MTHFR 677C>T and 1298A>C Variants in Mothers of Infants with Down Syndrome from Western Mexico.

Background: Several studies in mothers of infants with Down syndrome (DS) (MoIDS) have suggested that the 677C>T and 1298A>C variants of the 5,10-methylentetrahydrofolate reductase (MTHFR) gene can increase the risk of having a child with DS. Aim: This study aimed to evaluate the MTHFR 677C>T and 1298A>C variants as potential maternal risk factors for DS. Materials and Methods: Using TaqMan allelic discrimination assay, we genotyped 95 MoIDS and 164 control mothers from western Mexico. Data were analyzed using logistic regression analysis. Results: We found that MoIDS had a significantly higher risk for the MTHFR 677TT genotype (adjusted odds ratio [aOR] = 3.4, 95% confidence interval [95% CI]: 1.1-10.6), and the MTHFR 677T allele (aOR = 1.5, 95% CI: 1.0-2.3), particularly in MoIDS <35 years of age. Conclusions: Our findings indicate that the presence of the 677TT genotype and 677T allele of the MTHFR 677C>T variant are maternal risk factors for DS in Mexican MoIDS.

CUIDADO PALIATIVO CERCANO, ADAPTACIÓN DEL CUIDADO DE ENFERMERÍA BRINDADO EN TIEMPO DE PANDEMIA / CLOSE PALLIATIVE CARE, ADEQUACY OF NURSING CARE PROVIDED IN TIMES OF PANDEMIC

INTRODUCCIÓN: La pandemia a nivel mundial afectó gravemente los servicios de prevención y tratamiento de las Enfermedades No Transmisibles, viéndose las personas con cáncer afectadas por su tamizaje, tratamiento y acompañamiento a fin de vida. En este contexto, el cuidado brindado por enfermería se hizo complejo, generando impotencia y frustración frente al aislamiento y la mortalidad. OBJETIVO: Explorar la percepción de las enfermeras respecto al cuidado otorgado a personas en cuidados paliativos oncológicos en el contexto de la pandemia por COVID-19, en la Región Metropolitana de Chile. MÉTODOS: Estudio cualitativo exploratorio descriptivo en base al análisis de contenido temático de Krippendorff. Contó con una muestra intencionada de 6 enfermeras de unidades de cuidados paliativos. La recolección de datos fue con entrevistas semiestructuradas audio grabadas por video conexión, tras dar el consentimiento, entre septiembre del 2020 y abril del 2021. Las entrevistas trascritas fueron analizadas por cada uno de los investigadores por separado, para luego triangular los hallazgos y develar las categorías, logrando la saturación de datos. RESULTADOS: Las enfermeras de CP que participaron en esta investigación se vieron enfrentadas a desafíos generados por la pandemia, sin embargo, reconocen haber logrado un cuidado paliativo cercano en base a las adaptaciones en la gestión del cuidado, la cual estuvo mediada por factores facilitadores en el proceso. Esta experiencia las llevó a dar sentido al cuidado brindado, valorando las adecuaciones realizadas y el compromiso asumido en pos de mantener un cuidado humanizado a pesar de los obstáculos que se fueron presentando. CONCLUSIÓN: El afrontar la pandemia permitió a las enfermeras de cuidados paliativos adaptarse a través de una gestión del cuidado oportuna, segura, innovadora y humanizada, lo que dio sentido a dicho cuidado, relevando el desarrollo de los programas de cuidados paliativos en personas con limitación de la vida.

INTRODUCTION: The worldwide pandemic severely affected services related to the prevention and treatment of Non-Communicable Diseases, especially in people with cancer who require screening, treatment, and accompaniment at the end of life. In this context, the care provided by nurses became complex, creating feelings of impotence and frustration in the face of isolation and mortality. OBJECTIVE: To explore nurses' perceptions of the oncologic palliative care provided during the COVID-19 pandemic in the Metropolitan Region of Chile. METHODS: Descriptive exploratory qualitative study based on Krippendorff thematic content analysis. The study had an intentional sample of 6 nurses from palliative care units. Data was collected between September 2020 and April 2021, using semi-structured video interviews which were audio-recorded after obtaining consent. The transcribed interviews were analyzed by each of the researchers separately to triangulate the findings and reveal the categories that characterized the nurses' perceptions. RESULTS: While the PC nurses who participated in this research were faced with challenges generated by the pandemic, they were able to provide close palliative care based on adaptations in care management, adaptations facilitated by factors in the process. This experience enabled them to give meaning to the care provided, value the adjustments and the commitment made to maintain humanized care despite the obstacles. CONCLUSION: Facing the pandemic prompted palliative care nurses to adapt through timely, safe, innovative, and humanized care management, giving meaning to such care and highlighting the importance of palliative care programs in people with life limitations.

