Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 17 de 17
Filter
1.
Cancer Med ; 13(6): e7088, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38520136

ABSTRACT

INTRODUCTION: While demographic risk factors of cancer-related financial hardships have been studied, having minor children or being single have rarely been assessed in the context of healthcare-related financial hardships. METHODS: Using data from the 2015 to 2018 National Health Interview Survey, we assessed financial hardship (material and psychological hardship; behavioral coping due to costs: delaying/foregoing care, reducing prescription costs, or skipping specialists or follow-up care) among adults aged 18-59 years with cancer (N = 2844) by minor child parenting status and family structure. In a secondary analysis, we compared this group with individuals without cancer. Using logistic regression models, we compared those with and without children aged <18 years, further distinguishing between those who were single versus one of two or more adults in the family. RESULTS: Compared to individuals from families with two or more adults/without children, single adults with children more often reported cancer-related financial hardships, for example material hardship (45.9% vs. 38.8%), and reducing prescription costs, (50.7% vs. 34.4%, adjusted OR 1.57, 95% CI 1.07-2.28). Single adults without minor children and those from families with two or more adults/with minor children also reported greater financial hardships on some dimensions. Associations were similar among those without cancer, but the overall magnitude of financial hardships was lower compared to those with cancer. CONCLUSIONS: Our findings suggest that having minor children, and being a single adult are risk factors for cancer-related financial hardship. Financial vulnerability associated with family structure should be taken into consideration in healthcare, and especially cancer care.


Subject(s)
Financial Stress , Neoplasms , Adult , Child , Humans , Family Structure , Neoplasms/epidemiology , Neoplasms/therapy , Surveys and Questionnaires , Risk Factors
2.
Cancer Causes Control ; 35(2): 359-366, 2024 Feb.
Article in English | MEDLINE | ID: mdl-37775609

ABSTRACT

Since its inception in 1991, the mission of the National Breast and Cervical Cancer Early Detection Program's (NBCCEDP) mission is to improve access to mammography. This program has demonstrated evidence showing that it has improved breast cancer screening rates for women who are uninsured and underinsured. However, the literature has shown that NBCCEDP screenings are decreasing, and only reach a portion of eligible women. Reliable estimates at the sub-county level are needed to identify and reach eligible women. Our work builds upon previous estimates by integrating uninsured and insurance status into spatially adaptive filters. We use spatially adaptive filters to create small area estimates of standardized incidence ratios describing the utilization rate of NBCCEDP services in Minnesota. We integrate the American Community Survey (2010-2014) insurance status data to account for the percentage that an individual is uninsured. We test five models that integrate insurance status by age, sex, and race/ethnicity. Our composite model, which adjusts for age, sex, and race/ethnicity insurance statuses, reduces 95% of the estimation error. We estimate that there approximately 49,913.7 women eligible to receive services for Minnesota. We also create small geography (i.e., county and sub-county) estimates for Minnesota. The integration of the insurance data improved our utilization estimate. The development of these methods will allow state programs to more efficiently use their resources and understand their reach.


Subject(s)
Breast Neoplasms , Uterine Cervical Neoplasms , Female , Humans , United States , Breast Neoplasms/diagnosis , Breast Neoplasms/epidemiology , Medically Uninsured , Early Detection of Cancer , Minnesota/epidemiology , Poverty , Mammography , Uterine Cervical Neoplasms/diagnosis , Uterine Cervical Neoplasms/epidemiology , Mass Screening
3.
JAMA Oncol ; 9(4): 576, 2023 04 01.
Article in English | MEDLINE | ID: mdl-36821135

ABSTRACT

This JAMA Oncology Patient Page discusses classification of breast cancer and ERBB2 status.


