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OBJECTIVE: Diabetes mellitus is a serious public health problem that causes a decrease in the patients' quality of life. The present study was aimed to analyze the quality of life of patients with diabetes mellitus in Latin-American population through a systematic review, using the two instruments of greater validity and reliability at international level, SF-36 and WHOQOL. METHODS: We performed extensive searches in Redalyc, SciELO, PubMed, Scopus and Web of Science databases. To delimit our search, we only included countries that are members of the Latin American Association of Diabetes. We identified 2168 articles, where 35 were considered relevant for this systematic review. RESULTS: Our results showed that patients that regularly receive guidance and treatment to control the diabetes, showed better quality of life; in contrast, patients with foot ulcers or comorbidities showed the worse quality of life. CONCLUSION: The current literature analysis suggests that this disease greatly influences in the quality of life of the patients.
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Diabetes Mellitus Tipo 2/etnologia , Qualidade de Vida , Adulto , Idoso , Comorbidade , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/psicologia , Feminino , Controle Glicêmico , Nível de Saúde , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , América Latina/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Apoio Social , Resultado do Tratamento , Adulto JovemRESUMO
Diabetes mellitus is a serious public health problem worldwide. Type 1 diabetes mellitus is a metabolic disease which prevails in childhood; it is characterized by the persistence of high levels of glucose in the blood as a consequence of a deficit in the secretion or in the action of insulin. Type 1 diabetes mellitus has a chronic evolution and impacts the quality of life of patients. In order to describe the predictors of quality of life of patients with type 1 diabetes mellitus in Latin American countries, a systematic search was carried out in PubMed, Redalyc, SciELO, Scopus and Web of Science databases with the terms "SF-36", "WHOQOL" and "diabetes". A total of 2168 articles were identified, out of which only five were included in the qualitative analysis. It was found that comorbidities and complications decrease the quality of life of patients with type 1 diabetes mellitus, and factors such as adequate therapeutic adherence, good metabolic control, psychosocial and emotional well-being have a positive impact on the quality of life of these patients. Comorbidities and complications in patients with type 1 diabetes mellitus are the main predictors of poor quality of life.
La diabetes mellitus es un grave problema de salud pública en todo el mundo. Es una enfermedad metabólica de predominio en la infancia y se caracteriza por la persistencia de una glucemia elevada como consecuencia de un déficit en la secreción o en la acción de la insulina. Es de evolución crónica e impacta en la calidad de vida de los pacientes. Con el fin de describir los predictores de la calidad de vida de los pacientes con diabetes mellitus tipo 1 en los países latinoamericanos se realizó una búsqueda sistematizada en las bases de datos PubMed, Redalyc, SciELO, Scopus y Web of Science con los términos "SF-36", "WHOQOL" y "diabetes". Se identificaron 2168 artículos, de los cuales solo cinco fueron incluidos en el análisis cualitativo. Se encontró que la comorbilidad y las complicaciones disminuyen la calidad de vida de los pacientes con diabetes mellitus tipo 1, y que factores como la adecuada adherencia terapéutica, el buen control metabólico y el bienestar psicosocial y emocional impactan positivamente en la calidad de vida de estos pacientes. La comorbilidad y las complicaciones que presentan los pacientes con diabetes mellitus tipo 1 son los principales predictores de mala calidad de vida.
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In this study, we evaluated the expression profile changes of genes that intervene in the calcium signaling pathway, in young and adult Wistar rats, using the animal model of neonatal lesion in ventral hippocampus (NLVH) (a recognized animal model for schizophrenia) and compared to the group of control animals (Sham). Through microarray technology, gene expression profiles were obtained from the three brain areas (nucleus accumbens, prefrontal cortex, and hippocampus) of young male Wistar rats (45 days) and adults (90 days) whether or not subjected to NLVH. The calcium signaling pathway reported a greater number of differentially expressed genes with z-score two values, > 2 (over-expression) and < - 2 (under-expression), in the three evaluated areas. The comparative analyses of this approach were performed in juvenile and adult rats with ventral hippocampal lesion in neonate rats (NLVH). NLVH influenced change expressions in various genes involved in Ca2+ homeostasis, including Cacna1d, Atp2a2, Adcy2, Ppp3cb, and Ptk2b. The expression of Adcy2, Ppp3cb, and Ptk2b genes changed in both age groups; therefore, the study of gene expression profiles between juvenile and adult rats may help to understand the molecular mechanisms of schizophrenia.
