TY - JOUR AB - BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the resulting coronavirus disease 2019 (Covid-19) have afflicted tens of millions of people in a worldwide pandemic. Safe and effective vaccines are needed urgently. METHODS In an ongoing multinational, placebo-controlled, observer-blinded, pivotal efficacy trial, we randomly assigned persons 16 years of age or older in a 1:1 ratio to receive two doses, 21 days apart, of either placebo or the BNT162b2 vaccine candidate (30 μg per dose). BNT162b2 is a lipid nanoparticle-formulated, nucleoside-modified RNA vaccine that encodes a prefusion stabilized, membrane-anchored SARS-CoV-2 full-length spike protein. The primary end points were efficacy of the vaccine against laboratory-confirmed Covid-19 and safety. RESULTS A total of 43,548 participants underwent randomization, of whom 43,448 received injections: 21,720 with BNT162b2 and 21,728 with placebo. There were 8 cases of Covid-19 with onset at least 7 days after the second dose among participants assigned to receive BNT162b2 and 162 cases among those assigned to placebo; BNT162b2 was 95% effective in preventing Covid-19 (95% credible interval, 90.3 to 97.6). Similar vaccine efficacy (generally 90 to 100%) was observed across subgroups defined by age, sex, race, ethnicity, baseline body-mass index, and the presence of coexisting conditions. Among 10 cases of severe Covid-19 with onset after the first dose, 9 occurred in placebo recipients and 1 in a BNT162b2 recipient. The safety profile of BNT162b2 was characterized by short-term, mild-to-moderate pain at the injection site, fatigue, and headache. The incidence of serious adverse events was low and was similar in the vaccine and placebo groups. CONCLUSIONS A two-dose regimen of BNT162b2 conferred 95% protection against Covid-19 in persons 16 years of age or older. Safety over a median of 2 months was similar to that of other viral vaccines. (Funded by BioNTech and Pfizer; ClinicalTrials.gov number, NCT04368728.). AU - Polack, Fernando P. AU - Thomas, Stephen J. AU - Kitchin, Nicholas AU - Absalon, Judith AU - Gurtman, Alejandra AU - Lockhart, Stephen AU - Perez, John L. AU - Pérez Marc, Gonzalo AU - Moreira, Edson D. AU - Zerbini, Cristiano AU - Bailey, Ruth AU - Swanson, Kena A. AU - Roychoudhury, Satrajit AU - Koury, Kenneth AU - Li, Ping AU - Kalina, Warren V. AU - Cooper, David AU - Frenck, Robert W. AU - Hammitt, Laura L. AU - Türeci, Özlem AU - Nell, Haylene AU - Schaefer, Axel AU - Ünal, Serhat AU - Tresnan, Dina B. AU - Mather, Susan AU - Dormitzer, Philip R. AU - Şahin, Uğur AU - Jansen, Kathrin U. AU - Gruber, William C. DA - 2020/12// DO - 10.1056/NEJMoa2034577 IS - 27 PB - Massachusetts Medical Society PY - 2020 SP - 2603 EP - 2615 TI - Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine T2 - New England Journal of Medicine UR - http://www.nejm.org/doi/10.1056/NEJMoa2034577 VL - 383 ER - TY - JOUR AB - Background: The principal aim of this study was to investigate whether a caregiver-inclusive assistive technology intervention improved older care recipients' functional autonomy and decreased the perceived burden of their family caregivers compared to customary care. Methods: The study was a single-blind, mixed-methods, randomized controlled trial with baseline data collection and follow-ups at 6-, 22-, and 58-weeks after baseline evaluation, which was prospectively registered (ClinicalTrials.gov Identifier: NCT01640470. Registered 11/21/2011). Dyads comprising a care recipient and family caregiver were randomly assigned to either a caregiver-inclusive experimental group (N = 44) or a customary-care comparison group (N = 46). Eligible care recipients were aged ≥55 years and had one or more limitations with mobility or daily activities, and family caregivers provided at least four hours per week of assistance. Outcome measures were administered to both groups at baseline and at the three follow-up time points. The data collectors were blinded regarding participants' intervention group. The primary outcome measures were the Functional Autonomy Measurement System to assess care recipients' functional performance, and the Caregiver Assistive Technology Outcome Measure to assess caregivers' burden. Qualitative interviews examined participants' perceptions of the caregiver-inclusive and customary care interventions. Results: The experimental intervention addressed significantly more dyad-identified problematic activities, but caregiver involvement was evident in both groups and outcomes were not significantly different over time. In both groups, care recipients' functional autonomy declined significantly (P <.01), and caregivers' activity-specific and overall burden decreased significantly (P <.01). Conclusions: Given the unintended congruence between the caregiver-inclusive and customary care interventions, the overall findings lend support for the provision of assistive technology to reduce caregiver burden. AU - Mortenson, W. Ben AU - Demers, Louise AU - Fuhrer, Marcus J. AU - Jutai, Jeffrey W. AU - Bilkey, Jessica AU - Plante, Michelle AU - Deruyter, Frank DO - 10.1186/s12877-018-0783-6 IS - 1 KW - Assistive technology KW - Family caregivers KW - Older adults KW - Randomized controlled trial PB - BMC Geriatrics PY - 2018 SP - 1 EP - 12 TI - Effects of a caregiver-inclusive assistive technology intervention: A randomized controlled trial T2 - BMC Geriatrics VL - 18 ER - TY - JOUR AB - Background: Caregivers frequently provide support to people living with long-term conditions. However, there is paucity of evidence of interventions that support caregivers in their role. Rehabilitation EnAblement in Chronic Heart Failure (REACH-HF) is a novel home-based, health-professional-facilitated, self-management programme for patients with heart failure (HF) and their caregivers. Methods: Based on the random allocation of individual adult patients with reduced ejection fraction (HFrEF) and left ventricular ejection fraction <45% within the past five years, the caregiver of patients was allocated to receive the REACH-HF intervention over 12 weeks (REACH-HF group) or not (control group). Caregiver outcomes were generic health-related quality of life (EQ-5D-5L), Family Caregiver Quality of Life Scale questionnaire (FamQol), Caregiver Burden Questionnaire HF (CBQ-HF), Caregiver Contribution to Self-care of HF Index questionnaire (CC-SCHFI) and Hospital Anxiety and Depression Scale (HADS). Outcomes were compared between groups at 4, 6 and 12 months follow-up. Twenty caregivers receiving REACH-HF were purposively selected for qualitative interviews at 4 and 12 months. Results: Compared with controls (44 caregivers), the REACH-HF group (53 caregivers) had a higher mean CC-SCHFI confidence score at 12 months (57.5 vs 62.8, adjusted mean difference: 9.3, 95% confidence interval: 1.8–16.8, p = 0.016). No significant between group differences were seen in other caregiver outcomes. Qualitative interviews showed that most caregivers who received the REACH-HF intervention made positive changes to how they supported the HF patient they were caring for, and perceived that they had increased their confidence in the caregiver role over time. Conclusion: Provision of the REACH-HF intervention for caregivers of HF patients improved their confidence of self-management and was perceived for some to be helpful in supporting their caregiver role. AU - Wingham, Jennifer AU - Frost, Julia AU - Britten, Nicky AU - Greaves, Colin AU - Abraham, Charles AU - Warren, Fiona C. AU - Jolly, Kate AU - Miles, Jackie AU - Paul, Kevin AU - Doherty, Patrick J. AU - Singh, Sally AU - Davies, Russell AU - Noonan, Miriam AU - Dalal, Hasnain AU - Taylor, Rod S. DO - 10.1177/1474515119850011 IS - 7 KW - Heart failure KW - cardiac rehabilitation self-management KW - caregiver KW - home-based programme PY - 2019 SP - 611 EP - 620 TI - Caregiver outcomes of the REACH-HF multicentre randomized controlled trial of home-based rehabilitation for heart failure with reduced ejection fraction T2 - European Journal of Cardiovascular Nursing VL - 18 ER - TY - JOUR AB - Objective. To evaluate the effect of the "Caring for Caregivers" program in the caring ability and burden in family caregivers of patients with chronic diseases at health care institutions. Methods. A randomized controlled clinical trial was conducted in 34 relatives of patients with chronic diseases that had cared for them for more than 3 months. Zarit scale was used to measure caregiver burden and the CAI (Caring Ability Inventory) was also used to measure caring ability. An educational intervention was applied based on the "Caring for Caregivers" strategy of the Universidad Nacional de Colombia. Results. Although both groups improved their percentage of unburdened caregivers from the first to the second assessment, the difference between the two assessments was 41.2% in the intervention group whereas it was 11.8% in the control group, being only statistically significant the difference for the intervention group. Regarding the caring ability, no significant changes were identified in both groups. Conclusion. On family caregivers, it was observed that the "Caring for Caregivers" intervention had a positive impact on decreasing burden, but not on improving the caring ability. AU - Parra, Myriam Duran AU - Torres, Claudia Consuelo AU - Arboleda, Ligia Betty AU - Carvajal, Raquel Rivera AU - Franco, Sherly AU - Santos, Jenny DO - 10.17533/udea.iee.v37n1e04 IS - 1 KW - Caregivers KW - Chronic disease KW - Clinical trial KW - Control groups KW - Noncommunicable diseases PY - 2019 TI - Effectiveness of an educational nursing intervention on caring ability and burden in family caregivers of patients with chronic non-communicable diseases. A preventive randomized controlled clinical trial T2 - Investigacion y Educacion en Enfermeria VL - 37 ER - TY - JOUR AB - Objectives: To describe the support that patients reported receiving from family or friends (F/F) while participating in a self-care intervention for depressive symptoms; examine associations between patient-reported F/F support and use of self-care materials; and describe F/F perceptions of involvement in a subsample of F/F. Methods: One hundred eighty-nine of 223 (85%) patients aged 40+ with chronic physical conditions and co-morbid depressive symptoms participating in a randomized self-care intervention trial, completed structured telephone surveys at three months about the F/F support received. Ten F/F participated in post study qualitative interviews on the support provided. Results: 30%, 44%, and 91% of patients reported overall F/F support with self-care, F/F involvement with the self-care intervention and emotional support, respectively. 61% felt positively and 10% felt negatively or conflicted with F/F support. F/F involvement in the self-care intervention was the only variable associated with patient use of self-care materials when examined alongside all F/F support variables (Proportional Odds Ratio=1.21; 95% C.I.=1.01, 1.45). F/F perceived less involvement in the self-care intervention than patients. Discussion: Patients engaged in a self-care intervention for depressive symptoms use more self-care materials when they perceive F/F involvement in the intervention. Patients and F/F may perceive involvement differently and benefit from discussions about potential F/F roles. AU - Sussman, Tamara AU - McCusker, Jane AU - Yaffe, Mark AU - Belzile, Eric AU - Sewitch, Maida AU - Cole, Martin AU - Strumpf, Erin DO - 10.1177/1742395316633510 IS - 3 KW - Adherence KW - Chronic illnesses KW - Depression KW - Family support KW - Self-care PY - 2016 SP - 182 EP - 198 TI - Family members' or friends' involvement in self-care for patients with depressive symptoms and co-morbid chronic conditions T2 - Chronic Illness VL - 12 ER - TY - JOUR AB - Aim This randomized controlled clinical trial aimed to evaluate the contribution of family social support to the clinical/metabolic control of people with type 2 diabetes mellitus. Background Diabetes mellitus is a chronic disease that requires continuous care in order for individuals to reach glycemic control, the primordial goal of treatment. Family social support is essential to the development of care skills and their maintenance. However, there are few studies that investigate the contribution of family social support to diabetes control. Methods The study was developed between June 2011 and May 2013, and included 164 people who were randomized using simple randomization. The intervention group differed from the control group in that it included a family caregiver, who was recognized by the patient as a source of social support. The educational interventions received by people with diabetes mellitus were used as the basis of the education provided through telephone calls to patients’ family members and caregivers, and their purpose was to encourage dialogue between the patients and their relatives about the topics related to diabetes. Results Regarding the clinical impact, the results showed that there was a greater reduction in blood pressure and glycated hemoglobin in the intervention group than in the control group, showing a positive effect on the control of the disease. Conclusions Families should be incorporated into the care of people with diabetes mellitus and especially in health care programs, in particular those that can promote different forms of social support to strengthen the bond between family members. AU - Gomes, Lilian Cristiane AU - Coelho, Anna Claudia Martins AU - Gomides, Danielle dos Santos AU - Foss-Freitas, Maria Cristina AU - Foss, Milton César AU - Pace, Ana Emilia DO - 10.1016/j.apnr.2017.05.009 