Subject(s)
Breast Neoplasms , Humans , Female , Breast Neoplasms/drug therapy , Breast Neoplasms/genetics , Receptor, ErbB-2
4.
Acta odontol. Colomb. (En linea) ; 10(2)2020. tab, graf, tab, tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1123469

ABSTRACT

Objetivo: identificar y describir, desde la perspectiva del derecho fundamental a la sa-lud, la garantía de la atención sanitaria en menores dominicanos afectados con labio y/o paladar hendido (LPH) y sus madres. Métodos: en tanto este es un estudio descriptivo, se realizaron encuestas semiestructuradas y se aplicó la observación no participante en los territorios de residencia de familias con menores afectados por LPH, atendidos en una fundación de República Dominicana. Resultados: la mayoría de familias afectadas por LPH pertenecen a clases sociales vulnerables con limitada capacidad de pago para adquirir seguros de salud. De las 39 familias abordadas, 26 madres no contaron con seguro de salud durante la gestación, pero los 39 pacientes con LPH sí contaban con algún tipo de aseguramiento. Se evidenció negación sistemática en la prestación de servicios sanitarios, barreras administrativas, invisibilización de la problemática del LPH en los servicios de salud y en definitiva, un sistema de salud excluyente en la prác-tica. Conclusión: pese a que la atención sanitaria a gestantes y menores de 18 años se reconoce constitucionalmente como un derecho fundamental a cargo del Estado, la forma en que opera el sistema de salud dominicano supedita la atención a la capacidad de pago de las familias, lo que genera inequidades sociales y sanitarias que vulneran el goce efectivo del derecho a la salud de las madres y los menores que nacen con LPH.


Objective: Identify and describe from the perspective of the fundamental right to health, the guarantee of health care, in Dominican children affected with cleft lip and / or palate (CLP) and their mothers. Methods: Descriptive study on the guarantee of the right to health care in Dominican families affected with CLP and their characteristics. Semi-structured surveys and non-participant observation were carried out in the territories of residence of families with children under 18 years of age with CLP treated at a Foundation in the Dominican Republic Results: Most families affected by CLP belong to vulnerable social classes with limited ability to pay to purchase health insurance. Of the 39 families investigated, 26 mothers did not have health insurance during pregnancy, but all the patients did have some type of insurance. A systematic denial of health services, administrative barriers, invisibility of the CLP problem in health services, and an exclude health system in practice were evident. Conclusion:Despite the fact that health care for pregnant women and those under 18 years of age is constitutionally recognized as a fundamental right in charge of the State, the way the Dominican health system operates, subordinates attention to families' ability to pay, generating social inequities and health services that violate the effective enjoyment of the right to health of mothers and minors born with CLP.


Subject(s)
Cleft Lip , Cleft Palate , Health Services Accessibility , Health Equity , Delivery of Health Care , Right to Health
5.
Hepatology ; 70(3): 925-938, 2019 09.
Article in English | MEDLINE | ID: mdl-30414342

ABSTRACT

In cirrhosis, intestinal dysbiosis, intestinal barrier impairment, and systemic immune system abnormalities lead to gut bacterial translocation (GBT) and bacterial infection. However, intestinal immune system dysfunction and its contribution to barrier damage are poorly understood. This study correlates immune system dysregulation in the intestines of rats at different stages of CCl4 -induced cirrhosis with barrier function and pathogenic microbiota. The following variables were addressed in the small intestine: intraepithelial lymphocyte (IEL) and lamina propria lymphocyte (LPL) activation status and cytokine production (flow cytometry), cytokine mRNA and protein expression (quantitative real-time PCR and immunofluorescence), microbiota composition of ileum content (16S recombinant DNA massive sequencing), permeability (fecal albumin loss), and epithelial junctions (immunohistochemistry and immunofluorescence). The intestinal mucosa in rats with cirrhosis showed a proinflammatory pattern of immune dysregulation in IELs and LPLs, which featured the expansion of activated lymphocytes, switch to a T helper 1 (Th1) regulatory pattern, and Th17 reduction. In rats with cirrhosis with ascites, this state was associated with epithelial junction protein disruption, fecal albumin loss, and GBT. Direct correlations (P < 0.01) were observed between elevated interferon gamma (IFNγ)-expressing T cytotoxic LPLs and fecal albumin and between inflammatory taxa abundance and IFNγ-producing immune cells in the ileum. Bowel decontamination led to redistributed microbiota composition, reduced proinflammatory activation of mucosal immune cells, normalized fecal albumin levels, and diminished GBT; but there were no modifications in Th17 depletion. Conclusion: The intestinal mucosa of rats with cirrhosis acquires a proinflammatory profile of immune dysregulation that parallels the severity of cirrhosis; this impaired intestinal immune response is driven by gut dysbiosis and leads to disrupted barrier function, promoting GBT.


