Neurophysiology of Brain Networks Underlies Symptoms of Parkinson's Disease: A Basis for Diagnosis and Management.

Parkinson's disease (PD) is one of the leading neurodegenerative disorders. It is considered a movement disorder, although it is accepted that many nonmotor symptoms accompany the classic motor symptoms. PD exhibits heterogeneous and overlaying clinical symptoms, and the overlap of motor and nonmotor symptoms complicates the clinical diagnosis and management. Loss of modulation secondary to the absence of dopamine due to degeneration of the substantia nigra compacta produces changes in firing rates and patterns, oscillatory activity, and higher interneuronal synchronization in the basal ganglia-thalamus-cortex and nigrovagal network involvement in motor and nonmotor symptoms. These neurophysiological changes can be monitored by electrophysiological assessment. The purpose of this review was to summarize the results of neurophysiological changes, especially in the network oscillation in the beta-band level associated with parkinsonism, and to discuss the use of these methods to optimize the diagnosis and management of PD.

Descripción del acoso sexual en docentes de un entorno universitario ecuatoriano / Description of sexual harassment in teachers at an Ecuadorian university environment

El acoso sexual se manifiesta ante la presencia de una serie de conductas de carácter sexual, explícitas o implícitas que resultan invasivas para quien las recibe. El objetivo del presente estudio fue determinar la asociación entre tipo de acoso sexual y género en docentes y personal de apoyo a la academia de una universidad pública ecuatoriana. El estudio tuvo un diseño observacional con alcance asociativo y de corte transversal. Este se desarrolló en un entorno universitario ecuatoriano en 2021 con una población de 1247 docentes y personal de apoyo a la academia, seleccionando una muestra de 484 participantes mediante un muestreo no probabilístico de tipo sujetos voluntarios. Los datos se recolectaron a través de la aplicación de la encuesta ASIES. El 58,3% perteneció al género masculino, predominando las personas autoidentificadas como heterosexuales y la edad promedio fue 41 años. El 14,3% (69) sufrió alguna clase de acoso sexual durante su estadía en la institución, de las que, el 76,8% correspondió al género femenino, esas dos variables se asociaron significativamente (χ²=42,378; p=0,000). La diferencia en la prevalencia entre mujeres y hombres fue estadísticamente significativa (χ²= 42,378; valor p = 0,000). El acoso sexual se asoció significativamente con el género de los participantes autoidentificados como víctimas, observándose que en los hombres predominó en acoso verbal; mientras que, en las mujeres fue el no verbal

Sexual harassment manifests itself in a series of sexual, explicit, or implicit behaviors that are invasive for those who receive them. This study aimed to determine the association between the type of sexual harassment and gender in teachers and academic support staff of an Ecuado-rian public university. The study had an observational design with an associative and cross-sec-tional scope. This research was developed in an Ecuadorian university environment in 2021 with a population of 1,247 teachers and academy support staff, selecting a sample of 484 parti-cipants through a non-probabilistic sampling of voluntary subjects. The data were collected through the ASIES survey application. 58.3% were male, with a predominance of people self-identified as heterosexual, and the average age was 41. 14.3% (69) suffered sexual harass-ment during their stay at the institution, of which 76.8% corresponded to the female gender. These two variables were significantly associated (χ²=42.378; p=0.000). The difference in prevalence between women and men was statistically significant (χ²=42.378; p-value=0.000). Sexual harassment was significantly associated with the gender of the participants who self-identified as victims. It was observed that verbal harassment predominated in men and non-verbal in women.

[Association between metabolic syndrome, socioeconomic status and quality of life in mexicans]. / Asociación entre síndrome metabólico, nivel socioeconómico y calidad de vida en mexicanos.

