RESUMO
Hypertension (arterial blood pressure ≥ 140/90 mmHg) is a risk factor for cardiovascular diseases, with the greatest burden of attributable deaths in Chile, having a national prevalence of 27.6%. In 2018, the implementation of HEARTS begun in primary health care centers of the Public Health System, with the aim of achieving increase in control rates, by raising the proportion of hypertensive individuals who meet blood pressure goals (< 140/90 mmHg for individuals 15-79 years old and of 150/90 mmHg for individuals 80 years and older), and thus contributing to reduce cardiovascular morbidity and mortality associated with this condition. This is a descriptive study that follows average treatment and control rates from the Public Health System between 2017-2021 obtained from health centers statistics reports during HEARTS implementation. Treatment and control rates remained at 57% and 39% respectively between 2017-2019. Between 2020 and 2021, in the context of the SARS-CoV-2 pandemic, treatment and control rates decreased very significantly, reaching 46% and 26%, respectively, in December 2021, even though the number of centers reporting the implementation of HEARTS increased from 227 to 387 in this same period. Prior to the pandemic, during the last quarter of 2019, a decrease in cardiovascular health controls was already observed as a result of social protests. In light of the results, the technical pillars of the HEARTS Initiative have an important role in helping to recover the population control rates reached in 2019 and increasing the speed to achieve better hypertension control rates.
La hipertensión arterial (presión arterial ≥ 140/90 mmHg) es un factor de riesgo para las enfermedades cardiovasculares, que tienen la mayor carga de muertes atribuibles en Chile. En este país, la hipertensión tiene una prevalencia nacional del 27,6%. En el 2018 se inició la aplicación del paquete técnico HEARTS en los centros de atención primaria de salud del sistema público de salud de Chile, con el objetivo de lograr un aumento de las tasas de control, al elevar la proporción de personas hipertensas que cumplen con las metas de presión arterial (< 140/90 mmHg para personas de 15 a 79 años y de 150/90 mmHg para personas de 80 años o más) y así contribuir a reducir la morbilidad y la mortalidad cardiovascular asociadas a esta enfermedad. En este estudio descriptivo se realiza un seguimiento de las tasas promedio de tratamiento y control del sistema público de salud entre el 2017 y el 2021 obtenidas de los informes estadísticos de los centros de salud durante la aplicación de la iniciativa HEARTS. Las tasas de tratamiento y control se mantuvieron en 57% y 39%, respectivamente, en el período entre el 2017 y el 2019. Entre el 2020 y el 2021, en el contexto de la pandemia de SARS-CoV-2, las tasas de tratamiento y control disminuyeron de manera muy significativa, y se ubicaron en 46% y 26%, respectivamente, en diciembre del 2021, a pesar de que el número de centros que notificaron la aplicación de HEARTS aumentó de 227 a 387 en el mismo período. Antes de la pandemia, en el último trimestre del 2019, ya se había observado una disminución en los controles de salud cardiovascular debido a las protestas sociales. En vista de estos resultados, los pilares técnicos de la iniciativa HEARTS desempeñan un papel importante para ayudar a recuperar las tasas de control que se habían alcanzado en el 2019 y acelerar la consecución de mejores tasas de control de la hipertensión.
A hipertensão (pressão arterial ≥ 140/90 mmHg) é um fator de risco para doenças cardiovasculares, com a maior carga de mortes atribuíveis no Chile, onde a prevalência nacional é de 27,6%. Em 2018, teve início a implementação da iniciativa HEARTS em centros de atenção primária à saúde do sistema de saúde pública, com o objetivo de elevar as taxas de controle, pelo aumento da proporção de indivíduos hipertensos que alcançam as metas de pressão arterial (< 140/90 mmHg para pessoas de 15-79 anos e de 150/90 mmHg para pessoas a partir de 80 anos), e, assim, contribuir para a redução da morbimortalidade cardiovascular associada a essa condição. Este é um estudo descritivo que acompanha as taxas médias de tratamento e controle no sistema de saúde pública entre 2017 e 2021, obtidas de relatórios estatísticos dos centros de saúde durante a implementação da iniciativa HEARTS. Entre 2017 e 2019, as taxas de tratamento e de controle foram, respectivamente, de 57% e 39%. Entre 2020 e 2021, no contexto da pandemia causada pelo SARS-CoV-2, houve uma diminuição muito significativa das taxas de tratamento e de controle, que chegaram, respectivamente, a 46% e 26% em dezembro de 2021, embora o número de centros que informaram ter implementado o pacote HEARTS tenha aumentado de 227 para 387 no mesmo período. Antes da pandemia, durante o último trimestre de 2019, já se observava uma diminuição dos controles da saúde cardiovascular em consequência de uma onda de protestos sociais. Os resultados mostram que os pilares técnicos da iniciativa HEARTS são importantes para ajudar a recuperar as taxas de controle na população alcançadas em 2019 e aumentar a velocidade para atingir melhores taxas de controle da hipertensão.
