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Overview of the participation of community health workers in primary health care in 6 Latin American countries and a proposal for their integration into the health system: a qualitative study
No full textBackground: According to some health programmes, implementing primary health care through community health workers (CHWs) facilitates the connection between community and health services in Latin America. However, these are isolated processes that face different obstacles and would benefit from an overview of the corresponding health policies and programmes. Objective: To provide an overview of CHW participation in 6 Latin American countries. Methods: This exploratory qualitative study was based on 3 sources of information: a literature review, a review of public health policy documents, and interviews with experts who have led CHW programmes in 6 Latin American countries. Results: The role of CHWs in Latin America and some advances in public health policies in the region were evidenced. However, limitations arising from variable implementation of the WHO guidelines on health programmes with CHWs were also apparent. Conclusions: CHWs contribute to the primary healthcare processes in the 6 Latin American countries studied in versatile and comprehensive ways. However, they constitute an underutilized human resource because they must provide various services that are not always relevant in different work contexts. Therefore, we propose a classification of the CHW profile, using the level of access to healthcare services of the population they serve as the main differentiator. This way, CHWs will not have to provide a wide range of services but only those most relevant to the specific needs of each community.Incluye referencias bibliográfica
Revisión bibliográfica de la seguridad del fentanilo en el alivio del dolor en pacientes paliativos
No full textEsta investigación tiene como objetivo principal realizar una revisión bibliográfica exhaustiva sobre el uso del fentanilo en pacientes paliativos, con el propósito de mejorar la gestión del manejo del dolor mediante una cuidadosa evaluación de la farmacovigilancia con la metodología del ALGORITMO DE NARANJO y el análisis detallado de casos clínicos documentados en la literatura especializada. La revisión bibliográfica se enfocará en abordar tanto la eficacia como la seguridad del fentanilo en su aplicación a pacientes en cuidados paliativos, con el fin de proporcionar sedación y alivio del dolor de manera óptima. Además, se prestará especial atención a los efectos secundarios asociados con las diferentes formas farmacéuticas del fentanilo, con el objetivo de identificar posibles riesgos y complicaciones en su administración.
En este contexto, se resalta la importancia de la selección adecuada de las dosis y las vías de administración del fentanilo, considerando tanto los beneficios farmacoterapéuticos que puede ofrecer en el manejo del dolor en pacientes paliativos como los potenciales eventos adversos que pueden surgir. Es fundamental tener en cuenta que el fentanilo es un opioide potente utilizado para el tratamiento del dolor severo, y su uso inadecuado o incorrecto puede acarrear riesgos significativos para la salud de los pacientes. Por lo tanto, esta revisión bibliográfica se enfocará en proporcionar recomendaciones prácticas para garantizar una administración segura y efectiva del fentanilo en el contexto de los cuidados paliativos.
Además, se considerará la evidencia científica disponible en la literatura para respaldar las conclusiones y recomendaciones derivadas de esta revisión bibliográfica. Se analizarán estudios clínicos, ensayos farmacológicos y reportes de farmacovigilancia para obtener una visión integral de la seguridad y eficacia del fentanilo en pacientes paliativos. Asimismo, se examinarán las tendencias actuales en el uso de fentanilo en este contexto clínico, con el objetivo de identificar posibles áreas de mejora en la práctica clínica y en la gestión del dolor en pacientes en cuidados paliativos.
En conclusión, esta investigación se propone realizar una revisión bibliográfica detallada y rigurosa sobre el uso del fentanilo en pacientes paliativos, con un enfoque en la optimización de la gestión del dolor, la seguridad en la administración del medicamento y la identificación de posibles riesgos y beneficios asociados con su uso en este grupo de pacientes vulnerables.The main objective of this research is to conduct a comprehensive literature review on the use of fentanyl in palliative patients, to improve the management of pain management through a careful evaluation of pharmacovigilance with the ORANGE ALGORITHM methodology and the detailed analysis of clinical cases documented in the specialized literature. The literature review will focus on addressing both the efficacy and safety of fentanyl in its application to palliative care patients to provide optimal sedation and pain relief. In addition, special attention will be paid to the side effects associated with the different pharmaceutical forms of fentanyl, to identify possible risks and complications in its administration.