Background: In Mexico there is little information regarding the link between metabolic syndrome (MetS), socioeconomic status (SES) and quality of life (QoL). Objective: To assess the association between subjects who are at high risk of developing MetS with SES and QoL. Material and methods: Patients attending UMF-2 IMSS or Centro Urbano-SSA Clínica-1 were asked to participate. Anthropometric measures were collected, the AMAI, SF12, and ESF-I questionnaire where apply for SES, QoL, and MetS, respectively. Association were determined by calculating Spearman's rho and the risk (odds ratio and 95% confidence-interval) was assessed using logistic regression. Results: The difference of SES (193 ± 53 vs. 124 ± 50) and QoL (86.3 ± 14.8 vs. 56.0±25.4) questionnaires were significantly between low-risk and high-risk groups, respectively (p < 0.001). There was a negative correlation between ESF-I and SES (rho = -0.623, p < 0.001) as well as the QoL (rho = -0.719, p < 0.001). MetS risk was augmented by decreasing SES (C+: OR = 6.4, 95%IC: 3.2-13.0; D: OR = 66.1, 95%IC: 23.2-188.3), whereas increasing QoL attenuated it (OR = 0.93, 95%CI: 0.91-0.94). However, QoL mitigated the effect of SES (C+: OR = 4.5, 95%IC: 2.1-9.6; D: OR = 11.9, 95%IC: 3.8-37.6). Conclusions: Lower QoL and SES increased the risk of MetS in Central Mexico; however, improving the QoL can mitigated the effect SES has on developing MetS.

Introducción: en México existe escasa información respecto al vínculo entre el síndrome metabólico (MetS), el nivel socioeconómico (NSE) y la calidad de vida (CdV) de la población. Objetivo: evaluar la asociación entre sujetos que tienen alto riesgo de desarrollar MetS con NSE y CdV. Material y métodos: se invitó a participar a pacientes de la UMF-2 del IMSS y del Centro Urbano-SSA Clínica-1. Se recolectaron medidas antropométricas y se aplicaron los cuestionarios AMAI, SF12 y ESF-I para NSE, CdV y MetS, respectivamente. La asociación se determinó calculando rho de Spearman. El riesgo se evaluó mediante regresión logística (razon de momios e intervalo de confianza del 95%). Resultados: la diferencia entre NSE (193 ± 53 frente a 124 ± 50) y CdV (86.3 ± 14.8 frente a 56.0 ± 25.4) fue significativa entre los grupos de bajo y alto riesgo, respectivamente (p < 0.001). Hubo una fuerte correlación negativa entre las puntuaciones de la ESF-I y NSE (rho = -0.623, p < 0.001) así como con la CdV (rho = -0.719, p < 0.001). El riesgo de MetS aumentó al disminuir el NSE (C+: OR = 6.4, IC95%: 3.2 - 13.0; D: OR = 66.1, IC95%: 23.2 - 188.3), mientras que el aumento de la CdV lo atenuó (OR = 0.93, IC95%: 0.91 - 0.94). Interesantemente, la CdV mitigó el efecto del NSE (C+: OR = 4.5, IC95%: 2.1 - 9.6; D: OR = 11.9, IC95%: 3.8 - 37.6). Conclusión: Una menor CdV y NSE aumentan el riesgo de MetS en la región centro de México; sin embargo, el aumento en la CdV podría disminuir el efecto que tiene el NSE en el desarrollo de MetS.

Asociación entre síndrome metabólico, nivel socioeconómico y calidad de vida en mexicanos / Association between metabolic syndrome, socioeconomic status and quality of life in mexicans