Subject(s)
Bacterial Translocation/immunology , Dysbiosis/immunology , Interferon-gamma/metabolism , Intestinal Mucosa/immunology , Liver Cirrhosis/pathology , Adaptive Immunity/physiology , Animals , Ascites/metabolism , Cytokines/metabolism , Disease Models, Animal , Gastrointestinal Microbiome/immunology , Humans , Immunity, Innate/physiology , Intestinal Mucosa/microbiology , Liver Cirrhosis/microbiology , Male , Random Allocation , Rats , Rats, Wistar
6.
J Hepatol ; 64(5): 1049-1057, 2016 May.
Article in English | MEDLINE | ID: mdl-26723896

ABSTRACT

BACKGROUND & AIMS: In advanced cirrhosis, gut bacterial translocation is the consequence of intestinal barrier disruption and leads to bacterial infection. Bile acid abnormalities in cirrhosis could play a role in the integrity of the intestinal barrier and the control of microbiota, mainly through the farnesoid X receptor. We investigated the long-term effects of the farnesoid X receptor agonist, obeticholic acid, on gut bacterial translocation, intestinal microbiota composition, barrier integrity and inflammation in rats with CCl4-induced cirrhosis with ascites. METHODS: Cirrhotic rats received a 2-week course of obeticholic acid or vehicle starting once ascites developed. We then determined: bacterial translocation by mesenteric lymph node culture, ileum expression of antimicrobial peptides and tight junction proteins by qPCR, fecal albumin loss, enteric bacterial load and microbiota composition by qPCR and pyrosequencing of ileum mucosa-attached contents, and intestinal inflammation by cytometry of the inflammatory infiltrate. RESULTS: Obeticholic acid reduced bacterial translocation from 78.3% to 33.3% (p<0.01) and upregulated the expression of the farnesoid X receptor-associated gene small heterodimer partner. Treatment improved ileum expression of antimicrobial peptides, angiogenin-1 and alpha-5-defensin, tight junction proteins zonulin-1 and occludin, and reduced fecal albumin loss and liver fibrosis. Enteric bacterial load normalized, and the distinctive mucosal microbiota of cirrhosis was reduced. Gut immune cell infiltration was reduced and inflammatory cytokine and Toll-like receptor 4 expression normalized. CONCLUSIONS: In ascitic cirrhotic rats, obeticholic acid reduces gut bacterial translocation via several complementary mechanisms at the intestinal level. This agent could be used as an alternative to antibiotics to prevent bacterial infection in cirrhosis.


Subject(s)
Chenodeoxycholic Acid/analogs & derivatives , Inflammation/metabolism , Intestines/drug effects , Liver Cirrhosis, Experimental/drug therapy , Animals , Chenodeoxycholic Acid/pharmacology , Cytokines/metabolism , Inflammation/pathology , Intestinal Mucosa/metabolism , Intestines/pathology , Liver Cirrhosis, Experimental/microbiology , Liver Cirrhosis, Experimental/pathology , Male , Rats , Rats, Sprague-Dawley
7.
Invest Educ Enferm ; 33(2): 248-59, 2015.
Article in English, Spanish | MEDLINE | ID: mdl-26535846

ABSTRACT

OBJECTIVE: This study sought to contrast the perspectives on the social determination of oral health present in the scientific literature published in Colombia, Brazil, Ecuador, and Mexico since 1970 until 2012. METHODOLOGY: This was a cross-sectional descriptive study on the Latin American scientific production published in specialized databases between 1970 and 2012. RESULTS: The social determination of oral health in Latin America is characterized by the conflict among the players when seeking to overcome the limitations and traditional perspectives in health. The differences among the countries studied are explained by the existing relationship among research, higher education, and the socio-political trajectories of the countries and the similarities by health systems that have permitted accumulation of inequities in health. In Brazil, the concern for the individual and collective in local settings is important, while in Ecuador, Mexico, and Colombia the explanation based on the social determinants of the diseases predominates. CONCLUSION: The view of the social determination of the oral health-disease process in Latin America is characterized by a continuous dispute between emancipation and accumulation approaches. The scant impact of social determination in oral health obeys to the history of the odontology profession, the predominance of care policies and services of technical care nature.


