RESUMO
Las pasantías hospitalarias son un conjunto de estrategias de aprendizaje fundamentales para el desempeño clínico de los futuros profesionales. El objetivo del presente estudio fue valorar los conocimientos de los estudiantes de la Escuela de Nutrición y Dietética de la Universidad Central de Venezuela en las áreas de evaluación y diagnóstico nutricional de adultos hospitalizados antes y después de las pasantías para valorar así el impacto de la misma. La metodología consistió en aplicar un instrumento (cuestionario) diecinueve estudiantes a su ingreso a las pasantías hospitalarias en el noveno semestre (marzo julio 2002) y al finalizar las mismas. El instrumento fue elaborado a partir de la operacionalización de las variables y validado por expertos. Como pruebas estadísticas se utilizó t de Student para las muestras correlacionadas, con un nivel de significancia cuando P ≤0,05. Se plantearon cinco pares de hipótesis: evaluación nutricional subjetiva, evaluación nutricional antropométrica, evaluación nutricional bioquímica, diagnóstico nutricional integral y puntaje total. Se encontraron diferencias estadísticas significativas en la evaluación nutricional bioquímica (P =0,050), en el diagnóstico nutricional integral (P =0,001) y en el puntaje total de ambos tests (P=0,013), donde se presentaron mejoras con respecto al pre test. Se concluye que las pasantías hospitalarias ejercieron de manera global un impacto positivo sobre los conocimientos de los estudiantes, sin embargo, se deben plantear cambios en las estrategias instruccionales (de enseñanza y/o aprendizaje) para hacer más eficiente el esfuerzo y la inversión en los recursos de la enseñanza.
Assuntos
Avaliação Educacional , Internato e Residência , Gestão do Conhecimento para a Pesquisa em Saúde , Avaliação Nutricional , Medicina , Ciências da Nutrição , VenezuelaRESUMO
BACKGROUND: HIV-1 subtype B is largely predominant in the Caribbean, although other subtypes have been recently identified in Cuba. OBJECTIVES: To examine HIV-1 genetic diversity in Cuba. METHODS: The study enrolled 105 HIV-1-infected individuals, 93 of whom had acquired the infection in Cuba. DNA from peripheral blood mononuclear cells was used for polymerase chain reaction amplification and sequencing of pol (protease-reverse transcriptase) and env (V3 region) segments. Phylogenetic trees were constructed using the neighbour-joining method. Intersubtype recombination was analysed by bootscanning. RESULTS: Of the samples, 50 (48%) were of subtype B and 55 (52%) of diverse non-B subtypes and recombinant forms. Among non-B viruses, 12 were non-recombinant, belonging to six subtypes (C, D, F1, G, H and J), the most frequent of which was subtype G (n = 5). The remaining 43 (78%) non-B viruses were recombinant, with 14 different forms, the two most common of which were Dpol/Aenv (n = 21) and U(unknown)pol/Henv (n = 7), which grouped in respective monophyletic clusters. Twelve recombinant viruses were mosaics of different genetic forms circulating in Cuba. Overall, 21 genetic forms were identified, with all known HIV-1 group M subtypes present in Cuba, either as non-recombinant viruses or as segments of recombinant forms. Non-B subtype viruses were predominant among heterosexuals (72%) and B subtype viruses among homo- or bisexuals (63%). CONCLUSION: An extraordinarily high diversity of HIV-1 genetic forms, unparalleled in the Americas and comparable to that found in Central Africa, is present in Cuba.
Assuntos
Variação Genética , Infecções por HIV/virologia , HIV-1/genética , Cuba/epidemiologia , Bases de Dados Genéticas , Feminino , Genes pol , Proteína gp120 do Envelope de HIV/genética , Infecções por HIV/epidemiologia , HIV-1/classificação , Humanos , Masculino , Fragmentos de Peptídeos/genética , FilogeniaRESUMO
We recently reported the finding of phylogenetically related HIV-1 BG intersubtype recombinant and G subtype nonrecombinant viruses circulating among injecting drug users in the region of Galicia in northwestern Spain. Here, we report the characterization of near full-length genome sequences of nine of these viruses (seven BG recombinant and two of nonrecombinant G subtype), obtained from epidemiologically unlinked individuals. Bootscan analysis reveals that six recombinant viruses share an identical mosaic structure, with two intersubtype breakpoints delimiting a B subtype segment comprising most of Env gp120 and the external portion of Env gp41, with the remaining portions of the genome being of subtype G, thus mimicking a pseudotype virion structure. The seventh BG recombinant virus exhibits breakpoints in env coincident with the other BG viruses but contains additional B subtype segments in gag and pol. In phylogenetic trees of complete genomes and of the B subtype segment of env, all seven BG viruses group in a monophyletic cluster. G subtype portions of the BG viruses group uniformly with the newly derived nonrecombinant G subtype viruses of Galicia in bootscan analysis, which points to the locally circulating G subtype strain as parental of the recombinants. These results allow us to define a new HIV-1 circulating recombinant form (CRF14_BG), the first reported to originate in Western Europe.
