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Público·11 miembros
Jackson Cook
Jackson Cook

Learn Epidemiology and Biostatistics with Epidemiologia Clinica Alvaro Ruiz PDF Free Download

According to our results, current levels of attainment at each step of the hypertension care cascade are higher in Chile compared to most LMICs [12], while compared to HICs [13], levels of awareness, treatment and control were lower, higher and similar respectively. We found that levels of treated and controlled hypertension significantly increased from 2003 to 2017, while levels of awareness increased only among males between 2003 and 2010. In agreement with global trends, our analyses showed that the proportions of adults reaching each stage of the care cascade were similar to those reported in other HICs and were higher than those in LMICs between 2000 and 2010 [2, 12]. Several explanations have been put forward for the global improvement in levels of hypertension awareness, treatment and control, including increases in BP screening at the primary care and community levels, securing better treatment availability, reducing treatment costs, improving treatment adherence and preventing clinical inertia [33]. The GES was launched in Chile in 2005 with a wide marketing strategy and helped to disseminate evidence-based guidelines with simplified recommendations nationwide. In 2014, the law was enforced with an additional regulation called FOFAR, which, for the publicly insured, warranted medicines free-of-charge for hypertension, diabetes and dyslipidaemia. Although we cannot directly assess the impact of these programmes with the ENS data, we can speculate that they have had at least some positive impact through the improvements in treatment and control levels presented here.

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Detection of Alzheimer's disease (AD) prior to clinical inception will be paramount for introducing disease modifying treatments. We have begun collecting baseline characteristics of a community cohort for longitudinal assessment and testing of antecedent blood-based biomarkers. We describe the baseline visit from the first 131 subjects in relationship to a commonly described cytokine, interleukin 6 (IL-6). Subjects from the community presented for a free memory screening with varying degrees of memory concern. We quantified the baseline plasma levels of the cytokine IL-6 and assessed cognition (Montreal Cognitive Assessment, MoCA) and mood (Geriatric Depression Scale, GDS) in relationship to their memory concern. Baseline MoCA scores were inversely related to age, and this association was influenced by an AD risk factor, Apolipoprotein E (APOE4) carrier status. The degree of subjective cognitive decline correlated with GDS and was inversely related to MoCA scores. Interleukin 6 levels were related to age, body mass index, and years of education. It will be important to assess how these baseline IL-6 levels and forthcoming novel biomarkers relate to future cognitive decline. Copyright 2017 John Wiley & Sons, Ltd. Copyright 2017 John Wiley & Sons, Ltd.

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Cervical cancer (CC) occupies fourth place in cancer incidence and mortality worldwide in women, with 560,505 new cases and 284,923 deaths per year. Approximately, nine of every ten (87%) take place in developing countries. When a macroscopic nodal involvement is discovered during a radical hysterectomy (RH), there is controversy in the literature between resect macroscopic lymph node compromise or abandonment of the surgery and sending the patient for standard chemo-radiotherapy treatment. The objective of this study is to compare the prognosis of patients with CC whom RH was abandoned and bilateral pelvic lymphadenectomy and para-aortic lymphadenectomy was performed with that of patients who were only biopsied or with removal of a suspicious lymph node, treated with concomitant radiotherapy/chemotherapy in the standard manner. A descriptive and retrospective study was conducted in two institutions from Mexico and Colombia. Clinical records of patients with early-stage CC programmed for RH with an intraoperative finding of pelvic lymph, para-aortic nodes, or any extracervical involvement that contraindicates the continuation of surgery were obtained. Between January 2007 and December 2012, 42 clinical patients complied with study inclusion criteria and were selected for analysis. In patients with CC whom RH was abandoned due to lymph node affectation, there is no difference in overall survival or in disease-free period between systematic lymphadenectomy and tumor removal or lymph node biopsy, in pelvic lymph nodes as well as in para-aortic lymph nodes, when these patients receive adjuvant treatment with concomitant radiotherapy/chemotherapy. This is a hypothesis-generator study; thus, the recommendation is made to conduct randomized prospective studies to procure better knowledge on the impact of bilateral pelvic and para-aortic lymphadenectomy on this group of patients.

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