUMO

Direct oral anticoagulants have been an increasingly used class of drugs in the setting of nonvalvular atrial fibrillation, defying vitamin K antagonists' monopoly when it comes to anticoagulation due to its several limitations. Direct oral anticoagulants (DOACs) have entered the market as a noninferior and safer option in comparison with vitamin K antagonists, as their respective phase III clinical trials proved. The aim of this article was to update and summarize data on their clinical pharmacology and to review real-world data to know their comparative effectiveness and safety. We performed a systematic review using PubMed, Google Scholar, Embase, and Web of Science as search engines. Regarding pharmacodynamics, there were no substantial changes reported from their original profile. There were many advances in the knowledge about clinical pharmacokinetics of DOACs that have had a direct impact on their clinical use, mainly related to drug-drug interactions. In a real-world setting, DOACs have shown to be noninferior in preventing thromboembolic events compared to vitamin K antagonists. In regards to safety, DOACs have shown a lower bleeding risk relative to warfarin. Comparison between DOACs has demonstrated rivaroxaban to have the highest bleeding risk. Overall, the evidence gathered showed few changes from the original data presented in phase III clinical trials, concluding that their real-world use coincides greatly with them.


Assuntos
Fibrilação Atrial , Farmacologia Clínica , Acidente Vascular Cerebral , Humanos , Fibrilação Atrial/tratamento farmacológico , Acidente Vascular Cerebral/prevenção & controle , Administração Oral , Anticoagulantes/uso terapêutico , Rivaroxabana/uso terapêutico , Resultado do Tratamento , Vitamina K , Dabigatrana/uso terapêutico
9.
Int J Mol Sci ; 22(14)2021 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-34298880

RESUMO

BACKGROUND: The proximal tubule (PT) is the major target of cadmium (Cd2+) nephrotoxicity. Current dogma postulates that Cd2+ complexed to metallothionein (MT) (CdMT) is taken up through receptor-mediated endocytosis (RME) via the PT receptor megalin:cubilin, which is the predominant pathway for reuptake of filtered proteins in the kidney. Nevertheless, there is evidence that the distal parts of the nephron are also sensitive to damage induced by Cd2+. In rodent kidneys, another receptor for protein endocytosis, the 24p3 receptor (24p3R), is exclusively expressed in the apical membranes of distal tubules (DT) and collecting ducts (CD). Cell culture studies have demonstrated that RME and toxicity of CdMT and other (metal ion)-protein complexes in DT and CD cells is mediated by 24p3R. In this study, we evaluated the uptake of labeled CdMT complex through 24p3R after acute kidney injury (AKI) induced by gentamicin (GM) administration that disrupts PT function. Subcutaneous administration of GM at 10 mg/kg/day for seven days did not alter the structural and functional integrity of the kidney's filtration barrier. However, because of PT injury, the concentration of the renal biomarker Kim-1 increased. When CdMT complex coupled to FITC was administered intravenously, both uptake of the CdMT complex and 24p3R expression in DT increased and also colocalized after PT injury induced by GM. Although megalin decreased in PT after GM administration, urinary protein excretion was not changed, which suggests that the increased levels of 24p3R in the distal nephron could be acting as a compensatory mechanism for protein uptake. Altogether, these results suggest that PT damage increases the uptake of the CdMT complex through 24p3R in DT (and possibly CD) and compensate for protein losses associated with AKI.


