La heterogeneidad del alfabetismo en salud y el consentimiento informado en Chile / The case against template informed consent procedures in biomedical research: heterogeneity in health literacy in Chile

Se examinó el alfabetismo en salud en Chile con el fin de determinar si se pueden usar procedimientos de consentimiento informado estándares en esta población. Se evaluó el alfabetismo en salud con la versión abreviada de la prueba SAHLSA. Los resultados se expresaron como el porcentaje de respuestas correctas en cada prueba. El promedio global de respuestas correctas fue 85.4 ± 13.5 % (media aritmética ± desviación estándar, n=762). Hubo diferencias importantes entre los subgrupos examinados. El nivel más bajo de alfabetismo en salud se detectó en pescadores artesanales y sus familias y en estudiantes de liceos públicos, y el más alto en estudiantes universitarios y madres pobladoras atendidas en el sistema público de salud. Los resultados muestran la necesidad que los procedimientos de consentimiento informado tomen en cuenta la heterogeneidad del alfabetismo en salud de la población chilena.

Health literacy was examined in Chile to assess whether it is homogenous enough to allow the use of "templates" for informed consent, and to identity subgroups that may need special consideration when recruited for research because of their low health literacy abbreviated SAHLSA test of health literacy was used. Results were expressed as percent of correct answers out of the 50 items of the SAHLSA test. There was high health literacy with 85.4 ± 13.5 % (arithmetic mean ± standard deviation, «=762) of correct answers. There were important differences between groups, with lower scores in artisanal fishermen families and high-school students attending public schools, and higher scores in university students and mothers attending the public health system. Results show that a case by case approach is probably more appropriate when seeking informed consent in this population because of the variability of health literacy.

Nitric oxide is not involved in Neisseria gonorrhoeae-induced cellular damage of human Fallopian tubes in vitro

In the present study, we investigated whether cellular damage, as demonstrated by lactate dehydrogenase (LDH) release in the human fallopian tube (FT) infected by Neisseria gonorrhoeae (Ngo), correlated with high levels of nitric oxide synthase (NOS) mRNA and enzyme activity. Infection with Ngo induced a significant increase (~35-fold) in mRNA transcripts of the inducible isoform of NOS. Paradoxically, a reduction in NOS enzyme activity was observed in infected cultures, suggesting that gonococcal infection possibly influences translation of iNOS mRNA to the enzyme. In addition, treatment with the NOS inhibitor TRIM did not prevent gonococcal-induced cellular damage. In contrast, the addition of the inhibitor L-NAME induced a 40 percent reduction in LDH release, which correlated with a ~50 percent reduction in gonococcal numbers. Moreover, treatment of normal FT explants with an exogenous NO donor, SNAP, did not induce significant cellular damage. Taken together, our data suggest that NO does not contribute to cellular damage during infection of the human FT with Neisseria gonorrhoeae.

Apoptosis related genes expressed in cultured Fallopian tube epithelial cells infected in vitro with Neisseria gonorrhoeae

Background: Infection of the Fallopian tubes (FT) by Neisseria gonorrhoeae (Ngo) can lead to acute salpingitis, an inflammatory condition resulting in damage primarily to the ciliated cells, with loss of ciliary activity and sloughing of the cells from the epithelium. Recently, we have shown that Ngo infection induced apoptosis in FT epithelium cells by a TNF-alpha dependent mechanism that could contribute to the cell and tissue damage observed in gonococcal salpingitis. Aim: To investigate the apoptosis-related genes expressed during apoptosis induction in cultured FT epithelial cells infected in vitro by Ngo. Materials and Methods: In the current study, we used cDNA macroarrays and real time PCR to identify and determine the expression levels of apoptosis related genes during the in vitro gonococci infection of FT epithelial cells. Results: Significant apoptosis was induced following infection with Ngo. Macroarray analysis identified the expression of multiple genes of the TNF receptor family (TNFRSF1B, -4, -6, -10A, -10B and -10D) and the Bcl-2 family (BAK1, BAX, BLK, HRK and MCL-1) without differences between controls and infected cells. This lack of difference was confirmed by RT-PCR of BAX, Bcl-2, TNFRS1A (TNFR-I) and TNFRSF1B (TNFR-II). Conclusion: Several genes related to apoptosis are expressed in primary cultures of epithelial cells of the human Fallopian tube. Infection with Ngo induces apoptosis without changes in the pattern of gene expression of several apoptosis-related genes. Results strongly suggest that Ngo regulates apoptosis in the FT by post-transcriptional mechanisms that need to be further addressed.

Aportes al estudio del crecimiento de los niños en el Perú / Contributions to the growth of children in Peru

Basado en el I Censo Nacional de Talla en Escolares, su propósito es mostrar los cambios en la estatura de los niños peruanos a través del análisis con fines comparativos, las medidas de tendencia central y de dispersión a nivel departamental y nacional