Factores que inciden en la inasistencia al tratamiento antituberculoso. Pereira, 2007

Introducción: la tuberculosis es una enfermedad infecciosa que se transmite en forma directa; y en la actualidad es un grave problema de salud pública; por tanto, se hace necesario canalizar esfuerzos hacia la implementación de estrategias de mejoramiento para la adherencia de los usuarios al tratamiento antituberculoso en IPS públicas de Pereira, minimizando la probabilidad de resistencia al tratamiento convencional, siendo prioritario para ello conocer los factores que inciden en la inasistencia al tratamiento antituberculoso en Pereira. Métodos: estudio descriptivo, correlacional, retrospectivo y transversal, donde la población objeto fueron 37 usuarios, correspondientes al número total de inasistentes al tratamiento antituberculoso año 2007, de los cuales sólo a 11 fue posible aplicar la encuesta. Resultados: el 73% de los usuarios recibió educación acerca de la importancia en la continuidad del tratamiento; el 27% restante no la había recibido. El 64% de las personas contaban con los recursos suficientes para garantizar su desplazamiento al Centro de Salud, mientras que el 27% ocasionalmente disponían de recursos para su desplazamiento; 9% de ellos no contaban con ese recurso. El 9% de los pacientes presentaron reacciones adversas que motivaron su inasistencia. Conclusiones: las personas con tuberculosis sienten temor a ser estigmatizados o rechazados por la sociedad, factor éste que los obliga a suministrar datos incorrectos de ubicación; igualmente se observa falta de compromiso por parte del personal de salud, al consignar información de ubicación del paciente, registrando datos ilegibles e incompletos, que obstaculizan su localización posterior. AbstractFacto rs which affect the antituberculosis treatment asistant , Pereira, 2007Introduction: tuberculosis is an infective disease which is transmitted on a direct way and it is a serious health problem nowadays; for this reason, is necessary to canalize efforts towards the implementation of strategies to improve and motivate the users to take the antituberculosis treatment in the public IPS in Pereira, reducing the resistant probability to the conventional treatment, being in priority for this, to identify the factors which influence in the no assistant to the antituberculosis treatment in Pereira. Methods: descriptive study, correlated, retrospective y transverse, where the objective population of study were 37 users corresponding to the total number of unassitants to the tuberculosis treatment during 2007 from the mentioned, it was just possible to apply the survey to 11. Results: 73% of the users received education about the importance of a continuous treatment, the remaining 27% haven`t gotten it. The 64% of people with enough resources guarantee their movement to the health center, while the 27% occasionally have the resources to the movement and the 9% of them couldn`t make it. The 9% of the patients presented adverse reactions which motivated their missing. Conclusions: people with tuberculosis are scared of being stigmatized or rejected by the society, this factor makes them give wrong placing information; on the other hand it`s been observed the lack of compromise by the health employees at the moment of registering the information of the patient location, registering illegible and incomplete information, which obstaculizes further location. Keywords: Tuberculosis, treatment, unassistant, factors, health services, users

Factores que inciden en la inasistencia al tratamiento antituberculoso. Pereira, 2007

Introducción: la tuberculosis es una enfermedad infecciosa que se transmite en forma directa; y en la actualidad es un grave problema de salud pública; por tanto, se hace necesario canalizar esfuerzos hacia la implementación de estrategias de mejoramiento para la adherencia de los usuarios al tratamiento antituberculoso en IPS públicas de Pereira, minimizando la probabilidad de resistencia al tratamiento convencional, siendo prioritario para ello conocer los factores que inciden en la inasistencia al tratamiento antituberculoso en Pereira. Métodos: estudio descriptivo, correlacional, retrospectivo y transversal, donde la población objeto fueron 37 usuarios, correspondientes al número total de inasistentes al tratamiento antituberculoso año 2007, de los cuales sólo a 11 fue posible aplicar la encuesta. Resultados: el 73% de los usuarios recibió educación acerca de la importancia en la continuidad del tratamiento; el 27% restante no la había recibido. El 64% de las personas contaban con los recursos suficientes para garantizar su desplazamiento al Centro de Salud, mientras que el 27% ocasionalmente disponían de recursos para su desplazamiento; 9% de ellos no contaban con ese recurso. El 9% de los pacientes presentaron reacciones adversas que motivaron su inasistencia. Conclusiones: las personas con tuberculosis sienten temor a ser estigmatizados o rechazados por la sociedad, factor éste que los obliga a suministrar datos incorrectos de ubicación; igualmente se observa falta de compromiso por parte del personal de salud, al consignar información de ubicación del paciente, registrando datos ilegibles e incompletos, que obstaculizan su localización posterior. AbstractFacto rs which affect the antituberculosis treatment asistant , Pereira, 2007Introduction: tuberculosis is an infective disease which is transmitted on a direct way and it is a serious health problem nowadays; for this reason, is necessary to canalize efforts towards the implementation of strategies to improve and motivate the users to take the antituberculosis treatment in the public IPS in Pereira, reducing the resistant probability to the conventional treatment, being in priority for this, to identify the factors which influence in the no assistant to the antituberculosis treatment in Pereira. Methods: descriptive study, correlated, retrospective y transverse, where the objective population of study were 37 users corresponding to the total number of unassitants to the tuberculosis treatment during 2007 from the mentioned, it was just possible to apply the survey to 11. Results: 73% of the users received education about the importance of a continuous treatment, the remaining 27% haven`t gotten it. The 64% of people with enough resources guarantee their movement to the health center, while the 27% occasionally have the resources to the movement and the 9% of them couldn`t make it. The 9% of the patients presented adverse reactions which motivated their missing. Conclusions: people with tuberculosis are scared of being stigmatized or rejected by the society, this factor makes them give wrong placing information; on the other hand it`s been observed the lack of compromise by the health employees at the moment of registering the information of the patient location, registering illegible and incomplete information, which obstaculizes further location. Keywords: Tuberculosis, treatment, unassistant, factors, health services, users

