High-Throughput Identification of Crystalline Natural Products from Crude Extracts Enabled by Microarray Technology and microED.

The structural determination of natural products (NPs) can be arduous because of sample heterogeneity. This often demands iterative purification processes and characterization of complex molecules that may be available only in miniscule quantities. Microcrystal electron diffraction (microED) has recently shown promise as a method to solve crystal structures of NPs from nanogram quantities of analyte. However, its implementation in NP discovery remains hampered by sample throughput and purity requirements, akin to traditional NP-discovery workflows. In the methods described herein, we leverage the resolving power of transmission electron microscopy (TEM) and the miniaturization capabilities of deoxyribonucleic acid (DNA) microarray technology to address these challenges through the establishment of an NP screening platform, array electron diffraction (ArrayED). In this workflow, an array of high-performance liquid chromatography (HPLC) fractions taken from crude extracts was deposited onto TEM grids in picoliter-sized droplets. This multiplexing of analytes on TEM grids enables 1200 or more unique samples to be simultaneously inserted into a TEM instrument equipped with an autoloader. Selected area electron diffraction analysis of these microarrayed grids allows for the rapid identification of crystalline metabolites. In this study, ArrayED enabled structural characterization of 14 natural products, including four novel crystal structures and two novel polymorphs, from 20 crude extracts. Moreover, we identify several chemical species that would not be detected by standard mass spectrometry (MS) or ultraviolet-visible (UV/vis) spectroscopy and crystal forms that would not be characterized using traditional methods.

Crystalline analysis of dental enamel by X-Ray diffraction on pediatric patients with chronic kidney disease.

This study aimed to analyze the crystalline structure of dental enamel in pediatric patients with chronic kidney disease (CKD) by X-ray diffraction (XRD). The six tested samples had a mineral composition similar to hydroxyapatite, according to sheet JCPDS(Joint Committee on Powder Diffraction Standards) card #09-0432, which is normally found in dentine, and presented a lower amount of whitlockites (Ca, Mg)3(PO4)2. Pattern phases showed an increase in organic matter and a decrease in inorganic matter. At an interval of approximately 2θ = 15.7° to 27.2°, amorphous organic matter corresponding to hydrated glucose was found. The hydroxyapatite patterns in this study differed from that of dental enamel found on permanent teeth.

[Grief and palliative home-care services for patients at the end of life during the COVID-19 pandemic in Colombia. Analysis from the relatives´ perspective]. / Duelo y atención domiciliaria para pacientes al final de la vida durante la pandemia por COVID-19 en Colombia.Análisis desde la perspectiva de familiares.

INTRODUCTION: End-of-life care is one of the most crucial experiences for both the patient and their loved ones. However, as a result of the changes generated by the COVID 19 pandemic, the dynamics of the end-of-life process has undergone changes at both the family, social and health levels. In turn, this has altered the perception and development of the grief of relatives of patients who died during the pandemic regardless of the cause of death. Then, the aim of this study is to analyze the perceptions and some aspects of bereavement of died patients` relatives during the pandemic of Covid 19. METHODS: Through the admission evaluation and follow-up of the relatives with an adapted version of the international Care Of the Dying Evaluation (iCODE) questionnaire. RESULTS: 239 relatives were surveyed, of which 112 completed the follow-up questionnaire. Most of the patients died at home and their family members were highly involved in their care. Medical attention was considered adequate and the symptom with the highest perception was pain. 87% of those surveyed participated in funeral rites, and 42% rated them as very sober. Regarding grief, the scale of personal growth predominates, however, in the negative aspects, the feeling of pressure in the chest and frequent crying predominates. CONCLUSIONS: The end of life of home-care patients during the pandemic was perceived as adequate, allowing family support and symptom control. The grieving process shows no complications. The training of health professionals in these fundamental aspects of patient care is important.

A multidisciplinary approach to the Biobank concept: integrative review. / Abordaje multidisciplinar del concepto Biobanco: revisión integrativa.

Biobanks are multidisciplinary infrastructures and, accordingly, this integrative research seeks to bring out the concept of biobank in the various sciences that construct and interpret it, so as to arrive at a holistic understanding of its essential components. This integrative review - guided by PRISMA and with quality assessment following CASPe - resulted in a selection of 30 articles. Data were analysed by Aristotelian categories and the results were interpreted on the complexity paradigm of Edgar Morin. The biobank concept was clarified by considering it to be the representation of a biological, social and cultural phenomenon in which knowledge and practices from diverse scientific fields enter into complementary, antagonistic and ambiguous types of relationship. This network of signification, analysed here using categories from Aristotelian philosophy, has impacts on the construction of subjectivity and forms of socialisation.