Estrés, ansiedad y depresión en estudiantes de obstetricia de una universidad pública durante la pandemia por la COVID-19

Introducción: La pandemia por la COVID-19 ha generado repercusiones importantes en los estudiantes de educación superior. Su impacto ha permitido el desarrollo de afecciones en el aspecto académico y de salud, especialmente en la salud mental. Objetivo: Identificar el nivel de estrés, ansiedad y depresión durante la pandemia por la COVID-19 en los estudiantes de obstetricia de una universidad pública. Métodos: Estudio descriptivo y transversal, que se realizó en una muestra de 212 estudiantes de obstetricia quienes se seleccionaron de forma no probabilística. Se aplicaron 3 instrumentos: la escala de percepción global de estrés (EPGE), la escala de medición del desorden de ansiedad generalizada (GAD-7) y el cuestionario de salud del paciente (PHQ-9), todos con elevada confiabilidad. Se estimaron frecuencias absolutas y relativas. Resultados: La mayor proporción de los estudiantes era de sexo femenino (95,8 %) y tenía entre 21 y 25 años (66 %). Además, el 37,2 % se encontraba en cuarto año de la carrera y 6,1 % vivía solo. El eustrés moderado (85,8 %) y el alto distrés (66 %) se presentaron con mayor frecuencia. El 18,9 % tuvo un nivel grave de ansiedad, la preocupación (81,1 %) y la incapacidad para relajarse (80,7 %) fueron los síntomas más frecuentes. El 31,1 % y 11,8 % tuvo depresión leve y grave, respectivamente. Conclusión: Durante la pandemia por la COVID-19 la mayor parte de los estudiantes de obstetricia presentan niveles altos de estrés, depresión leve y ansiedad grave.

Introduction: The COVID-19 pandemic has generated significant repercussions in higher education students. Its impact has led to the development of academic and health conditions, especially in mental health. Objective: To identify the level of stress, anxiety and depression during the COVID-19 pandemic in midwifery students of a public university. Methods: Descriptive and cross-sectional study, which was carried out in a sample of 212 midwifery students who were selected in a non-probabilistic way. Three instruments were applied: the global perception of stress scale (EPGE), the generalized anxiety disorder measurement scale (GAD-7) and the patient health questionnaire (PHQ-9), all with high reliability. Absolute and relative frequencies were estimated. Results: The highest proportion of the students was female (95,8 %) and aged between 21 and 25 years (66%). In addition, 37,2% were in their fourth year and 6,1% lived alone. Moderate eustress (85,8%) and high distress (66%) occurred more frequently. 18,9% had a severe level of anxiety and worry (81,1%), and inability to relax (80,7%) were the most frequent symptoms. 31,1% and 11,8% had mild and severe depression, respectively. Conclusion: During the COVID-19 pandemic, most of the midwifery students present high levels of stress, mild depression and severe anxiety.

Características de las mujeres usuarias del método anticonceptivo de esterilización femenina

Introducción: La esterilización femenina es un método anticonceptivo permanente, cuya elección representa una decisión transcendental en la vida de la mujer; influenciada por el contexto y las cualidades personales. Objetivo: Describir las características de las mujeres usuarias del método anticonceptivo de esterilización femenina. Métodos: Estudio de tipo descriptivo basado en la Encuesta Demográfica y de Salud Familiar del 2021. De las bases de datos se seleccionaron a 2 306 mujeres de 20 a 49 años, usuarias de esterilización femenina, en quienes se analizaron las características sociodemográficas, reproductivas y propias del método. Se estimaron recuentos no ponderados y ponderados con intervalos de confianza al 95 %. Resultados: Respecto a las características sociodemográficas, el 51 % tiene de 40 a 49 años, 87,9 % es de zona urbana, 42,8 % tiene nivel de estudios secundarios y 11,4 % es muy pobre. En relación con el perfil reproductivo, 61,7 % tiene de 3 a 4 hijos, 3,7 % recibió la visita de un personal de salud para hablar de planificación familiar y 29,2 % tiene antecedente de aborto. Referente a las características relacionadas al método, el 5,7 % no fueron informadas acerca de que no podrían tener más hijos y 19,9 % tenía de 2 a 3 años de haberlo realizado. Conclusión: Las mujeres, en su mayoría, son adultas, de buen nivel educativo y residen en zonas urbanas. Además, tienen de 3 a más hijos y saben que no pueden tener más después de la esterilización femenina.

Introduction: Female sterilization is a permanent contraceptive method, whose choice represents a transcendental decision in a woman's life, influenced by her context, and her personal qualities. Objective: To describe the characteristics of women users of the female sterilization contraceptive method. Methods: Descriptive study based on the Demographic and Family Health Survey of 2021. From the databases, 2 306 women between 20 and 49 years of age were selected as users of female sterilization, in which the sociodemographic, reproductive and method-specific characteristics were analyzed. Unweighted and weighted counts with 95% confidence intervals. Results: Regarding sociodemographic characteristics, 51% were aged 40 to 49 years, 87.9% were urban, 42.8% had secondary education and 11.4% were very poor. Regarding the reproductive profile, 61.7% have 3 to 4 children, 3.7% have been visited by health personnel to discuss family planning and 29.2% have a history of abortion. Regarding the characteristics related to the method, 5.7% were not informed that they could not have more children and 19.9% had had an abortion 2 to 3 years before. Conclusion: Most of the women are adults, well-educated and live in urban areas. In addition, they have 3 or more children and know that they cannot have more children after female sterilization.

Personal protective equipment: Analysis of supply among midwives during the COVID-19 pandemic in Peru.