RESUMO
[ABSTRACT]. Hypertension (arterial blood pressure ≥ 140/90 mmHg) is a risk factor for cardiovascular diseases, with the greatest burden of attributable deaths in Chile, having a national prevalence of 27.6%. In 2018, the implemen- tation of HEARTS begun in primary health care centers of the Public Health System, with the aim of achieving increase in control rates, by raising the proportion of hypertensive individuals who meet blood pressure goals (< 140/90 mmHg for individuals 15–79 years old and of 150/90 mmHg for individuals 80 years and older), and thus contributing to reduce cardiovascular morbidity and mortality associated with this condition. This is a descriptive study that follows average treatment and control rates from the Public Health System between 2017–2021 obtained from health centers statistics reports during HEARTS implementation. Treatment and control rates remained at 57% and 39% respectively between 2017-2019. Between 2020 and 2021, in the context of the SARS-CoV-2 pandemic, treatment and control rates decreased very significantly, reaching 46% and 26%, respectively, in December 2021, even though the number of centers reporting the implementation of HEARTS increased from 227 to 387 in this same period. Prior to the pandemic, during the last quarter of 2019, a decrease in cardiovascular health controls was already observed as a result of social protests. In light of the results, the technical pillars of the HEARTS Initiative have an important role in helping to recover the population control rates reached in 2019 and increasing the speed to achieve better hypertension control rates.
[RESUMEN]. La hipertensión arterial (presión arterial ≥ 140/90 mmHg) es un factor de riesgo para las enfermedades car- diovasculares, que tienen la mayor carga de muertes atribuibles en Chile. En este país, la hipertensión tiene una prevalencia nacional del 27,6%. En el 2018 se inició la aplicación del paquete técnico HEARTS en los centros de atención primaria de salud del sistema público de salud de Chile, con el objetivo de lograr un aumento de las tasas de control, al elevar la proporción de personas hipertensas que cumplen con las metas de presión arterial (< 140/90 mmHg para personas de 15 a 79 años y de 150/90 mmHg para personas de 80 años o más) y así contribuir a reducir la morbilidad y la mortalidad cardiovascular asociadas a esta enfer- medad. En este estudio descriptivo se realiza un seguimiento de las tasas promedio de tratamiento y control del sistema público de salud entre el 2017 y el 2021 obtenidas de los informes estadísticos de los centros de salud durante la aplicación de la iniciativa HEARTS. Las tasas de tratamiento y control se mantuvieron en 57% y 39%, respectivamente, en el período entre el 2017 y el 2019. Entre el 2020 y el 2021, en el contexto de la pandemia de SARS-CoV-2, las tasas de tratamiento y control disminuyeron de manera muy significativa, y se ubicaron en 46% y 26%, respectivamente, en diciembre del 2021, a pesar de que el número de centros que notificaron la aplicación de HEARTS aumentó de 227 a 387 en el mismo período. Antes de la pandemia, en el último trimestre del 2019, ya se había observado una disminución en los controles de salud cardiovascular debido a las protestas sociales. En vista de estos resultados, los pilares técnicos de la iniciativa HEARTS desempeñan un papel importante para ayudar a recuperar las tasas de control que se habían alcanzado en el 2019 y acelerar la consecución de mejores tasas de control de la hipertensión.