Introducción: en México existe escasa información respecto al vínculo entre el síndrome metabólico (MetS), el nivel socioeconómico (NSE) y la calidad de vida (CdV) de la población. Objetivo: evaluar la asociación entre sujetos que tienen alto riesgo de desarrollar MetS con NSE y CdV. Métodos: se invitó a participar a pacientes de la UMF-2 del IMSS y del Centro Urbano-SSA Clínica-1. Se recolectaron medidas antropométricas y se aplicaron los cuestionarios AMAI, SF12 y ESF-I para NSE, CdV y MetS, respectivamente. La asociación se determinó calculando rho de Spearman. El riesgo se evaluó mediante regresión logística (razon de momios e intervalo de confianza del 95%). Resultados: la diferencia entre NSE (193  53 frente a 124  50) y CdV (86.3  14.8 frente a 56.0  25.4) fue significativa entre los grupos de bajo y alto riesgo, respectivamente (p < 0.001). Hubo una fuerte correlación negativa entre las puntuaciones de la ESF-I y NSE (rho = -0.623, p < 0.001) así como con la CdV (rho = -0.719, p < 0.001). El riesgo de MetS aumentó al disminuir el NSE (C+: OR = 6.4, IC95%: 3.2 - 13.0; D: OR = 66.1, IC95%: 23.2 - 188.3), mientras que el aumento de la CdV lo atenuó (OR = 0.93, IC95%: 0.91 - 0.94). Interesantemente, la CdV mitigó el efecto del NSE (C+: OR = 4.5, IC95%: 2.1 - 9.6; D: OR = 11.9, IC95%: 3.8 - 37.6). Conclusión: Una menor CdV y NSE aumentan el riesgo de MetS en la región centro de México; sin embargo, el aumento en la CdV podría disminuir el efecto que tiene el NSE en el desarrollo de MetS.

Background: In Mexico there is little information regarding the link between metabolic syndrome (MetS), socioeconomic status (SES) and quality of life (QoL) Objective: To assess the association between subjects who are at high risk of developing MetS with SES and QoL. Methods: Patients attending UMF-2 IMSS or Centro Urbano-SSA Clínica-1 were asked to participate. Anthropometric measures were collected, the AMAI, SF12, and ESF-I questionnaire where apply for SES, QoL, and MetS, respectively. Association were determined by calculating Spearman's rho and the risk (odds ratio and 95% confidence-interval) was assessed using logistic regression. Results: The difference of SES (193  53 vs. 124  50) and QoL (86.3  14.8 vs. 56.025.4) questionnaires were significantly between low-risk and high-risk groups, respectively (p < 0.001). There was a negative correlation between ESF-I and SES (rho = -0.623, p < 0.001) as well as the QoL (rho = -0.719, p < 0.001). MetS risk was augmented by decreasing SES (C+: OR = 6.4, 95%IC: 3.2-13.0; D: OR = 66.1, 95%IC: 23.2-188.3), whereas increasing QoL attenuated it (OR = 0.93, 95%CI: 0.91-0.94). However, QoL mitigated the effect of SES (C+: OR = 4.5, 95%IC: 2.1-9.6; D: OR = 11.9, 95%IC: 3.8-37.6).

Sellado apical de dos materiales de obturación retrógrada en dientes unirradiculares / Apical sealing of two root-end filling materials in unirradicular teeth

Objetivo: Comparar la capacidad de sellado de dos materiales para obturación retrógrada en dientes permanentes unirradiculares: el agregado de trióxido mineral (MTA®) y el silicato tricálcico (Biodentine®). Materiales y métodos: Se seleccionaron 38 dientes permanentes unirradiculares con cierre apical completo, los cuales fueron divididos aleatoriamente en dos grupos experimentales (n = 15): Grupo 1: MTA®, Grupo 2: Biodentine®. Además, se usaron controles positivos y negativos. El tratamiento radicular se realizó con el sistema rotatorio Mtwo y la obturación mediante el sistema termoplástico de onda continua (Beefill), y se usó como sellador el cemento tipo Grossman. Se realizó la apicectomía del extremo apical, luego la preparación de cavidades retroapicales estandarizadas y las respectivas obturaciones con MTA® y Biodentine®, según grupo. Posteriormente, los especímenes se sometieron a un proceso de filtración apical de tinta china y de transparentación, mientras que la filtración apical fue evaluada por medio de un microscopio estereoscópico. Los datos fueron analizados con la prueba U de Mann-Whitney. Resultados: El análisis inferencial mostró que Biodentine® tuvo una menor microfiltración que el MTA®, con una diferencia estadísticamente significativa al 95% (p < 0,034). Conclusión: El cemento Biodentine® mostró una mayor capacidad de sellado a nivel apical que el cemento MTA® en obturaciones retrógradas de dientes unirradiculares ex vivo. (AU)