Los biobancos son infraestructuras multidisciplinares y esta investigación integradora pretende exponer su concepto a las diferentes ciencias que lo construyen e interpretan, para entender sus elementos esenciales de forma holística. La revisión integradora se realizó siguiendo la guía PRISMA y la evaluación de la calidad según CASPe dando como resultado un total de 30 trabajos. El análisis de los datos se realizó a través de las categorías aristotélicas y los resultados se interpretaron según el paradigma de la complejidad de Edgar Morin. El concepto de Biobanco fue aclarado al considerarlo como la representación de un fenómeno bio-socio-cultural en el que los campos científicos desarrollan relaciones de tipo: complementarias, antagónicas y ambiguas de conocimientos y prácticas. Esta red de significación, desde la filosofía, impacta en la construcción de la subjetividad y en las formas de socialización.

Abordaje multidisciplinar del concepto Biobanco: revisión integrativa / A multidisciplinary approach to the Biobank concept: integrative review

Resumen Los biobancos son infraestructuras multidisciplinares y esta investigación integradora pretende exponer su concepto a las diferentes ciencias que lo construyen e interpretan, para entender sus elementos esenciales de forma holística. La revisión integradora se realizó siguiendo la guía PRISMA y la evaluación de la calidad según CASPe dando como resultado un total de 30 trabajos. El análisis de los datos se realizó a través de las categorías aristotélicas y los resultados se interpretaron según el paradigma de la complejidad de Edgar Morin. El concepto de Biobanco fue aclarado al considerarlo como la representación de un fenómeno bio-socio-cultural en el que los campos científicos desarrollan relaciones de tipo: complementarias, antagónicas y ambiguas de conocimientos y prácticas. Esta red de significación, desde la filosofía, impacta en la construcción de la subjetividad y en las formas de socialización.

Abstract Biobanks are multidisciplinary infrastructures and, accordingly, this integrative research seeks to bring out the concept of biobank in the various sciences that construct and interpret it, so as to arrive at a holistic understanding of its essential components. This integrative review - guided by PRISMA and with quality assessment following CASPe - resulted in a selection of 30 articles. Data were analysed by Aristotelian categories and the results were interpreted on the complexity paradigm of Edgar Morin. The biobank concept was clarified by considering it to be the representation of a biological, social and cultural phenomenon in which knowledge and practices from diverse scientific fields enter into complementary, antagonistic and ambiguous types of relationship. This network of signification, analysed here using categories from Aristotelian philosophy, has impacts on the construction of subjectivity and forms of socialisation.

New susceptibility loci for severe COVID-19 by detailed GWAS analysis in European populations

Given the highly variable clinical phenotype of Coronavirus disease 2019 (COVID-19), a deeper analysis of the host genetic contribution to severe COVID-19 is important to improve our understanding of underlying disease mechanisms. Here, we describe an extended GWAS meta-analysis of a well-characterized cohort of 3,260 COVID-19 patients with respiratory failure and 12,483 population controls from Italy, Spain, Norway and Germany/Austria, including stratified analyses based on age, sex and disease severity, as well as targeted analyses of chromosome Y haplotypes, the human leukocyte antigen (HLA) region and the SARS-CoV-2 peptidome. By inversion imputation, we traced a reported association at 17q21.31 to a highly pleiotropic [~]0.9-Mb inversion polymorphism and characterized the potential effects of the inversion in detail. Our data, together with the 5th release of summary statistics from the COVID-19 Host Genetics Initiative, also identified a new locus at 19q13.33, including NAPSA, a gene which is expressed primarily in alveolar cells responsible for gas exchange in the lung.

Stroke etiologies in patients with COVID-19: the SVIN COVID-19 multinational registry.

BACKGROUND AND PURPOSE: Coronavirus disease 2019 (COVID-19) is associated with a small but clinically significant risk of stroke, the cause of which is frequently cryptogenic. In a large multinational cohort of consecutive COVID-19 patients with stroke, we evaluated clinical predictors of cryptogenic stroke, short-term functional outcomes and in-hospital mortality among patients according to stroke etiology. METHODS: We explored clinical characteristics and short-term outcomes of consecutively evaluated patients 18 years of age or older with acute ischemic stroke (AIS) and laboratory-confirmed COVID-19 from 31 hospitals in 4 countries (3/1/20-6/16/20). RESULTS: Of the 14.483 laboratory-confirmed patients with COVID-19, 156 (1.1%) were diagnosed with AIS. Sixty-one (39.4%) were female, 84 (67.2%) white, and 88 (61.5%) were between 60 and 79 years of age. The most frequently reported etiology of AIS was cryptogenic (55/129, 42.6%), which was associated with significantly higher white blood cell count, c-reactive protein, and D-dimer levels than non-cryptogenic AIS patients (p

Growth and Puberty in a 2-Year Open-Label Study of Lisdexamfetamine Dimesylate in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder.

