El parto adolescente por cohorte y su relación con factores sociodemográficos, en Panamá

Objetivo: Describir la prevalencia del parto adolescente por cohorte a través de los años y su relación con factores sociodemográficos, en Panamá. Metodología: A partir de un análisis secundario de la "Encuesta nacional de salud sexual y reproductiva 2014-2015" de Panamá, utilizando cohortes por año de nacimiento (1966-1975, 1976-1985, 1986-1995 y 1996-2000), la relación enunciada se analizó mediante regresión logística. Se incluyeron 4795 adultas (20-49 años) y 821 adolescentes (15-19 años). Resultados: Se encontró un aumento en la prevalencia del parto adolescente entre cohortes, donde la prevalencia fue de 30,9 % en la cohorte mayor (1966-1975) y de 51,5 % en la cohorte de 1986-1995. En todas las cohortes, el parto adolescente estuvo asociado a la ruralidad (1966-1975, 42,3 % rural no indígena; 1976-1985, 56,6 % rural indígena; 1986-1995, 65,4 % rural no indígena y 58,2 % rural indígena). En todas las cohortes, el parto adolescente se relacionó con menor bienestar, encontrándose una prevalencia mayor que el 40 % en el quintil menor de riqueza en todas las cohortes. El parto adolescente se asoció a tener 4 o más hijos en las cohortes mayores (1966-1975 y 1976-1985), con prevalencias mayores que el 63 %. Conclusiones: La prevalencia del parto en adolescente en Panamá se ha mantenido en crecimiento. Las poblaciones rurales y de menor bienestar se han mantenido con mayor prevalencia de parto adolescente, indicando dónde enfocar las intervenciones preventivas.

Objective: To describe the prevalence of adolescent childbirth by cohort over time and its relationship with sociodemographic factors in Panama. Methodology: The analysis was conducted through logistic regression, based on a secondary analysis of the Panama "Encuesta nacional de salud sexual y reproductiva 2014- 2015" (2014-2015 National Survey on Sexual and Reproductive Health), using cohorts by year of birth (1966-1975, 1976-1985, 1986-1995, and 1996-2000). A total of 4795 adult women (20-49 years old) and 821 adolescent girls (15-19 years old) were included. Results: We found an increased prevalence of adolescent childbirth between cohorts, where prevalence was 30.9% in the older cohort (1966-1975) and 51.5% in the 1986- 1995 cohort. In all cohorts, adolescent childbirth was associated with rurality (1966-1975, 42.3% rural non Indigenous; 1976- 1985, 56.6% rural Indigenous; 1986-1995, 65.4% rural non Indigenous, and 58.2% rural Indigenous). Adolescent childbirth was also associated with lower well-being; across all cohorts, there was a prevalence of over 40% in the lowest wealth quintile. Adolescent childbirth was associated with having 4 or more children in the older cohorts (1966-1975 and 1976-1985), with a prevalence of over 63%. Conclusions: The prevalence of adolescent childbirth in Panama has continued to increase. Rural and lower well-being populations have continued to exhibit a higher prevalence of adolescent childbirth, which signals where to focus preventive interventions.

Objetivo: Descrever a prevalência do parto adolescente por conjuntos estabelecidos por anos e sua relação com fatores sociodemográficos, em Panamá. Metodologia: A partir de uma análise secundária da "Enquete nacional de saúde sexual e reprodutiva 2014-2015" de Panamá, utilizando conjuntos por ano de nascimento (1966-1975, 1976-1985, 1986-1995 e 1996-2000), a relação enunciada foi analisada por meio de regressão logística. Incluíram-se 4795 adultas (29-49 anos) e 821 adolescentes (15-19 anos). Resultados: Achou-se um aumento na prevalência do parto adolescente entre conjuntos, onde a prevalência foi de 30,9% no conjunto mais velho (1966-1975) e de 51,5% no conjunto de 1986-1995. Em todos os conjuntos, o parto adolescente esteve associado à ruralidade (1966-1975, 42,3% rural não indígena; 1976-1985, 56,6% rural indígena; 1986-1995, 65,4% rural não indígena e 58C,2% rural indígena). Em todos os conjuntos, o parto adolescente relacionou-se com menor bem-estar, sendo achada uma prevalência maior ao 40% no quintil menor de riqueza em todos os conjuntos. O parto adolescente associou-se a ter 4 ou mais filhos nos conjuntos mais velhos (1966-1975 e 1976- 1985), com prevalências maiores ao 63%. Conclusões: A prevalência do parto em adolescentes em Panamá tem mantido seu crescimento. As populações rurais e com menor bem-estar mantêm a maior prevalência do parto adolescente, indicando onde enfocar as intervenções preventivas.

