Morphological Response in Cancer Spheroids for Screening Photodynamic Therapy Parameters.

Photodynamic therapy (PDT) is a treatment which uses light-activated compounds to produce reactive oxygen species, leading to membrane damage and cell death. Multicellular cancer spheroids are a preferable alternative for PDT evaluation in comparison to monolayer cell cultures due to their ability to better mimic in vivo avascular tumour characteristics such as hypoxia and cell-cell interactions, low cost, and ease of production. However, inconsistent growth kinetics and drug responsiveness causes poor experimental reproducibility and limits their usefulness. Herein, we used image analysis to establish a link between human melanoma C8161 spheroid morphology and drug responsiveness. Spheroids were pre-selected based on sphericity, area, and diameter, reducing variation in experimental groups before treatment. Spheroid morphology after PDT was analyzed using AnaSP and ReViSP, MATLAB-based open-source software, obtaining nine different parameters. Spheroids displayed a linear response between biological assays and morphology, with area (R2 = 0.7219) and volume (R2 = 0.6138) showing the best fit. Sphericity, convexity, and solidity were confirmed as poor standalone indicators of spheroid viability. Our results indicate spheroid morphometric parameters can be used to accurately screen inefficient treatment combinations of novel compounds.

In Vitro Low-Fluence Photodynamic Therapy Parameter Screening Using 3D Tumor Spheroids Shows that Fractionated Light Treatments Enhance Phototoxicity.

The evaluation of novel photosensitizers (PSs) for photodynamic therapy (PDT) is difficult due to the limitations of two-dimensional cell culture and multiple parameters (dose, light intensity, uptake time), which complicate progression to in vivo experiments and clinical translation. Three-dimensional (3D) cell culture models like multicellular cancer tumor spheroids (MCTS) show great similarities to in vivo avascular tumor conditions, improving the speed and accuracy of screening novel compounds with various treatment combinations. In this study, we utilize C8161 human melanoma spheroids to screen PDT treatment combinations using protoporphyrin IX (PpIX) and drug-loaded carbon dot (CD) conjugates PpIX-CD and PpIX@CD at ultralow fluence values (<10 J/cm2). Conjugates show equivalent light-induced damage to PpIX from 1 µg/mL with significantly less dark cytotoxicity up to 72 h after exposure, shown by LDH release and dsDNA content. Fractionated treatments, carried out by dividing light exposure with 24 h intervals, demonstrate an enhanced PDT effect compared to single exposure at equal concentrations. Light sheet fluorescence microscopy combined with live/dead staining demonstrates that spheroids sustain extensive damage after PDT, with PpIX and PpIX-CD showing improved uptake compared to PpIX@CD. We show that PDT parameter screening can be carried out using a low-cost and convenient combination of assays to improve the efficiency of evaluating novel compounds.

[Radio-diagnostic congruence improvement in a first-level unit]. / Mejoramiento de congruencia radiodiagnóstica en una unidad de primer nivel de atención.

Background: Radiology is a fundamental tool on outpatient Family Medicine practice. Its adverse effects include its abuse, given that the patient is exposed to unnecessary radiation, and health care costs increase. Objective: To evaluate the implementation of a radio-diagnostic congruence strategy (RDCS) in a first-level unit in Mexico City. Material and methods: It was carried out an experimental, longitudinal study that covered both a previous period of time and another one after implementing the RDCS. It was evaluated the congruence between the diagnosis and the appropriateness of the imaging studies on the basis of the correspondent clinical practice guidelines. It was applied as well a bivariate statistical analysis that associated the diagnosis, the anatomical region and the patients' sex. Results: The number of imaging studies diminished substantially, while the congruence increased; this was associated to the anatomical region and the diagnosis; sex was not a decisive variable. Conclusions: Implementing the RDCS shows positive effects, since the number of requests for imaging diminished (in 43.7%), and the radio-diagnostic congruence increased (8.5%) after implementing the RDCS. The reduction of requests for imaging could have been influenced by the fact that the medical staff could have been inhibited after been monitored, which could have led them to dispatch only the necessary requests for imaging. Our findings concur with the literature in the number of imaging studies requested in the first level of care, and the necessity to check out its appropriateness in order to increase its effectivity.

