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Parkinson's disease (PD) is a chronic and progressive neurodegenerative disease with the major symptoms comprising loss of movement coordination (motor dysfunction) and non-motor dysfunction, including gastrointestinal symptoms. Alterations in the gut microbiota composition have been reported in PD patients vs. controls. However, it is still unclear how these compositional changes contribute to disease etiology and progression. Furthermore, most of the available studies have focused on European, Asian, and North American cohorts, but the microbiomes of PD patients in Latin America have not been characterized. To address this problem, we obtained fecal samples from Colombian participants (n = 25 controls, n = 25 PD idiopathic cases) to characterize the taxonomical community changes during disease via 16S rRNA gene sequencing. An analysis of differential composition, diversity, and personalized computational modeling was carried out, given the fecal bacterial composition and diet of each participant. We found three metabolites that differed in dietary habits between PD patients and controls: carbohydrates, trans fatty acids, and potassium. We identified six genera that changed significantly in their relative abundance between PD patients and controls, belonging to the families Lachnospiraceae, Lactobacillaceae, Verrucomicrobioaceae, Peptostreptococcaceae, and Streptococcaceae. Furthermore, personalized metabolic modeling of the gut microbiome revealed changes in the predicted production of seven metabolites (Indole, tryptophan, fructose, phenylacetic acid, myristic acid, 3-Methyl-2-oxovaleric acid, and N-Acetylneuraminic acid). These metabolites are associated with the metabolism of aromatic amino acids and their consumption in the diet. Therefore, this research suggests that each individual's diet and intestinal composition could affect host metabolism. Furthermore, these findings open the door to the study of microbiome-host interactions and allow us to contribute to personalized medicine.
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BACKGROUND: The incidence of sporadic colorectal cancer (CRC) among individuals <50 years (early-onset CRC) has been increasing in the United States (U.S.) and Puerto Rico. CRC is currently the leading cause of cancer death among Hispanic men and women living in Puerto Rico (PRH). The objective of this study was to characterize the molecular markers and clinicopathologic features of colorectal tumors from PRH to better understand the molecular pathways leading to CRC in this Hispanic subpopulation. METHODS: Microsatellite instability (MSI), CpG island methylator phenotype (CIMP), and KRAS and BRAF mutation status were analyzed. Sociodemographic and clinicopathological characteristics were evaluated using Chi-squared and Fisher's exact tests. RESULTS: Of the 718 tumors analyzed, 34.2% (n = 245) were early-onset CRC, and 51.7% were males. Among the tumors with molecular data available (n = 192), 3.2% had MSI, 9.7% had BRAF, and 31.9% had KRAS mutations. The most common KRAS mutations observed were G12D (26.6%) and G13D (20.0%); G12C was present in 4.4% of tumors. A higher percentage of Amerindian admixture was significantly associated with early-onset CRC. CONCLUSIONS: The differences observed in the prevalence of the molecular markers among PRH tumors compared to other racial/ethnic groups suggest a distinct molecular carcinogenic pathway among Hispanics. Additional studies are warranted.
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Neoplasias Colorretais , Proteínas Proto-Oncogênicas B-raf , Masculino , Feminino , Humanos , Proteínas Proto-Oncogênicas B-raf/genética , Proteínas Proto-Oncogênicas B-raf/metabolismo , Metilação de DNA , Porto Rico/epidemiologia , Proteínas Proto-Oncogênicas p21(ras)/genética , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/genética , Neoplasias Colorretais/metabolismo , Instabilidade de Microssatélites , Biomarcadores/metabolismo , Hispânico ou Latino/genéticaRESUMO
No cardiovascular risk score has included Latin American patients in its development. The ACC/AHA ASCVD risk score has not been validated in Latin America; consequently, its predictive capacity in the population of the region is unknown. The aim of this study is to evaluate the discrimination capacity and calibration of the ACC/AHA ASCVD score to predict the 10-year risk of a cardiovascular event in a primary prevention cohort followed in a Colombian hospital. A retrospective cohort study was conducted in primary prevention patients belonging to an intermediate/high-risk and low-risk cohort without established atherosclerotic disease. Cardiovascular risk was calculated at inclusion. The calibration was analyzed by comparing observed and expected events in the different risk categories. A discrimination analysis was made using the area under the ROC curve and C statistic. A total of 918 patients were included-202 from the intermediate/high-risk and 716 from the low-risk cohort. The median cardiovascular risk was 3.6% (IQR 1.7-8.5%). At the 10-year follow-up, 40 events (4,4%) occurred. The area under the ROC curve was 0.782 (95% CI 0.71-0.85). The Hosmer-Lemeshow test did not show differences between expected and observed events. The ACC/AHA ASCVD score is calibrated and has good discrimination capacity in predicting 10-year risk of cardiovascular events in a Colombian population.
