LGBTIQ, pensar la diversidad / LGBTIQ, Thinking About Diversity

Con el objetivo de analizar la percepción acerca del colectivo LGBTIQ por parte del personal de salud, administrativos y usuarios del siste-ma de salud en CeMAP CABA (Ciudad Autónoma de Buenos Aires) OsPeCon, así como identificar la discriminación, sus causas y consecuencias, se realizó un estudio cualitativo, de caso, etnográfico.Se realizaron cinco grupos focales y se analizó la información siguiendo los pasos de la teoría fundamentada. En los grupos focales surgieron dudas acerca de la definición de orientación sexual y las siglas I-Q. Se reconocieron prejuicios relacionados al VIH/SIDA, ETS y adicciones como base de la discriminación y la estigmatización. Se evidenció la persistencia de creencias populares como origen de la orientación sexual. Se vio reflejada la heteronormatividad como característica social y la diferencia generacional como postura negativa. Se identificó como forma de discriminación a la violencia verbal y el rechazo al contacto, teniendo como consecuencia depresión, consumo de sustancias y suicidio. Las cuestiones de géneros son temas en continua evolución en la sociedad, por lo que creemos importante estar informados, con una visión empática y de respeto para brindar una atención adecuada a las personas LGBTIQ, teniendo un rol que nos permite deconstruir los estereotipos (AU)

This qualitative ethnographic case study analyzes perceptions of the LGBTIQ community held biomedical professionals, administrative staff and patients in the Health center of OSPeCon, CABA.The purpose of this analysis is to identify discrimination, its causes and consequencesFive focus groups were carried out and the information was analyzed according to the grounded theory.Major themes that emerged from focus groups included confusion regarding the definition of sexual orientation and the acronym I-Q Beliefs related to HIV/AIDS, STD and addiction were noted to be the foundation for discrimination and stigmatization. Other beliefs identified included heteronormativity, which was more prevalent in older generations. The use of popular beliefs to explain the origin of sexual orientation was often justification for discrimination Means of discrimination included verbal violence and rejecting personal contact. Consequences of discrimination identified included depression, substance abuse and suicide. Gender issues continue to evolve and we hope to analyze our own beliefs, deconstruct stereotypes, and educate ourselves in the development of an empathic and respectful attitude to this vulnerable population (AU)

Migración y salud: una cuestión intercultural, 2018 / Migration and health: an intercultural question, 2018

Se realizó un estudio cualitativo, etnográfico para conocer y analizar la percepción de los pacientes extranjeros respecto de su vínculo con el sistema de salud en Argentina, considerando la cultura de origen y proceso migratorio mediante trece entrevistas semiestructuradas. Se incluyeron pacientes extranjeros mayores de 18 años que consultaron a un Centro de Atención Primaria de la Salud (CeMAP) de un agente del subsitema sanitario de la seguridad social argentina. Los mismos fueron seleccionados de manera intencional y por conveniencia. Las transcripciones se analizaron según la teoría fundamentada. En las entrevistas se destacó una relación médico-paciente más estrecha en comparación con la del país de origen, destacándose la calidez, compromiso y mayor comunicación con el binomio paciente-familia, siendo notables estas diferencias en la etapa del embarazo y en el ámbito de la salud sexual y reproductiva. Se han hallado diferencias sustanciales con el país de origen en temáticas como control prenatal y acompañamiento del parto, alimentación, medicinas tradicionales, accesibilidad al sistema sanitario, siendo influyente el tiempo de residencia en Argentina para lograr el empoderamiento en relación con el sistema de salud. Esto nos estimula a seguir trabajando en la cultura y proceso migratorio de los pacientes, explorar su cosmovisión, para propiciar un enfoque intercultural que permita adquirir herramientas para la atención de dicha población (AU)

A qualitative, ethnographic study was carried out to identify and analyze the perception and beliefs of foreign patients, regarding their experiences in Argentina ́s healthcare system, taking into consideration their culture of origin and migratory process through semi-structured interviews. It're included foreign patients over 18 years of age who consulted at a Primary Health Care Center (CeMAP) of an agent of the Argentine social security health system. They were selected intentionally and for convenience. Thirteen semi-structured in-depth interviews were recorded and the transcripts were analyzed according to the Fundamental Theory. In the interviews, a closer patient-physician relationship stood out when compared with the country of origin, highlighting the warmth, commitment and greater communication with the patient and its family, these differences were more notable during prenatal, reproductive and sexual care. Substantial differences have been found with the country of origin in topics such as prenatal post-partum care, nutrition, traditional medicines, and accessibility to the health system. There was a positive impact of length of residency in Argentina on patient empowerment within the healthcare system. This is an estimate to continue working on the culture and the migration process of patients, to explore their worldview, to propose an intercultural approach that allows us to acquire tools for the care of this population (AU)

Correlation of serum leptin and insulin levels of pregnant protein-restricted rats with predictive obesity variables.