Introducción: la radiología es un recurso fundamental en la consulta externa de Medicina Familiar. Sus efectos adversos incluyen su abuso, pues se expone al paciente a radiación innecesaria y se eleva el gasto en los servicios públicos. Objetivo: evaluar la implementación de una estrategia de congruencia radiodiagnóstica (ECR) en una unidad del primer nivel de atención en Ciudad de México. Material y métodos: se hizo un estudio experimental, longitudinal, que abarcó un periodo previo y uno posterior a la ECR. Se evaluó la congruencia entre el diagnóstico y la pertinencia del estudio con base en las guías de práctica clínica correspondientes. Se aplicó un análisis bivariado con cálculo de medidas de asociación y significación estadística entre el diagnóstico, la región anatómica y el sexo de los pacientes. Resultados: disminuyó sustancialmente el número de estudios y aumentó la congruencia. Esta estuvo asociada a la región anatómica y al diagnóstico. El sexo no fue una variable que influyera. Conclusiones: implementar la ECR muestra efectos positivos, pues disminuyó el número de estudios radiológicos solicitados (en un 43.7%) y se elevó la congruencia radiodiagnóstica en el periodo expost (en un 8.5%). En la disminución de estudios realizados pudo influir una inhibición del personal médico, que quizás se percibió auditado y restringió la solicitud de radiografías solo a los casos necesarios. Nuestros hallazgos coinciden con la literatura en el número de estudios radiológicos que se solicitan en el primer nivel de atención y la necesidad de revisar su correcta indicación para elevar su efectividad.

Response to Comments on article "Improvement of radiodiagnostic congruence in the first level of care".

Se agradecen los comentarios y el interés por los resultados reportados en el artículo Mejoramiento de congruencia radiodiagnóstica en una unidad de primer nivel de atención, se amplían algunos detalles sobre la lista de cotejo y se presentan algunas sugerencias sobre las condiciones de trabajo en equipo al interior de una unidad de atención primaria para facilitar la reproducibilidad del estudio.While thanking the comments and interest in the results reported on the article Improvement of radiodiagnostic congruence in a first-level care unit, some details related on the checklist are expanded, and some suggestions on working conditions are presented; in particular on the conformation of medical teams within a primary care unit, to facilitate the reproducibility of the study.

Carbon dot-protoporphyrin IX conjugates for improved drug delivery and bioimaging.

Photodynamic therapy (PDT) uses photosensitisers such as protoporphyrin IX (PpIX) to target tumours via the release of toxic singlet oxygen when irradiated. The effectivity of the treatment is limited by the innate properties of the photosensitizers; they typically exhibit inefficient accumulation in target tissue and high dark toxicity. Carbon dots (CDs) are biocompatible fluorescent nanoparticles which can improve PpIX cellular uptake and solubility. In this work, we present conjugates synthesised by host-guest encapsulation (PpIX@CD) and amide cross-linking (PpIX-CD). Characterization demonstrated conjugates have a loading efficiency of 34-48% and similar singlet oxygen production to PpIX. PpIX-containing CDs showed a 2.2 to 3.7-fold decrease in dark toxicity. PpIX-CD and PpIX@CD showed equivalent light-induced toxicity to PpIX in concentrations >1 µg/ml, leading to a 3.2 to 4.1-fold increase in photo-toxicity index (PI). The less soluble fraction of cross-linked conjugates (PpIX-CD)p did not show significant difference from PpIX. Confocal light scanning microscopy demonstrated rapid intracellular uptake and accumulation of conjugates. Our results demonstrate the variations between cross-linking strategies in CD-based conjugates, highlighting their potential as carriers in drug delivery and bioimaging applications.

Prevalence of overweight, obesity and history of chronic disease in Mexican students / Prevalencia de sobrepeso, obesidad y antecedentes de enfermedad crónica en universitarios mexicanos

Background: Chronic-degenerative diseases are the main causes of morbidity and mortality in Mexico and are associated with overweight and obesity, which are considered a global epidemic. There is an increased risk of these conditions in patients with family history of chronic-degenerative diseases. Objective: To determine the prevalence of overweight and obesity and its association with family history of type 2 diabetes mellitus (T2DM) and high blood pressure (HBP) in university students from Mexico City. Methods: An observational and prevalence study was designed. It was administered a survey to 1168 university students and their clinical history was used; multivariate analysis was performed to determine association measures (odds ratio) and statistical significance (chi squared). Results: Combined prevalence of overweight and obesity was 36.38%, 26.02% for overweight and 10.36% for obesity. The prevalence of parental antecedents of T2DM and HBP was 42.38%; there were no significant differences by sex. The history of chronic disease increased the probability of being overweight and obese. This probability is higher if both parents have T2DM or HBP. The prevalence of T2DM/HBP comorbidity in both parents was low. Conclusions: Family history of T2DM and HBP is associated with the combined presence of overweight and obesity, but not differentially. Students whose parents have T2DM and HBP should be monitored to prevent these diseases, especially those who already are overweight and obese.