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Sinalização do Cálcio/genética , Esquizofrenia/genética , Adenilil Ciclases/genética , Adenilil Ciclases/metabolismo , Animais , Calcineurina/genética , Calcineurina/metabolismo , Canais de Cálcio/genética , Canais de Cálcio/metabolismo , Quinase 2 de Adesão Focal/genética , Quinase 2 de Adesão Focal/metabolismo , Perfilação da Expressão Gênica , Hipocampo/metabolismo , Masculino , Ratos , Ratos Wistar , ATPases Transportadoras de Cálcio do Retículo Sarcoplasmático/genética , ATPases Transportadoras de Cálcio do Retículo Sarcoplasmático/metabolismo , Esquizofrenia/metabolismoRESUMO
The polymorphisms of the serotonin receptor 2C (HTR2C) gene have been proposed to influence suicidal behavior. The aim of our study was to explore the role of the HTR2C gene variant Cys23Ser (rs6318) in the pathogenesis of suicidal behavior through a systematic review and meta-analysis. The search was performed using EBSCO and PubMed databases. To be included in the analysis, the studies had to evaluate suicidal behavior (attempted, ideation, or completed suicide). The results of the meta-analysis were expressed as odds ratios (ORs). Because HTR2C lies on chromosome X, pooled ORs were calculated, respectively, for each of the models used, namely: allelic, homozygous, dominant, and recessive for the female group and allelic for the male group. The meta-analysis comprised 3867 individuals, including 1668 cases and 2199 controls. The HTR2C Cys23Ser (rs6318) polymorphism did not show a significant association with suicidal behavior either in women (OR: 0.75; 95% confidence interval: 0.55-1.00) or in men (OR: 0.89; 95% confidence interval: 0.64-1.23). Similarly, nonsignificant associations were observed for all of the genetic models used in any of the populations/subgroups studied. Our findings suggest that the rs6318 (Cys23Ser) polymorphism is not associated with suicidal behavior. However, because of the study limitations, we suggest more researches should be performed, increasing the sample sizes and statistical power, to determine the association between the rs6318 variant and suicidal behavior.
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Receptor 5-HT2C de Serotonina/genética , Comportamento Autodestrutivo/genética , Suicídio/psicologia , Alelos , Estudos de Casos e Controles , Feminino , Frequência do Gene/genética , Predisposição Genética para Doença/genética , Genótipo , Humanos , Masculino , Razão de Chances , Polimorfismo de Nucleotídeo Único/genética , Receptor 5-HT2C de Serotonina/metabolismo , Fatores de Risco , Ideação Suicida , Tentativa de Suicídio/psicologiaRESUMO
OBJECTIVE: In recent years, suicide in children and adolescents has increased considerably, becoming the second cause of death in this age group. Therefore, the aim of this study was to identify characteristics and factors that could precipitate deaths by suicide in children and adolescents. METHODS: Using the psychological autopsy method, we studied 28 suicide cases of children and adolescents between 10 and 17 years old. Socio-demographic factors, characteristics of the suicide and family history were documented. RESULTS: The proportion of deaths by suicide was the same in females and males (50% each). Most of the suicides were performed at the child/adolescent's home (78.6%) and no history of previous suicide attempts were registered (85.7%). Also, the majority of suicidal individuals came from a dysfunctional family (60.7%). CONCLUSIONS: Our results identified characteristics of children and adolescents that had died by suicide, such as dying at their homes and coming from dysfunctional families. Knowing the characteristics of children and adolescents that had ended their lives by suicide should be considered in future studies to help developing preventive programs and strategies for treating suicidal behaviors in Mexican children and adolescents.