Aim: To compare the sealing capacity of mineral trioxide (MTA®) and tricalcium silicate (Biodentine®) for retrograde filling in single-root permanent teeth. Materials and methods: Thirty-eight permanent single-root teeth with complete apical closure were selected and randomly divided into two experimental groups (n = 15): Group 1: MTA®, and Group 2: Biodentine®, in addition to positive and negative controls. Root treatment was performed with the MTWO rotary system, and obturation was carried out by means of the continuous wave thermoplastic system (Beefill) using Grossman-type cement as a sealant. Apical end apicoectomy was performed followed by the preparation of standardized retro-apical cavities and the respective fillings with MTA ® and Biodentine® according to the study group. Subsequently, the specimens were subjected to an apical filtration process of Chinese ink and transparency, while the apical filtration was evaluated with a stereoscopic microscope. The data were analyzed with the Mann-Whitney U test. Results: Inferential analysis showed that Biodentine® had less microleakage than MTA® with a statistically significant difference of 95% (p <0.034). Conclusion: Biodentine® cement showed greater apical sealing capacity than MTA® cement in retrograde fillings of single-root teeth ex vivo. (AU)

Differential effects of the methylenetetrahydrofolate reductase polymorphisms (C677T and A1298C) on hematological malignancies among Latinos: a meta-analysis.

Our objective was to determine the association between the methylenetetrahydrofolate reductase polymorphisms (C677T and A1298C) and the risk of developing acute lymphoblastic leukemia (ALL), chronic myeloid leukemia (CML), acute myeloid leukemia (AML), and multiple myelomas (MM) in Latinos. PubMed, SCOPUS, EBSCO, LILACS, and other Latin-specific databases were searched for case-control studies that investigated the association between these polymorphisms and hematologic malignancies until November 2017. Genotype distributions were extracted and either fixed-effects or random-effects models were used to calculate the pooled crude odds ratios (ORs) for the heterozygous, homozygous, dominant, recessive, and allelic genetic models. No publication bias was detected by the Begg-Mazumdar's test and Egger's test. From 290 publications, we identified 15 studies on the C677T polymorphism and 13 studies on the A1298C polymorphism. We observed a significant decrease in risk for the C677T polymorphism (OR range=0.54-0.75, p<0.01) and a significant increase in risk for the A1298C polymorphism (OR range=1.28-2.52, p<0.05) in developing ALL for all genetic models. No associations were determined for CML, AML, or MM for either polymorphism. This meta-analysis demonstrated that the A1298C polymorphism was associated with an increased risk of developing ALL, whereas the C677T polymorphism was associated with a decreased risk (protective factor) in the Latino population.

[Health-worker barriers to syphilis screening in pregnant women in Bolivia's Los Andes network]. / Barreras del personal de salud para el tamizaje de sífilis en mujeres embarazadas de la Red Los Andes, Bolivia.

OBJECTIVE: Identify health-worker barriers that keep pregnant women who receive prenatal care from being screened for syphilis (Los Andes Health Network, Bolivia). METHODS: Semi-structured interviews were done with 46 health care providers and 249 clinical health records of pregnant women were analyzed in eight public health facilities in the Los Andes network. RESULTS: Health-worker barriers to syphilis screening in pregnant women included lack of time by personnel to raise awareness of the benefit of syphilis screening; some mentioned that syphilis tests should only be done in facilities that attend deliveries and have a laboratory; lack of communication between clinicians and laboratory personnel; and problems with provision of supplies and reagents. The clinical record review found that only 55.4% contained syphilis laboratory results and only 37.4% of perinatal clinical histories had records of laboratory results. The interviews found that providers believe that syphilis screening is done in 100% of pregnant women receiving prenatal care. CONCLUSION: Syphilis screening is not being done according to Bolivia's strategy for the elimination of congenital syphilis, and is not done on more than half of pregnant women in prenatal care with perinatal clinical history records. This is not perceived by health professionals and can become a barrier to syphilis screening in pregnant women.

