Creencias y prácticas para el cuidado de la salud de las personas sordas de Antioquia

Objetivo: Describir las creencias y prácticas para el cuidado de la salud de personas sordas de Antioquia, con el fin de identificar necesidades en educación para la salud de esta población. Metodología: estudio cualitativo, con técnicas etnográficas, enmarcado en una investigación acción participación Se condujeron 24 entrevistas semiestructuradas y 4 grupos focales con personas sordas, en encuentros mediados por un intérprete oficial de la lengua de señas colombiana, de los que se registró video y audio, para su posterior transcripción y análisis. Resultados: Emergieron denuncias relacionadas con la barrera lingüística que les impide conocer sobre el cuidado de la salud; también surgieron creencias y prácticas adquiridas en el hogar y con pares acerca la salud sexual y reproductiva, la salud mental y los estilos de vida. Los participantes manifestaron inquietudes y preocupaciones sobre el cuidado, la salud y la enfermedad, que no han sido abordadas con claridad y en su propia lengua. Conclusiones: Las personas sordas reclaman educación para el cuidado de la salud, de calidad y bajo un enfoque diferencial, que contribuya a su autonomía, autodeterminación y al goce efectivo del derecho a la salud.

Objective: To describe the beliefs and practices for health care of deaf people in Antioquia, in order to identify health education needs of this population. Methodology: qualitative study with ethnographic techniques framed in a participatory action research; 22 semi-structured interviews and 4 focus groups were conducted with deaf people, in meetings mediated by an official interpreter of the Colombian Sign Language, of which video and audio were recorded for later transcription and analysis. Results: Complaints related to the language barrier that prevents them from knowing about health care emerged; beliefs and practices acquired at home and with peers about sexual and reproductive health, mental health, and lifestyles. The participants expressed concerns about care, health and illness that have not been addressed clearly and in their own language. Conclusions: Deaf people demand quality health care education under a differential approach, which will contribute to their autonomy, self-determination and the effective enjoyment of the right to health.

Objetivo: Descrever as crenças e práticas de atenção à saúde de pessoas surdas em Antioquia, a fim de identificar as necessidades de educação em saúde dessa população. Metodologia: estudo qualitativo com técnicas etnográficas, enquadrado numa pesquisa-ação participante; Foram realizadas 22 entrevistas semiestruturadas e 4 grupos focais com pessoas surdas, em encontros mediados por um intérprete oficial da Língua de Sinais Colombiana, dos quais foram gravados vídeo e áudio para posterior transcrição e análise. Resultados: Emergiram queixas relacionadas à barreira da língua que os impede de saber sobre os cuidados de saúde; crenças e práticas adquiridas em casa e com colegas sobre saúde sexual e reprodutiva, saúde mental e estilos de vida. Os participantes expressaram preocupações e preocupações sobre cuidados, saúde e doença que não foram abordadas de forma clara e em sua própria linguagem. Conclusões: Os surdos demandam uma educação em saúde de qualidade sob um enfoque diferenciador, que contribua para sua autonomia, autodeterminação e gozo efetivo do direito à saúde.

El cuidado de niños con discapacidad, actitudes de cuidadores y madres sustitutas / Care of children with disabilities, attitudes of caregivers and surrogate mothers / O cuidado de crianças com deficiência, atitudes de cuidadores e mães substitutas

Introducción: La labor del cuidado de niños con discapacidad en primera infancia, esta me-diada por las prácticas y los conocimientos de sus cuidadores y de sus actitudes. Entender el término actitud es complejo; para su análisis, se retoma la teoría de la autodeterminación, ya que la motivación es fundamental en la labor realizada por un cuidador y determina, en gran medida, la actitud con la que se afrontan las circunstancias. Objetivo: comprender las actitudes que tienen los cuidadores de niños con discapacidad física. Materiales y méto-dos: estudio cualitativo, basado en la teoría fundamentada. Participaron 12 madres sustitutas a cargo de niños menores de 6 años con discapacidad motora. Se utilizó un muestreo por conveniencia, que finalizó con la saturación teórica de las categorías. La recolección de la información se llevó a cabo por medio entrevistas semiestructuradas, las cuales fueron audio grabadas y posteriormente transcritas para su análisis. Teóricamente se estudiaron las acti-tudes de cuidadoras de niños con discapacidad motora. Resultados: Las actitudes de las cui-dadoras pueden clasificarse en tres dimensiones: afectivas, cognitivas y comportamentales, lo que permite entender su naturaleza. Por otro lado, la motivación y la autodeterminación son elementos que determinan el por qué elegir una labor como el cuidado de otra persona. Conclusiones: El cuidado, analizado en el contexto de madres sustitutas trasciende la figura de un trabajo remunerado, hacia una construcción de un rol que aporta disfrute y le da sentido a la vida.