KW - Clinical trial KW - Diabetes mellitus KW - Health education KW - Nursing care KW - Social support PY - 2017 SP - 68 EP - 76 TI - Contribution of family social support to the metabolic control of people with diabetes mellitus: A randomized controlled clinical trial T2 - Applied Nursing Research VL - 36 ER - TY - JOUR AB - Background The prevalence of heart failure is increasing in Lebanon but to date there is no systematic evaluation of a disease management intervention. Objective The aim of this study was to evaluate the effect of involving family caregivers in the self-care of patients with heart failure on the risk of hospital readmission. Design A multi-site, block randomised controlled trial. Settings The study was conducted over a 13-month period in three tertiary medical centres in Beirut and Mount Lebanon, Lebanon. Participants Adult patients presenting for an exacerbation of heart failure to one of the study centres were included. Patients with limited life expectancy or physical functionality, planned cardiac bypass or valve replacement surgery, living alone or in nursing homes, or aged less than 18 years were excluded. Methods Patients allocated to the intervention group and their family caregivers were provided with a comprehensive, culturally appropriate, educational session on self-care maintenance and symptom management along with self-care resources. The usual care group received the self-care resources only. Follow-up phone calls were conducted 30 days following discharge by a research assistant blinded to treatment assignment. The primary outcome was hospital readmission and the secondary outcomes were self-care, quality of life, major vascular events and healthcare utilization. Results The final sample included 256 patients hospitalized for heart failure randomised into control (130 patients) and intervention (126 patients) groups. The mean age was 67 (SD = 8) years, and the majority (55%) were male. Readmission at 30 days was significantly lower in the intervention group compared to the control group (n = 10, 9% vs. n = 20, 19% respectively, OR = 0.40, 95% CI = 0.02, 0.10, p = 0.02). Self-care scores improved in both groups at 30 days, with a significantly larger improvement in the intervention group than the control group in the maintenance and confidence sub-scales, but not in the self-care management sub-scale. No differences were seen in quality of life scores or emergency department presentations between the groups. More patients in the control group than in the intervention group visited health care facilities (n = 24, 23% vs. n = 12, 11% respectively, OR = 0.39, 95% CI = 0.18, 0.83, p = 0.01). Conclusion The trial results confirmed the potential of the family-centred self-care educational intervention under evaluation to reduce the risk of readmission in Lebanese patients suffering from exacerbated heart failure. Further research is needed to validate these findings with longer periods of follow-up and to identify the intervention components and intensity required to induce sustained benefits on patients’ self-care management and quality of life. AU - Deek, Hiba AU - Chang, Sungwon AU - Newton, Phillip J. AU - Noureddine, Samar AU - Inglis, Sally C. AU - Arab, Ghina Al AU - Kabbani, Samer AU - Chalak, Wael AU - Timani, Nadim AU - Macdonald, Peter S. AU - Davidson, Patricia M. DO - 10.1016/j.ijnurstu.2017.07.015 IS - February 2016 KW - Clinical trial KW - Disease management KW - Education KW - Family KW - Heart failure KW - Nursing KW - Self-care PB - Elsevier PY - 2017 SP - 101 EP - 111 TI - An evaluation of involving family caregivers in the self-care of heart failure patients on hospital readmission: Randomised controlled trial (the FAMILY study) T2 - International Journal of Nursing Studies UR - http://dx.doi.org/10.1016/j.ijnurstu.2017.07.015 VL - 75 ER - TY - JOUR AB - BACKGROUND: COPD is a highly incapacitating disease, particularly among older people, implying significant burden for family caregivers. Involving caregivers in comprehensive pulmonary rehabilitation programs might benefit their functional coping to care demands; however, there is no objective evidence to sustain such assumption. This study is a secondary analysis aiming to analyze the effects of a family-based pulmonary rehabilitation program on close family caregivers of older subjects with COPD. METHODS: This is a mixed-method study. Family caregivers were randomly assigned to family-based (experimental) or conventional (control) pulmonary rehabilitation. Caregivers from the family-based pulmonary rehabilitation (n = 20; 80.0% female; age 63.1 ± 9.5 y) attended the psychoeducational component together with their relatives. In the conventional pulmonary rehabilitation, caregivers did not participate (n = 19; 68.4% female; age 53.6 ± 11.3 y). Self-rated instruments (Family Crisis Oriented Personal Scales, Depression Anxiety and Stress Scales, and Carers’ Assessment of Difficulties Index) and focus group interviews were used to assess the intervention. RESULTS: Caregivers from the family-based pulmonary rehabilitation had significantly greater improvements in overall family coping (P = .01), reframing (P = .01), seeking spiritual support (P = .01), and mobilizing to acquire help (P = .02). No significant differences were found for emotional state. Significant improvements in overall burden (P = .01), reactions to caregiving (P = .01), physical demands of caring (P = .044), and poor family support (P = .038) were observed, although there were no significant between-group differences. Qualitative data sustained the benefits of involving family caregivers in pulmonary rehabilitation. CONCLUSIONS: The findings provide valuable evidence to recommend the inclusion of COPD family caregivers in comprehensive pulmonary rehabilitation. Family-oriented pulmonary rehabilitation maximizes care-givers’ adaptive coping and potentially prevents negative psychological outcomes; however, further research is needed. AU - Figueiredo, Daniela AU - Cruz, Joana AU - Jácome, Cristina AU - Marques, Alda DO - 10.4187/respcare.04624 IS - 8 KW - Burden KW - COPD KW - Coping KW - Emotional state KW - Family caregiving PY - 2016 SP - 1081 EP - 1089 TI - Exploring the benefits to caregivers of a family-oriented pulmonary rehabilitation program T2 - Respiratory Care VL - 61 ER - TY - JOUR AB - As the prevalence of chronic diseases increase, there is a need for consumer-centric health informatics applications that assist individuals with disease self-management skills. However, due to the cost of development of these applications, there is also a need to build a disease agnostic architecture so that they could be reused for any chronic disease. This paper describes the architecture of a collaborative virtual environment (VE) platform, LIVE©, that was developed to teach self-management skills and provide social support to those individuals with type 2 diabetes. However, a backend database allows for the application to be easily reused for any chronic disease. We tested its usability in the context of a larger randomized controlled trial of its efficacy. The usability was scored as ‘good’ by half of the participants in the evaluation. Common errors in the testing and solutions to address initial usability issues are discussed. Overall, LIVE© represents a usable and generalizable platform that will be adapted to other chronic diseases and health needs in future research and applications. AU - Johnson, Constance M. AU - McIlwain, Steve AU - Gray, Oliver AU - Willson, Bradley AU - Vorderstrasse, Allison DO - 10.1016/j.jbi.2017.06.004 KW - Chronic disease KW - Consumer health informatics KW - Self-management KW - Type 2 diabetes KW - Virtual environments PY - 2017 SP - 198 EP - 206 TI - Creating a sustainable collaborative consumer health application for chronic disease self-management T2 - Journal of Biomedical Informatics UR - http://dx.doi.org/10.1016/j.jbi.2017.06.004 VL - 71 ER - TY - JOUR AB - Background: In 2011, there were approximately 3.3 million adult 30-day all-cause hospital readmissions in the US generating $41.3 billion in hospital costs. Community health worker (CHW) care delivery is one of very few interventions demonstrated to reduce health care utilization among populations with chronic disease. While there are a number of studies demonstrating improved disease-specific outcomes with CHW interventions, studies examining the effect of CHW care delivery on 30-day readmission rates are rare. Methods: This study is a randomized control trial designed to determine if linking hospitalized patients with chronic disease to community health workers (CHWs) can decrease 30-day readmissions. Participants were randomly assigned to receive the 30-day CHW intervention or usual care (no CHW). All study participants completed surveys at baseline and the end of the study 30 days post-discharge. The primary outcome was 30-day readmission and secondary outcomes included emergency department visits, missed appointments, and patient satisfaction. Results: We plan to enroll 1200 hospitalized patients during a 24-month intervals. As of December 2017, 350 patients have been consented and randomly assigned to either the intervention or control arm. A number of challenges have been encountered in implementing a CHW initiative at the time of hospital discharge. Conclusion: This trial tests the effectiveness of CHW care delivery at the time of hospital discharge in reducing 30-day readmission rates and improving outcomes among patients with chronic disease. We describe and discuss challenges in launching this CHW intervention and strategies utilized to overcome these obstacles. Clinical Trials.gov registration submitted 3/14/2017: Protocol ID# 2017A050810 and Clinical Trials.gov ID# NCT03085264 Community Health Worker Care Transitions Study (C-CAT). AU - Carter, Jocelyn AU - Walton, Anne AU - Donelan, Karen AU - Thorndike, Anne DO - 10.1016/j.cct.2018.09.013 IS - July KW - Care delivery KW - Care transitions KW - Community health worker KW - Hospitalization KW - Randomization PB - Elsevier PY - 2018 SP - 32 EP - 37 TI - Implementing community health worker-patient pairings at the time of hospital discharge: A randomized control trial T2 - Contemporary Clinical Trials UR - https://doi.org/10.1016/j.cct.2018.09.013 VL - 74 ER - TY - JOUR AB - Background: Many community-based self-management programs have been developed for older adults with type-2 diabetes mellitus (T2DM), bolstered by evidence from randomized controlled trials (RCTs) that T2DM can be prevented and managed through lifestyle modifications. However, the evidence for their effectiveness is contradictory and weakened by reliance on single-group designs and/or small samples. Additionally, older adults with multiple chronic conditions (MCC) are often excluded because of recruiting and retention challenges. This paper presents a protocol for a two-armed, multisite, pragmatic, mixed-methods RCT examining the effectiveness and implementation of the Aging, Community and Health Research Unit-Community Partnership Program (ACHRU-CPP), a new 6-month interprofessional, nurse-led program to promote self-management in older adults (aged 65 years or older) with T2DM and MCC and support their caregivers (including family and friends). Methods/design: The study will enroll 160 participants in two Canadian provinces, Ontario and Alberta. Participants will be randomly assigned to the control (usual care) or program study arm. The program will be delivered by registered nurses (RNs) and registered dietitians (RDs) from participating diabetes education centers (Ontario) or primary care networks (Alberta) and program coordinators from partnering community-based organizations. The 6-month program includes three in-home visits, monthly group sessions, monthly team meetings for providers, and nurse-led care coordination. The primary outcome is the change in physical functioning as measured by the Physical Component Summary (PCS-12) score from the short form-12v2 health survey (SF-12). Secondary client outcomes include changes in mental functioning, depressive symptoms, anxiety, and self-efficacy. Caregiver outcomes include health-related quality of life and depressive symptoms. The study includes a comparison of health care service costs for the intervention and control groups, and a subgroup analysis to determine which clients benefit the most from the program. Descriptive and qualitative data will be collected to examine implementation of the program and effects on interprofessional/team collaboration. Discussion: This study will provide evidence of the effectiveness of a community-based self-management program for a complex target population. By studying both implementation and effectiveness, we hope to improve the uptake of the program within the existing community-based structures, and reduce the research-to-practice gap. Trial registration: ClinicalTrials.gov, Identifier: NCT02158741. Registered on 3 June 2014. AU - Markle-Reid, Maureen AU - Ploeg, Jenny AU - Fraser, Kimberly D. AU - Fisher, Kathryn Ann AU - Akhtar-Danesh, Noori AU - Bartholomew, Amy AU - Gafni, Amiram AU - Gruneir, Andrea AU - Hirst, Sandra P. AU - Kaasalainen, Sharon AU - Stradiotto, Caralyn Kelly AU - Miklavcic, John AU - Rojas-Fernandez, Carlos AU - Sadowski, Cheryl A. AU - Thabane, Lehana AU - Triscott, Jean A.C. AU - Upshur, Ross DO - 10.1186/s13063-017-1795-9 IS - 1 KW - Community-based settings KW - Group-based programs KW - Health-related quality of life KW - Hybrid effectiveness-implementation design KW - Older adults KW - Pragmatic KW - Randomized controlled trial KW - Self-management KW - Type-2 