Calidad de vida en personas con obesidad, diabetes e hipertensión

Introduction: obesity is understood as the abnormal or excessive accumulation of fat that can be harmful to health and is measured according to the body mass index (BMI); on the other hand, diabetes is defined as a chronic disease that appears when the pancreas does not produce enough insulin or when the body does not effectively use the insulin it produces; finally, hypertension is the main risk factor for cardiovascular disease. Objective: to determine the quality of life in people with obesity, diabetes and hypertension in an urban population of the city of Orizaba, Veracruz. Material and methods: quantitative, descriptive, correlational, prospective and cross-sectional research, with simple random probability sampling. Results and discussion: the quality of life in people with obesity (28 people) was 7.16% high, 21.42% medium and 71.42% low. In diabetes (44 persons), 67.7% scored high and 6.5% regular. In hypertension (42 persons), 56.6% mentioned having a very good quality of life, 9.7% good and 1.6% fair. The results are in contrast to research studies where the quality of life in people with obesity, diabetes and hypertension was different since they identified important affectations limiting the development of daily activities. Conclusions: it is recommended that health professionals and nursing students continue to carry out research work with quantitative, qualitative and mixed approaches to obtain real information that can be used to create designs for future interventions.Introducción: la obesidad se entiende como la acumulación anormal o excesiva de grasa que puede ser perjudicial para la salud, y se mide de acuerdo con el índice de masa corporal (IMC), por otro lado, la diabetes, se define como una enfermedad crónica que aparece cuando el páncreas no produce insulina suficiente o cuando el organismo no utiliza eficazmente la insulina que fabrica, por último, la hipertensión es el principal factor de riesgo para sufrir una enfermedad cardiovascular. Objetivo: determinar la calidad de vida en personas con obesidad, diabetes e hipertensión, de una población urbana de la ciudad de Orizaba, Veracruz. Material y métodos: investigación cuantitativa, descriptiva, correlacional, prospectiva y transversal, con muestreo probabilístico aleatorio simple. Resultados y discusión: la de calidad de vida en personas con obesidad (28 personas), el 7.16% alta, 21.42% media y 71.42%, es baja. En diabetes (44 personas), el 67.7%, puntuó como alta y el 6.5% regular. En hipertensión (42 personas), el 56.6% mencionó tener una muy buena calidad de vida, 9.7% buena y 1.6% regular. Los resultados se contraponen investigaciones donde la calidad de vida en personas con obesidad, diabetes e hipertensión fue diferente ya que identificaron afectaciones importantes limitando desarrollar actividades cotidianas. Conclusiones: se recomienda que los profesionales de salud y los estudiantes de Enfermería sigan realizando trabajos de investigación con enfoques cuantitativos, cualitativos y mixtos, para obtener información real que sirva para la creación de diseños para intervenciones futuras

Pros percibidos, creencias y conocimientos del consumo de alcohol en estudiantes de enfermería: enfoque cualitativo

Introduction: The pros are considered as the value that an individual gives to beliefs, perceptions or positive consequences about the benefits of developing a behavior, in this case, alcohol consumption, especially if the individual's knowledge about this action is deficient. Objective: To analyze the perceived pros, beliefs and knowledge of alcohol consumption in nursing students. Methods: Qualitative study of focused ethnographic type; it was carried out from May to June 2022; with simple random probabilistic sampling. Ten undergraduate nursing students were recruited to analyze the perceived pros, beliefs and knowledge of alcohol consumption; interviews were conducted with prior informed consent and attention to ethical considerations. The data were analyzed in the qualitative data package ATLAS.ti, constructing codes, categories and semantic networks. Results: 90% were women and 10% men, with an average age of 21 years. In relation to the perceived pros, it was identified that "I think it is not necessary to drink" and "I think it influences, at least in my case, I feel that I am a very introverted person and somehow alcohol consumption helps me to loosen up better and live together more". In terms of beliefs, the population considers that "it is not unpleasant to work with drinkers because the patient should be cared for regardless of their condition, but it is more difficult because they are ruder or more complicated to handle". Regarding knowledge, it was found that "I consider that my education on substance use has been thanks to school", "I have not fallen thanks to God into any addiction". Conclusions: Analyzing the perceived pros, beliefs and knowledge of alcohol consumption in nursing students allows us to make a series of recommendations for practice, public policies and future research and intervention projects, since although the sample is aware of the effects of alcohol consumption on the body, their pros and beliefs lead them to adopt a risk pattern, which if not intervened will expose them to greater problems.Introducción: Los pros, son considerados como el valor que un individuo otorga a las creencias, percepciones o consecuencias positivas sobre los beneficios de desarrollar una conducta, en este caso, el consumo de alcohol, máxime si los conocimientos del individuo sobre esa acción son deficientes. Objetivo: Analizar los pros percibidos, creencias y conocimientos del consumo de alcohol en estudiantes de enfermería. Material y métodos: Estudio cualitativo de tipo etnográfico focalizado; se realizó en los meses de mayo a junio de 2022; con muestreo probabilístico aleatorio simple. Se reclutaron a 10 estudiantes de la licenciatura en enfermería a fin de analizar los pros percibidos, creencias y conocimientos del consumo de alcohol.; se realizaron entrevistas con previo consentimiento informado y atención a las consideraciones éticas. Los datos se analizaron en el paquete de datos cualitativos ATLAS.ti, construyendo códigos, categorías y redes semánticas. Resultados: el 90% son mujeres y el 10% hombres y con media de edad de 21 años. Con relación a los pros percibidos se identificó que “pienso que no es necesario beber” y “creo que influye, por lo menos en mi caso, siento que soy una persona muy introvertida y de alguna manera el consumo del alcohol ayuda a soltarme mejor y convivir más”. Para las creencias la población considera que “no es desagradable trabajar con bebedores porque se debe dar atención al paciente independientemente de cómo esté su condición, sí es más dificultoso porque son más groseros o complicados de manejar”. Respecto a los conocimientos se encontró que “considero que mi educación sobre el uso de sustancias ha sido gracias a la escuela”, “no he caído gracias a Dios en ninguna adicción”. Conclusiones: Analizar los pros percibidos, creencias y conocimientos del consumo de alcohol en estudiantes de enfermería permite realizar una serie de recomendaciones a la práctica, políticas públicas y futuros proyectos de investigación e intervención, ya que la muestra aunque conoce los efectos en el organismo por el consumo de alcohol, sus pros y creencias los lleva a adoptar un patrón de riesgo, que de no ser intervenido estarán expuestos a problemas mayores