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Suicídio/psicologia , Adolescente , Asfixia/mortalidade , Criança , Conflito Familiar/psicologia , Saúde da Família , Feminino , Humanos , Masculino , Anamnese , México/epidemiologia , Lesões do Pescoço/mortalidade , Intoxicação/mortalidade , Suicídio/estatística & dados numéricosRESUMO
BACKGROUND AND OBJECTIVE: Suicide is a worldwide health problem and climatological characteristics have been associated with suicide behavior. However, approaches such as the Knowledge Discovery in Database are not frequently used to search for an association between climatological characteristics and suicide. The aim of the present study was to assess the association between weather data and suicide in a Mexican population. METHODS: We used the information of 1357 patients who completed suicide from 2005 to 2012. Alternatively, weather data were provided by the National Water Commission. We used the Knowledge Discovery in Database approach with an Apriori algorithm and the data analyses were performed with the Waikato Environment for Knowledge Analysis software. One hundred rules of association were generated with a confidence of 0.86 and support of 1. RESULTS: We found an association between environmental temperature and suicide: days with no rain and temperatures between 30 °C and 40 °C (86-104 °F) were related to males completing suicide by hanging. CONCLUSIONS: In the prevention of suicidal behavior, the Knowledge Discovery in Database could be used to establish climatological characteristics and their association with suicide. This approach must be considered in future prevention strategies.
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Clima , Sistemas de Gerenciamento de Base de Dados , Suicídio , Feminino , Humanos , Masculino , México , TemperaturaRESUMO
BACKGROUND: The present study compared sociodemographic characteristics, comorbidities with substance use, and impulsivity features in three groups of psychiatric patients - suicide attempters, nonsuicidal self-injury, and nonsuicidal without self-injury - to determine the predictive factors for nonsuicidal self-injury or suicide behavior. PATIENTS AND METHODS: Demographic features and self-reported substance use were assessed in 384 Mexican psychiatric patients. Impulsivity features were evaluated using the Plutchik Impulsivity Scale. Comparison analyses between groups were performed and a logistic regression model used to determine the factors associated with nonsuicidal with self-injury behavior and suicidal behavior. RESULTS: Different predictive factors were observed for nonsuicidal self-injury and suicidal behavior. Females were more likely to present nonsuicidal self-injury behaviors (odds ratio [OR] 0.42, 95% confidence interval [CI] 0.18-0.93; P=0.03). For suicide attempters, the factors associated were younger age (OR 0.89, 95% CI 0.85-0.93; P<0.001), less than 6 years of schooling (OR 0.2, 95% CI 0.06-0.6; P=0.004), and higher impulsivity traits, such as self-control (OR 1.19, 95% CI 1.03-1.36; P=0.01), planning of future actions (OR 0.79, 95% CI 0.66-0.95; P=0.01), and physiological behavior (OR 1.34, 95% CI 1.01-1.78; P=0.03). CONCLUSION: Our results show that in a Mexican population, impulsivity features are predictors for suicide attempts, but not for self-injury. Other factors related to sociocultural background and individual features (such as personality) may be involved in this behavioral distinction, and should be studied in future research aimed at better understanding of both self-harmful behaviors.
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Resumen: INTRODUCCIÓN: La conducta suicida es un problema de salud pública. Se sugiere que la personalidad impulsiva o predeterminada participa en los actos de agresividad como el suicidio. OBJETIVO: En este estudio se identificaron diferencias sociodemográficas, de intento de suicidio y la presencia de depresión entre individuos con característica de agresividad impulsiva o predeterminada. MÉTODOS: Se realizó un estudio de tipo transversal que incluyó a 200 residentes de Villahermosa, Tab., México, usuarios de los servicios de salud en ese Estado. La agresividad predeterminada o impulsiva se caracterizó usando la Escala de Agresión Impulsiva/Predeterminada (IPAS). Las características sociodemográficas, de intento de suicidio y de depresión fueron divididas de acuerdo al tipo de agresividad. Subsecuentemente fueron comparadas las características entre los dos grupos. RESULTADOS: Los resultados psicológicos revelaron que la agresividad impulsiva está presente en 62.71 % de la población. Estar desempleado y ser mujer fueron asociadas con la agresividad predeterminada. De igual forma, la mayor proporción de personas con depresión se observó en el grupo de personas predeterminadas (x2 = 18.29, gl = 1, p = 0.001). La proporción de personas con por lo menos un intento de suicidio a lo largo de la vida es similar en las impulsivas y las predeterminadas (6.06% y 6.30%, respectivamente). DISCUSIÓN Y CONCLUSIÓN: El presente estudio no muestra relación entre la personalidad y la proporción del intento de suicidio en los usuarios de los servicios de salud en Tabasco. Sin embargo, el estado de ánimo podría estar asociado con la toma de decisiones.
