Survival of patients with mucosal melanoma in Cali, Colombia: a retrospective cohort study.

BACKGROUND: Mucosa melanoma is a rare condition with aggressive behavior and a less favorable prognosis compared to cutaneous melanoma. The objective of this study was to estimate the overall survival and clinical outcomes of patients diagnosed with mucosal melanoma in a Colombian hospital. METHODS: A retrospective cohort study was conducted at Fundación Valle del Lili, a single center located in Cali, Colombia. Patients aged ≥ 18 years, both sexes, diagnosed with mucosal melanoma by histopathology study were included between 2010-2019. Patients who received extra-institutional treatment or whose vital status was unknown during follow-up were excluded. Demographic, clinical and laboratory data were obtained from medical records and laboratory and pathology databases. A descriptive analysis was performed. Survival analysis was conducted using the Kaplan-Meier method. RESULTS: A total of 23 patients were included. Median age was 63 years old (IQR: 57-68) and 52.2% were woman. Clinical stage was 34.8% early, 26.1% locally advanced and 39.1% metastatic. The main primary locations were nasopharynx (30.4%), genitals (26.1%), rectum (21.7%), oral cavity (13%) and paranasal sinuses (8.7%). The majority received surgery (30.4%) and immunotherapy (26.1%) as first line treatment. Overall survival at one year was 80.8%, at three years 44.3%, and at five years 36.9%. CONCLUSION: Mucosal melanoma is a rare, aggressive disease with adverse oncological outcomes due to late diagnosis and limited treatment options. This study provides real-world data in a single-center of Colombia.

Autosomal dominant polycystic kidney disease in Colombia.

BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic cause of chronic kidney disease (CKD) that requires dialysis. Knowing geographical clusters can be critical for early diagnosis, progression control, and genetic counseling. The objective was to establish the prevalence, geographic location, and ethnic groups of patients with ADPKD who underwent dialysis or kidney transplant in Colombia between 2015 and 2019. METHODS: We did a cross-sectional study with data from the National Registry of Chronic Kidney Disease (NRCKD) managed by the High-Cost Diseases Fund (Cuenta de Alto Costo [CAC] in Spanish) between July 1, 2015, and June 30, 2019. We included Colombian population with CKD with or without renal replacement therapy (RRT) due to ADPKD. Crude and adjusted prevalence rates were estimated by state and city. RESULTS: 3,339 patients with ADPKD were included, period prevalence was 9.81 per 100,000 population; there were 4.35 cases of RRT per 100,000 population, mean age of 52.58 years (± 13.21), and 52.78% women. Seventy-six patients were Afro-Colombians, six were indigenous, and one Roma people. A total of 46.07% began scheduled dialysis. The highest adjusted prevalence rate was in Valle del Cauca (6.55 cases per 100,000 population), followed by Risaralda, and La Guajira. Regarding cities, Cali had the highest prevalence rate (9.38 cases per 100,000 population), followed by Pasto, Medellin, and Bucaramanga. CONCLUSIONS: ADPKD prevalence is lower compared to Europe and US; some states with higher prevalence could be objective to genetic prevalence study.

The role of corticosteroids in patients hospitalized for COVID-19 at Mexico general Hospital.

OBJECTIVE: To compare the evolution of hospitalized patients infected with SARS-CoV-2 who received corticosteroid-based treatment versus patients who received standard therapy. METHOD: Retrospective, observational, and analytical study. Clinical records were collected from the different intensive care units, and data were obtained from confirmed COVID-19 patients over 18 years of age who were hospitalized. The population was divided into two groups: patients who received corticosteroid treatment, and those who received standard therapy. RESULTS: A total of 1603 patients were admitted to hospital, and of these 984 (62.9%) were discharged due to death. The main result was the identification by odds ratio (OR: 4.68; 95% confidence interval [95% CI]: 3.75-5.83; p = 0.001) as risk for death to the use of systemic steroids, as well as the use of invasive mechanical ventilation (OR: 2.26; 95% CI: 1.80-2.82; p < 0.001). The male gender was the most affected with 1051 (65.6%) patients. Mean age was 56 years (± 14). CONCLUSIONS: Corticosteroid use was associated with poor prognosis in patients hospitalized for COVID-19 compared to those receiving standard therapy.