[RESUMO]. A hipertensão (pressão arterial ≥ 140/90 mmHg) é um fator de risco para doenças cardiovasculares, com a maior carga de mortes atribuíveis no Chile, onde a prevalência nacional é de 27,6%. Em 2018, teve início a implementação da iniciativa HEARTS em centros de atenção primária à saúde do sistema de saúde pública, com o objetivo de elevar as taxas de controle, pelo aumento da proporção de indivíduos hipertensos que alcançam as metas de pressão arterial (< 140/90 mmHg para pessoas de 15-79 anos e de 150/90 mmHg para pessoas a partir de 80 anos), e, assim, contribuir para a redução da morbimortalidade cardiovascular associada a essa condição. Este é um estudo descritivo que acompanha as taxas médias de tratamento e controle no sistema de saúde pública entre 2017 e 2021, obtidas de relatórios estatísticos dos centros de saúde durante a implementação da iniciativa HEARTS. Entre 2017 e 2019, as taxas de tratamento e de controle foram, respectivamente, de 57% e 39%. Entre 2020 e 2021, no contexto da pandemia causada pelo SARS-CoV-2, houve uma diminuição muito significativa das taxas de tratamento e de controle, que chegaram, respectivamente, a 46% e 26% em dezembro de 2021, embora o número de centros que informaram ter implementado o pacote HEARTS tenha aumentado de 227 para 387 no mesmo período. Antes da pandemia, durante o último trimestre de 2019, já se observava uma diminuição dos controles da saúde cardiovascular em consequência de uma onda de protestos sociais. Os resultados mostram que os pilares técnicos da ini- ciativa HEARTS são importantes para ajudar a recuperar as taxas de controle na população alcançadas em 2019 e aumentar a velocidade para atingir melhores taxas de controle da hipertensão.
Assuntos
Doenças Cardiovasculares , Hipertensão , COVID-19 , Protocolos Clínicos , Procedimentos Clínicos , Saúde Pública , Chile , Doenças Cardiovasculares , Hipertensão , Protocolos Clínicos , Procedimentos Clínicos , Saúde Pública , Doenças Cardiovasculares , Hipertensão , Procedimentos Clínicos , Saúde PúblicaRESUMO
Chikungunya virus (CHIKV) is an alphavirus from the Togaviridae family that causes acute arthropathy in humans. It is an arthropod-borne virus transmitted initially by the Aedes (Ae) aegypti and after 2006's epidemic in La Reunion by Ae albopictus due to an adaptive mutation of alanine for valine in the position 226 of the E1 glycoprotein genome (A226V). The first isolated cases of CHIKV were reported in Tanzania, however since its arrival to the Western Hemisphere in 2013, the infection became a pandemic. After a mosquito bite from an infected viremic patient the virus replicates eliciting viremia, fever, rash, myalgia, arthralgia, and arthritis. After the acute phase, CHIKV infection can progress to a chronic stage where rheumatic symptoms can last for several months to years. Although there is a great number of studies on the pathogenesis of CHIKV infection not only in humans but also in animal models, there still gaps in the proper understanding of the disease. To this date, it is unknown why a percentage of patients do not develop clinical symptoms despite having been exposed to the virus and developing an adaptive immune response. Also, controversy stills exist on the pathogenesis of chronic joint symptoms. It is known that host immune response to an infectious disease is reflected on patient's symptoms. At the same time, it is now well-established that host genetic variation is an important component of the varied onset, severity, and outcome of infectious disease. It is essential to understand the interaction between the aetiological agent and the host to know the chronic sequelae of the disease. The present review summarizes the current findings on human host genetics and its relationship with immune response in CHIKV infection.
RESUMO
In Colombia, the human papillomavirus (HPV) vaccine was launched in 2012 in the context of a school-based national vaccination program targeting girls ages 9 to 14 and offering catch-up vaccination for girls ages 14 to 17. In this study, we evaluated the program's impact on type-specific HPV infection by comparing HPV cervical prevalence among vaccinated and nonvaccinated women. This is a comparative cross-sectional study conducted 5 years after the quadrivalent HPV vaccination implementation in a sentinel Colombian City. This study included young women (18-25 years old) who had been vaccinated in the catch-up group and were attending universities and technical institutions, and women who attended primary health care facilities for Pap smear screening. The HPV prevalence of 1,287 unvaccinated women was compared with the prevalence of 1,986 vaccinated women. The prevalence of HPV16/18 infections was significantly lower in vaccinated compared with unvaccinated women (6.5% vs. 15.4%; P < 0.001), whereas for HPV6/11 infections, a decrease of 63.7% in vaccinated women (1.02% vs. 2.81%) was observed. The adjusted effectiveness to HPV16/18 was 61.4%; 95% CI, 54.3%-67.6%. However, the effectiveness against HPV16/18 was significantly higher among women vaccinated before their sexual debut 91.5%; 95% CI, 86.8-94.5, compared with effectiveness for vaccination after their sexual debut, 36.2%; 95% CI, 23.6-46.7. Five years after the introduction of HPV vaccines in Colombia, high effectiveness of HPV to prevent HPV16/18 infections is observed in the catch-up cohorts including virgin and sexually active women. PREVENTION RELEVANCE: Monitoring HPV vaccines post-licensure plays an important role in assessing the progress of immunization programs, demonstrating the impact of vaccines on the population, and providing data for policy needs. In Colombia, HPV vaccines showed effectiveness when administered before start of sexual activity, and two doses are sufficient to achieve good protection.
Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Mulheres , Adolescente , Adulto , Criança , Colômbia/epidemiologia , Estudos Transversais , Feminino , Papillomavirus Humano 16 , Papillomavirus Humano 18 , Humanos , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/uso terapêutico , Prevalência , Vacinação , Adulto JovemRESUMO
Host immune response and virulence factors are key to disease susceptibility. However, there are no known association studies of human leukocyte antigen (HLA) class I and II alleles with chikungunya virus (CHIKV) infection in the Latin American population. Here, we aimed to identify HLA alleles present in patients with CHIKV infection versus healthy controls as well as the allelic association with the clinical spectrum of the disease. We conducted a cross-sectional analysis of a community cohort and included patients aged 18 years and older with serologically confirmed CHIKV infection. HLA typing of HLA-A, HLA-B, and HLA-DRB1 alleles was performed. Two-by-two tables were used to establish associations between allele presence and clinical characteristics. Data from 65 patients with confirmed CHIKV infection were analyzed for HLA typing. CHIKV infection was significantly associated with the presence of HLA-A*68 [p = .005; odds ratio (OR): 8.90; 95% confidence interval (CI): 1.88-42.13], HLA-B*35 (p = .03; OR: 2.01; 95% CI: 1.06-3.86), HLA-DRB*01 (p <.001; OR: 5.70; 95% CI: 1.95-16.59), HLA-DRB1*04 (p <.001; OR: 7.37; 95% CI: 3.33-16.30), and HLA-DRB1*13 (p = .004; OR: 3.75; 95% CI: 1.50-9.39) alleles in patients versus healthy subjects. A statistically significant relationship was found between the presence of a rash on the face or abdomen and the presence of HLA-DRB1*04 (p = .028; OR: 3.2; 95% CI: 1.11-9.15 and p = .007; OR: 4.33; 95% CI: 1.45-12.88, respectively). Our study demonstrated that, in our cohort, HLA type I and type II alleles are associated with CHIKV infection, and an HLA type II allele is associated with dermatological symptoms. Further research is needed to establish a path for future investigation of genes outside the HLA system to improve knowledge of the pathophysiology of CHIKV infection and its host-pathogen interaction.
Assuntos
Febre de Chikungunya , Predisposição Genética para Doença , Antígenos HLA-A , Antígenos HLA-B , Cadeias HLA-DRB1 , Alelos , Febre de Chikungunya/genética , Estudos Transversais , Frequência do Gene , Antígenos HLA-A/genética , Antígenos HLA-B/genética , Cadeias HLA-DRB1/genética , HumanosRESUMO
ABSTRACT Hypertension (arterial blood pressure ≥ 140/90 mmHg) is a risk factor for cardiovascular diseases, with the greatest burden of attributable deaths in Chile, having a national prevalence of 27.6%. In 2018, the implementation of HEARTS begun in primary health care centers of the Public Health System, with the aim of achieving increase in control rates, by raising the proportion of hypertensive individuals who meet blood pressure goals (< 140/90 mmHg for individuals 15-79 years old and of 150/90 mmHg for individuals 80 years and older), and thus contributing to reduce cardiovascular morbidity and mortality associated with this condition. This is a descriptive study that follows average treatment and control rates from the Public Health System between 2017-2021 obtained from health centers statistics reports during HEARTS implementation. Treatment and control rates remained at 57% and 39% respectively between 2017-2019. Between 2020 and 2021, in the context of the SARS-CoV-2 pandemic, treatment and control rates decreased very significantly, reaching 46% and 26%, respectively, in December 2021, even though the number of centers reporting the implementation of HEARTS increased from 227 to 387 in this same period. Prior to the pandemic, during the last quarter of 2019, a decrease in cardiovascular health controls was already observed as a result of social protests. In light of the results, the technical pillars of the HEARTS Initiative have an important role in helping to recover the population control rates reached in 2019 and increasing the speed to achieve better hypertension control rates.
