Search

This study evaluates the psychometric properties of the Access of Older Adults to Outpatient Primary-Care Health Services Scale (AOAOPHSS), in research conducted among 707 Mexican older adults selected by convenience from 14 rural and one urban locations. The AOAOPHSS explores 10 dimensions of two integrated subscales: Accessibility and Personal Abilities. Data analysis was performed in five phases. First, potentially biased responses were identified. Second, the response efficiency of the items and their association with external variables were evaluated. Third, the basic properties of the scores for the subscales’ dimensions of the AOAOPHSS were identified using non-parametric Mokken Scaling Analysis (MSA). Fourth, the Structural Equation Modeling methodology was used to identify the properties of the internal structure of the latent construct. Finally, reliability and internal consistency were evaluated at both score and item levels. The following findings emerged. 13 items with inefficient response options were removed, and 24 were retained using the MSA. The latent structure of the latter was defined based on 21 items of five Accessibility Subscale dimensions. Its internal consistency reliability ranged between 0.67 and 0.81 (omega coefficients) and between 0.61 and 0.78 (alpha coefficients). Accordingly, this paper discusses the overall implications of using the Accessibility Subscale.

Introduction: According to reports from China and Europe, there are various clinical and laboratory risk factors that associate with both death and the use of a ventilator in coronavirus disease 2019 (COVID-19). In Wuhan, blood type A was related to these complications, but this factor is unknown for Latin America. Objective was to describe the association of blood type with complications related to COVID-19 infection. Material and methods: A retrospective comparative study from the clinical files of patients cared for in the emergency department between April and May 2020. Results: Data was analyzed from 120 patients hospitalized with COVID-19 infection. There were no differences in age and gender by blood type. Type O was the most frequent (80.8%) followed by type A (11.7%) and type B (7.5%). In univariate analysis, there was no impact of blood type on survival, individually (groups A, B, O) (log rank 0.154). In multivariate analysis, only age influenced prognosis ( p =0.004). Above the risk, type O showed no impact on mortality (OR 1.0119, 95% CI: 0.3898–2.6272, p =0.980) or ventilator use (1.5616, 95% CI: 0.4834–5.0453, p =0.456), likewise for types A and B (OR 0.9882, 95% CI, 0.3806–2.5657). Conclusion: Blood type does not impact prognosis in Mexican patients with COVID-19.

The objective of this work was to validate the content of a scale formulated in Spanish for older adults in Mexico, with the aim of comprehensively measuring the access of this population group to outpatient primary-care services. To this end, we carried out a methodological content-validity study in four stages: (1) construction of the scale; (2) evaluation of item legibility; (3) quantitative content evaluation by two groups of judges selected by convenience: participant-judges including older adults with adequate reading comprehension, surveyed in person (n = 23), and expert-judges comprised of researchers specialized in the fields of health services, psychometrics and aging, surveyed online (n = 7); and (4) collection of qualitative feedback from several of the participant-judges (older adults, n = 4). The content was validated both by sequentially examining the level of consensus in the responses of both groups of judges, using the Tastle and Wierman method, and by calculating Aiken’s Validity Coefficient with a 90% confidence interval. The scale contained 65 items pertaining to 10 dimensions of two major constructs: accessibility (n = 39) and personal abilities (n = 26). Five items were eliminated in accordance with the minimum-consensus criterion (0.5). This is the first psychometric scale to be developed in Mexico with the view of integrating the characteristics of health-care services and the abilities of the older adults in a single questionnaire designed to measure the access of this population group to outpatient primary-care services.

La investigación tiene como objetivo general diseñar un Programa General de Recreación para los estudiantes de la Universidad de Matanzas. Además, se pretende confeccionar un marco teórico referencial sobre los siguientes temas: ocio, recreación y animación turística. También se propone un procedimiento metodológico que contribuye a solucionar el problema general de la investigación. Dentro de esta propuesta se encuentra el diseño y aplicación de una encuesta para recopilar información acerca de la variable preferencias recreativas de los estudiantes universitarios. A partir del procesamiento de los datos con el programa estadístico SPSS (Statistical Product and Service Solutions), se conocerán las posibilidades que tienen los encuestados en su tiempo libre y las actividades recreativas que se deben planificar. Así, se obtuvieron las mejores vías para informar a los estudiantes de las actividades recreativas: los murales y carteles, así como los avisos estudiantiles. Se conformó un Programa General de Recreación para cada sede universitaria, el cual se hizo con un horario para cada uno de los días de la semana y un orden de actividades que toma en cuenta la frecuencia semanal de estas. Asimismo, se ofrecen indicaciones para que la aplicación de dicho programa sea eficiente. Los métodos, técnicas y herramientas utilizadas fueron los siguientes: el análisis histórico-lógico, el análisis síntesis, la entrevista, la revisión documental, la encuesta, la tormenta de ideas y el método de expertos.