Assuntos
Cádmio/metabolismo , Endocitose/fisiologia , Túbulos Renais Proximais/metabolismo , Proteína-2 Relacionada a Receptor de Lipoproteína de Baixa Densidade/metabolismo , Metalotioneína/metabolismo , Receptores de Superfície Celular/metabolismo , Animais , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Néfrons/metabolismo
10.
Environ Toxicol Pharmacol ; 83: 103587, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33460805

RESUMO

PM2.5 exposure is associated with a glomerular filtration rate (GFR) reduction, and renal tissue damage. The goal of this study was demonstrate the acute effect of PM2.5 on the kidney. Male rats were acutely exposed to PM2.5 or filtered air. Blood pressure was mesure and early kidney biomarkers were evaluated in serum and urine samples, and also IL-1ß, IL-6 and TNFα were determined. Oxidative biomarkers, angiotensin/bradykinin-related proteins, KIM-1, IL-6 and histology were determined. Blood pressure, GFR, and early kidney damage biomarkers increase together with oxidative biomarkers and angiotensin/bradykinin endocrine-related proteins increased after exposure to PM2.5. Urinary IL-6 increased after exposure to PM2.5, whereas in kidney cortex decreased. Histological changes were observed and accompanied by the induction of KIM-1. Acute exposure to PM2.5 not decline kidney function. However, it can induce early kidney damage biomarkers, oxidative stress, inflammation and angiotensin mediators, which perhabs culminates in a lose of renal function.


Assuntos
Poluentes Atmosféricos/toxicidade , Nefropatias/etiologia , Rim/efeitos dos fármacos , Material Particulado/toxicidade , Animais , Pressão Sanguínea/efeitos dos fármacos , Citocinas/imunologia , Citocinas/urina , Inflamação/etiologia , Inflamação/imunologia , Inflamação/patologia , Inflamação/fisiopatologia , Rim/patologia , Rim/fisiologia , Nefropatias/patologia , Nefropatias/fisiopatologia , Nefropatias/urina , Pulmão/efeitos dos fármacos , Pulmão/imunologia , Pulmão/patologia , Masculino , Ratos Sprague-Dawley
11.
Clin Rheumatol ; 40(1): 279-285, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32557253

RESUMO

INTRODUCTION/OBJECTIVES: Articular cartilage and periarticular muscle tissues are strongly affected during knee osteoarthritis (OA). Creatine kinase (CK) is an enzyme expressed in several tissues, but the isoform CK-MM is specific of skeletal muscle, and its serum concentration is used as a biomarker of muscle damage. Genetic variants of the CKM gene have been associated with various pathologies, but to date, there are no reports of association with OA. Due to the rs4884 polymorphism being well represented in the Mexican population, it is used as an ancestry informative marker; thus, the goal of this preliminary report was to evaluate the association of this polymorphism in primary knee OA Mexican patients. METHOD: Eighty-seven patients with primary knee OA were compared with 107 healthy controls. Serum CK-MM was determined using the dot blot system, and genotyping was performed using the OpenArray system. Logistic regression models were used to assess the association between the rs4884 polymorphism and OA susceptibility adjusting by gender, age, and body mass index. RESULTS: There were no significant differences in serum CK-MM values between patients and controls. The GG genotype and the G allele had a higher frequency in the control group compared with the OA group (24.3% vs. 12.6%, OR = 0.34, 95% CI = 0.14-0.84, P = 0.019; and 40.2% vs. 28.2%, OR = 0.51, 95% CI = 0.32-0.82, P = 0.005, respectively). CONCLUSIONS: Our results suggest a protection role of the rs4884 polymorphism against knee OA development; further studies are required to confirm it. Key Points • CK-MM enzyme catalyzes the conversion of creatine and ATP to create phosphocreatine and ADP; this reaction is reversible. • In tissues that consume ATP rapidly, such as skeletal muscle, the phosphocreatine serves as an important energy reservoir. • During knee OA, peripheral muscle tissues of the joint may be affected. • The rs4884 polymorphism of the CKM gene may participate as a protective factor in the development of OA.