Introducción: las enfermedades crónico-degenerativas son de las principales causas de morbimortalidad en México y están asociadas a sobrepeso y obesidad, que son consideradas una epidemia mundial. Hay un mayor riesgo de estos padecimientos en quienes tienen antecedentes familiares de enfermedades crónico-degenerativas. Objetivo: determinar la prevalencia de sobrepeso y obesidad y su asociación con antecedentes parentales de diabetes mellitus tipo 2 (DM2) e hipertensión arterial sistémica (HAS) en universitarios de la Ciudad de México. Métodos: estudio observacional y de prevalencia; se aplicó una encuesta a 1168 universitarios y se consultó su historia clínica; se realizó un análisis multivariado para determinar medidas de asociación (razón de momios) y significación estadística con prueba de chi cuadrada. Resultados: se encontró una prevalencia combinada de sobrepeso y obesidad de 36.38%; por separado, 26.02% de sobrepeso y 10.36% de obesidad. La prevalencia de antecedentes paternos de DM2 y HAS fue 42.38%; no hubo diferencias importantes por sexo. Los antecedentes de enfermedad crónica elevaron la probabilidad de mostrar sobrepeso y obesidad. Esta es mayor si ambos padres padecen DM2 o HAS. La prevalencia de comorbilidad DM2/HAS en ambos padres fue baja. Conclusiones: los antecedentes familiares de DM2 y HAS están asociados a la presencia combinada de sobrepeso y obesidad, pero no diferencialmente. Se debe monitorear a los universitarios con padres con DM2 y HAS para prevenir su desarrollo, especialmente en quienes ya muestran sobrepeso y obesidad.

Sintomatología asociada al estrés y condiciones laborales de operarios de taxi de un sitio de la Ciudad de México / Stress-related symptoms and working conditions among Mexico City taxi drivers

Introducción: Los estilos de vida no saludables se relacionan con hábitos y conductas que deterioran los órganos y sus funciones generando envejecimiento prematuro y enfermedades crónicodegenerativas, estas condiciones se ven agravadas por las desigualdades sociales en ciertos grupos laborales, tal es el caso de los conductores de taxis, los cuales presentan riesgos ambientales, físicos, químicos, bioquímicos, así como exigencias laborales como son extensión de jornada, bajos salarios, las formas de organización y la falta de apoyo sindical. Estudiar el proceso salud/enfermedad de estos trabajadores, permite identificar el desgaste laboral y la integridad mental determinada por la cantidad e intensidad de trabajo y proponer medidas de prevención. Método: Se diseñó un estudio transversal, observacional y descriptivo, se aplicó una encuesta, valoración antropométrica, análisis bioquímicos, cuyos resultados tuvieron un procesamiento para identificar asociaciones y significancia estadística. Resultados: el 32.5% de la muestra conduce más de 9 horas. al día sin descansos, el 21.8% presentó supervisión estricta y 48.7% son obligados a cubrir cuotas diarias. Más de la mitad de la muestra se encuentra con exposición constante a condiciones adversas tanto en la unidad como en el lugar de trabajo. Se encontró asociación de estas condiciones con la prevalencia de enfermedades crónico degenerativas como diabetes mellitus, hipertrigliceridemia e hipercolesterolemia, más altas con las reportadas a nivel nacional. Conclusiones: las condiciones de los conductores de taxis tanto laborales como de salud mental y física se encuentran deterioradas de manera extrema por lo cual se necesitan estrategias multidisciplinarias para su disminución(AU)

Introduction: Unhealthy lifestyles are related to habits and behaviors that can contribute to the deterioration and function of organ systems, leading to premature aging and degenerative chronic diseases. These conditions are aggravated due to the social inequality in certain occupations. Such is the case of taxi drivers, who experience environmental, physical, chemical, and biochemical risks, as well as high work demands such as long work days, low pay and little union support. By studying the health / disease process of these workers we can identify occupational burnout and mental integrity determined by the amount and intensity of the work, and propose preventive measures. Methods: A cross-sectional, observational and descriptive study was designed. We obtained data via a survey, anthropometric measurements, and laboratory testing. We examined associations and tested them for statistical significance. Results: Of the overall respondents, 32.5% reported driving more than 9 hours a day without breaks; 21.8% mentioned strict supervision and 48.7% reported being required to meet daily fee quotas. More than half the sample was continuously exposed to adverse conditions in the cab and the workplace. We found associations between these working conditions and the prevalence of chronic degenerative diseases, including diabetes, hypertriglyceridemia and hypercholesterolemia, higher than national average prevalence figures. Conclusion: occupational, physical and psychological working conditions among taxi drivers are very poor, and multidisciplinary strategies are needed to diminish them(AU)

Life, health and work conditions of taxi drivers in Mexico City / Condiciones de vida, salud y trabajo en conductores de taxi en la Ciudad de México