In this context, the importance of the proper selection of doses and routes of administration of fentanyl is highlighted, considering both the pharmacotherapeutic benefits it can offer in the management of pain in palliative patients and the potential adverse events that can arise. It is essential to keep in mind that fentanyl is a potent opioid used for the treatment of severe pain, and its inappropriate or incorrect use can carry significant health risks for patients. Therefore, this literature review will focus on providing practical recommendations to ensure the safe and effective administration of fentanyl in the palliative care setting.
In addition, the scientific evidence available in the literature will be considered to support the conclusions and recommendations from this literature review. Clinical studies, pharmacological trials, and pharmacovigilance reports will be analyzed to obtain a comprehensive view of the safety and efficacy of fentanyl in palliative patients. We will also examine current trends in the use of fentanyl in this clinical setting, to identify possible areas for improvement in clinical practice and pain management in palliative care patients.
In conclusion, this research aims to conduct a detailed and rigorous literature review on the use of fentanyl in palliative patients, with a focus on the optimization of pain management, the safe administration of the drug, and the identification of potential risks and benefits associated with its use in this vulnerable patient group.Incluye bibliografíaPregradoTecnólogo(a) en Regencia de Farmaci
Esclerosis múltiple: evaluación de eficacia y seguridad de su farmacoterapia por medio de revisión bibliográfica
No full textLa esclerosis múltiple es una enfermedad crónica del sistema nervioso central, caracterizada por la desmielinización de las fibras nerviosas, que provoca diversos síntomas neurológicos. Es la enfermedad neurológica más común en adultos de Europa y Norteamérica. Este estudio realiza una revisión bibliográfica enfocada en la farmacoterapia y seguridad para evaluar la eficacia de los medicamentos interferón beta y ocrelizumab. Se analizan los principios de farmacología relacionados con su mecanismo de acción, la historia de la enfermedad, síntomas asociados, fisiopatología y epidemiología. El objetivo es recopilar y comparar información bibliográfica sobre los medicamentos para la esclerosis múltiple, determinando cuáles son los más recomendados y sus razones, identificando posibles similitudes entre las fuentes revisadas. Los resultados destacan la eficacia y perfil de seguridad de ambos fármacos, proporcionando una guía basada en evidencia para su uso clínicoMultiple sclerosis is a chronic disease of the central nervous system, characterized by the demyelination of nerve fibers, which leads to various neurological symptoms. It is the most common neurological disease in adults in Europe and North America. This study conducts a literature review focused on pharmacotherapy and safety to evaluate the efficacy of the drugs interferon beta and ocrelizumab. It analyzes harmacological principles related to their mechanism of action, the history of the disease, associated symptoms, pathophysiology, and epidemiology. The objective is to gather and compare bibliographic information on drugs for multiple sclerosis, determining which are most recommended and the reasons for their use, identifying possible similarities among the reviewed sources. The results highlight the efficacy and safety profile of both drugs, providing an evidence-based guide for their clinical use.Incluye bibliografíaPregradoTecnólogo(a) en Regencia de Farmaci
Nutritional, ruminal, and metabolic parameters of beef bulls fed high-energy diets as a function of dietary addition of a magnesium oxide blend associated or not with monensin
No full textThis study aimed to evaluate the impact of a magnesium oxide blend (MG) and monensin (MON) on the nutritional, ruminal, and metabolic parameters of finishing bulls fed high grain diet. Six ruminally cannulated bulls (542 ± 33.6 kg) were used in a 6 × 6 Latin square design with treatments arranged as a 2 × 3 factorial, with 6 periods of 23 days. The MG was included at 0, 2.5, or 5.0 g/kg of dry matter (DM) - MG0, MG2.5, and MG5.0, respectively, without or with MON (30 mg/kg of DM). During each experimental period, days 1–10 were designated for dietary additive adaptation. Days 11–20 (feeding period), were used to assess DM and nutrient intakes, digestibility, ruminal pH, volatile fatty acids (VFA) profile, and blood parameters. Days 21–23 (corn challenge period), included supplementing all treatments with 2 kg/day of ground corn, replacing 2 kg/day of forage, to observe responses in ruminal pH and DM intake (DMI) in the presence of increased fermentable carbohydrates in the rumen. The ruminal pH increased linearly (P = 0.01) with the MG level during the feeding period. In the corn challenge, bulls fed diets without MON and MG5.0, as well as those fed MON and MG2.5 or MG5.0 showed a marked increase in rumen pH value during the first day. In the feeding period, the DMI was greater (quadratic: P = 0.05) for MG2.5 compared to other tested doses. The DM and nutrient intakes were greater (quadratic: P ≤ 0.05) for the MG2.5 group. Bulls fed MON diets had 0.5 kg lower DM and nutrient intakes than those without MON (P ≤ 0.05). The ruminal and intestinal digestibility of diet compounds did not differ among treatments (P ≥ 0.08). The DM and organic matter (OM) apparent total-tract digestibility tended to be (quadratic: P = 0.06) and were greater (quadratic: P = 0.05) for the MG2.5 group. The microbial crude protein synthesis (MCP) was greater for Bulls fed the MG2.5 diet (quadratic: P = 0.03). Bulls fed diets without MON had a lower valeric acid (MON × Time: P = 0.03) and those fed diets without MG had a lower iso-valeric acid (MG × Time: P = 0.03) molar proportion 12 hours post-feeding than 1 hour pre-feeding. Glucose levelsIncluye referencias bibliográfica
Physical exercise and complementary therapy "mindfulness" on the executive function (attention) of patients with damage from head trauma and brain disease
No full textIntroducción: el traumatismo craneoencefálico (TCE) es la lesión interna o externa provocada por un golpe violento del exterior, que afecta al cráneo y al cerebro. La meditación genera resultados positivos en los procesos cognitivos, funciones ejecutivas y mejora, a nivel psicoemocional. Objetivo: analizar el efecto del ejercicio físico y la terapia complementaria “conciencia plena” en la función ejecutiva (atención), de pacientes que han sufrido trauma o enfermedad cerebral. Materiales y métodos: para tal efecto, se contó con un grupo de pacientes con daño craneoencefálico que asisten a terapia física, basada en ejercicio físico. El grupo experimental recibió durante dos meses, dos veces por semana, la terapia conciencia plena, durante 20 minutos, una vez que habían finalizado el ejercicio aeróbico; por su parte, el grupo control solamente recibió la terapia de ejercicio aeróbico. Todos los sujetos llenaron el instrumento de propiedades psicométricas de la versión en español de la escala “Mindful Attention Awareness Scale” (MAAS), al inicio y al finalizar el tratamiento para valorar el efecto que tuvo la terapia conciencia plena. Resultados y discusión: el grupo experimental obtuvo mejores resultados entre las mediciones de pre y post, además, en comparación al grupo control, obtuvo valores más altos posterior a la terapia en el promedio obtenido de la esca Likert. Conclusiones: es indispensable, para la mejora de procesos atencionales, la aplicación de la terapia de conciencia plena, en pacientes con algún tipo de alteración craneoencefálica en conjunto, con ejercicio físico.ntroduction: Traumatic brain injury (TBI) is an internal or external injury caused by a violent blow from the outside that affects the skull and brain. Meditation achieves positive results in cognitive processes, executive functions, and improvement at a psycho-emotional level. Objective: To analyze the effect of physical exercise and the complementary therapy “mindfulness” on the executive function (attention) of patients who have suffered from trauma or brain disease. Materials and methods: For this purpose, a group of patients with cranial brain damage who attend physical therapy based on physical exercise was included. The experimental group received mindfulness therapy twice a week for two months for 20 minutes once they had finished aerobic exercise, while the control group only received aerobic exercise therapy. All subjects filled out the psychometric properties instrument of the Spanish version of the “Mindful Attention Awareness Scale” (MAAS) at the beginning and at the end of the treatment to assess the effect of the mindfulness therapy. Results and discussion: The experimental group obtained better results between the pre and post measurements, in addition, compared to the control group, it obtained higher values after the therapy in the average obtained from the Likert scale. Conclusion:the application of mindfulness therapy in patients with some type of craniocerebral alteration in conjunction with physical exercise is essential to improve attentional processes.Incluye referencias bibliográfica