El presente trabajo persigue como objetivo evaluar la satisfacción de los estudiantes de la Carrera de Turismo de la Universidad de Matanzas con su proceso de formación en el curso 2018-2019. Para ello se emplea la encuesta de satisfacción que aplica el Ministerio de Educación Superior una vez al año en todos los centros universitarios del país, a dicha encuesta se le agregan tantas columnas como asignaturas se imparte por año académico. Los resultados obtenidos cuantitativamente arrojan, que la satisfacción de los estudiantes oscila desde 52% hasta 95%. En cuanto a los resultados cualitativos y principales sugerencias se encuentran: más formación en idioma y mayores horas de prácticas laborales. A partir de los resultados obtenidos se determina que la encuesta aplicada es muy general por lo que se dificulta la obtención de datos que indiquen la presencia de posibles mejoras, de ahí que se realice una investigación y se proponga una nueva encuesta para la evaluación de la satisfacción.

Objetivo: Identificar los determinantes de acceso a los servicios de atención primaria en adultos mayores residentes en áreas rurales y urbanas de diferentes regiones del mundo. Material y Método: Se realizó una revisión sistemática de la literatura en bases electrónicas a partir de publicaciones cualitativas y cuantitativas, de fuente primaria o secundaria, descritas entre 2015 y 2019. Se determinaron palabras clave enmarcadas bajo el Modelo de Dimensiones y habilidades de Levesque, Harris y Russell. El análisis se efectuó utilizando una lista de chequeo con cinco criterios técnicos de evaluación elegidos por conveniencia técnico-académica. Resultados: La búsqueda inicial identificó 118 manuscritos para revisión. Los estudios fueron analizados y clasificados en cinco segmentos que involucran a cinco regiones del mundo. Los principales determinantes de acceso encontrados fueron clasificados en habilidades personales de los adultos mayores y características propias del sistema de salud tanto para el área rural y urbana. Conclusiones: Se concluye que a nivel mundial el principal determinante de acceso a los servicios de atención primaria en adultos mayores residentes de áreas rurales es la falta de disponibilidad de servicios; mientras que los adultos mayores urbanos mantienen a las barreras financieras como el principal obstáculo para su acceso a la salud.

Introduction: During the era of COVID-19, an increase has surged in the number of cases of mucormycosis; the use of high doses of steroids, and states of immunosuppression such as diabetes are the main related risk factors. In the treatment of acute leukemia, it is recommended to reduce the dose of chemotherapy, postponing highly myeloablative schemes and the use of caution with monoclonal antibodies. Case presentation: We present the case of a patient (25 years-old male) with acute lymphoblastic leukemia and COVID-19 confirmed infection who developed rhino-cerebral mucormycosis during the induction stage. Conclusion: In the age of COVID-19, taking samples through a nasal swab should be avoided in individuals with risk of infection from mucormycosis, such as diabetes, cancer, or individuals treated with high doses of steroids.

La Agricultura Familiar se reafirma a partir del debate mundial sobre el campesinado y su papel fundamental en la sociedad respecto a intereses globales como la sostenibilidad ambiental, la seguridad y soberanía alimentaria, la creación de mercados de proximidad entre productores y consumidores, la alimentación sana basada en formas de agricultura sostenible y la superación de la pobreza rural. Dada su relevancia, diversas organizaciones y movimientos sociales promueven la Agricultura Familiar como forma alternativa de producción y organización social; este es el caso de la Red Nacional de Agricultura Familiar (RENAF) que busca visibilizar la importancia de esta categoría y respaldar la promulgación de políticas públicas diferenciales en Colombia. Este artículo proporciona una reflexión sobre la construcción multidimensional de la Agricultura Familiar en el país y sobre las posibilidades que ofrece para enfrentar la crisis generada por el modelo extractivista del régimen agroalimentario. Se resaltan las características particulares de los agricultores familiares, en especial su racionalidad productiva, social, ambiental y económica, que constituyen estrategias de resistencia frente al modelo extractivista y fuentes de autonomía para reproducir sus condiciones sociales de vida.

El mieloma múltiple (MM) es una neoplasia originada de células B secundaria a diversas mutaciones post-germinales y cuya característica es el desarrollo de una clona de células plasmáticas que secretan un subtipo específico de inmunoglobulina conocido como el componente monoclonal. Dentro de las manifestaciones clínicas más comunes se encuentran tanto la anemia, la enfermedad renal y las lesiones óseas, pero cada vez son más los casos que muestran al diagnóstico manifestaciones clínicas atípicas que pueden influir con el pronóstico y con la calidad de vida. Debido a que el tratamiento moderno del MM es altamente prometedor, es necesario identificar aquellas condiciones clínicas que limiten la eficacia terapéutica.