Abstract: INTRODUCTION: Suicidal behaviour is a public health problem. It has been suggested that impulsive or premeditated personality interferes with aggressive acts such as suicide. OBJECTIVE: In this study, we identified the socio-demographic differences when attempting suicide, as well as the concomitant depression among individuals characterized by impulsive or premeditated aggression. METHODS: We performed a transversal study that included 200 residents of Villahermosa, Tabasco, Mexico, who regularly use the city's General Health Services. The premeditated or impulsive aggression was evaluated using the Impulsive/Premeditated Aggression scale (IPAS). The sample was divided in two groups: impulsive and premeditator individuals. Suicidal attempt, presence of depression and socio-demographic characteristics were evaluated after wards and compared between groups. RESULTS: The psychological evaluation revealed that impulsive aggression is present in 62.71% of the population. We observed that being unemployed and/or being a woman were characteristics associated with premeditated aggression. The premeditators group had the higher proportion of concomitant depression (x2 = 18.29, gl = 1, p = 0.001). The proportion of people that had attempted suicide at least once during their lives was similar in both groups (impulsive = 6.06%, premeditators = 6.30%). DISCUSSION AND CONCLUSION: This study does not show any association between the personality (impulsive or premeditative) and the frequency of suicide attempts in the Tabascan General Health Services users. Nevertheless, the frame of mind (depression) could be associated with taking decisions when attempting suicide.
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BACKGROUND: Neonatal lesion in the ventral hippocampus (NLVH) is a validated animal model to study schizophrenia from a neurodevelopmental perspective. This animal model is also used to investigate how neonatal lesions may alter the genetic expression of dopaminergic receptors. The present study compares mRNA expression levels of dopamine receptors (drd2 and drd3) in lymphocytes and brain of NLVH animals at two different age stages: young and adult. METHODS: The NLVH procedure was performed on 20 male Wistar rats at postnatal days 5-7. The mRNA expression levels of drd2 and drd3 genes in lymphocytes, nucleus accumbens, hippocampus and prefrontal cortex were measured and analyzed at postnatal days 45 and 90. The results were compared and contrasted with respective sham groups. RESULTS: In lymphocytes, only in NLVH-adult group we observed drd2 mRNA expression, while drd2 mRNA expression was not observed in the NLVH-juvenile rats; on the other hand, the drd3 mRNA expression did not show significant statistical differences. In hippocampus no differences were observed between drd2 mRNA or drd3 mRNA expression when comparing juvenile/adult shams with NLVH groups. In the prefrontal area, a decrease in drd2 mRNA expression levels were observed in the NLVH-adult group (F(1,3) = 52.83, p = 0,005) in comparison to the sham-adult group. Finally, in the nucleus accumbens, a strong decrease of drd3 mRNA expression was observed in the NLVH-adult group in comparison to the sham-adult group (F(1,3) = 123,2, p < 0.001). CONCLUSIONS: Our results show that differences in drd2 and drd3 mRNA levels in NLVH-adults are patent when compared to the sham-adult group or with the NLVH-juvenile group. These findings suggest that the expression levels may be regulated during adulthood, leading to behavioral and neurochemical changes related to schizophrenia. Therefore, more studies are necessary to determine the role of dopamine receptors as possible molecular markers for neurodevelopmental changes associated with schizophrenia.