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Aterosclerose , Doenças Cardiovasculares , Humanos , Estudos Retrospectivos , Colômbia/epidemiologia , Medição de Risco , Fatores de Risco , Aterosclerose/epidemiologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controleRESUMO
La uncinariasis fue descrita por primera vez por Dubini en 1838. Es una helmintiasis intestinal causada por el Necator americanus y/o Ancylostoma duodenale. Frecuentemente son endémicas de áreas tropicales y subtropicales; afecta tanto a niños como a adultos. La transmisión asciende cuando existen entornos socioculturales y demográficos que favorecen la contaminación fecal, por lo que es considerado un problema de salud pública en el mundo. Se presenta el caso de un paciente masculino de 20 años que acudió a urgencias por astenia, adinamia, taquicardia y palidez mucocutánea generalizada; el hemograma reportó anemia severa y eosinofilia. Se requirió transfusión de 4 UI de glóbulos rojos y sulfato ferroso. El examen coprológico mostró infección por Necator americanus, que fue tratada con albendazol y, posteriormente, fue egresado de la institución sanitaria. La infección por uncinarias constituye una causa olvidada para el clínico de hemorragia de las vías digestivas y desarrollo de anemia. Por tanto, el presente estudio destaca que esta parasitosis es una causa importante en el diagnóstico diferencial. Además, se ofrece mayor importancia a las estrategias preventivas como la capacitación a profesionales de salud, el refuerzo de técnicas de aseo, la disminución de la contaminación y el aumento de la higiene personal(AU)
Hookworm infection was first described by Dubini in 1838. It is an intestinal helminth infection caused by Necator americanus and/or Ancylostoma duodenale. They are frequently endemic to tropical and subtropical areas and affect both children and adults. Transmission increases when there are socio-cultural and demographic environments that favor fecal contamination; therefore, it is a public health problem worldwide. We describe the case of a 20-year-old male patient who presented to the emergency department with asthenia, adynamia, tachycardia, and generalized mucocutaneous pallor. The blood test showed severe anemia and eosinophilia. Transfusion of 4 IU of red blood cells and ferrous sulphate was required. The coprological test showed infection by Necator americanus, which was treated with albendazole. Afterwards, the patient was discharged from the health institution. Hookworm infection is a neglected cause of gastrointestinal bleeding and anemia by the clinician. Therefore, the present study highlights this parasitosis as an important cause in the differential diagnosis. In addition, greater importance is given to preventive strategies such as training the health professionals, reinforcement of hygiene techniques, decrease of contamination and increase of proper personal hygiene(AU)
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Humanos , Masculino , Adulto JovemRESUMO
Objetivo: caracterizar los microorganismos involucrados en las infecciones intraabdominales, y fenotipificar sus perfiles de resistencia al uso de los antibióticos en el Servicio de Cirugía General del Instituto Autónomo Hospital Universitario de Los Andes, entre los años 2014 al 2017. Metodología: enfoque cuantitativo; tipo descriptivo, diseño no experimental de estudio de casos y transversal, a través de toma de muestras de secreciones abdominales en quirófano a las cuales se les realizó cultivo en medios de agar sangre y McConkey, tinción Gram, contaje de leucocitos, y prueba Kirby-Bauer de sensibilidad antimicrobiana. Muestra de 211 pacientes mayores de 16 años que acudieron a la institución con el diagnóstico de abdomen agudo quirúrgico infeccioso. Resultados: el abdomen agudo quirúrgico infeccioso por apendicitis aguda fue la infección intraabdominal más común, grupo etario que acudió con más frecuencia: <26 años. Agentes etiológicos más frecuentemente aislados: bacilos Gram negativos, especies más frecuentes: E. col i (57,3%), K. pneumon iae (10,9%) y P. a e rug i nosa (6,16%). De todos los microorganismos aislados 57,6% expresaron al menos un fenotipo de resistencia. Fenotipo más común: betalactamasa de espectro extendido y bomba de eflujo de quinolonas (18,8%). Microorganismos con mayores porcentajes de resistencia: Staphylococcus sp. y Enterococcus sp (~100%). Los mejores porcentajes de sensibilidad de la E. col i , K . p neumon ia e y P . a e rug i nosa fueron hacia al colistin, carbapenémicos y amikacina (100%). Conclusión: Los carbapenémicos y los aminoglucósidos seguirán siendo los fármacos de elección en las infecciones intraabdominales del Instituto Autónomo Hospital Universitario de Los Andes(AU)
