The level of knowledge about different aspects of health of the population served in the Pedro Borras health area in the city of Pinar del Río

A prospective study in order to determine level knowledge of the population about health, before and after the implantation of the Integral Medical Attention Programme to the Family, was carried out at the outpatient services in the "Pedro Borrás" Teaching Community Polyclinic Health Area. Of the population attending to this outpatient area, 917 individuals older than 15 years, were selected at random. These individuals were surveyed at the beginning of the study (November 1986), in order to collect data of main necessary aspects that the population must be acquainted with on health condition and health promotion, and were surveyed again after six months of the performance of the system (May 1987), and results of both surveys were compared and shown in tables with statistical data. The main programmes for health promotion before the implantation of the new system were, known, effectively, by the population in ratios ranging 0.26-0.49. After the performance of the new programme it was observed how the level of knowledge raises to 0.31-0.70, and knowledges on obesity and sedentary habits (0.69) and on prevention of accidents (0.70) becomes significative. We consider all these changes depending on a greater educational work by the physician and nurse in charge of the plan.     

Epidemiology of epilepsy in developing countries.

Epilepsy is an important health problem in developing countries, where its prevalence can be up to 57 per 1000 population. This article reviews the epidemiology of epilepsy in developing countries in terms of its incidence, prevalence, seizure type, mortality data, and etiological factors. The prevalence of epilepsy is particularly high in Latin America and in several African countries, notably Liberia, Nigeria, and the United Republic of Tanzania. Parasitic infections, particularly neurocysticercosis, are important etiological factors for epilepsy in many of these countries. Other reasons for the high prevalence include intracranial infections of bacterial or viral origin, perinatal brain damage, head injuries, toxic agents, and hereditary factors. Many of these factors are, however, preventable or modifiable, and the introduction of appropriate measures to achieve this could lead to a substantial decrease in the incidence of epilepsy in developing countries.     

Necesidades de información y uso de Internet en pacientes con cáncer de mama en España

Objective

To analyze information needs and search strategies among women with breast cancer in Spain. An additional aim was to explore how the internet, as a source of health information, influences the autonomy and active management of this disease among patients. The research was conducted in 2010 and 2011.

Method

This study forms part of a broader qualitative study that focuses on describing patients’ experiences of breast cancer and the trajectory of the disease, with the aim of creating a platform of integrated information resources for patients, relatives and healthcare professionals (PyDEsalud: http://www.pydesalud.com). We carried out 41 in-depth, semi-structured interviews with breast cancer patients in different stage of the disease, who were aged between 32 and 69 years. The interviewees’ were selected by intentional sampling, which included 15 Spanish regions. The field work was carried out from June to August, 2010. The interviews were recorded on videotape or audio. Based on patients’ narratives of their disease, a thematic-inductive analysis was performed of the information gathered.

Results

The findings show the importance of the internet as a source of health information. Moreover, the internet is a resource that is able to promote the empowerment process among patients and, consequently, to aid improvement in disease management.

Conclusions

Users need access to web sites with high quality health information, adapted to their needs and objectives.     

Hospital mortality in acute coronary syndrome: differences related to gender and use of percutaneous coronary procedures

Background  

To identify differences among men and women with acute coronary syndrome in terms of in-hospital mortality, and to assess whether these differences are related to the use of percutaneous cardiovascular procedures.     

Psychological factors considerably influence the results of 6-min walk test after coronary bypass surgery

The 6-min walk test (6MWT) is a simple, low-cost method for estimating physical exercise capacity of cardiac patients, when exercise test cannot be performed, as in patients early after coronary artery bypass surgery. As the test requests active cooperation of patients, possibly not only somatic, but psychological factors can influence the results. 358 patients who arrived to Phase II residential cardiac rehabilitation after their first coronary artery bypass surgery were included in the prospective study. 6-MWT was performed at the beginning and at the end of 3 weeks program. Hospital Anxiety and Depression Scale (HADS), Type-D personality test were filled in 3 weeks after surgery. RESULTS: Patients characterized as Type-D personality (8.5%) covered considerably shorter distance than non-Type-D patients both at the beginning (255 +/- 91 m vs. 319 +/- 106 m, p < 0.01) and at the end of 6MWT (361 +/- 91 m vs. 411 +/- 106 m, p < 0.05) without any substantial differences in heart rate or rating of perceived exertion. Patients with high level of anxiety (16.5%) had lower walking distance compared to non anxious patients both at the beginning and the ending test (274 +/- 97 m vs. 320 +/- 106 m, p < 0.01 and 374 +/- 110 m vs. 413 +/- 104 m, p < 0.05), and evaluated higher rate of perceived exertion (12.5 +/- 1.1 vs. 11.9 +/- 1.4, p < 0.05 and 11.7 +/- 0.8 vs. 11.3 +/- 1.3, p < 0.05). Patients who were depressed according to HADS (14%) walked shorter distance than non depressed patients both at the beginning (267 +/- 88 m vs. 320 +/- 107 m, p < 0.01), and end of 6MWT (347 +/- 99 m vs. 416 +/- 104 m, p < 0.001). There were no differences in somatic function of patients with and without psychological alternations. CONCLUSION: Psychological factors (Type D personality, anxiety and depression) considerably influence 6MWT walking distance after coronary artery bypass surgery.     