BACKGROUND: Stimulant medications for the treatment of attention-deficit/hyperactivity disorder have a history of safe and effective use; however, concerns exist that they may adversely affect growth trajectories in children and adolescents. OBJECTIVE: The objective of this study was to evaluate the longer-term effects of lisdexamfetamine dimesylate on weight, height, body mass index and pubertal development in children and adolescents with attention-deficit/hyperactivity disorder. METHODS: Children and adolescents aged 6-17 years with attention-deficit/hyperactivity disorder took open-label lisdexamfetamine dimesylate (30, 50 or 70 mg/day) in this open-label 2-year safety and efficacy study. Safety evaluations included treatment-emergent adverse events, measurement of weight, height and body mass index, and self-reported pubertal status using Tanner staging. RESULTS: The safety analysis population comprised all enrolled participants (N = 314) and 191 (60.8%) completed the study. Weight decrease was reported as a treatment-emergent adverse event in 63 participants (20.1%) and two participants (0.6%) discontinued the study as a result of treatment-emergent adverse events of weight decrease. Growth retardation of moderate intensity was reported as a treatment-emergent adverse event for two participants. From baseline to the last on-treatment assessment, there were increases in mean weight of 2.1 kg (standard deviation 5.83) and height of 6.1 cm (standard deviation 4.90), and a body mass index decrease of 0.5 kg/m2 (standard deviation 1.72). Mean weight, height and body mass index z-scores decreased over the first 36 weeks of the study and then stabilised. Changes from baseline to the last on-treatment assessment in mean z-scores for weight, height and body mass index were significantly less than zero (- 0.51, - 0.24 and - 0.59, respectively; nominal p < 0.0001). The proportion of participants with a z-score of < - 1 ranged from 5.1% (baseline) to 22.1% (week 84) for weight, 8.2% (baseline) to 12.6% (week 96) for height, and 8.3% (baseline) to 28.8% (week 96) for body mass index. Thirteen participants (4.1%) shifted to a weight below the fifth percentile at the last on-treatment assessment from a higher weight category at baseline. At the last on-treatment assessment, most participants remained at their baseline Tanner stage or had shifted higher. CONCLUSIONS: Findings from this comprehensive examination of growth outcomes associated with lisdexamfetamine dimesylate treatment over 2 years were consistent with previous studies of stimulant medications. Whilst mean weight and height increased over the course of the study, there was a small but transient reduction in mean weight, height and body mass index z-scores. A small increase in the proportion of participants in the lowest weight and body mass index categories highlights the importance of the regular monitoring of weight and height. There was no evidence of delayed onset of puberty. CLINICALTRIALS. GOV IDENTIFIER: NCT01328756.