diabetes mellitus PB - Trials PY - 2017 SP - 1 EP - 16 TI - The ACHRU-CPP versus usual care for older adults with type-2 diabetes and multiple chronic conditions and their family caregivers: Study protocol for a randomized controlled trial T2 - Trials VL - 18 ER - TY - GEN TI - (No Title) UR - http://www.scielo.org.co/pdf/amc/v38n3/v38n3a05.pdf ER - TY - JOUR AB - La tecnología y los avances en la medicina permiten a las personas sobrevivir a enfermedades fatales y con ello a la incidencia de enfermedades crónicas que se constituyen en principal causa de discapacidad. El apoyo social ha demostrado tener una influencia positiva sobre la experiencia del cuidado de las enfermedades crónicas y de los cuidadores familiares. Se describe como “un proceso de interacción entre personas o grupos de personas, que a través del contacto sistemático establecen vínculos de amistad y de información, recibiendo apoyo material, emocional y afectivo en la solución de situaciones cotidianas en momentos de crisis”. El presente artículo representa la revisión del concepto de apoyo social desde su origen, señala varias definiciones que expertos han dado al tema y cita ejemplos de su aplicación en la investigación con contribuciones de la sociología, psicología, medicina y enfermería. Constituye el marco de referencia del estudio de tipo evaluativo que tiene por objetivo determinar la efectividad del apoyo social dado a través de una red con tecnología punta a cuidadores familiares de personas con enfermedad crónica en Latinoamérica. AU - Vega Angarita, Olga Marina AU - González Escobar, Dianne Sofía DO - 10.22463/17949831.943 IS - 1 KW - CDU::6 - Ciencias aplicadas::61 - Medicina::614 - KW - Chronic illness KW - Cuidadores familiares KW - Enfermedad crónica KW - Family KW - info:eu-repo/semantics/article PY - 2009 SP - 51 EP - 62 TI - Apoyo social: Elemento clave en el afrontamiento de la enfermedad Crónica T2 - Revista Ciencia y Cuidado VL - 6 ER - TY - JOUR AB - The epidemiology of acute renal failure is reviewed. The causes affecting its incidence, particularly that of the definition criteria used, are discussed. Depending on the criteria chosen the incidence can vary between 200 and 600 per million in-habitants in the adult population. The epidemiological information related with the need of dialysis in acute renal failure is analysed. The different incidences in geographical areas where the acute renal failure develops are reviewed. The present general trend to a higher incidence in acute renal failure is commented. AU - Hernández, Germán Gamarra IS - SUPPL.3 PY - 2013 SP - 116 EP - 117 TI - Epidemiología de la insuficiencia renal aguda T2 - Acta Médica Colombiana VL - 38 ER - TY - JOUR AB - One of the tensions found in the Interpretation from the psychology of the Quality of Life and Its Dimensions in Old Age Adults from the Soacha and Sibaté Municipalities (Cundinamarca, Colombia) research project is the one between optimism and conformism, or, in other words, that between a positive possible future perception or learned helplessness. This article is about this tension, present in the narratives of the old-age participants. RESUMEN Una de las tensiones encontradas en el proyecto de investigación Interpretación desde la Psicología de la calidad de la Vida y sus Dimensiones en Adultos Mayores de Soacha y Sibaté (Cundinamarca, Colombia) es aquella entre el optimis AU - Trujillo García, Sergio AU - Tovar Guerra, Claudia AU - Ardila Lozano, Martha Cecilia IS - 2 PY - 2007 SP - 263 EP - 268 TI - El Anciano Conformista ¿Un Optimista Con Experiencia?: Resonancias De Una Investigación En Soacha Y Sibaté T2 - Universitas Psychologica UR - http://www.scielo.org.co/pdf/rups/v6n2/v6n2a06.pdf VL - 6 ER - TY - JOUR AB - El presente trabajo hace un abreviado recuento de los diferentes conceptos que ha tenido la psicoterapia a través del tiempo; menciona y describe brevemente las principales corrientes actuales en el tema. Hace referencia a las tendencias que han surgido, en particular, en la psicoterapia con adultos mayores, así como la importancia de su uso para el logro de una buena salud mental en la vejez, en la cual suelen presentarse problemas psicológicos como la depresión, además de una baja autoestima. Se señalan asimismo los diversos modelos psicoterapéuticos para el trabajo con adultos mayores, las modificaciones en la psicoterapia en el trabajo con senectos, las metas de la psicoterapia y los problemas que plantea la psicoterapia en la vejez. Finalmente, se hacen algunas recomendaciones a los profesionales de la salud que trabajan con grupos o personas de edades avanzadas tendientes al logro de una atención adecuada y de óptima calidad. AU - Edith, Zoila AU - Zamora, Hernández IS - 2 KW - mental health KW - modelos psicoterapéuticos KW - old age KW - psicoterapia KW - psychotherapeutic models KW - salud mental>>>psychotherapy KW - vejez PY - 2005 SP - 79 EP - 100 TI - La psicoterapia en la vejez T2 - Revista Intercontinental de Psicología y Educación VL - 7 ER - TY - JOUR AB - Population over 65 years old has been increasing worldwide in the last decades. So has increased psychoanalytic consultation of elderly people. This paper approaches the possible advantages of such psychoanalytic treatments in persons who have surpassed middle-age crisis and are in the process of aging. The author emphasizes on the conflicts between the projects born from ideals and what was or still can be achieved, and on setting aspirations into a new perspective. The author also brings up depression and mourning for losses that have occurred as well as for the diminishing of body functions and the harm and loss on the image of the body from the youth. A clinical vignette from an analysis illustrates these ideas. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(journal abstract) AU - Ferman Fernández, Abel PY - 2004 SP - 169 EP - 169 TI - Psicoanálisis en la vejez: Cuando el cuerpo se hace biografía y narración. T2 - Revista Uruguaya de Psicoanálisis VL - 99 ER - TY - JOUR AB - Objetivo: determinar la prevalencia de hipertensión arterial en personas ≥18 años de edad y su comportamiento según género y edad en Colombia. Fuente de los datos: la búsqueda fue realizada en bases de datos PubMed, Lilacs, Ovid, Google Académico y Scielo. No restricción por año de realización de los estudios. Estrategia de búsqueda: (Hypertension) AND (Colombia) o (Hipertensión Arterial) AND (Colombia) o (Cardiovascular Risk Factors) AND (Colombia). Selección de los estudios: se incluyeron estudios descriptivos, de corte poblacional y transversal que determinen la prevalencia de hipertensión en población ≥18 años de edad. Con revisores múltiples, 23 estudios cumplieron los criterios de inclusión. Extracción de los datos: la calidad de la información verificada según la declaración STROBE y evaluando el riesgo de sesgo en cada estudio. Síntesis de los datos: se determina la prevalencia con intervalos de confianza y heterogeneidad. La prevalencia de hipertensión (52 570 individuos) es 24% [IC 95% 19-29%; p<0.001]. Ligeramente más prevalente en hombres 29% [IC 95% 23-37%; p<0.001], aumenta proporcionalmente con la edad y menos prevalente en área urbana 21% [IC 95% 14-29%; p<0.001]. La tendencia cambia en relación a género-edad, prevalece más en hombres a edad temprana y en mujeres a partir de la adultez media. Conclusión: Existe una tendencia al aumento de la prevalencia de hipertensión en Colombia. No hay mayores diferencias entre géneros. Existe variabilidad de prevalencia en relación con la edad, edad-género y área geográfica de residencia; esto explicado por el comportamiento fisiológico cambiante y el nivel socioeconómico de la muestra poblacional incluida. (Acta Med Colomb 2019; 44. DOI: https://doi.org/10.36104/amc.2019.1293). Palabras clave (MeSH): prevalencia, hipertensión arterial, Colombia, adultos AU - Marina Sofía Zurique-Sánchez, Cristina Paola Zurique-Sánchez AU - Paul Anthony Camacho-López, Marina Sánchez-Sanabria AU - Hernández-Hernández, Santiago Carlos KW - adultos KW - colombia KW - hipertensión arterial KW - mesh KW - prevalencia PY - 2019 SP - 1 EP - 15 TI - Prevalencia de hipertensión arterial en Prevalence of arterial hypertension in T2 - Acta medica Colombiana UR - http://www.actamedicacolombiana.com/anexo/articulos/2019/04-2019-08.pdf ER - TY - JOUR AU - Jáuregui Balenciaga, Inmaculada IS - 43 KW - annotate KW - community KW - discipline KW - institutional KW - knowledge KW - patent KW - publication KW - read KW - science KW - share KW - source PY - 2008 SP - 133 EP - 142 TI - Vejez y depresión: una visión sociocultural T2 - Zerbitzuan: Gizarte zerbitzuetarako aldizkaria = Revista de servicios sociales ER - TY - JOUR AB - This study was conducted to examine the relationships between family caregivers' perception of caregiving and its influencing factors among Taiwanese with hospitalized relatives. The study used a cross-sectional and descriptive correlational design. A convenience sample of 200 primary caregivers of hospitalized patients diagnosed with cancer, stroke and chronic illness was recruited in a Taiwanese Medical Center; this focus was chosen because cancer, stroke and chronic illness generally require long term care. Data were collected by structured questionnaires. Pearson product-moment correlation and stepwise multiple regression analyses were used to analyse the results of this study. Family caregivers who lacked family support and whose patients' ADL (activities of daily living) dependency was increasing experienced a greater caregiving burden. Family caregivers who had better psychological well-being, better quality of relationship and more caregiving knowledge experienced a lower caregiving burden. Quality of relationship, lack of family support and patients' ADL dependency accounted for 43% of the Zarit Burden Interview variance. The results indicated that family caregivers' perception of caregiving included sacrifice, strain, embarrassment, anger and loss of control. It is vital for nurses to understand these caregiving perceptions and their related factors to provide a holistic care plan. AU - Yeh, Pi Ming AU - Chang, Yuanmay DO - 10.1111/ijn.12333 IS - 5 KW - Family caregiver perception KW - Hospitalized patients KW - Taiwan KW - Zarit Burden Interview PY - 2015 SP - 622 EP - 634 TI - Use of Zarit Burden Interview in analysis of family caregivers' perception among Taiwanese caring with hospitalized relatives T2 - International Journal of Nursing Practice VL - 21 ER - TY - JOUR AU - Gobernacion de Cundinamarca PY - 2015 TI - Análisis de Situación de Salud con el Modelo de los Determinantes Sociales de Salud T2 - Gobernacion de Cundinamarca UR - http://www.cundinamarca.gov.co/wcm/connect/07f0fd4e-9af4-4dc6-921a-28bed95a7c17/ASIS+Cundinamarca+2015+WEB.pdf?MOD=AJPERES&CVID=llg82jv ER - TY - JOUR AB - Background: Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods: The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings: Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation: Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI. Funding: Bill & Melinda Gates Foundation. AU - Bikbov, Boris AU - Purcell, Caroline A. AU - Levey, Andrew S. AU - Smith, Mari AU - Abdoli, Amir AU - Abebe, Molla AU - Adebayo, Oladimeji M. AU - Afarideh, Mohsen AU - Agarwal, Sanjay Kumar AU - Agudelo-Botero, Marcela AU - Ahmadian, Elham AU - Al-Aly, Ziyad AU - Alipour, Vahid AU - Almasi-Hashiani, Amir AU - Al-Raddadi, Rajaa M. AU - Alvis-Guzman, Nelson AU - Amini, Saeed AU - Andrei, Tudorel AU - Andrei, Catalina Liliana AU - Andualem, Zewudu AU - Anjomshoa, Mina AU - Arabloo, Jalal AU - Ashagre, Alebachew Fasil AU - Asmelash, Daniel AU - Ataro, Zerihun AU - Atout, Maha Moh d.Wahbi AU - Ayanore, Martin Amogre AU - Badawi, Alaa AU - Bakhtiari, Ahad AU - Ballew, Shoshana H. AU - Balouchi, Abbas AU - Banach, Maciej AU - Barquera, Simon AU - Basu, Sanjay AU - Bayih, Mulat Tirfie AU - Bedi, Neeraj AU - Bello, Aminu K. AU - Bensenor, Isabela M. AU - Bijani, Ali AU - Boloor, Archith AU - Borzì, Antonio M. AU - Cámera, Luis Alberto AU - Carrero, Juan J. AU - Carvalho, Félix AU - Castro, Franz AU - Catalá-López, Ferrán AU - Chang, Alex R. AU - Chin, Ken Lee AU - Chung, Sheng Chia AU - Cirillo, Massimo AU - Cousin, Ewerton AU - Dandona, Lalit AU - Dandona, Rakhi AU - Daryani, Ahmad AU - Das Gupta, Rajat AU - Demeke, Feleke Mekonnen AU - Demoz, Gebre Teklemariam AU - Desta, Desilu Mahari AU - Do, Huyen Phuc AU - Duncan, Bruce B. AU - Eftekhari, Aziz AU - Esteghamati, Alireza AU - Fatima, Syeda Sadia AU - Fernandes, João C. AU - Fernandes, Eduarda AU - Fischer, Florian AU - Freitas, Marisa AU - Gad, Mohamed M. AU - Gebremeskel, Gebreamlak Gebremedhn AU - Gebresillassie, Begashaw Melaku AU - Geta, Birhanu AU - Ghafourifard, Mansour AU - Ghajar, Alireza AU - Ghith, Nermin AU - Gill, Paramjit Singh AU - Ginawi, Ibrahim Abdelmageed AU - Gupta, Rajeev AU - Hafezi-Nejad, Nima AU - Haj-Mirzaian, Arvin AU - Haj-Mirzaian, Arya AU - Hariyani, Ninuk AU - Hasan, Mehedi AU - Hasankhani, Milad AU - Hasanzadeh, Amir AU - Hassen, Hamid Yimam AU - Hay, Simon I. AU - Heidari, Behnam AU - Herteliu, Claudiu AU - Hoang, Chi Linh AU - Hosseini, Mostafa AU - Hostiuc, Mihaela AU - Irvani, Seyed Sina Naghibi AU - Islam, Sheikh Mohammed Shariful AU - Jafari Balalami, Nader AU - James, Spencer L. AU - Jassal, Simerjot K. AU - Jha, Vivekanand AU - Jonas, Jost B. AU - Joukar, Farahnaz AU - Jozwiak, Jacek Jerzy AU - Kabir, Ali AU - Kahsay, Amaha AU - Kasaeian, Amir AU - Kassa, Tesfaye Dessale AU - Kassaye, Hagazi Gebremedhin AU - Khader, Yousef Saleh AU - Khalilov, Rovshan AU - Khan, Ejaz Ahmad AU - Khan, Mohammad Saud AU - Khang, Young Ho AU - Kisa, Adnan AU - Kovesdy, Csaba P. AU - Kuate Defo, Barthelemy AU - Kumar, G. Anil AU - Larsson, Anders O. AU - Lim, Lee Ling AU - Lopez, Alan D. AU - Lotufo, Paulo A. AU - Majeed, Azeem AU - Malekzadeh, Reza AU - März, Winfried AU - Masaka, Anthony AU - Meheretu, Hailemariam Abiy Alemu AU - Miazgowski, Tomasz AU - Mirica, Andreea AU - Mirrakhimov, Erkin M. AU - Mithra, Prasanna AU - Moazen, Babak AU - Mohammad, Dara K. AU - Mohammadpourhodki, Reza AU - Mohammed, Shafiu AU - Mokdad, Ali H. AU - Morales, Linda AU - Moreno Velasquez, Ilais AU - Mousavi, Seyyed Meysam AU - Mukhopadhyay, Satinath AU - Nachega, Jean B. AU - Nadkarni, Girish N. AU - Nansseu, Jobert Richie AU - Natarajan, Gopalakrishnan AU - Nazari, Javad AU - Neal, Bruce AU - Negoi, Ruxandra Irina AU - Nguyen, Cuong Tat AU - Nikbakhsh, Rajan AU - Noubiap, Jean Jacques AU - Nowak, Christoph AU - Olagunju, Andrew T. AU - Ortiz, Alberto AU - Owolabi, Mayowa Ojo AU - Palladino, Raffaele AU - Pathak, Mona AU - Poustchi, Hossein AU - Prakash, Swayam AU - Prasad, Narayan AU - Rafiei, Alireza AU - Raju, Sree Bhushan AU - Ramezanzadeh, Kiana AU - Rawaf, Salman AU - Rawaf, David Laith AU - Rawal, Lal AU - Reiner, Robert C. AU - Rezapour, Aziz AU - Ribeiro, Daniel Cury AU - Roever, Leonardo AU - Rothenbacher, Dietrich AU - Rwegerera, Godfrey M. AU - Saadatagah, Seyedmohammad AU - Safari, Saeed AU - Sahle, Berhe Weldearegawi AU - Salem, Hosni AU - Sanabria, Juan AU - Santos, Itamar S. AU - Sarveazad, Arash AU - Sawhney, Monika AU - Schaeffner, Elke AU - Schmidt, Maria Inês AU - Schutte, Aletta Elisabeth AU - Sepanlou, Sadaf G. AU - Shaikh, Masood Ali AU - Sharafi, Zeinab AU - Sharif, Mehdi AU - Sharifi, Amrollah AU - Silva, Diego Augusto Santos AU - Singh, Jasvinder A. AU - Singh, Narinder Pal AU - Sisay, Malede Mequanent M. AU - Soheili, Amin AU - Sutradhar, Ipsita AU - Teklehaimanot, Berhane Fseha AU - Tesfay, Berhe etsay AU - Teshome, Getnet Fetene AU - Thakur, Jarnail Singh AU - Tonelli, Marcello AU - Tran, Khanh Bao AU - Tran, Bach Xuan AU - Tran Ngoc, Candide AU - Ullah, Irfan AU - Valdez, Pascual R. AU - Varughese, Santosh AU - Vos, Theo AU - Vu, Linh Gia AU - Waheed, Yasir AU - Werdecker, Andrea AU - Wolde, Haileab Fekadu AU - Wondmieneh, Adam Belay AU - Wulf Hanson, Sarah AU - Yamada, Tomohide AU - Yeshaw, Yigizie AU - Yonemoto, Naohiro AU - Yusefzadeh, Hasan AU - Zaidi, Zoubida AU - Zaki, Leila AU - Zaman, Sojib Bin AU - Zamora, Nelson AU - Zarghi, Afshin AU - Zewdie, Kaleab Alemayehu AU - Ärnlöv, Johan AU - Coresh, Josef AU - Perico, Norberto AU - Remuzzi, Giuseppe AU - Murray, Chris J.L. DO - 10.1016/S0140-6736(20)30045-3 IS - 10225 PY - 2020 SP - 709 EP - 733 TI - Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017 T2 - The Lancet VL - 395 ER - TY - JOUR AB - ResumenObjetivo: Describir y comparar el soporte social percibido por las personas con enfermedad crónica y sus cuidadores familiares. Materiales y métodos: Estudio de tipo descriptivo, comparativo, de corte transversal desarrollado con una muestra de 1.257 personas con enfermedad crónica y 1.184 cuidadores familiares en las cinco macro regiones geográficas de Colombia entre los años 2012 - 2014. Resultados: Las condiciones de las personas con enfermedad crónica y de los cuidadores familiares participantes en el estudio, reflejan predominio femenino con niveles de escolaridad medio-bajo, y con residencia en la zona urbana. La mitad de los participantes tienen pareja estable y trabajo remunerado. La situación de enfermedad crónica se presenta para la mayoría, por más de un año. La familia es la principal fuente de apoyo social y a pesar de ello, la cuarta parte de personas con enfermedad crónica perciben que son una carga para sus familias y la tercera parte de los cuidadores familiares, percibe sobrecarga intensa con el cuidado. Se reporta un nivel adecuado de soporte social, en especial en las regiones Amazonía y Orinoquía. Conclusiones: Las personas con enfermedad crónica y sus cuidadores familiares tienen niveles de soporte social percibido heterogéneos en las diferentes macro regiones geográficas de Colombia. El soporte social percibido es insuficiente para respaldar la experiencia del cuidado de la salud de estas personas. AbstractObjective: To describe and compare the social support perceived by people with chronic disease (CD) and their family caregivers (FC) in Colombia. Materials and methods: This is a descriptive, comparative cross-sectional study developed with a sample of 1257 people with CD and 1184 FC in the five macro geographical regions of Colombia between 2012 and 2014. Results: The conditions of participants with CD and their FC reflects female predominance with medium-low levels of schooling who live in the urban area. Half of the participants have a regular partner as well as a paid job. The situation of chronic disease occurs mostly for over a year. The family is the main source of social support and yet a quarter of people with CD perceive to be a burden to their families and the third of the FC perceived intense care overload. An adequate level of social support is reported, especially in the Amazon and Orinoco regions. Conclusions: People with chronic illness and their family caregivers have heterogeneous levels of perceived social support in the different macro geographical regions of Colombia. The perceived social support is insufficient to support the experience of health care of these people. AU - Barrera Ortiz, Lucy AU - Campos, María Stella AU - Gallardo Solarte, Karina AU - Coral Ibarra, Rosa Del Carmen AU - Hernández Bustos, Adriana DO - 10.22267/rus.161801.23 IS - 1 KW - apoyo social KW - bireme KW - colombia KW - decs KW - enfermedad crónica KW - fuente PY - 2016 SP - 102 EP - 102 TI - Soporte social percibido por las personas con enfermedad crónica y sus cuidadores familiares en cinco macro regiones geográficas de Colombia T2 - Universidad y Salud VL - 18 ER - TY - GEN AU - Organización Mundial de la Salud PY - 2019 TI - Hipertensión datos y cifras UR - https://www.who.int/es/news-room/fact-sheets/detail/hypertension ER - TY - JOUR AU - Arias, Claudia Josefina KW - apoyo social - red KW - assessment KW - de apoyo social KW - network KW - old age social support KW - vejez- evaluación PY - 2009 SP - 147 EP - 158 TI - La red de apoyo social en la vejez. Aportes para su evaluación T2 - Revista de Psicologia da IMED VL - 1 ER - TY - JOUR AB - Loneliness is a prevalent and global problem for adult populations, and a number of different studies have linked it to multiple chronic conditions, including: heart disease, lung disease, cardiovascular disease, hypertension, atherosclerosis, stroke, and metabolic disorders, such as obesity and metabolic disease. Is a major predictor of psychological problems, such as depression, psychological stress, and anxiety. Loneliness is linked to overall morbidity and mortality in adult populations. But limited interventions have demonstrated long-term effectiveness in reducing loneliness in adults with these same chronic conditions. Our research of the extant literature addresses the following question: What evidence exists regarding the relationships between loneliness and health? We focus on recent findings with respect to the links between loneliness and health. AU - Yanguas, Javier AU - Pinazo-Henandis, Sacramento AU - Tarazona-Santabalbina, Francisco José DO - 10.23750/abm.v89i2.7404 IS - 2 KW - Effectiveness KW - Health KW - Interventions KW - Isolation KW - Loneliness KW - Older people PY - 2018 SP - 302 EP - 314 TI - The complexity of loneliness T2 - Acta Biomedica VL - 89 ER - TY - JOUR AB - La diabetes es una grave enfermedad crónica que se desencadena cuando el páncreas no produce suficiente insulina (una hormona que regula el nivel de azúcar, o glucosa, en la sangre), o cuando el organismo no puede utilizar con eficacia la insulina que produce. La diabetes es un importante problema de salud pública y una de las cuatro enfermedades no transmisibles (ENT) seleccionadas por los dirigentes mundiales para intervenir con carácter prioritario. En las últimas décadas han aumentado sin pausa el número de casos y la prevalencia de la enfermedad. AU - García Bello, Laura AU - Torales Salinas, Judith AU - Giménez, María Belén AU - Flores, Laura Emilce AU - Gómez de Ruiz, Nancy AU - Centurión, Osmar Antonio DO - 10.18004/rvspmi/2312-3893/2016.03(02)71-076 IS - 2 PY - 2016 SP - 71 EP - 76 TI - The risk of those who care for risk: FIDRISK in healthcare personnel T2 - Revista Virtual de la Sociedad Paraguaya de Medicina Interna VL - 3 ER - TY - RPRT AU - Organización Mundial de la Salud PY - 2016 TI - Informe mundial sobre diabetes UR - https://apps.who.int/iris/bitstream/handle/10665/204877/WHO_NMH_NVI_16.3_spa.pdf;jsessionid=41229FB71BEA490E9EE6D8CB5325276A?sequence=1 ER - TY - BOOK AU - Ministerio de Salud y Protección Social PY - 2016 SN - 9789588903828 SP - 20 EP - 23 TI - Guía de práctica clínica para el diagnóstico, tratamiento y seguimiento de la diabetes mellitus tipo 2 en la población mayor de 18 años ER - TY - JOUR AB - La discapacidad es un fenómeno complejo que afecta al individuo y su relación con el entorno. Su prevalencia a nivel mundial va en aumento, de igual manera sucede en Colombia. El objetivo del artículo es analizar las características sociodemográficas y de la discapacidad de la población que reside en el municipio de Soacha (Cundinamarca, Colombia), utilizando los datos secundarios consignados en el registro de localización y caracterización de las personas con discapacidad entre enero 1 del 2016 y 31 de diciembre de 2018 a través de un estudio de corte transversal. De los resultados, se obtiene una muestra de 1311 registros, el 58% fueron hombres, el estrato socioeconómico 2 predominó con un 48.4%, la alteración corporal que se evidenció con mayor frecuencia fue en el sistema nervioso, al igual que la dificultad para realizar actividades como caminar, correr; así mismo, se demostró la asociación entre las barreras físicas con la edad. Este estudio permitirá optimizar la toma de decisiones en políticas públicas dirigidas a las necesidades de la población. AU - Rodríguez González, Sandra Johanna AU - Pública, Magíster en Salud AU - time, Full KW - Aspectos sociales KW - Características de la población KW - Characteristics of these people KW - Colombia KW - Disability assessment KW - Disabled people KW - Estudios sociodemográficos KW - Evaluación de la discapacidad KW - Healthcare electronic records KW - Personas con discapacidad KW - Personas con discapacidades KW - Población discapacitada KW - Promoción de salud KW - Registros electrónicos de salud PY - 2020 TI - Caracterización sociodemográfica de la población en condición de discapacidad municipio de Soacha (Cundinamarca) Colombia T2 - instname:Universidad del Rosario UR - https://repository.urosario.edu.co/handle/10336/20955 ER - TY - JOUR AB - Background: Self-Management Support (SMS), refers to the actions taken by individuals to recognise and manage their own health. It is increasingly recognised that individuals with chronic obstructive pulmonary disease (COPD) require additional support with their Self-management. Emerging evidence suggests that the use of a social network intervention can improve health outcomes and increase quality of life. In order to understand the potential benefits of SMS in COPD, the GENIE (Generating Engagement in Network Support) SMS tool was implemented and evaluated in a COPD primary care context. The GENIE intervention is a social networking tool that consists of 3 parts; a concentric circle modelling to map existing social networks; a questions sections to elicit preferences for activities; a map of selected resources is then produced, aligned with the user's interests and suggestions for connections to existing network members and to new resources. Methods: A pilot, parallel, single blind, block randomised controlled trial. Patients with COPD ranging from mild-very severe were recruited. Participants provided written consent and were then randomised to either the intervention or usual care. The primary aim was to understand the clinical benefit through the analysis of health status, symptom burden and quality of life. The secondary outcome measure was health utilisation. NHS cost differences were reported between groups using the GENIE intervention over usual care. Results: The GENIE pilot results demonstrate maintenance in health status and clinical symptoms with a decrease in anxiety. An overall increase in quality of life was observed, these findings did not reach significance. A cost reduction was demonstrated in inpatient stay with no difference in primary care costs. Overall a cost reduction in NHS service utilisation was indicated in the intervention group. Conclusion: This pilot study indicated that using a social network intervention can encourage the development of new social connections and extend existing support networks for COPD patients. Increasing network support in this population is of benefit to both patients and NHS providers in terms of cost reductions and enhancing wellbeing. This broadens the understanding of possible new approaches to SMS in community COPD patients, which could now be investigated in a larger population over a longer period. Trial registration: Clinical Trials.gov PRS National Library of Medicine. Protocol ID number: 19175, Clinical Trial ID: NCT02935452. AU - Welch, Lindsay AU - Orlando, Rosanna AU - Lin, Sharon X. AU - Vassilev, Ivaylo AU - Rogers, Anne DO - 10.1186/s12890-020-1130-1 IS - 1 KW - Chronic Obstructive Pulmonary Disease (COPD) KW - Self-management support KW - Social intervention PB - BMC Pulmonary Medicine PY - 2020 SP - 1 EP - 14 TI - Findings from a pilot