El empoderamiento de la mujer panameña y su relación con la violencia conyugal según la Encuesta Nacional de Salud Sexual y Reproductiva

Introducción. La Organización Mundial de la Salud reconoce que la violencia conyugal es una problemática que va más allá del ámbito familiar, afecta a todos los sectores de la sociedad convirtiéndose en un grave problema de salud pública y de derechos humanos. Objetivo: examinar la relación entre elementos del empoderamiento femenino y tipos de violencia conyugal. Métodos: con datos de la Encuesta Nacional de Salud Sexual y Reproductiva (2014-2015) se analizaron 3679 mujeres casadas/unidas. Se construyeron tres indicadores de empoderamiento como variable independiente, como variable dependiente se estudió la violencia física/sexual. Los datos fueron analizados con el programa SPSS utilizando descripciones de frecuencia, cruce de variables y pruebas de significancia estadística. Resultados: Aquellas mujeres que más justifican la violencia conyugal, son las que más sufren agresiones físicas como empujones y/o sacudidas (15%), las que no justifican la violencia por ninguna razón, solo 4.1% sufren ataques de este tipo (p=0.000). El 3.1% de las mujeres con menor participación en el hogar son las que menos agresiones sufren en comparación con las que toman más decisiones y sufren más agresiones (8.1%) (p< 0.000). El grado de participación en aspectos importantes de Salud Sexual y Reproductiva (SSR), muestra que aquellas que no tenían ningún tipo de intervención, padecen mayores agresiones de tipo sexual (7.3%), estas agresiones disminuyen cuando la mujer toma mayores decisiones en SSR (0.4%) (p=0.000). Conclusiones: Hay una asociación positiva entre una menor vivencia de violencia física/sexual con mayores niveles de autonomía en temas de SSR y Rechazo a la Violencia Conyugal. (provisto por Infomedic International)

Inequidades en la salud sexual y reproductiva de las mujeres indígenas de Panamá / Inequities in sexual and reproductive health of indigenous women in Panama

Las mujeres indígenas en toda América Latina, incluyendo Panamá, presentan condiciones de inequidad en lo que se refiere a la salud sexual y reproductiva. La fecundidad elevada, el alto índice de embarazo adolescente, y la falta de una adecuada atención y asistencia a la salud materna, son evidencia de esto. Las altas tasas de mortalidad materna están relacionadas con falta de cobertura de los servicios de salud sexual y reproductiva...

Nonsense mutations of the bHLH transcription factor TWIST2 found in Setleis Syndrome patients cause dysregulation of periostin.

Setleis Syndrome (OMIM ID: 227260) is a rare autosomal recessive disease characterized by abnormal facial development. Recently, we have reported that two nonsense mutations (c.486C>T [Q119X] and c.324C>T [Q65X]) of the basic helix-loop-helix (bHLH) transcription factor TWIST2 cause Setleis Syndrome. Here we show that periostin, a cell adhesion protein involved in connective tissue development and maintenance, is down-regulated in Setleis Syndrome patient fibroblast cells and that periostin positively responds to manipulations in TWIST2 levels, suggesting that TWIST2 is a transactivator of periostin. Functional analysis of the TWIST2 mutant form (Q119X) revealed that it maintains the ability to localize to the nucleus, forms homo and heterodimers with the ubiquitous bHLH protein E12, and binds to dsDNA. Reporter gene assays using deletion constructs of the human periostin promoter also reveal that TWIST2 can activate this gene more specifically than Twist1, while the Q119X mutant results in no significant transactivation. Chromatin immunoprecipitation assays show that both wild-type TWIST2 and the Q119X mutant bind the periostin promoter, however only wild-type TWIST2 is associated with higher levels of histone acetylation across the 5'-regulatory region of periostin. Taken together, these data suggest that the C-terminal domain of TWIST2, which is missing in the Q119X mutant form of TWIST2, is responsible for proper transactivation of the periostin gene. Improper regulation of periostin by the mutant form of TWIST2 could help explain some of the soft tissue abnormalities seen in these patients therefore providing a genotype-phenotype relationship for Setleis Syndrome.

Factors controlling the reactivity of hydrogen sulfide with hemeproteins.