Background: In informal work, unfavorable working conditions derived from labor flexibility, employment insecurity and reduction of purchasing power have more impact in marginal population. For taxi drivers, informal work may be detrimental to their working conditions, and to their life and health as well. Objective: To analyze the relationship between the living and working conditions of taxi drivers from the Milpa Alta precinct and their health conditions from March to July, 2016. Methods: A complete medical record was performed on 44 male taxi drivers, aged 21 to 73 years, from a Milpa Alta taxi stand in Mexico City. Two questionnaires were administered, one on material life conditions and another on labor conditions. Anthropometric measures were taken as well as the lipid levels and glucose through capillary samples. The diagnosis of metabolic syndrome (MS) was made with ATPIII criteria. Based on the results, the pathological profile was defined and the relationship between working and health conditions, the frequencies of the symptomatology by devices and systems, as well as the prevalence of the diagnoses of degenerative disease were analyzed. Results: It was found that 93% of the participants presented some component of MS; 34% presented three or more components. The nosological entities with highest frequencies were dyslipidemia (86%), obesity (52%), type 2 diabetes mellitus (18%) and hypertension (25%). Conclusions: The symptoms with higher frequencies were those related to the work process instead of the material conditions of life.

Introducción: Las inadecuadas condiciones de trabajo generadas por la flexibilidad laboral, la inseguridad del empleo y la disminución del poder adquisitivo en el trabajo informal tienen más impacto en la población marginal. Para los operadores de taxi, la informalidad puede afectar sus condiciones de trabajo, de vida y de salud. Objetivo: Analizar la relación entre las condiciones de vida y trabajo de varones operarios de taxi de la delegación Milpa Alta y sus condiciones de salud en el periodo de marzo a julio de 2016. Métodos: Se realizó una historia clínica completa a 44 operadores de taxi del sexo masculino de 21 a 73 años, de un sitio de taxis de Milpa Alta, Ciudad de México. Se aplicaron dos cuestionarios, uno sobre condiciones materiales de vida y otro sobre condiciones laborales. Se hicieron mediciones de lípidos y glucosa en muestras capilares y medidas antropométricas. El diagnóstico de síndrome metabólico (SM) se estableció con los criterios del ATPIII. A partir de los resultados se definió el perfil patológico y se analizaron las relaciones entre las condiciones de trabajo y de salud, las frecuencias de la sintomatología por aparatos y sistemas, así como la prevalencia diagnósticos de enfermedad crónico-degenerativa. Resultados: El 93% de los participantes presentó algún componente del SM; 34% cumplió con tres o más criterios. Las entidades nosológicas con mayor prevalencia fueron las dislipidemias (86%), la obesidad (52%), la diabetes mellitus tipo 2 (18%) y la hipertensión arterial (25%). Conclusiones: Los síntomas más frecuentes fueron aquellos que se relacionan con el proceso de trabajo más que con las condiciones materiales de vida.

Performatividad del género, medicalización y salud en mujeres transexuales en Ciudad de México / Gender performativity, medicalization and health in transsexual women in Mexico City

RESUMEN La Organización Mundial para la Salud y la American Psychological Association consideran que la transexualidad es una patología y plantean la adecuación sexogenérica para el ajuste biopsíquico de las personas trans. Mediante el análisis discursivo de la experiencia, en este estudio se describen los procesos de medicalización y performatividad del género en su relación con la salud de un grupo de mujeres trans de la Ciudad de México, para lo cual se desarrolló un estudio cualitativo en el que se realizaron, en el año 2015, diez entrevistas semiestructuradas. Como parte de la medicalización, la patologización de la transexualidad generó sufrimiento psíquico; por su parte, la adecuación sexogenérica también implicó riesgos adicionales. Se puede concluir que, en las mujeres trans, la violencia y la exclusión resultan las principales experiencias que explican los problemas de salud más relevantes por lo que se sugiere disminuir la discriminación, así como avanzar en intervenciones médicas más seguras.

ABSTRACT The World Health Organization and the American Psychological Association consider transsexuality a pathology and suggest sex-gender reassignment for the biopsychic adjustment of trans people. Through the discursive analysis of experience, this study describes the processes of medicalization and gender performativity in relation to the health of a group of trans women from Mexico City. For this purpose, a qualitative study was conducted in which 10 semi-structured interviews were carried out in 2015. As part of medicalization, the pathologization of transsexuality generated psychic suffering; on the other hand, sex-gender reassignment also entailed additional risks. It is possible to conclude that in trans women, violence and exclusion constitute the primary experiences explaining their foremost health problems. Therefore, it is suggested that it is necessary for discrimination be reduced and for advancements to be made in safer medical interventions.

