Introducción: La prueba de Papanicolau ayuda a detectar de manera oportuna en la intervención de rutina el cáncer de cuello uterino. Objetivo: Analizar factores asociados al tamizaje para cáncer de ...cuello uterino en mujeres de 12 a 49 años en Perú durante el año 2019. Metodología: Se realizó un estudio observacional, analítico-transversal de un análisis secundario de datos de la Encuesta Demográfica y de Salud Familiar del 2019. Muestreo bietápico, probabilístico, equilibrado y estratificado. Se utilizó estadística descriptiva y analítica (nivel de inferencia p<0,05). Para el análisis bivariado y multivariado se utilizaron razones de prevalencia con intervalo de confianza de 95 % y p<0,05. Resultados: La frecuencia de tamizaje de cáncer de cuello uterino en las regiones políticas con menores valores de prevalencia fueron Pasco (0,52 %) y Tumbes (0,55 %). Discusión: Los factores asociados al tamizaje de cáncer de cuello uterino son la edad, tener pareja, nivel educación superior, nivel socioeconómico pobre, residir en área rural, tener seguro de salud, edad de inicio de relaciones sexuales y haber escuchado del cáncer de cuello uterino.
Introducción: Los pacientes con el fenotipo delgado metabólicamente obeso (DMO) pueden presentar el mismo riesgo que los obesos clásicos para desarrollar enfermedades crónicas a largo plazo. No ...obstante, la prevalencia y los factores que se encuentran asociados este varía de acuerdo con la población estudiada. Objetivo: determinar la prevalencia y los factores se encuentran asociados al fenotipo DMO en el Perú. Métodos: Estudio analítico de corte transversal. Análisis secundario de la base de datos del estudio PERU MIGRANT. Los factores asociados que se consideraron fueron: edad (30-44 años, de 45-59 años, y 60 a más años), sexo, estado socioeconómico, nivel de educación, migración, tabaquismo, consumo de alcohol y nivel actividad física. Resultados: La prevalencia del fenotipo DMO fue de 32,23% (IC95% 27,61-37,10). En el análisis multivariable, el sexo masculino mostró 39% menor probabilidad de presentar el fenotipo DMO (PRa: 0,610; IC95% 0,428-0,869; p=0,006), en comparación con el sexo femenino. Mientras que, pertenecer a los grupos de edad entre 45-59 años y de 60 años a más presentó 110,5% (PRa: 2,105; IC95% 1,484-2,988; p<0,001) y 97,6% (PRa: 1,976; IC95% 1,270-3,075; p=0,003), respectivamente, mayor probabilidad de presentar DMO, en comparación con el grupo de 29-44 años. Conclusiones: El pertenecer al sexo femenino y a los grupos de edad de 45 a 59 y 60 años a más, aumentaron la probabilidad de presentar el fenotipo DMO. Se recomienda la realización de futuros estudios con prospectivos y con un tamaño de muestra mayor para confirmar dichos hallazgos, así como la inclusión de nuevas variables.
Introducción: La nutrición adecuada, dejar de fumar y beber alcohol son medidas preventivas y de tratamiento, ayudan a prevenir complicaciones de la enfermedad por reflujo gastroesofágico. Sin ...embargo, aún existen dudas sobre la intensidad de la actividad física y sus beneficios en el desarrollo de la enfermedad. Objetivo: Determinar la asociación entre la actividad física y la enfermedad por reflujo gastroesofágico en una muestra de pobladores peruanos. Metodología: Estudio transversal analítico con el uso base de datos secundarias del estudio COHORT CRONICAS. La variable principal fue la presencia o no de enfermedad por reflujo gastroesofágico, lo cual se determinó a través de un autoinforme por diagnóstico médico. La variable independiente fue actividad física, cuyos niveles fueron definidos de acuerdo con el protocolo del cuestionario internacional de actividad física, este se dicotomizó la variable en “bajo” y “medio/alto”. Resultados: Se trabajó con un total de 3211 sujetos. La prevalencia de reflujo gastroesofágico fue 4.48% y el 5.36% practicaba actividad física moderada/severa. En la regresión múltiple, se observó que los pacientes con actividad física baja tenían 391% mayor frecuencia de presentar reflujo gastroesofágico, respecto a quienes realizaban actividad física moderado/alta; se ajustó las covariables: sexo, edad, estatus socioeconómico, estado de fumador, bebedor de alcohol, actividad física e índice de masa corporal (RP=4.91; IC95%: 1.19 – 20.23). Conclusiones: El estudio mostró que la actividad física de intensidad moderada/alta se asocia con una menor prevalencia de enfermedad por reflujo gastroesofágico. Si los resultados actuales se confirman en investigaciones futuras, los hallazgos de este estudio podrían ser importantes para la prevención y el tratamiento del reflujo gastroesofágico, a través de la intensidad de la actividad física.
