RESUMO
During the SARS COV-2 pandemic, the vast majority of infected patients are showing symptoms related to lung damage. At pediatric ages, especially newborns, symptoms from other organ systems without respiratory illness could make COVID-19 hard to diagnose. We are reporting three cases of newborns who were attended in the course of the mitigation phase in the emergency service of a maternal hospital in Barranquilla, Colombia, for high temperature and general compromised condition. During their clinical course, they developed gastrointestinal symptoms without showing any respiratory manifestations. They were not epidemiologically linked to a contact suspected to be a COVID-19 case and their mothers had had no respiratory symptoms since the public health emergency in our country was declared 45 days before. The absence of clinical respiratory manifestations in this group of patients with COVID-19 should draw clinicians' attention to the need to suspect SARS CoV-2 infection in febrile newborns.
Durante la pandemia por SARS CoV-2 la gran mayoría de pacientes ha presentado afectación pulmonar como síntoma cardinal. En los niños, especialmente en recién nacidos, la sintomatología debida al efecto en otros sistemas diferentes al respiratorio puede dificultar el diagnóstico. Se reportan tres casos de recién nacidos atendidos durante la fase de mitigación de la pandemia por SARS CoV-2 en el servicio de urgencias de un hospital materno-infantil en Barranquilla, Colombia, por presentar cuadros febriles que afectaban su estado general. En su evolución clínica predominó la sintomatología gastrointestinal sin que desarrollaran nunca manifestaciones respiratorias. La investigación epidemiológica no evidenció contacto con casos sospechosos o positivos para COVID-19. Sus madres no habían tenido síntomas respiratorios en los 45 días transcurridos desde la declaración de la emergencia en salud pública en el país. La ausencia de manifestaciones clínicas respiratorias en este grupo de pacientes con COVID-19 debe llamar la atención de los clínicos sobre la necesidad de sospechar la infección por SARS CoV-2 en recién nacidos con estados febriles.
Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/transmissão , Febre/etiologia , Transmissão Vertical de Doenças Infecciosas , Sepse Neonatal/etiologia , Pneumonia Viral/transmissão , Complicações Infecciosas na Gravidez , Adolescente , Adulto , Doenças Assintomáticas , COVID-19 , Teste para COVID-19 , Técnicas de Laboratório Clínico , Infecções por Coronavirus/sangue , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Diagnóstico Diferencial , Diarreia Infantil/etiologia , Serviço Hospitalar de Emergência , Enterocolite Necrosante/diagnóstico , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Humanos , Recém-Nascido , Masculino , Sepse Neonatal/virologia , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/virologia , SARS-CoV-2 , Migrantes , Adulto JovemRESUMO
ABSTRACT Objective Food insecurity and child malnutrition are central topics in many food programs around the world; however, these indices do not diminish. The creation of strategies is necessary to increase the effectiveness of nutritional improvement programs. The objective of this research was to improve the nutritional quality of three local dishes included in the regular diet of the population by adding amaranth and to evaluate their acceptance by children from three communities in Tochimilco, Puebla, Mexico. Methods The study was carried out in three communities of "Tochimilco", Puebla, Mexico, in order to evaluate three local dishes: banana smoothie, beans and corn tortillas, which were chosen by mothers of the region in participative workshops on preparation of local dishes enriched with amaranth. Two sensory tests were applied: paired-comparison and hedonic scale to 208 and 210 children of preschool and scholar age, respectively. Results It was found that consumers showed similar preference for banana smoothie and beans enriched with amaranth compared to non-enriched dishes; while the amaranth enriched tortilla gained more preference in the different statistical tests and it was the dish with higher content of amino acids. Sensory attributes were similarly assessed and there were no significant differences among rural and urban communities and school year. Conclusion Children easily accept the addition of amaranth to the dishes they are accustomed to, as it does not change their food culture. It is possible to improve child nutrition by designing healthier dishes and incorporating them into the daily cooking of those who prepare the food.