OBJETIVO: Comparar la evolución de los pacientes hospitalizados infectados por SARS-CoV-2 que recibieron tratamiento a base de corticoesteroides frente a los pacientes que recibieron la terapia estándar. MÉTODO: Estudio de tipo retrospectivo, observacional y analítico. Se recolectaron los expedientes clínicos de las diferentes unidades de terapia intensiva y se obtuvieron datos de los pacientes confirmados de COVID-19, mayores de 18 años, que estuvieron hospitalizados. Se dividió la población en dos grupos: pacientes que recibieron tratamiento con corticoesteroides y pacientes que recibieron terapia estándar. RESULTADOS: De un total de 1603 pacientes ingresados a hospitalización, 984 (62.9%) fallecieron. El resultado principal fue la identificación mediante razón de momios (odds ratio [OR]: 4.68; intervalo de confianza del 95% [IC95%]: 3.75-5.83; p = 0.001) como riesgo para defunción con uso de esteroides sistémicos, así como con uso de ventilación mecánica invasiva (OR: 2.26; IC95%: 1.80-2.82; p < 0.001). El sexo masculino fue el más afectado, con 1051 (65.6%) pacientes. La media de edad fue de 56 años (± 14). CONCLUSIONES: El uso de corticoesteroides se asoció con mal pronóstico en los pacientes hospitalizados por COVID-19, en comparación con los que recibieron la terapia estándar.

Colombian HIV/AIDS registry and health risk management / Registro colombiano de VIH/SIDA y gestión del riesgo en salud

Abstract HIV/AIDS information systems are a critical tool for keeping track of the HIV pandemic in any country, leading to the AIDS elimination to 2030 and achievement of the 95-95-95 goals set by 2025. In this article, we describe the data management process of the Colombian National HIV/AIDS registry, its epidemiological results and contributions to research and health risk management. This registry is a longitudinal database. Variables and periodicity are defined by The Ministry of Health and Social Protection. Reporting is done by health insurers and their healthcare providers on annual bases. The information is uploaded through a web platform run by the High-Cost Diseases Fund, in charge of the validation, auditing process, consolidation, analysis and publication of the data. Security and confidentiality of the information is also taken care of by the High-Cost Disease Fund. Main results include epidemiological follow up of the epidemic, periodic evaluation of 25 risk management indicators, publication of research studies and the calculation of an economic incentive for insurers to improve health risk management. The registry has shown to be useful not only for the management of clinical information but also for administrative purposes.

Resumen Los sistemas de información sobre el VIH/SIDA son una herramienta fundamental para realizar el seguimiento de la pandemia del VIH en cualquier país, con miras a la eliminación del SIDA hasta el 2030 y al logro de las metas 95-95-95 establecidas para el 2025. En este artículo se describe el proceso de gestión de datos del Registro Nacional de VIH/SIDA de Colombia, sus resultados epidemiológicos, sus aportes a la investigación y a la gestión del riesgo en salud. Este registro es una base de datos longitudinal. Las variables y la periodicidad son definidas por el Ministerio de Salud y Protección Social. Los reportes son realizados por las aseguradoras de salud y sus prestadores de servicios de salud sobre bases anuales. La información se carga a través de una plataforma web gestionada por el Fondo de Enfermedades de Alto Costo, encargado del proceso de validación, auditoría, consolidación, análisis y publicación de los datos. El Fondo de Enfermedades de Alto Coste también se encarga de la seguridad y la confidencialidad de la información. Los principales resultados son el seguimiento epidemiológico de la epidemia, la evaluación periódica de 25 indicadores de gestión del riesgo, la publicación de estudios de investigación y el cálculo de un incentivo económico para que las aseguradoras mejoren la gestión del riesgo sanitario. El registro ha demostrado ser útil no sólo para la gestión de la información clínica, sino también para fines administrativos.

