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Violence is a pressing global concern, causing more than 475 000 deaths annually and disproportionately affecting women and children. While environmental, genetic, and epigenetic factors contribute to violent behavior, this article focuses on the genetic aspect, particularly the roles of the X and Y chromosomes. The monoamino oxidase A () gene influences neurotransmitter catabolism and is located on the X chromosome. Polymorphisms, such as tandem repeat variants associated with low transcriptional activity, have been linked to aggression, particularly in men, as X chromosome inactivation complicates studies in women. Other variants, including single-nucleotide polymorphisms, have also been associated with violent behavior. Additionally, individuals with fragile X syndrome often exhibit increased aggression patterns. The Y chromosome's sex-determining region Y gene () plays a pivotal role in male sexual development and behavior. Besides directing testicular formation, is expressed in other tissues, influencing violence by modulating catecholamine release and inhibiting the monoamio oxidasa A. Evolutionary hypotheses suggest that may have adapted to promote male aggression for survival. Despite evidence linking the X and Y chromosomes to violence, conflicting findings highlight the need for further research to fully understand their roles in aggressive behavior. This article focuses on the genetic component, specifically analyzing the bibliographic evidence associating Y and X chromosome genetics to violent behavior.

Long QT syndrome is a rare cardiac channelopathy characterized by prolonged QT intervals and altered T wave morphology. The etiology of long QT syndrome is multifactorial, including environmental and genetic factors. In addition, several heart diseases have been associated with the individual's ethnicity. The objective of the present case report is to describe the genetic and clinical findings of a 44-year-old Ecuadorian man who experienced recurrent episodes of syncope, prolonged QT intervals, and emergent arrhythmias. Through next-generation sequencing, genetic analysis identified a p.Val612Met variant in the KCNH2 gene, associated with long QT syndrome type 2. These findings were key in classifying the patient's condition as life-threatening and guiding the implementation of a personalized treatment strategy.

Introduction: Reproductive immunology has advanced significantly, recognizing the immune system as crucial in pregnancy development and facilitating the identification of abnormalities causing recurrent reproductive failure, as well as proposing targeted treatments for these patients.

Methods: This is a descriptive, observational, and retrospective study conducted at the Reproductive Immunology Unit of the Hospital Clínico San Carlos in Madrid. Clinical and analytical data were analyzed for patients diagnosed with recurrent reproductive failure between 2019 and 2023. Data on treatments received as prophylaxis for pregnancy loss and their success rates were also collected. Finally, a comparative study of the two major subgroups in the cohort was performed.

Results: A total of 277 patients were included. The most prevalent diagnosis was recurrent miscarriage (64.2%), followed by recurrent implantation failure (25.2%). Immunological and/or vascular abnormalities were detected in 88.8% of patients. The most prevalent immunological abnormality was the expansion of cytotoxic natural killer cells (49.5%), followed by HLA-C-KIR mismatch (39.1%) and the presence of antiphospholipid antibodies (38.5%). The comparative study between the recurrent miscarriage and the recurrent implantation failure subgroups revealed statistically significant differences regarding the presence of antinuclear antibodies (15.4% vs. 28.3%, p=0.03) and vitamin D deficiency (37.2 vs 60.0%, p=0.01). The most commonly used medications were low-dose acetylsalicylic acid, low-molecular-weight heparin, hydroxychloroquine, and/or prednisone, with an overall success rate of 97.3%. Neither moderate nor severe side effects were reported.

Conclusions: Immunological studies to identify causes of recurrent reproductive failure are highly useful in cases where other etiologies have been excluded. Targeted therapies for addressing these abnormalities have demonstrated significant effectiveness.

The volume of information about medical interventions has grown exponentially in recent decades. The increasing involvement of patients in decision-making creates a scenario in which they can constantly interact with multiple sources of information that can be correct, incorrect or misleading. In this context, promoting knowledge dissemination through reliable sources and fostering health literacy among the general population is crucial. The Informed Health Choices project aims to generate resources that can help individuals cultivate critical thinking about health interventions, thereby reducing unnecessary harm and financial costs. The Key Concepts of Informed Health Choices serve as the foundation for creating these resources. This is a list of principles potentially relevant for people without formal training in health topics to assess the reliability of the information about interventions. Resources based on these Key Concepts have been tested on primary and secondary school students in Africa, showing positive results in the short- and medium-term. This initiative is not free from limitations or considerations concerning its applicability but sheds light on how to face the new challenges that health education brings in times of . This article aims to contextualize the current scenario of health information and to introduce the Key Concepts for making informed health choices and the resources created based on them.The text is part of a methodological series on clinical epidemiology, biostatistics and research methodology conducted by the Evidence-based Medicine team at the School of Medicine of the University of Valparaíso, Chile.