Assuntos
Osteoartrite do Joelho , Estudos de Casos e Controles , Creatina , Creatina Quinase Forma MM , Frequência do Gene , Predisposição Genética para Doença , Genótipo , Humanos , México , Músculos , Osteoartrite do Joelho/genética , Polimorfismo de Nucleotídeo Único
12.
Can Med Educ J ; 9(2): e46-e51, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-30018683

RESUMO

BACKGROUND: Global health education initiatives inconsistently balance trainee growth and benefits to host communities. This report describes a global health elective for medical trainees that focuses on community engagement and participatory research to provide mutually beneficial outcomes for the communities and trainees. METHODS: An eight-year university-community partnership, the Chilcapamba to Montreal Global Health Elective is a two-month shared decision-making research and clinical observership experience in rural Ecuador for medical trainees at McGill University, Canada. Research topics are set by matching community-identified priorities with skillsets and interests of trainees, taking into consideration local potential impact. RESULTS: Community outcomes included development of a Community Health Worker program, new collaborations with local organizations, community identification of health priorities, and generation of health improvement recommendations. Collaborative academic outputs included multiple bursary awards, conference presentations and published manuscripts. CONCLUSION: This medical global health elective engages communities using participatory research to prioritise socially responsible and locally beneficial outcomes.

13.
BMJ Open ; 8(7): e020760, 2018 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-29982205

RESUMO

OBJECTIVES: We aimed to implement participatory research to answer a question posed by four Kichwa indigenous communities in Andean Ecuador about what actionable factors are associated with childhood stunting, overweight and food insecurity among their people. DESIGN: We used mixed methods including household questionnaires, discussion groups with respondents of the questionnaires and anthropometric measurement of children (6 months to 12 years) from surveyed households. SETTING: The study involved four Andean indigenous communities transitioning from traditional to Western lifestyles. They subsist mainly on small-scale agriculture and have a rich cultural heritage including their traditional language. PARTICIPANTS: Anthropometric data were collected from 298 children from 139 households in four communities; all households completed the questionnaire. We held five discussion groups (6-10 participants each): three composed of mothers and two of farmers. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes were stunting, overweight, food insecurity and their relationship with demographics, dietary habits and agricultural habits. RESULTS: Of 298 children, 48.6% were stunted and 43.3% overweight for age. Stunted children were more likely to live in households that sold livestock (ORa 1.77, 95% CIa 1.06 to 2.95) and with illiterate primary caretakers (ORa 1.81, 95% CIa 1.07 to 3.06), but were less likely to live in households with irrigation (ORa 0.47, 95% CIa 0.27 to 0.81). Overweight children were more likely to be male (ORa 1.87, 95% CIa 1.02 to 3.43) and live in a household that sold livestock (ORa 2.14, 95% CIa 1.14 to 4.02). Some 67.8% of children lived in a household with food insecurity, more frequently in those earning below minimum wage (ORa 2.90, 95% CIa 1.56 to 5.41) and less frequently in those that ate quinoa in the past 24 hours (ORa 0.17, 95% CIa 0.06 to 0.48). Discussion groups identified irrigation and loss of agricultural and dietary traditions as important causes of poor childhood nutrition. CONCLUSION: Many indigenous communities face tumultuous cultural, nutritional and epidemiological transitions. Community-based interventions on factors identified here could mitigate negative health outcomes.


Assuntos
Abastecimento de Alimentos/estatística & dados numéricos , Transtornos do Crescimento/etnologia , Sobrepeso/etnologia , Características de Residência , Irrigação Agrícola , Animais , Estatura , Peso Corporal , Chenopodium quinoa , Criança , Pré-Escolar , Pesquisa Participativa Baseada na Comunidade , Dieta , Equador/epidemiologia , Comportamento Alimentar , Feminino , Grupos Focais , Humanos , Renda , Lactente , Alfabetização , Gado , Masculino , Grupos Populacionais , Inquéritos e Questionários
14.
Qual Health Res ; 28(5): 800-812, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29571278

RESUMO

This participatory research study examines the tensions and opportunities in accessing allopathic medicine, or biomedicine, in the context of a cervical cancer screening program in a rural indigenous community of Northern Ecuador. Focusing on the influence of social networks, the article extends research on "re-appropriation" of biomedicine. It does so by recognizing two competing tensions expressed through social interactions: suspicion of allopathic medicine and the desire to maximize one's health. Semistructured individual interviews and focus groups were conducted with 28 women who had previously participated in a government-sponsored cervical screening program. From inductive thematic analysis, the article traces these women's active agency in navigating coherent paths of health. Despite drawing on social networks to overcome formidable challenges, the participants faced enduring system obstacles-the organizational effects of the networks of allopathic medicine. Such obstacles need to be understood to reconcile competing knowledge systems and improve health care access in underresourced communities.