Persons with Substance Abuse Disorders and Other Addictions: Coping with the COVID-19 Pandemic.

Cuba implemented policies mandating social distancing on March 11, 2020, which were still in place at the time of this study. During such periods of isolation, people with psychoactive substance-related disorders and other addictions may be tempted to reduce tension, stress, uncertainty and possible distress by increasing the use of substances or practices they have abused. This can mean relapses and setbacks for patients undergoing treatment. A multidisciplinary team of health professionals specializing in addiction at the Center for Academic Development in Drug Addiction, in Havana, Cuba, cares for people with these disorders and followed their evolution during the initial period of COVID-19 social isolation. With the aim of characterizing strategies employed by patients undergoing treatment for substance abuse and addictions, we conducted a qualitative study from April 2020 through May 2020, using a convenience sample of 37 patients (all students) who had been progressing towards recovery from addictive behaviors when face-to-face encounters were suspended due to COVID-19 restrictions. Contact was maintained through information and communication technologies. The research used telepsychology and focused on understanding patient life experiences. Patients were interviewed using a semi-structured survey, which was then transcribed and coded thematically using a grounded-theory approach. We found that patients' ability to cope successfully with challenges presented by COVID-19 were influenced by: 1) the individual's own methods for maintaining self-control (commitment to studies, projects, and work with therapists) that aided them in their goals concerning abstinence; 2) difficulties faced in addressing specific events and situations (doubts, uncertainties, disagreements, isolation and time use); 3) perpetuation and revivification of myths related to substances and addictive activities (exacerbation of supposed benefits of tobacco, alcohol, marijuana, overuse of social networks); and 4) tendencies toward irrationality and lack of emotional control (fear, sadness, anger, constant worry and self-imposed demands). Our findings suggest that despite the potential negative psychological impact of preventive social isolation during the COVID-19 pandemic, individual coping mechanisms developed by these patients, aiming at improved self-control, allowed most to avoid setbacks that could have affected their recovery. Nevertheless, patients faced challenges to their recovery that were compounded by difficulties in specific situations, myths related to substances and addictive activities, and tendencies toward irrationality or lack of emotional control.

Bacillus coagulans GBI-30, 6068 decreases upper respiratory and gastrointestinal tract symptoms in healthy Mexican scholar-aged children by modulating immune-related proteins.

This randomized, double-blind, parallel and placebo-controlled study aimed to evaluate the effect of Bacillus coagulans GBI-30, 6086® probiotic (GanedenBC30®) against upper respiratory tract infections (URTI) and gastrointestinal tract infections (GITI) in eighty healthy school-aged children (6-8 years old). The participants received daily a sachet containing either GanedenBC30 (1 × 109 colony-forming units) or placebo (maltodextrin) for three months. GanedenBC30 significantly decreased the incidence of URTI symptoms including nasal congestion, bloody nasal mucus, itchy nose, and hoarseness. The duration of the URTI-associated symptoms of hoarseness, headache, red eyes, and fatigue was also decreased. GanedenBC30 supplementation also significantly reduced the incidence rate of flatulence. These beneficial effects were associated with the modulation of serum TNFα, CD163, G-CSF, ICAM-1, IL-6, IL-8, MCP-2, RAGE, uPAR, and PF4. Therefore, probiotic B. coagulans GBI-30, 6086 modulated immune-related proteins in healthy children, decreasing several URTI and GITI symptoms, thus, this functional ingredient may contribute to a healthier lifestyle.

An Intersectoral Intervention to Prevent Early Alcohol Use in Cuban Adolescents.

