Prevención del embarazo en adolescentes: una responsabilidad ética compartida para una salud sexual y reproductiva de la población / Prevention of adolescent pregnancy: a shared ethical responsibility for the sexual and reproductive health of the population

El embarazo precoz es un problema común en las sociedades a nivel mundial. Esta situación se acentúa especialmente en las sociedades más pobres y con mayor falta de educación. La investigación pretende describir desde la perspectiva de las adolescentes los factores sociales y psicológicos relacionados al embarazo adolescente, con el propósito de lograr un trabajo conjunto entre las autoridades sanitarias, los profesionales de salud y estudiantes de obstetricia, para concienciar a las adolescentes sobre las consecuencias de un embarazo a temprana edad, a fin de evitar embarazos no deseados y desarrollar en las adolescentes la habilidad de tomar decisiones en aspectos que afectan su desarrollo integral. La metodología del trabajo responde a un enfoque cuantitativo, descriptivo de corte transversal. Para el estudio cuantitativo se utilizó la técnica de la encuesta y como instrumento el cuestionario, y al diseño no experimental. Se solicitó el consentimiento informado del jefe del hogar y el asentimiento del adolescente. La muestra 40 adolescentes que acuden a un consultorio. Las relaciones con los padres es un indicador que se evalúa en cuanto a los factores sociales se puede concluir que un alto porcentaje hablan abiertamente con sus padres de la planificación y estos, están pendientes de sus hijos a la llegada en el hogar En cuanto a los factores psicológicos menos de la mitad se considera ansiosa, triste sin esperanzas. se encuentra protegida en el hogar. Un alto porcentaje no encuentra protección en el hogar en cuanto se refiere a ropa limpia, alimentos, cuidados.

Cross-cultural adaptation and validation of a questionnaire on eating habits and physical activity of university students in confinement due to coronavirus disease.

OBJECTIVE: The purpose of the current study was to cross-culturally adapt and validate an online questionnaire to assess eating habits and physical activity of university students under confinement due to coronavirus disease (COVID-19). DESIGN: Generation of a cross-sectional online survey to university students conducted during confinement due to COVID-19. The study was divided into two phases. SETTINGS: Students, Chile. PARTICIPANTS: Phase 1 considered the process of translation and back translation, expert panel, cultural adaptation and the generation of a pilot to validate a preliminary format of the questionnaire. In Phase 2, information from the instrument was collected from two hundred and sixty-eight university students, ages 16 to 30 years old, with a mean age of 21·6 (3·3) The major proportion of participants were female (82 %). RESULTS: The adapted questionnaire was statistically validated in three dimensions: (A) eating habits and behaviours during quarantine, (B) perception of risk and (C) physical activity changes during the quarantine. The reliability of Cronbach's α for dimensions A, B and C was 0·59, 0·85 and 0·97, respectively. The complete questionnaire obtained 0·61 in internal consistency and 0·61 (0·58-0·67) ICC reliability. A statistically significant positive correlation matrix was observed. CONCLUSIONS: This questionnaire is a practical tool to obtain accurate information about the relation of COVID-19 confinement on people's eating habits and physical activity. Therefore, it could contribute to establishing appropriate strategies to prevent negative effects on people's health.

Genistein Activates Transcription Factor EB and Corrects Niemann-Pick C Phenotype.

Niemann-Pick type C disease (NPCD) is a lysosomal storage disease (LSD) characterized by abnormal cholesterol accumulation in lysosomes, impaired autophagy flux, and lysosomal dysfunction. The activation of transcription factor EB (TFEB), a master lysosomal function regulator, reduces the accumulation of lysosomal substrates in LSDs where the degradative capacity of the cells is compromised. Genistein can pass the blood-brain barrier and activate TFEB. Hence, we investigated the effect of TFEB activation by genistein toward correcting the NPC phenotype. We show that genistein promotes TFEB translocation to the nucleus in HeLa TFEB-GFP, Huh7, and SHSY-5Y cells treated with U18666A and NPC1 patient fibroblasts. Genistein treatment improved lysosomal protein expression and autophagic flux, decreasing p62 levels and increasing those of the LC3-II in NPC1 patient fibroblasts. Genistein induced an increase in ß-hexosaminidase activity in the culture media of NPC1 patient fibroblasts, suggesting an increase in lysosomal exocytosis, which correlated with a decrease in cholesterol accumulation after filipin staining, including cells treated with U18666A and NPC1 patient fibroblasts. These results support that genistein-mediated TFEB activation corrects pathological phenotypes in NPC models and substantiates the need for further studies on this isoflavonoid as a potential therapeutic agent to treat NPCD and other LSDs with neurological compromise.

Recent insights on the role of cholesterol in non-alcoholic fatty liver disease.