RESUMO Objetivo A insegurança alimentar e a desnutrição infantil são temas centrais de muitos programas alimentares ao redor do mundo; no entanto, esses índices não diminuem. É preciso criar estratégias para aumentar a eficácia dos programas de desenvolvimento nutricional. A presente pesquisa teve como objetivo melhorar a qualidade nutricional de três pratos típicos da dieta normal da população local, adicionando amaranto às comidas típicas e avaliando a aceitação dele por crianças de três comunidades em Tochimilco, Puebla, México. Métodos O estudo foi realizado nas três comunidades para avaliar os três pratos típicos desta mesma região: vitamina de banana, feijão e as tortilhas de milho. Estas comidas foram escolhidas por mães da região em oficinas participativas de preparação de pratos locais enriquecidos com amaranto. Dois testes sensoriais foram aplicados: comparação pareada e escala hedônica para 208 e 210 crianças em idade pré-escolar e escolar, respectivamente. Resultados Verificou-se que os consumidores mostraram uma preferência semelhante pela vitamina de banana e feijão enriquecido com amaranto do que os mesmos não enriquecidos; enquanto a tortilha de milho enriquecida com amaranto ganhou mais preferência nos diferentes testes estatísticos e foi o prato com maior teor de aminoácidos. Os atributos sensoriais foram avaliados da mesma forma e não houve diferenças significativas entre as comunidades rurais e urbanas e as notas escolares. Conclusão As crianças aceitam facilmente a incorporação de amaranto nos pratos típicos da dieta delas, pois não repre-sentou nenhuma alteração da sua cultura alimentar. É possível melhorar a nutrição infantil, criando pratos mais saudáveis e incorporando-os na culinária cotidiana daqueles que preparam a comida.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Transtornos da Nutrição Infantil , Alimentos Fortificados , Criança , Pré-Escolar , Participação da Comunidade , Culinária , Amaranthus , MéxicoRESUMO
PURPOSE: Given the increasing number and diversity of cancer survivors in the USA and persistent racial/ethnic disparities in breast cancer care, we sought to examine the role of acculturation in adherence to recommended surgical treatment and survivorship care recommendations. METHODS: Study participants included 343 Mexican American women with stage I to III breast cancer who participated in the Ella Binational Breast Cancer Study and were treated at The University of Texas MD Anderson Cancer Center in Houston, Texas, between March 2007 and June 2011. Participants completed a questionnaire measuring acculturation, and clinical and demographic variables were obtained from an institutional database. Multivariable logistic regression models were constructed to examine differences in surgical procedures received and adherence to long-term survivorship care by acculturation level. RESULTS: Bilingual (odds ratio [OR] = 1.85; 95% confidence interval [CI] = 0.85-4.02, P = .11) and English-dominant women (OR = 2.39; 95% CI = 1.02-5.61, P = .04) were more likely to receive breast-conserving surgery (versus mastectomy) than were Spanish-dominant women. Among all patients, adherence to surveillance mammography and clinic visits decreased over time; the decline in clinic visit adherence was statistically significant (P = .005). Although no statistically significant association was found between acculturation and adherence to long-term survivorship care, receipt of breast-conserving surgery (versus mastectomy) was significantly associated with higher adherence to surveillance mammograms. CONCLUSION: Acculturation may play a role in decision-making about surgical management of breast cancer, and further studies with larger samples are needed to explore its role in adherence to survivorship care recommendations. Findings from this study may help identify patients requiring additional support while making decisions pertaining to their cancer treatment and survivorship care.