Long-Term Safety and Efficacy of Lisdexamfetamine Dimesylate in Children and Adolescents with ADHD: A Phase IV, 2-Year, Open-Label Study in Europe.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is increasingly recognized as a persistent disorder requiring long-term management. OBJECTIVES: Our objective was to evaluate the 2-year safety and efficacy of lisdexamfetamine dimesylate (LDX) in children and adolescents with ADHD. METHODS: Participants (aged 6-17 years) with ADHD received open-label, dose-optimized LDX 30, 50, or 70 mg/day for 104 weeks. Safety monitoring included treatment-emergent adverse events (TEAEs), vital signs, electrocardiography, and growth. The TEAEs decreased appetite, weight decrease, insomnia events (including insomnia, initial insomnia, middle insomnia, and terminal insomnia), headache, and psychiatric TEAEs were pre-defined as being of special interest. Efficacy was assessed as a secondary objective using the ADHD Rating Scale IV (ADHD-RS-IV), the Clinical Global Impressions-Improvement (CGI-I) scale, and the CGI-Severity (CGI-S) scale. RESULTS: Of 314 participants enrolled, 191 completed the study. TEAEs were reported in 89.8% of participants, led to discontinuation in 12.4%, and were reported as serious in 8.9%. TEAEs that were reported by ≥5% of participants and considered by investigators as related to LDX were decreased appetite (49.4%), weight decrease (18.2%), insomnia (13.1%), initial insomnia (8.9%), irritability (8.6%), nausea (6.7%), headache (5.7%), and tic (5.1%). The median time to first onset and duration, respectively, of TEAEs of special interest were as follows: decreased appetite, 13.5 and 169.0 days; weight decrease, 29.0 and 225.0 days; insomnia, 17.0 and 42.8 days; and headache, 22.0 and 2.0 days. Reports of decreased appetite, weight decrease, insomnia, and headache were highest in the first 4-12 weeks. Psychiatric TEAEs were infrequent: psychosis and mania (n = 1), suicidal events (suicidal ideation, n = 2; suicide attempt, n = 1), and aggression events (aggression, n = 14; anger, n = 2; hostility, n = 1). At the last on-treatment assessment (LOTA), mean increases from baseline in vital signs were as follows: pulse rate, 7.0 bpm (95% confidence interval [CI] 5.7-8.2); systolic blood pressure (SBP), 3.4 mmHg (95% CI 2.2-4.5); and diastolic blood pressure (DBP), 3.2 mmHg (95% CI 2.2-4.2). Pre-defined thresholds for a potentially clinically important (PCI) high pulse rate were met at one or more visits by 22 participants (7.0%), for PCI high SBP were met by 45 children (22.4%) and 17 adolescents (15.2%), and for PCI high DBP were met by 78 children (38.8%) and 24 adolescents (21.4%). The mean QT interval corrected using Fridericia's formula (QTcF) decreased from baseline to LOTA (-0.6 ms [95% CI -2.3 to 1.2]; range -50 to +53). Mean changes in growth from baseline to LOTA were weight, 2.1 kg (95% CI 1.5-2.8); height, 6.1 cm (95% CI 5.6-6.7); and body mass index (BMI), -0.5 kg/m2 (95% CI -0.7 to -0.3). There was a general shift to lower z score categories for height, weight, and BMI from baseline to LOTA. The mean change in ADHD-RS-IV from baseline to LOTA was -25.8 (95% CI -27.0 to -24.5) for total score, -12.6 (95% CI -13.4 to -11.9) for the hyperactivity/impulsivity subscale score, and -13.1 (95% CI -13.8 to -12.4) for the inattention subscale score. At LOTA, 77.9% of participants had a CGI-I score of 1 or 2. In addition, 77.3 and 69.2% of participants were classified as treatment responders, based on a CGI-I score of 1 or 2 and a ≥30% or ≥50% reduction from baseline in ADHD-RS-IV total score, respectively. CONCLUSIONS: The safety profile of LDX in this longer-term study was similar to that reported in previous studies. The efficacy of LDX was maintained throughout the 2-year study period. CLINICALTRIALS. GOV IDENTIFIER: NCT01328756.

Hipertensión arterial y auriculoterapia / Arterial hypertension and auricular therapy

La hipertensión arterial es uno de los principales factores de riesgo cardiovascular; la tendencia mundial al incremento de la expectativa de vida ha propiciado un tránsito mayor al envejecimiento y simultáneamente un incremento de su prevalencia. Las evidencias científicas para apoyar la efectividad de la auriculoterapia en el tratamiento de esta enfermedad resultan aparentemente insuficientes, por lo que muchos profesionales de la salud la desestiman, lo que dio motivo a realizar un trabajo de revisión de la literatura científica, con el objetivo de abordar aspectos relacionados con la aplicación de la auriculoterapia en el tratamiento de la hipertensión arterial, así como esclarecer los mecanismos a través de los cuales reduce la presión sanguínea. Se encontró que en la genesis de la hipertensión arterial intervienen lesiones por plenitud calurosa, o exceso de Yang de hígado, y por calor por vacío, o deficiencia del Yin de riñón. El efecto corrector de la auriculoterapia sobre la hipertensión arterial se explica a través de mecanismos neurológicos, humorales y bioeléctricos que producen sedación, vasodilatación, diuresis e hipotensión; entre los puntos de la auriculopuntura más utilizados en el tratamiento de la hipertensión arterial se incluyen: shenmen auricular, hipertensión arterial 1 y 2, corazón e hígado. Se hacen algunas consideraciones sobre el tema (AU)

