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BACKGROUND: The internet has become an important source of health information for users worldwide. The novel coronavirus caused a pandemic search for information with broad dissemination of false or misleading health information. OBJECTIVE: The aim of this study was to evaluate the quality and readability of online information about the coronavirus disease (COVID-19), which was a trending topic on the internet, using validated instruments and relating the quality of information to its readability. METHODS: The search was based on the term "Wuhan Coronavirus" on the Google website (February 6, 2020). At the search time, the terms "COVID-19" or "SARS-CoV-2" (severe acute respiratory syndrome coronavirus 2) did not exist. Critical analysis was performed on the first 110 hits using the Health on the Net Foundation Code of Conduct (HONcode), the Journal of the American Medical Association (JAMA) benchmark, the DISCERN instrument, and Google ranking. RESULTS: The first 110 websites were critically analyzed, and only 1.8% (n=2) of the websites had the HONcode seal. The JAMA benchmark showed that 39.1% (n=43) of the websites did not have any of the categories required by this tool, and only 10.0% (11/110) of the websites had the four quality criteria required by JAMA. The DISCERN score showed that 70.0% (n=77) of the websites were evaluated as having a low score and none were rated as having a high score. CONCLUSIONS: Nonhealth personnel and the scientific community need to be aware about the quality of the information they read and produce, respectively. The Wuhan coronavirus health crisis misinformation was produced by the media, and the misinformation was obtained by users from the internet. The use of the internet has a risk to public health, and, in cases like this, the governments should be developing strategies to regulate health information on the internet without censuring the population. By February 6, 2020, no quality information was available on the internet about COVID-19.
Assuntos
Comunicação , Compreensão , Informação de Saúde ao Consumidor , Infecções por Coronavirus/prevenção & controle , Coronavirus , Internet , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , COVID-19 , Informação de Saúde ao Consumidor/normas , Humanos , Disseminação de Informação , Serviços de Informação , Leitura , SARS-CoV-2RESUMO
Cancer treatments are associated with short and long-effects. Epidemiological reports have revealed clinical features of metabolic syndrome (MS), obesity or overweight in young cancer survivors. The aim of the study was to examine the prevalence of unhealthy weight status and risk factors associated with MS related to chemotherapy. We study 52 pediatric cancer patients and analyze cholesterol, triglycerides, glycosylated hemoglobin, body mass index, waist circumference (WC), FINDRISC test. All the parameters were analyzed according to the percentile corresponding to sex and age of each child. The data show an important modification in weight, body mass index, and WC as in triglycerides, and cholesterol that could be associated with the development of MS. The variance analysis showed that the WC, triglycerides, and cholesterol are statistically correlated in our population. A follow-up for MS in children cancer survivor should be considered necessary.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Índice de Massa Corporal , Síndrome Metabólica/epidemiologia , Neoplasias/tratamento farmacológico , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Glicemia/metabolismo , Criança , Colesterol/metabolismo , Feminino , Seguimentos , Humanos , Masculino , Síndrome Metabólica/induzido quimicamente , Síndrome Metabólica/metabolismo , México/epidemiologia , Neoplasias/patologia , Obesidade/induzido quimicamente , Obesidade/metabolismo , Sobrepeso/induzido quimicamente , Sobrepeso/metabolismo , Prevalência , Prognóstico , Fatores de RiscoRESUMO
Long-term childhood cancer survivors are at great risk of developing late adverse effects after treatment, such as, reduced growth, obesity, decreased fertility, high blood pressure, cardiovascular diseases, impaired glucose, another form of cancer, among others organ dysfunctions, some of them are part of the metabolic syndrome. Metabolic syndrome and cancer connection is still not entirely understood, but there are some notions about it. Metabolic alterations produced during childhood cancer are more likely determined by treatments like radiotherapy, chemotherapy, glucocorticoids therapy, and surgery. Cancer treatment is associated to vascular alterations, hormone deficiencies, changes in insulin sensitivity, lipid metabolism, and inflammatory mediators. Obesity has been considered a crucial component in metabolic syndrome; obesity risk factors during childhood cancer include cranial radiation, female gender, and exposure to glucocorticoids such as dexamethasone. In addition, local radiotherapy or surgery may cause endocrine deficiencies, depends on the directly damage of endocrine organs. Patients who received some types of cancer treatment should be evaluated periodically to early diagnostic metabolic disorders associated to antineoplastic therapy.