During pregnancy and protein restriction, changes in serum insulin and leptin levels, food intake and several metabolic parameters normally result in enhanced adiposity. We evaluated serum leptin and insulin levels and their correlations with some predictive obesity variables in Wistar rats (90 days), up to the 14th day of pregnancy: control non-pregnant (N = 5) and pregnant (N = 7) groups (control diet: 17% protein), and low-protein non-pregnant (N = 5) and pregnant (N = 6) groups (low-protein diet: 6%). Independent of the protein content of the diet, pregnancy increased total (F1,19 = 22.28, P < 0.001) and relative (F1,19 = 5.57, P < 0.03) food intake, the variation of weight (F1,19 = 49.79, P < 0.000) and final body weight (F1,19 = 19.52, P < 0.001), but glycemia (F1,19 = 9.02, P = 0.01) and the relative weight of gonadal adipose tissue (F1,19 = 17.11, P < 0.001) were decreased. Pregnancy (F1,19 = 18.13, P < 0.001) and low-protein diet (F1,19 = 20.35, P < 0.001) increased the absolute weight of brown adipose tissue. However, the relative weight of this tissue was increased only by protein restriction (F1,19 = 15.20, P < 0.001) and the relative lipid in carcass was decreased in low-protein groups (F1,19 = 4.34, P = 0.05). Serum insulin and leptin levels were similar among groups and did not correlate with food intake. However, there was a positive relationship between serum insulin levels and carcass fat depots in low-protein groups (r = 0.37, P < 0.05), while in pregnancy serum leptin correlated with weight of gonadal (r = 0.39, P < 0.02) and retroperitoneal (r = 0.41, P < 0.01) adipose tissues. Unexpectedly, protein restriction during 14 days of pregnancy did not alter the serum profile of adiposity signals and their effects on food intake and adiposity, probably due to the short term of exposure to low-protein diet.

Correlation of serum leptin and insulin levels of pregnant protein-restricted rats with predictive obesity variables

During pregnancy and protein restriction, changes in serum insulin and leptin levels, food intake and several metabolic parameters normally result in enhanced adiposity. We evaluated serum leptin and insulin levels and their correlations with some predictive obesity variables in Wistar rats (90 days), up to the 14th day of pregnancy: control non-pregnant (N = 5) and pregnant (N = 7) groups (control diet: 17 percent protein), and low-protein non-pregnant (N = 5) and pregnant (N = 6) groups (low-protein diet: 6 percent). Independent of the protein content of the diet, pregnancy increased total (F1,19 = 22.28, P < 0.001) and relative (F1,19 = 5.57, P < 0.03) food intake, the variation of weight (F1,19 = 49.79, P < 0.000) and final body weight (F1,19 = 19.52, P < 0.001), but glycemia (F1,19 = 9.02, P = 0.01) and the relative weight of gonadal adipose tissue (F1,19 = 17.11, P < 0.001) were decreased. Pregnancy (F1,19 = 18.13, P < 0.001) and low-protein diet (F1,19 = 20.35, P < 0.001) increased the absolute weight of brown adipose tissue. However, the relative weight of this tissue was increased only by protein restriction (F1,19 = 15.20, P < 0.001) and the relative lipid in carcass was decreased in low-protein groups (F1,19 = 4.34, P = 0.05). Serum insulin and leptin levels were similar among groups and did not correlate with food intake. However, there was a positive relationship between serum insulin levels and carcass fat depots in low-protein groups (r = 0.37, P < 0.05), while in pregnancy serum leptin correlated with weight of gonadal (r = 0.39, P < 0.02) and retroperitoneal (r = 0.41, P < 0.01) adipose tissues. Unexpectedly, protein restriction during 14 days of pregnancy did not alter the serum profile of adiposity signals and their effects on food intake and adiposity, probably due to the short term of exposure to low-protein diet.