RESUMEN La hipertensión arterial (presión arterial ≥ 140/90 mmHg) es un factor de riesgo para las enfermedades cardiovasculares, que tienen la mayor carga de muertes atribuibles en Chile. En este país, la hipertensión tiene una prevalencia nacional del 27,6%. En el 2018 se inició la aplicación del paquete técnico HEARTS en los centros de atención primaria de salud del sistema público de salud de Chile, con el objetivo de lograr un aumento de las tasas de control, al elevar la proporción de personas hipertensas que cumplen con las metas de presión arterial (< 140/90 mmHg para personas de 15 a 79 años y de 150/90 mmHg para personas de 80 años o más) y así contribuir a reducir la morbilidad y la mortalidad cardiovascular asociadas a esta enfermedad. En este estudio descriptivo se realiza un seguimiento de las tasas promedio de tratamiento y control del sistema público de salud entre el 2017 y el 2021 obtenidas de los informes estadísticos de los centros de salud durante la aplicación de la iniciativa HEARTS. Las tasas de tratamiento y control se mantuvieron en 57% y 39%, respectivamente, en el período entre el 2017 y el 2019. Entre el 2020 y el 2021, en el contexto de la pandemia de SARS-CoV-2, las tasas de tratamiento y control disminuyeron de manera muy significativa, y se ubicaron en 46% y 26%, respectivamente, en diciembre del 2021, a pesar de que el número de centros que notificaron la aplicación de HEARTS aumentó de 227 a 387 en el mismo período. Antes de la pandemia, en el último trimestre del 2019, ya se había observado una disminución en los controles de salud cardiovascular debido a las protestas sociales. En vista de estos resultados, los pilares técnicos de la iniciativa HEARTS desempeñan un papel importante para ayudar a recuperar las tasas de control que se habían alcanzado en el 2019 y acelerar la consecución de mejores tasas de control de la hipertensión.
RESUMO A hipertensão (pressão arterial ≥ 140/90 mmHg) é um fator de risco para doenças cardiovasculares, com a maior carga de mortes atribuíveis no Chile, onde a prevalência nacional é de 27,6%. Em 2018, teve início a implementação da iniciativa HEARTS em centros de atenção primária à saúde do sistema de saúde pública, com o objetivo de elevar as taxas de controle, pelo aumento da proporção de indivíduos hipertensos que alcançam as metas de pressão arterial (< 140/90 mmHg para pessoas de 15-79 anos e de 150/90 mmHg para pessoas a partir de 80 anos), e, assim, contribuir para a redução da morbimortalidade cardiovascular associada a essa condição. Este é um estudo descritivo que acompanha as taxas médias de tratamento e controle no sistema de saúde pública entre 2017 e 2021, obtidas de relatórios estatísticos dos centros de saúde durante a implementação da iniciativa HEARTS. Entre 2017 e 2019, as taxas de tratamento e de controle foram, respectivamente, de 57% e 39%. Entre 2020 e 2021, no contexto da pandemia causada pelo SARS-CoV-2, houve uma diminuição muito significativa das taxas de tratamento e de controle, que chegaram, respectivamente, a 46% e 26% em dezembro de 2021, embora o número de centros que informaram ter implementado o pacote HEARTS tenha aumentado de 227 para 387 no mesmo período. Antes da pandemia, durante o último trimestre de 2019, já se observava uma diminuição dos controles da saúde cardiovascular em consequência de uma onda de protestos sociais. Os resultados mostram que os pilares técnicos da iniciativa HEARTS são importantes para ajudar a recuperar as taxas de controle na população alcançadas em 2019 e aumentar a velocidade para atingir melhores taxas de controle da hipertensão.