Modelos de evaluación de la calidad del servicio deportivo, una revisión documental
No full textObjetivo: Determinar los modelos de evaluación de la calidad de servicio que han sido utilizados en servicios deportivos en los últimos 5 años, a través de una revisión documental en las bases de datos Scopus y SportDiscus. Metodología: Se realizó una revisión documental de las bases de datos Scopus y SportDiscus con un análisis estadístico descriptivo. La información se filtró de acuerdo con los criterios de inclusión. Resultados: Se incluyeron 12 artículos. 8 de ellos de la base de datos Sport Discus y 4 de la base de datos de Scopus. Todos ellos, realizaron una aplicación de un modelo de evaluación de la calidad del servicio en organizaciones deportivas, especialmente en Europa y Asia. Discusión: Se identificó que la evaluación de la calidad del servicio en organizaciones deportivas, en los últimos 5 años, no se realizó con modelos tradicionales y ampliamente documentados como el ServPerf y el ServQual. Por el contrario, se observó un uso mixto y heterogéneo de los modelos de evaluación de la calidad del servicio que no permite contar con criterios unificados ni comparaciones objetivas. Conclusiones: Los modelos de evaluación de la calidad del servicio en servicios deportivos deben ser específicos para el sector debido a que los modelos tradicionales no atienden las particularidades y necesidades del mismo.Objective: To determine the service quality evaluation models that have been used in sports services in the last 5 years, through a documentary review in the Scopus and SportDiscus databases. Methodology: A documentary review of the Scopus and SportDiscus databases was carried out with a descriptive statistical analysis. Information was filtered according to inclusion criteria. Results: 12 articles were included. 8 of them from the Sport Discus database and 4 from the Scopus database. All of them applied a service quality evaluation model in sports organizations, especially in Europe and Asia. Discussion: It was identified that service quality evaluation in sports organizations, in the last 5 years, was not carried out with traditional and widely documented models such as ServPerf and ServQual. On the contrary, a mixed and heterogeneous use of service quality evaluation models was observed, which does not allow for unified criteria or objective comparisons. Conclusions: Service quality evaluation models in sports services must be specific to the sector because traditional models do not address its particularities and needs.Incluye bibliografíaPregradoProfesional en Ciencias del DeporteCiencias del Deport
Estudio fitoquímico biodirigido de la actividad antieclosión del extracto de la corteza de Guazuma ulmifolia en nemátodos Cyathostominae
No full textRESTRICCION MAYO 03-2025. Los nematodos son una familia de parásitos con un alto potencial patogénico. En la actualidad, se han reportado serias afectaciones sobre la salud animal, como es el caso de los equinos, donde generan daños en la motilidad intestinal, cólicos, diarrea e incluso la muerte. Dichas enfermedades se han descrito como unas de las más infecciosas debido a la prevalencia y resistencia que se ha generado a lo largo de los años, como consecuencia del uso indiscriminado de los fármacos disponibles, subdosificaciones, el potencial reproductivo propio de la población y su tamaño.
Con la disminución de la eficacia de los fármacos actuales, surge la necesidad de buscar nuevas alternativas de tratamiento para dichas parasitosis. Entre ellas se encuentra el uso de plantas, ya que por su composición fitoquímica pueden poseer actividad biológica. Guazuma ulmifolia es un arbusto endémico de Sudamérica al que previamente se le han realizado ciertos estudios, donde se le ha atribuido diferentes propiedades frente a patologías humanas, microorganismos y parásitos.
Los resultados de dichos estudios son prometedores, por lo que se plantea este estudio fitoquímico biodirigido de la actividad anti-eclosión del extracto de Guazuma ulmifolia sobre los parásitos Cyathostominae. Para ello, se realizó la extracción del material vegetal de la corteza de la planta con tres solventes de diferente polaridad: hexano, diclorometano (DCM) y una mezcla de metanol (MeOH) y acetato de metilo (AceOMe). Este último se continuó fraccionando mediante cromatografía en columna, realizando un total de 2 fraccionamientos y las respectivas pruebas preliminares.