Assuntos
Detecção Precoce de Câncer/métodos , Acessibilidade aos Serviços de Saúde/organização & administração , Indígenas Sul-Americanos/psicologia , População Rural , Neoplasias do Colo do Útero/diagnóstico , Adulto , Idoso , Barreiras de Comunicação , Pesquisa Participativa Baseada na Comunidade , Equador , Feminino , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Humanos , Entrevistas como Assunto , Idioma , Pessoa de Meia-Idade , Racismo/etnologia , Sexismo/etnologia , Rede Social , Neoplasias do Colo do Útero/etnologia
15.
Prog Community Health Partnersh ; 9(3): 327-34, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26548783

RESUMO

BACKGROUND: Based on a participatory research (PR) partnership between Family Medicine at McGill University, Canada and the Andean community of Chilcapamba, Ecuador, a medical student study focused on maternal and newborn health. OBJECTIVES: To evaluate the access to maternal and newborn care and the occurrence of intrafamilial violence in women with children 5 years of age or less in three indigenous communities of Ecuador. METHODS: A semistructured survey explored the perinatal and intrapartum care as well as intrafamilial violence. RESULTS: All women (N = 30) received prenatal care, 29 received postnatal care from a physician and 77% gave birth at the hospital. Eighty percent of women experienced intrafamilial violence; 73% reported psychological and 53% physical violence. CONCLUSIONS: There is good access to maternal and newborn health care, although the reported level of violence is high. Results were shared with the community and will be used in a local community health worker (CHW) training program. Our project highlights the importance of PR to investigate sensitive health challenges.


Assuntos
Serviços de Saúde da Criança/estatística & dados numéricos , Pesquisa Participativa Baseada na Comunidade/métodos , Pesquisas sobre Atenção à Saúde/estatística & dados numéricos , Serviços de Saúde do Indígena/estatística & dados numéricos , Serviços de Saúde Materna/estatística & dados numéricos , Adulto , Canadá , Violência Doméstica/estatística & dados numéricos , Equador , Feminino , Humanos , Recém-Nascido , Masculino , Adulto Jovem
16.
Edumecentro ; 5(3): 167-182, sep.-dic. 2013. ilus
Artigo em Espanhol | LILACS | ID: lil-685259

RESUMO

Fundamento: la investigación aborda la problemática relacionada con el insuficiente dominio de las habilidades investigativas en los estudiantes de la carrera Licenciatura en Psicología. Objetivo: diseñar actividades que contribuyan al desarrollo de habilidades investigativas desde la asignatura Metodología de la Investigación para estudiantes de primer año de la carrera Licenciatura en Psicología en la Sede de Ciencias Médicas de Placetas. Métodos: se realizó una investigación desde una metodología cualitativa en el período septiembre 2011 a junio 2012, la muestra fue seleccionada de forma intencional para un total de 31 compañeros, se utilizaron métodos: del nivel teórico, del empírico: análisis documental, entrevista en profundidad (semiestructurada) a los docentes, observación directa participante y no participante a los estudiantes, cuestionario para el diagnóstico inicial y entrevista grupal, y se realizó triangulación metodológica y de fuentes; además para valorar la propuesta se utilizó el criterio de especialistas y del nivel matemático: análisis porcentual. Resultados: se constatan dificultades para asumir el proceso de investigación desde la asignatura Metodología de la Investigación y en el marco de la actividad científico-estudiantil, escaso dominio de conocimientos teórico-metodológicos para desarrollar eficazmente la labor investigativa, falta de motivación por la investigación en el área profesional, por tanto, los autores proponen talleres que contribuyan al desarrollo de las habilidades investigativas en este contexto. Conclusiones: la propuesta fue valorada por especialistas, quienes la consideraron pertinente y efectiva; asumiendo como indicadores la actualidad, estructura, utilidad, calidad, cientificidad, factibilidad y necesidad de su introducción e incidencia en la mejora de la calidad del proceso de enseñanza-aprendizaje en el contexto universitario.