Hypertension is one of the main cardiovascular risk factors; the worldwide tendency to increase life expectation has brought about a greater transit to aging, and at the same time, an increase of its prevalence. The scientific evidence to support the effectiveness of auricular therapy for the treatment of the disease is insufficient and many health-care professionals underestimate it, which led to carry out a revision of the scientific literature with the objective of dealing with some aspects related to the application of auricular therapy for the treatment of hypertension, as well as to elucidate the mechanisms by which it reduces blood pressure. It was found that in the genesis of hypertension there are lesions due to hot plenitude or liver yang excess and because of heat by vacuum or kidney yin deficiency. The corrective effect of auricular therapy on hypertension is explained by means of neurological, humoral and bioelectric mechanisms that produce sedation, vasodilatation, diuresis and hypotension. Among the most used auricular acupuncture points for the treatment of hypertension are: auricular shenmen, hypertension 1 and 2, heart and liver. Some considerations about the topic are carried out in this work (AU)

The Manchester-Fothergill and the Elevate Posterior technique for the correction of a cervical elongation and large enterocele in a patient with bladder exstrophy and multiple surgeries.

INTRODUCTION AND HYPOTHESIS: A 60-year-old woman presented with congenital bladder exstrophy, urinary incontinence since birth, and pelvic organ prolapse since the menopause at the age of 46 years. METHODS: The patient (gravida 2, para 2 by cesarean sections and tubal ligation) described an extensive past surgical history that included epispadias and neourethral procedures, anti-reflux surgery using the Lich-Grégoir technique, bilateral ureterosigmoidostomy achieving continence, uterine fixation after the Doléris operation, and neovaginal reconstruction. The physical examination revealed a fourth-degree enterocele with cervical elongation (POP-Q: Aa-2, Ba-2, C + 3, D + 4, gh:5, pb:2.5, Tvl:6, Ap + 3, Bp +6). Gynecological ultrasound and uro-CT were performed to ensure that the ureterosigmoidostomy had been successful, and CT-based 3D bone reconstructions were obtained to calculate the distance between the pubic rami and the ischial spines. Based on a literature review of the management options for these patients and the specific characteristics of our patient, a decision was made to perform trachelectomy (the Manchester technique with Fothergill stitches) and a polypropylene mesh placement with sacrospinous ligament anchor (Elevate Posterior® PC, AMS). RESULTS: Six months after the surgery, we observed good anatomical and functional results with significant improvement in the patient's quality-of-life scale score. CONCLUSION: We believed that the vaginal approach was minimally invasive with a low risk of morbidity in our patient, who had a very altered anatomy, but produced a satisfactory functional result.

Inteligência e contágio emocional: um estudo com trabalhadores brasileiros e angolanos / Emotional intelligence and contagion: a study with Brazilian and Angolan workers

O estudo comparou trabalhadores brasileiros e angolanos em relação à inteligência emocional e ao contágio de emoções, considerando função gerencial, sexo e nível educacional. Participaram 431 trabalhadores, sendo 300 do Brasil e 131 de Angola, 71,5% com ensino superior, 37,8% exercendo função gerencial e idade média de 30 anos. Utilizou-se um survey eletrônico. Os resultados indicaram diferenças entreos países quanto à inteligência, mas não ao contágio. No Brasil, mulheres e gestores obtiveram médias mais elevadas de inteligência emocional, e em Angola, mulheres com ensino superior apresentaram maiores médias de inteligência emocional. Em relação ao contágio de emoções positivas, mulheres gestoras com ensino superior se contagiam menos que homens na mesma posição. Encontraram-se correlações positivas entre inteligência emocional e contágio

This study compared Brazilian and Angolan workers in emotional intelligence and contagion, considering their managerial position, sex, and educational level. Participants were 431 workers, 300 from Brazil and 131 from Angola, 71.5% with a higher education, 37.8% in a management position, and a mean age of 30 years. They answered an electronic questionnaire. Results indicate there are differences in emotional intelligence, but no differences were found for contagion. In Brazil women and managers had higher average of emotional intelligence mean while in Angola women with a higher education had higher average of emotional intelligence. For the contagion of positive emotions, women managers with a higher education were less contagioned than men managers. The results showed positive correlations between emotional intelligence and contagion

Inteligência e contágio emocional: um estudo com trabalhadores brasileiros e angolanos / Emotional intelligence and contagion: a study with Brazilian and Angolan workers