Objective: to characterize the microorganisms involved in intraabdominal infections, and to phenotype their resistance profiles to the use of antibiotics in the General Surgery Service of the Instituto Autónomo Hospital Universitario de Los Andes, from 2014 to 2017. Methodology: quantitative approach; descriptive type, nonexperimental design of case study and transversal, through sampling of abdominal secretions in the operating room which were cultured in blood agar and McConkey media, Gram stain, leukocyte count, and Kirby-Bauer test for antimicrobial sensitivity. Sample of 211 patients older than 16 years who attended the institution with the diagnosis of acute surgical infectious abdomen. Results: acute surgical infectious abdomen due to acute appendicitis was the most common intra-abdominal infection, most frequent age group: <26 years. Most frequently isolated etiologic agents: Gram-negative bacilli, most frequent species: E. co l i (57.3%), K. p neumon ia e (10.9%) and P . a e rug i nosa (6.16%). Of all the isolated microorganisms, 57.6% expressed at least one resistance phenotype. Most common phenotype: extended-spectrum beta-lactamase and quinolone efflux pump (18.8%). Microorganisms with the highest percentages of resistance: Staphylococcus sp. and Enterococcus sp (~100%). The best percentages of sensitivity of E. col i , K . pneumoniae and P . a e rug i nosa were to colistin, carbapenemics and amikacin (100%). Conclusion: Carbapenemics and aminoglycosides will remain the drugs of choice in intra-abdominal infections at Instituto Autónomo Hospital Universitario de Los Andes(AU)
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Infecções Bacterianas , Farmacorresistência BacterianaRESUMO
Introducción: La salud mental ha sido afectada durante la pandemia por COVID-19, también en los estudiantes de enfermería se ha observado un efecto negativo sobre sus niveles de depresión y ansiedad. Objetivo: Describir la relación existente entre los factores sociodemográficos y la salud mental de estudiantes de enfermería en tiempos de COVID-19. Métodos: Estudio cuantitativo, descriptivo, transversal, cuya población fue de 577 estudiantes de enfermería de una universidad privada de Trujillo, Perú, matriculados en el semestre 2021-01. Se tomó una muestra de 328 estudiantes mediante muestreo no probabilístico por conveniencia. Los datos se recolectaron mediante los cuestionarios para evaluar síntomas de ansiedad (GAD-7) y depresión (PHQ-9), estos instrumentos fueron enviados mediante un formulario de Google. Los datos fueron procesados y descritos en frecuencias absolutas y porcentajes; para el análisis inferencial se utilizó la prueba de Chi cuadrado de Pearson. Resultados: Los factores sociodemográficos muestran que 31,10 por ciento pertenecía al primer ciclo, 95,70 por ciento era de género femenino, 31,40 por ciento tenía edades de hasta 18 años, 92,10 por ciento era soltero, 68,90 por ciento profesaba la religión católica y 85,40 por ciento indicó residir en el departamento de La Libertad. Asimismo, se encontró que 45,40 por ciento de los estudiantes tenía nivel leve de ansiedad y 19,80 por ciento nivel severo; además, 39,60 por ciento no presentó síntomas depresivos, 18,90 por ciento presentó depresión mayor leve y 2,10 por ciento depresión mayor severa, se encontró solo una relación estadística significativa entre el factor género y los síntomas depresivos (p < 0,05). Conclusiones: No se encontró relación entre los factores sociodemográficos y los síntomas de ansiedad(AU)
Introduction: Mental health has been affected during the pandemic by COVID-19, also in nursing students a negative effect on their levels of depression and anxiety has been observed. Objective: To describe the relationship between sociodemographic factors and mental health of nursing students in times of COVID-19. Methods: Quantitative, descriptive, cross-sectional study, whose population was 577 nursing students of a private university in Trujillo, Peru, enrolled in the semester 2021-01. A sample of 328 students was taken by non-probabilistic convenience sampling. Data were collected using the questionnaires to evaluate anxiety symptoms (GAD-7) and depression (PHQ-9), these instruments were sent through a