Background: the study addresses the problems associated with an insufficient mastery of research skills in Psychology students. Objective: to design activities that will contribute to the development of research skills in first year Psychology students through the subject Research Methodology, in the Medical University Branch of Placetas. Methods: a study, with a qualitative methodology, was conducted from September 2011 to June 2012. Theoretical and empirical methods were used, among the latter, documentary analysis, semi-structured in-depth interviews with teachers, participating and non-participating direct observation of students, initial diagnostic questionnaire and group interview. A methodological triangulation of sources was carried out. In addition, from the mathematical level, a percentage analysis was conducted. Expert judgment was used to evaluate the proposal. Results: there were difficulties in taking on the research process from the subject Research Methodology, and in the context of students' scientific activity. There was a poor command of theoretical and methodological knowledge to effectively develop research work, and lack of motivation for research in the professional area. Therefore, it is proposed the use of workshops that contribute to the development of research skills in this context. Conclusions: the proposal was assessed by specialists, who considered that it was relevant and effective, assuming as indicators the topicality, structure, utility, quality, scientific approach, feasibility and necessity of its introduction, and impact in improving the quality of the teaching-learning process in the university context.


Assuntos
Psicologia , Pesquisa , Ensino , Educação , Aprendizagem
17.
Rev Edumecentro ; 5(3)2013.
Artigo em Espanhol | CUMED | ID: cum-54605

RESUMO

Fundamento: La investigación aborda la problemática relacionada con el insuficiente dominio de las habilidades investigativas en los estudiantes de la carrera Licenciatura en Psicología.Objetivo: diseñar actividades que contribuyan al desarrollo de habilidades investigativas desde la asignatura Metodología de la Investigación para estudiantes de primer año de la carrera Licenciatura en Psicología en la Sede de Ciencias Médicas de Placetas.Métodos: se realizó una investigación desde una metodología cualitativa en el período septiembre 2011 a junio 2012, la muestra fue seleccionada de forma intencional para un total de 31 compañeros, se utilizaron métodos: del nivel teórico, del empírico: análisis documental, entrevista en profundidad (semiestructurada) a los docentes, observación directa participante y no participante a los estudiantes, cuestionario para el diagnóstico inicial y entrevista grupal, y se realizó triangulación metodológica y de fuentes; además para valorar la propuesta se utilizó el criterio de especialistas y del nivel matemático: análisis porcentual.Resultados: se constatan dificultades para asumir el proceso de investigación desde la asignatura Metodología de la Investigación y en el marco de la actividad científico-estudiantil, escaso dominio de conocimientos teórico-metodológicos para desarrollar eficazmente la labor investigativa, falta de motivación por la investigación en el área profesional, por tanto, los autores proponen talleres que contribuyan al desarrollo de las habilidades investigativas en este contexto.Conclusiones: la propuesta fue valorada por especialistas, quienes la consideraron pertinente y efectiva; asumiendo como indicadores la actualidad, estructura, utilidad, calidad, cientificidad, factibilidad y necesidad de su introducción e incidencia en la mejora de la calidad del proceso de enseñanza-aprendizaje en el contexto universitario(AU)


Assuntos
Humanos , Pesquisa , Psicologia , Congressos como Assunto , Ensino , Aprendizagem
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