Rice bran supplementation during nutritional recovery period of malnourished rats improves colon development.

OBJECTIVE: To investigate the colon's development in rats subjected to protein energy malnutrition followed by supplementation with rice bran. MATERIALS AND METHODS: Weaned Wistar male rats (21 days old), weight (40-50 g) were divided into two groups: diet with 17% protein (C; control group) or an aproteic diet (A; aproteic group), for 12 days. After this, 50% of the rats from each group were sacrificed. The remaining rats were further distributed in the three groups for a recovery (21 days): control (C) continued to receive the control diet whereas the aproteic group (A) received either a control diet (AC) or a control diet supplemented with 5% of rice bran (ARB). RESULTS: The A group showed alterations in the colon and cecum, excreted dry feces mass and fecal nitrogen, compared with C rats. In the proximal colon of A rats, the external muscularis and the width of the colon wall were higher whereas in the distal colon they were lower than C. After the recovery period, the relative cecum mass, colon mass and colon length of the recovered groups (AC and ARB) were higher than in the C group. Dry feces and fecal nitrogen excreted of the rats from recovered groups were lower than C group. Colon length of the AC group was lower than in the C group. Only the crypt's depth from ARB group was higher than in the C group. CONCLUSION: Control diet supplemented with 5% rice bran, reestablished the large intestine of aproteic rats. The recovery in the ARB group was even better than in the AC rats.

Serum leptin and insulin levels in lactating protein-restricted rats: implications for energy balance.

The present study analysed the effect of protein restriction on serum insulin and leptin levels and their relationship with energy balance during lactation. Four groups of rats received isocaloric diets containing 170 g protein/kg or 60 g protein/kg from pregnancy until the 14th day of lactation: control non-lactating, control lactating (both fed a control diet), low-protein non-lactating and low-protein lactating. Energy intake, body composition, energy balance, serum insulin and leptin concentrations and the relationship between these hormones and several factors related to obesity were analysed. Low-protein-intake lactating rats exhibited hypoinsulinaemia, hyperleptinaemia, hypophagia and decreased energy expenditure compared with control lactating rats. The protein level in the carcasses was lower in the low-protein lactating group than in the control lactating group, resulting in a higher fat content in the first group compared with the latter. Body fat correlated inversely with serum insulin and positively with serum leptin level. There was a significant negative correlation between serum leptin and energy intake, and a positive relationship between energy intake and serum insulin level in lactating rats and in the combined data from both groups. Energy expenditure was correlated positively with serum insulin and negatively with serum leptin in lactating rats and when data from control non-lactating and lactating rats were pooled. Lactating rats submitted to protein restriction, compared with lactating control rats, showed that maternal reserves were preserved owing to less severe negative energy balance. This metabolic adaptation was obtained, at least in part, by hypoinsulinaemia that resulted in increased insulin sensitivity favouring enhanced fat deposition, hyperleptinaemia and hypophagia.

Magnesium deficiency improves glucose homeostasis in the rat: studies in vivo and in isolated islets in vitro.

The serum mineral levels, glucose disappearance rate (kg), total area under the glucose (DeltaG) and insulin (DeltaI) curves, and static insulin secretion were compared among rats fed a Mg-deficient diet for 6 (DF-6) or 11 (DF-11) weeks, and rats fed a control diet for the same periods (CO-6 and CO-11 groups). No change in glucose homeostasis was observed among DF-6, CO-6 and CO-11 rats. DF-11 rats showed an elevated kg and a reduced DeltaG and DeltaI. For evaluating the effect of supplementation, rats fed a control or Mg-deficient diet for 6 weeks were then fed a Mg- supplemented diet for 5 weeks (SCO and SDF groups respectively). The serum Mg levels in SDF rats were similar to those in CO-11 and SCO rats, but higher than in the DF-11 group. SDF rats showed similar kg, DeltaG and DeltaI compared with the CO-11 and SCO groups. However, a significantly lower kg and higher DeltaG and DeltaI were observed in SDF compared with DF-11 rats. Basal and 8.3 mmol glucose/l-stimulated insulin secretion by islets from DF-11 rats were higher than by islets from CO-11 rats. These results indicate that moderate Mg depletion for a long period may increase the secretion and sensitivity to insulin, while Mg supplementation in formerly Mg-deficient rats may prevent the increase in sensitivity and secretion of insulin.