[Adolescense pregnancy in a marginalized rural community in Mexico]. / Embarazo en adolescentes de una comunidad rural de alta marginalidad. Un estudio mixto de caso.

OBJECTIVE:: To identify objective and subjective conditions in the lives of pregnant teens within a highly-marginalized community in the state of Puebla, Mexico. MATERIALS AND METHODS:: Objective and subjective conditions of pregnant teens were evaluated through a mixed methodology (surveys, observation guides and a structured interview guide). RESULTS:: The main family characteristic is the absence of a father due to migration, no desire to study or work and the new meaning of pregnancy: the initial social stigma for engaging in a sexual activity and then, the stigma for being a young mother. CONCLUSIONS:: Objective conditions show family disintegration, lack of access to education at the community, high school and college level as well as unemployment as processes linked to teen pregnancy; thus, making it practically impossible to develop life goals. Subjective conditions center around the reproduction of gender stereotypes related to maternity.

Embarazo en adolescentes de una comunidad rural de alta marginalidad. Un estudio mixto de caso / Adolescense pregnancy in a marginalized rural community in Mexico

Resumen: Objetivo: Identificar condiciones de vida y asociaciones subjetivas en el embarazo en adolescentes de una comunidad rural marginal en Puebla, México. Material y métodos: Con metodología cualicuantitativa, que incluyó una encuesta, guías de observación y una entrevista semiestructurada, caracterizando el contexto, identificando condiciones materiales de vida y obteniendo narrativas del plan de vida en adolescentes embarazadas entre 2013 y 2014. Resultados: Se observó migración y desintegración familiar, limitados servicios educativos, de salud y escasas opciones de trabajo. Destacan condiciones como ausencia parental, baja escolaridad e ingreso, malas condiciones de vivienda y saneamiento básico deficiente, que buscan superarse mediante estudio y empleo. Se narran estereotipos tradicionales de género y modelos familiares que se repiten generacionalmente. Conclusión: Tanto las condiciones objetivas como el aprendizaje subjetivo limitan las oportunidades para realizar el plan de vida y determinan la incidencia del embarazo entre adolescentes.

Abstract: Objective: To identify objective and subjective conditions in the lives of pregnant teens within a highly-marginalized community in the state of Puebla, Mexico. Materials and methods: Objective and subjective conditions of pregnant teens were evaluated through a mixed methodology (surveys, observation guides and a structured interview guide). Results: The main family characteristic is the absence of a father due to migration, no desire to study or work and the new meaning of pregnancy: the initial social stigma for engaging in a sexual activity and then, the stigma for being a young mother. Conclusions: Objective conditions show family disintegration, lack of access to education at the community, high school and college level as well as unemployment as processes linked to teen pregnancy; thus, making it practically impossible to develop life goals. Subjective conditions center around the reproduction of gender stereotypes related to maternity.

[Gender performativity, medicalization and health in transsexual women in Mexico City]. / Performatividad del género, medicalización y salud en mujeres transexuales en Ciudad de México.

The World Health Organization and the American Psychological Association consider transsexuality a pathology and suggest sex-gender reassignment for the biopsychic adjustment of trans people. Through the discursive analysis of experience, this study describes the processes of medicalization and gender performativity in relation to the health of a group of trans women from Mexico City. For this purpose, a qualitative study was conducted in which 10 semi-structured interviews were carried out in 2015. As part of medicalization, the pathologization of transsexuality generated psychic suffering; on the other hand, sex-gender reassignment also entailed additional risks. It is possible to conclude that in trans women, violence and exclusion constitute the primary experiences explaining their foremost health problems. Therefore, it is suggested that it is necessary for discrimination be reduced and for advancements to be made in safer medical interventions.

La Organización Mundial para la Salud y la American Psychological Association consideran que la transexualidad es una patología y plantean la adecuación sexogenérica para el ajuste biopsíquico de las personas trans. Mediante el análisis discursivo de la experiencia, en este estudio se describen los procesos de medicalización y performatividad del género en su relación con la salud de un grupo de mujeres trans de la Ciudad de México, para lo cual se desarrolló un estudio cualitativo en el que se realizaron, en el año 2015, diez entrevistas semiestructuradas. Como parte de la medicalización, la patologización de la transexualidad generó sufrimiento psíquico; por su parte, la adecuación sexogenérica también implicó riesgos adicionales. Se puede concluir que, en las mujeres trans, la violencia y la exclusión resultan las principales experiencias que explican los problemas de salud más relevantes por lo que se sugiere disminuir la discriminación, así como avanzar en intervenciones médicas más seguras.

Mortality from Congenital Heart Disease in Mexico: A Problem on the Rise.