Assuntos
Aculturação , Neoplasias da Mama/terapia , Sobrevivência , Idoso , Neoplasias da Mama/mortalidade , Sobreviventes de Câncer , Feminino , Humanos , Mastectomia/estatística & dados numéricos , Americanos Mexicanos , TexasRESUMO
Objective To evaluate the effect of a games-based intervention on palliative care nursing students' scores on the Collett-Lester Fear of Death Scale. The challenge was to innovate and integrate grief-related theory and experiences into the classroom. Method Quasi-experimental study. Before and after the games-based intervention, 101 and 111 students completed the questionnaires, respectively. The intervention was performed in the context of a palliative care class taught during the first semester of the third year of the nursing programme. Results The students obtained moderate mean scores on the variable fear of death (between 14 and 19) at both time points (pre- and post-intervention). Both men and women indicated a heightened sense of fear post-intervention and a decrease in self-perceived emotional preparedness, which support the value of the games for exposing the student to situations that closely approximated reality. Conclusion The use of games as a didactic tool in the classroom context helped the students recognize the fear generated by proximity to death in the patient and family and in the student him- or herself.
Assuntos
Jogos Experimentais , Enfermagem de Cuidados Paliativos na Terminalidade da Vida/educação , Cuidados Paliativos/métodos , Estudantes de Enfermagem/psicologia , Adolescente , Adulto , Atitude Frente a Morte , Educação em Enfermagem/métodos , Avaliação Educacional , Medo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto JovemRESUMO
RESUMEN Objetivo Evaluar el efecto de un programa, basado en juegos, sobre estudiantes de enfermería de la asignatura cuidados paliativos, midiendo el miedo a la muerte mediante la Escala Collett-Lester. El desafío es innovar, e integrar en el aula, teoría y experiencias cercanas al contexto de duelo. Método Estudio cuasi-experimental. Realizaron los cuestionarios 101 y 111 estudiantes, antes y después de la intervención de los juegos, respectivamente. Asignatura impartida en el primer semestre de tercer curso. Resultados Los estudiantes obtuvieron valores medios moderados en la variable "miedo a la muerte" (entre 14 y 19) para ambos momentos (pre y post). Hombres y mujeres aumentan estos valores de miedo en el post-test, a la vez que disminuyen su "percepción sobre preparación emocional", evidenciando el valor de los juegos, al exponer al estudiante a situaciones cercanas a las reales. Conclusión Consideramos que la herramienta didáctica de los juegos, aplicada en el contexto del aula, facilita que el estudiante pueda reconocer el miedo que genera la cercanía de la muerte, tanto en el enfermo y familia, como el propio.
RESUMO Objetivo Avaliar o efeito de um programa, baseado em jogos, sobre estudantes de enfermagem da disciplina cuidados paliativos, medindo o medo da morte por meio da Escala Collett-Lester. O desafio é inovar e integrar, na sala de aula, teoria e experiências próximas ao contexto do luto. Método Estudo quase-experimental. Realizaram os questionários 101 e 11 estudantes, antes e depois da intervenção dos jogos, respectivamente. Disciplina ministrada no primeiro semestre do terceiro ano. Resultados Os estudantes obtiveram valores médios moderados na variável "medo da morte" (entre 14 e 19) para os dois momentos (pré e pós). Homens e mulheres aumentam esses valores de medo no pós-teste, ao mesmo tempo que diminuem sua "percepção sobre preparo emocional", evidenciando-se o valor dos jogos ao expor o estudante a situações próximas às reais. Conclusões Consideramos que a ferramenta didática dos jogos, aplicada no contexto da sala de aula, fornece ao estudante a oportunidade de reconhecer o medo que a proximidade da morte gera, tanto no doente e na família, quanto nele próprio.
ABSTRACT Objective To evaluate the effect of a games-based intervention on palliative care nursing students' scores on the Collett-Lester Fear of Death Scale. The challenge was to innovate and integrate grief-related theory and experiences into the classroom. Method Quasi-experimental study. Before and after the games-based intervention, 101 and 111 students completed the questionnaires, respectively. The intervention was performed in the context of a palliative care class taught during the first semester of the third year of the nursing programme. Results The students obtained moderate mean scores on the variable fear of death (between 14 and 19) at both time points (pre- and post-intervention). Both men and women indicated a heightened sense of fear post-intervention and a decrease in self-perceived emotional preparedness, which support the value of the games for exposing the student to situations that closely approximated reality. Conclusion The use of games as a didactic tool in the classroom context helped the students recognize the fear generated by proximity to death in the patient and family and in the student him- or herself.