Low protein diet confers resistance to the inhibitory effects of interleukin 1beta on insulin secretion in pancreatic islets*

High protein content in the diet during childhood and adolescence has been associated to the onset insulin-dependent diabetes mellitus. We investigated the effect of interleukin-1beta (IL-1beta) on insulin secretion, glucose metabolism, and nitrite formation by islets isolated from rats fed with normal protein (NP, 17%) or low protein (LP, 6%) after weaning. Pretreatment of islets with IL-1beta for 1 h or 24 h inhibited the insulin secretion induced by glucose in both groups, but it was less marked in LP than in NP group. Islets from LP rats exhibited a decreased IL-1beta-induced nitric oxide (NO) production, lower inhibition of D-[U(14)C]-glucose oxidation to (14)CO(2) and less pronounced effect of IL-1beta on alpha-ketoisocaproic acid-induced insulin secretion than NP islets. However, when the islets were stimulated by high concentrations of K(+) the inhibitory effect of IL-1beta on insulin secretion was not different between groups. In conclusion, protein restriction protects beta-cells of the deleterious effect of IL-1beta, apparently, by decreasing NO production. The lower NO generation in islets from protein deprived rats may be due to increased free fatty acids oxidation and consequent alteration in Ca(2+) homeostasis.

Reduced insulin secretion in response to nutrients in islets from malnourished young rats is associated with a diminished calcium uptake.

Changes in (45)Ca uptake and insulin secretion in response to glucose, leucine, and arginine were measured in isolated islets derived from 4-week-old rats born of mothers maintained with normal protein (NP, 17%) or low protein (LP, 6%) diet during pregnancy and lactation. Glucose provoked a dose-dependent stimulation of insulin secretion in both groups of islets, with basal (2.8 mmol/L glucose) and maximal release (27.7 mmol/L glucose) significantly reduced in LP compared with NP islets. In the LP group the concentration-response curve to glucose was shifted to the right compared with the NP group, with the half-maximal response occurring at 16.9 and 13.3 mmol/L glucose, respectively. In LP islets, glucose-induced first and second phases of insulin secretions were drastically reduced. In addition, insulin response to individual amino acids, or in association with glucose, was also significantly reduced in the LP group compared with NP islets. Finally, in LP islets the (45)Ca uptake after 5 minutes or 90 minutes of incubation (which reflect mainly the entry and retention, respectively, of Ca(2+)), was lower than in NP islets. These data indicate that in malnourished rats both initial and sustained phases of insulin secretion in response to glucose were reduced. This poor secretory response to nutrients seems to be the consequence of an altered Ca(2+) handling by malnourished islet cells.

Protein deficiency and nutritional recovery modulate insulin secretion and the early steps of insulin action in rats.

Maternal malnutrition was shown to affect early growth and leads to permanent alterations in insulin secretion and sensitivity of offspring. In addition, epidemiological studies showed an association between low birth weight and glucose intolerance in adult life. To understand these interactions better, we investigated the insulin secretion by isolated islets and the early events related to insulin action in the hind-limb muscle of adult rats fed a diet of 17% protein (control) or 6% protein [low (LP) protein] during fetal life, suckling and after weaning, and in rats receiving 6% protein during fetal life and suckling followed by a 17% protein diet after weaning (recovered). The basal and maximal insulin secretion by islets from rats fed LP diet and the basal release by islets from recovered rats were significantly lower than that of control rats. The dose-response curves to glucose of islets from LP and recovered groups were shifted to the right compared to control islets, with the half-maximal response (EC50) occurring at 16.9 +/- 1.3, 12.4 +/- 0.5 and 8.4 +/- 0.1 mmol/L, respectively. The levels of insulin receptor, as well as insulin receptor substrate-1 and phosphorylation and the association between insulin receptor substrate-1 and phosphatidylinositol 3-kinase were greater in rats fed a LP diet than in control rats. In recovered rats, these variables were not significantly different from those of the other two groups. These results suggest that glucose homeostasis is maintained in LP and recovered rats by an increased sensitivity to insulin as a result of alterations in the early steps of the insulin signal transduction pathway.

Protein deficiency during pregnancy and lactation impairs glucose-induced insulin secretion but increases the sensitivity to insulin in weaned rats.

