Redes personales como factores de riesgo y protección en mujeres privadas de libertad / Personal networks as risk factors and protection of women in prison / Redes pessoais como fatores de risco e proteção mulheres privadas de sua liberdade

Resumen El trabajo analiza las redes personales de las mujeres privadas de libertad, identificando factores de riesgo y protección en tres etapas definidas por el ingreso a prisión y orientadas a la reinserción. Se realizó una investigación documental en bases de datos (WOS, Scopus y Google Académico), empleando Mendeley como gestor. Los resultados muestran que, las redes, antes de prisión están permeadas por la violencia y ausencia de apoyo; durante la prisión se dividen en internas externas y presentan modificaciones relacionales importantes (ruptura de pareja, distanciamiento o no de los/as hijos/as y apoyo de nuevas personas) y; en semilibertad se amplían y mejoran estas, favoreciendo la reinserción social, no obstante, la mayoría regresa al entorno familiar y comunitario inicial enfrentándose a los factores de riesgo asociados.

Abstract This paper analyzes the personal networks of women in prison, identifying risk and protection factors in three stages, defined by prison entry, aimed at reintegration. Documentary research was carried out on databases (WOS, Scopus and academic Google), using Mendeley as manager. The results show that, before imprisonment, networks are permeated by violence and lack of support during prison they are divided into internal-external and present important relational modifications (breakup of a couple, distance or not from children and support of new people) and; in day release they expand and improve these, promoting social reinsertion; nevertheless, most return to the initial family and community environment facing the associated risk factors.

Resumo Este artigo analisa as redes pessoais de mulheres privadas de liberdade identificando fatores de risco e proteção em três etapas e definidos pela entrada na prisão, visando a reintegração. Uma pesquisa documental foi realizada em bancos de dados (WOS, Scopus e Google scholar), utilizando Mendeley como gerente. Os resultados mostram que, as redes, antes da prisão são permeadas pela violência e falta de apoio; durante a prisão são divididas em modificações relacionais internas-externas e apresentam importantes (separação do casal, distanciamento ou não dos filhos e apoio de novas pessoas) e; na semi-liberdade são ampliadas e melhoradas, favorecendo a reintegração social, no entanto, a maioria retorna ao ambiente familiar e comunitário inicial diante dos fatores de risco associados.

Association between Postmortem Kidney Biopsy Findings and Acute Kidney Injury from Patients with SARS-CoV-2 (COVID-19).

BACKGROUND AND OBJECTIVES: AKI in coronavirus disease 2019 (COVID-19) is associated with higher morbidity and mortality. The objective of this study was to identify the kidney histopathologic characteristics of deceased patients with diagnosis of COVID-19 and evaluate the association between biopsy findings and clinical variables, including AKI severity. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Our multicenter, observational study of deceased patients with COVID-19 in three third-level centers in Mexico City evaluated postmortem kidney biopsy by light and electron microscopy analysis in all cases. Descriptive and association statistics were performed between the clinical and histologic variables. RESULTS: A total of 85 patients were included. Median age was 57 (49-66) years, 69% were men, body mass index was 29 (26-35) kg/m2, 51% had history of diabetes, 46% had history of hypertension, 98% received anticoagulation, 66% were on steroids, and 35% received at least one potential nephrotoxic medication. Severe AKI was present in 54% of patients. Biopsy findings included FSGS in 29%, diabetic nephropathy in 27%, and arteriosclerosis in 81%. Acute tubular injury grades 2-3 were observed in 49%. Histopathologic characteristics were not associated with severe AKI; however, pigment casts on the biopsy were associated with significantly lower probability of kidney function recovery (odds ratio, 0.07; 95% confidence interval, 0.01 to 0.77). The use of aminoglycosides/colistin, levels of C-reactive protein and serum albumin, previous use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, antivirals, nonsteroid anti-inflammatory drugs, and anticoagulants were associated with specific histopathologic findings. CONCLUSIONS: A high prevalence of chronic comorbidities was found on kidney biopsies. Nonrecovery from severe AKI was associated with the presence of pigmented casts. Inflammatory markers and medications were associated with specific histopathologic findings in patients dying from COVID-19.

Prevalence of diabetic retinopathy and its relationship with glomerular filtration rate and other risk factors in patients with type 2 diabetes mellitus in Spain. DM2 HOPE study.