OBJECTIVE: To report the details of provision of personal protective equipment to midwives during the COVID-19 pandemic in Peru METHODS: This is a non-experimental, descriptive, cross-sectional study. An online survey of 679 midwives working at public healthcare centres was conducted via questionnaires. The following aspects were outlined: method of supply and frequency of delivery of personal protective equipment, type of personal protective equipment provided by the institution, and self-purchase. Furthermore, features of the midwives' workplace were described. For statistical analysis, absolute frequencies and relative proportions were used for categorical variables, and mean and standard deviation were used for numerical variables. MEASUREMENTS AND FINDINGS: The most important finding of this study is that a large proportion of midwives (66.6%) did not receive new personal protective equipment for each shift; 41.9% of midwives who received personal protective equipment during each shift exclusively provided services in the COVID-19 ward, whereas 27.6% did not. The least received supplies were of N95 respirator masks (41.7%) and disposable isolation suit gown (50.5%). Only a certain proportion of midwives (38.6%) were trained by their own institutions on the use of personal protective equipment. KEY CONCLUSIONS: The provision of personal protective equipment to midwives and training on personal protective equipment were insufficient at all workplaces. Therefore, measures must be taken to increase the supply of this material to midwives who are essential workers in reproductive health.

Factores asociados con la aceptación de la vacuna contra SARS-CoV-2 en embarazadas peruanas, 2022 / Factors associated with the acceptance of vaccination against SARS-CoV-2 in Peruvian pregnant women, 2022

Resumen OBJETIVO: Describir los factores asociados con la aceptación de la vacuna contra SARS-CoV-2 en embarazadas peruanas. MATERIALES Y MÉTODOS: Estudio observacional, analítico, transversal y retrospectivo efectuado en una muestra de pacientes embarazadas atendidas en el Centro Materno Infantil Santa Anita, Lima, Perú, seleccionadas por muestreo aleatorio simple entre los meses de enero a junio del 2022. RESULTADOS: Se analizaron 315 embarazadas. La proporción de aceptación de la vacuna contra SARS-CoV-2 fue del 58.1%. Del total de inmunizadas, 96.2% contaba con dos dosis y 3.8% solo una. El principal motivo por el que solo recibieron una dosis fue haber enfermado de COVID-19 y considerar que con era suficiente (42.8%). El motivo principal para no vacunarse fue el temor a que el biológico dañara a su hijo (40.1%). Los factores asociados con el trabajo dependiente obtuvieron una razón de prevalencia (Rp) de 2.18 (IC95%: 1.13-4.18; p = 0.019) y la infección previa por SARS-CoV-22 una Rp = 2.41 (IC95%: 1.03-5-59; p = 0.040). CONCLUSIÓN: Más de la tercera parte de las embarazadas no aceptó la vacunación contra el SARS-CoV-2. Los factores asociados con la aceptación de la vacuna fueron el antecedente de infección SARS-CoV-2 y realizar un trabajo dependiente.

Abstract OBJECTIVE: We describe the acceptance of the SARS-CoV-2 vaccine in Peruvian pregnant women and associated factors during 2022. METHODS: Observational, analytical, cross-sectional and retrospective study with a sample of 315 pregnant women selected by simple random sampling, January to June 2022. RESULTS: The acceptance rate of the SARS-CoV-2 vaccine was 58.1%. Of the total number of immunized women, 96.2% had two doses and 3.8% had only one dose; the main reason for having only one dose was having been ill with COVID-19 and one dose was sufficient (42.8%) while the main reason for not having any dose was the fear that the vaccine would harm the baby (40.1%). Regarding associated factors dependent work obtained a Prevalence Ratio (Rp= 2.18) CI95% [1.13-4.18; p=0.019] and previous SARS-CoV-22 infection an Rp= 2.41 CI95% [1.03-5.59; p=0.040]. CONCLUSION: more than one third of pregnant women did not accept vaccination against SARS-CoV-2; factors associated with acceptance of vaccination against COVID-19 were a history of SARS-CoV-2 infection and performing dependent work.

Asociación entre determinantes sociales y salud mental: efecto de la doble carga laboral y doméstica / Association between social determinants and mental health: Effect of the double burden of paid and domestic

RESUMEN Fundamento los trastornos mentales comunes están entre las primeras causas de carga de enfermedad en Chile y Latinoamérica. El género y la posición socioeconómica son importantes determinantes sociales de la salud mental. Objetivo determinar el rol de la doble carga doméstica y laboral en la asociación entre determinantes sociales y trastornos mentales comunes. Métodos: análisis secundario de una muestra representativa de la población chilena laboralmente activa en 2009-2010. Se emplearon modelos logísticos para determinar la asociación entre las variables de interés y sospecha de trastornos mentales comunes. Resultados la frecuencia de sospecha de trastornos mentales comunes era casi el doble entre las mujeres, pero la asociación entre género y trastornos mentales no se observó al incorporar la doble carga laboral y doméstica. El ingreso se asociaba con trastornos mentales solamente entre los hombres. Conclusiones: la distribución de la doble carga laboral y doméstica, que es más frecuente entre las mujeres, puede contribuir a la mayor frecuencia de sospecha de trastornos mentales entre las mujeres. Es importante fortalecer las políticas sociales y laborales que minimicen las brechas en el trabajo remunerado y fomenten la corresponsabilidad en las labores domésticas y de cuidado.