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Estrés, ansiedad, depresión y apoyo familiar en universitarios mexicanos durante la pandemia de COVID-19

Objetivo: Identificar los niveles de estrés, ansiedad y depresión presentes en los universitarios durante la pandemia en relación con el apoyo que brinda la familia.Materiales y métodos: Se trata de un estudio de tipo cuantitativo con un diseño descriptivo, correlacional y transversal. La muestra (n=105) fueron estudiantes de la Facultad de Enfermería de la Universidad Veracruzana; se obtuvo a través de un muestreo no probabilístico a conveniencia. Los datos fueron recolectados a través de un instrumento digital (Google Forms). Las variables se midieron utilizando la Escala de Depresión, Ansiedad y Estrés (DASS-21) y el Inventario de Percepción de Apoyo Familiar (IPAF). Los datos fueron analizados mediante estadística descriptiva y la prueba de correlación de Spearman.Resultados: Los resultados evidencian que no existe una asociación entre las variables estudiadas: r=-0.192, n=105, p=0.134, pero sí existe depresión (85.8 %), ansiedad (84 %) y estrés (77.4 %) en los estudiantes, aunque se presentan de forma leve, y un nivel medio bajo de apoyo familiar (afecto 61.3%, adaptabilidad 62.3% y autonomía 40.6 %).Conclusión: Los trastornos por ansiedad, estrés y depresión afectan gradualmente diversas esferas de actuación personal de los estudiantes, por lo cual una intervención oportuna y preventiva es relevante

Motivations And Expectations About Entering A Bachelor's Degree In Nursing

Introducción: la motivación es la integración de procesos mentales que regulan la conducta, decretando la dirección del comportamiento, por otro lado, la expectativa es una evaluación subjetiva de la probabilidad de alcanzar una meta, ambas variables son importantes al momento de caracterizar el perfil de ingreso a la licenciatura, debido a que pueden direccionar la trayectoria académica e influenciar la calidad profesional. Objetivo: determinar las motivaciones y expectativas en los estudiantes de nuevo ingreso a la licenciatura de enfermería. Metodología: estudio cuantitativo, descriptivo, correlacional y transversal, aplicando el cuestionario inicial de motivos y expectativas (Blanco et al., 2017) en una muestra de 130 individuos. Resultados: 74.6% de la población son mujeres y sobresale el grupo etario de 17 a 20 años (89.2%), 63.8% eligió la profesión enfermería como su primera opción, 62.3% tiene motivación intrínseca y 84.6% expectativas de la misma clasificación. Conclusión: Los aspectos que determinan los motivos de ingreso son el deseo de un trabajo prestigioso, éxito académico y buen salario, mientras que las expectativas son moduladas por la experiencia con un ser querido enfermo e implicación en la comunidad y sociedad.Introduction: motivation is the integration of mental processes that regulate behavior, decreeing the direction of behavior, on the other hand, expectation is a subjective evaluation of the probability of reaching a goal, both variables are important when characterizing the profile of admission to the bachelor's degree, because they can direct the academic trajectory and influence the professional quality. Objective: to determine the motivations and expectations of new undergraduate nursing students. Methodology: quantitative, descriptive, correlational and cross-sectional study, applying the initial questionnaire of motives and expectations (Blanco et al., 2017) in a sample of 130 individuals. Results: 74.6% of the population are women and the age group from 17 to 20 years old stands out (89.2%), 63.8% chose the nursing profession as their first choice, 62.3% have intrinsic motivation and 84.6% expectations of the same classification. Conclusion: The aspects that determine the motives for entry are the desire for a prestigious job, academic success and good salary, while expectations are modulated by experience with a sick loved one and involvement in the community and society

Novel Design Methodology for DC-DC Converters Applying Metaheuristic Optimization for Inductance Selection

Nowadays in modern industrial applications, where the power supply efficiency is more important than the output noise performance, DC-DC converters are widely used in order to fulfill the requirements. Yet, component selection and precise estimation of parameters can improve the converter&rsquo;s performance, leading to smaller and more efficient designs. Hence, metaheuristic optimization algorithms can be applied using the mathematical model of DC-DC converters, in order to optimize their performance through an optimal inductance selection. Therefore, this work presents a novel design methodology for DC-DC converters, where the inductance selection is optimized, in order to achieve an optimal relation between the inductance size and the required energy. Moreover, a multi-objective metaheuristic optimization is presented through the Earthquake Algorithm, for parameter estimation and component selection, using the inductance of a buck DC-DC converter as a case study. The experimental results validate the design methodology, showing ripple improvement and operating power range extension, which are key features to have an efficient performance in DC-DC converters. Results also confirm the Small-Signal Model of the circuit, as a correct objective function for the parameter optimization, achieving more than 90% of accuracy on the presented behavior