AIM: Diabetic retinopathy (DR) is the leading cause of blindness in working age population in developed countries. Albuminuria and estimated glomerular filtration rate (eGFR) have been considered biomarkers for DR. This study aimed to investigate the prevalence of DR and its relationship with eGFR and other risk factors in type 2 diabetic patients (T2DM) in Spain. METHODS: A cross-sectional and descriptive study has been performed in 14,266 patients. Clinical records were reviewed. Demographic data, clinical diagnoses, clinical variables, and results from laboratory tests were recorded. Prevalence rates of DR were calculated. Logistic regression analysis was applied to assess predictors of the DR presence/absence. RESULTS: DR prevalence was 14.9%, being more prevalent in women (p = 0.0087) and in older patients (p < 0.0001). Duration of disease (OR = 5.3, IC95% = 3.8-7.4; p < 0.0001), eGFR < 60 ml/min/1.73 m2 (OR = 2.0, IC95% 1.6-2.4; p < 0.0001), levels of HbA1c ≥ 7% (OR = 1.9, IC95% = 1.5-2.3; p < 0.0001) and high blood pressure (OR = 1.6, IC95% = 1.2-2.1; p = 0.0032) were associated with higher risk of DR. DR was also more frequent in patients taking insulin (32,6% vs. 10,2%; p < 0.0001). CONCLUSION: Around one in seven patients with T2DM has DR after nine years since diagnosis. Time since diagnosis, insulin therapy, cardiovascular profile, and renal dysfunction are associated with DR in patients with T2DM in Spain.

La formación de tecnólogos en Higiene y Epidemiología en Cuba: antecedentes y perspectivas / The training of technologists in Hygiene and Epidemiology in Cuba: background and perspectives

La política de desarrollo de recursos humanos ha sido factor de máxima relevancia en la estrategia cubana para la creación y consolidación de su sistema de salud. En el presente trabajo los autores reflexionan sobre la evolución histórica y perspectivas en la formación de los tecnólogos de la salud en el área de la Higiene y Epidemiología, teniendo en cuenta los nuevos retos y problemas epidemiológicos a los cuales se enfrenta hoy no solo Cuba, sino el resto del mundo de forma generalizada. Se caracterizan las etapas de la formación de técnicos medios y tecnólogos en el área de la Higiene y Epidemiología en Cuba, atendiendo a las peculiaridades en los currículos. Se aborda el actual modelo del Licenciado en Higiene y Epidemiología y se muestra el impacto social del rediseño de la carrera, que ha dado respuesta a las exigencias de los servicios de salud cubanos.

The human resources development policy has been a major factor in the Cuban strategy for the creation and consolidation of its health system. In the present work the authors reflect on the historical evolution and perspectives in the training of the health technologists in the area of Hygiene and Epidemiology, taking into account the new challenges and epidemiological problems that are facing not only Cuba but also the rest of the world in a generalized way. The stages of the training of technicians and technologists in the area of Hygiene and Epidemiology in Cuba are characterized, taking into account the peculiarities in the curricula. It addresses the current model of the Bachelor in Hygiene and Epidemiology and shows the social impact of the career redesign, which has met the demands of the Cuban health services.

Trematodes with a reproductive division of labour: heterophyids also have a soldier caste and early infections reveal how colonies become structured.

Recent findings have extended the documentation of complex sociality to the Platyhelminthes, describing the existence of a reproductive division of labour involving a soldier caste among the parthenitae of trematode parasites. However, all species examined to date occupy high positions in trematode interspecific dominance hierarchies and belong to two closely related families, the Echinostomatidae and the Philophthalmidae (Superfamily Echinostomatoidea). Further, the two species documented as lacking soldiers also belong to the Echinostomatidae. Here, we examine four species of intermediate dominance, all belonging to the family Heterophyidae (Superfamily Opisthorchioidea): Euhaplorchis californiensis, Phocitremoides ovale, Pygidiopsoides spindalis and Stictodora hancocki, all of which infect the California horn snail, Cerithideopsis californica (=Cerithidea californica). We quantify morphology, distribution and behaviour of rediae from fully developed colonies. We also provide information on colony structure for three developing heterophyid colonies to better understand colony development. We discuss the implications of our findings, particularly with respect to how they suggest alternatives to the conclusions of other researchers concerning the nature of trematode sociality. Our analyses of morphological, distributional and behavioural patterns of developed colonies indicate that these heterophyid trematodes have a non-reproductive caste whose function is defence of the colony from invading trematodes. Hence, a soldier caste occurs for species lower in dominance hierarchies than previously known, and is present in at least two superfamilies of digenean trematodes, suggesting that selection for a soldier caste may be much more common among the Trematoda than previously recognised.

zmsbt1 and zmsbt2, two new subtilisin-like serine proteases genes expressed in early maize kernel development.