Se evaluó la actividad biológica de los extractos, así como de las fracciones, a una concentración de 500 µg/ml, empleando un control positivo (Lugol) y un control negativo (DMSO) frente a los huevos de Cyathostominae obtenidos a partir de equinos infectados, empleando el método de flotación McMaster. Teniendo en cuenta el resultado de la prueba de inhibición de la eclosión de huevos, se calculó el efecto inhibitorio. Para el tratamiento estadístico de estos datos, se realizó la verificación de supuestos previos a ANOVA y los contrastes octogonales.
Se encontró que con una concentración de 500 g/ml, el extracto con mayor actividad fue E3 (MeOH + AceOMe), con una inhibición de la eclosión del 63.33 % y un error estándar de 1.84. Con cromatografías sucesivas se obtuvo C1F2, una fracción de E3 que obtuvo una inhibición del 86.61 %, con un error estándar de 1.26. Del respectivo fraccionamiento de C1F2, finalmente se obtiene C2F3, con una inhibición del 83.3 % y un error estándar de 0.87.
Se determinó que a los tratamientos (extractos y fracciones) se les atribuye un efecto sobre la inhibición de la eclosión. En los ensayos 1, los tratamientos generan significativamente mayor actividad que el control negativo, y el control positivo tuvo un mayor efecto inhibitorio de la eclosión de los huevos que los tratamientos. Sin embargo, en los ensayos 2 y 3, el efecto inhibitorio generado por el control positivo no difiere significativamente del que generan los tratamientos, y estos últimos presentan un efecto significativamente mayor que el control negativo.
A partir de las pruebas preliminares realizadas al extracto E3, el segundo y tercer fraccionamiento, que incluye a C1F2 y sobre C2F3, se establece la posible presencia de metabolitos como flavonoides, alcaloides, esteroles, taninos y quinonas. De C2F3, se identificó que los compuestos a los que se les puede atribuir el potencial de la actividad principalmente son taninos y quinonas.
Se evidencia que el porcentaje de inhibición de la eclosión (% IE) es mejor en los fraccionamientos 1 y 2 respecto al resultado de la actividad biológica generada por el extracto en la prueba in-vitro. Dichas fracciones son promisorias para ser empleadas como controladores ambientales, dada su capacidad para interferir en el estadio del huevo de los nematodos ciatostominos en su forma preparasitaria.Nematodes are a family of parasites with a high pathogenic potential. Currently, serious effects on animal health have been reported, as is the case of horses, where they cause damage to intestinal motility, colic, diarrhea and even death. These diseases have been described as some of the most infectious due to the prevalence and resistance that has been generated over the years, because of the indiscriminate use of available drugs, underdosage, the reproductive potential of the population and its size.
With the decrease in the effectiveness of current drugs, the need arises to look for new treatment alternatives for these parasitic infections. Among them is the use of plants, since due to their phytochemical composition they can have biological activity. Guazuma ulmifolia is an endemic shrub from South America to which certain studies have previously been carried out, where different properties have been attributed to it against human pathologies, microorganisms, and parasites.
The results of these studies are promising, thus prompting this phytochemical-directed study of the anti-hatching activity of Guazuma ulmifolia extract on Cyathostominae parasites. For this purpose, plant material extraction was carried out from the bark of the plant using three solvents of different polarities: hexane, dichloromethane (DCM), and a mixture of methanol (MeOH) and methyl acetate (AceOMe). The latter was further fractionated using column chromatography, performing a total of 2 fractionations and respective preliminary tests.
The biological activity of the extracts, as well as the fractions, was evaluated at a concentration of 500 µg/ml, using a positive control (Lugol) and a negative control (DMSO) against Cyathostominae eggs obtained from infected horses, using the McMaster flotation method. Considering the result of the egg hatching inhibition test, the inhibitory effect was calculated. For the statistical treatment of these data, verification of assumptions prior to ANOVA and octagonal contrasts were carried out.
