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  • 1
    Online Resource
    Online Resource
    Vulnerability as a palimpsest: Practices and public policy in a Mexican hospital setting
    SAGE Publications ; 2022
    In:  Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine Vol. 26, No. 6 ( 2022-11), p. 753-776
    Details
    In: Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, SAGE Publications, Vol. 26, No. 6 ( 2022-11), p. 753-776
    Abstract: Vulnerability is a concept associated with the effects of social inequities to access health care services. On a hospital level, vulnerable populations must be identified and favored over others. The aims of this study were the analysis of the conceptions and practices of social workers regarding vulnerable patients, and the identification of theoretical elements of vulnerability given by academics. Hospital ethnography and a focus group were implemented. Social workers related vulnerability to the social needs of each patient; however, they state that they have dilemmas to identify a person in a vulnerable condition; these dilemmas are related to social differences and deservingness. Academics indicated that the vulnerability should refer to the lack of access to health services offered by the institution. Academics agree with social workers regarding the importance of considering the overlapped social and individual circumstances in each patient to recognize their vulnerable condition, regardless of belonging to any of the pre-established vulnerable groups. Finally, taking into account the way of conceptualizing vulnerability and how public policy on the identification of vulnerable patients in the hospital has been implemented, these two elements are explained using the palimpsest model, which is a figure of thought that can be applied to analyze the sociocultural significance of this complex issue, as well as other social dynamics.
    Type of Medium: Online Resource
    ISSN: 1363-4593 , 1461-7196
    URL: Article
    DOI: 10.1177/1363459320988879
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2034459-4
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  • 2
    Online Resource
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    Reduction of Instrumentation-Related Spine Surgical Site Infections After Optimization of Surgical Techniques. A Single Center Retrospective Analysis
    SAGE Publications ; 2022
    In:  Global Spine Journal
    Details
    In: Global Spine Journal, SAGE Publications
    Abstract: Retrospective cohort study. Objective Although surgical risk factors for developing spine surgical site infections (S-SSI) have been identified, the impact of such knowledge in its prevention has not been demonstrated. Methods We evaluated in 500 patients undergoing spine surgery between 2011 and 2019 at Hospital 12 de Octubre the changes in S-SSI rates over time. Surgical variables independently related to S-SSI were analyzed by univariate and multivariate analysis using binary logistic regression models. A case-control sub-analysis (1:4), matched by the surgical variables identified in the overall cohort was also performed. Results Twenty cases of S-SSI were identified (4%), with a significant decrease in the incidence rate across consecutive time periods (6.6% [2011-2014] vs .86% [2015-2019] ; P-value 〈 .0001)). Multivariate analysis identified arthrodesis involving sacral levels (odds ratio [OR]: 2.57; 95% confidence interval [95%CI] : 1.02-6.47; P-value = .044) and instrumentation over 4-8 vertebrae (OR: 2.82; 95%CI: 1.1-7.1; P-value = .027) as independent risk factors for S-SSI. The reduction in the incidence of S-SSI concurred temporally with a reduction in instrumentations involving 4-8 vertebrae (55% vs 21.8%; P-value 〈 .0001) and sacral vertebrae (46.9% vs 24.6%; P-value 〈 .0001) across both periods. The case-control analysis matched by these surgical variables failed to identify other factors independently related to the occurrence of S-SSI. Conclusions Spinal fusion of more than 4 levels and the inclusion of sacral levels were independently related to the risk of S-SSI. Optimization of surgical techniques by reducing these two types of instrumentation could significantly reduce S-SSI rates.