randomised trial of a social network self-management intervention in COPD T2 - BMC Pulmonary Medicine VL - 20 ER - TY - JOUR AB - Diabetes Mellitus, a chronic disease that affects the whole world as our country Mexico, the first place with this disease, its incidence increases with age up to 20 % in people over 60 years old all of them susceptible to geriatric syndromes, with possible repercussions either due to lack of control of blood glucose levels or to an excess in control. The objective of this non-systematic review is to raise awareness of the general population of diabetes mellitus and the context of different geriatric syndromes, as well as timely diagnosis and pharmacological and non-pharmacological treatment. AU - Juan Manuel Guerrero Godinez, Ana Maria Barragán Vigil, Carmen Lucia Navarro Macias, Luis Manuel Murillo Bonilla, Rodolfo Paul Uribe Gonzalez, Martha Alicia Saánchez Criz IS - 2 KW - Aging KW - Diabetes Mellitus KW - Exercise KW - Habits KW - Humans KW - Middle Aged KW - Self Care KW - Type 2 PY - 2017 SP - 81 EP - 94 TI - La diabetes mellitus en el adulto mayor T2 - Revista de medicina Clínica VL - 1 ER - TY - JOUR AB - Diabetes is a complex disorder, slowly progressing and affecting many people worldwide, in particular through its association with microvascular (retinopathy, nephropathy and neuropathy) and macrovascular (coronary heart disease, cerebrovascular and peripheral vascular disease) complications. World-wide prevalence and incidence of diabetes are increasing over time, and with all of its complications diabetes is currently one of the most costly and burdensome chronic diseases. Precise estimates for the prevalence and incidence of diabetes, microvascular complications and the associated increased relative risks of cardiovascular disease will be summarized in this chapter. Much time and effort has been spent on large scale genome wide association studies and several genes have been identified in patients with diabetes. Powerproblems, common variants, interactions, and mild-to moderately associated risks urge the need for replication and further research. Environmental risk factors have been investigated in large cohort studies, and are further established in randomized controlled trials. The most common established risk factors for CVD in diabetes are age, sex, obesity, smoking, blood pressure, lipids and lipoproteins. Diabetes related risk factors like duration of diabetes, hyperglycemia, hyperinsulinemia and albuminuria also play a very important role in the development of cardiovascular disease in diabetic patients. Nutritional factors, physical activity and inflammatory markers have also been indicated in the development of diabetes and the development of cardiovascular disease in people with diabetes. Prevention and treatment of cardiovascular complications in diabetes should be multifactorial with a focus on lifestyle as well as risk factor targeting glucose lowering, blood pressure, blood cholesterol lowering. The most important and recent landmark trials covering this topic will be described. © 2011 Nova Science Publishers, Inc. All rights reserved. AU - Goday, Alberto DO - 10.1056/nejm198806163182414 IS - 6 KW - diabetes mellitus KW - incidence KW - prevalence PY - 2002 SN - 9781616689261 SP - 657 EP - 670 TI - Epidemiology of Diabetes and its Non-Coronary Complications T2 - Revista Española de Cardiologia VL - 55 ER - TY - JOUR AU - Naranjo Hernández, Ydalsys IS - 1 PY - 2016 SP - 1 EP - 3 TI - Diabetes mellitus: Un reto para la salud pública T2 - Revista Finlay VL - 6 ER - TY - JOUR AB - El objetivo del presente estudio fue examinar las relaciones de la autoeficacia y el apoyo social percibido con la adherencia terapéutica en pacientes diabéticos tipo II. Se estudiaron 118 pacien- tes de ambos sexos, de entre 35 y 64 años, de la ciudad de Concepción (Chile), quienes respondieron la Escala de Autoeficacia Generalizada y el Cuestionario de Apoyo Social Percibido. La adherencia se midió a través de dos indicadores: el autorreporte de ingestión de medicamentos y el nivel de compensación metabólica. Se encontró que tanto la autoeficacia como el apoyo social presentaron relaciones significativas con ambos indicadores de adherencia, siendo algo mayor la magnitud de la relación de la adherencia con el apoyo social que con la autoeficacia. Se proponen diversas ex- plicaciones para los resultados obtenidos. AU - Canales, Sergio AU - Barra, Enrique IS - 2 KW - Adherencia. KW - Apoyo social KW - Autoeficacia KW - Diabetes PY - 2014 SP - 167 EP - 173 TI - Autoeficacia, apoyo social y adherencia al tratamiento en adultos con diabetes mellitus tipo II T2 - Psicología y Salud VL - 24 ER - TY - JOUR AB - It is estimated that rates of non-adherence to chronic diseases are around 50%. International studies have reported some psychosocial factors related to treatment adherence. The purpose of the present study was to detect the relationship between psychosocial factors and treatment adherence in a sample of Type 2 Diabetics subjects from a public health institution. To this end, a non - experimental transversal correlational study was designed with a 50 DM2 subjects sample, which average age was 60,76 years old. Self-report measures of stress level, coping style, depressive symptoms, social support perception and treatment adherence, were obtained. The results revealed that 40% of participants had glycosylated hemoglobin over 9%, and 66% of them shown moderate to high stress levels. In average during the last 7 days, the participants have accomplished the diet 4,37 days, consumed fruits and vegetables 3,14 days and took glycemia test in 1,1 days. There is a direct correlation between the stress level and concentrations of glycosylated hemoglobin. Unlike stress, social support and depressive symptomatology was not associated with treatment adherence. These results confirm low levels of treatment adherence and high rates of stress in DM2 patients, as well as its association with high levels of glycosylated hemoglobin. © 2011 Sociedad Chilena de Psicología Clínica. AU - Ortiz, Manuel AU - Ortiz, Eugenia AU - Gatica, Alejandro AU - Gómez, Daniela DO - 10.4067/S0718-48082011000100001 IS - 1 KW - Copying style KW - Depression KW - Psychological stress KW - Treatment adherence KW - Type 2 diabetes mellitus PY - 2011 SP - 5 EP - 11 TI - Factores psicosociales asociados a la adherencia al tratamiento de la diabetes mellitus Tipo 2 T2 - Terapia Psicologica VL - 29 ER - TY - JOUR AB - Objetivo: Realizar una revisión de la literatura para determinar la prevalencia reportada de DM2 en Colombia y estudiar los factores de riesgo para amputación de miembros inferiores en pacientes con DM. Materiales y métodos: Se realizaron dos búsquedas sistemáticas de literatura en Pubmed y dos revistas indexadas a nivel regional, nacional e internacional incluyendo una revisión de 12 artículos. Resultados: Según la Federación Internacional de Diabetes, en Centroamérica y Suramérica se estimaron 467.580 millones de personas afectadas por DM2 para el año 2013. Los 5 países con mayor prevalencia de DM son: Brasil, Colombia, Chile, Argentina y Venezuela. En Colombia no existen datos actualizados sobre la prevalencia de la enfermedad y se ha estimado que estos pacientes tienen 3 veces más riesgo de desarrollar enfermedad arterial periférica y amputación de miembros inferiores. La DM2 es una enfermedad con alta tasa de complicaciones multiorgánicas como la amputación de miembros inferiores. Discusión: El 80% de los casos reportados se han encontrado en países de bajos y moderados ingresos como Colombia. Aun así, su prevalencia en este país continúa incierta. En esta revisión de literatura, la enfermedad arterial periférica se estudia como uno de los factores de riesgo más predisponentes para la amputación de miembros inferiores. Conclusiones: La DM2 es una enfermedad con alta prevalencia a nivel global. En Colombia son pocos los datos registrados, sin embargo, la información existente ha recalcado la importancia de desarrollar mejores estrategias de prevención, detección y manejo, ya que aproximadamente el 50% de la población no ha sido diagnosticada. AU - Ortegate, M. Sangiovanni, S. Diaz, M. Aguilar, J. Garcia, J. Asencio, H. IS - 1 KW - Colombia KW - Diabetes mellitus tipo 2 KW - Pie diabético KW - amputación KW - factores de riesgo KW - pie diabético. PY - 2018 SP - 49 EP - 56 TI - Epidemiología de diabetes mellitus tipo 2 en la población colombiana y factores de riesgo que predisponen a la amputación de miembros inferiores. Revisión de la literatura T2 - Salutem Scientia Spiritus VL - 4 ER - TY - JOUR AB - RESUMEN Se realizó un estudio prospectivo , de carácter observacional ,para determinar los niveles de hemoglobina glicosilada A1c (Hb A1c) como parámetro de control metabólico en pacientes con diabetes mellitus del Hospital de Clínicas de La Paz,. Se seleccionó una muestra de 72 pacientes que contaban con controles periódicos de Hb A1C. De los mismos solo uno era diabético de tipo 1, el resto (71) son diabéticos tipo 2. El 69% (49) de los pacientes eran mujeres y un 31 % (23) varones. La mayor parte de los pacientes están por encima de los 45 años, dato en relación con el tipo de diabetes que se presenta (DMT2), el único caso de diabetes mellitus tipo 1 se da en un paciente menor de 25 años. Dos tercios de los pacientes (69% del total) no cuentan siquiera con una dosificación inicial de HbA1c. Se solicitó el examen al 75 % de los pacientes, solamente el 32,7% de los pacientes lo efectivizaron. El 43,3% de los pacientes que cuentan con el control presentaban un nivel de Hb A1c por debajo de 7,5%, sin embargo solo el 20 % logran la meta de Hb A1c por debajo de 6,5 %, que es la cifra que ha demostrado reducir las complicaciones crónicas de la diabetes. Se debe solicitar en la totalidad de los pacientes la dosificación de Hb A1c (como mínimo tres veces al año) para permitirnos conocer la efectividad del manejo realizado y lograr la prevención de complicaciones crónicas. Palabras clave Hemoglobina glicosilada A1C, diabetes mellitus, control metabólico. ABSTRACT This is a prospective observational study in order to determine the levels of glycosylated hemoglobin A1c (HbA1c) as parameter of metabolic control in patients with diabetes mellitus in the Hospital de Clinicas, La Paz. A sample of 72 patients was selected who had periodic controls of HbA1c. Only one of these patients had diabetes type 1, the rest (71) had diabetes type 2. Of the patients, 49 (69%) were females and 23 (31%) were males. The majority of the patients were older than 45 years, which is to be expected in relation with the type of diabetes presented (DMT2), being the only case of diabetes type 1 a man under 25 years of age. Two thirds of the patients (69% of the total) did not even have an initial measurement of HbA1c. This measurement was requested in 75% of the patients, but only 32.7% had the test done. The 43.3% of the patients who had the control, showed a level of HbA1c below 7.5%, however, only 20% achieved the goal of a HbA1c below 6.5%, which is the level that has been shown to reduce the chronic complications of diabetes. In all patients a periodic control of HbA1c should be requested at least 3 times per year, in order to know the effectiveness of our work and to prevent chronic complications of diabetes. INTRODUCCIÓN Es importante contar con datos del medio, respecto al control glucémico de los pacientes con DM, especialmente aquellos que cuentan con otros factores de riesgo cardiovascular (obesidad, HAS, LDL aumentado, enfermedad coronaria.). La diabetes se ha convertido en una de las enfermedades crónicas más importantes en cuanto al número de personas afectadas, la morbilidad global, la mortalidad prematura y las repercusiones sociales 1. La diabetes es un trastorno metabólico crónico de gran alcance epidemiológico que requiere un tratamiento de por vida y, sobre todo, la obtención de un adecuado control metabólico que logre el retraso en la aparición de las complicaciones micro y macro vasculares que en definitiva condicionan la evolución de la enfermedad. Mucho antes de los estudios Diabetes Complications Control Trial (DCCT) y United Kingdom Prospective Diabetes Study (UKPDS) , Pirart había alertado en el sentido que el mal control metabólico acumulado durante años se asocia con una mayor prevalencia e incidencia de retinopatía, nefropatia y neuropatía, y especialmente la retinopatía grave 2. En la actualidad, con los dos estudios mencionados, entre otros, la medicina basada en la evidencia demuestra sin lugar a dudas la enorme importancia de controlar adecuadamente la glicemia. El estado de hiperglucemia sostenida complica rápidamente al paciente diabético. Las complicaciones microvasculares están directamente relacionadas con ese estado. Hemoglobina glucosilada A1C como parámetro de control metabólico en pacientes AU - Reyes, Andrés AU - Urquizo, Guillermo IS - 2 KW - Glycosylated haemoglobin A1C KW - diabetes mellitus KW - metabolic control PY - 2008 SP - 54 EP - 58 TI - Hemoglobina glucosilada A1C como parámetro de control metabólico en pacientes con diabetes mellitus T2 - Cuadernos UR - http://www.scielo.org.bo/pdf/chc/v53n2/v53n2a08.pdf VL - 53 ER - TY - JOUR AU - Guzmán, G. Arce, A. Saavedra, H. Rojas, M. Solarte, J. Mina, M. Gutierrez, K. Martinez, V. DO - 10.24875/alad.18000319 IS - 1 PY - 2018 SP - 35 EP - 43 TI - Adherencia al tratamiento farmacológico y control glucémico en pacientes adultos con diabetes mellitus tipo 2 T2 - Alad VL - 8 ER - TY - JOUR AU - Mayorga, Cecilia AU - Gallardo, Lorena AU - Galvez, José IS - 10 KW - aging KW - family health KW - indigenous peoples KW - psychometrics