ABSTRACT Background Common mental disorders are among the leading contributors to the burden of disease in Chile and Latin America. Gender and socioeconomic position are important social determinants of mental health. Objective: This study is aimed at determining the role of the double burden of paid job and unpaid domestic work in the association of social determinants with common mental disorders. Methods Secondary analyses of a sample representative of the employed or recently employed Chilean population between 2009-2010. Logistic models were used to determine the association between the variables of interest and positive screen for common mental disorders. Results Positive screen for common mental disorders was two times as frequent in women, compared to men, but the association between gender and the outcome was not observed when controlling for the double burden of paid and unpaid work. Income was associated with common mental disorders only among men. Conclusions The distribution of the double burden of paid and unpaid work, which is more frequent among women, could contribute to the higher frequency of common mental disorders among them. It is important that social and labor public policies address this issue, to reduce the gap experienced by women with respect to paid work, and to foster co-responsibility in domestic and care tasks.

Reflectance Confocal Microscopy and Electrical Impedance Spectroscopy in the Early Detection of Melanoma in Changing Lesions during Long-term Follow-up of Very High-risk Patients.

Electrical impedance spectroscopy has clinical relevance in diagnosing malignancy in melanocytic lesions. Sixty-eight lesions with changes during digital follow-up of patients at very high risk of developing melanoma were prospectively included in this study from February to December 2016. Electrical impedance spectroscopy and reflectance confocal microscopy were performed to evaluate their performance in this subset of difficult lesions. Forty-six lesions were considered suspicious on reflectance confocal microscopy and were excised, of these, 19 were diagnosed as melanoma. Fifteen melanomas were detected by electrical impedance spectroscopy, while 4 received a score lower than 4, which suggested no malignancy. The addition of reflectance confocal microscopy improves accuracy while maintaining the same sensitivity. In the case of electrical impedance spectroscopy scores <4, lesions exhibiting changes in follow-up may need short-term monitoring or excision if dermoscopy shows criteria for melanoma. Results of electrical impedance spectroscopy in this subset of very early lesions should be carefully considered due to the risk of false negatives.

Prevalencia y factores asociados a distintos tipos de violencia íntima de pareja en mujeres peruanas

RESUMEN Introducción: La violencia íntima de pareja es un problema de salud pública que genera un impacto negativo sobre el estado de salud de la mujer, cuyo origen multifactorial, demanda la necesidad de nuevas estrategias de prevención integrales. Objetivo: Determinar la prevalencia y factores asociados a los distintos tipos de violencia íntima de pareja en mujeres peruanas. Métodos: Estudio transversal, realizado a partir de la Encuesta Demográfica y de Salud Familiar del 2019. Se analizaron 21 518 registros de mujeres en edad reproductiva. Se estimaron recuentos no ponderados y ponderados, con sus intervalos de confianza al 95 %. Se utilizó la prueba ji cuadrado. Resultados: La prevalencia de violencia íntima de pareja fue 57,7 %. El maltrato psicológico se presentó en 52,8 %, el físico en 29,5 % y el sexual en 7,1 %. En los casos de violencia física, 21,8 % tenía instrucción primaria y 84,3 % refirió que su pareja bebía alcohol. En las mujeres con maltrato psicológico, 72,7 % tenía de 30 a 49 años y 80,2 % era de zona urbana. En las víctimas de violencia sexual, 48,5 % era pobre o muy pobre y 47 % tuvo instrucción secundaria. Conclusiones: La violencia íntima de pareja es un problema muy prevalente, que está asociado a diferentes factores sociodemográficos, aunque el abuso sexual y físico no se asocian con el área de residencia, ni la violencia psicológica con la edad.

ABSTRACT Introduction: Intimate partner violence is a public health problem that has a negative impact on the health status of women, and whose multifactorial origin demands the need for new comprehensive and prevention strategies. Objective: To determine the prevalence and factors associated with the different types of intimate partner violence in Peruvian women. Methods: Cross-sectional study, carried out from the 2019 Demographic and Family Health Survey, 2,518 records of women of reproductive age were analyzed. Unweighted and weighted counts were estimated, with its 95% confidence intervals. The chi square test was used. Results: The prevalence of intimate partner violence was 57,7 %. Psychological abuse occurred in 52,8 % of women, physical abuse in 29,5 % and sexual abuse in 7,1 %. In the cases of physical violence, 21,8 % had primary education and 84,3 % reported that their partner drank alcohol. Among the women with psychological abuse, 72,7 % were between 30 and 49 years old and 80,2 % were from urban areas. Among the victims of sexual violence, 48,5 % were poor or very poor and 47 % had secondary education. Conclusions: Intimate partner violence is a very prevalent problem, which is associated with different sociodemographic factors, although sexual and physical abuse were not associated with the area of ​​residence, nor psychological violence with age.

Características epidemiológicas y complicaciones obstétricas en gestantes con diagnóstico de COVID-19 en un hospital público