Dilemma in clinical practice: methods of tumor detection in patients with deep vein thrombosis

Thrombosis being developed on the basis of acquired thrombophilia is a frequent and recognized complication of malignant diseases. Thrombosis may be presenting the first (and the only) symptom of cancers, therefore some kind of diagnostic procedure seems to be necessary for detecting malignancies. The occurrence of deep venous thrombosis with solid tumors had been studied, and the literature had been reviewed. The authors have discussed: 1. The epidemiology, 2. The prevalence and incidence of cancer with different types of thrombosis, 3. The most frequent malignancies, 4. The occult and undiagnosed tumors, 5. The cases at an early stage of cancer. Finally the authors tried to define a suitable diagnostic strategy. The point of this standard is that a detailed screening in patients at a high risk of cancer is reasonable even if there are no symptoms suggesting malignancy.     

Toxic effects of systemic cisplatin on rat eyes and the protective effect of hesperidin against this toxicity

Context: In the present study, cisplatin (CP) induced eye toxicity and the beneficial effect of hesperidin (HP) was investigated.

Methods: Twenty-eight rats were equally divided into four groups; the first group was kept as control. In the second and third group, CP and HP were given at the doses of 7?mg/kg and 50?mg/kg/d, respectively. In the fourth group, CP and HP were given together at the same doses. Tissue samples were collected on day 14 of CP treatment.

Results: The results demonstrated that CP caused a significant increase in thiobarbituric acid reactive substances (TBARS) levels and decrease of glutathione levels and antioxidant enzyme activity (catalase, superoxide dismutase and glutathione peroxidase) in eye tissues compared to other groups, HP prevented these effects of CP. Besides, CP led to histopathological damage in the retina and cornea. On the other hand, HP treatment prevented histopathological effects of CP.

Conclusion: CP had severe dose-limiting toxic effects and HP treatment can be beneficial against the toxic ocular effects of CP. Thus, it appears that co-administration of HP with CP may be a useful approach to attenuate the negative effects of CP on the eye.     

Effect of long-term oral pretreatment with levosimendan on cardiac arrhythmias during coronary artery occlusion in conscious rats

Heart failure is frequently associated with cardiac arrhythmias. The aim of the present study was to investigate the effect of levosimendan, a new cardiotonic drug for the treatment of congestive heart failure, on experimental ischaemic arrhythmias. Acute coronary artery occlusion was produced in conscious rats 7-10 days after placement of ligature around the left main coronary artery. Acute pretreatment with levosimendan (0.2 or 0.6 mg/kg orally 1 h before coronary artery occlusion) did not influence the incidence, onset and duration of arrhythmias. Long-term pretreatment with levosimendan (0.2 or 0.6 mg/kg orally twice a day for 2 weeks) increased the survival rate (50% and 81% vs. 44% in controls) and the number of animals without any arrhythmia (37% and 31% vs. 5% in controls). The present results demonstrate that chronic oral treatment with levosimendan could be beneficial in congestive heart failure and arrhythmias resulting from regional myocardial ischaemia.     

New prolyl oligopeptidase inhibitors developed from dicarboxylic acid bis(l-prolyl-pyrrolidine) amides

Isophthalic acid bis(l-prolyl-pyrrolidine) amide is a very potent prolyl oligopeptidase inhibitor, but it has a log P value of -0.2, which is very low for a compound targeted to the brain. Therefore, these types of compounds were further modified to improve the structure-activity relationships, with the focus on increasing the log P value. The inhibitory activity against prolyl oligopeptidase from pig brain was tested in vitro. The most promising compounds resulted from replacing the pyrrolidinyl group at the P5 site by cycloalkyl groups, such as cyclopentyl and cyclohexyl groups, and by a phenyl group. These compounds are slightly more potent, and they have a significantly higher log P value. The potency of these compounds was further increased by replacing the pyrrolidinyl group at the P1 site by 2(S)-cyanopyrrolidinyl and 2(S)-(hydroxyacetyl)pyrrolidinyl groups.