Subject(s)
Delivery of Health Care/organization & administration , Mouth Diseases/epidemiology , Oral Health , Cross-Sectional Studies , Humans , Latin America/epidemiology , Politics
8.
Invest. educ. enferm ; 33(2): 248-259, May-Aug. 2015.
Article in English | LILACS, BDENF - Nursing | ID: lil-760925

ABSTRACT

Objective. This study sought to contrast the perspectives on the social determination of oral health present in the scientific literature published in Colombia, Brazil, Ecuador, and Mexico since 1970 until 2012. Methodology. This was a cross-sectional descriptive study on the Latin American scientific production published in specialized databases between 1970 and 2012. Results. The social determination of oral health in Latin America is characterized by the conflict among the players when seeking to overcome the limitations and traditional perspectives in health. The differences among the countries studied are explained by the existing relationship among research, higher education, and the socio-political trajectories of the countries and the similarities by health systems that have permitted accumulation of inequities in health. In Brazil, the concern for the individual and collective in local settings is important, while in Ecuador, Mexico, and Colombia the explanation based on the social determinants of the diseases predominates. Conclusion. The view of the social determination of the oral health-disease process in Latin America is characterized by a continuous dispute between emancipation and accumulation approaches. The scant impact of social determination in oral health obeys to the history of the odontology profession, the predominance of care policies and services of technical care nature.


Objetivo. Contrastar las perspectivas sobre determinación social de la salud bucal presentes en la literatura científica publicada en Colombia, Brasil, Ecuador y México desde 1970 hasta 2012. Metodología. Estudio descriptivo transversal sobre la producción científica latinoamericana publicada en bases de datos especializadas entre 1970 y 2012. Resultados. La determinación social de la salud bucal en Latinoamérica se caracteriza por la conflictividad entre los actores al intentar superar las limitaciones de las perspectivas tradicionales en salud. Las diferencias entre países estudiados se explican por la relación existente entre la investigación, la educación superior y las trayectorias sociopolíticas de los países; las similitudes, por los sistemas de salud que han permitido la acumulación de inequidades en salud. En Brasil la preocupación por lo individual y colectivo en ámbitos locales es importante, mientras que en Ecuador, México y Colombia predomina la explicación basada en los determinantes sociales de las enfermedades. Conclusión. La mirada de la determinación social del proceso salud enfermedad bucal en Latinoamérica se caracteriza por una disputa continua entre enfoques de emancipación y acumulación. El escaso impacto de la determinación social en salud bucal obedece a la historia de la profesión odontológica, al predominio de políticas y servicios de atención de carácter técnico asistencial.


Objetivo. Contrastar as perspectivas sobre determinação social da saúde bucal presentes na literatura científica publicada na Colômbia, no Brasil, no Equador e no México desde 1970 até 2012. Metodologia. Estudo descritivo transversal sobre a produção científica latino-americana publicada em bases de dados especializadas entre 1970 e 2012. Resultados. A determinação social da saúde bucal na América Latina se caracteriza pelos conflitos entre os atores ao tentar superar as limitações das perspectivas tradicionais em saúde. As diferenças entre países estudados se explicam pela relação existente entre a investigação, a educação superior e as trajetórias sociopolíticas dos países e, as similitudes por sistemas de saúde que permitiram a acumulação de inequidades na saúde. No Brasil a preocupação pelo individual e coletivo em âmbitos locais é importante, enquanto no Equador, no México e na Colômbia predomina a explicação baseada nos determinantes sociais das doenças Conclusão. A mirada da determinação social do processo saúde doença bucal na América Latina se caracteriza por uma disputa contínua entre enfoques de emancipação e acumulação. O escasso impacto da determinação social em saúde bucal obedece à história da profissão odontológica, ao predomínio de políticas e serviços de atendimento de caráter técnico assistencial.