Assuntos
Infecções por HIV/epidemiologia , Infecções por HIV/virologia , HIV-1/classificação , HIV-1/genética , Recombinação Genética , Feminino , Genoma Viral , Proteína gp120 do Envelope de HIV/genética , Proteína gp41 do Envelope de HIV/genética , Humanos , Masculino , Dados de Sequência Molecular , Análise de Sequência de DNA , Espanha/epidemiologia , Abuso de Substâncias por Via Intravenosa/complicações , VírionAssuntos
Infecções por HIV/virologia , HIV-1/genética , Proteína gp120 do Envelope de HIV/genética , HIV-1/isolamento & purificação , HIV-1/metabolismo , Humanos , Fragmentos de Peptídeos/genética , Receptores de Quimiocinas/genética , Receptores de Quimiocinas/metabolismo , Receptores de HIV/genética , Receptores de HIV/metabolismo , Recombinação Genética , Espanha , Células Tumorais CultivadasRESUMO
The findings that BF intersubtype recombinant human immunodeficiency type 1 viruses (HIV-1) with coincident breakpoints in pol are circulating widely in Argentina and that non-recombinant F subtype viruses have failed to be detected in this country were reported recently. To analyse the mosaic structures of these viruses and to determine their phylogenetic relationship, near full-length proviral genomes of eight of these recombinant viruses were amplified by PCR and sequenced. Intersubtype breakpoints were analysed by bootscanning and examining the signature nucleotides. Phylogenetic relationships were determined with neighbour-joining trees. Five viruses, each with predominantly subtype F genomes, exhibited mosaic structures that were highly similar. Two intersubtype breakpoints were shared by all viruses and seven by the majority. Of the consensus breakpoints, all nine were present in two viruses, which exhibited identical recombinant structures, and four to eight breakpoints were present in the remaining viruses. Phylogenetic analysis of partial sequences supported both a common ancestry, at least in part of their genomes, for all recombinant viruses and the phylogenetic relationship of F subtype segments with F subtype viruses from Brazil. A common ancestry of the recombinants was supported also by the presence of shared signature amino acids and nucleotides, either unreported or highly unusual in F and B subtype viruses. These results indicate that HIV-1 BF recombinant viruses with diverse mosaic structures, including a circulating recombinant form (which are widespread in Argentina) derive from a common recombinant ancestor and that F subtype segments of these recombinants are related phylogenetically to the F subtype viruses from Brazil.
Assuntos
Variação Genética , Genoma Viral , Infecções por HIV/virologia , HIV-1/genética , Mosaicismo , Recombinação Genética , Proteínas Virais , Argentina , Sequência de Bases , DNA Viral , Feminino , Produtos do Gene gag/genética , Produtos do Gene gag/fisiologia , Produtos do Gene rev/genética , Produtos do Gene rev/fisiologia , Antígenos HIV/genética , Antígenos HIV/fisiologia , Proteína gp41 do Envelope de HIV/genética , Proteína gp41 do Envelope de HIV/fisiologia , Transcriptase Reversa do HIV/genética , Transcriptase Reversa do HIV/fisiologia , HIV-1/classificação , Proteínas do Vírus da Imunodeficiência Humana , Humanos , Masculino , Dados de Sequência Molecular , Filogenia , Estrutura Terciária de Proteína , Análise de Sequência de Proteína , Análise de Sequência de RNA , Proteínas Virais Reguladoras e Acessórias/genética , Proteínas Virais Reguladoras e Acessórias/fisiologia , Produtos do Gene gag do Vírus da Imunodeficiência Humana , Produtos do Gene rev do Vírus da Imunodeficiência HumanaRESUMO
El propósito de esta investigación era saber si existían diferencias estadísticas significativas en la evaluación de la composición corporal (C.C); empleando dos métodos: uno antropométrico (usando ecuaciones generalizadas) y otro fotónico (D.P.X). Para tal fin se evaluaron 31 mujeres (20-60 años): 21 normopeso y 10 con exceso de peso, según el índice de masa corporal (IMC). Los datos de ambos métodos permitieron comparar tres variables: porcentaje de grasa corporal (Kgs) (G.C.) y peso magro (Kgs) (P.M). Además se cuantificaron el índice cintura cadera, los errores de medición intra e interobservador y correlaciones entre IMC y cinco pliegues cutáneos. Los resultados se analizaron con parámetros de estadística descriptiva y la prueba de correlación de Pearson para las tres variables, estimándose diferencias estadísticamente significativas si P<0.05. Las correlaciones se hallaron moderadamente altas: 0.68, 0.78 y 0.76 para G.C. y P.M. respectivamente, siendo estadísticamente significativas las dos primeras variables. Se concluye que las ecuaciones generalizadas para tomar C.C. no están adaptadas para una población que difiere en etnia y adiposidad corporal, por lo tanto se necesitan estudios de validación cruzada con poblaciones que presenten nuestras características. Simultáneamente, las industrias manufactureras del equipo fotónico deben calibrarse para comparar sus resultados y recomendar entonces el método apropiado.