El objetivo del estudio fue determinar el efecto reparador del suero autólogo en lesiones corneales de conejos producidas por agentes químicos. Se realizó un estudio piloto preclínico-experimental de ...caso-control con 10 unidades oculares obtenidas de cinco conejos. Las superficies corneales fueron lesionadas mediante abrasión quirúrgica controlada y posterior aplicación de alcohol al 70% o ácido sulfúrico pH 1 (ácido de batería). Los casos fueron tratados con suero autólogo y los controles con suero fisiológico. Se siguió la evolución con fluoresceína y registro fotográfico inmediatamente después de producida la lesión, y a las 24, 48 y 72 horas. Los conejos fueron sacrificados y se hizo la evaluación histopatológica de las córneas. Los casos mostraron reducción significativa del perímetro de la lesión y mayor transparencia (p<0.008). Se observó diferencia significativa con relación a la progresión y calidad de tejido en el área lesionada (p<0.05). La evaluación histológica mostró un tejido corneal más uniforme y organizado en los casos. Se concluye que el suero autólogo presentó un mayor beneficio frente al uso del placebo en lesiones corneales producidas por estos agentes químicos.
Background Antiphospholipid syndrome is defined by the combination of thrombotic events and/or obstetric morbidity in patients who have tested positive persistently for antiphospholipid antibodies. ...With good treatment, approximately 70% of pregnant women with antiphospholipid syndrome will deliver a viable live infant. However, current management does not prevent all maternal, fetal, and neonatal complications of antiphospholipid syndrome. Objectives This observational, retrospective, single-center cohort study aimed to assess pregnancy outcome in women with antiphospholipid antibodies who were treated with hydroxychloroquine in addition to conventional treatment during pregnancy. Study Design One-hundred seventy pregnancies in 96 women with persistent antiphospholipid antibodies were analyzed: (1) 51 pregnancies that occurred in 31 women were treated with hydroxychloroquine for at least 6 months before pregnancy, and the therapy continued throughout gestation (group A); (2) 119 pregnancies that occurred in 65 women with antiphospholipid antibodies that were not treated with hydroxychloroquine were included as controls (group B). Results Hydroxychloroquine-treatment was associated with a higher rate of live births (67% group A vs 57% group B; P = .05) and a lower prevalence of antiphospholipid antibodies–related pregnancy morbidity (47% group A vs 63% B; P = .004). The association of hydroxychloroquine with a lower rate of any complication in pregnancy was confirmed after multivariate analysis (odds ratio, 2.2; 95% confidence interval, 1.2–136; P = .04). Fetal losses at >10 weeks of gestation (2% vs 11%; P = .05) and placenta-mediated complications (2% vs 11%; P = .05) were less frequent in group A than group B. Pregnancy duration was longer in group A than group B (27.6 6-40 vs 21.5 6-40 weeks; P = .03). There was a higher rate of spontaneous vaginal labor in hydroxychloroquine-treated women compared with group B (37.3% vs 14.3%; P = .01). Conclusions Despite the heterogeneity in the 2 groups in terms of systemic lupus erythematosus prevalence and previous pregnancy history, our results support the concept that women with antiphospholipid antibodies may benefit from treatment with hydroxychloroquine during pregnancy to improve pregnancy outcome. The addition of hydroxychloroquine to conventional treatment is worthy of further assessment in a proper designed randomized controlled trial.