RESUMEN Introducción: La COVID-19 en embarazadas ha supuesto un desafío en la atención materna, puesto que podría incrementar el riesgo de padecer algunas enfermedades obstétricas y resultados perinatales negativos. Objetivo: Describir las características epidemiológicas y complicaciones obstétricas en gestantes con diagnóstico de COVID-19. Métodos: Estudio descriptivo y transversal, realizado en una muestra de 235 gestantes con diagnóstico de COVID-19, seleccionadas de forma no aleatoria. Se estudiaron las características epidemiológicas y las complicaciones obstétricas, que fueron reportadas mediante estadística descriptiva. Resultados: La edad promedio de las gestantes fue de 27,6 ± 3,7 años, el 65,5 % era conviviente y 77,4 % tenía instrucción secundaria. Además, el 71,5 % tenía entre 37 y 40 semanas de gestación, 28,5 % no tuvo ninguna atención prenatal, 68,9 % era multigesta y 27,7 % tuvo antecedente de aborto. El 90,6 % fue asintomática y la cefalea fue el síntoma más frecuente (7,4 %). Entre las complicaciones obstétricas, el 30,6 % tuvo un parto por cesárea, 20 % presentó anemia y 15,7 % ruptura prematura de membrana. El síndrome de Hellp (0,9 %) y la eclampsia (0,4 %), fueron las menos frecuentes. Conclusiones: En las gestantes con la COVID-19 existe una elevada tasa de complicaciones obstétricas, principalmente la cesárea y la anemia. La mayoría de las gestantes es asintomática y tiene un resultado serológico IgM/IgG.

ABSTRACT Introduction: COVID-19 in pregnant women has been a challenge in maternal care, since it could increase the risk of suffering from some obstetric diseases and negative perinatal results. Objective: To describe the epidemiological characteristics and obstetric complications in pregnant women diagnosed with COVID-19. Methods: Descriptive, and cross-sectional study, carried out in a sample of 235 pregnant women with a diagnosis of COVID-19, selected in a non-random way. Epidemiological characteristics and obstetric complications were studied, which were reported by descriptive statistics in univariate tables. Results: The average age of the pregnant women was 27.6 ± 3.7 years, 65.5 % were cohabiting and 77.4 % had secondary education. In addition, 71.5 % were between 37 and 40 weeks' gestation, 28.5 % had no prenatal care, 68.9 % were multi-pregnant, and 27.7 % had a history of abortion; 90.6 % were asymptomatic and headache was the most frequent symptom (7.4 %). Among obstetric complications, 30.6 % had a cesarean birth, 20 % had anemia and 15.7 % premature rupture of the membrane. Hellp syndrome (0.9 %) and eclampsia (0.4 %) were the least frequent. Conclusions: In pregnant women with COVID-19 there is a high rate of obstetric complications, which are mainly caesarean section and anemia. Most pregnant women are asymptomatic and have an IgM / IgG serological result.

Terminologia embryologica y anexos embrionarios: propuesta de términos embriológicos en español / Terminologia embryologica and embryonic annexes: proposed embryological terms in Spanish

Es importante unificar criterios en los términos usados en embriología, para facilitar su estudio, investigación y divulgación, donde se espera que los términos tengan un valor informativo, ausencia de epónimos y homónimos; y evitar la sinonimia. El objetivo de este trabajo consistió en proponer la traducción al español de los términos de Terminologia Embryologica correspondientes al capítulo "Desarrollo de anexos extra-embrionarios y membranas fetales". Se utilizaron libros y artículos científicos de embriología y obstetricia; diccionarios en los idiomas español/latín - latín/español y se definió la traducción de los términos de acuerdo a su frecuente utilización y cita en la enseñanza de la embriología. La información obtenida del análisis de los artículos y libros consultados fue organizada en 5 tablas: Tabla I, Traducción al español de términos en latín existentes en Terminologia Embryologica; Tabla II, Modificación de términos en latín de la Terminologia Embryologica traducidos al español; Tabla III, Términos modificados del latín, y traducidos al español; Tabla IV, Términos no encontrados en la revisión de textos y artículos; Tabla V, Términos no usados, términos y códigos repetidos. El presente trabajo aporta en la traducción de términos embriológicos del latín al español, no siendo necesariamente una traducción literal, sino más bien una interpretación basada en artículos científicos y textos actualmente utilizados en la enseñanza y el estudio de la embriología. Los resultados de este trabajo pretenden contribuir a la generación de Terminologia Embryologica en español y esperamos sean discutidos y mejorados con propuestas constructivas de parte de los expertos en el área de la morfología.

It is important to regulate criteria in the terminology used in embryology, to promote the study, research and communication in this field. Terms are expected to have informative value, absence of eponyms and homonyms and further, to avoid synonymy. The aim of this work was to propose the Spanish translation of the terms of Terminologia Embryologica corresponding to the chapter "Development of extra-embryonic attachments and fetal membranes". Books and scientific articles on embryology and obstetrics were used; dictionaries in Spanish / Latin - Latin / Spanish languages and the translation of the terms was defined according to their frequent use and quotation in the teaching of embryology. The information obtained from the analysis of the articles and books consulted was organized in 5 tables: Table I, Spanish translation of Latin terms existing in Terminologia Embryologica; Table II, modification of Latin terms of Terminologia Embryologica translated into Spanish; Table III, modified Latin terms, and translated into Spanish; Table IV, terms not found in the review of texts and articles; Table V, unused terms, repeated terms and codes. The present work contributes in the translation of embryological terms from Latin to Spanish, not necessarily being a literal translation, but rather an interpretation based on scientific articles and texts currently used in the teaching and study of embryology. The results of this work are intended to contribute to the generation of Terminologia Embryologica in Spanish and we hope that will be discussed and improved with constructive proposals from experts in the area of morphology.