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1177/21925682221109557
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2648287-3
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  • 3
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    Online Resource
    Association between Genetic Variant rs2267716 of CRHR2 Gene with Colorectal Cancer
    SAGE Publications ; 2022
    In:  Journal of Investigative Medicine Vol. 70, No. 4 ( 2022-04), p. 947-952
    Details
    In: Journal of Investigative Medicine, SAGE Publications, Vol. 70, No. 4 ( 2022-04), p. 947-952
    Abstract: Colorectal cancer (CRC) is the third most common cancer and one of the main causes of death around the world. Multiple lines of evidence have suggested the role of the corticotropin-releasing hormone (CRH) family in CRC induction, including the low expression of corticotropin-releasing hormone receptor 2 ( CRHR2), which is an angiogenesis inhibitor and inflammatory modulator. Previous research suggests that CRHR2 expression in colonic intestinal cells can regulate migration, proliferation and apoptosis through the modulation of several pathways. The aim of this study was to analyze the association of the rs10250835, rs2267716 and rs2267717 variants of CRHR2 gene with CRC in the Mexican population in order to consider its predictive value in CRC. This cross-sectional study included a group of 187 unrelated patients with sporadic CRC and a control group of 191 healthy blood donors. DNA extraction from peripheral blood was carried out using the Miller method. Identification of the rs10250835 variant was performed using PCR-restriction fragment length polymorphism (RFLP) and the rs2267716 and rs2267717 variants using TaqMan allelic discrimination assay. The minor allele homozygous CC of the rs2267716 variant of CRHR2 showed significant difference between CRC and control group (p=0.025), as well as the GCA haplotype (p=0.007), corresponding to the rs10250835, rs2267716 and rs2267717 variants, respectively. Our results suggest that the rs2267716 variant and GCA haplotype of CRHR2 represent a risk factor for CRC development in Mexican patients.
    Type of Medium: Online Resource
    ISSN: 1081-5589 , 1708-8267
    URL: Article
    DOI: 10.1136/jim-2021-002047
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
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  • 4
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    Research and Conservation Priorities for Tortoises and Freshwater Turtles of Colombia
    SAGE Publications ; 2016
    In:  Tropical Conservation Science Vol. 9, No. 4 ( 2016-12), p. 194008291667370-
    Details
    In: Tropical Conservation Science, SAGE Publications, Vol. 9, No. 4 ( 2016-12), p. 194008291667370-
    Type of Medium: Online Resource
    ISSN: 1940-0829 , 1940-0829
    URL: Article
    DOI: 10.1177/1940082916673708
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2496920-5
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  • 5
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    Online Resource
    The cost of hospital care for HIV patients in Colombia: an insurer’s perspective
    SAGE Publications ; 2019
    In:  International Journal of STD & AIDS Vol. 30, No. 7 ( 2019-06), p. 696-702
    Details
    In: International Journal of STD & AIDS, SAGE Publications, Vol. 30, No. 7 ( 2019-06), p. 696-702
    Abstract: The aim of this study was to evaluate the cost derived from the hospitalization of people living with HIV (PLHIV) in Colombia between 2011 and 2015. This is an analysis of the direct cost of PLHIV hospitalization from the perspective of an insurer of the Colombian General Social Security System. The costs were calculated in Colombian pesos and corrected for inflation on the basis of the 2017 Consumer Price Index of the Bank of the Republic of Colombia. It was converted to US dollars at the Market Representative Exchange Rate of the same year. We analyzed 1129 hospitalizations in 612 PLHIV, of which 12% started with a diagnosis of HIV during the same hospitalization, with the majority in the AIDS stage (63%). The median overall cost of hospitalizations was US$1509 (25th and 75th percentiles: US$711–US$3254), being even higher in patients with AIDS and as the CD4 T lymphocyte count decreased. The cost derived from the medical care of PLHIV increases as the clinical control of the disease worsens, and it is a key indicator of the impact of the strategies implemented for the timely identification of the infection and subsequent management of the disease.
    Type of Medium: Online Resource
    ISSN: 0956-4624 , 1758-1052
    URL: Article
    DOI: 10.1177/0956462419835636
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2009782-7
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  • 6
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    Low disease activity state associated with fewer incident vertebral fractures in Mestizo women with systemic lupus erythematosus
    SAGE Publications ; 2023
    In:  Lupus Vol. 32, No. 11 ( 2023-10), p. 1328-1334
    Details
    In: Lupus, SAGE Publications, Vol. 32, No. 11 ( 2023-10), p. 1328-1334
    Abstract: Low disease activity state (LDAS) has been linked to a significant reduction in flares and damage accrual in patients with systemic lupus erythematosus (SLE); however, the effect of LDAS on the risk of vertebral fractures (VFs) in subjects with SLE is unknown, considering that low bone mineral density (BMD) and VF are frequent in SLE. Objective to evaluate whether achieving LDAS ≥50% of the observation time prevents new VF and BMD changes in Mestizo women. Methods We carried out a longitudinal, observational, and retrospective study. Mestizo women with SLE were included for a median of an 8-year follow-up. LDAS was described as Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score ≤4, prednisone ≤7.5 mg/day, and stable immunosuppressive therapies. BMD measurements and lateral thoracic and lumbar radiographs for a semiquantitative analysis for VF were assessed at baseline and during the follow-up. Uni- and multivariable interval-censored survival regression models were carried out. Results We included 110 patients: 35 (31.8%) had new VF. A total of 56 patients (50.1%) achieved LDAS ≥50% of the time during the follow-up and achieved a significantly lesser risk of incident VF (HR = 0.16; 95% CI, 0.06–0.49). After adjusting by age, BMI, menopause, prevalent VF, baseline BMD, cumulative glucocorticoid use, and anti-osteoporotic therapy, LDAS-50 was significantly related to a decrease in the risk of a new VF (HR = 0.39; 95% CI, 0.16–0.98). There was no association between LDAS and BMD measurement changes. When only patients on LDAS but not in remission ( n = 43) were evaluated for the risk of incident VF, both uni- and multivariate analyses were significant (HR = 0.12; 95 CI, 0.04–47; p = 0.001, and HR = 0.26; 95% CI, 0.7–0.88; p = 0.03). Conclusions LDAS ≥50% of the time was significantly associated with a diminished risk of new VF in Mestizo women with SLE, even in patients not in remission. However, LDAS did not help modify BMD changes over time.
