Factores asociados a síntomas depresivos con importancia clínica en el postparto en adolescentes de Cartagena, Colombia

Objetivo: Establecer los factores asociados a síntomas depresivos con importancia clínica (SDIC) en el posparto en adolescentes de Cartagena (Colombia). Método: Se realizó un estudio analítico observacional transversal, con una muestra de puérperas adolescentes, con edades entre 10 y 19 años, captadas durante la cita de control a los siete días del posparto  en los centros de atención primaria de Cartagena durante 2012. La información fue recolectada con la Escala de Depresión Postparto de Edinburgh, la escala de Duke para apoyo social y el cuestionario de Apgar para funcionalidad familiar. Resultados: Participaron en el estudio 460 adolescentes; la edad media fue 16,6 años (DE=2,1); 49,6 % (228) de las adolescentes presentaron SDIC; el 44,3 % (204) presentó bajo apoyo social y el 67,2 % (309) tenía familias disfuncionales. Los SDIC se asociaron a bajo apoyo social (OR=2,4; IC95 % 1,4-4,7), bajo apoyo afectivo (OR=2,0; IC95 % 1,1-3,8) y bajo apoyo confidencial (OR=2,1; IC95 % 1,2-3,8). Conclusión: La presentación de síntomas depresivos con importancia clínica en el posparto adolescente se asocia a bajo apoyo social, bajo apoyo social afectivo y bajo apoyo social confidencial

Anthropometry, dietary intake, physical activity and sitting time patterns in adolescents aged 15-17 years; an interational comparison in eigth Latina American countries

Background: Although there is high prevalence of obesity and other cardiovascular risk factors among Latin American adolescents, there is limited evidence on dietary intake and physical activity (PA) patterns in this population. Therefore, we characterized anthropometry, dietary intake, PA and sitting time (ST) in adolescents aged 15-17 years from eight Latin American countries. Methods: Six hundred seventy-one adolescents (41.4% girls) from the Latin American Study of Nutrition and Health (ELANS) were included. Nutritional status was classified by four BMI (kg/m2) categories. Waist circumference (WC) was categorized as above or below thresholds. Dietary intake was assessed through two non-consecutive 24-h dietary recalls. PA and ST were measured using the International Physical Activity Questionnaire (IPAQ). We calculated overall and country-specific estimates by sex and tested for differences between boys and girls. Results: Differences in the prevalence of overweightness (15.1 and 21.6%) and obesity (8.5 and 6.5%) between boys and girls, respectively, were statistically insignificant (p = 0.059). Average energy intake was 2289.7 kcal/day (95% CI: 2231-2350) for boys and 1904.2 kcal/day (95% CI: 1840-1963) for girls (p 0.05 for all outcomes). There was no statistically significant difference in the prevalence of total energy (TE) saturated fat and added sugar (>10% of TE) between girls and boys (49.6% versus 44.8 and 81.7% versus 76.1%, respectively). Prevalence of physical inactivity was 19% in boys and 43.7% in girls (p 0.05). Conclusions: These findings highlight the high prevalence of poor dietary intake and physical inactivity in adolescents from Latin American countries. Therefore, effective and sustainable strategies and programmes are needed that promote healthier diets, regular PA and reduce ST among Latin American adolescents.Coca Cola Company///Estados UnidosFerrero///ItaliaInternational Life Science Institute//ILSI/ArgentinaUniversidad de Costa Rica//UCR/Costa RicaPontificia Universidad Católica de Chile///ChilePontificia Universidad Javeriana///ColombiaUniversidad Central de Venezuela//UCV/VenezuelaUniversidad San Francisco de Quito////EcuadorInstituto de Investigación Nutricional de Perú///PerúHospital Infantil Sabará///BrasilUCR::Vicerrectoría de Docencia::Salud::Facultad de Medicina::Escuela de Medicin

Socio-demographic patterns of public, private and active travel in Latin America: cross-sectional findings from the ELANS study