KW - surveys and ques- KW - tionnaires PY - 2019 SP - 1283 EP - 1290 TI - Propiedades psicométricas de la escala APGAR-familiar en personas mayores residentes en zonas rurales multiétnicas chilenas T2 - Revista médica de Chile VL - 147 ER - TY - JOUR AB - Los instrumentos de atención integral a la familia ofrecen una apreciación gráfica y esquemática de la familia y sus relaciones, permite desarrollar una visión integrada de las interacciones actuales, los puntos débiles y fuertes de la familia, así como su desarrollo histórico, son un elemento importante de diagnóstico para el médico familiar. AU - Suarez, M. AU - Alcalá, M. IS - 1 KW - consulta KW - cuando este los detecta KW - en KW - este instrumento también sirve KW - favorecer una relación médico KW - la conversación durante la KW - paciente KW - para PY - 2014 SP - 53 EP - 57 TI - Apgar Familiar: Una Herramienta Para Detectar Disfunción Familiar T2 - Revista Médica La Paz VL - 20 ER - TY - GEN AU - Reyes, C. AU - Aroyo, G. IS - 94 KW - UNAM FUNCIONALIDAD FAMILIAR CIFRAS HEMOGLOBINA DIA PY - 2014 SP - 1 EP - 47 TI - Funcionalidad familiar y su relación con cifras de hemoglobina glicosilada en diabéticos tipo 2 de una UMF, del IMSS ER - TY - RPRT AB - The author describes experiences gained in the zinc and copper serum concentration estimations in burned children. Without added substitution therapy the serum zinc concentration rises by 19.9% and the serum copper concentration by 5.8% in the course of time. If only zinc is substituted the values rises by 83.6% for zinc, but the value for copper decreases by 18.8%. If the serum zinc and copper concentration is low on admission and if both added zinc and copper are given, the concentration for zinc rises by 102.5%, but the concentration of copper only rises by 25% and does not reach normal values. Serum zinc and copper concentration drops to its maximal extent 48 hours after the accident. The time of hospitalisation calculated per percentage of burned body surface decreases slightly if substitution therapy is given, although the average serum zinc and copper values do not even reach normal levels. The rate of infection and the type of infection are not markedly different whether no substitution, only zinc and copper serum concentration to the area of the burned body surface, the normal value, the dosages used in substitution therapy and the side effects of the therapy are discussed. Routine therapy is probably not justified because of the normal changes of the serum concentration, because side effects are not completely understood and because of the antagonism between zinc and copper known from veterinary medicine. If more than 20% of the total body surface has been burned zinc and copper deficiency is probable. The dosage referred to in the literature are too high and much lower dosages (10--30 mg of zinc sulphate per day and 0.08 mg/kg of copper sulphate per day) are advised. These amounts should be sufficient if given in addition to a diet, which should be administered as early as possible after the accident. AU - DANE KW - 27 KW - actividades KW - calle g esquina a KW - cano de la tercera KW - cotidianas KW - edad KW - enfermedad crónica KW - estado de salud KW - personas con discapacidad KW - salud del anciano KW - ve- PY - 2005 SP - 1 EP - 6 TI - Boletin DANE Soacha Cundinamarca ER - TY - JOUR AB - censo general, 2005,perfil Viterbo-Caldas AU - Municipal, Perfil PY - 2010 TI - B o l e t í n ER - TY - RPRT TI - (No Title) ER - TY - JOUR AB - OBJETIVO: Identificar la relación entre determinadas enfermedades crónicas y la presencia de discapacidad en habitantes de 60 años o más de siete centros urbanos de América Latina y el Caribe que participaron en el estudio multicéntrico Salud, Bienestar y Envejecimiento (SABE). MÉTODOS: En 2000 y 2001 se realizó un estudio descriptivo de corte transversal con una muestra de 10 891 personas de 60 años o más que residían en siete ciudades de la Región: Bridgetown, Barbados; Buenos Aires, Argentina; Ciudad de La Habana, Cuba; México, D.F., México; Montevideo, Uruguay; Santiago, Chile, y São Paulo, Brasil. Las variables dependientes fueron la dificultad para realizar actividades básicas y actividades instrumentales de la vida diaria (ABVD y AIVD, respectivamente). Las variables independientes, recopiladas mediante autoinforme, fueron la edad, el sexo, el nivel educacional, el vivir solo o acompañado, la evaluación de la propia salud y la presencia o no de hipertensión arterial, diabetes mellitus, cáncer, enfermedad pulmonar obstructiva crónica, cardiopatía isquémica (CI), enfermedades cerebrovasculares (ECV) y artrosis. Se evaluó la presencia de depresión y deterioro cognoscitivo en los participantes y se calculó su índice de masa corporal. Para comparar el grado de influencia de las diferentes variables sobre la discapacidad, se calculó un coeficiente estandarizado para cada caso. RESULTADOS: Las variables que mostraron una asociación directa con dificultades para realizar ABVD y AIVD en las ciudades estudiadas fueron: padecer de un mayor número de enfermedades no transmisibles, de ECV o de artrosis, así como tener mayor edad, ser mujer, evaluar la salud propia como mala, tener deterioro cognoscitivo y padecer de depresión. En general, las asociaciones más fuertes se encontraron entre la dificultad para realizar AIVD, por un lado, y por el otro la depresión, mayor edad, la evaluación de la salud propia como mala y la presencia de ECV, artrosis o deterioro cognoscitivo. CONCLUSIONES: Se ofrece por primera vez una descripción sistematizada de la asociación entre la presencia de discapacidad y de enfermedades crónicas no transmisibles en adultos mayores en América Latina y el Caribe. Como las dificultades de los adultos mayores para realizar AIVD son las primeras en aparecer, se deben establecer mecanismos de seguimiento que permitan detectar tempranamente este tipo de discapacidad. AU - Menéndez, Jesús AU - Guevara, Adialys AU - Arcia, Néstor AU - León Díaz, Esther María AU - Marín, Clara AU - Alfonso, Juan C. DA - 2005/5// DO - 10.1590/S1020-49892005000500007 IS - 5-6 KW - Salud del anciano KW - actividades cotidianas KW - enfermedad crónica KW - estado de salud KW - personas con discapacidad PB - Organización Panamericana de la Salud PY - 2005 SP - 353 EP - 361 TI - Enfermedades crónicas y limitación funcional en adultos mayores: estudio comparativo en siete ciudades de América Latina y el Caribe T2 - Revista Panamericana de Salud Pública VL - 17 ER - TY - JOUR AB - Despite the many advantages that laparoscopic surgery has for patients, it involves a series of risks for the surgeon. These are related to the reduced freedom of movement and forced postures which lead to greater muscle fatigue than with conventional surgery. In laparoscopic surgery there are few references on the introduction of training programs in ergonomics, despite the numerous advantages demonstrated in other disciplines. The application of ergonomic criteria in the surgical field could have great benefits, both for surgeons and patients. In this work we attempt to review the existing literature and our experience to provide the surgeon with some ergonomic guidelines for body stance and positioning of equipment. We also present a training model based on ergonomics which we have introduced into the training activities carried out in our Centre. © 2011 AEC. AU - Pérez-Duarte, Francisco Julián AU - Sánchez-Margallo, Francisco Miguel AU - Díaz-Güemes Martín-Portugués, Idoia AU - Sánchez-Hurtado, Miguel Ángel AU - Lucas-Hernández, Marcos AU - Usón Gargallo, Jesús DA - 2012/5// DO - 10.1016/J.CIRESP.2011.04.021 IS - 5 KW - Cirugía laparoscópica KW - Ergonomía KW - Fatiga muscular KW - Instrumental KW - Programas de formación PB - Elsevier PY - 2012 SP - 284 EP - 291 TI - Ergonomía en cirugía laparoscópica y su importancia en la formación quirúrgica T2 - Cirugía Española UR - https://www.elsevier.es/es-revista-cirugia-espanola-36-articulo-ergonomia-cirugia-laparoscopica-su-importancia-S0009739X11002168 VL - 90 ER - TY - JOUR AB - La diabetes tipo 2 es uno de los mayores problemas para los sistemas de salud de Latinoamérica, región que abarca 21 países y más de 569 millones de habitantes. La Federación Internacional de Diabetes (IDF por sus siglas en inglés) estimó en el 2017 que la prevalencia ajustada de diabetes en la región era de 9.2% entre los adultos de 20 a 79 años, solo Norteamérica (11.1%) y el Sur de Asia (10.8%) tenían tasas mayores1.. De los 371 millones de adultos que viven con diabetes, 34 millones (9%) residen en nuestra región. El crecimiento en el número de casos esperado (62%) para el año 2045 es mayor en nuestros países que lo pronosticado para otras áreas. La expectativa de crecimiento se basa en la prevalencia alta de las condiciones que preceden a la diabetes como la obesidad y la intolerancia a la glucosa. Aún más grave es que el 40% de los pacientes con diabetes ignoran su condición. AU - ALAD DO - 10.1007/978-3-642-16483-5_167 PY - 2019 SP - 2 EP - 119 TI - Guías ALAD sobre el Diagnóstico, Control y Tratamiento de la Diabetes Mellitus Tipo 2 con Medicina Basada en Evidencia Edición 2019 T2 - Revista de ALAD ER - TY - JOUR AB - The long-term complications of diabetes have major consequences for individual subjects and growing healthcare delivery and cost implications for society. Evidence for the benefits of good glycaemic control, as monitored by glycated haemoglobin measurements, has been developed in the 25 years since they were introduced to the point where HbA1c assays play central roles in patient management, clinical guidance and audit, and clinical trial design. In this review this evidence is examined and three classes of uncertainty identified that diminish confidence in the effectiveness of these roles for HbA1c. 1 Analytical variability between different methods for HbA1c has restricted the application of clinical targets and this problem has recently been addressed by reference method standardization. There are two approaches to this which result in different HbA1c values and this discrepancy needs to be resolved. 2 Biological variability in HbA 1c values between individuals also restricts its predictive role when applied to populations. The correlations between HbA1c measurements and various components of glycaemia (overall, fasting, post-prandial) are still uncertain and differences in protein glycation and de-glycation are greater between subjects than often thought. The influence of variability in erythrocyte life span is an area where research is needed, especially in diabetic subjects. 3 Clinical variability is the most important and complex area of uncertainty. A predictive link between HbA1c and clinical outcomes is not as clear-cut as often stated. The correlation with the development of microvascular disease is well established in Type 1 diabetes, but in Type 2 subjects (90% of those with diabetes) the evidence that HbA1c monitoring is of value in predicting or preventing macrovascular disease is not strong, although it is the major cause of morbidity and early death in this group. It is recommended that, as a matter of urgency, these issues be examined, particularly within the context of self-care in diabetes. AU - Jeffcoate, S. L. DO - 10.1046/j.1464-5491.2003.01065.x IS - 7 KW - Complications KW - Glycaemic control KW - Glycated haemoglobin KW - HbA1c PY - 2004 SP - 657 EP - 665 TI - Diabetes control and complications: The role of glycated haemoglobin, 25 years on T2 - Diabetic Medicine VL - 21 ER - TY - JOUR AB - The management of diabetes is rapidly evolving in the last years either by incorporation of new proposals to make the diagnosis, or for modified intermediate objectives that we should seek to reduce vascular risk, or the recommended means to achieve these objetives. For guide us in this area moving at varying intervals published several guides among which stands out for its diffusion and predicament of the American Society of Diabetes. In this article we summarise the most important changes made in the recommendations this year and we remind you of the most significant aspects that remain the same as in previous versions. © 2010 Elsevier España, S.L. y SEMERGEN. AU - Barquilla García, A. AU - Mediavilla Bravo, J. J. AU - Comas Samper, J. M. AU - Seguí Díaz, M. AU - Carramiñana Barrera, F. AU - Zaballos Sánchez, F. J. DO - 10.1016/j.semerg.2010.03.008 IS - 7 KW - American Diabetes Association KW - Antiplatelet KW - Diabetes KW - Diagnosis KW - Glucose Objectives KW - Prediabetes PY - 2010 SP - 386 EP - 391 TI - Recomendaciones de la Sociedad Americana de Diabetes para el manejo de la diabetes mellitus T2 - Semergen VL - 36 ER - TY - JOUR AB - Cómo citar este artículo: Resumen El tratamiento de las enfermedades crónicas no transmisibles constituye en la actualidad uno de los mayores retos que enfrentan los sistemas de salud a nivel mundial. Esto se debe a que dichas enfermedades afectan a todos los grupos de edad y a todas las regiones y países, con independencia de su grado de desarrollo. Cuba no está exenta de ello. Sin embargo, la Organización Mundial de la Salud señala que se realiza un manejo inadecuado de estos padecimientos, por diferentes razones, en la mayoría de los sistemas de salud. El objetivo del presente artículo, es lograr la concientización de la problemática actual y futura de las enfermedades crónicas, donde la prevención y promoción de salud sigue siendo el arma fundamental para combatir el reto. Se debe tener en cuenta la importancia de estos conocimientos para el personal profesional en formación, la necesidad de establecer estrategias presentes y futuras para garantizar la salud de nuestra