RESUMO
OBJECTIVE: The aim of this study was to develop an initial valid tool to measure attitudes toward cancer-related cognitive changes. SUBJECTS AND METHODS: After revising the literature, three main dimensions were hypothesized. Eight judges were contacted to obtain content validity evidence. A robust Exploratory Factor Analysis (EFA) was performed via a parallel analysis with an Unweighted Least Squares (ULS) estimator and polychoric correlations. The results were crossed with sociodemographic variables to find possible statistical differences and estimate the size effect. Analysis was performed in the software Factor and the statistical package R. RESULTS: A sample of 374 participants was obtained, involving oncology patients, their caregivers, and people from the general community. A statistical fit was found in two dimensions: Awareness and Judgments [root mean squared error of approximation (RMSEA) = 0.042, standardized root mean square residual (SRMR) = 0.02, comparative fit index (CFI) = 0.99, Tucker-Lewis index (TLI) = 0.98] with a moderate correlation between them (r = 0.612). Optimal reliability indices were obtained for the total scale and its dimensions. No real statistical difference was found between sociodemographic variables; the interpretation norms were established via the quartiles. CONCLUSIONS: The first attempt to measure the construct of interest was developed with two primary validity evidence based on the content and its internal structure. This instrument could help strengthen the prevention of cancer-related cognitive changes. More research is needed to adhere more valid evidence to the scale.
Assuntos
Oncologia , Neoplasias , Humanos , Colômbia , Reprodutibilidade dos Testes , Software , CogniçãoRESUMO
INTRODUCTION AND AIMS: The adenoma detection rate (ADR) is the most important quality indicator for the prevention of colorectal cancer but serrated polyps are also precursor lesions of the disease. The aim of our study was to compare the detection rate of proximal serrated polyps (PSPs) and that of clinically significant serrated polyps (CSSPs) between endoscopists and analyze the relation of those parameters to the ADR. METHODS: An observational, prospective, cross-sectional study was conducted on all patients that underwent colonoscopy at the Policlínico Peruano Japonés within the time frame of July 2015 and August 2016. The ADR and PSP and CSSP detection rates between endoscopists were compared through multivariate logistic regression and the association between those parameters was calculated through the Pearson correlation coefficient. RESULTS: The study included 15 endoscopists and 1,378 colonoscopies. The PSP detection rate ranged from 1.8-17% between endoscopists and had an almost perfect correlation with the CSSP detection rate (p = 0.922), as well as strongly correlating with the ADR (p = 0.769). CONCLUSIONS: There was great variability in the PSP detection rate between endoscopists. It also had an almost perfect correlation with the CSSP detection rate and strongly correlated with the ADR. Those results suggest a high CSSP miss rate at endoscopy and a low PSP detection rate.
Assuntos
Pólipos do Colo , Neoplasias Colorretais , Pólipos do Colo/diagnóstico , Colonoscopia , Neoplasias Colorretais/diagnóstico , Estudos Transversais , Humanos , Estudos ProspectivosRESUMO
AIM: Analysing the antimicrobial activity-against food-borne micro-organisms-of modified chitosan-starch films using formic and acetic acid as chitosan solvents and Melicoccus bijugatus leaves and fruit extracts. METHODS AND RESULTS: The films' antimicrobial activity against mesophilic aerobic bacteria, total coliform and fungi were also analysed, in accordance with the Mexican Official Norms (NOM-092-SSA1-1994, NOM-111-SSA1-1994 and NOM-113-SSA1-1994). The pH values of the films and extracts were measured, and the volatile compounds of the extracts and two films were determined by Gas Chromatography-Mass Spectrometry (GC-MS) considering the relationship among the type of compounds, extracts concentration, films' pH and the antimicrobial activity against bacteria and fungi. The best results are obtained by films with formic acid and 10% (v/v) of leaf and fruit extracts, in comparison with untreated chitosan-starch films. CONCLUSIONS: The extracts' compounds improved the films' antimicrobial capacity and inhibited the growth of micro-organisms with no previous sterilization required. It is correlated to the pH of the media, the combination of solvent/extract used and its concentration. SIGNIFICANCE AND IMPACT OF THE STUDY: This is one of the few researches where the antimicrobial activity of M. bijugatus extracts is studied. It was found that the presence of these extracts is capable of improving the antimicrobial activities of chitosan-starch films. The performance of the modified films suggests their potential application as novel food packaging materials and encourages further research.