Assuntos
Humanos , Masculino , Feminino , Estudantes de Enfermagem , Morte , Educação em Enfermagem , Medo , Jogos Experimentais , Cuidados Paliativos , Espanha , Bacharelado em EnfermagemRESUMO
BACKGROUND: Bovine babesiosis is a tick-borne disease caused by the protozoan parasites of the genus Babesia. In their host vector, Babesia spp. undergo sexual reproduction. Therefore, the development of sexual stages and the subsequent formation of the zygote are essential for the parasite to invade the intestinal cells of the vector tick and continue its life-cycle. HAP2/GCS1 is a protein identified in plants, protozoan parasites and other organisms that has an important role during membrane fusion in fertilization processes. The identification and characterization of HAP-2 protein in Babesia would be very significant to understand the biology of the parasite and to develop a transmission-blocking vaccine in the future. RESULTS: To isolate and sequence the hap2 gene DNA from an infected bovine with Babesia bigemina was purified. The hap2 gene was amplified, cloned and sequenced. The sequences of hap2 from four geographically different strains showed high conservation at the amino acid level, including the typical structure with a signal peptide and the HAP2/GSC domain. Antisera anti-HAP2 against the conserved extracellular region of the HAP2 amino acid sequence were obtained from rabbits. The expression of hap2 in the host and vector tissues was analyzed by using semi-quantitative RT-PCR, and the protein was examined by western blot and immunofluorescence. Based on the RT-PCR and WB results, HAP2 is expressed in both, sexual stages induced in vitro, and in infected ticks as well. We did not detect any expression in asexual erythrocytic stages of B. bigemina, relevantly anti-HAP2 specific antibodies were able to block zygotes formation in vitro. CONCLUSION: Babesia bigemina HAP2 is expressed only in tick-infecting stages, and specific antibodies block zygote formation. Further studies regarding the function of HAP2 during tick infection may provide new insights into the molecular mechanisms of sexual reproduction of the parasite.
Assuntos
Anticorpos Antiprotozoários/imunologia , Babesia/genética , Proteínas de Protozoários/genética , Proteínas de Protozoários/imunologia , Carrapatos/parasitologia , Animais , Babesia/crescimento & desenvolvimento , Babesiose/parasitologia , Bovinos , Doenças dos Bovinos/parasitologia , DNA de Protozoário/genética , DNA de Protozoário/isolamento & purificação , Proteínas de Protozoários/química , Proteínas de Protozoários/isolamento & purificação , Reação em Cadeia da Polimerase em Tempo Real , Análise de Sequência de DNA , Carrapatos/fisiologiaRESUMO
BACKGROUND: Stroke rehabilitation in low- and middle-income countries, such as Mexico, is often hampered by lack of clinical resources and funding. To provide a cost-effective solution for comprehensive post-stroke rehabilitation that can alleviate the need for one-on-one physical or occupational therapy, in lower and upper extremities, we proposed and implemented a technology-assisted rehabilitation gymnasium in Chihuahua, Mexico. The Gymnasium for Robotic Rehabilitation (Robot Gym) consisted of low- and high-tech systems for upper and lower limb rehabilitation. Our hypothesis is that the Robot Gym can provide a cost- and labor-efficient alternative for post-stroke rehabilitation, while being more or as effective as traditional physical and occupational therapy approaches. METHODS: A typical group of stroke patients was randomly allocated to an intervention (n = 10) or a control group (n = 10). The intervention group received rehabilitation using the devices in the Robot Gym, whereas the control group (n = 10) received time-matched standard care. All of the study subjects were subjected to 24 two-hour therapy sessions over a period of 6 to 8 weeks. Several clinical assessments tests for upper and lower extremities were used to evaluate motor function pre- and post-intervention. A cost analysis was done to compare the cost effectiveness for both therapies. RESULTS: No significant differences were observed when comparing the results of the pre-intervention Mini-mental, Brunnstrom Test, and Geriatric Depression Scale Test, showing that both groups were functionally similar prior to the intervention. Although, both training groups were functionally equivalent, they had a significant age difference. The results of all of the upper extremity tests showed an improvement in function in both groups with no statistically significant differences between the groups. The Fugl-Meyer and the 10 Meters Walk lower extremity tests showed greater improvement in the intervention group compared to the control group. On the Time Up and Go Test, no statistically significant differences were observed pre- and