Introducción: La obesidad es una enfermedad que se ha convertido en una preocupación importante de salud pública. El objetivo de esta investigación, fue analizar los cambios en la calidad de vida y ...en parámetros clínicos, fisiológicos y antropométricos en pacientes con obesidad, pertenecientes a un programa multidisciplinario para pérdida de peso.
Materiales y métodos: Estudio observacional de cohorte retrospectivo que incluyó pacientes con obesidad en un programa multidisciplinario. La comparación de variables cuantitativas al ingreso y egreso del programa se realizó con la prueba de rangos con signo de Wilcoxon, mientras que las variables cualitativas fueron comparadas con la prueba de McNemar. El análisis estadístico fue realizado en el programa STATA V.15.
Resultados: Se analizaron 323 pacientes, se observó que la mediana del peso disminuyo 4.4 kg (p<0.001). La adherencia a la actividad física aumentó de 30% (n=97) a 90% (n=289) (p<0.001). De igual modo, la mediana del VO2 max aumentó de 23.6 (RIC 19.7-30.4) al ingreso a 32.9 (RIC 27.8-38) al egreso. En cuanto a calidad de vida, el autocuidado fue una de las dimensiones con mayor impacto durante el programa, con una disminución en el reporte de dificultades extremas de 17.7% a 0.3%. Asimismo, la escala visual análoga (EVA) aumento la mediana de 50 (RIC 50-70) a 80 (RIC 70-90) (p<0.001).
Conclusión: El abordaje multidisciplinario de la obesidad ofrece un enfoque integral al paciente, impactando no solo aspectos físicos, sino psicológicos y emocionales del problema mejorando su calidad de vida.
Introduction: Obesity is a disease that has become a major public health concern. The objective of this research was to analyze the changes in the quality of life and in clinical, physiological, and anthropometric parameters in patients with obesity, belonging to a multidisciplinary program for weight loss.
Materials and methods: Observational retrospective cohort study that included obese patients in a multidisciplinary program. The comparison of quantitative variables at admission and discharge from the program was performed with the Wilcoxon signed rank test, while the qualitative variables were compared with the McNemar test. Statistical analysis was performed in the STATA V.15 program.
Results: 323 patients were analyzed; it was shown that the median weight decreased 4.4 kg (p<0.001). Adherence to physical activity increased from 30% (n=97) to 90% (n=289) (p<0.001). Similarly, the median VO2 max increased from 23.6 (IQR 19.7-30.4) on admission to 32.9 (IQR 27.8-38) on discharge. Regarding quality of life, self-care was one of the dimensions with the greatest impact during the program, with a decrease in the report of extreme difficulties from 17.7% to 0.3%. Likewise, the visual analogue scale (VAS) increased the median from 50 (RIC 50-70) to 80 (RIC 70-90) (p<0.001).
Conclusion: The multidisciplinary approach to obesity offers a comprehensive approach to the patient, impacting not only physical, but also psychological and emotional aspects of the problem, improving her quality of life.
Abstract
Background
Effective therapeutics for respiratory viruses are needed. Early data suggest that nitazoxanide (NTZ) may be beneficial for treating acute respiratory viral illness.
Methods
From ...March 2014 through March 2017, a double-blind, placebo-controlled trial was conducted in 260 participants ≥1 year old hospitalized with influenza-like illness at 6 hospitals in Mexico. Participants were randomized 1:1 to NTZ (age ≥12 years, 600 mg twice daily; age 4–11 years and 1–3 years, 200 or 100 mg twice daily, respectively) or placebo for 5 days in addition to standard of care. The primary endpoint was time from first dose to hospital discharge. Influenza reverse-transcription polymerase chain reaction and Respifinder 22 multiplex test were used for virus detection.
Results
Of 260 participants enrolled, 257 were randomized and took at least 1 dose of study treatment (intention-to-treat population): 130 in the NTZ group and 127 in the placebo group. The Kaplan-Meier estimate of the median duration of hospitalization was 6.5 (interquartile range IQR, 4.0–9.0) days in the NTZ group vs 7.0 (IQR, 4.0–9.0) days in the placebo group (P = .56). Duration of hospitalization between the 2 treatments was similar in children (P = .29) and adults (P = .62), influenza A and B (P = .32), and other respiratory viruses. Seven (5.4%) and 6 (4.7%) participants in the NTZ and placebo groups, respectively, reported serious adverse events.
Conclusions
Treatment with NTZ did not reduce the duration of hospital stay in severe influenza-like illness. Further analyses based on age and evaluations by virus did not reveal any subgroups that appeared to benefit from NTZ.
Clinical Trials Registration
NCT02057757.
Treatment of children and adults hospitalized with severe acute respiratory illness with nitazoxanide in addition to standard of care was safe, but did not reduce hospital stay, complications, nor shedding of influenza and other respiratory viruses.