Assuntos
Anti-Infecciosos , Quitosana , Contaminação de Alimentos/prevenção & controle , Extratos Vegetais , Sapindaceae/química , Ácidos , Anti-Infecciosos/farmacologia , Quitosana/farmacologia , Microbiologia de Alimentos , Embalagem de Alimentos , Frutas/química , Extratos Vegetais/farmacologia , Folhas de Planta/química , Solventes , AmidoRESUMO
INTRODUCTION AND AIMS: The adenoma detection rate (ADR) is the most important quality indicator for the prevention of colorectal cancer but serrated polyps are also precursor lesions of the disease. The aim of our study was to compare the detection rate of proximal serrated polyps (PSPs) and that of clinically significant serrated polyps (CSSPs) between endoscopists and analyze the relation of those parameters to the ADR. METHODS: An observational, prospective, cross-sectional study was conducted on all patients that underwent colonoscopy at the Policlínico Peruano Japonés within the time frame of July 2015 and August 2016. The ADR and PSP and CSSP detection rates between endoscopists were compared through multivariate logistic regression and the association between those parameters was calculated through the Pearson correlation coefficient. RESULTS: The study included 15 endoscopists and 1,378 colonoscopies. The PSP detection rate ranged from 1.8-17% between endoscopists and had an almost perfect correlation with the CSSP detection rate (p = 0.922), as well as strongly correlating with the ADR (p = 0.769). CONCLUSIONS: There was great variability in the PSP detection rate between endoscopists. It also had an almost perfect correlation with the CSSP detection rate and strongly correlated with the ADR. Those results suggest a high CSSP miss rate at endoscopy and a low PSP detection rate.
RESUMO
Mezcal is a traditional Mexican spirit, obtained from the distillation of fermented agave juices. Its preparation has been conducted for centuries in an artisanal manner. The method used to determine the correct alcohol content is of particular interest: a stream of the liquor is poured into a small vessel to induce surface bubbles. These bubbles, known as pearls by the Mezcal artisans, remain stable for tenths of seconds only if the alcohol content is close to 50%. For higher or lower alcohol content, the bubbles burst rapidly. The long bubble lifetime is the result of surfactant-induced surface tension changes. However, the precise mechanism and its relation to alcohol content remain unexplained. In this investigation, the extended lifetime of pearls was studied both experimentally and numerically. It was found that changes in surface tension, density, viscosity (resulting from mixing ethanol and water), and the presence of surfactants are all relevant to extend the bubble lifetime. The dimensionless bubble lifetime was found to reach its maximum value when the Bond number was close to unity, corresponding to 2 mm Mezcal bubbles. These findings show that the traditional empirical method does work. Beyond this, the understanding of the process provides physical insight to many other natural and industrial problems for which the stability of surface bubbles is of importance, such as bio-foams, froth floatation, and volcanic flows.
RESUMO
Urbanization can be detrimental to health in populations due to changes in dietary and physical activity patterns. The aim of this study was to determine the effect of migration on the incidence of hypertension. Participants of the PERU MIGRANT study, that is, rural, urban and rural-to-urban migrants, were re-evaluated after 5 years after baseline assessment. The outcome was incidence of hypertension; and the exposures were study group and other well-known risk factors. Incidence rates, relative risks (RRs) and population attributable fractions (PAFs) were calculated. At baseline, 201 (20.4%), 589 (59.5%) and 199 (20.1%) participants were rural, rural-to-urban migrant and urban subjects, respectively. Overall mean age was 47.9 (s.d.±12.0) years, and 522 (52.9%) were female. Hypertension prevalence at baseline was 16.0% (95% confidence interval (CI) 13.7-18.3), being more common in urban group; whereas pre-hypertension was more prevalent in rural participants (P<0.001). Follow-up rate at 5 years was 94%, 895 participants were re-assessed and 33 (3.3%) deaths were recorded. Overall incidence of hypertension was 1.73 (95%CI 1.36-2.20) per 100 person-years. In multivariable model and compared with the urban group, rural group had a greater risk of developing hypertension (RR 3.58; 95%CI 1.42-9.06). PAFs showed high waist circumference as the leading risk factor for the hypertension development in rural (19.1%), migrant (27.9%) and urban (45.8%) participants. Subjects from rural areas are at higher risk of developing hypertension relative to rural-urban migrant or urban groups. Central obesity was the leading risk factor for hypertension incidence in the three population groups.