BACKGROUND AND OBJECTIVES: Temporal trends in mortality from congenital heart disease (CHD) vary among regions. It is therefore necessary to study this problem in each country. In Mexico, congenital anomalies were responsible for 24% of infant mortality in 2013 and CHD represented 55% of total deaths from congenital anomalies among children under 1 year of age. The objectives of this study were to analyze the trends in infant mortality from CHD in Mexico (1998 to 2013), its specific causes, age at death and associated socio-demographic factors. METHODS: Population-based study which calculated the compounded annual growth rate of death rom CHD between 1998 and 2013. Specific causes, age at which death from CHD occurred and risk factors associated with mortality were analyzed for the year 2013. RESULTS: Infant mortality from CHD increased 24.8% from 1998 to 2013 (114.4 to 146.4/ 100,000 live births). A total of 3,593 CHD deaths occurred in 2013; the main causes were CHD with left-to-right shunt (n = 487; 19.8/100,000 live births) and cyanotic heart disease (n = 410; 16.7/100,000). A total of 1,049 (29.2%) deaths from CHD occurred during the first week of life. Risk factors associated with mortality from CHD were, in order of magnitude: non-institutional birth, rural area, birth in a public hospital and male sex. CONCLUSIONS: Mortality from CHD has increased in Mexico. The main causes were CHD with left-to-right shunt, which are not necessarily fatal if treated promptly. Populations vulnerable to death from CHD were identified. Approximately one-third of the CHD occurred during the first week of life. It is important to promote early diagnosis, especially for non-institutional births.

["Give me a pill": the meanings of AIDS in bareback practice in Mexico City and its implications for HIV prevention]. / "Dame una pastilla": los significados del VIH/sida en la práctica del bareback en la ciudad de México e implicaciones para la prevención.

OBJECTIVE: To analyze and understand the meanings that gay men in Mexico City associate to unprotected sex such as bareback practices. MATERIALS AND METHODS: Exploratory qualitative study that uses grounded theory analysis of semistructured interviews with gay men that practice bareback sex recruited through the internet. Also a documentary analysis was performed. RESULTS: Gay men engage in bareback sexual practices because they have access to antiretroviral therapy. Access to treatment changes the meanings around AIDS and the perceived risk of infection. The confidence on treatment and the dropback of the Mexican government on preventive strategies explain these perceptions. CONCLUSIONS: Urban and middle class gay men in Mexico City have changed their perception with respect to HIV infection. It is necessary to understand the meanings related to bareback sexual practices and the use of condoms as a preventive strategy. We have to retake the discussion on preventive strategies, damage mitigation, stigma, discrimination, early diagnosis and the impact of antiretroviral therapy.

"Dame una pastilla": los significados del VIH/sida en la práctica del bareback en la ciudad de México e implicaciones para la prevención / "Give me a pill": the meanings of AIDS in bareback practice in Mexico City and its implications for HIV prevention

Objetivo. Analizar los significados que, sobre el sexo bareback, tienen hombres gay en la ciudad de México. Material y métodos. Investigación cualitativa basada en la teoría fundamentada que utilizó entrevistas semiestructuradas a barebackeros reclutados a través de páginas web. También se realizó un análisis documental sobre el tema. Resultados. Los entrevistados reportaron tener sexo desprotegido. La argumentación al respecto indicó que el acceso al tratamiento antirretroviral modifica la percepción del riesgo de infección. La confianza en torno a los beneficios de este tratamiento y la disminución de las campañas de prevención se identificaron como nociones que guían esta práctica. Conclusiones. Los hombres gay de la ciudad de México con ingresos económicos medios y altos y acceso a antirretrovirales han variado su percepción respecto al VIH. Esto hace necesaria una revisión de los programas de prevención, reducción de riesgos, diagnósticos tempranos y un análisis de nuevas formas de estigmatización y discriminación que podrían causar las campañas que desconozcan estos nuevos significados.

Objective. To analyze and understand the meanings that gay men in Mexico City associate to unprotected sex such as bareback practices. Materials and methods. Exploratory qualitative study that uses grounded theory analysis of semistructured interviews with gay men that practice bareback sex recruited through the internet. Also a documentary analysis was performed. Results. Gay men engage in bareback sexual practices because they have access to antiretroviral therapy. Access to treatment changes the meanings around AIDS and the perceived risk of infection. The confidence on treatment and the dropback of the Mexican government on preventive strategies explain these perceptions. Conclusions. Urban and middle class gay men in Mexico City have changed their perception with respect to HIV infection. It is necessary to understand the meanings related to bareback sexual practices and the use of condoms as a preventive strategy. We have to retake the discussion on preventive strategies, damage mitigation, stigma, discrimination, early diagnosis and the impact of antiretroviral therapy.