Introdução: o cuidado de crianças com deficiência na primeira infância, está influenciado pelas praticas e conhecimentos dos cuidadores e as suas atitudes. Compreender o conceito atitude é complexo; para a sua análise considera-se a teoria da autodeterminação, principalmente porque a motivação é fundamental no trabalho do cuidador e determina em grande medida, a atitude com a qual afrontam as situações. Objetivo: compreender as atitudes que tem os cuidadores de crianças com deficiência física. Materiais e métodos: estudo qualitativo, baseado na teoria fundamentada. Participaram 12 mães substitutas a cargo de crianças menores de 6 anos com deficiência motora. Utilizou-se a amostragem por conveniência, que finalizou com a saturação teórica das categorias. A recolecção da informação realizou-se através de entrevistas semiestruturadas que foram áudio-gravadas e posteriormente transcritas para a analise. Resultados: as atitudes dos cuidadores classificaram-se em três dimensões: afetivas, cognitivas e comportamentais, permitindo estabelecer a sua natureza. Por outro lado, a motivação e a autodeterminação foram elementos que que determinaram o por quê escolher o trabalho de cuidar de outra pessoa. Conclusão: o cuidado, analisado no contexto de mães substitutas transcende a figura do trabalho remunerado à construção de um papel que fornece prazer e sentido à vida.

Hepatic C9 cells switch their behaviour in short or long exposure to soft substrates.

BACKGROUND INFORMATION: There have been several studies to understand the influence of stiffness of the culture substrates for different types of adherent cells. It is generally accepted that cell proliferation, spreading and focal adhesions increase with higher matrix stiffness. However, what remains unclear is whether this kind of cell behaviour may be reverted by culturing on soft substrates those cell lines that were originally selected or primed on stiff surfaces. RESULTS: Here, we studied the influence of substrate softness on proliferation, adhesion and morphology of the highly proliferative hepatic C9 cell line. We cultured C9 cells on soft and stiff polydimethylsiloxane (PDMS) substrates prepared with two different elastic moduli in the range of 10 and 200 kPa, respectively. Lower cell proliferation was observed on substrates with lower stiffness without affecting cell viability. The proliferation rate of C9 cell line along with extracellular growth-regulated kinase (ERK) phosphorylation was decreased on soft PDMS. Despite this cell line has been described as a hepatic epithelial cell, our characterisation demonstrated that the origin of C9 cells is uncertain, although clearly epithelial, with the expression of markers of several hepatic cells. Surprisingly, consecutive passages of C9 cells on soft PDMS did not alter this mesenchymal phenotype, vimentin expression did not decrease when culturing cells in soft substrates, even though the ERK phosphorylation levels eventually were increased after several passages on soft PDMS, triggering again an increase of cell proliferation. CONCLUSIONS AND SIGNIFICANCE: This study shows that the exposure of C9 cells to soft substrates promoted a decrease of cell proliferation rate, as reported for other types of cells on PDMS, whereas a much longer term exposure caused cells to adapt to softness after trained for several passages, reactivating proliferation. During this phenomenon, the morphology and phenotype of trained cells was modified accompanying the increase of cell proliferation rate contrary to the effect observed in short periods of cell culture. In contrast to previous reports, cell death was not observed during these experiments, discarding a cell selection mechanism and suggesting soft cell adaptation may be limited in time in C9 cells.

Knowledge and interactions of the local community with the herpetofauna in the forest reserve of Quininí (Tibacuy-Cundinamarca, Colombia).

BACKGROUND: The study of human-nature relationship has made possible to understand the life dynamics of the communities and the biodiversity with which they cohabit. Although there has been a rise of ethnobiological studies over the last decade, little is known about human interaction with herpetofauna in South America and Colombia. In this work, we analyzed the knowledge, perception, and interaction of a local community located in the forest reserve of Quininí (RFPCQ) in Cundinamarca (Colombia), concerning to the herpetofauna that inhabits the area. METHODS: We performed semi-structured surveys containing 30 questions categorized into three groups: academic knowledge (1), use and cultural beliefs (2), and interactions (3) related to the herpetofauna that occurs in the region. The obtained data in question groups 1 and 2 are presented as a qualitative summary. For the question group 3, we assigned the answers to a hostility value according to the possible reaction of each individual interviewed in a hypothetical encounter with the herpetofauna and built tendency charts in order to see the positive or negative reactions due to the birthplace (urban/rural) and gender (male/female). RESULTS: The community recognized the presence of amphibians and reptiles that cohabit their space, as well as their potential habitats. Besides, the role of herpetofauna was recognized in the magical/religious traditions for some inhabitants of the region, mainly associated with the fate and cure of chronic diseases. In general, the perception of amphibians and reptiles varied according to the origin and gender of the people, which tend to have a more positive perception of reptiles than compared to amphibians in most cases. CONCLUSIONS: Although there was a general lack of knowledge on the part of the inhabitants of the RFPCQ about the biological and ecological aspects of herpetofauna, the population recognized the basic information about the habitats of these animals within the reserve area. There is a wide variety of uses of amphibians and reptiles in traditional medicine. Greater efforts should be made in the transmission and dissemination of knowledge about the ecological functions of herpetofauna.