población, fundamentalmente desde la atención primaria y las organizaciones vinculados a ellas. La población, que resulta la más afectada, debe tomar mayor conciencia de lo que representa, en general, padecer una enfermedad crónica. Palabras clave: enfermedad crónica, terapéutica, prevención de enfermedades, promoción de la salud Abstract The treatment to non-transmissible chronic diseases is currently on of the greatest challenges faced by the health systems worldwide. This is due to the fact that these diseases affect all age groups, all regions and countries regardless their level of development. Cuba is not the exception. The World Health Organization, however, points out that there is an inadequate management of these ailments, for different reasons, in most of the health systems. The objective of this article is the awareness of the current and future problem of chronic diseases where health promotion and prevention still is the main weapon to fight the challenge. The importance of these elements should be taken into consideration from the personnel in training, the need to set present and future strategies to guarantee the health of our population, mainly from the primary health care attention and organizations linked to them. The most affected population should be aware of what suffering from a chronic disease represents in general. AU - Ángel, Miguel AU - Valdés, Serra AU - Serra Ruíz, Melissa AU - Viera García, Marleny IS - 2 KW - chronic diseases KW - disease prevention KW - health promotion KW - therapeutics PY - 2018 SP - 140 EP - 148 TI - Las enfermedades crónicas no transmisibles: magnitud actual y tendencias futuras Non Transmissible Chronic Diseases: Current Magnitude and Future Trends T2 - Revista Finlay VL - 8 ER - TY - JOUR AB - Background: There are several scales available to evaluate family functioning. However, in Colombia, the basic psychometric properties of these tools among adolescent students are unknown. Objective: To evaluate of the internal consistency and the factors of the family {APGAR} scale in adolescent st... AU - Forero, laura AU - Avendaño, Mónica AU - Duarte, Zuly AU - Campo-Arias, Adalberto IS - 1 KW - Validation studies KW - adolescent KW - adolescentes KW - análisis de factores KW - estudiantes KW - estudios de validación KW - factor analyses KW - students PY - 2006 SP - 23 EP - 29 TI - Consistencia interna y análisis de factores de la escala APGAR para evaluar el funcionamiento familiar en estudiantes de básica secundaria T2 - Revista Colombiana de Psiquiatría VL - 35 ER - TY - JOUR AB - RESUMEN Objetivo: Determinar la validez de constructo y confiabilidad del APGAR familiar en pacientes odontológicos adultos de Cartagena, Colombia. Métodos: Estudio de validación de escalas sin criterio de referencia en 227 pacientes entre 22 y 94 años atendidos en una Clínica Odontológica Universitaria del Norte (Colombia). Los datos del APGAR se extrajeron a partir de la historia clínica de salud familiar. La consistencia interna se estimó con la fórmula de Kuder-Richardson y la validez de constructo, empleando análisis factorial exploratorio (AFE) y confirmatorio (AFC). Los siguientes índices de ajuste se obtuvieron a partir del AFC: χ2, p-valor para χ2, grados de libertad (gl), raíz cuadrada del error medio de aproximación, índice comparativo de ajuste e índice de Tucker-Lewis. El análisis de los datos se hizo a través de Stata v.13.2 para Windows (StataCorp, TX, USA) y Mplus v.7.31 para Windows (Muthén & Muthén, LA, USA). Resultados: El promedio global del APGAR familiar fue 17,07±3,15 y la prevalencia de disfunción familiar fue 44,4 % (IC 95%: 38-51 %). La consistencia interna fue 0,90. El AFE reportó un solo factor que explicó el 64,1 % de la varianza total. El AFC mostró como índices de ajuste χ2=702,960; gl=10, p-valor=0.001; RCEMA=0.155 (IC90%: 0.107-0.209); ICA=0.961; ITL=0.922. Conclusiones: En la muestra, APGAR familiar resultó ser un instrumento de tamizaje con alta utilidad clínica, excelente consistencia interna pero cuestionable validez de constructo. Deben realizarse investigaciones adicionales a fin de obtener escalas con adecuadas propiedades psicométricas para la medición de constructos en salud. ABSTRACT Objective: To determine construct validity and reliability of the family APGAR scale in dental adult patients from Cartagena, Colombia. Methods: Scale validation study without a reference criterion in 227 patients between 22 and 94 years old whom consulted a college-based dental clinic. Family APGAR data was obtained from the family health charts. Internal consistency was calculated with the Kuder-Richardson formula and construct validity, by AU - Díaz-Cárdenas, Shyrley AU - Tirado-Amador, Lesbia AU - Simancas-Pallares, Miguel DA - 2017/10// DO - 10.18273/REVSAL.V49N4-2017003 IS - 4 PB - Universidad Industrial de Santander PY - 2017 SP - 541 EP - 548 TI - Validez de constructo y confiabilidad de la APGAR familiar en pacientes odontológicos adultos de Cartagena, Colombia T2 - Revista de la Universidad Industrial de Santander. Salud VL - 49 ER - TY - JOUR AB - El pr esente trabajo propone hacer una descripción de la importancia de la familia en el proceso de la enfermedad de pacientes crónicos. El estudio se apoyó principalmente en dos teorías psicológicas, que son: la Teoría del vínculo de John Bowlby y la Teoría de sistemas familiares de Murray Bowen. Se llevaron a cabo entrevistas en profundidad, con el fin de realizar historias de vida en pacientes diagnosticados con insuficiencia renal crónica. Estas historias de vida proporcionaron el material para realizar un análisis conceptual del fenómeno a investigar. Asimismo, éste estudio se apoya en la metodología de la Teoría Fundamentada de Glaser y Strauss. Los resultados que arrojó el presente estudio, son que la participación en las redes sociales del individuo, se da de manera favorable en la medida en que el sujeto concibe tener una vida lo más parecida hasta antes de su diagnóstico. Esta postura que toma el paciente, proporciona tanto un afrontamiento de la propia muerte, así como la planeación de su vida futura útil para él y para los suyos. AU - Vargas Flores, José de Jesús AU - Ibáñez Reyes, Edilberta Joselina AU - Jiménez Rodríguez, David IS - 2 KW - Teoría de sistemas familiares y redes sociales KW - Teoría del vínculo TI - Redes Sociales de Apoyo en el proceso de la enfermedad crónica T2 - Revista Electrónica de Psicología Iztacala UR - http://www.revistas.unam.mx/index.php/repi/article/view/21695/20431 UR - http://www.revistas.unam.mx/index.php/repi/article/view/21695 VL - 6 ER - TY - JOUR AB - Attention mechanisms play a central role in NLP systems, especially within recurrent neural network (RNN) models. Recently, there has been increasing interest in whether or not the intermediate representations offered by these modules may be used to explain the reasoning for a model's prediction, and consequently reach insights regarding the model's decision-making process. A recent paper claims that 'Attention is not Explanation' (Jain and Wallace, 2019). We challenge many of the assumptions underlying this work, arguing that such a claim depends on one's definition of explanation, and that testing it needs to take into account all elements of the model. We propose four alternative tests to determine when/whether attention can be used as explanation: a simple uniform-weights baseline; a variance calibration based on multiple random seed runs; a diagnostic framework using frozen weights from pretrained models; and an end-to-end adversarial attention training protocol. Each allows for meaningful interpretation of attention mechanisms in RNN models. We show that even when reliable adversarial distributions can be found, they don't perform well on the simple diagnostic, indicating that prior work does not disprove the usefulness of attention mechanisms for explainability. AU - Briones, M. AU - Chica, C IS - 1 PY - 2017 SP - 148 EP - 162 TI - Influencia del apoyo social sobre el nivel de hemoglobina glisosilada en pacientes diabeticos tipo 2 atendidos en el centro de salud el carmen en el periodo de julio a octubre de 2016 T2 - Universidad Católica del Ecuador VL - 148 ER - TY - JOUR AU - Mijangos, Laura AU - Blanca, Hurtado AU - Virgilio, Lima IS - 1 KW - cirugía de retina KW - de la cirugía KW - desprendimiento de KW - general KW - hemorragia vítrea KW - retina KW - retiniana en un hospital KW - retinopatía diabética KW - retinopatía diabética y complejidad PY - 2012 SP - 18 EP - 24 TI - Retinopatía diabética y complejidad de la cirugía retiniana en un hospital general T2 - Cirugía y Cirujanos VL - 80 ER - TY - JOUR AB - Resumen Objetivo: Evaluar comportamiento de hemoglobina glicosilada (HbA1c) y frecuencia de hipoglicemias sintomáticas con esquema basal con insulina NPH comparado con insulina glargina en diabéticos tipo 2 (DM2), atendidos en un programa de riesgo cardiovascular. Materiales y métodos: Estudio observacional de cohorte retrospectivo. Se revisaron 613 historias clínicas de pacientes con DM2 manejados con esquema basal con insulina NPH o glargina, de los cuales 76 cumplieron los criterios de inclusión. Se revisó historia clínica al momento de inclusión (consulta No. 1), a los seis (consulta No. 2) y a los doce meses (consulta No. 3). Resultados: Se analizaron 13 pacientes del grupo glargina y 63 del grupo NPH (edad 64,9 [± 10,9 años], 54% mujeres). En la consulta No. 1 el promedio de HbA1c fue 7.8% en grupo con NPH y 7.5% en grupo glargina. Al final del seguimiento los niveles de HbA1c fueron 7.5% en grupo NPH y 7.9% en grupo glargina (p= 0.4). Los eventos de hipoglucemia fueron 3 en la primera consulta y 4 en la tercera, todos recibían NPH. En la segunda consulta se presentaron 5 eventos en pacientes con NPH y 1 caso con glargina (p=0.9). Las variables más fuertemente asociadas con niveles bajos de HbA1c fueron enfermedad renal crónica y sexo femenino. Conclusiones: Los pacientes con DM2 de este estudio no presentaron diferencia estadísticamente significativa en valores de HbA1c de acuerdo al tipo de insulina recibida. Se observó menor frecuencia de hipoglucemias en pacientes que utilizaban insulina glargina sin encontrarse diferencia estadísticamente significativa. Palabras clave: Diabetes mellitus tipo 2; Insulina glargina; Insulina NPH; Hipoglucemias; Control metabolico. Glycosylated hemoglobin behavior and frequency of hypoglycemia in type 2 diabetics treated with insulin glargine or NPH Abstract To evaluate performance of glycosylated hemoglobin (HbA1c) and frequency of symptomatic hypoglycemia scheme with basal insulin glargine compared to NPH insulin in type 2 diabetics (DM2), served in a program of cardiovascular risk. Materials and methods: Observational retrospective cohort. 613 medical records of patients with DM2 managed scheme with basal insulin NPH or glargine, of which 76 met the inclusion criteria were reviewed. medical records were reviewed at the time of inclusion (see No. 1), six (see No. 2) and twelve months (see No. 3). Results: 13 patients in the glargine group and 63 in the NPH group (age 64.9 [± 10.9 years], 54% female) were analyzed. The consultation No. 1 mean HbA1c was 7.8% with NPH group and 7.5% in glargine group. At follow-up HbA1c levels were 7.5% in NPH group and 7.9% in glargine group (p = 0.4). Hypoglycemic events were 3 in the first visit and 4 in the third, all received NPH. In the second consultation five events occurred in patients with NPH and 1 case with glargine (p = 0.9). The variables most strongly associated with low levels of HbA1c were chronic kidney disease and women. Conclusions: Patients with DM2 of this study showed no statistically significant difference in HbA1c values according to the type of insulin received. Lower frequency of hypoglycemia in patients using insulin glargine no statistically significant difference was observed. AU - Rivera, Alex AU - Álvarez, Tatiana AU - Ochoa, Francisco IS - 1 KW - Diabetes mellitus type 2 KW - Glargine insulin KW - Hypoglycemia KW - Metabolic control KW - NPH insulin PY - 2016 SP - 3 EP - 10 TI - Comportamiento de hemoglobina glicosilada y frecuencia de hipoglicemias en diabéticos tipo 2 tratados con insulina glargina o NPH T2 - Rev. Méd. Risaralda VL - 22 ER - TY - JOUR AB - Psychological and social factors can profoundly influence a patient's success in adhering to a prescribed self-care regimen. A total of 34 inpatients with type II diabetes who attended the diabetes education program at a single clinic were studied as a retrospective cohort, beginning between 6 and 12 months after discharge. At the start of the study, the patients were classified into two groups, those with good control and those with poor control of diabetes, based on the rate of change of the glycosylated hemoglobin (HbAlc) value relative to the value at admission. Data for each patient were collected retrospectively from their medical records. Patients' family function was assessed by the adaptability, partnership, growth, affection, and resolve (APGAR) scoring system. Multiple regression analysis was used to determine the effect of demographic, medical, and social factors on metabolic improvement. The family APGAR score was higher in the good control group than in the group with poor control. (Internal Medicine 32: 763–767, 1993). © 1993, The Japanese Society of Internal Medicine. All rights reserved. AU - Yamamoto, Wari AU - Origasa, Hideki AU - Yaginuma, Toshio AU - Kanazawa, Yasunori DO - 10.2169/internalmedicine.32.763 IS - 10 KW - diabetes control KW - family APGAR KW - patient education PY - 1993 SP - 763 EP - 767 TI - Effect of social factors on metabolic improvement in type II diabetic patients T2 - Internal