To encourage development of negative attitudes toward alcohol use and thus prevent early onset of alcohol use, an intersectoral intervention was conducted from 2014 to 2015 among Cuban adolescents in 14 schools in Havana. The intervention included 312 students (189 girls and 123 boys) aged 14 to 15 years in 10th grade of high school or vocational school. Workshops were conducted using participatory techniques and group dynamics. Qualitative methods were applied, including narrative, desiderative and projective techniques. Indicators included attitudes, motivation, interests and perception of risk. Following the intervention, 82.7% (258/312) of participants reported healthy cultural and recreational interests and 61.9% (193/312) reinforced negative attitudes toward drinking. Such interventions can help prevent early onset of alcohol use in school settings. Given the positive results, the intervention is slated to be reproduced in other Cuban provinces. KEYWORDS Adolescents, prevention, alcoholism, attitudes, Cuba.

Risk factors for congenital diaphragmatic hernia in the Bogota birth defects surveillance and follow-up program, Colombia.

PURPOSE: The mortality rate for congenital diaphragmatic hernia (CDH) remains high and prevention efforts are limited by the lack of known risk factors. The aim of this study was to determine prevalence, risk factors, and neonatal results associated with CDH on a surveillance system hospital-based in Bogotá, Colombia. METHODS: The data used in this study were obtained from The Bogota Birth Defects Surveillance and Follow-up Program (BBDSFP), between January 2001 and December 2013. With 386,419 births, there were 81 cases of CDH. A case-control methodology was conducted with 48 of the total cases of CDH and 192 controls for association analysis. RESULTS: The prevalence of CDH was 2.1 per 10,000 births. In the case-control analysis, risk factors found were maternal age ≥35 years (OR, 33.53; 95 % CI, 7.02-160.11), infants with CDH were more likely to be born before 37 weeks of gestation (OR, 5.57; 95 % CI, 2.05-15.14), to weigh less than 2500 g at birth (OR, 9.05; 95 % CI, 3.51-23.32), and be small for gestational age (OR, 5.72; 95 % CI, 2.18-14.99) with a high rate of death before hospital discharge in the CDH population (CDH: 38 % vs BBDSFP: <1 %; p < 0.001). CONCLUSIONS: The prevalence of CDH calculated was similar to the one reported in the literature. CDH is strongly associated with a high rate of death before hospital discharge and the risk factors found were maternal age ≥35 years, preterm birth, be small for gestational age, and have low weight at birth. These neonatal characteristics in developing countries would help to identify early CDH. Prevention efforts have been limited by the lack of known risk factors and established epidemiological profiles, especially in developing countries.

From the boom to the crisis: changes in employment conditions of immigrants in Spain and their effects on mental health.

BACKGROUND: Migrant workers have been one of the groups most affected by the economic crisis. This study evaluates the influence of changes in employment conditions on the incidence of poor mental health of immigrant workers in Spain, after a period of 3 years, in context of economic crisis. METHODS: Follow-up survey was conducted at two time points, 2008 and 2011, with a reference population of 318 workers from Colombia, Ecuador, Morocco and Romania residing in Spain. Individuals from this population who reported good mental health in the 2008 survey (n = 214) were interviewed again in 2011 to evaluate their mental health status and the effects of their different employment situations since 2008 by calculating crude and adjusted odds ratios (aORs) for sociodemographic and employment characteristics. FINDINGS: There was an increased risk of poor mental health in workers who lost their jobs (aOR = 3.62, 95%CI: 1.64-7.96), whose number of working hours increased (aOR = 2.35, 95%CI: 1.02-5.44), whose monthly income decreased (aOR = 2.75, 95%CI: 1.08-7.00) or who remained within the low-income bracket. This was also the case for people whose legal status (permission for working and residing in Spain) was temporary or permanent compared with those with Spanish nationality (aOR = 3.32, 95%CI: 1.15-9.58) or illegal (aOR = 17.34, 95%CI: 1.96-153.23). In contrast, a decreased risk was observed among those who attained their registration under Spanish Social Security system (aOR = 0.10, 95%CI: 0.02-0.48). CONCLUSION: There was an increase in poor mental health among immigrant workers who experienced deterioration in their employment conditions, probably influenced by the economic crisis.

Paracoccidioides brasiliensis PbP27 gene: knockdown procedures and functional characterization.