post-intervention when comparing the control and the intervention groups. For the 6 Minute Walk Test, both groups presented a statistically significant difference pre- and post-intervention, showing progress in their performance. The robot gym therapy was more cost-effective than the traditional one-to-one therapy used during this study in that it enabled therapist to train up to 1.5 to 6 times more patients for the approximately same cost in the long term. CONCLUSIONS: The results of this study showed that the patients that received therapy using the Robot Gym had enhanced functionality in the upper extremity tests similar to patients in the control group. In the lower extremity tests, the intervention patients showed more improvement than those subjected to traditional therapy. These results support that the Robot Gym can be as effective as traditional therapy for stroke patients, presenting a more cost- and labor-efficient option for countries with scarce clinical resources and funding. TRIAL REGISTRATION: ISRCTN98578807 .
Assuntos
Exercícios em Circuitos , Robótica , Reabilitação do Acidente Vascular Cerebral/instrumentação , Adulto , Idoso , Exercícios em Circuitos/economia , Análise Custo-Benefício , Feminino , Humanos , Extremidade Inferior , Masculino , México , Pessoa de Meia-Idade , Terapia Ocupacional , Modalidades de Fisioterapia , Projetos Piloto , Robótica/economia , Reabilitação do Acidente Vascular Cerebral/economia , Extremidade Superior , CaminhadaRESUMO
BACKGROUND: Incidence rates for breast cancer are higher among Mexican-American (MA) women in the United States than women living in Mexico. Studies have shown higher prevalence of breast cancer risk factors in more acculturated than less acculturated Hispanic/Latinas in the United States. We compared the prevalence of behavioral risk factors and family history of breast cancer by level of acculturation and country of residence in women of Mexican descent. METHODS: Data were collected from 1,201 newly diagnosed breast cancer patients living in Mexico (n = 581) and MAs in the United States (n = 620). MA participants were categorized into three acculturation groups (Spanish dominant, bilingual, and English dominant); women living in Mexico were used as the referent group. The prevalence of behavioral risk factors and family history of breast cancer were assessed according to acculturation level, adjusting for age at diagnosis and education. RESULTS: In the adjusted models, bilingual and English-dominant MAs were significantly more likely to have a body mass index of 30 kg/m(2) or greater, consume more than one alcoholic beverage a week, and report having a family history of breast cancer than women living in Mexico. All three U.S. acculturation groups were significantly more likely to have lower total energy expenditure (≤533 kcal/d) than women in Mexico. English-dominant women were significantly less likely to ever smoke cigarettes than the Mexican group. CONCLUSIONS: Our findings add to the limited scientific literature on the relationships among acculturation, health behavior, and family history of breast cancer in Mexican and MA women.
Assuntos
Aculturação , Neoplasias da Mama/prevenção & controle , Comportamentos Relacionados com a Saúde/etnologia , Mamografia/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Adulto , Idoso , Neoplasias da Mama/etnologia , Neoplasias da Mama/psicologia , Família , Feminino , Predisposição Genética para Doença , Inquéritos Epidemiológicos , Humanos , Idioma , Estilo de Vida , Modelos Logísticos , Mamografia/psicologia , Programas de Rastreamento/psicologia , Americanos Mexicanos/psicologia , Americanos Mexicanos/estatística & dados numéricos , México/etnologia , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Fatores de Risco , Identificação Social , Estados Unidos/epidemiologiaRESUMO
Lacking in the literature are data addressing the extent to which changes in reproductive and lifestyle factors predispose women in developing nations to higher breast cancer rates, and the degree to which these are due to globalization influences. This article describes the development and psychometric assessment of an instrument intended to measure global, predominantly U.S., influences on breast cancer risk profile among women residing in Mexico. Using investigator consensus and a focus group methodology, the Measure of Globalization Influence on Health Risk (MGIHR) was developed and completed by 341 women. Psychometric analysis support the use of an 11-item Consumerism and Modernity scale and 7-item Reproductive Control and Gender Role scale. The MGIHR is a valid and reliable instrument for understanding changing lifestyle and reproductive factors for breast cancer risk and may provide a more complete understanding of breast cancer development and needed interventions.