RESUMO
RESUMEN El síndrome de Sjögren primario (SSp) es una enfermedad autoinmune que afecta principalmente al tejido glandular. A pesar de ello, puede involucrar otros sistemas, siendo el compromiso neuropsiquiátrico una manifestación extraglandular común. Su presentación clínica varía ampliamente según el dominio que se encuentre afectado, y por tanto puede dividirse en tres grandes categorías: sistema nervioso central, sistema nervioso periférico y psiquiátrico. Algunas de estas complicaciones comparten mecanismos fisiopatológicos comunes, entre los principales la vasculitis/vasculopatía, la infiltración linfocítica y la presencia de anticuerpos antineuronales. La diversidad en la presentación clínica de esta entidad impide hacer una aproximación diagnóstica común, por lo cual la utilización de estudios específicos depende de un adecuado reconocimiento y de la localización por parte del clínico. El tratamiento debe dirigirse al mecanismo fisiopatológico implicado y, de acuerdo con el tipo de manifestación, puede incluso estar limitado al manejo sintomático.
ABSTRACT Primary Sjögren's syndrome is an autoimmune disease that mainly involves glandular tissue. Despite this, it can potentially develop systemic involvement, within which neuropsychiatric manifestations are common. The clinical presentation may vary widely depending on the domain affected, and may thus be classified into three categories: central nervous system, peripheral nervous system, and psychiatric. Some of these complications share a common pathophysiology, amongst which are vasculitis/ vasculopathy, lymphocytic infiltration and positive antineuronal antibodies. The wide clinical presentation makes it difficult to establish a common diagnostic approach, making it essential for the clinician to recognise and localise the type of compromise, so that diagnostic tools can be more advantageously employed. Treatment must be directed towards the underlying pathophysiology, and depending on the type of compromise, it can even be limited solely to the management of symptoms.
Assuntos
Humanos , Síndrome de Sjogren , Neuropsiquiatria , Qualidade de Vida , Doenças Autoimunes , Terapêutica , Diagnóstico , NeurologiaRESUMO
A b s t r a c t Purpose: To describe health-related QOL (HRQOL) in patients with musculoskeletal symptoms, compared to a population with other comorbidities, and a healthy population. Methods: A cross-sectional study was carried out on an open population involved in a community-oriented program for control of rheumatic diseases (COPCORD) study in Colombia, using EQ-5D-3L for estimating QOL, and the health assessment questionnaire disability index (HAQ-DI) for functional capacity. Results: Out of the total 4020 individuals evaluated, 2274 had rheumatic diseases, 642 had non-rheumatic diseases, and 1104 were healthy subjects. Spondyloarthritis (SpA) and rheumatoid arthritis (RA) patients had more complaints regarding pain/discomfort and mobility. As for daily activities, the diseases that mostly affected them were systemic lupus erythematosus (SLE) and RA. RA and fibromyalgia (FM) patients had the worst scores as regards anxiety/depression and self-care dimensions. FM patients had the lowest QOL measured by EQ-VAS (57.7 ± 26.2). The most frequent non-rheumatic diseases were cardiovascular and mental disorders, with 20% of these patients having a moderate level of pain/discomfort and anxiety/depression. The rheumatic patients reported a decrease in functional capacity (HAQ: 0.49), in contrast to the healthy population (0.01), and the population having other diseases (0.06). Conclusion: Rheumatic disease patients in Colombia had the worst QOL compared to the healthy population and patients with other comorbidities. Rheumatic patients had greater functional limitations, even more so when having comorbidities. This study revealed potential factors of interest requiring the attention of public health authorities, and for improving patients' QOL.