Assuntos
Hipertensão/epidemiologia , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Fatores de RiscoRESUMO
BACKGROUND: Although migration and urbanization have been linked with higher obesity rates, especially in low-resource settings, prospective information about the magnitude of these effects is lacking. We estimated the risk of obesity and central obesity among rural subjects, rural-to-urban migrants and urban subjects. METHODS: Prospective data from the PERU MIGRANT Study were analyzed. Baseline data were collected in 2007-2008 and participants re-contacted in 2012-2013. At follow-up, outcomes were obesity and central obesity measured by body mass index and waist circumference. At baseline, the primary exposure was demographic group: rural, rural-to-urban migrant and urban. Other exposures included an assets index and educational attainment. Cumulative incidence, incidence ratio (IR) and 95% confidence intervals (95% CI) for obesity and central obesity were estimated with Poisson regression models. RESULTS: At baseline, mean age (±s.d.) was 47.9 (±12.0) years, and 53.0% were females. Rural subjects comprised 20.2% of the total sample, whereas 59.7% were rural-to-urban migrants and 20.1% were urban dwellers. A total of 3598 and 2174 person-years were analyzed for obesity and central obesity outcomes, respectively. At baseline, the prevalence of obesity and central obesity was 20.0 and 52.5%. In multivariable models, migrant and urban groups had an 8- to 9.5-fold higher IR of obesity compared with the rural group (IR migrants=8.19, 95% CI=2.72-24.67; IR urban=9.51, 95% CI=2.74-33.01). For central obesity, there was a higher IR only among the migrant group (IR=1.95; 95% CI=1.22-3.13). Assets index was associated with a higher IR of central obesity (IR top versus bottom tertile 1.45, 95% CI=1.03-2.06). CONCLUSIONS: Peruvian urban individuals and rural-to-urban migrants show a higher incidence of obesity compared with their rural counterparts. Given the ongoing urbanization occurring in middle-income countries, the rapid development of increased obesity risk by rural-to-urban migrants suggests that measures to reduce obesity should be a priority for this group.
Assuntos
Doenças Cardiovasculares/epidemiologia , Obesidade/epidemiologia , População Rural , Migrantes/estatística & dados numéricos , População Urbana , Urbanização , Índice de Massa Corporal , Doenças Cardiovasculares/prevenção & controle , Escolaridade , Feminino , Seguimentos , Prioridades em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/prevenção & controle , Obesidade Abdominal/complicações , Obesidade Abdominal/epidemiologia , Peru/epidemiologia , Distribuição de Poisson , Prevalência , Estudos Prospectivos , Fatores de Risco , População Rural/tendências , Fatores Socioeconômicos , População Urbana/tendências , Urbanização/tendênciasRESUMO
INTRODUCTION AND OBJECTIVES: Despite the magnitude of the Colombian health system reform, introduced in 1993, changes in specialized medical practice have not been evaluated. This paper is the follow-up of a similar study on the practice of neurology done by the authors before the reform. MATERIAL AND METHODS: Of the 62 members of the Colombian Association of Neurology living in Bogotá, 47 (76%) of them responded an anonymous survey inquiring on the characteristics of their medical practice and registering all the medical encounters during one week in October 1998. RESULTS: Two thirds of the total working time is devoted by neurologists to clinical work. Half of the neurologists in the sample have invested in diagnostic equipment. There was no significant change in the total number of patients attended during the week, as compared with the 1993 study, and the diagnostic profile was similar. The proportion of private patients was significantly lower, while patients from prepaid medical schemes increased. Patients belonging to the Obligatory Health Plan, designed to cover lowest income population, and to prepaid medicine are not distributed homogeneously throughout all ages. The first year of life is particularly uncovered by the Obligatory Health Plan, while prepaid schemes do not address the problems of individuals age 60 or more. CONCLUSIONS: There has been a significant reduction in private practice compensated by an increase in prepaid medicine. There is no evidence of increased coverage for neurological disorders.
Assuntos
Reforma dos Serviços de Saúde/legislação & jurisprudência , Administração de Serviços de Saúde , Neurologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Colômbia , Feminino , Reforma dos Serviços de Saúde/economia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Inquéritos e QuestionáriosRESUMO
Eighty-four cerebrospinal fluid (CSF) samples from different children who presented with signs and symptoms of meningitis were evaluated for the presence of Mycobacterium tuberculosis complex organisms by the Gen-Probe Amplified Mycobacterium tuberculosis Direct Test (MTD; Gen-Probe, San Diego, Calif.). All CSF samples had negative acid-fast smears by the Ziehl-Neelsen staining method. M. tuberculosis was recovered from five samples. M. tuberculosis did not grow from 19 additional samples, but the samples were from patients who fulfilled specific clinical and laboratory criteria for probable tuberculous meningitis (TBM). The remaining samples (n = 60) were from patients with other infections or noninfectious causes of meningitis. The results of the MTD were interpreted as positive or negative on the basis of recommended cutoff values for respiratory specimens. These results were interpreted as true or false positives or true or false negatives on the basis of the results of M. tuberculosis culture or whether the patient fulfilled criteria for probable TBM. The Gen-Probe MTD was 33% sensitive and 100% specific for detecting M. tuberculosis complex organisms in these 84 CSF samples. If the cutoff values for positive results were decreased for the MTD (> or = 11,000 versus > or = 30,000 relative light units), the sensitivity increased to 83% and the specificity remained 100%. These results for the MTD are encouraging considering that TBM is a highly fatal disease and difficult to diagnose by conventional laboratory techniques.