Google form. Data were processed and described in absolute frequencies and percentages; Pearson's Chi-square test was used for inferential analysis. Results: The sociodemographic factors show that 31.10 percent belonged to the first cycle, 95.70 percent were female, 31.40 percent were aged up to 18 years, 92.10 percent were single, 68.90 percent professed the Catholic religion and 85.40 percent indicated residing in the department of La Libertad. It was also found that 45.40 percent of the students had mild anxiety and 19.80 percent severe anxiety; in addition, 39.60 percent did not present depressive symptoms, 18.90 percent presented mild major depression and 2.10 percent severe major depression; only a significant statistical relationship was found between the gender factor and depressive symptoms (p < 0.05). Conclusions: No relationship was found between sociodemographic factors and anxiety symptoms(AU)
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Humanos , Feminino , Adulto Jovem , Saúde Mental , COVID-19/epidemiologia , Epidemiologia DescritivaRESUMO
Las disautonomías son el resultado de un mal funcionamiento del sistema nervioso autónomo, entre las cuales se encuentra el síndrome de taquicardia ortostática postural, un problema de salud variable y complejo que tiene una prevalencia considerable, principalmente en adolescentes y mujeres. Este produce una amplia variedad de signos y síntomas que son similares a los de otras patologías, lo que, sumado a la falta de pruebas diagnósticas específicas, muchas veces retrasa el diagnóstico. A pesar de la existencia de criterios estandarizados para determinar la presencia del síndrome, existe aún una brecha en el conocimiento acerca del mismo. Esto dificulta el abordaje del padecimiento y, por consiguiente, su tratamiento oportuno. Conocer más sobre este síndrome y los factores que dificultan su diagnóstico temprano permitiría mejorar la atención de los pacientes y su calidad de vida
Dysautonomias are the result of a malfunction of the autonomic nervous system, among which is the postural orthostatic tachycardia syndrome, a variable and complex health problem that has a considerable prevalence, mainly in adolescents and women. It produces a wide variety of signs and symptoms that are similar to those of other pathologies, which, added to the lack of specific diagnostic tests, often delays diagnosis. Despite the existence of standardized criteria to determine the presence of the syndrome, there is still a gap in knowledge about it. This hinders the approach to the condition and, consequently, its timely treatment. Understanding more about this syndrome and the factors that hinder its early diagnosis would improve patient care and quality of life
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Sistema Nervoso Autônomo , Diagnóstico , Síndrome da Taquicardia Postural Ortostática , Taquicardia , El Salvador , Disautonomias PrimáriasRESUMO
RESUMEN Introducción: El uso de la mascarilla es indispensable para reducir la propagación de la COVID-19, pero, un porcentaje importante de personas se rehúsan a su uso. Es posible que las creencias jueguen un rol sustancial en la aceptación o rechazo de su uso. Sin embargo, se carece de una escala para evaluar las creencias sobre el uso de mascarillas para prevenir el contagio de la COVID-19. Objetivo: Traducir y determinar las evidencias de validez, de estructura interna y confiabilidad del autoinforme de creencias sobre el uso de las mascarillas. Métodos: El autoinforme de creencias sobre el uso de las mascarillas fue administrado a 1 218 personas de diferentes provincias del Perú (Medad = 27,4 años, DE = 12,6), elegidas de forma no probabilística. El instrumento fue sometido a un proceso de doble traducción del inglés al español y viceversa; además, mediante el programa Proyecto Jamovi versión 1.6, se determinó la estructura interna con análisis factorial (exploratorio y confirmatorio) y finalmente se estimó la confiabilidad. Resultados: El análisis factorial exploratorio identificó cuatro factores emergentes que explicaron el 53,7 % de la varianza. El modelo fue verificado y obtuvo índices de ajuste aceptables (χ² = 154 gl = 46; p < 0,01; CFI = 0,96; TLI = 0,942; RMSEA = 0,602). Además, se apreciaron cargas factoriales estandarizadas mayores a 0,30. Conclusión: La versión en español del autoinforme de creencias sobre el uso de las mascarillas muestra evidencias de validez, de estructura y confiabilidad por consistencia interna adecuadas.