RESUMEN Objetivo: Describir la calidad de vida relacionada con la salud en pacientes con síntomas musculoesqueléticos, en comparación con pacientes con enfermedades no reumáticas y una población sana. Métodos: Se realizó un estudio transversal en comunidad abierta, en personas involucradas en un programa orientado a la comunidad para el control de enfermedades reumáticas (COP-CORD) en Colombia, utilizando el EQ-5D-3L para estimar la calidad de vida y el cuestionario de evaluación de la salud (HAQ- DI) para la capacidad funcional. Resultados: Se evaluaron 4.020 individuos; 2.274 tenían enfermedades reumáticas, 642 tenían enfermedades no reumáticas y 1.104 eran sujetos sanos. Los pacientes con espondiloartritis (SpA) y artritis reumatoide (AR) tuvieron mayores quejas con respecto al dolor/malestar y la movilidad. En cuanto a las actividades diarias, los enfermos con lupus eritematoso sistémico (LES) y AR fueron los más afectados. Los pacientes con AR y fibromialgia (FM) tuvieron las peores puntuaciones en ansiedad/depresión en las dimensiones de cuidado personal. Los pacientes con FM tuvieron la calidad de vida más baja medida por EQ-VAS (57,7 ± 26,2). Las enfermedades no reumáticas más frecuentes fueron los trastornos cardiovasculares y mentales; el 20% de estos pacientes tenía un nivel moderado de dolor/malestar y ansiedad/depresión. Los pacientes reumáticos reportaron una disminución de la capacidad funcional (HAQ: 0,49); en contraste con la población sana (0,01) y la población con otras enfermedades (0,06). Conclusión: Los pacientes con enfermedades reumáticas en Colombia tuvieron la peor calidad de vida en comparación con la población sana y los pacientes con otras enfermedades. Los pacientes reumáticos tuvieron una mayor limitación funcional, incluso más que los que tenían otras enfermedades. Este estudio reveló posibles factores relacionados con las enfermedades reumáticas que requieren la atención de las autoridades de salud pública con el objetivo de mejorar la calidad de vida de los pacientes.
Assuntos
Humanos , Qualidade de Vida , Doenças Reumáticas , Inquéritos e Questionários , Pacientes , Atividades Cotidianas , Comorbidade , Voluntários SaudáveisRESUMO
In 2012, Colombia launched human papillomavirus (HPV) vaccination program for girls ages 9 to 12, and in 2013, the target age was expanded to 9 to 17 years. Monitoring the changes of HPV infection prevalence among young women has been proposed as an endpoint for early assessment of HPV vaccination programs. However, the data on HPV prevalence in young ages are very limited. The purpose of this study was to determine the prevalence of HPV infection and the distribution of genotypes in a group of nonvaccinated women ages 18 to 25 years old in three Colombian cities as baseline for the monitoring of the HPV national vaccination program. A total of 1,782 sexually active women were included. Cervical smear samples were collected to perform the Pap smear and HPV DNA detection using a Linear Array HPV assay. Of the 1,782 specimens analyzed, 60.3% were positive for any HPV type; 42.2% were positive for high-risk HPV (HR-HVP) types, and 44.4% for low-risk HPV (LR-HPV) types. Multiple and single infections were identified in 37.1% and 23.2% of samples, respectively. HR-HPV types -16, -52, and -51 were the most predominant with proportions of 11.3%, 7.92%, and 7.9%, correspondingly. The prevalence for HR-HPV 16/18 was 14.4%. HR-HPV prevalence in women with abnormal cytology (75.16%) was higher than in women with normal cytology (38.6%). In conclusion, a high prevalence of HR-HPV was observed among younger women. This HPV type-specific prevalence baseline may be used to monitor postvaccination longitudinal changes and to determine its impact on HPV-related disease incidence in Colombia population. Cancer Prev Res; 11(9); 581-92. ©2018 AACR.
Assuntos
Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/epidemiologia , Neoplasias do Colo do Útero/prevenção & controle , Adulto , Colo do Útero/patologia , Colo do Útero/virologia , Colômbia/epidemiologia , DNA Viral/genética , DNA Viral/isolamento & purificação , Feminino , Técnicas de Genotipagem , Humanos , Teste de Papanicolaou , Papillomaviridae/genética , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/prevenção & controle , Infecções por Papillomavirus/virologia , Prevalência , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/virologia , Vacinação , Esfregaço Vaginal , Adulto JovemRESUMO
We conducted a double blind random study on 79 patients with gastric ulcer: 39 received sucralfate, 1 g 4 times a day (Group 1) and 40 received a single evening dose of famotidine, 40 mg (Group 2). At 4 weeks, endoscopy revealed healing of the ulcer in 46% of patients in Group1 and 40% in group 2 (NS). At 8 weeks, corresponding figures were 90% and 75 (NS). All patients were able to complete treatment and minor side effects were reported from all patients, 36% with sucralfate and 28% with famotidine. Thus, sucralfate and famotidine are equally effective for therapy of gastric ulcer. The higher percentage of helaing with sucralfate observed in this study was not statistically significant