Subject(s)
Humans , Latin America , Health Status Disparities , Social Medicine , Oral Health , Public Health
9.
J Hepatol ; 59(4): 723-30, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23742913

ABSTRACT

BACKGROUND & AIMS: Depletion of circulating CD4(+) T-helper (Th) lymphocytes, especially naive Th cells, is common in cirrhosis. Little is known about the pathogenetic mechanisms involved in Th-cell depletion in cirrhosis. We investigated the mechanisms involved in circulating Th-cell lymphopenia in cirrhosis. METHODS: Circulating naive and memory Th cells were analyzed by flow cytometry in 60 patients with cirrhosis and 40 sex- and age-matched healthy controls. Thymopoiesis, apoptosis, cell activation, and proliferation were assessed through CD31, annexin-V, HLA-DR and Ki-67 expression, respectively. Lipopolysaccharide (LPS)-binding protein (LBP) and spleen size were measured as indicators of bacterial translocation and splenic pooling, respectively. RESULTS: Compared to controls, patients showed reduced numbers of Th cells involving a greater depletion of the naive than memory Th-cell compartment (2.7- vs. 1.5-fold, respectively). Recent thymic emigrants were diminished (p < 0.01), and each patient had a lower number of CD31(+) naive Th cells than the matched-control. Spontaneous and induced apoptosis (Annexin-V(+)) of Th cells was increased in patients. Activated (HLA-DR(+)) and proliferating (Ki-67(+)) memory Th cells were increased in patients (p < 0.01), and they directly correlated with plasma LBP (p < 0.05) and negatively with naive Th cells (p < 0.01), respectively. Naive Th cells were inversely correlated (p < 0.01) with their frequencies of apoptosis and of activated memory Th cells, LBP, and spleen size. On multivariate analysis, defective thymic generation of naive Th cells, increased memory Th-cell activation, and splenomegaly were independently associated with Th-cell depletion. CONCLUSIONS: Th-cell immunodeficiency in cirrhosis is explained by a universal defect in thymopoiesis exacerbated by splenic pooling and activation-driven cell-death induced by bacterial translocation.


Subject(s)
Liver Cirrhosis/complications , Liver Cirrhosis/immunology , Lymphopenia/etiology , Lymphopenia/immunology , T-Lymphocytes, Helper-Inducer/immunology , Acute-Phase Proteins/immunology , Apoptosis , Carrier Proteins/immunology , Case-Control Studies , Cell Proliferation , Female , Homeostasis , Humans , Immunologic Memory , Liver Cirrhosis/pathology , Lymphocyte Activation , Lymphopenia/pathology , Male , Membrane Glycoproteins/immunology , Middle Aged , Platelet Endothelial Cell Adhesion Molecule-1/metabolism , Prospective Studies , Spleen/immunology , Spleen/pathology , T-Lymphocyte Subsets/immunology , T-Lymphocyte Subsets/pathology , T-Lymphocytes, Helper-Inducer/pathology , Thymus Gland/immunology , Thymus Gland/pathology
11.
Hepatology ; 56(5): 1861-9, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22611024

