Iatreia (Jan 2003)
Asociación de polimorfismos en DNA mitocondrial y diabetes mellitus tipo 2 Descriptive study of the current status of the pediatric practice in Antioquia
Abstract
<p>La Diabetes mellitus tipo 2 (DM2) es un trastorno metabólico<br />caracterizado por una marcada resistencia a la insulina en los tejidos blanco; la prevalencia de DM2 presenta grandes diferencias en poblaciones humanas; es muy alta en aquéllas originadas por migraciones que han cambiado su etilo de vida; alcanza niveles hasta del 30% en poblaciones de americanos nativos como los Pima, que presentan la incidencia más alta en el ámbito mundial (1), en contraste con la población británica que sólo alcanza el 2%. Para explicar este fenómeno James Neel propuso la hipótesis del ";;;;genotipo económico";;;; en la cual sugiere que el genotipo que confiere susceptibilidad a DM2 acompañada de obesidad, aparece en los humanos como un genotipo con ventajas evolutivas para períodos de escasez de alimentos, pero es desventajoso cuando la población entra a períodos de abundancia.</p><p><br />Con el fin de probar el efecto que el DNA mitocondrial (mtDNA), puede tener en el genotipo económico nos propusimos evaluar la asociación de polimorfismos en mtDNA y DM2, comparando estadísticamente las frecuencias alélicas y haplotípicas de locipolimórficos en el mtDNA entre un grupo de casos y un grupo control para DM2 en población antioqueña.</p> BACKGROUND: Even though the implementation of the Law 100 of 1993 has given rise to profound changes in the medical attention services and working conditions of health service personnel, there are few studies that explore the impact on the latter. The purpose of the present study was to describe the current situation of pediatricians and pediatric subspecialists in Antioquia during the 2004-2005 period, with emphasis on social, workrelated and economic factors. MATERIALS AND METHODS: Crossing the data bases of the Pediatrics Society of Antioquia and some pharmaceutical companies, a universe of 321 pediatricians was obtained, from which 220 were randomly interviewed. RESULTS AND CONCLUSIONS: The resulting profile yielded a man (53.2%) or a woman (46.8%) aged 44.6 years, who graduated from the public local university (70.2%), works in the metropolitan area (94%), in a private institution (56.8%) on a second or third level health service. He/she has a work load of 8,62 hours a day, 5.51 days a week and works night shifts in 58.8% of cases. 43% earn less than $4.000.000,oo (Colombian pesos) for their activity as pediatricians and they feel satisfied with their professional activity, but not with the salary received or the hourly work load intensity. Families demand that more time is spent at home. These pediatricians are sedentary and regularly take part in continued medical education activities. This study constitutes an approach to the specific conditions of pediatrics in Antioquia and should be reproduced in other specialties and places throughout the country.