Failures of 13-Valent Conjugated Pneumococcal Vaccine in Age-Appropriately Vaccinated Children 2-59 Months of Age, Spain

Vaccination with the 13-valent conjugated pneumococcal disease (PCV13) has reduced invasive pneumococcal disease (IPD), but there have been reports of vaccine failures. We performed a prospective study in children aged 2-59 months who received diagnoses of IPD during January 2012-June 2016 in 3 pediatric hospitals in Catalonia, Spain, a region with a PCV13 vaccination coverage of 63%. We analyzed patients who had been age-appropriately vaccinated but who developed IPD caused by PCV13 serotypes. We detected 24 vaccine failure cases. The serotypes involved were 3 (16 cases); 19A (5 cases); and 1, 6B, and 14 (1 case each). Cases were associated with children without underlying conditions, with complicated pneumonia (OR 6.65, 95% CI 1.91-23.21), and with diagnosis by PCR (OR 5.18, 95% CI 1.84-14.59). Vaccination coverage should be increased to reduce the circulation of vaccine serotypes. Continuous surveillance of cases of IPD using both culture and PCR to characterize vaccine failures is necessary

Effectiveness of the 13-valent pneumococcal conjugate vaccine in preventing invasive pneumococcal disease in children aged 7-59 months. A matched case-control study

Background The 13-valent pneumococcal conjugate vaccine (PCV13) was licensed based on the results of immunogenicity studies and correlates of protection derived from randomized clinical trials of the 7-valent conjugate pneumococcal vaccine. We assessed the vaccination effectiveness (VE) of the PCV13 in preventing invasive pneumococcal disease (IPD) in children aged 7-59 months in a population with suboptimal vaccination coverage of 55%. Methods The study was carried out in children with IPD admitted to three hospitals in Barcelona (Spain) and controls matched by hospital, age, sex, date of hospitalization and underlying disease. Information on the vaccination status was obtained from written medical records. Conditional logistic regression was made to estimate the adjusted VE and 95% confidence intervals (CI). Results 169 cases and 645 controls were included. The overall VE of ≥1 doses of PCV13 in preventing IPD due to vaccine serotypes was 75.8% (95% CI, 54.1-87.2) and 90% (95% CI, 63.9-97.2) when ≥2 doses before 12 months, two doses on or after 12 months or one dose on or after 24 months, were administered. The VE of ≥1 doses was 89% (95% CI, 42.7-97.9) against serotype 1 and 86.0% (95% CI, 51.2-99.7) against serotype 19A. Serotype 3 showed a non-statistically significant effectiveness (25.9%; 95% CI, -65.3 to 66.8). Conclusions The effectiveness of ≥1 doses of PCV13 in preventing IPD caused by all PCV13 serotypes in children aged 7-59 months was good and, except for serotype 3, the effectiveness of ≥1 doses against the most frequent PCV13 serotypes causing IPD was high when considered individually

Impact of the 13-valent conjugated pneumococcal vaccine on the direct costs of invasive pneumococcal disease requiring hospital admission in children aged < 5 years. A prospective study

The lack of invasive pneumococcal disease (IPD) cost studies may underestimate the effect of pneumococcal polysaccharide conjugated vaccines (PCV). The objective of this study was to estimate the direct costs of hospitalized IPD cases. A prospective study was made in children aged <5 years diagnosed with IPD in two high-tech hospitals in Catalonia (Spain) between 2007-2009 (PCV7 period) and 2012-2015 (PCV13 period). Costs were calculated according to 2014 Catalan Health Service rates using diagnostic-related groups. In total, 319 and 154 cases were collected, respectively. Pneumonia had the highest cost (65.7% and 62.0%, respectively), followed by meningitis (25.8% and 26.1%, respectively). During 2007-2015, the costs associated with PCV7 serotypes (Pearson coeffcient (Pc) = 0.79; p = 0.036) and additional PCV13 serotypes (Pc = 0.75; p = 0.05) decreased, but those of other serotypes did not (Pc = 0.23 p = 0.62). The total mean cost of IPD increased in the PCV13 period by 31.4% (¿3016.1 vs. ¿3963.9), mainly due to ICU stay (77.4%; ¿1051.4 vs. ¿1865.6). During the PCV13 period, direct IPD costs decreased due to a reduction in the number of cases, but cases were more severe and had a higher mean cost. During 2015, IPD costs increased due to an increase in the costs associated with non-PCV13 serotypes and serotype 3 and this requires further investigation