ABSTRACT

UNLABELLED: Cirrhosis with ascites is associated with a high rate of gut bacterial translocation (GBT) and spontaneous bacterial infections of enteric origin. We addressed the activation state and role of intestinal dendritic cells (DCs) in experimental ascitic cirrhosis and their relationship with GBT. Cirrhosis with ascites was CCl(4) induced in rats. To examine their activation state and functions, DCs (CD103(+) RT1B(+) CD3(-) CD45RA(-) ) were isolated from the intestinal lamina propria and mesenteric lymph nodes (MLNs), and the following parameters were determined by flow cytometry: surface antigen expression; spontaneous or lipopolysaccharide-stimulated tumor necrosis factor alpha (TNF-α) production; and in vitro capacity to phagocytose latex beads and to migrate toward the chemokine (C-C motif) ligand 21. GBT was defined as the growth of bacteria in MLNs culture. Bacterial DNA (Bact-DNA) in MLNs was identified by polymerase chain reaction. In rats with Bact-DNA in MLNs without GBT, intestinal and MLNs CD103(+) -DCs showed features of activation, expansion of the proinflammatory CD4(+) -DC subpopulation, augmented TNF-α production, and increased phagocytic and migratory capacities. In contrast, in rats with GBT, CD103(+) -DCs showed the absence of an activated phenotype, lowered TNF-α production, and relatively deficient phagocytosis and migration capacities. The CD103(+) -DC of rats without Bact-DNA in MLNs or GBT were similar to controls. In cirrhotic rats, bowel decontamination with antibiotics eliminated Bact-DNA in MLNs and GBT, normalized the activation state and functions of CD103(+) -DCs, and increased their TNF-α production. CONCLUSION: In experimental cirrhosis with ascites, continuous pressure of gut bacteria shapes the phenotypic and functional profile of intestinal DCs to produce effects that range from their activation and enhanced functions to their exhaustion and tolerance.


Subject(s)
Bacterial Translocation/immunology , Dendritic Cells/immunology , Dendritic Cells/metabolism , Liver Cirrhosis/immunology , Lymph Nodes/microbiology , Animals , Anti-Bacterial Agents/pharmacology , Antigens, CD/metabolism , Ascites/chemically induced , Ascites/immunology , CD4 Antigens/metabolism , Carbon Tetrachloride , Cell Movement , Cell Proliferation , DNA, Bacterial/immunology , DNA, Bacterial/isolation & purification , Dendritic Cells/cytology , Dendritic Cells/drug effects , Feces/microbiology , Integrin alpha Chains/metabolism , Intestinal Mucosa/immunology , Intestine, Small/immunology , Liver Cirrhosis/chemically induced , Lymph Nodes/immunology , Male , Mesentery , Phagocytosis , Rats , Rats, Wistar , Tumor Necrosis Factor-alpha/metabolism
12.
Rev. bioét. (Impr.) ; 19(2)maio-ago. 2011.
Article in English | LILACS | ID: lil-621814

ABSTRACT

Objetivos: analisar as políticas de saúde sexual e reprodutiva realizadas na Colômbia para explicar a persistência da gravidez na adolescência. Quadro metodológico: produzindo uma investigação de caráter sócio-histórico a abordagem baseou-se na sociologia política. Resultados: as reformas de ajuste estrutural impostas sobre a América Latina transformaram a política social numa lógica neoliberal que excluía sistematicamente muitos adolescentes. A gravidez na adolescência mostrao fracasso das políticas desenvolvidas durante as reformas introduzidas no período compreendido entre 1992 e 2006. Dos efeitos gerados, um dos problemas é o sistema de saúde pública no país, que proporciona a clandestinidade do aborto. Conclusões: os principais obstáculos para oexercício dos direitos fundamentais são: o poder ideológico da Igreja sobre a sexualidade e reprodução, e o poder político do Estado sobre o corpo da mulher. Recomendações: Bioética propõe um desafio no desenvolvimento das políticas públicas.


Objetivos: Analizar las políticas de salud sexual y reproductiva formuladas en Colombia para explicar la persistencia del embarazo adolescente. Marco teórico metodológico: Mediante una investigación de carácter socio-histórica se desarrolla un enfoque basado en las ciencias sociales. Resultados: Las reformas de ajuste estructural impuestas en América Latina transformaron las políticas sociales en una lógica neoliberal que excluyó sistemáticamente a muchos de los adolescentes. El embarazo adolescente muestra el fracaso de las políticas elaboradas durante las reformas llevadas a cabo entre 1992 y 2006. Sus efectos generaron problemas de salud pública en el país relacionados con el aborto clandestino. Conclusiones: Los principales obstáculos para el ejercicio de los derechos fundamentales son: el poder ideológico de la Iglesia sobre la sexualidad y la reproducción, y el poder político del Estado sobre el cuerpo de la mujer. Recomendaciones: La bioética propone un desafío en el desarrollo de políticas públicas.