    Type of Medium: Online Resource
    ISSN: 0961-2033 , 1477-0962
    URL: Article
    DOI: 10.1177/09612033231202878
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2008035-9
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  • 7
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    Assessing school-lunch feeding and nutrition education strategy for healthier kids in selected Philippine public schools
    SAGE Publications ; 2020
    In:  Nutrition and Health Vol. 26, No. 3 ( 2020-09), p. 231-242
    Details
    In: Nutrition and Health, SAGE Publications, Vol. 26, No. 3 ( 2020-09), p. 231-242
    Abstract: Nutrition interventions during the early years of a child’s life are anchored on the need to provide good nutrition and proper health care to optimize their growth potential as adults. In the Philippines, undernutrition is a persistent problem among 0–10 year old Filipino children. In this age group, children consume a diet poor in quantity and quality. Aim: This study aimed to assess the effects of a school-lunch and nutrition education intervention among schoolchildren in terms of attaining good nutrition. Method: Using a quasi-experimental design, children aged 7–9 years from public elementary schools in the province of Laguna, Philippines were categorized into three intervention groups and one non-intervention group. Anthropometric measurements; nutrition knowledge, attitude and behavior; and food intake among children and households were collected at baseline and endline periods. SPSS for Windows version 16 and Stata version 15 were utilized for data analysis. Results: Mean scores on knowledge, attitude and behavior of schoolchildren in intervention groups increased significantly at endline ( p 〈 0.05). Protein requirement was met by more children and households than the energy requirement. Most children with normal nutritional status after the interventions (25.3%) belonged to the group with the complete intervention of school-lunch and nutrition education. Conclusions: The provision of both school-lunch feeding and nutrition education is effective in improving the knowledge, attitude and behavior scores and nutritional status of schoolchildren. The adoption and institutionalization of complete intervention with school-lunch and nutrition education in elementary public schools should be pursued.
    Type of Medium: Online Resource
    ISSN: 0260-1060 , 2047-945X
    URL: Article
    DOI: 10.1177/0260106020930466
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2647106-1
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  • 8
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    Kidney transplantation outcomes in lupus nephritis: A 37-year single-center experience from Latin America
    SAGE Publications ; 2021
    In:  Lupus Vol. 30, No. 10 ( 2021-09), p. 1644-1659
    Details
    In: Lupus, SAGE Publications, Vol. 30, No. 10 ( 2021-09), p. 1644-1659
    Abstract: We assessed patient and graft outcomes and prognostic factors in kidney transplantation in patients with end-stage kidney disease (ESKD) secondary to lupus nephritis (LN) undergoing kidney transplantation from August 1977 to December 2014 in a Latin American single center. Methods The primary endpoint was patient survival, and the secondary endpoints were death-censored graft survival for the first renal transplant and the rate of recurrent LN (RLN). Kaplan–Meier method was used for survival analysis. Factors predicting patient and death-censored graft survivals were examined by Cox proportional-hazards regression analyses. Results 185 patients were retrospectively evaluated. Patient survival rates were 88% at one year, 82% at three years, 78% at five years, and 67% at ten years. Death-censored graft survival for the first renal transplant was 93% at one year, 89% at three years, 87% at five years, and 80% at ten years. RLN was diagnosed in 2 patients (1.08%), but no graft was lost because of RLN. Thirty-nine (21.1%) patients died, and 65 (35.1%) patients experienced graft loss during the follow-up. By multivariable analyses, older recipient age and 1-month posttransplantation eGFR 〈 45 ml/min/1.73m 2 were associated with lower patient survival and an increased risk of graft loss, while induction immunosuppressive therapy exerted a protective effect on patients’ survival. In the subgroup of patients in whom disease activity was measured at the time of transplantation, a higher SLEDAI score was also associated with lower patient survival and an increased risk of graft loss. Conclusion In a mostly Mestizo population, kidney transplantation is an excellent therapeutic alternative in LN patients with ESKD. Older recipient age, an eGFR 〈 45 ml/min/1.73m 2 at one month posttransplantation, and disease activity at the time of transplantation are predictive of a lower patient and death-censored graft survival, while induction immunosuppressive therapy has a protective effect on patient survival. RLN is rare and does not influence the risk of graft loss.