MAIN CONCLUSION: Two subtilisin-like proteases show highly specific and complementary expression patterns in developing grains. These genes label the complete surface of the filial-maternal interface, suggesting a role in filial epithelial differentiation. The cereal endosperm is the most important source of nutrition and raw materials for mankind, as well as the storage compartment enabling initial growth of the germinating plantlets. The development of the different cell types in this tissue is regulated environmentally, genetically and epigenetically, resulting in the formation of top-bottom, adaxial-abaxial and surface-central axes. However, the mechanisms governing the interactions among the different inputs are mostly unknown. We have screened a kernel cDNA library for tissue-specific transcripts as initial step to identify genes relevant in cell differentiation. We report here on the isolation of two maize subtilisin-related genes that show grain-specific, surficial expression. zmsbt1 (Zea mays Subtilisin1) is expressed at the developing aleurone in a time-regulated manner, while zmsbt2 concentrates at the pedicel in front of the endosperm basal transfer layer. We have shown that their presence, early in the maize caryopsis development, is dependent on proper initial tissue determination, and have isolated their promoters to produce transgenic reporter lines that assist in the study of their regulation.

Importance of telemedicine in diabetes care: Relationships between family physicians and ophthalmologists.

Diabetic retinopathy (DR) is the worldwide leading cause of legal blindness. In 2010, 1.9% of diabetes mellitus (DM) patients were legally blind and 10.2% had visual impairment. The control of DM parameters (glycemia, arterial tension and lipids) is the gold standard for preventing DR complications, although, unfortunately, DR still appeared in a 25% to 35% of patients. The stages of severe vision threading DR, include proliferative DR (6.96%) and diabetic macular edema (6.81%). This review aims to update our knowledge on DR screening using telemedicine, the different techniques, the problems, and the inclusion of different professionals such as family physicians in care programs.

Reassessing the Significance of Intimal Arteritis in Kidney Transplant Biopsy Specimens.

Intimal arteritis (the presence of v-lesions) in kidney transplant biopsy specimens is believed to have major prognostic and diagnostic significance. We assessed the relationship of v-lesions to prognosis in 703 indication biopsy specimens and used microarray-based molecular tests to re-examine the relationship of v-lesions to rejection. v-Lesions were noted in 49 specimens (7%) and were usually mild (v1). The presence of v-lesions had no effect on graft survival compared with the absence of v-lesions. Pathologists using current conventions almost always interpreted v-lesions as reflecting T cell-mediated rejection (TCMR), either pure or mixed with antibody-mediated rejection (ABMR). The molecular scores questioned the conventional diagnoses in 29 of 49 specimens (59%), including ten that were conventional TCMR with no molecular rejection and nine that were conventional TCMR mixed with pure ABMR molecularly. The presence of tubulointerstitial inflammation (i-t) meeting TCMR criteria allowed subclassification of v-lesion specimens into 21 i-t-v-lesion specimens and 28 isolated v-lesion specimens. Molecular TCMR scores were positive in 95% of i-t-v-lesion specimens but only 21% of isolated v-lesion specimens. Molecular ABMR scores were often positive in isolated v-lesion biopsies (46%). Time of biopsy after transplantation was critical for understanding isolated v-lesions: most early isolated v-lesion specimens had no molecular rejection and were DSA negative, whereas most isolated >1 year after transplantation had positive DSA and ABMR scores. Therefore, v-lesions in indication biopsy specimens do not affect prognosis and can reflect TCMR, ABMR, or no rejection. Time after transplantation, DSA, and accompanying inflammation provide probabilistic basis for interpreting v-lesions.

Disappearance of T Cell-Mediated Rejection Despite Continued Antibody-Mediated Rejection in Late Kidney Transplant Recipients.

The prevalent renal transplant population presents an opportunity to observe the adaptive changes in the alloimmune response over time, but such studies have been limited by uncertainties in the conventional biopsy diagnosis of T cell-mediated rejection (TCMR) and antibody-mediated rejection (ABMR). To circumvent these limitations, we used microarrays and conventional methods to investigate rejection in 703 unselected biopsies taken 3 days to 35 years post-transplant from North American and European centers. Using conventional methods, we diagnosed rejection in 205 biopsy specimens (28%): 67 pure TCMR, 110 pure ABMR, and 28 mixed (89 designated borderline). Using microarrays, we diagnosed rejection in 228 biopsy specimens (32%): 76 pure TCMR, 124 pure ABMR, and 28 mixed (no borderline). Molecular assessment confirmed most conventional diagnoses (agreement was 90% for TCMR and 83% for ABMR) but revealed some errors, particularly in mixed rejection, and improved prediction of failure. ABMR was strongly associated with increased graft loss, but TCMR was not. ABMR became common in biopsy specimens obtained >1 year post-transplant and continued to appear in all subsequent intervals. TCMR was common early but progressively disappeared over time. In 108 biopsy specimens obtained 10.2-35 years post-transplant, TCMR defined by molecular and conventional features was never observed. We conclude that the main cause of kidney transplant failure is ABMR, which can present even decades after transplantation. In contrast, TCMR disappears by 10 years post-transplant, implying that a state of partial adaptive tolerance emerges over time in the kidney transplant population.