ABSTRACT Introduction: The use of a mask is essential to reduce the spread of COVID-19, however, a significant percentage of people refuse to use it. Beliefs may play an important role in accepting or rejecting their use. Objective: To translate and determine the evidence of validity of internal structure and reliability of the self-report of beliefs about the use of masks. Methods: The self-report of beliefs about the use of masks was administered to 1218 people from different provinces of Peru (M age = 27,4 years, SD = 12,6), chosen in a non-probabilistic way. The instrument was subjected to a process of double translation from English to Spanish and vice versa; In addition, using the Jamovi Project version 1.6 program, the internal structure was determined with factor analysis (exploratory and confirmatory), and finally reliability was estimated. Results: The exploratory factor analysis identified four emerging factors that explained 53.7% of the variance. The model was verified and obtained acceptable fit indices (χ² = 154 gl = 46; p < 0,01; CFI = 0,96; TLI = 0,942; RMSEA = 0,602). In addition, standardized factor loadings greater than 0,30 were observed. Conclusions: The Spanish version of the self-report of beliefs about the use of masks shows evidence of validity of structure and reliability due to adequate internal consistency.
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Cardiovascular disease (CVD) is the main cause of morbidity and mortality in patients with type 2 diabetes mellitus (DM2). However, scarce specific data are available about the prevalence of CVD in that population in daily clinical practice. The CAPTURE study investigated the contemporary prevalence of CVD in a representative sample of DM2 population in 13 countries, distributed over 5 continents (n = 9823). Among the 834 Argentinian participants, the CVD prevalence was 41.5% (n = 347) (95% confidence interval [95%CI]: 38.4-44.7%), while worldwide rate was 34.8% (n = 3582) (95%CI: 32.7-36.8%). In most cases, it was categorized as atherosclerotic CVD 35.3% (n = 295) (95%CI: 32.3; -38.4%). Likewise, the rate of use of antidiabetic drugs with proven cardiovascular benefits was low, both in Argentina (12.8%: n = 107) and global data (21.9%; n = 2151).
La enfermedad cardiovascular (ECV) es la principal causa de morbimortalidad en los pacientes con diabetes mellitus tipo 2 (DM2). Sin embargo, se dispone de escasos datos específicos sobre la prevalencia de ECV en esta población en la práctica clínica cotidiana. El estudio CAPTURE investigó la prevalencia contemporánea de ECV en una muestra representativa de la población con diagnóstico de DM2 en 13 países, distribuidos en 5 continentes (n = 9823). Entre los 834 participantes de Argentina, la prevalencia de ECV fue de 41.5% (n = 347) (intervalo de confianza del 95% [IC95%]: 38.4-44.7%), mientras que a nivel mundial la prevalencia fue 34.8% (n = 3582) (IC95%: 32.7-36.8%). La mayoría de los casos fue categorizada como ECV aterosclerótica: 35.3% (n = 295) (IC95%:32.3-38.4%). Asimismo, la utilización de medicamentos antidiabéticos con beneficios cardiovasculares comprobados fue baja: 12.8% (n = 107) y 21.9% (n = 2151) en Argentina y a nivel global respectivamente.
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Aterosclerose , Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Argentina/epidemiologia , Aterosclerose/complicações , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Humanos , PrevalênciaRESUMO
The article addresses some forms of sexual violence suffered by Latin American women during migratory transit through Mexico. In-depth, semi-structured, qualitative-phenomenological interviews were conducted with 10 women in different stages of major transmigration states. The findings demonstrate the ubiquity of sexual violence during the migration. Five themes were identified: (a) The migration dimension of "being a woman"; (b) Recognition of contextual factors associated with the migratory process: "Intermediaries, road, shelters and sisterhood"; (c) The costs of migration: Abuse, discrimination, and persecution: "Criminal groups, physical violence, and "La Bestia"; (d) Triggers and supports: "Escape and future expectations"; and (e) God as a support.