It was found that with a concentration of 500 g/ml, the extract with the highest activity was E3 (MeOH + AceOMe), with an inhibition of hatching of 63.33% and a standard error of 1.84. With successive chromatographies, C1F2 was obtained, a fraction of E3 that obtained an inhibition of 86.61%, with a standard error of 1.26. From the respective fractionation of C1F2, C2F3 is finally obtained, with an inhibition of 83.3% and a standard error of 0.87.
It was determined that the treatments (extracts and fractions) are attributed an effect on the inhibition of hatching. In trials 1, the treatments generated significantly greater activity than the negative control, and the positive control had a greater inhibitory effect on egg hatching than the treatments. However, in trials 2 and 3, the inhibitory effect generated by the positive control does not differ significantly from that generated by the treatments, and the latter have a significantly greater effect than the negative control.
From the preliminary tests carried out on the E3 extract, the second and third fractionation, which includes C1F2 and C2F3, the possible presence of metabolites such as flavonoids, alkaloids, sterols, tannins and quinones is established. From C2F3, it was identified that the compounds to which the activity potential can be attributed are mainly tannins and quinones.
It is evident that the percentage of hatching inhibition (% EI) is better in fractionations 1 and 2 compared to the result of the biological activity generated by the extract in the in-vitro test. These fractions are promising to be used as environmental controllers, given their ability to interfere in the egg stage of cyathostomine nematodes in their preparasitic formIncluye bibliografíaPregradoQuímico(a) FarmacéuticoQuímica FarmacéuticaSostenibilidad ambienta
Comunicación asertiva y terapéutica. “un acercamiento a las mujeres con diagnóstico de cáncer de seno”
No full textEl cáncer según la OMS (Organización Mundial de la Salud) es la principal causa de muerte en el mundo; y el cáncer de mama uno de los más frecuentes (1), sin embargo, este tipo de patología afecta a muchas mujeres, específicamente en Colombia, ya que para el año 2021 se atedió 505 casos nuevos de cáncer de mama, ocupando así el segundo lugar morbimortalidad en este grupo etario (2), por lo que una adecuada atención y relación terapéutica es fundamental para la adherencia al tratamiento. Objetivo Describir cual es la apreciación de las mujeres diagnosticadas con cáncer de seno frente a la comunicación asertiva y terapéutica que brinda el personal de salud. Metodología Estudio descriptivo/exploratorio con enfoque cualitativo, a partir de entrevistas semiestructuradas a profundidad a mujeres diagnosticadas con cáncer de seno. Resultados; La Comunicación relacionada con el diagnóstico, tratamiento y seguimiento, por parte de los profesionales, es percibida por el 60% de las participantes como deficiente poco empática, irrespetuosa de su privacidad, lo que genera deshumanización en el servicio. El tiempo de atención de consulta en todos los estadios es limitado lo que impide un adecuado conocimiento de la situación del paciente obstaculizando la relación profesional paciente. Conclusiones Los resultados revelan experiencias desafiantes para las mujeres en su interacción con el personal de salud; y señalan la necesidad urgente de mejorar la relación profesional-paciente, incorporando una comunicación más empática y centrada en el individuo para ofrecer un cuidado integral y respetuoso.Cancer, according to the WHO (World Health Organization), is the leading cause of death in the world; and breast cancer one of the most frequent (1), however, this type of pathology affects many women, specifically in Colombia, since for the year 2021 505 new cases of breast cancer were diagnosed, thus occupying the second place morbidity and mortality in this age group (2), so adequate care and therapeutic relationship is essential for adherence to treatment. Objective: To describe the assessment of women diagnosed with breast cancer regarding the assertive and therapeutic communication provided by health personnel. Methodology This is a descriptive/exploratory study with a qualitative approach, based on semi-structured in-depth interviews with women diagnosed with breast cancer. Results; Communication related to diagnosis, treatment and follow-up by professionals is perceived by 60% of the participants as deficient, lacking empathy, disrespectful of their privacy, which generates dehumanization in the service. The consultation time at all stages is limited, which prevents an adequate knowledge of the patient's situation, hindering the professional- patient relationship. Conclusions The results reveal challenging experiences for women in their interaction with health personnel; and point out the urgent need to improve the professional-patient relationship, incorporating more empathetic and individual-centered communication to offer comprehensive and respectful care.Incluye bibliografíaPregradoEnfermero(a