Activation of the renin–angiotensin system (RAS), renal oxidative stress and inflammation are constantly present in experimental hypertension. Nitric oxide (NO) inhibition with Nw-nitro-L-arginine ...methyl ester (L-NAME) has previously been reported to produce hypertension, increased expression of Angiotensin II (Ang II) and renal dysfunction. The use of Losartan, an Ang II type 1 receptor (AT1R) antagonist has proven to be effective reducing hypertension and renal damage; however, the mechanism by which AT1R blockade reduced kidney injury and normalizes blood pressure in this experimental model is still complete unknown. The current study was designed to test the hypothesis that AT1R activation promotes renal NAD(P)H oxidase up-regulation, oxidative stress and cytokine production during L-NAME induced-hypertension.
Male Sprague–Dawley rats were distributed in three groups: L-NAME, receiving 70mg/100ml of L-NAME, L-NAME+Los, receiving 70mg/100ml of L-NAME and 40mg/kg/day of Losartan; and Controls, receiving water instead of L-NAME or L-NAME and Losartan.
After two weeks, L-NAME induced high blood pressure, renal overexpression of AT1R, NAD(P)H oxidase sub-units gp91, p22 and p47, increased levels of oxidative stress, interleukin-6 (IL-6) and interleukin-17 (IL-17). Also, we found increased renal accumulation of lymphocytes and macrophages. Losartan treatment abolished the renal expression of gp91, p22, p47, oxidative stress and reduced NF-κB activation and IL-6 expression.
These findings indicate that NO induced-hypertension is associated with up-regulation of NADPH oxidase, oxidative stress production and overexpression of key inflammatory mediators. These events are associated with up-regulation of AT1R, as evidenced by their reversal with AT1R blocker treatment.
Treatment of low anterior resection syndrome (LARS) is challenging. Percutaneous tibial nerve stimulation (PTNS) can improve select bowel disorders. An RCT was conducted to assess the efficacy of ...PTNS compared with sham stimulation in patients with severe LARS.
This was a multicentre, double-blind RCT. Patients with major LARS score were allocated to receive PTNS or sham therapy (needle placement simulation without nerve stimulation). The study included 16 sessions of 30 min once a week for 12 consecutive weeks, followed by four additional sessions once a fortnight for the following 4 weeks. The primary endpoint was efficacy of PTNS defined by the LARS score 12 months after treatment. Secondary endpoints included faecal incontinence, quality of life (QoL), and sexual function.
Between September 2016 and July 2018, 46 eligible patients were assigned randomly in a 1 : 1 ratio to PTNS or sham therapy. Baseline characteristics were similar. LARS scores were reduced in both groups, but only patients who received PTNS maintained the effect in the long term (mean(s.d.) score 36.4(3.9) at baseline versus 30.7(11.5) at 12 months; P = 0.018; effect size -5.4, 95 per cent c.i. -9.8 to -1.0), with a mean reduction of 15.7 per cent at 12-month follow-up. The faecal incontinence score was improved after 12 months in the PTNS group (mean(s.d.) score 15.4(5.2) at baseline versus 12.5(6.4) at 12 months; P = 0.018). No major changes in QoL and sexual function were observed in either group. There was no therapy-associated morbidity. Three patients discontinued the study, but none owing to study-related issues.
PTNS has positive effects in some patients with major LARS, especially in those with faecal incontinence. Registration number: NCT02517853 (http://www.clinicaltrials.gov).
In the context of smart cities, there is a general benefit from monitoring close encounters among pedestrians. For instance, for the access control to office buildings, subway, commercial malls, ...etc., where a high amount of users may be present simultaneously, and keeping a strict record on each individual may be challenging. GPS tracking may not be available in many indoor cases; video surveillance may require expensive deployment (mainly due to the high-quality cameras and face recognition algorithms) and can be restrictive in case of low budget applications; RFID systems can be cumbersome and limited in the detection range. This information can later be used in many different scenarios. For instance, in case of earthquakes, fires, and accidents in general, the administration of the buildings can have a clear record of the people inside for victim searching activities. However, in the pandemic derived from the COVID-19 outbreak, a tracking that allows detecting of pedestrians in close range (a few meters) can be particularly useful to control the virus propagation. Hence, we propose a mobile clustering scheme where only a selected number of pedestrians (Cluster Heads) collect the information of the people around them (Cluster Members) in their trajectory inside the area of interest. Hence, a small number of transmissions are made to a control post, effectively limiting the collision probability and increasing the successful registration of people in close contact. Our proposal shows an increased success packet transmission probability and a reduced collision and idle slot probability, effectively improving the performance of the system compared to the case of direct transmissions from each node.