Assuntos
Antineoplásicos/efeitos adversos , Síndrome Metabólica/etiologia , Neoplasias/complicações , Neoplasias/terapia , Diagnóstico Precoce , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , SobreviventesRESUMO
El hematoma paravesical espontáneo es una complicación infrecuente, con pocos casos reportados en la literatura. Aproximadamente el 2 % de los pacientes que se traten con enoxaparina profiláctica tendrán complicaciones hemorrágicas, de las cuales el 20 % son hematomas retroperitoneales o intracraneales, en dependencia de los factores de riesgo. Por tales razones se presenta el caso de un paciente de 35 años de edad, previamente sano, que fue sometido a una sutura de tendón de Aquiles después de sufrir un trauma, al que se le administró profilácticamente una sola dosis de enoxaparina en el posoperatorio inmediato y 24 horas después comenzó a quejarse de dolor en fosa iliaca derecha y disuria. El ultrasonido abdominal demostró un hematoma paravesical, que fue confirmado por topografía. Se manejó conservadoramente con sonda intravesical por diez días. Se realizó seguimiento del paciente, sin que se encontraran secuelas. Los autores infieren que el sangrado fue secundario a una sobredistensión vesical secundaria a la anestesia que provocó el sangrado de la pared de la vejiga. Este reporte demuestra que la enoxaparina profiláctica puede causar hematomas paravesicales espontáneos asociados a la sobredistención vesical. Sin embargo son necesarios otros reportes similares para confirmar lo anteriormente planteado.
Spontaneous paravesical hematoma is an infrequent complication, with a few reported cases in literature. Approximately 2 % of the patients treated with prophylactic enoxoparin will have hemorrhagic complications, from which 2 0% are retroperitoneal or intracranial hematomas depending on the risk factors. For such reasons it is presented a 35 year old patient, previously healthy, who was performed to a suture of the Achilles tendon after suffering a trauma. He was administered prophylactically a single doses of enoxoparin in the immediate post surgery and 24 hours later he started to complain of pain in the right lower quadrant and dysuria. Abdominal ultrasound showed a paravesical hematoma secondary to anesthesia which caused bleeding of the vesicle walls. This report shows prophylactic exoparin may produce spontaneous paravesical hematomas associated to vesical overdistention. However it is necessary other similar reports to confirm the previous statement.
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Admission to the intensive care unit (ICU) of a patient who has been grafted with hematopoietic stem cells is a serious event, but the role of the ICU in this setting remains controversial. Data were analyzed from patients who underwent autologous or allogeneic bone marrow transplantation at the Centro de Hematología y Medicina Interna de Puebla, México, between May 1993 and October 2014. In total, 339 patients were grafted: 150 autografts and 189 allografts; 68 of the grafted patients (20%) were admitted to the ICU after transplantation: 27% of the allografted and 11% of the autografted patients (p = 0.2). Two of 17 autografted patients (12%) and 5 of 51 allografted patients (10%) survived. All patients who required insertion of an endotracheal tube died, whereas 7 of 11 patients without invasive mechanical ventilation survived (p = 0.001). Only 10% of the grafted patients survived their stay in the ICU; this figure is lower than those reported from other centers and may reflect several facts, varying from the quality of the ICU support to ICU admission criteria to the initial management of all the grafts in an outpatient setting, which could somehow delay the arrival of patients to the hospital.