    Type of Medium: Online Resource
    ISSN: 0961-2033 , 1477-0962
    URL: Article
    DOI: 10.1177/09612033211028663
    RVK:
    XA 10000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2008035-9
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  • 9
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    Bridging the gaps of headache care for underserved populations: Current status of the headache field in Latin America
    SAGE Publications ; 2022
    In:  Cephalalgia Vol. 42, No. 10 ( 2022-09), p. 1086-1090
    Details
    In: Cephalalgia, SAGE Publications, Vol. 42, No. 10 ( 2022-09), p. 1086-1090
    Abstract: To evaluate the current status of specialized headache care and research in Latin America. Background Latin America corresponds to about 9% of the global population. There is considerably limited access to headache services, and very few resources are allocated to headache research in this region. Methods The study consisted of two parts. First, in order to evaluate headache-related scientific output from Latin American countries we performed a 10-year bibliometric analysis and contrasted the results with a human developmental index–adjusted projection model. Secondly, we conducted a survey addressing different aspects of headache research, education, clinical practice, and awareness among members of the Latin American Headache Society. Results During the last 10 years 70% of Latin American countries published less than three articles regarding headache disorders. This contrasts with an average expected publication rate of 889 scientific papers. Indeed, none of the countries fulfilled their human developmental index – adjusted projected scientific output, with Brazil being the closest reaching 84.1% of what would be considered optimal according to the model. From the 86 headache-dedicated professionals that responded to the survey, most (64%) reported not having a headache specialization programme of any kind available in their countries. The biggest impediments towards conducting research observed by participants were the lack of time (39%), resources (22%), and training (21%). Conclusions Latin American countries have a considerable gap in headache-related scientific production, and also in formal education, research, and implementation of multidisciplinary services. Access to specialized headache care is particularly limited for patients with lower economic income.
    Type of Medium: Online Resource
    ISSN: 0333-1024 , 1468-2982
    URL: Article
    DOI: 10.1177/03331024221093623
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2019999-5
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  • 10
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    Graphene oxide and reduced graphene oxide nanocomposites grafted with hollow gold nanoshells as photothermal agents
    SAGE Publications ; 2022
    In:  Journal of Composite Materials Vol. 56, No. 9 ( 2022-04), p. 1453-1464
    Details
    In: Journal of Composite Materials, SAGE Publications, Vol. 56, No. 9 ( 2022-04), p. 1453-1464
    Abstract: Nanocomposites based on graphene oxide (GO) or reduced graphene oxide (rGO) grafted with hollow gold nanoshells (HGNs) were developed as enhanced photothermal agents with improved biocompatibility. Infrared and Raman spectroscopy allowed determining that graphene was highly oxidized due to the presence of oxygenated groups that allowed further functionalization and provided anchor points for the grafting of HGNs. Using HRTEM and STEM, good dispersion of the HGN on the surface of the graphitic materials was observed. Meanwhile, using UV–Vis spectroscopy, an increase of absorbance in the near-infrared region was appreciated, resulting in an enhancement of the photothermal properties of the nanocomposites in contrast to the materials separately. Remarkable temperature increases were obtained in short periods of irradiation using a low-power laser. Moreover, a decrease in the cytotoxicity of GO and rGO was observed in the human neuronal line hNS1 under the presence of the plasmonic nanoparticles on the surface.
    Type of Medium: Online Resource
    ISSN: 0021-9983 , 1530-793X
    URL: Article
    DOI: 10.1177/00219983221073982
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 160490-9
    detail.hit.zdb_id: 2081924-9
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