Non-alcoholic fatty liver disease (NAFLD) encompasses a spectrum of hepatic histopathological changes ranging from non-inflammatory intracellular fat deposition to non-alcoholic steatohepatitis (NASH), which may progress into hepatic fibrosis, cirrhosis, or hepatocellular carcinoma. NAFLD hallmark is the excessive hepatic accumulation of neutral lipids that result from an imbalance between lipid availability and lipid removal. Recent data suggest that disturbed hepatic cholesterol homeostasis and liver free cholesterol (FC) accumulation are relevant to the pathogenesis of NAFLD/NASH. Hepatic FC accumulation in NAFLD results from alterations in intracellular cholesterol transport and from unbalanced cellular cholesterol homeostasis characterized by activation of cholesterol biosynthetic pathways, increased cholesterol de-esterification and attenuation of cholesterol export and bile acid synthesis pathways. FC accumulation leads to liver injury through the activation of intracellular signaling pathways in Kupffer cells (KCs), Stellate cells (HSCs) and hepatocytes. The activation of KCs and HSCs promotes inflammation and fibrogenesis. In addition, FC accumulation in liver mitochondria induces mitochondrial dysfunction, which results in increasing production of reactive oxygen species, and triggers the unfolded protein response in the endoplasmic reticulum (ER) causing ER stress and apoptosis. These events create a vicious circle that contributes to the maintenance of steatosis and promotes ongoing hepatocyte death and liver damage, which in turn may translate into disease progression. In the present review we summarize the current knowledge on dysregulated cholesterol homeostasis in NAFLD and examine the cellular mechanisms of hepatic FC toxicity and its contribution to ongoing liver injury in this disease. The therapeutic implications of this knowledge are also discussed.

Hepatic metabolic response to restricted copper intake in a Niemann-Pick C murine model.

Niemann-Pick C disease (NPC) is a vesicular trafficking disorder primarily caused by mutations in the Npc1 gene and characterized by liver dysfunction and neuropathology. Altered hepatic copper metabolism has recently been reported in NPC disease. Therefore, we aimed to analyze the effects of a copper deficient diet and copper chelation using d-penicillamine on copper homeostasis in the liver of Npc1(-/-) mice of different ages. We examined liver metal ion content by AAS, and copper and iron metabolism gene expression in the liver using qPCR in Npc1(+/+) and Npc1(-/-) mice. We found higher copper and lower iron content in the liver of Npc1(-/-) mice of different ages, compared to controls; these changes in copper and iron content were correlated with increased ceruloplasmin, metallothionein 1, and transferrin receptor gene expression and decreased gene expression of Commd1, ferritin-light chain and ferroportin in the liver of Npc1(-/-) mice of different ages. Npc1(-/-) mice responded to a copper-deficient diet with a decrease in copper content in the liver, bile and heart. These results correlated with a reduction in the hepatic expression of ceruloplasmin and metallothionein 1 during the first week of treatment. d-penicillamine revealed hepatic adaptive response and an improvement in hepatic function in Npc1(-/-) mice without any effect on neurological functions. Our results confirm that the NPC1 protein is required for copper and iron homeostasis. To our knowledge, this is the first report documenting the hepatic adaptive response to low-copper intake in a Npc1(-/-) mouse model.

Metals content in placentas from moderate cigarette consumers: correlation with newborn birth weight.

Cigarette consumption during pregnancy produces deleterious effects in both, mother and fetus, some of them due to the presence of toxic elements in cigarette smoke, such as cadmium. Placenta constitutes a dual-purpose specimen for evaluating the pollutant burden exerted on the mother as well as on the fetus. The main objective of this study was to establish a correlation between placental concentration and distribution of some metal elements and birth weight of neonates delivered by mothers, who were either moderate smokers or nonsmokers. Forty nonsmoking and moderate smoking pregnant women paired per age, parity, weight, height and body mass index were selected. Smoking was assessed by self-reported cigarette consumption during pregnancy and urine cotinine concentration before delivery. Placental metal concentrations were evaluated by atomic absorption spectrometry (copper and cadmium) and neutron activation analysis (zinc and iron). Newborns from smokers had lower birth weights compared to infants from nonsmokers. Birth weights were correlated with placental cadmium concentrations in both, smokers and nonsmokers. Placental zinc and cadmium of smokers were mainly located at the maternal side and their levels were higher than those found in nonsmoker's placentas. In addition, all metal nutrient/pollutant ratios were decreased in the smoker group. In this first study performed in our region, we found that moderate smoking mothers deliver neonates with decreased birth weight and highly correlated to placental cadmium concentration. Decreased metal nutrient/pollutant ratios, a condition here found in smokers, may indicate a placental dysfunction, contributing to impair birth weight.

Increased levels of metallothionein in placenta of smokers.

Experiments were designed to evaluate and compare metallothionein (MT), zinc and cadmium levels in human placentas of smoking and non-smoking women. Smoking was assessed by self-reported cigarette consumption and urine cotinine levels before delivery. Smoking pregnant women with urine cotinine levels higher than 130 ng/ml were included in the smoking group. Determination of placental MT was performed by western blot analysis after tissue homogenization and saturation with cadmium chloride (1000 ppm). Metallothionein was analyzed with a monoclonal antibody raised against MT-1 and MT-2 and with a second anti mouse antibody conjugated to alkaline phosphatase. Zinc and cadmium were determined by neutron activation analysis and atomic absorption spectrometry respectively. Smokers showed higher placental MT and cadmium levels, together with decreased newborn birth weights, as compared to non-smokers. The semi-quantitative analysis of western blots by band densitometry indicated that darker bands corresponded to MT present in smokers' samples. This study confirms that cigarette smoking increases cadmium accumulation in placental tissue and suggests that this element has a stimulatory effect on placental MT production.