Análisis bibliométrico de la investigación en genética y la ruptura de ligamento cruzado anterior en deporte: una revisión
No full textIntroducción: El componente genético se ha establecido como un factor de riesgo considerable para la ruptura del ligamento cruzado anterior (RLCA). La investigación actual se ha centrado en conocer los genes candidatos que pueden influir y predisponer a un sujeto a padecer esta lesión. Objetivo: Se llevó a cabo un análisis bibliométrico para rastrear los resultados de la indagación e identificar las tendencias globales, así como las brechas en el conocimiento sobre la relación entre el componente genético y la RLCA. Metodología: Los datos fueron extraídos de las bases Pubmed y Scopus, igual que analizados en el paquete Bibliometrix del software R. Se identificó un total de 63 estudios publicados a partir del 2007. Resultados: La mayoría de las publicaciones identificadas fueron artículos de investigación (85.71 %). Los autores con mayor número de aquellas se encuentran en Polonia y Sudáfrica. El análisis a través del mapa de coocurrencias reveló que hay una línea principal de investigación basada en el estudio de polimorfismos genéticos, especialmente en los genes de las familias del colágeno (COL1A1, COL5A1, COL12A1, en mayor frecuencia). Un total de 54 genes candidatos fueron identificados en los estudios. Conclusión: Esperamos que este estudio pueda contribuir a encontrar puntos claves y vacíos de investigación, al proporcionar análisis integrales e información estructurada sobre
este tema.Introduction: Genetic component has been established as a significant risk factor for anterior cruciate ligament rupture (ACLR). Current research has focused on knowing the candidate genes that can influence and predispose a subject to this injury. Objective: A bibliometric analysis was carried out to trace the results of the research and identify global trends and gaps in knowledge about the relationship between the genetic component and ACLR. Methodology: Data were extracted from the Pubmed and Scopus databases and analyzed in the Bibliometrix package of the R software. A total of 63 studies published since 2007 were identified. Results: Most of the publications recovered were research articles (85.71%). The authors with the highest number of those are in Poland and South Africa. The analysis through the co-occurrence map reveals that there is a mainline of research based on the study of genetic polymorphisms, especially in the genes of the collagen families (COL1A1, COL5A1, COL12A1, in greater frequency). A total of 54 candidate genes were identified within the studies. Conclusion: We hope that this study can help to find key points and research gaps by providing a comprehensive analysis and structured information on this topicIntrodução: O componente genético foi estabelecido como um fator de risco significativo para a ruptura do ligamento cruzado anterior (RLCA). As pesquisas atuais têm se concentrado em identificar os genes candidatos que podem influenciar e predispor um indivíduo a essa lesão. Objetivo: Foi realizada uma análise bibliométrica para rastrear os resultados das pesquisas e identificar tendências globais e lacunas no conhecimento sobre a relação entre o componente genético e a RLCA. Metodologia: Os dados foram extraídos das bases de dados Pubmed e Scopus e analisados no pacote Bibliometrix do software R. Um total de 63 estudos publicados desde 2007 foram identificados. Resultados: A maioria das publicações recuperadas foram artigos de pesquisa (85,71%). Os autores com o maior número dessas publicações estão na Polônia e na África do Sul. A análise por meio do mapa de coocorrência revela que há uma linha principal de pesquisa baseada no estudo de polimorfismos genéticos, especialmente nos genes das famílias de colágeno (COL1A1, COL5A1, COL12A1, com maior frequência). Um total de 54 genes candidatos foram identificados nos estudos. Conclusão: Esperamos que este estudo possa ajudar a encontrar pontos-chave e lacunas de pesquisa, fornecendo uma análise abrangente e informações estruturadas sobre este temaIncluye bibliografí
Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021
No full textBackground: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic. Funding: Bill & Melinda Gates Foundation.Incluye referencias bibliográfica