Background and Aims FLT3-ITD mutations in acute myeloid leukemia (AML) are associated with a poor prognosis. In Latin America, little epidemiological data exist about these mutations and their ...influence on clinical evolution and prognosis. Standardization and well-established clinical correlation make FLT3 mutational analysis by molecular methods an invaluable tool to decide among treatment options and to determine AML prognosis. Methods We assessed the prevalence of FLT3-ITD mutations in 138 patients with AML at four hematology referral centers from Mexico and Colombia. Molecular methods based on polymerase chain reaction (PCR) were employed for determining FLT3-ITD status. Results Mutations were present in 28 patients indicating a prevalence of 20.28%. Median age was 47 years (5–96). The FLT3 mutation positive group was older, had higher WBC and hemoglobin values and lower platelet counts but without statistical significance. A not previously described mutation in the FLT3 gene was found in one patient involving a nucleotide exchange of timine for cytosine at the 66608 position. A high mortality was found in the FLT3-mutated group, 67.8 vs. 42.72% in the non-mutated group and median survival was 4.9 months vs. 20.4 months, p = 0.009. A mutated FLT3 did not confer poor prognosis to those with M3 AML. The mutated FLT3 population had poor overall survival (OS) despite hematoprogenitor stem cell transplantation (HSCT). Conclusion Prevalence of FLT3-ITD mutation in AML was present in a proportion comparable to other populations and, when present, was associated with a very poor prognosis.
Resumen: Introducción: la obesidad es una enfermedad que se ha convertido en una preocupación importante de salud pública. El objetivo de esta investigación, fue analizar los cambios en la calidad de ...vida y en los parámetros clínicos, fisiológicos y antropométricos en los pacientes con obesidad, pertenecientes a un programa multidisciplinario para pérdida de peso. Materiales y métodos: estudio observacional de cohorte retrospectivo que incluyó pacientes con obesidad en un programa multidisciplinario. La comparación de las variables cuantitativas al ingreso y egreso del programa se realizó con la prueba de rangos con signo de Wilcoxon, mientras que las variables cualitativas fueron comparadas con la prueba de McNemar. El análisis estadístico fue realizado en el programa STATA V.15. Resultados: se analizaron 323 pacientes, se observó que la mediana del peso disminuyó 4,4 kg (p < 0,001). La adherencia a la actividad física aumentó de 30% (n = 97) a 90% (n = 289) (p < 0,001). De igual modo, la mediana del VO2 max aumentó de 23,6 (RIC 19,7-30,4) al ingreso a 32,9 (RIC 27,8–38,0) al egreso. En cuanto a la calidad de vida, el autocuidado fue una de las dimensiones con mayor impacto durante el programa, con una disminución en el reporte de dificultades extremas de 17,7% a 0,3%. Asimismo, la escala visual análoga (EVA) aumento la mediana de 50 (RIC 50-70) a 80 (RIC 70-90) (p < 0,001). Conclusión: el abordaje multidisciplinario de la obesidad ofrece un enfoque integral al paciente, impactando no solo los aspectos físicos, sino psicológicos y emocionales del problema mejorando su calidad de vida. Abstract: Introduction: Obesity is a disease that has become a major public health concern. The objective of this research was to analyze the changes in the quality of life and in clinical, physiological, and anthropometric parameters in patients with obesity, belonging to a multidisciplinary program for weight loss. Materials and methods: Observational retrospective cohort study that included obese patients in a multidisciplinary program. The comparison of quantitative variables at admission and discharge from the program was performed with the Wilcoxon signed rank test, while the qualitative variables were compared with the McNemar test. Statistical analysis was performed in the STATA V.15 program. Results: 323 patients were analyzed; it was shown that the median weight decreased 4.4 kg (p < 0.001). Adherence to physical activity increased from 30% (n = 97) to 90% (n = 289) (p < 0.001). Similarly, the median VO2 max increased from 23.6 (IQR 19.7-30.4) on admission to 32.9 (IQR 27.8-38) on discharge. Regarding quality of life, self-care was one of the dimensions with the greatest impact during the program, with a decrease in the report of extreme difficulties from 17.7% to 0.3%. Likewise, the visual analogue scale (VAS) increased the median from 50 (RIC 50-70) to 80 (RIC 70-90) (p < 0.001). Conclusion: The multidisciplinary approach to obesity offers a comprehensive approach to the patient, impacting not only physical, but also psychological and emotional aspects of the problem, improving her quality of life.
Since the early 2000’s, the Atlas of Variations in Medical Practice in the Spanish National Health System (namely, Atlas VPM) has been analysing and informing unwarranted variations in health care ...provision and outcomes in the Spanish Health System.
Atlas VPM covers a two-fold perspective: a geographic one, where unwarranted variations would reflect the uneven exposure of the population to health care as a consequence of the place of residence; and, a provider-specific approach, where unwarranted variations would reflect differences in utilisation and outcomes that are at provider-level.
Building on routine data (hospital and primary care electronic records, administrative data, geographic information, etc.) Atlas VPM has adapted the classical small area methods and has included a large panoply of techniques, such as Bayesian methods, hierarchical modelling or time-series forecasting.
Led by the Data Science for Health Services and Policy Research group at the Institute for Health Sciences in Aragon, Atlas VPM implies a linkage and exchange process with the 17 Departments of Health of the Spanish regions where the research agenda is shared and research outcomes are translated into profiling and benchmarking interactive tools meant to facilitate clinical and policy decision-making.
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