Paracoccidioides brasiliensis PbP27 gene encodes a protein localized in both the fungal cytoplasm and cell wall. The parasitic infectious form produces this protein preferentially with the gene's expression varying between the fungus phylogenetic species. The biological function of the native p27 has yet to be determined during either growth of the yeast or host infection. Therefore, in this study, through the use of antisense RNA technology and Agrobacterium tumefaciens-mediated transformation, we generated mitotically stable PbP27 mutants (PbP27 aRNA) with the goal to evaluate the role of p27 in the biology and virulence of this fungus. PbP27 expression was reduced 60-75% in mutants, as determined by real-time PCR in correlation with a decrease in p27 expression. No alterations in the growth curve or in the ability to shift from mycelia to yeast or from yeast to mycelia were observed in PbP27 aRNA strains; however, we did observe a reduction in cell vitality. Moreover, a decrease in cell viability of PbP27 aRNA yeast cells after interaction with IFN-γ-stimulated macrophages was detected. Based on these results, we propose that p27 plays a role in yeast cell architecture and represents one of the mechanisms employed by this fungus for its interaction with the monocyte/macrophage system.

Inhibition of PbGP43 expression may suggest that gp43 is a virulence factor in Paracoccidioides brasiliensis.

Glycoprotein gp43 is an immunodominant diagnostic antigen for paracoccidioidomycosis caused by Paracoccidioides brasiliensis. It is abundantly secreted in isolates such as Pb339. It is structurally related to beta-1,3-exoglucanases, however inactive. Its function in fungal biology is unknown, but it elicits humoral, innate and protective cellular immune responses; it binds to extracellular matrix-associated proteins. In this study we applied an antisense RNA (aRNA) technology and Agrobacterium tumefaciens-mediated transformation to generate mitotically stable PbGP43 mutants (PbGP43 aRNA) derived from wild type Pb339 to study its role in P. brasiliensis biology and during infection. Control PbEV was transformed with empty vector. Growth curve, cell vitality and morphology of PbGP43 aRNA mutants were indistinguishable from those of controls. PbGP43 expression was reduced 80-85% in mutants 1 and 2, as determined by real time PCR, correlating with a massive decrease in gp43 expression. This was shown by immunoblotting of culture supernatants revealed with anti-gp43 mouse monoclonal and rabbit polyclonal antibodies, and also by affinity-ligand assays of extracellular molecules with laminin and fibronectin. In vitro, there was significantly increased TNF-α production and reduced yeast recovery when PbGP43 aRNA1 was exposed to IFN-γ-stimulated macrophages, suggesting reduced binding/uptake and/or increased killing. In vivo, fungal burden in lungs of BALB/c mice infected with silenced mutant was negligible and associated with decreased lung ΙΛ-10 and IL-6. Therefore, our results correlated low gp43 expression with lower pathogenicity in mice, but that will be definitely proven when PbGP43 knockouts become available. This is the first study of gp43 using genetically modified P. brasiliensis.

Impact of economic crisis on mental health of migrant workers: what happened with migrants who came to Spain to work?

OBJECTIVES: To assess changes in mental health in a sample of migrant workers after the eruption of the economic crisis in Spain. METHODS: 318 migrant workers were interviewed. Mental health, sociodemographic, and economic crisis related variables were obtained through face-to-face (2008) and phone (2011) interviews. Prevalence of poor mental health (PMH) was compared (2011-2008) and multivariate logistic regression models were fitted. RESULTS: Change in prevalence of PMH was higher in men (aOR 4.63; 95 % CI 2.11-10.16). Subgroups of men showing the largest detrimental mental health effects were: unemployed, with low salaries (≤1,200 euros) and those reporting family burden. An increase of PMH was found in women, without significant associations. CONCLUSIONS: Mental health of migrant workers in Spain has worsened during the economic crisis.

From questionnaire to database: field work experience in the 'Immigration, work and health survey' (ITSAL Project).