Hemoglobin I (HbI) from the clam Lucina pectinata is an intriguing hemeprotein that binds and transports H(2)S to sulfide-oxidizing chemoautotrophic bacteria to maintain a symbiotic relationship and to protect the mollusk from H(2)S toxicity. Single point mutations at E7, B10, and E11 were introduced into the HbI heme pocket to define the reactivity of sulfide with hemeproteins. The functional and structural properties of mutant and wild-type recombinant proteins were first evaluated using the well-known ferrous CO and O(2) derivatives. The effects of these mutations on the ferric environment were then studied in the metaquo and hydrogen sulfide derivatives. The results obtained with the ferrous HbI mutants show that all the E7 substitutions and the PheB10Tyr mutation influence directly CO and O(2) binding and stability while the B10 and E11 substitutions induce distal structural rearrangements that affect ligand entry and escape indirectly. For the metaquo-GlnE7His, -PheB10Val, -PheB10Leu, and -E11 variants, two individual distal structures are suggested, one of which is associated with H-bonding interactions between the E7 residues and the bound water. Similar H-bonding interactions are invoked for these HbI-H(2)S mutant derivatives and the rHbI, altering in turn sulfide reactivity within these protein samples. This is evident in the resonance Raman spectra of these HbI-H(2)S complexes, which show reduction of heme iron as judged by the appearance of the nu(4) oxidation state marker at 1356 cm(-1), indicative of heme-Fe(II) species. This reduction process depends strongly on distal mutations showing faster reduction for those HbI mutants exhibiting the strongest H-bonding interactions. Overall, the results presented here show that (a) H(2)S association is regulated by external kinetic barriers, (b) H(2)S release is controlled by two competing reactions involving simple sulfide dissociation and heme reduction, (c) at high H(2)S concentrations, reduction of the ferric center dominates, and (d) reduction of the heme is also enhanced in those HbI mutants having polar distal environments.

Hemoglobin I from Lucina pectinata: a model for distal heme-ligand control.

Lucina pectinata hemoglobin I (HbI), which is a ferric sulfide-reactive hemeprotein, contains a distal pocket characterized by the presence of GlnE7 and PheB10. To elucidate the structural-functional properties of HbI, oxygen binding kinetics and FTIR studies with recombinant HbI (rHbI) and a set of mutants were conducted using CO and CN- as sensors of the hemeprotein environment. Three nuCO modes were observed for rHbI at 1936 cm(-1) (A3, closed conformer) 1950 cm(-1) (A1,2, closed conformer) and 1960 cm(-1) (A0, open conformer). These nuCO were affected by substitution of GlnE7 and PheB10 in the CO complexes. The contribution of GlnE7 is demonstrated when this residue is replaced with Asn, Val or His. For instance, decreasing the positive electrostatic environment with GlnE7Val, causes an increase of 65% in the population of A0 and the disappearance and 55% reduction of the population of the A1,2 and A3 respectively. The contribution of PheB10 to the stabilization of ligands is also observed in the Leu and Tyr mutants. The PheB10Leu mutation produced an 8% decrease in the population of the A3 conformer while that of the A1,2 configuration increased by 30%. This suggests that GlnE7 and PheB10 contribute to the A3 conformer stabilizing the CO in a closed configuration. With CN- as probe no substantial differences in the nuCN was observed upon substitution of GlnE7 by Val while a slight down shift in the nuCN from 2120 cm(-1) to 2117 cm(-1) was observed in the PheB10Leu mutant. This implies that in HbICN GlnE7 moves away from the binding site while PheB10 remains in the vicinity of the bound CN-. Here, a mechanism in which the flexibility of the distal protein matrix coupled with hemeporphyrin movement toward a different configuration is suggested as an important process in the H2S transport and delivery in hemoglobin I.

Mitos, conocimientos, prácticas y opiniones sobre sexualidad humana en adolescentes panameños / Myths, knowledge, practice and opinions on human sexuality in panamenian adolescents

Presenta el estudio de algunos mitos y prácticas sexuales de 1269 estudiantes adolescentes entre 14 y 19 años, con una media de edad de 16 años, de colegios públicos y privados pertenecientes a la provincia de Panamá. Se encontró que más de la cuarta parte de la población tenía mitos en diferentes áreas como : menstruación, masturbación, métodos anticonceptivos y relaciones sexuales. Al evaluar sus conocimientos se encontró que sólo un 4 porciento maneja la terminología correcta de los órganos reproductores esternos e internos del hombre y la mujer. Un 19 porciento conocía y manejaba el concepto días fértiles. Un 74 porciento había escuchado hablar alguna vez de algún método anticonceptivo y un 75 porciento poseían la definición correcta de ciertas palabras claves como : Ovulación, mestruación, orgasmo, entre otros. El 39 porciento de estos estudiantes ya habían iniciado vida sexual activa y un 48 porciento de ellos, habían iniciado antes de los 15 años de edad, El 57 porciento utilizó alguna vez métodos anticonceptivos. Un 12 porciento reportó haber estado enbarazada o haber enbarazado a alguien. Este estudio sugiere que los mitos y las crencias populares pueden influir en la conducta sexual de los adolescentes. El conocimiento de estos mitos es de gran utilidad al momento de implementar programas de educación sexual en las escuelas de Panamá