Food is medicine (FIM) initiatives are an emerging strategy for addressing nutrition-related health disparities increasingly endorsed by providers, payers, and policymakers. However, food insecurity ...screening protocols and oversight of medically-tailored food assistance programs are novel for many healthcare settings. Here, we describe the pre-implementation planning processes used to successfully engage federally-qualified health centers (FQHCs) across Kansas to develop new FIM initiatives. A Kansas-based philanthropic foundation facilitated pre-implementation planning for FQHCs over 17 months across 3 stages: 1) Community inquiry, 2) FIM learning event with invitation for FQHC attendees to request pre-implementation funding, and 3) Pre-implementation planning workshops and application assignments for FQHC grantees to develop a FIM implementation grant proposal. We evaluated satisfaction and perceived utility of these pre-implementation planning activities via post-workshop surveys and qualitative comparisons of FIM design components from pre-implementation and implementation grant applications. All 7 FQHCs attending the learning event applied for and were awarded pre-implementation planning grants; 6 submitted an implementation grant application following workshop completion. FQHCs rated pre-implementation support activities favorably; however, most clinics cited limited staff as a barrier to effective planning. As compared to pre-implementation planning grant proposals, all FQHCs elected to narrow their priority population to people with pre-diabetes or diabetes with better articulation of evidence-based nutrition prescriptions and intervention models in their final program designs. In the midst of a nationwide FIM groundswell, we recommend that funders, clinic stakeholders, and evaluators work together to devise and financially support appropriate pre-implementation planning activities prior to launching new FIM initiatives.
With the aim to determine the presence of individual nitro-PAH contained in particles in the atmosphere of Mexico City, a monitoring campaign for particulate matter (PM(10) and PM(2.5)) was carried ...out in Northern Mexico City, from April 2006 to February 2007. The PM(10) annual median concentration was 65.2μgm(-3) associated to 7.6μgm(-3) of solvent-extractable organic matter (SEOM) corresponding to 11.4% of the PM(10) concentration and 38.6μgm(-3) with 5.9μgm(-3) SEOM corresponding to 15.2% for PM(2.5). PM concentration and SEOM varied with the season and the particle size. The quantification of nitro-polycyclic aromatic hydrocarbons (nitro-PAH) was developed through the standards addition method under two schemes: reference standard with and without matrix, the former giving the best results. The recovery percentages varied with the extraction method within the 52 to 97% range depending on each nitro-PAH. The determination of the latter was effected with and without sample purification, also termed fractioning, giving similar results. 8 nitro-PAH were quantified, and their sum ranged from 111 to 819pgm(-3) for PM(10) and from 58 to 383pgm(-3) for PM(2.5), depending on the season. The greatest concentration was for 9-Nitroanthracene in PM(10) and PM(2.5), detected during the cold-dry season, with a median (10th-90th percentiles) concentration in 235pgm(-3) (66-449pgm(-3)) for PM(10) and 73pgm(-3) (18-117pgm(-3)) for PM(2.5). The correlation among mass concentrations of the nitro-PAH and criteria pollutants was statistically significant for some nitro-PAH with PM(10), SEOM in PM(10), SEOM in PM(2.5), NO(X), NO(2) and CO, suggesting either sources, primary or secondary origin. The measured concentrations of nitro-PAH were higher than those reported in other countries, but lower than those from Chinese cities. Knowledge of nitro-PAH atmospheric concentrations can aid during the surveillance of diseases (cardiovascular and cancer risk) associated with these exposures.
PDF