Medicine VL - 32 ER - TY - BOOK AU - Ruiz, Álvaro AU - Gómez, Carlos CY - Bogotá, D.C, Colombia ET - Segunda PB - Editorial Médica Panamericana PY - 2015 SP - 461 EP - 461 TI - Epidemiología clínica. Investigación Clínica Aplicada ER - TY - GEN AU - Banco Mundial TI - Prevalencia de la diabetes (% de la población de 20 a 79 años) | Data UR - https://datos.bancomundial.org/indicator/SH.STA.DIAB.ZS?end=2019&start=2019&view=map ER - TY - GEN AU - Ministerio de Salud y Protección PY - 2020 SP - 200 EP - 200 TI - Analisis de situación de Salud (ASIS) Colombia, 2020 T2 - Imprenta Nacional de Colombia UR - https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/PSP/asis-2020-colombia.pdf ER - TY - JOUR AU - Rodríguez, Miguel AU - García, Emilio AU - Amariles, Pedro AU - Rodríguez, Alfonso AU - José, María DO - 10.1157/13125407 IS - 8 KW - Cumplimiento de la medicación KW - Incumplimiento terapéutico KW - Test de cumplimiento KW - cumplimiento de la medicación KW - incumplimiento terapéutico PB - Elsevier PY - 2008 SP - 413 EP - 417 TI - Revisión de tests de medición del cumplimiento terapéutico utilizados en la práctica clínica T2 - Atencion Primaria UR - http://dx.doi.org/10.1157/13125407 VL - 40 ER - TY - CONF AB - Identifying and controlling bias is a key problem in empirical sciences. Causal diagram theory provides graphical criteria for deciding whether and how causal effects can be identified from observed (nonexperimental) data by covariate adjustment. Here we prove equivalences between existing as well as new criteria for adjustment and we provide a new simplified but still equivalent notion of d- separation. These lead to eficient algorithms for two important tasks in causal diagram analysis: (1) listing minimal covariate adjustments (with polynomial delay); and (2) identifying the subdiagram involved in biasing paths (in linear time). Our results improve upon existing exponential-time solutions for these problems, enabling users to assess the effects of covariate adjustment on diagrams with tens to hundreds of variables interactively in real time. AU - Textor, Johannes AU - Liśkiewicz, MacIej PY - 2011 SP - 681 EP - 688 TI - Adjustment criteria in causal diagrams: An algorithmic perspective T2 - Proceedings of the 27th Conference on Uncertainty in Artificial Intelligence, UAI 2011 ER - TY - JOUR AU - Textor, Johannes AU - Hardt, Juliane DO - 10.1097/EDE.0b013e318225c2be IS - 5 PY - 2011 SP - 745 EP - 745 TI - DAGitty: A graphical tool for analyzing causal diagrams T2 - Epidemiology VL - 22 ER - TY - GEN AU - University of Washington PY - 2019 TI - Institute for Health Metrics and Evaluation (IHME). T2 - GBD Compare. ER - TY - JOUR AU - Arias Liliana IS - 1 PY - 2014 SP - 26 EP - 28 TI - El APGAR familiar en el cuidado primario de salud. T2 - Colombia Médica VL - 21 ER - TY - RPRT AU - Rodríguez, Ana AU - Pinzon, Patricia AU - Salinas, Martha AU - Espitia, Veronica AU - Rodriguez, Gerardo AU - Garzón, Dayhanna PY - 2013 SP - 19 EP - 62 TI - SECRETARIA DE EDUCACIÓN Y CULTURA DE SOACHA PLAN TERRITORIAL DE FORMACIÓN DOCENTE 2012-2015 T2 - Secretaria de Educación y Cultura Carrera VL - 7 ER - TY - JOUR AB - La denominación de diabetes mellitus comprende un gru-po de enfermedades metabólicas caracterizadas por hiper-glucemia, resultante de defectos en la secreción de insuli-na, en la acción de la insulina o en ambas 1 . La diabetes se puede asociar con complicaciones agudas que pueden dar lugar a alteraciones importantes, como precipitación de accidentes cardiovasculares o cerebrovas-culares, lesiones neurológicas, coma y riesgo vital, en caso de no tratamiento urgente. Igualmente, la hiperglucemia crónica de la diabetes se asocia a daños a largo plazo, que provocan disfunción y fa-llo de varios órganos: en especial, ojos, riñones, nervios, corazón y vasos sanguíneos. COMPLICACIONES AGUDAS DE LA DIABETES MELLITUS Hipoglucemia Constituye la complicación mas frecuentemente asociada al tratamiento farmacológico de la diabetes mellitus. Cual-quier persona en tratamiento con antidiabéticos orales o insulina puede sufrirla, aunque ocurre con mayor fre-cuencia en pacientes que siguen tratamiento intensivo con insulina, presentan una larga evolución de la diabetes me-llitus y/o padecen neuropatía autónoma 2 . La definición de hipoglucemia es bioquímica y puede definirse como una concentración de glucosa en sangre venosa inferior a 60 mg/dl o capilar inferior a 50 mg/dl. Esta definición puede ser precisa pero no resulta muy útil, ya que muchos episodios de glucemia inferior a esta cifra no son detectados, en especial durante el sueño, y algunos pacientes pueden presentar un deterioro neurológico con una concentración ligeramente superior a la indicada, mientras otros presentan síntomas de alarma de hipoglu-cemia con cifras superiores a 60 mg/dl o cuando la gluce-mia se reduce rápidamente y pasa de concentraciones muy altas a cifras normales 3 . Mas útil es la definición clínica de la misma dependien-te de la gravedad de los síntomas y signos clínicos, divi-diendo de esta manera la hipoglucemia en: AU - Mediavilla, José Javier DA - 2001/1// DO - 10.1016/s1138-3593(01)73931-7 IS - 3 PB - Elsevier BV PY - 2001 SP - 132 EP - 145 TI - Complicaciones de la diabetes mellitus. Diagnóstico y tratamiento T2 - SEMERGEN - Medicina de Familia VL - 27 ER - TY - JOUR AB - Rev Nefrol Dial Traspl. 2018; 38 (1): 65-83 RESUMEN La diabetes tipo 2 (DM2) es uno de los grandes problemas de salud pública a nivel mundial y uno de los mayores desafíos del siglo XXI. La glucemia es un parámetro de laboratorio fácil de evaluar y ocupa un rol fundamental tanto en el diagnóstico como en el seguimiento de la DM. La determinación de proteínas glicadas, en especial la hemoglobina (HbA1c) y las proteínas séricas (fructosamina) permiten cuantificar el promedio de la misma a lo largo de semanas o meses, complementando el monitoreo glucémico. Los métodos que se implementan para lograr el control glucémico en la enfermedad renal cróni-ca (ERC) se extrapolan de estudios con DM sin ERC, debido a la falta de evidencia de estudios randomizados de alta calidad en esta población. Se debe considerar que en ERC existen cambios metabólicos que determinan que la hemoglobina (Hb) presente comportamientos variables, moti-vo por el que surge la discusión de si la HbA1c constituye un marcador confiable para definir control glucémico o de utilidad en la predicción del desarrollo de complicaciones en esta subpo-blación. Se presenta una revisión acerca del rol de la HbA1c en el paciente con DM sin ERC para luego mostrar las dificultades que se presen-tan en la subpoblación con ERC, centrándose especialmente en los pacientes en tratamiento de hemodiálisis y diálisis peritoneal. ABSTRACT Type 2 diabetes (DM2) is one of the greatest public health problems in the world and one of the biggest challenges of the 21st century. Glycemia is a laboratory parameter that is easy to evaluate and plays a fundamental role both in the diagnosis of DM and in its follow-up. The identification of glycated proteins, especially hemoglobin (HbA1c) and serum proteins (fructosamine), makes it possible to quantify their average over weeks or months, which complements glucose monitoring. The methods implemented to achieve glycemic control in chronic kidney disease (CKD) are extrapolated from studies on DM without CKD, due to the lack of evidence from high quality randomized studies in this population. It should be considered that in CKD there are metabolic changes determining that hemoglobin (Hb) shows variable behaviors; this is why it is discussed whether HbA1c constitutes a reliable marker to define glycemic control or whether it is useful to predict the development of complications in this subpopulation. A review of the role of HbA1c in DM patients without CKD is presented, showing also the difficulties that AU - De'Marziani, Guillermo AU - Elbert, Alicia Ester IS - 1 KW - HbA1c KW - PALABRAS CLAVE: hemoglobina glicada KW - control glucémico KW - diabetes KW - diálisis renal KW - enfermedad renal crónica PY - 2018 SP - 65 EP - 83 TI - ARTÍCULO DE REVISIÓN. GLYCATED HEMOGLOBIN (HbA1c). USEFULNESS AND LIMITATIONS IN PATIENTS WITH CHRONIC KIDNEY DISEASE T2 - Rev Nefrol Dial Traspl UR - www.renal.org.ar VL - 38 ER - TY - RPRT AU - Secretaria de Salud. Municipio de Soacha PY - 2012 SP - 38 EP - 95 TI - Análisis de situación de Salud con el modelo de los determinantes Sociales de Salud. ER - TY - JOUR AB - La obesidad es una enfermedad crónica de alta prevalencia en Chile y en la mayoría de los países del mundo. Se caracteriza por un mayor contenido de grasa corporal, lo cual -dependiendo de su magnitud y de su ubicación topográfica- va a determinar riesgos de salud que limitan las expectativas y calidad de vida. En adultos, la obesidad se clasifica de acuerdo al Índice de Masa Corporal (IMC), por la buena correlación que presenta este indicador con la grasa corporal y riesgo para la salud a nivel poblacional. La fuerte asociación existente entre la obesidad abdominal y la enfermedad cardiovascular ha permitido la aceptación clínica de indicadores indirectos de grasa abdominal como la medición de circunferencia de cintura. La definición de los puntos de corte de IMC y de circunferencia de cintura ha sido controversial en poblaciones de diferentes etnias y grupos etarios. AU - Manuel Moreno DA - 2012/3// DO - 10.1016/s0716-8640(12)70288-2 IS - 2 PB - Elsevier BV PY - 2012 SP - 124 EP - 128 TI - Definición y clasificación de la obesidad T2 - Revista Médica Clínica Las Condes VL - 23 ER - TY - JOUR AB - Resumen Objetivo Describir el estilo de vida y determinar la adherencia al tratamiento de pacientes con diabetes mellitus tipo 2 mediante la aplicación de los cuestionarios IMEVID y Morisky-Green con el fin de orientar medidas de intervención multidisciplinaria enfocadas en la promoción de la salud y la prevención de la enfermedad. Método Estudio transversal. A los pacientes con diagnóstico de diabetes mellitus tipo 2 de una Institución Prestadora de Servicios de Salud (IPS) en Neiva (Huila), se les aplicó los cuestionarios IMEVID y Morisky-Green para estimar los factores que influyen en la adherencia al tratamiento. Resultados Respecto al estilo de vida el 47,14% (n=33) de los sujetos cuentan con "estilo de vida favorable", el 34,29% (n=24) "estilo de vida poco favorable" y el 18,57% (n=13) "estilo de vida desfavorable" para el control metabólico de su enfermedad. La proporción global de pacientes con una buena adherencia al tratamiento farmacológico fue del 71,43%. Conclusiones En la población estudiada existe una importante diferencia entre la mayor adherencia al manejo farmacológico en comparación con el manejo no farmacológico de su diabetes, si el estilo de vida es el determinante más influyente en la salud y a la vez el más modificable, resulta muy necesario investigar a profundidad las razones por las cuales los pacientes pueden adherirse más fácil a su esquema terapéutico farmacológico que al mejoramiento de su estilo de vida, así como también el implementar estrategias de modificación de estos resultados. Palabras clave: Diabetes Mellitus tipo 2. Estilo de vida. Cooperación del paciente. Adherencia al tratamiento. (Fuente: DeCS) AU - Barbosa, Alejandra AU - Quintero, Cesar IS - 1 PY - 2018 SP - 1 EP - 7 TI - Estilo de vida y adherencia al tratamiento de pacientes con diabetes mellitus tipo 2. T2 - R.F.S. Revista Facultad de Salud UR - http://journalusco.edu.co/index.php/RFS VL - 10 ER - TY - JOUR AU - De La Cruz María AU - Vargas Juan AU - Ledezma Erika AU - Holguín Mariana AU - Martínez Alan AU - Fragoso Lilia IS - 3 PY - 2013 SP - 478 EP - 485 TI - Causas de desapego a tratamiento, dieta y seguimiento de pacientes con diabetes y posibles factores asociados con la enfermedad T2 - Rev. salud pública. VL - 15 ER - TY - JOUR AB - Aim To assess glycemic control in diabetic patients, to measure the impact on such control of adherence to hypoglycemic agents and to medical visits, and to explore factors that allow for predicting adherence. Methods Study of historical cohorts of diabetic patients. The proportion of patients who achieved the target HbA1c levels was estimated. Adherence was assessed using the Haynes-Sackett test. Change in HbA1c from the first to the last visit, adherence, and attendance to visits were analyzed according to comorbidities, cardiovascular risk factors, and treatments used. Results The study simple consisted of 639 patients (mean follow-up time, 11.1 ± 11.2 months), of whom 66.6% achieved target HbA1c levels. Change in HbA1c from the first to the last visit was explained in 54.2% of patients by baseline HbA1c (P<0.001), in 13% by treatment adherence (P<0.001), and in 9.6% by visit adherence (P<0.001). Non-insulinization (P=0.011) and smoking cessation (P=0.032) predisposed to greater adherence. Insulinization (P=0.019) and lack of diabetes education (P=0.033) predisposed to visit non-compliance. Conclusions Improvement in HbA1c is determined by baseline HbA1c, treatment adherence, and attendance to visits. Patients on insulin have poorer adherence and are more likely to miss the appointments, those who stop smoking adhere more to hypoglycemic agents, and those given therapeutic education are more likely to keep the appointments. AU - García Eduardo AU - Ramírez Davinia AU - García Alba AU - Morera Óscar DA - 2017/12// DO - 10.1016/j.endinu.2017.08.004 IS - 10 KW - Diabetes control KW - Hypoglycemic agents KW - Treatment adherence PB - Elsevier Doyma PY - 2017 SP - 531 EP - 538 TI - Determinants of adherence to hypoglycemic agents and medical visits in patients with type 2 diabetes mellitus T2 - Endocrinologia, Diabetes y Nutricion VL - 64 ER -