Assuntos
Doença Enxerto-Hospedeiro/diagnóstico , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Insuficiência Respiratória/diagnóstico , Sepse/diagnóstico , Adolescente , Adulto , Feminino , Doença Enxerto-Hospedeiro/epidemiologia , Doença Enxerto-Hospedeiro/etiologia , Doença Enxerto-Hospedeiro/terapia , Hospitais Universitários , Humanos , Lactente , Unidades de Terapia Intensiva , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Ambulatório Hospitalar , Prognóstico , Insuficiência Respiratória/epidemiologia , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/terapia , Risco , Sepse/epidemiologia , Sepse/etiologia , Sepse/terapia , Análise de Sobrevida , Transplante Autólogo/efeitos adversos , Transplante Homólogo/efeitos adversosRESUMO
Antecedentes. Las tendencias de obesidad y sobrepeso en México muestran un significativo incremento en las últimas encuestas nacionales. Esto se ve reflejado en el incremento de las enfermedades crónicas no transmisibles, además de un mayor consumo de agentes para pérdida de peso. Objetivo. Encontrar la relación entre el consumo de productos adelgazantes, el sobrepeso y la obesidad en profesores de una universidad privada de Puebla, México. Materiales y métodos. Se realizó un diseño no experimental, transversal descriptivo, utilizando un muestreo probabilístico aleatorio simple, en el que participaron 100 profesionistas; 27 hombres y 73 mujeres. Se aplicó un cuestionario para conocer los hábitos, el consumo de agentes para pérdida de peso, además de mostrárseles modelos anatómicos que determinaron la percepción de la persona con su cuerpo. Finalmente se realizó la medición antropométrica y se obtuvo el cálculo de su índice de masa corporal (IMC). Resultados. El 45% de las personas involucradas presentan sobrepeso y obesidad.38% consumen productos para bajar de peso; de estos, 84,2% eran mujeres. Entre mayor índice de masa corporal (IMC) mayor consumo de productos para bajar de peso (p<0.05). Se observa una relación inversa entre mayor obesidad y menor número de comidas al día, a la par con un menor número de horas de ejercicio. Finalmente, la mayoría de las personas con sobrepeso se perciben con un IMC mayor. Conclusión. El consumo de agentes para pérdida de peso se relaciona con el incremento del sobrepeso y la obesidad en los profesionistas.
Background. Current tendencies in obesity and overweight in México shows a significant increase in the last National Nutrition and Health Surveys, which is reflected in the rise of chronic non-transmissible diseases and an increase of anti-obesity drugs. Objective. Find the relationship between the consumption of anti-obesity drugs, overweight and obesity in teachers at a private university of Puebla city, in Mexico. Materials and methods. This is a non-experimental, cross-sectional descriptive design, where a simple random probability sampling was used. 100 professional workers at a private university of Puebla city participated, 27 men and 73 women. It was applied a test to each one of them, in order to identify their habits and consume of anti-obesity drugs. Anatomical models were presented to the participants to determinate their self-perception of body image. Finally anthropometric measures were done and body mass index was calculated. Results. 45% of participants presented overweight and obesity; 38% consume anti-obesity drugs, of these, 84.2% are women. It was observed that higher body mass index (BMI) gives a higher consume of anti-obesity drugs (p<0.05). It was determined an inversed relationship between a higher obesity degree and a lower number of meals a day, correlated also with a lower number of exercise hours. Finally people with a healthy BMI, have adequate self-perception of body image and the majority of people with overweight, perceived themselves with a higher BMI. Conclusions. The consumption of anti-obesity drugs is related to the increase of overweight and obesity in professional workers.
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BACKGROUND: The Sertoli and Leydig cell tumor is an unusual neoplasm that belongs to the sex cord-stromal tumors. Generally these tumors are associated with good prognosis. These tumors usually present virilizing symptoms such as oligomenorrhea or amenorrhea, hirsutism, voice raucity, laryngeal protuberance and clitoromegaly. CASE PRESENTATION: A 12 year old girl referred acute abdominal pain with no other clinical manifestations. An abdominal ultrasound showed a semisolid mass suggestive of ovarian tumor. The diagnosis was confirmed by a computed tomography. A unilateral salpingo oophorectomy was performed and the pathologist reported a Sertoli-Leydig tumor with intermediate differentiation. The outcome was excellent. CONCLUSIONS: These tumors represent a rare condition in children. However, they can occur at any age, therefore it is important to acknowledge the clinical manifestations, diagnostic approach and therapeutic options. In this case the patient presented unusual symptoms which makes it more interesting.