OBJECTIVE: Despite the need for information in the area of migration and health, the available data are sparse. We describe the field work in a cross-sectional study on the health of immigrant workers in Spain. METHOD: A convenience sample of workers from Colombia, Ecuador, Morocco and Rumania in four cities was targeted, using a block-walking approach. The outcome rates of the American Association of Public Opinion Research were estimated. RESULTS: Of 6,504 persons approached, 71.4% were eligible contacts. Of these contacts, only 57.8% completed interviews. Response and cooperation rates were above 50%. CONCLUSIONS: Block-walking enabled surveyors to access difficult-to-reach groups. The use of specifically trained surveyors with a background similar to that of the target population increased the effectiveness of our methods.

The effect of perceived discrimination on the health of immigrant workers in Spain.

BACKGROUND: Discrimination is an important determinant of health inequalities, and immigrants may be more vulnerable to certain types of discrimination than the native-born. This study analyses the relationship between immigrants' perceived discrimination and various self-reported health indicators. METHODS: A cross-sectional survey was conducted (2008) amongst a non-random sample of 2434 immigrants from Ecuador, Morocco, Romania and Colombia in four Spanish cities: Barcelona, Huelva, Madrid and Valencia. A factorial analysis of variables revealed three dimensions of perceived discrimination (due to immigrant status, due to physical appearance, and workplace-related). The association of these dimensions with self-rated health, mental health (GHQ-12), change in self-rated health between origin and host country, and other self-reported health outcomes was analysed. Logistic regression was used adjusting for potential confounders (aOR-95%CI). Subjects with worsening self-reported health status potentially attributable to perceived discrimination was estimated (population attributable proportion, PAP %). RESULTS: 73.3% of men and 69.3% of women immigrants reported discrimination due to immigrant status. Moroccans showed the highest prevalence of perceived discrimination. Immigrants reporting discrimination were at significantly higher risk of reporting health problems than those not reporting discrimination. Workplace-related discrimination was associated with poor mental health (aOR 2.97 95%CI 2.45-3.60), and the worsening of self-rated health (aOR 2.20 95%CI 1.73- 2.80). 40% (95% CI 24-53) PAP of those reporting worse self-rated health could be attributable to discrimination due to immigrant status. CONCLUSIONS: Discrimination may constitute a risk factor for health in immigrant workers in Spain and could explain some health inequalities among immigrant populations in Spanish society.

Gene expression analysis of Paracoccidioides brasiliensis transition from conidium to yeast cell.

Paracoccidioides brasiliensis infectious process relies on the initial expression of virulence factors that are assumed to be controlled by molecular mechanisms through which the conidia and/or mycelial fragments convert to yeast cells. In order to analyze the profile of the thermally-induced dimorphic gene expression, 48 h C-L transition cultures which had been incubated at 36 degrees C were studied. By this time approximately 50% of the conidial population had already reverted to yeast form cells. At this transition time, an EST-Orestes library was constructed and characterized. As a result, 79 sequences were obtained, of which 39 (49.4%) had not been described previously in other libraries of this fungus and which could represent novel exclusive C-Y transition genes. Two of these sequences are, among others, cholestanol delta-isomerase, and electron transfer flavoprotein-ubiquinoneoxidoreductase (ETF-QO). The other 40/79 (50.6%) sequences were shared with Mycelia (M), Yeast (Y) or Mycelia to yest transition (M-Y) libraries. An important component of this group of sequences is a putative response regulator receiver SKN7, a protein of high importance in stress adaptation and a regulator of virulence in some bacteria and fungi. This is the first report identifying genes expressed during the C-Y transition process, the initial step required to understand the natural history of P. brasiliensis conidia induced infection.

[Precarious employment in undocumented immigrants in Spain and its relationship with health]. / La precariedad laboral en inmigrantes en situación irregular en España y su relación con la salud.