Objective: To analyze the sexual and reproductive health policies in Colombia and their relationship with the persistence of adolescent pregnancy. Methodological framework: a social sciences approach was applied using qualitative methods. Results: Structural adjustment reformsimposed throughout Latin America in conjunction with the neoliberal model that systematically excluded many adolescents. The consequences of the policies developed from 1992 to 2006 left high rates of adolescent pregnancies and abortions. Adolescent pregnancy shows the failure ofthese policies because its effects generated public health problems in the country. Conclusions: The main obstacles to adolescents exercising their fundamental sexual and reproductive rights are: the Church, the neoliberal model and the state?s political power over women?s bodies. Recommendations: Bioethics proposes new initiatives in the development of reproductive and sexual public policies.


Subject(s)
Abortion , Adolescent , Bioethics , Public Health , Health Policy , Public Policy , Reproductive Health
13.
Rev. gerenc. políticas salud ; 9(19): 69-89, dic. 2010. tab
Article in Spanish | LILACS | ID: lil-586284

ABSTRACT

En este artículo se presenta el enfoque teórico-metodológico construido para el análisis de las políticas de salud sexual y reproductiva para jóvenes en Colombia, como resultado de una tesis doctoral sobre el tema. Su objetivo es comprender lo político de la configuración de una política pública dirigida a una población específica: los jóvenes. Más allá de partir de la evaluación tradicional de resultados o del impacto de una política, este análisis parte de entender las políticas, no como un asunto técnico o de expertos, sino como el resultado de una correlación de fuerzas que implica procesos, conflictos y confrontaciones entre diversos actores, razón por la cual se propone la contienda política como herramienta de análisis. Se inicia con una revisión crítica de estudios con pretensiones similares ubicados en distintos campos, para luego presentar en forma detallada el aporte de la investigación con el enfoque elaborado.


This paper presents the theoretical and methodological approach that was elaborated for the analysis of the formulation of sexual and reproductive public policies for the youth in Colombia. This is the result of a doctoral thesis and its objective is to understand the configuration of the political aspects of the public policies that are thought for a specific population: young people. This analysis intends to go deeper than a traditional evaluation about the impact of a policy. This approach assumes it not only as a technical issue, but as a result for correlating forces in which processes, conflicts and confrontations between different actors are involved. The research uses the political contention as an analysis tool. The study starts with a critical revision of previous studies with similar goals, but performed in other locations, and then, it presents the contributions of the current investigation in detail.


Neste articulo apresenta-se um enfoque teórico-metodológico construído para a análise das políticas de saúde sexual e reprodutiva para jovens na Colômbia, como resultado de uma tese de doutorado sobre o assunto. O seu objetivo é entender a questão política dentro das políticas públicas dirigidas a uma população específica: os jovens. Este análise tenta ir mais profundo do que uma avaliação tradicional de resultados ou do impacto de uma política especifica, mostrando as políticas, não como um assunto técnico ou de especialistas, mas sim como o resultado de uma correlação de forças que implica processos, conflitos e confrontações entre diversos atores, razão pela qual se propõe a disputa política como ferramenta de análise. Começa-se com uma revisão critica de estudos com pretensões similares em diversos campos, para então apresentar de forma detalhada a contribuição da pesquisa com o enfoque elaborado.


Subject(s)
Adolescent , Reproductive Health , Colombia , Health Policy
14.
Hepatology ; 52(6): 2086-95, 2010 Dec.
Article in English | MEDLINE | ID: mdl-21105108