Assuntos
Neoplasias Ovarianas/patologia , Tumor de Células de Sertoli-Leydig/patologia , Dor Abdominal/etiologia , Criança , Feminino , Humanos , Neoplasias Ovarianas/cirurgia , Ovariectomia , Salpingectomia , Tumor de Células de Sertoli-Leydig/cirurgiaRESUMO
BACKGROUND: As a first step in the prevention of diabetes, the International Diabetes Federation recommends identification of persons at risk using the Finnish type 2 Diabetes Risk Assessment (FINDRISC) survey. The frequency of diabetes mellitus, impaired fasting glucose, and glucose intolerance in high-risk groups identified by FINDRISC is unknown in our country. The aim of this study was to determine the frequency of diabetes mellitus, impaired fasting glucose, and glucose intolerance in higher-risk groups using a FINDRISC survey in an urban population. METHODS: We used a television program to invite interested adults to fill out a survey at a television station. An oral glucose tolerance test was performed in all persons with a FINDRISC score ≥ 15 points (high-risk and very high-risk groups). Patients were classified as normal (fasting glucose < 100 mg/dL and 2-hour glucose < 140 mg/dL), or having impaired fasting glucose (fasting glucose 100-125 mg/dL and 2-hour glucose < 140 mg/dL), glucose intolerance (fasting glucose < 126 mg/dL and 2-hour glucose 140-199 mg/dL), and diabetes mellitus (fasting glucose ≥ 126 mg/dL or 2-hour glucose ≥ 200 mg/dL). We describe the frequency of each diagnostic category in this selected population according to gender and age. RESULTS: A total of 186 patients had a score ≥ 15. The frequencies of diabetes mellitus, impaired fasting glucose, glucose intolerance, and normal glucose levels were 28.6%, 25.9%, 29.2%, and 16.2%, respectively. We found a higher frequency of diabetes mellitus and impaired fasting glucose in men than in women (33% versus 27% and 40% versus 21%, respectively) and more glucose intolerance in women than in men (34% versus 16%, P < 0.05). Patients with diabetes mellitus (52.55 ± 9.2 years) were older than those with impaired fasting glucose (46.19 ± 8.89 years), glucose intolerance (46.15 ± 10.9 years), and normal levels (41.9 ± 10.45 years, P < 0.05). We found a higher frequency of diabetes mellitus in those aged over 50 years than in younger subjects (46.15% versus 15.88%, respectively). CONCLUSION: The FINDRISC survey is a very useful tool for identifying individuals at high risk of developing diabetes and prediabetic states, especially in those older than 50 years.
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El sistema inmunológico está capacitado para reconocer lo propio y lo no propio, por el cual, la pregunta ¿por qué el feto no es rechazado?, ha causado curiosidad. Actualmente se sabe que durante el embarazo existen modificaciones fisiológicas tanto en la inmunidad innata como en la adaptativa que le permiten al feto desarrollarse sin ser agredido por la respuesta inmune de la madre y al mismo tiempo le permiten a la madre continuar protegida contra los invasores del medio. Estos cambios que se manifiestan en el sistema inmune son consecuencia de las variaciones hormonales asociadas a la gestación, como consecuencia las células del sistema inmune y la liberación de citocinas es diferente en cada trimestre del embarazo, además también ahora se sabe que la participación de estas citocinas son esenciales en la implantación del feto, así como en los procesos patológicos asociados al embarazo como preeclampsia y abortos espontáneos.
Immunologic system is able to recognize the own and the non-own, therefore the curious question: Why the fetus is not rejected? Nowadays, it is known that during pregnancy there are physiological modifications about the innate immunity as in the adaptive one allowing fetus to develop without any aggression by the immune response of the mother against the environment aggressors. These changes manifesting in the immunologic system are consequences of hormonal variations associated with pregnancy due to the immunologic system cells and the release of cytokines is different in each trimester of pregnancy, now it is possible to know that the involvement of these cytokines is essential in the implantation of fetus, as well as in pathological processes associated with pregnancy including the pre-eclampsia and the spontaneous abortions.
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In recent years the survival of patients with systemic lupus erythematosus has increased markedly. Consequently, long-term complications, such as osteoporosis, are currently of paramount importance. SLE is known to increase the risk of bone fractures, and numerous studies have found that SLE patients have osteoporosis. Of the various risk factors associated with osteoporosis in SLE, disease duration, the use of corticosteroids and chronic disease-related damage are consistently reported, with differences between studies probably due to the different populations studied. The role of chronic inflammation in osteoporosis is also important. On the other hand, little attention has been paid to osteoporotic fractures, especially of the vertebra, which are associated with reduced quality of life, increased mortality rates and increased risk of new vertebral and non-vertebral fractures in the general population.