Factores asociados al inicio tardío de la atención prenatal en un Centro de Salud del Callao, Perú / Associated Factors to Late Start of Prenatal Care at a Callao Health Center, Peru

RESUMEN Introducción: La atención prenatal es una estrategia de salud que contribuye con la reducción de la morbimortalidad materna y perinatal, por lo cual es relevante que se realice de forma continua, integral, periódica y precoz. Objetivo: Determinar los factores asociados al inicio tardío de la atención prenatal en un Centro de Salud del Callao, Perú. Métodos: Estudio observacional, analítico, de corte transversal, realizado en el Centro de Salud Alta Mar del Callao, Perú, durante los meses de setiembre a noviembre 2019. Se seleccionó una muestra no probabilística de 149 gestantes, a quienes se les aplicó un cuestionario validado. Las variables en estudio fueron los factores sociodemográficos, personales, obstétricos e institucionales, además del inicio tardío de la atención prenatal. Resultados: En el análisis bivariado los factores sociodemográficos e institucionales no demostraron asociación significativa. Mientras que los factores personales como el antecedente de violencia (OR= 2,3; IC95 por ciento = 1,1-4,9) y el desinterés de la pareja (OR= 3,7; IC95 por ciento = 1,8-7,7), así como el factor obstétrico, embarazo no planificado (OR= 6,6; IC95 por ciento = 2,7-16,4), se asociaron con el inicio tardío de la atención prenatal. En el análisis multivariado, el desinterés de la pareja (OR= 2,7; IC95 por ciento = 1,2-6,1) y el embarazo no planificado (OR= 5,6; IC95 por ciento = 2,2-14,3), mantuvieron la asociación. Conclusiones: El desinterés de la pareja y el embarazo no planificado fueron asociados al inicio tardío de la atención prenatal, los cuales incrementan la posibilidad de ocurrencia de este evento(AU)

ABSTRACT Introduction: Prenatal care is a health strategy that contributes to the reduction of maternal and perinatal morbidity and mortality; therefore, it is relevant to carry it out continuously, comprehensively, periodically and early. Objective: To determine the factors associated with the late start of prenatal care in a Callao Health Center, Peru. Methods: An observational, analytical, cross-sectional study was carried out at Alta Mar del Callao Health Center, Peru, from September to November 2019. A non-probability sample of 149 pregnant women was selected. They had a validated questionnaire. The variables under study were the sociodemographic, personal, obstetric and institutional factors, in addition to the late start of prenatal care. Results: No significant association was shown in the bivariate analysis the sociodemographic and institutional factors. While personal factors such as the history of violence (OR = 2.3; 95 percent CI = 1.1-4.9) and the partner´s disinterest (OR = 3.7; 95 percent CI = 1.8- 7,7), as well as the obstetric factor, unplanned pregnancy (OR = 6.6; 95 percent CI = 2.7-16.4), were associated with the late start of prenatal care. In the multivariate analysis, the partner´s disinterest (OR = 2.7; 95 percent CI = 1.2-6.1) and unplanned pregnancy (OR = 5.6; 95 percent CI = 2.2-14.3), kept the association. Conclusions: The partner´s disinterest and the unplanned pregnancy were associated with the late start of prenatal care, which increase the possibility of this event to occur(AU)

Método anticonceptivo de elección en el postaborto / Contraceptive method of choice post-abortion

Resumen OBJETIVO: Identificar el método anticonceptivo elegido por las pacientes atendidas en un Hospital de Lima, Perú, luego de un aborto. MATERIALES Y MÉTODOS: Estudio observacional, descriptivo, retrospectivo y transversal efectuado en el Hospital San Bartolomé de Lima, Perú, en 2017. Criterios de inclusión: pacientes con diagnóstico de aborto con evolución favorable y que recibieron consejería especializada de los distintos métodos anticonceptivos, sin importar si ya utilizaba alguno. Criterio de exclusión: pacientes con alguna complicación grave. La selección de las pacientes se efectuó mediante muestreo probabilístico aleatorio simple. Los datos se analizaron mediante estimación de frecuencias absolutas y relativas. RESULTADOS: Se incluyeron 116 mujeres que abortaron. El 28.4% optó por un método anticonceptivo; y de éstas, 6.9% optó por un método inyectable mensual, 6.9% por el inyectable trimestral, 6% por el oral combinado, 0.9% por el implante subdérmico, 1.7% por el dispositivo intrauterino y 0.9% por la ligadura de trompas. El 59.5% de las pacientes no estaban utilizando algún método anticonceptivo; el 62.9% tuvo, al menos, un aborto previo y 31.4% tuvo un aborto en su último embarazo. CONCLUSIONES: En esta muestra de estudio se apreció que la mayoría de las mujeres que por alguna causa abortaron no eligió un método anticonceptivo; no obstante, los inyectables mensuales y trimestrales fueron los más elegidos entre quienes sí optaron por uno.

Abstract OBJECTIVE: Identify the contraceptive method chosen by the patients treated at a Hospital in Lima, Peru, after an abortion. MATERIALS AND METHODS: An observational, descriptive, retrospective and cross-sectional study was carried out at the San Bartolomé Hospital, in Lima, Peru, in 2017; women who had a diagnosis of abortion with favorable evolution and who received specialized counseling in the different contraceptive methods were included, regardless of whether they used a previous one; while those that had a serious complication were excluded. The choice of contraceptive methods in post-abortion was studied and the selection of women was made through a simple random probabilistic sampling. For the data analysis, the estimation of absolute and relative frequencies was performed. RESULTS: 116 women were included. 28.4% opted for a contraceptive method, and of these, 6.9% decided on a monthly injection, 6.9% for a quarterly injection, 6% for combined oral, 0.9% for a subdermal implant, 1.7% for an intrauterine device and 0.9% for tubal ligation. On the other hand, 59.5% of the observed women were not using a contraceptive method, in addition, 62.9% had at least one previous abortion and 31.4% had an abortion with their last pregnancy. CONCLUSIONS: In this study sample, it was appreciated that the majority of women who aborted for some reason did not choose a contraceptive method; however, monthly and quarterly injectables were the most chosen among those who did choose one.