ABSTRACT

UNLABELLED: Systemic activation of the inflammatory immune system contributes to the progression of cirrhosis with ascites. Immune cells become activated after interacting at the mesenteric lymph nodes (MLNs) with bacteria translocated from the gut, and thereafter reach the bloodstream through recirculation. It is unknown whether systemic activation of the immune system is present in pre-ascitic cirrhosis, in which gut bacterial translocation has not been described. The purpose of this study was to determine whether systemic activation of the immune system initiates in rats with compensated carbon tetrachloride (CCl(4))-induced cirrhosis, and if so to establish the activation site of immune cells. We studied the activation status of immune cells in peripheral blood, MLNs, and hepatic lymph nodes (HLNs). Systemic inflammation was present in rats with cirrhosis, as shown by expansion (P < 0.01) of circulating total and inflammatory monocytes and recently activated CD134(+) T helper (T(h)) cells. The same populations of cells were increased (P < 0.01) in MLNs and HLNs. Bacterial translocation was absent in rats with cirrhosis or control rats, but bacterial DNA fragments were present in the MLNs of 54% of rats with cirrhosis. The liver was the source of activated immune cells present in the blood, as shown by the direct correlation between activated T(h) cells in the blood and HLNs, but not in MLNs, and the normalization by gut decontamination with antibiotics of activated cells in MLNs, but not in the blood or HLNs. CONCLUSION: In experimental cirrhosis, systemic activation of the immune system occurs before ascites development and is driven by recirculation of cells activated in HLNs. In addition, in compensated cirrhosis, bacterial DNA fragments reach the MLNs, where they elicit a local inflammatory response.


Subject(s)
Carbon Tetrachloride Poisoning/immunology , Liver Cirrhosis, Experimental/immunology , Liver/physiopathology , Animals , DNA, Bacterial/metabolism , Inflammation , Rats
15.
J Anat ; 214(3): 301-9, 2009 Mar.
Article in English | MEDLINE | ID: mdl-19245497

ABSTRACT

C cells are primarily known for producing calcitonin, a hypocalcemic and hypophosphatemic hormone. Nevertheless, besides their role in calcium homeostasis, C cells may be involved in the intrathyroidal regulation of follicular cells, suggesting a possible interrelationship between the two endocrine populations. If this premise is true, massive changes induced by different agents in the activity of follicular cells may also affect calcitonin-producing cells. To investigate the behaviour of C cells in those circumstances, we have experimentally induced two opposite functional thyroid states. We hyperstimulated the follicular cells using a goitrogen (propylthiouracil), and we suppressed thyroid hormone synthesis by oral administration of thyroxine. In both scenarios, we measured T(4), TSH, calcitonin, and calcium serum levels. We also completely sectioned the thyroid gland, specifically immunostained the C cells, and rigorously quantified this endocrine population. In hypothyroid rats, not only follicular cells but also C cells displayed hyperplastic and hypertrophic changes as well as increased calcitonin levels. When exogenous thyroxine was administered to the rats, the opposite effect was noted as a decrease in the number and size of C cells, as well as decreased calcitonin levels. Additionally, we noted that the two cell types maintain the same numerical relation (10 +/- 2.5 follicular cells per C cell), independent of the functional activity of the thyroid gland. Considering that TSH serum levels are increased in hypothyroid rats and decreased in thyroxine-treated rats, we discuss the potential involvement of thyrotropin in the observed results.


Subject(s)
Goiter/pathology , Hypothyroidism/pathology , Animals , Body Weight/drug effects , Calcitonin/blood , Calcium/blood , Cell Size/drug effects , Goiter/chemically induced , Goiter/metabolism , Hypothyroidism/blood , Hypothyroidism/chemically induced , Male , Paracrine Communication/physiology , Propylthiouracil , Rats , Rats, Wistar , Thyrotropin/blood , Thyroxine/blood
17.
Rev. cient. (Bogotá) ; 6(1): 7-13, ene.-jun. 2000.
Article in Spanish | LILACS | ID: lil-386011

ABSTRACT

El seminario de Filosofía e Historia de las Ciencias ha relatado su historia en distintos momentos. En este, su momento actual, el proceso concluyó con la creación de la Divición de Humanidades que, recogiendo la tradición, creando nuevos enfoques y problematizando los saberes y los discursos, pretenden seguir siendo el bastión donde se fundamentan las políticas de Humanidades para las diferentes Facultades de la Universidad El Bosque. Este documento recoje los liniamientos generales para dichas políticas en la Faculta de Odontología.


Subject(s)
Humanities
SELECTION OF CITATIONS
SEARCH DETAIL
...