Background: In Chile, despite high obstetric coverage and consolidated registration systems, there has been a stagnation in the reduction of maternal mortality, reflecting the need to identify social factors and determinants. These are often overlooked by traditional surveillance systems.

Objective: To adapt and validate, through expert consensus, a verbal autopsy instrument based on the three delays model, with a gender and intercultural approach.

Methods: Expert validation study using the Delphi method in three phases, carried out between June and October 2024. Forty experts in maternal health, epidemiological surveillance, gender, and interculturality participated. Seven criteria were evaluated: clarity, relevance, cultural relevance, socio-health relevance, regulatory relevance, and the incorporation of gender and intercultural approaches. The process sought to reach consensus to ensure the methodological and contextual quality of the instrument.

Results: The final instrument includes 95 items organized into six thematic blocks. An overall consensus of 85% was achieved on the evaluated criteria. The adaptation incorporated variables such as mental health, gender-based violence, ethnic identity, and perceived quality of care. Operational validation identified implementation, logistical, and ethical challenges, leading to a gradual implementation plan in regulatory, pilot, and national expansion phases.

Conclusions: The instrument adapted and validated by experts offers a complementary tool for monitoring maternal mortality in Chile. Its comprehensive approach would allow identifying social and structural factors associated with maternal deaths, favoring more equitable and culturally relevant interventions aimed at preventing avoidable maternal deaths. Field validation is essential to assess the impact of its application.

Introduction: According to the World Health Organization (WHO), 2.8 million mothers and newborns die each year from preventable causes, highlighting inequalities in access to quality healthcare services. The study describes the factors that limit institutional childbirth among Ashaninka mothers in the Peruvian Amazon.

Methods: The research was descriptive, using a questionnaire administered to 152 Ashaninka mothers from five communities in Río Tambo.

Results: Most Ashaninka mothers who gave birth at home were between 25 and 29 years old, lived with their partners, came from the Koterini Tarzo community, were Catholic, had incomplete secondary education, were housewives, and had a paternal income of less than or equal to 1000 PEN. They chose home birth for cultural reasons such as privacy, tradition, and economics, preferring traditional birth attendants because of their cultural acceptance and experience. Cultural practices included the burial of the placenta, the use of herbs such as "piri piri," and vertical births. The perception of inadequate facilities and the prevalence of cesarean sections limit the acceptance of institutional childbirth. Added to this is a preference for female healthcare personnel, a lack of information about health procedures, and the prohibition of cultural practices.

Conclusions: There is a need to reform the maternal care model in Indigenous contexts, involving healthcare personnel, policymakers, and local authorities to create culturally relevant and accessible services. It is suggested that an intercultural approach be integrated into professional training and that traditional medicine be combined with the healthcare system. Future studies should evaluate the impact of these interventions on maternal and perinatal outcomes in Indigenous communities.

Clinical practice guidelines are a set of recommendations developed systematically and based on the best available evidence. Their purpose is to enable healthcare providers and patients to make the best decisions regarding healthcare interventions associated with a particular clinical condition, considering each patient's specific circumstances. One element that has gained importance recently is considering patient preferences when developing healthcare recommendations to increase adherence to therapeutic measures and patient satisfaction. One way to incorporate these preferences is by including patients or their representatives in developing these tools. Patient participation can take place through their inclusion as members of the development panel and/or at different stages of the guideline development process. This can be achieved through various methods like discussion groups, semi-structured interviews, or surveys. However, challenges still need to be addressed to optimally incorporate patients' perspectives, which, among other reasons, are related to socioeconomic barriers, educational gaps, and the persistence of a paternalistic view of healthcare. This article has been developed in the context of a methodological series on clinical epidemiology, biostatistics, and research methodology carried out by the departments of Research Methodology and Evidence-Based Medicine at the School of Medicine of the University of Valparaíso, Chile.