[Healthy life expectancy in older adults with social security]. / Esperanza de vida saludable en adultos mayores con seguridad social.

BACKGROUND: Population aging increases the prevalence of chronic diseases. This morbidity impacts on the relatively high mortality levels and has disabling effects. Classic health indicators -life expectancy at birth and gross mortality rate- are complemented by the disability-free life expectancy (DFLE), whose advantage is a standardization of concepts, sources of information and calculation methods. In this investigation, the healthy life expectancy in adult older population with social security in Mexico is estimated. METHODS: Life expectancy was estimated from the mortality analysis and by constructing life tables of the population affiliated to the Mexican Institute of Social Security. Chiang's method was used and the disability prevalence-adjusted life table was modified using Sullivan's method. The healthy life expectancy, life expectancy free of disability and life expectancy with disability in the older adult analysis was highlighted. RESULTS: Life expectancy free of disability was estimated at 66.5 years. In females, it was 16 years and, in men, 15.2 years, indicating that from this age on they live less time with a healthy life. CONCLUSIONS: Healthy life expectancy is an indicator that can be useful to build scenarios to support the planning, administration and strategic management of healthy aging programs.

INTRODUCCIÓN: El envejecimiento poblacional incrementa la prevalencia de enfermedades crónicas. Esta morbilidad incide en los niveles de mortalidad relativamente altos y tiene efectos discapacitantes. Los indicadores clásicos de salud ­esperanza de vida al nacer y tasa bruta de mortalidad­ se complementan con la esperanza de vida libre de discapacidad (EVLD), cuya ventaja es la estandarización de los conceptos, las fuentes de información y los métodos de cálculo. En esta investigación se estima la esperanza de vida saludable en población adulta mayor con seguridad social en México. MÉTODOS: la esperanza de vida se estimó a partir del análisis de la mortalidad y construcción de tablas de vida de la población derechohabiente del Instituto Mexicano del Seguro Social. Se utilizó el método de Chiang y se modificó la tabla de vida ajustada por la prevalencia de discapacidad mediante el método de Sullivan. Se resaltó el análisis de la esperanza de vida saludable, esperanza de vida libre de discapacidad y esperanza de vida con discapacidad en el adulto mayor. RESULTADOS: la esperanza de vida libre de discapacidad se estimó en 66.5 años. En las mujeres fue de 16 años y en los hombres de 15.2 años, lo que indica que a partir de esta edad viven menos tiempo con vida saludable. CONCLUSIONES: la esperanza de vida saludable es un indicador que puede ayudar a construir escenarios para sustentar la planeación, administración y gestión estratégica de programas de envejecimiento saludable.

Factores relacionados con la falta de lectura de carteles que difunden prueba para detectar VIH en gestantes / Factors related to the not reading information posters about the HIV detection test in pregnant women

Objetivo: identificar los factores que se relacionan con la falta de lectura en dos carteles diseñados para difundir pruebas de escrutinio que detectan el VIH en gestantes. Métodos: estudio descriptivo en gestantes ingresadas en un instituto de tercer nivel de atención. Se diseñaron y colocaron carteles de difusión sobre la aplicación gratuita de la prueba de escrutinio oral para detectar seropositividad al VIH en gestantes. Se analizaron variables sociodemográficas, religión, edad materna y trimestre de embarazo. Para evaluar la lectura o no del cartel se construyó y aplicó un cuestionario, previamente probado, donde se identificó el número de mujeres que declararon haber visto y leído los carteles así como sus datos sociodemográficos. Se aplicaron un total de 475 cuestionarios. Resultados: de las siete variables incluidas en el cuestionario, se encontró que la edad, la religión y el trimestre de embarazo al ingreso a la institución, tuvieron diferencias estadísticamente significativas en la frecuencia de no lectura del cartel. Conclusiones: es necesario generar alternativas comunicacionales enfocadas a aquellos grupos menos receptivos de la información a través de conocer los factores que influyen en la lectura o no de información. Las acciones de educación para la salud siguen formando parte fundamental en la toma de conciencia y modificación de conductas en la población, por lo que estas deben considerar y combinar no solo elementos educativos sino también psicológicos, culturales, comunicacionales y sociodemográficos con la finalidad de impactar de mejor manera el ámbito de la salud individual y social.