OBJECTIVE: To describe the characteristics of precarious employment in undocumented immigrants in Spain and its relationship with health. METHODS: A qualitative study was conducted using analytic induction. Criterion sampling, based on the Immigration, Work and Health project (Inmigración, Trabajo y Salud [ITSAL]) criterion (current definitions of 'legal immigrant' in Spain and in the literature) was used to recruit 44 undocumented immigrant workers from four different countries, living in four Spanish cities. RESULTS: The characteristics of precariousness perceived by undocumented immigrants included high job instability; disempowerment due to lack of legal protection; high vulnerability exacerbated by their legal and immigrant status; perceived insufficient wages and lower wages than coworkers; limited social benefits and difficulty in exercising their rights; and finally, long hours and fast-paced work. Our informants reported they had no serious health problems but did describe physical and mental problems associated with their employment conditions and legal situation. CONCLUSIONS: Our results suggest that undocumented immigrants' situation may not fit the model of precarious employment exactly. However, the model's dimensions can be expanded to better represent undocumented immigrants' situation, thus strengthening the general model. Precarious employment in this group can be defined as <>, as it affects their working and social lives. If these workers continue to be exposed to such precarious conditions, the impact on their health may increase.

Discrimination, work and health in immigrant populations in Spain.

One of the most important social phenomena in the global context is the flow of immigration from developing countries, motivated by economic and employment related issues. Discrimination can be approached as a health risk factor within the immigrant population's working environment, especially for those immigrants at greater risk from social exclusion and marginalisation. The aim of this study is to research perceptions of discrimination and the specific relationship between discrimination in the workplace and health among Spain's immigrant population. A qualitative study was performed by means of 84 interviews and 12 focus groups held with immigrant workers in five cities in Spain receiving a large influx of immigrants (Madrid, Barcelona, Valencia, Alicante and Huelva), covering representative immigrant communities in Spain (Romanians, Moroccans, Ecuadorians, Colombians and Sub-Saharan Africans). Discourse narrative content analysis was performed using pre-established categories and gradually incorporating other emerging categories from the immigrant interviewees themselves. The participants reported instances of discrimination in their community and working life, characterised by experiences of racism, mistreatment and precarious working conditions in comparison to the Spanish-born population. They also talked about limitations in terms of accessible occupations (mainly construction, the hotel and restaurant trade, domestic service and agriculture), and described major difficulties accessing other types of work (for example public administration). They also identified political and legal structural barriers related with social institutions. Experiences of discrimination can affect their mental health and are decisive factors regarding access to healthcare services. Our results suggest the need to adopt integration policies in both the countries of origin and the host country, to acknowledge labour and social rights, and to conduct further research into individual and social factors that affect the health of the immigrant populations.

Use of AFLP and RAPD molecular genetic markers and cytogenetic analysis to explore relationships among taxa of the Patagonian Bromus setifolius complex.

Bromus setifolius var. pictus (Hook) Skottsb., B. setifolius var. setifolius Presl. and B.setifolius var. brevifolius Ness are three native Patagonian taxa in the section Pnigma Dumort of the genus Bromus L. AFLP and RAPD analysis, in conjunction with genetic distance measurements and statistical techniques, revealed variation within this group and indicated that B. setifolius var. brevifolius was closely related to B. setifolius var. pictus, with both taxa being more distantly related to B. setifolius var. setifolius. Cytogenetic analysis confirmed the chromosomal number of B. setifolius var. pictus (2n = 70) and B. setifolius var. setifolius (2n = 28) and showed for the first time that B. setifolius var. brevifolius had 2n = 70. The combination of molecular genetic and cytogenetic evidence supported a species status for two of the three taxa and suggested hypotheses for the evolutionary origin of these complex taxa. Species status was also indicated for B. setifolius var. setifolius. Based on these findings, we suggest that B. setifolius var. pictus be referred to as B. pictus Hook var. pictus, and B. setifolius var brevifolius as B. pictus Hook var brevifolius. The correlation between AFLP diversity and variation in ecological parameters suggested that this marker system could be used to assess breeding progress and to monitor the domestication of Patagonian Bromus species for agronomic use.