Various biomarkers based on blood counts have been useful for the prognosis of patients critically ill with COVID-19.To describe the usefulness of the neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR) and lymphocyte-to-platelet (LPR) ratios for the prognosis of mortality and ventilatory support requirement for COVID-19.Retrospective cohort of clinical records of patients with COVID-19 who required hospital care.One-hundred and -twenty-five cases were analyzed; mean age was 51 years, and 60 % were of the male gender; 21.6 % had type 2 diabetes mellitus, and 18.4 % had hypertension. Mean leukocyte count was 9.5 x 10NLR and MLR are useful for predicting mortality in patients with COVID-19.Diversos biomarcadores basados en conteos sanguíneos han sido de utilidad para el pronóstico de los pacientes en estado crítico por COVID-19.Describir la utilidad de los índices neutrófilo/linfocito (INL), monocito/linfocito (IML) y linfocito/plaqueta (IPL) para el pronóstico de la mortalidad y necesidad de soporte ventilatorio por COVID-19.Cohorte retrospectiva de registros clínicos de pacientes con COVID-19 que requirieron atención hospitalaria.Se analizaron 125 casos, la edad media fue de 51 años y 60 %, del sexo masculino; 21.6 % padecía diabetes mellitus tipo 2 y 18.4 %, hipertensión. La media de leucocitos fue 9.5 × 10INL e IML son de utilidad para predecir la mortalidad en pacientes con COVID-19.

espanolIntroduccion: Diversos biomarcadores basados en conteos sanguineos han sido de utilidad para el pronostico de los pacientes en estado critico por COVID-19. Objetivo: Describir la utilidad de los indices neutrofilo/linfocito (INL), monocito/linfocito (IML) y linfocito/plaqueta (IPL) para el pronostico de la mortalidad y necesidad de soporte ventilatorio por COVID-19. Metodo: Cohorte retrospectiva de registros clinicos de pacientes con COVID-19 que requirieron atencion hospitalaria. Resultados: Se analizaron 125 casos, la edad media fue de 51 anos y 60 %, del sexo masculino; 21.6 % padecia diabetes mellitus tipo 2 y 18.4 %, hipertension. La media de leucocitos fue 9.5 × 103/µL y la de neutrofilos, de 8.0 × 103/µL. La media del INL fue de 12.01; del IML, de 0.442 y del IPL, de 373.07. Respecto al area bajo la curva se registraron los siguientes valores en cuanto a mortalidad: INL, 0.594; IML, 0.628 e ILP, 0.505; en cuanto a ventilacion mecanica: INL, 0.581; IML, 0.619 e ILP, 0.547. En el analisis univariado, INL > 13 (RM = 2.750, p = 0.001) e IML > 0.5 (RM = 2.069, p = 0.047) se asociaron a mortalidad; ILP no mostro impacto en la mortalidad ni en el soporte respiratorio. Conclusion: INL e IML son de utilidad para predecir la mortalidad en pacientes con COVID-19. EnglishIntroduction: Various biomarkers based on blood counts have been useful for the prognosis of patients critically ill with COVID-19. Objective: To describe the usefulness of the neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR) and lymphocyte-to-platelet (LPR) ratios for the prognosis of mortality and ventilatory support requirement for COVID-19. Method: Retrospective cohort of clinical records of patients with COVID-19 who required hospital care. Results: One-hundred and twenty-five cases were analyzed; mean age was 51 years, and 60 % were of the male gender; 21.6 % had type 2 diabetes mellitus, and 18.4 % had hypertension. Mean leukocyte count was 9.5 x 103/µL, with a neutrophil mean of 8.0 x 103/µL. Mean NLR was 12.01, while for MLR it was 0.442, and for LPR, 373.07. Regarding the area under the curve, the following values were recorded for mortality: 0.594 for NLR, 0.628 for MLR and 0.505 for LPR; as for mechanical ventilation, the values were 0.581 for NLR, 0.619 for MLR and 0.547 for LPR. In the univariate analysis, an NLR value > 13 (OR: 2.750, p = 0.001) and an MLR of > 0.5 (OR: 2.069, p = 0.047) were associated with mortality; LPR showed no impact on mortality or respiratory support. Conclusion: NLR and MLR are useful for predicting mortality in patients with COVID-19.