Background: Active travel such as walking or cycling has been associated with more favorable health outcomes. However, evidence on patterns of transportation in Latin America is scarce. Therefore, the aim of this study was to quantify and characterise socio-demographic patterns of public, private and active travel in Latin American countries. Methods: Data from the Latin American Study of Nutrition and Health, a population-based, cross-sectional survey conducted in eight Latin American countries including Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela (n = 9218; age range: 15–65 years). Transportation modes include public (bus, taxi, subway and train), private (car and motorcycle) and active (walking and/or cycling). Outcomes for this study include time spent in different modes of transportation. We performed overall and country-specific descriptive analyses to examine differences by sex, age, socioeconomic and education level. Results: For the overall cohort, public transport represent 34.9% of the total travel time, whereas private, walking and cycling represent 48.2%, 10.6% and 6.3% of the total travel time. Time spent using public travel was highest in Venezuela (48.4%); Peru had the highest proportions of private travel (52.5%); Time spent walking and cycling was highest in Costa Rica (14.8% and 12.2%, respectively). The average travel time spent in public and private transport were 299.5 min/week (95% CI: 292.4307.0) and 379.6 min/week (95% CI: 368.0, 391.5) respectively; figures for walking and cycling were 186.9 min/week (95% CI: 181.8, 191.9) and 201.1 min/week (95% CI: 187.8, 216.9). Conclusions: Public and private transport were the most common forms of travel in Latin America. Active travel (walking or cycling) represent 17% of total physical activity, therefore, promoting and providing the right infrastructure for active commuting could translate in increasing the population overall levels of physical activity in Latin America

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Factores asociados a síntomas depresivos con importancia clínica en el postparto en adolescente en la ciudad de Cartagena- Colombia 2011

Tesis (Enfermero). -- Universidad de Cartagena. Facultad de Enfermería. Departamento de Investigación, 2011Estudio analítico de corte transversal; la población estuvo representada por puérperas adolescentes ubicadas en centros de atención primaria de Cartagena, con una muestra constituida por 460 adolescentes entre los 10 y 19 años; el muestreo utilizado fue aleatorio simple, Para la recolección de la información se aplicó la escala de depresión postparto de Edimburg, la escala de Duke para apoyo social, y el cuestionario de Apgar para funcionalidad familiar. La aparición de síntomas depresivos en el posparto adolescente está asociada con el bajo apoyo social, bajo apoyo social afectivo y confidencial, el no contar con una pareja estable y no haber culminado los estudios de básica secundari

Factores asociados a síntomas depresivos con importancia clínica en el posparto en adolescentes de Cartagena (Colombia)

Objetivo: Establecer los factores asociados a síntomas depresivos con importancia clínica (SDIC) en el posparto en adolescentes de Cartagena (Colombia). Método: Se realizó un estudio analítico observacional transversal, con una muestra de puérperas adolescentes, con edades entre 10 y 19 años, captadas durante la cita de control a los siete días del posparto en los centros de atención primaria de Cartagena durante 2012. La información fue recolectada con la Escala de Depresión Postparto de Edinburgh, la escala de Duke para apoyo social y el cuestionario de Apgar para funcionalidad familiar. Resultados: Participaron en el estudio 460 adolescentes; la edad media fue 16,6 años ( DE =2,1); 49,6 % (228) de las adolescentes presentaron SDIC ; el 44,3 % (204) presentó bajo apoyo social y el 67,2 % (309) tenía familias disfuncionales. Los SDIC se asociaron a bajo apoyo social ( OR =2,4; IC 95 % 1,4-4,7), bajo apoyo afectivo ( OR =2,0; IC 95 % 1,1-3,8) y bajo apoyo confidencial ( OR =2,1; IC 95 % 1,2-3,8). Conclusión: La presentación de síntomas depresivos con importancia clínica en el pospar - to adolescente se asocia a bajo apoyo social, bajo apoyo social afectivo y bajo apoyo social confidencial

Factores asociados a síntomas depresivos con importancia clínica en el postparto en adolescentes de Cartagena, Colombia

Objetivo: Establecer los factores asociados a síntomas depresivos con importancia clínica (SDIC) en el posparto en adolescentes de Cartagena (Colombia). Método: Se realizó un estudio analítico observacional transversal, con una muestra de puérperas adolescentes, con edades entre 10 y 19 años, captadas durante la cita de control a los siete días del posparto  en los centros de atención primaria de Cartagena durante 2012. La información fue recolectada con la Escala de Depresión Postparto de Edinburgh, la escala de Duke para apoyo social y el cuestionario de Apgar para funcionalidad familiar. Resultados: Participaron en el estudio 460 adolescentes; la edad media fue 16,6 años (DE=2,1); 49,6 % (228) de las adolescentes presentaron SDIC; el 44,3 % (204) presentó bajo apoyo social y el 67,2 % (309) tenía familias disfuncionales. Los SDIC se asociaron a bajo apoyo social (OR=2,4; IC95 % 1,4-4,7), bajo apoyo afectivo (OR=2,0; IC95 % 1,1-3,8) y bajo apoyo confidencial (OR=2,1; IC95 % 1,2-3,8). Conclusión: La presentación de síntomas depresivos con importancia clínica en el posparto adolescente se asocia a bajo apoyo social, bajo apoyo social afectivo y bajo apoyo social confidencial