We studied glucose homeostasis in rat pups from dams fed on a normal-protein (170 g/kg) (NP) diet or a diet containing 60 g protein/kg (LP) during fetal life and the suckling period. At birth, total serum protein, serum albumin and serum insulin levels were similar in both groups. However, body weight and serum glucose levels in LP rats were lower than those in NP rats. At the end of the suckling period (28 d of age), total serum protein, serum albumin and serum insulin were significantly lower and the liver glycogen and serum free fatty acid levels were significantly higher in LP rats compared with NP rats. Although the fasting serum glucose level was similar in both groups, the area under the blood glucose concentration curve after a glucose load was higher for NP rats (859 (SEM 58) mmol/l per 120 min for NP rats v. 607 (SEM 52) mmol/l per 120 min for LP rats; P < 0.005). The mean post-glucose increase in insulin was higher for NP rats (30 (SEM 4.7) nmol/l per 120 min for NP rats v. 17 (SEM 3.9) nmol/l per 120 min for LP rats; P < 0.05). The glucose disappearance rate for NP rats (0.7 (SEM 0.1) %/min) was lower than that for LP rats (1.6 (SEM 0.2) %/min; P < 0.001). Insulin secretion from isolated islets (1 h incubation) in response to 16.7 mmol glucose/l was augmented 14-fold in NP rats but only 2.6-fold in LP rats compared with the respective basal secretion (2.8 mmol/l; P < 0.001). These results indicate that in vivo as well as in vitro insulin secretion in pups from dams maintained on a LP diet is reduced. This defect may be counteracted by an increase in the sensitivity of target tissues to insulin.

Indicadores das condiçöes nutricionais na regiäo do Polonoroeste: III. Estudo clínico nutricional / Nutritional status indicators in Polonoroeste area: III. Clinical nutritional study

O estudo do exame clínico-nutricional é parte do Inquérito Nutricional, realizado no "Diagnóstico em Saúde do Polonoroeste-MT em 1983". No intuito de reconhecer a situaçäo nutricional da populaçäo da regiäo em estudo, o grupo do Inquérito Nutricional procedeu ao estudo do Consumo Alimentar das famílias, ao estudo dos dados antropométricos e de sinais clínico-nutricionais de crianças na faixa etária de 3 a 72 meses. Foram examinadas 585 crianças da amostra como proposta por SANCHES & CARVALHEIRO adaptado por MEIRELLES e SANCHES. O exame clínico-nutricional foi realizado segundo a metodologia recomendada por JELLIFFE. Foram encontrados sinais clínicos sugestivos de carência nutricional em 6,6% das crianças; sinais de anemia em 9,7% e de bócio em 2,7%. Näo foi possível definir com precisäo outros quadros carenciais

Indicadores das condiçöes nutricionais na regiäo Polonoroeste: V. Desnutriçäo proteíco-energética e parasitoses intestinais em um grupo de crianças de 3 a 72 meses de idade da cidade de Mirassol D'Oeste, Mato Grosso, Brasil / Nutritional conditions indicators in Polonoroeste area: V. Proteic-energetic malnutrition and intestinal parasites in a group of children from 3 to 72 months from Mirassol D'Oeste, Mato Grosso, Brasil

Este trabalho tem por objetivo caracterizar a desnutriçäo protéico-energética associada a parasitose intestinal em grupo de 149 crianças de ambos os sexos, na faixa etária de 3 a 72 meses, da cidade de Mirassol D'Oeste, na regiäo do Projeto Polonoroeste em Mato Grosso. De cada criança foram coletados os seguintes dados: sexo, peso, idade e amostra de fezes para exame parasitológico. Os dados peso/idade obtidos foram analisados pelos critérios de GOMEZ. Utilizou-se como padräo de referência o National Center for Health Statistic (NCHS). Para diagnóstico dos parasitas intestinais executou-se o método de Hoffman, Pons e Janer. O grupo estudado constitui-se em sua maioria de crianças desnutridas, sendo a forma leve de desnutriçäo mais comum que as formas moderada e grave. As enteroparasitoses foram encontradas em 69% das amostras examinadas. A "Giardia lamblia" foi o protozoário mais comum e o "Ancilostomídeo" o helminto mais encontrado. O teste X2 näo mostrou relaçäo de dependência entre o estado nutricional e a freqüência de enteroparasitoses