Characterization and phenotypic variation with passage number of cultured human endometrial adenocarcinoma cells.

Despite numerous endometrial cancer cell lines, little is know about the progression and transition of primary cultured endometrial tumours. Herein, a stage I grade III endometrial adenocarcinoma was maintained in primary culture and the phenotypic and protein expression changes were observed in relation to passage number. At early passage numbers, cultured human endometrial cancer (CHEC) cells displayed classic epithelial cell morphology, growing in groups in a glandular structure and staining positive for cytokeratin. However, with increasing passage number, CHEC cells changed in morphology to display a stromal phenotype which was accompanied by a significant reduction in cytokeratin and increases in alpha-actin and vimentin expression. Simultaneous culture of stromal cells isolated from the original tumour failed to show the same morphological characteristics or protein expression patterns. We further characterised CHEC cells through a screening of cancer related proteins, among others, caveolin-1 and Tissue factor in comparison with established cancer cell lines and corresponding non-cancerous cells. This report demonstrates that endometrial adenocarcinoma cells in culture can undergo phenotypic and protein expression changes reminiscent of epithelial-mesenchymal transition. This work suggests that primary tumours and cell lines displaying stromal morphologies may have undergone epithelial-mesenchymal transition from an adenocarcinoma origin.

TRAIL mediates apoptosis in cancerous but not normal primary cultured cells of the human reproductive tract.

Cancer of the reproductive tract encompasses malignancies of the uterine corpus, cervix, ovary, Fallopian tube, among others and accounts for 15% of female cancer mortalities. Tumour necrosis factor-related apoptosis-inducing ligand (TRAIL) mediates apoptosis by binding to death receptors and offers a promising cancer treatment. The goal of this study was to investigate and characterize the effect of TRAIL in endometrial cancer cell lines and normal (non-cancerous) epithelial cells of endometrial origin. We also examined the effect of TRAIL in other primary cultured cancers and normal cells of the human female reproductive tract and evaluated if TRAIL mediated apoptosis correlated with death receptors and decoy receptors 1 and 2.Herein, we demonstrate that TRAIL at concentrations which kill cancerous cells, does not mediate apoptosis or alter cell viability in normal human endometrium, ovary, cervix or Fallopian tube. The partial inhibition by a caspase 9 inhibitor and the total inhibition by a caspase 8 inhibitor demonstrates the dependency on the extrinsic apoptotic pathway. The selective mortality does not correlate with the presence of death or decoy receptors. These results suggest that TRAIL may be an effective treatment for endometrial cancer and other female reproductive cancers, with minimal secondary effects on healthy tissue.

Tissue factor is regulated by epidermal growth factor in normal and malignant human endometrial epithelial cells.

Tissue Factor (TF), the initiator of the extrinsic coagulation cascade, is overexpressed in a variety of cancers. TF is also expressed in normal human endometrium but little is known about its expression or regulation in endometrial cancer. We demonstrate herein that TF is expressed in the endometrial adenocarcinoma cell line Ishikawa. Furthermore, epidermal growth factor (EGF) induces a rapid and sustained increase in TF expression. Estradiol and progesterone had no effect on basal or EGF-induced TF expression in Ishikawa cells. In contrast to the pronounced and sustained upregulation at the protein level, EGF treatment elicited only a modest and transient increase in TF mRNA levels. This activity corresponded to the response observed from an exogenous TF promoter construct. However, the induction of TF was abrogated by cycloheximide as well as actinomycin-D, inhibitors or protein- and mRNA-synthesis, respectively, demonstrating that EGF mediates its effect through activation of the TF gene. Fractionation experiments showed that EGF increases TF presence in caveolin-I containing membrane fractions. Coagulation and invasion assays were used to explore the physiological implications of TF regulation. The results demonstrate that EGF-mediated induction of TF increases the procoagulant activity and invasive potential of Ishikawa cells. Furthermore, immunocytochemistry confirmed that TF is regulated by EGF in primary cultures of normal endometrial epithelial cells and malignant tumor cells. In conclusion, EGF-mediated upregulation of TF results in accumulation of this glycoprotein in caveolae-like membrane fractions and increased coagulative and invasive potential. Our results suggest that TF may play an integral role in endometrial carcinogenesis.

Progesterone increases tissue factor gene expression, procoagulant activity, and invasion in the breast cancer cell line ZR-75-1.