Mutational spectrum in a worldwide study of 29,700 families with BRCA1 or BRCA2 mutations.

The prevalence and spectrum of germline mutations in BRCA1 and BRCA2 have been reported in single populations, with the majority of reports focused on White in Europe and North America. The Consortium of Investigators of Modifiers of BRCA1/2 (CIMBA) has assembled data on 18,435 families with BRCA1 mutations and 11,351 families with BRCA2 mutations ascertained from 69 centers in 49 countries on six continents. This study comprehensively describes the characteristics of the 1,650 unique BRCA1 and 1,731 unique BRCA2 deleterious (disease-associated) mutations identified in the CIMBA database. We observed substantial variation in mutation type and frequency by geographical region and race/ethnicity. In addition to known founder mutations, mutations of relatively high frequency were identified in specific racial/ethnic or geographic groups that may reflect founder mutations and which could be used in targeted (panel) first pass genotyping for specific populations. Knowledge of the population-specific mutational spectrum in BRCA1 and BRCA2 could inform efficient strategies for genetic testing and may justify a more broad-based oncogenetic testing in some populations

DNA Glycosylases Involved in Base Excision Repair May Be Associated with Cancer Risk in BRCA1 and BRCA2 Mutation Carriers

Peer reviewe

Actitudes de la parturienta frente al protocolo de atención hospitalaria, en una clínica de maternidad durante los meses de febrero a mayo, Cartagena 2008

Trabajo de Investigación -- Universidad de Cartagena. Facultad de Enfermería, 2008Este trabajo de investigación tiene como objetivo identificar las diferentes actitudes de la parturienta frente al protocolo de atención en una clínica de maternidad en cartagena durante los meses de febrero a mayo del 200

Degradación del colorante Rojo Punzó por medio de lodos anaerobios

The presence of colored liquid effluents generated deterioration in the quality of watersources that receive disfavoring its aesthetic characteristics, sensory and presence of fish fauna due to interference with the entrance leading to natural light so that the primary productivity in these ecosystems, thus deteriorate the links in the food chain and loss of biodiversity is therefore, important initiatives to reduce the demand for environmental goods and services also environmental liabilities around the discharges colored in this way, through the study of degradation of the red dye Ponceau aims to address and improve the technical and scientific environment to the effluent treatment in the presence of azo dyessuch as Ponceau red. This study determined the anaerobic biodegradability of PonceauRed dye using microbial counts.La presencia de vertimientos líquidos con contenidos de colorantes ha generado deterioro en la calidad del agua de las fuentes que reciben estas descarga, desfavoreciendo sus características estéticas, organolépticas y la presencia de fauna íctica debido a las interferencias que provocan con el ingreso luz natural para que se de la productividad primaria en estos ecosistemas, de esta forma se deterioran los eslabones en la cadena trófica y la pérdida de biodiversidad; es por ello, que es importante las iniciativas para disminuir la demanda de bienes y servicios ambientales, además, de los pasivos ambientales entorno a los vertimientos coloreados, de esta forma, mediante este estudio de degradación del colorante rojo Punzó se pretende dar solución e incrementar la capacidad técnica y científica entorno al tratamiento de efluentes con presencia de colorantes azoicos como es el caso del rojo Punzó. El presente trabajo determinó la biodegradabilidad anaerobia del colorante Rojo Punzó empleando recuentos microbianos

The incorporation of biophysical and social components in coastal management

Change is inherent in coastal systems, which are amongst the most dynamic ones on Earth. Increasing anthropogenic pressure on coastal zones interferes with natural coastal dynamics and can cause ecosystem imbalances that render the zones less stable. Furthermore, human occupation of coastal zones often requires an uncharacteristic degree of stability for these inherently dynamic coastal systems. Coastal management teams face multifaceted challenges in protecting, rehabilitating and conserving coastal systems. Diverse monitoring schemes and modelling tools have been developed to address these challenges. In this article, we explore various perspectives: the integration of biophysical, ecological and social components; the uncertainties of diverse data sources; and the development of flexible coastal interventions. We propose general criteria and guidance for an Ecosystem-based Management (EbM) to coastal management, which aims primarily at adaptation to global change and uncertainties, and to managing and integrating social aspects and biophysical components based on the flows of energy and matter