Background Peripheral blood B cells include lymphocytes at various stages of differentiation, each with a specific function in the immune response. All these stages show variations in percentage and absolute number throughout human life. The numbers and proportions of B subpopulation are influenced by factors such as gender, age, ethnicity, and lifestyle. This study establishes reference values according to age of peripheral blood B cell subtypes in healthy Mexican population. Methods Peripheral blood from healthy new-borns and adults were analysed for total B cell subpopulations, using surface markers such as CD19, IgM, IgD, CD21, CD24, CD27, and CD38, to identify naive, memory with and without isotype switch, double-negative, transitional, and plasmablast cells. Results We observed a significant variation in terms of frequency and absolute counts between all groups analysed. Values from each B cell subpopulation show variations according to age. Conclusions In order to attempt to elucidate reference values for B cell subpopulation, the present study evaluated a population sample of healthy blood donors from this region. Values reported here can also be used as a tool for diagnosis of diseases in which B cell maturation is affected.

Resumen Objetivos Identificar aquellos factores que impactan en la respuesta terapeutica para alcanzar una segunda remision (2 RC) en pacientes con leucemia aguda linfoblastica (LAL) en recaida. Metodos Estudio observacional y analitico anidado en una cohorte retrospectiva de adultos (>18 anos) portadores de LAL que fueron atendidos durante 2008-2014 y que interrumpieron el protocolo HGMLAL07 al detectarse recaida e iniciaron otro esquema. Resultados Se estudiaron 69 pacientes y el 62,3% (n = 43) correspondia a hombres. La media de edad fue de 29 anos. Los regimenes terapeuticos empleados fueron: alta intensidad (55,1%) [Hyper-CVAD (n = 34), IDA-Flag (n = 1), mitoxantrona-DARAC (n = 3)], moderada intensidad (4,3%) [Esquemas de reinduccion (n = 3)] y tratamiento paliativo de baja intensidad con soporte transfusional (40,6%, n = 28). Solo 19 pacientes (27,5%) integraron una 2 RC. La media de supervivencia fue 120 (2- 575) dias y el 29% sobrevivio al ano de seguimiento. El uso de un segundo regimen intensivo o moderado no brindo ventaja sobre el esquema conservador (prueba log-Rank, p = 0,812). Ninguna variable demostro valor pronostico sobre la supervivencia a 1 ano. La duracion de la primera RC (OR 6,78, p = 0,005, 95% IC: 1,7532-26,2803) y recibir un primer tratamiento intensivo (OR 0,22, p = 0,018, 95% IC: 0,0661-0,7813) fueron variables pronosticas de falla terapeutica para alcanzar la 2 RC. Conclusiones Poseer una primera RC

Acute leukaemias are characterised by uncontrolled proliferation of immature blood cells with lymphoid or myeloid lineage. Morphological classification is based on the identification of the leukaemia cell line and its stage of differentiation. The first microscopic descriptions dating from the 1930s pointed to 2 different types of leukaemia cells: lymphoid and myeloid. In 1976, the consensus that led to the French-American-British (FAB) classification was achieved. This includes criteria for identifying myeloid and lymphoid leukaemias, and gives a list of morphological subtypes, describing how these affect the patient's prognosis. Today, despite new classifications based on sophisticated studies, FAB classification is widely used by experts due to its technical simplicity, good diagnostic reliability and cost-effectiveness.

Iron deficiency anaemia is a public health problem that affects all age groups. In Mexico, it is a common cause of morbidity, and accounts for 50% of cases of anaemia worldwide. It is more prevalent during the first 2 years of life, during adolescence and pregnancy. It is characterised by fatigue, weakness, pallor and koilonychia. Treatment is based on dietary recommendations and oral and intravenous iron supplements. In this review article, we summarise the characteristics of iron efficiency anaemia, its metabolism, epidemiology, symptoms and diagnosis, and explore different therapeutic approaches.

Cadmium is a well-characterized nephrotoxic agent that is also capable of accumulating and diffusing across the placenta; however, only a few studies have addressed its effects over fetal kidneys and none of them has used a panel of sensitive and specific biomarkers for the detection of kidney injury. The goal of this study was to determine cadmium renal effects in rat fetuses by the quantification of early kidney injury biomarkers. Pregnant Wistar rats were exposed by inhalation to an isotonic saline solution or to CdCl2 solution (DDel =1.48 mg Cd kg(-1) day(-1) ) during gestational days (GD) 8-20. On GD 21, dams were euthanized and samples obtained. Kidney injury biomarkers were quantified in amniotic fluid samples and fetal kidneys were microscopically evaluated to search for histological alterations. Our results showed that cadmium exposure significantly raised albumin, osteopontin, vascular endothelial growth factor and tissue inhibitor of metalloproteinases-1 levels in amniotic fluid, whereas it decreased creatinine. Clusterin, calbindin and IFN-inducible protein 10 did not show any change. Accordingly, histological findings showed tubular damage and precipitations in the renal pelvis. In conclusion, gestational exposure to cadmium induces structural alterations in fetal renal tissue that can be detected by some kidney injury biomarkers in amniotic fluid samples. Copyright © 2016 John Wiley & Sons, Ltd.