Progesterone in hormonal preparations increases the incidence of breast cancer. Tissue factor (TF), the initiator of the extrinsic coagulation pathway, is associated with metastasis in a wide variety of cancers. We demonstrate herein that TF mRNA and protein are up-regulated by progesterone in the breast cancer cell line ZR-75. Epidermal growth factor, also associated with increased breast cancer risk, did not regulate TF. The increase in TF is both rapid and transient; increasing after 6 h, reaching a maximum at 24 h, before decreasing to basal levels at 72 h. Sucrose gradient experiments demonstrated that TF is located in the heavy fraction of the plasma membrane, although caveolin-1 is not expressed in ZR-75. To understand the physiological implications of an increase in TF, we performed coagulation and invasion assays. An increase in TF corresponded to an increase in procoagulant activity. Furthermore, progesterone increased the invasion of ZR-75 cells through a matrigel, an effect that was blocked by an antibody against TF. Because TF expression is associated with an enhanced risk of metastasis, we postulate that the progesterone-dependent up-regulation of TF provides a survival advantage to burgeoning breast cancer cells and may contribute to the increased risk of cancer associated with combined hormone replacement therapy.

Differential regulation of glucose transporter expression by estrogen and progesterone in Ishikawa endometrial cancer cells.

Estrogen replacement therapy and other unopposed estrogen treatments increase the incidence of endometrial abnormalities, including cancer. However, this effect is counteracted by the co-administration of progesterone. In the endometrium, glucose transporter (GLUT) expression and glucose transport are known to fluctuate throughout the menstrual cycle. Here, we determined the effect of estrogen and progesterone on the expression of GLUT1-4 and on the transport of deoxyglucose in Ishikawa endometrial cancer cells. Cells were incubated with estrogen, progesterone or combined estrogen and progesterone for 24 h and the effect on the expression of GLUT1-4 and on deoxyglucose transport was determined. We show that GLUT1 expression is upregulated by estrogen and progesterone individually, but that combined estrogen and progesterone treatment reverses this increase. Hormonal treatments do not affect GLUT2, GLUT3 or GLUT4 expression. Transport studies demonstrate that estrogen increases deoxyglucose transport at Michaelis-Menten constants (Kms) corresponding to GLUT1/4, an effect which disappears when progesterone is added concomitantly. These data demonstrate that different hormonal treatments differentially regulate GLUT expression and glucose transport in this endometrial cancer cell line. This regulation mirrors the role played by estrogen and progesterone on the incidence of cancer in this tissue and suggests that GLUT1 may be utilized by endometrial cancer cells to fuel their demand for increased energy requirement.

Incidencia de trauma dentoalveolar en atletas participantes en los XIX juegos deportivos Centroamericanos y del Caribe San Salvador 2002 / Incidence of dentoalveolar trauma in athletes participating in the XIX Central American and Caribbean sports games San Salvador 2002

El propósito de ésta investigación fue determinar la incidencia de trauma dentoalveolar en los atletas participantes en los XIX Juegos deportivos centroamericanos y del Caribe San Salvador 2002. El diseño se enmarca en un estudio de tipo observacional, descriptivo transversal, realizado en 4167 atletas. La información se obtuvo a través del examen clínico, efectuado a todo atleta que sufrió lesiones buco faciales en 19 escenarios deportivos, y en las clínicas odontológicas de la villa CABE, toda la información se procesó en Excel 2000, y los análisis estadísticos en el programa informático EPI INFO 6.04d 2002, la incidencia se determinó aplicando la fórmula para tasas de incidencia. La incidencia resultante fue de 0.0076, que representa al 0.76% de la población total en estudio. Las laceraciones de tejidos blandos, seguido por la concusión dental en los incisivos centrales superiores fueron las lesiones más prevalentes. El género más afectado fue el masculino y la edad media fue de 25 años de edad, la mayoría practicantes de Karate Do o deportes de contacto, que presentaron en total 32 lesiones traumáticas. La realización de los juegos en El Salvador fue una oportunidad propicia para llevar a cabo la presente investigación, los resultados obtenidos, representan una contribución a la Odontología deportiva en El Salvador, documentando por primera vez datos epidemiológicos sobre trauma dentoalveolar en eventos deportivos de ésta magnitud a nivel nacional y regional; otro aporte importante puede ser la consideración que hagan los organismos rectores del deporte en el país para incorporar al Odontólogo en el equipo médico de toda delegación deportiva para prevenir y tratar correctamente el trauma dentoalveolar.

The purpose of this research was to determine the incidence of dentoalveolar trauma in the athletes participating in the XIX Central American and Caribbean Sports Games San Salvador 2002. The design is part of an observational, descriptive, cross-sectional study carried out in 4167 athletes. The information was obtained through the clinical examination, carried out on every athlete who suffered bucco-facial injuries in 19 sports venues, and in the dental clinics of the CABE village, all the information was processed in Excel 2000, and the statistical analyzes in the program computerized EPI INFO 6.04d 2002, the incidence was determined by applying the formula for incidence rates. The resulting incidence was 0.0076, which represents 0.76% of the total study population. Soft tissue lacerations, followed by dental concussion in the upper central incisors were the most prevalent injuries. The most affected gender was the male and the average age was 25 years old, the majority practicing Karate Do or contact sports, who presented a total of 32 traumatic injuries. The holding of the games in El Salvador was a propitious opportunity to carry out this research, the results obtained represent a contribution to sports dentistry in El Salvador, documenting for the first time epidemiological data on dentoalveolar trauma in sporting events of this magnitude at the national and regional level; Another important contribution may be the consideration made by the governing bodies of sport in the country to incorporate the Dentist in the medical team of all sports delegations to prevent and correctly treat dentoalveolar trauma.