Building a microfluidic cell culture platform with stiffness control using Loctite 3525 glue.

The study of mechanotransduction signals and cell response to mechanical properties requires designing culture substrates that possess some, or ideally all, of the following characteristics: (1) biological compatibility and adhesive properties, (2) stiffness control or tunability in a dynamic mode, (3) patternability on the microscale and (4) integrability in microfluidic chips. The most common materials used to address cell mechanotransduction are hydrogels, due to their softness. However, they may be impractical when complex scaffolds are sought and they lack viscous dissipative properties that are very important in mechanobiology. In this work, we show that an off-the-shelf, biocompatible photosensitive glue, Loctite 3525, may be used readily in mechanobiology assays without any special treatment prior to fabrication of cell culture platforms. Despite a high (MPa) stiffness easily tunable by UV exposure time at a fixed dose, 3T3 fibroblasts showed a response to the mechanics of the material similar to that obtained on much softer (kPa) hydrogels. Loctite's viscous dissipation properties indeed seemed to be responsible for such cell mechanical response, as suggested by recent works where more complex two-phase hydrogels were employed. More interestingly, it was possible to stiffen soft Loctite substrates by post-exposing them during cell culture, to observe changes in cell spreading caused by a dynamic stiffness modification. Thanks to Loctite 3525's patternability, micropillars were also fabricated to demonstrate the compatibility with traction force microscopy studies. Finally, the glue was used as an excellent adhesion layer for hydrogels on glass or PDMS, without the need for additional treatment, enabling the easy fabrication of microfluidic chips integrating hydrogels.

Experiencia de la técnica del ganglio centinela en la cirugía del cáncer de mama, Medellín, Colombia, 2009 / Experience with the sentinel node technique in breast cancer in Medellín, Colombia

Introducción. El cáncer de mama es el segundo cáncer más común y una importante causa de muerte entre las mujeres. Uno de los pilares para su tratamiento es la determinación del estadio de los ganglios axilares mediante el vaciamiento axilar completo. Este procedimiento conlleva gran morbilidad, la cual ha disminuido considerablemente con la implementación de la técnica del ganglio centinela. Objetivo. Describir los resultados obtenidos con la técnica del ganglio centinela en la cirugía de cáncer de mama en un centro especializado en patología de mama de Medellín. Metodología. Se llevó a cabo un estudio descriptivo, retrospectivo. Se revisaron las historias clínicas de 164 pacientes con cáncer de mama en estadio temprano. Se creó una base de datos en Microsoft Office Excel®, y se procesó con el programa estadístico SPSS®, versión 13. Resultados. El 86% de las pacientes tenía ganglio centinela negativo en la impronta y 82,3% en la patología final. El 4,3% fueron falsos negativos, y 3,5% correspondió a micrometástasis. No hubo falsos positivos. El 17% requirió vaciamiento axilar; de éstos, 78% no presentó evidencia patológica de compromiso residual. El informe más común de histología fue carcinoma ductal con infiltración, el cual, también, presentó el mayor porcentaje de ganglio centinela positivo (78,3%). De los ganglios centinela positivos en la patología final, 90% presentaron tumores positivos para receptores de estrógenos y de progesterona. Conclusión. La técnica del ganglio centinela es una buena alternativa para el manejo de cáncer temprano de mama, ya que evita intervenciones quirúrgicas que conllevan a mayor morbimortalidad de las pacientes. Con el resultado negativo se puede afirmar con bastante certeza que no hay otros ganglios afectados.

Breast cancer is the second most common cancer and an important cause of mortality in the female population. A key component of breast cancer therapy is the staging of regional lymph nodes via complete axillary lymph node dissection, which carries substantial morbidity. Nevertheless morbidity has significantly been reduced by implementing the technique of the sentinel lymph node biopsy. Objective: Description of results obtained with the technique of sentinel lymph node biopsy in breast cancer surgery in a breast pathology center in Medellín, Colombia. Methods: Retrospective study in which the medical records of 164 patients with early stage breast cancer were review and placed in a data base on Microsoft Office Excel® and statistically analyzed with the program SPSS 13®. Results: 86% of patients were sentinel lymph node negative on imprint and 82.3% on final pathology; 4.3% were false negative (3.5% due to micro-metastasis) and no false positive results were found. 17% of patients required complete axillary lymph node dissection of which 78% had no evidence of disease on final pathology. The most frequently found histological type was the Infiltrating ductal carcinoma, which also had the most sentinel lymph node positive pathology results (78.3%). 90% of patients with positive sentinel lymph nodes were also positive for estrogen and progesterone receptors. Conclusion: sentinel lymph node biopsy is a good alternative for the management of early staged breast cancer given that it prevents patients from invasive surgery that carries substantial morbidity and mortality. A negative sentinel lymph node gives the physician security that there aren’t other lymph nodes involved.