Use of AFLP and RAPD molecular genetic markers and cytogenetic analysis to explore relationships among taxa of the Patagonian Bromus setifolius complex

Bromus setifolius var. pictus (Hook) Skottsb., B. setifolius var. setifolius Presl. and B. setifolius var. brevifolius Ness are three native Patagonian taxa in the section Pnigma Dumort of the genus Bromus L. AFLP and RAPD analysis, in conjunction with genetic distance measurements and statistical techniques, revealed variation within this group and indicated that B. setifolius var. brevifolius was closely related to B. setifolius var. pictus, with both taxa being more distantly related to B. setifolius var. setifolius. Cytogenetic analysis confirmed the chromosomal number of B. setifolius var. pictus (2n = 70) and B. setifolius var. setifolius (2n = 28) and showed for the first time that B. setifolius var. brevifolius had 2n = 70. The combination of molecular genetic and cytogenetic evidence supported a species status for two of the three taxa and suggested hypotheses for the evolutionary origin of these complex taxa. Species status was also indicated for B. setifolius var. setifolius. Based on these findings, we suggest that B. setifolius var. pictus be referred to as B. pictus Hook var. pictus, and B. setifolius var brevifolius as B. pictus Hook var brevifolius. The correlation between AFLP diversity and variation in ecological parameters suggested that this marker system could be used to assess breeding progress and to monitor the domestication of Patagonian Bromus species for agronomic use.

Prevalencia de caries y alteraciones dentales en niños con labio fisurado y paladar hendido de una fundación de Santiago de Cali / Caries and dental alteration prevalence in cleft lip and palate children in a fundation of Santiago de Cali

Objetivo: Determinar las alteraciones dentales y la prevalecía de caries en niños de 3 a 14 años con labio fisurado y paladar hendido en una Fundación de la ciudad de Santiago de Cali en el 2007.Materiales y métodos: Se realizó un estudio de tipo Observacional descriptivo de corte transversal, en una población de estudio de 30 niños con labio fisurado y paladar hendido entre los 3 y 14 años, que asistían a la fundación operación sonrisa. La recolección de información se realizo mediante una encuesta y un examen clínico analizando caries dental, alteraciones dentarias, y adicional a esto un índice de placa, utilizando el Índice de Higiene oral Simplificado (IHO-S). Resultados: Se encontró que el 100% de la población presentaban alteraciones dentarias, siendo las mas frecuentes apiñamiento con un 70% y anodoncia con 63.3%, para caries dental se encontró una frecuencia del 90% en la población presentando al menos una lesión. Conclusiones: El estrato socioeconómico alto no estuvo presente en la población. La raza blanca fue la que mas se presento en la investigación. La población presento alteraciones dentarias de tamaño, forma y número; Donde el apiñamiento se observo en mayor proporción, en el sexo masculino y la dentición temporal. La caries dental se presento en la mayoría de niños aunque se presento bajo el índice de placa bacteriana; lo cual se puede explicar por los altos porcentajes de Hipoplasia y apiñamientp. La caries se presenta en similar proporción en ambos sexos, y es más frecuente cuando la erupción de estos niños es retardada.

Objective: To de termine the caries and dental alteration prevalence in cleft lip and palate in 3 to 14 years old children in a fundation of Santiago de Cali in 2007. Materials and methods: A sample of 30 children were studied with fissured lip and cleft palate among 3 and 14 years old who were attended by the foundation Smile Operation. The gathering of information was done by a survey and a clinical exam analyzing dental caries, alterations and addition to this a plaque index, using the simplified index of oral Hygiene (SIOH). Results: All of children presented dental alterations, the most frequent alteration was close together teeth in 70% follow of congenitally missing teeth in 63.3%, also dental caries was 90% in the population presenting least one lesion. Conclusions: High socioeconomic level was not present in this sample, and we only conclude for low socioeconomic level. the most of population were white people, all subjects present dental alteration, in dental size, form and amount. Instead low dental plaque index were found in most of children, the experience of caries was high, and in equal proportions in boys and gils.