O estudo comparou trabalhadores brasileiros e angolanos em relação à inteligência emocional e ao contágio de emoções, considerando função gerencial, sexo e nível educacional. Participaram 431 trabalhadores, sendo 300 do Brasil e 131 de Angola, 71,5% com ensino superior, 37,8% exercendo função gerencial e idade média de 30 anos. Utilizou-se um surveyeletrônico. Os resultados indicaram diferenças entreos países quanto à inteligência, mas não ao contágio. No Brasil, mulheres e gestores obtiveram médias mais elevadas de inteligência emocional, e em Angola, mulheres com ensino superior apresentaram maiores médias de inteligência emocional. Em relação ao contágio de emoções positivas, mulheres gestoras com ensino superior se contagiam menos que homens na mesma posição. Encontraram-se correlações positivas entre inteligência emocional e contágio(AU)

Efficacy of lisdexamfetamine dimesylate throughout the day in children and adolescents with attention-deficit/hyperactivity disorder: results from a randomized, controlled trial.

Lisdexamfetamine dimesylate (LDX) is a long-acting, prodrug stimulant therapy for patients with attention-deficit/hyperactivity disorder (ADHD). This randomized placebo-controlled trial of an optimized daily dose of LDX (30, 50 or 70 mg) was conducted in children and adolescents (aged 6-17 years) with ADHD. To evaluate the efficacy of LDX throughout the day, symptoms and behaviors of ADHD were evaluated using an abbreviated version of the Conners' Parent Rating Scale-Revised (CPRS-R) at 1000, 1400 and 1800 hours following early morning dosing (0700 hours). Osmotic-release oral system methylphenidate (OROS-MPH) was included as a reference treatment, but the study was not designed to support a statistical comparison between LDX and OROS-MPH. The full analysis set comprised 317 patients (LDX, n = 104; placebo, n = 106; OROS-MPH, n = 107). At baseline, CPRS-R total scores were similar across treatment groups. At endpoint, differences (active treatment - placebo) in least squares (LS) mean change from baseline CPRS-R total scores were statistically significant (P < 0.001) throughout the day for LDX (effect sizes: 1000 hours, 1.42; 1400 hours, 1.41; 1800 hours, 1.30) and OROS-MPH (effect sizes: 1000 hours, 1.04; 1400 hours, 0.98; 1800 hours, 0.92). Differences in LS mean change from baseline to endpoint were statistically significant (P < 0.001) for both active treatments in all four subscales of the CPRS-R (ADHD index, oppositional, hyperactivity and cognitive). In conclusion, improvements relative to placebo in ADHD-related symptoms and behaviors in children and adolescents receiving a single morning dose of LDX or OROS-MPH were maintained throughout the day and were ongoing at the last measurement in the evening (1800 hours).

"Without money you're nothing": poverty and health in Mexico from women's perspective.

The objective of this qualitative study was to get to know poor Mexican women's experience of poverty in relation to health care. Forty-nine interviews were carried out with poor adult women in Mexico (between 35 and 65 years old). Three central elements were detected in relation to the women's experience of poverty and health care: their socio-economic dependence on their family; the notion of social belonging in their experience with health care rights, reflected in the idea and acceptance that, due to their poverty, they can only be attended at philanthropic institutions; and the existence of survival mechanisms when facing an illness. In recovering the experience of poor women in relation to their health care, we identified that there is a clear idea that, if women had had economic resources, their health problem would have been solved differently. They are also convinced that, due to being poor, they have to content themselves with bad-quality medical care. This conformity finally makes them resign to the fact of either loosing a part of their own body, or even just waiting for death.

"Without money you're nothing": poverty and health in Mexico from women's perspective

O objetivo do presente trabalho foi conhecer a vivência da pobreza em relação à assistência à saúde no caso de mulheres pobres mexicanas. Desenvolveu-se uma pesquisa qualitativa no México, realizando 40 entrevistas com mulheres entre 35 e 65 anos de idade. Detectaram-se três elementos centrais a respeito da vivência da pobreza e da assistência à saúde: a dependência socioeconômica para com a família; a noção de uma pertença social na vivência dos direitos de atenção à saúde, que se reflete na consideração e aceitação de que, devido a sua condição, somente podem ser atendidas em instituições filantrópicas; e a existência de mecanismos de sobrevivência diante de um evento de doença. Ao recuperar a experiência das mulheres pobres com relação à assistência à saúde, identificou-se que existe uma idéia clara de que, se tivessem contado com recursos econômicos suficientes, seus problemas de saúde teriam sido resolvidos de outra maneira. Também têm a convicção de que, por serem pobres, devem se conformar com uma atenção médica de má qualidade, e esta conformidade finalmente provoca sua resignação com o fato de perderem uma parte dos seus corpos, ou ainda mais esperarem a chegada da morte.