Socio-demographic patterning of objectively measured physical activity and sedentary behaviours in eight Latin American countries: findings from the ELANS study

Physical activity (PA) and sedentary behaviours (SB) are two independent risk factors for non-communicable diseases. However, there is a lack of objectively measured information on PA and SB in low- and middle-income countries. The aim of this study was to use objective data to characterise socio-demographic patterns of PA and SB in eight Latin American countries. 2,732 participants (aged 15-65 years) from the Latin American Study of Nutrition and Health (ELANS) were included. PA and SB data were collected using accelerometers. Overall and country-specific average levels of time spent in PA and SB were compared by sex, age, socioeconomic and education level. Overall, the mean time spent in SB was 571.6 min/day, ranging from 553.8 min/day in Chile to 596.7 min/day in Peru. Average levels of light, moderate-to-vigorous physical activity (MVPA) and total PA were 311.1 min/day (95% CI: 307.7; 314.5), 34.9 min/day (95% CI: 34.0; 35.9) and 7531.2 MET-min/week (95% CI: 7450.4; 7611.9), respectively. MVPA and total PA were higher in men than women. The prevalence of physical inactivity was 40.6%, ranging from 26.9% (Chile) to 47% (Costa Rica and Venezuela). Women were more physically inactive than men (47.7% versus 33.0%). SB levels were highest among those with higher education; PA graded positively with socioeconomic level. Our findings can inform the planning of health policies and programmes designed to reduce levels of physical inactivity, as well as inform the local and cultural adaptation of these policies and programmes for implementation in Latin America

Socio-demographic patterning of objectively measured physical activity and sedentary behaviours in eight Latin American countries: findings from the ELANS study

Physical activity (PA) and sedentary behaviours (SB) are two independent risk factors for non-communicable diseases. However, there is a lack of objectively measured information on PA and SB in low- and middle-income countries. The aim of this study was to use objective data to characterise socio-demographic patterns of PA and SB in eight Latin American countries. 2,732 participants (aged 15-65 years) from the Latin American Study of Nutrition and Health (ELANS) were included. PA and SB data were collected using accelerometers. Overall and country-specific average levels of time spent in PA and SB were compared by sex, age, socioeconomic and education level. Overall, the mean time spent in SB was 571.6 min/day, ranging from 553.8 min/day in Chile to 596.7 min/day in Peru. Average levels of light, moderate-to-vigorous physical activity (MVPA) and total PA were 311.1 min/day (95% CI: 307.7; 314.5), 34.9 min/day (95% CI: 34.0; 35.9) and 7531.2 MET-min/week (95% CI: 7450.4; 7611.9), respectively. MVPA and total PA were higher in men than women. The prevalence of physical inactivity was 40.6%, ranging from 26.9% (Chile) to 47% (Costa Rica and Venezuela). Women were more physically inactive than men (47.7% versus 33.0%). SB levels were highest among those with higher education; PA graded positively with socioeconomic level. Our findings can inform the planning of health policies and programmes designed to reduce levels of physical inactivity, as well as inform the local and cultural adaptation of these policies and programmes for implementation in Latin America

Helicobacter pylori cagA and vacA genotypes in Cuban and Venezuelan populations

The aim of this study was to determine the presence of Helicobacter pylori cytotoxin-associated gene (cagA)/vacuolating cytotoxin gene (vacA) among patients with chronic gastritis in Cuba and Venezuela. Gastric antrum biopsies were taken for culture, DNA extraction and PCR analysis. Amplification of vacA and cagA segments was performed using two regions of cagA: 349 bp were amplified with the F1/B1 primers and the remaining 335 bp were amplified with the B7629/B7628 primers. The VA1-F/VA1-R set of primers was used to amplify the 259-bp (s1) or 286-bp (s2) product and the VAG-R/VAG-F set of primers was used to amplify the 567-bp (m1) or 642-bp (m2) regions of vacA. cagA was detected in 87% of the antral samples from Cuban patients and 80.3% of those from Venezuelan patients. All possible combinations of vacA regions were found, with the exception of s2/m1. The predominant combination found in both countries was s1/m1. The percentage of cagA+ strains was increased by the use of a second set of primers and a greater number of strains was amplified with the B7629/B7628 primers in the Cuban patients (p = 0.0001). There was no significant difference between the presence of the allelic variants of vacA and cagA in both populations. The predominant genotype was cagA+/s1m1 in both countries. The results support the necessary investigation of isolates circulating among the human population in each region