Assuntos
Neoplasias da Mama/etiologia , Internacionalidade , Neoplasias da Mama/epidemiologia , Feminino , Grupos Focais , Humanos , México/epidemiologia , Pessoa de Meia-Idade , Psicometria , Fatores de Risco , Inquéritos e QuestionáriosRESUMO
OBJETIVOS: Correlacionar el grado de funcionalidad renal de acuerdo a la clasificación de K-DOQUI con el control glucémico a través del porcentaje de hemoglobina glucosilada y de glucosa sérica, en adultos mayores diabéticos del módulo de diabetes, y comparar los resultados con los pacientes no diabéticos del módulo Gerontológico. MATERIAL Y MÉTODOS: Se incluyeron dos grupos: El primero conformado por diabéticos del módulo de diabetes, y el segundo por no diabéticos del módulo de gerontología. Muestreo no probabilístico por conveniencia en adultos mayores de 60 años y más, se aplicó ficha de identificación, se envió al laboratorio para toma de productos, y se determinó funcionalidad renal en función del Grado K-Doqui. Se utilizaron pruebas de U de Mann Whitney, t de student para muestras independientes, Chi cuadrada y correlación de Spearman, nivel de significancia 0.05, programa estadístico SPSS v 18. RESULTADOS: El total fue de 240 pacientes, Para funcionalidad renal; nueve pacientes del módulo de diabetes presentaron estadio 4, por seis del módulo gerontológico. (p=0.455). Para el control glucémico por hemoglobina glucosilada, el promedio para el módulo de diabetes 6.8%, y para módulo gerontológico 6.2%, (p=0.000). Al asociar función renal y control glicémico por hemoglobina gucosilada, se obtuvo asociación directa con significancia estadística para el módulo de diabetes (p=0.002), mientras que para el módulo gerontológico no se presentó dicha asociación (p=0.118). CONCLUSIONES: A diferencia del grupo control, para el grupo de diabéticos se obtuvo asociación directa entre control glicémico y daño renal, aunque su correlación fue baja.
OBJECTIVE: To correlate the renal functionality degree according to K-DOQUI classification with the glycemic control through the percentage of glycated hemoglobin and serum glucose, in elder diabetic from the diabetes module and to compare it with the non-diabetic patients from the gerontological module. MATERIAL AND METHODS: Two groups were included, the first one consisting of diabetics from the diabetes module, the second one of non-diabetics from the gerontological module. No probabilistic of convenience sample in adults over 60 years, an identification card was applied, it was sent to the clinic's laboratory for taking products and determine the renal functionality based on the patients K-DOQUI degree. U Man Whitney, t Student for independent samples, Square Xi, and Spearman correlation were used. Significance level 0.05 Statistical Program SPSS 18 V. RESULTS: 240 total patients. For renal functionality 9 patients from the diabetes module presented stage 4, by 6 patients from the gerontological module (p=0.455). For glycemic control of glycated hemoglobin the average for diabetes module was 6.8%, and 6.2% for gerontological module (p=0.000). While associating the renal function and glycemic control of glycated hemoglobin, a direct association was obtained, with a statistical significance for the diabetes module (p=0.002). For the gerontological module there was no association (p=0.118). CONCLUSIONS: Unlike the control group, for the non-diabetic group a direct association between glycemic control and kidney failure was obtained, though its correlation was low.