Objective: to identify the factors associated with unreading of two posters designed to spread screening tests that detect HIV in a pregnant woman. Methods: descriptive study conducted in hospitalized pregnant women in a tertiary care institution, in which posters were designed and placed to provide information on the free performance of oral screening test to detect HIV seropositivity in pregnant women. Sociodemographic variables, religion, maternal age and pregnancy trimester were analyzed. For evaluating whether the poster was read or not, a previously tested questionnaire was designed and applied to identify the number of women who reported having seen and read the signs and their basic demographic data. The total number of questionnaires was 475. Results: of the seven variables included in the questionnaire, it was found that age, religion and pregnancy trimester on admission to the institution had statistically significant differences in the frequency of unread poster. Conclusions: it is necessary to generate alternative communications targeted at those least receptive groups to information through knowing the factors that have an effect on reading or not of some information. Health education actions remain a fundamental part in raising awareness and in behavioral change in the population, so these should consider and combine not only educational elements but also psychological, cultural, communication and sociodemographic ones in order to have a better impact on the individual and social health.

Occlusal assessment in surgically assisted unilateral cleft lip and palate patients.

OBJECTIVE: The aim of this study was to assess the magnitude of occlusal changes in individuals with unilateral cleft lip and palate (CLP). The study was conducted on study cast models of 25 subjects, 14 men and 11 women aged from 7 to 20 years, without previous orthodontic treatment and with surgical repair carried out at São Marcos Hospital, Teresina, Piauí State, Brazil. METHODS: The cast models were assessed by three orthodontists based on the occlusal scores established by Atack et al., whose scores range from 1 to 5, according to the magnitude of transverse and sagittal changes. RESULTS: Intra and inter-observer reproducibility of occlusal scores was satisfactory and statistically significant according to the Spearman correlation test with significance level set at 5%. With regard to the distribution of occlusal scores, 30.67% of the subjects achieved scores 1 and 2, 22% score 3 and 47.53% achieved scores 4 and 5. CONCLUSIONS: Four was the score most frequently assigned by the observers, disclosing a high degree of transverse and sagittal disorders in the occlusion of patients.

Occlusal assessment in surgically assisted unilateral cleft lip and palate patients

OBJECTIVE: The aim of this study was to assess the magnitude of occlusal changes in individuals with unilateral cleft lip and palate (CLP). The study was conducted on study casts of 25 subjects, 14 men and 11 women aged from 7 to 20 years, without previous orthodontic treatment and with surgical repair carried out at São Marcos Hospital, Teresina, Piauí State, Brazil. METHODS: The casts were assessed by three orthodontists based on the occlusal scores established by Atack et al., whose scores range from 1 to 5, according to the magnitude of transverse and sagittal changes. RESULTS: Intra and inter-observer reproducibility of occlusal scores was satisfactory and statistically significant according to the Spearman Correlation test with significance level set at 5%. With regard to the distribution of occlusal scores, 30.67% of the subjects achieved scores 1 and 2, 22% score 3 and 47.53% achieved scores 4 and 5. CONCLUSIONS: Four was the score most frequently assigned by the observers, disclosing a high degree of transverse and sagittal disorders in the occlusion of patients.

OBJETIVO: o propósito do presente estudo foi avaliar a magnitude das alterações oclusais em 25 indivíduos com fissura transforame incisivo unilateral, sendo 14 do sexo masculino e 11 do sexo feminino, com idades entre 7 e 20 anos, não tratados ortodonticamente e operados no Hospital São Marcos, na cidade de Teresina/PI. MÉTODOS: os modelos de estudo desses pacientes foram avaliados por três ortodontistas, utilizando-se como referência os índices oclusais de Atack et al., cujos escores variam de 1 a 5, de acordo com a magnitude das alterações transversais e anteroposteriores. RESULTADOS: os níveis de confiabilidade e reprodutibilidade do índice oclusal intraexaminador e interexaminadores, respectivamente, mostraram-se bastante satisfatórios e estatisticamente significativos quando aplicado o teste de correlação de Spearman, com intervalo de confiança de 5%. Quanto à distribuição dos índices oclusais, 30,67% dos indivíduos apresentaram os índices 1 e 2; 22% o índice 3; e 47,53% os índices 4 e 5. CONCLUSÃO: o índice oclusal 4 foi o mais referido, de acordo com todos os escores atribuídos pelos examinadores, evidenciando um acentuado grau de alterações transversais e anteroposteriores na oclusão dos pacientes.

Potent, selective inhibitors of fibroblast growth factor receptor define fibroblast growth factor dependence in preclinical cancer models.

We describe here the identification and characterization of 2 novel inhibitors of the fibroblast growth factor receptor (FGFR) family of receptor tyrosine kinases. The compounds exhibit selective inhibition of FGFR over the closely related VEGFR2 receptor in cell lines and in vivo. The pharmacologic profile of these inhibitors was defined using a panel of human tumor cell lines characterized for specific mutations, amplifications, or translocations known to activate one of the four FGFR receptor isoforms. This pharmacology defines a profile for inhibitors that are likely to be of use in clinical settings in disease types where FGFR is shown to play an important role.