Video laringoscopio Glidescope y la laringoscopia Machintosh para la intubación en el Hospital Nacional Daniel Alcides Carrión 2014 / Glidescope videolaryngoscope and Macintosh laryngoscopy for the intubation at the National Hospital Daniel Alcides Carrion 2014

Objetivo: Describir las características asociadas al uso de la videolaringoscopía Glidescope y la laringoscopía Machintosh como sistema de control de la vía aérea, en pacientes sometidos a anestesia general en la institución. Método: Analizamos 75 pacientes sometidos a anestesia general e intubación endotraqueal a quienes se les evaluó y en algunos casos se determinaron predictores de vía aérea difícil. Se utilizó laringoscopía directa Machintosh y videolaringoscopía Glidescope como dispositivos de intubación. Se valoró la dificultad de la técnica empleada, tiempo de intubación y número de intentos. Se reportaron los cambios en la pulsioximetría previa y posterior a la intubación. En la visita posterior a los pacientes se verificó la presencia de odinofagía, tos, sangrado, náuseas entre otros. Resultados: Independientemente de los predictores de vía aérea difícil se catalogó como técnica dificultosa al 57.9 por ciento de procedimientos con videolaringoscopía y con laringoscopía directa al 37.8 por ciento de los casos. En los pacientes con predictores de vía aérea difícil el uso de la videolaringoscopía fue más efectivo que la laringoscopía directa. El 100 por ciento de los casos fueron intubables, sin embargo se necesitaron hasta 3 intentos con el uso de laringoscopía directa (8.3 por ciento de los casos). No hubo diferencia significativa en el tiempo de intubación, saturación de oxígeno previa y posterior al procedimiento. La odinofagía y las náuseas fueron los síntomas mayormente referidos en el post operatorio. Conclusiones: La totalidad de los casos fueron exitosos con el uso de los dos dispositivos, sin embargo la videolaringoscopía ofreció menor dificultad al tratarse de aquellos pacientes con predictores de vía aérea difícil. El personal debe entrenarse en el uso de nuevos dispositivos para abordar casos de vía aérea difícil.

Objective: To describe the characteristics associated with use of the Glidescope videolaryngoscope and Machintosh laryngoscopy as a control system of the airway in patients undergoing general anesthesia in the institution. Method: We analyzed 75 patients undergoing general anesthesia and endotracheal intubation who were evaluated and in some cases of difficult airway predictors were determined. Direct laryngoscopy Machintosh and videolaryngoscope Glidescope as intubation devices used. The difficulty of the technique used, intubation time and number of trials was assessed. Changes were reported in pre-and post-intubation pulse oximetry. In the subsequent visit patients the presence of sore throat, cough, bleeding, nausea among others verified. Results: Regardless of the predictors of difficult airway was classified as difficult to 57.9 per cent of procedures videolaryngoscope and direct laryngoscopy to 37.8 per cent of cases technique. In patients with difficult airway predictors using the videolaryngoscope was more effective than direct laryngoscopy. 100 per cent of the cases were intubables, however it took up to 3 attempts using direct laryngoscopy (8.3 per cent of cases). There was no significant difference in intubation time, oxygen saturation pre and post procedure. The sore throat and nausea symptoms were mostly reported in the postoperative period. Conclusions: All the cases were successful with the use of two devices, however videolaryngoscope offered less difficult y when dealing with patients with difficult airway predictors. Staff should be trained in the use of new devices to address cases of difficult airway.

A PCR-based forward genetics screening, using expression domain-specific markers, identifies mutants in endosperm transfer cell development.

Mutant collections are an invaluable source of material on which forward genetic approaches allow the identification of genes affecting a wide variety of biological processes. However, some particular developmental stages and morphological structures may resist analysis due to their physical inaccessibility or to deleterious effects associated to their modification. Furthermore, lethal mutations acting early in development may escape detection. We have approached the characterization of 101 maize seed mutants, selected from a collection of 27,500 visually screened Mu-insertion lines, using a molecular marker approach based on a set of genes previously ascribed to different tissue compartments within the early developing kernel. A streamlined combination of qRT-PCR assays has allowed us to preliminary pinpoint the affected compartment, establish developmental comparisons to WT siblings and select mutant lines with alterations in the different compartments. Furthermore, clusters of markers co-affected by the underlying mutation were identified. We have analyzed more extensively a set of lines presenting significant variation in transfer cell-associated expression markers, and have performed morphological observations, and immunolocalization experiments to confirm the results, validating this approach as an efficient mutant description tool.