Introduction: The impact of confinement on eating habits has been associated with mental health, gender, and socioeconomic status. This study examined the consumption of sugar-sweetened beverages and fast food during the COVID-19 confinement period in Chile, a country with a history of high consumption of processed foods.

Methods: A cross-sectional design was done from responses obtained through an online survey between May and August 2020. Data were collected and managed using the SurveyMonkey® electronic tool (hosted at the Institut d'Investigació en Atenció Primària (IDIAP) Jordi Gol i Gurina, Barcelona, Spain). We recruited through online platforms and social networks using convenience and snowball sampling. People aged 18 years and older were included. The consumption of sugar-sweetened beverages and fast food was analyzed in relation to socioeconomic and sociodemographic variables. Logistic and log-binomial regression models were evaluated using Stata v18. P<0.05 was considered statistically significant.

Results: 6971 (93%) people completed the questionnaire. The participants were predominantly born in Chile (94.6%), with a majority being women (63.5%) and under 50 years old (74%). The prevalence of consumption of sugary drinks and fast food was 15.4% (men, 14.6%; women, 15.9%) and 19.6% (men, 17.2%; women, 21%), respectively. Age 40 years and older was a protective factor for both women and men. Factors associated with the consumption of sugar-sweetened beverages included a change in employment status (prevalence ratio 1.26; 95% confidence interval 1.02 to 1.45) and, for fast food consumption, being female (1.18; 1.06 to 1.32).

Conclusions: Sex, age, and change in income were associated with increased consumption of sugar-sweetened beverages and fast food during the COVID-19 pandemic. These results reaffirm the importance of implementing social and communicational strategies that promote healthy eating, especially during health emergency scenarios.

Event-based surveillance is an important strategy for the early detection of outbreaks of all types of diseases, especially in low- and middle-income countries. This research focuses on an evidence map, which systematizes and graphically represents the information gathered on the effectiveness of various interventions in these contexts. Key interventions include data quality, training, communication, multisectoral collaboration, timeliness, mortality and morbidity reduction, cost-effectiveness, early response to events, sensitivity, signals, and usefulness for real events. In this study, a review and evaluation of the literature was conducted on a total of 22 systematic reviews; 15 met the inclusion criteria, containing a total of 82 open-access primary articles. The quality of the evidence was assessed using the AMSTAR tool, identifying reviews with high, medium, and low reliability. The results show that event-based surveillance has been successfully implemented in countries such as the United States, Brazil, China, Australia, Canada, India, Japan, New Zealand, Taiwan, the Netherlands, the United Arab Emirates, and others. From the evidence gathered in these countries, it is clear that event-based surveillance improves early outbreak detection, alert response, and minimizes the spread of diseases. Further research and improvement of these strategies are needed for effective early detection and response to public health events.

Introduction: Primary dysmenorrhea is defined as pain during the menstrual cycle, recurrent cramping type in the absence of an identifiable cause. It can negatively affect the quality of life of those who suffer from it. The objective is to determine the association between pain intensity in primary dysmenorrhea and the impact on quality of life related to menstrual health, presenteeism, and sexual function in adult Chilean women.

Methods: Cross-sectional observational study. A sample of 392 women with painful menstruation in the last six months. A self-reported survey was distributed on social media between January and June 2024, consisting of sociodemographic questions, pain intensity and perception, the EQ5D-3L quality of life questionnaire, the Stanford Presenteeism Scale, and the Women's Sexual Function Questionnaire adapted to the study.

Results: The mean age was 29.2 +/- 8.2 years, and the mean pain intensity was 6.7 +/- 2.04 points. High pain intensity was associated with greater impairment. Those with severe or extreme pain experienced a significant impact on their quality of life related to menstrual health. Among the compromised aspects, the most notable were the performance of usual activities (OR 9.99), lower work performance (lack of concentration), and decreased social activities. The most common mitigation measures used were local heat (96.7%), herbal teas (63.5%), and medication (90%).

Conclusions: Dysmenorrhea impacts different dimensions of quality of life. Despite its high prevalence, it is often underestimated, and women often normalize pain by employing various methods to mitigate it. The concept of menstrual health is a subjective and multidimensional experience. The results suggest the importance of comprehensively updating the management of dysmenorrhea and incorporating new studies on economic evaluation, prevalence, and self-image to delve deeper into the subject.