Barreras del personal de salud para el tamizaje de sífilis en mujeres embarazadas de la Red Los Andes, Bolivia / Health-worker barriers to syphilis screening in pregnant women in Bolivia’s Los Andes network

Objetivo. Identificar barreras del personal de salud por las cuales las embarazadas que asisten al control prenatal no se realizan el tamizaje de sífilis (Red de Salud Los Andes, Bolivia). Métodos. Se realizaron 46 entrevistas semiestructuradas a proveedores de salud y se analizaron los registros de 249 expedientes clínicos de embarazadas de ocho establecimientos públicos de salud de la Red Los Andes. Resultados. Entre las barreras del personal de salud para el tamizaje de sífilis en embarazadas se identificaron el tiempo insuficiente del personal para sensibilizar sobre el beneficio del tamizaje de sífilis, algunos mencionaron que las pruebas de sífilis se deberían hacer solo en centros donde atienden partos y tienen laboratorio, la poca comunicación entre el personal de la consulta médica y laboratorio, así como también problemas de abastecimiento de suministros y reactivos. En la revisión de expedientes clínicos se observó que 55,4% contaba con los resultados de laboratorio de sífilis en sus expedientes y solo 37,4% de historias clínicas perinatales contaba con registro de resultados de laboratorios. A través de las entrevistas, se pudo observar que los proveedores perciben que el tamizaje de sífilis se realiza al 100% de las embarazadas que asisten al control prenatal. Conclusión. El tamizaje para sífilis no se está realizando según lo establecido en la estrategia de país para la eliminación de la sífilis congénita, y no llega a más de la mitad de embarazadas en control prenatal con registros en las historias clínicas perinatales. Esto no es percibido por los profesionales de la salud y puede transformarse en una barrera para el tamizaje de sífilis en mujeres embarazadas.

Objective. Identify health-worker barriers that keep pregnant women who receive prenatal care from being screened for syphilis (Los Andes Health Network, Bolivia). Methods. Semi-structured interviews were done with 46 health care providers and 249 clinical health records of pregnant women were analyzed in eight public health facilities in the Los Andes network. Results. Health-worker barriers to syphilis screening in pregnant women included lack of time by personnel to raise awareness of the benefit of syphilis screening; some mentioned that syphilis tests should only be done in facilities that attend deliveries and have a laboratory; lack of communication between clinicians and laboratory personnel; and problems with provision of supplies and reagents. The clinical record review found that only 55.4% contained syphilis laboratory results and only 37.4% of perinatal clinical histories had records of laboratory results. The interviews found that providers believe that syphilis screening is done in 100% of pregnant women receiving prenatal care. Conclusion. Syphilis screening is not being done according to Bolivia’s strategy for the elimination of congenital syphilis, and is not done on more than half of pregnant women in prenatal care with perinatal clinical history records. This is not perceived by health professionals and can become a barrier to syphilis screening in pregnant women.

Caracterización, riesgos ocupacionales y percepción de salud de vendedores informales de lotería y chance / Characterization, occupational risks and perception of health of informal lottery vendors / Caracterização, riscos ocupacionais e percepção de saúde de vendedores informais de loteriaq

Objetivo: analizar las características sociodemográficas, percepción de la salud y riesgos ocupacionales de la población de vendedores informales de lotería y chance de Villavicencio y Yopal. Materiales y Métodos: estudio descriptivo, transversal y prospectivo. La muestra no aleatoria estuvo integrada por 249 vendedores informales. Las variables estudiadas fueron: características sociodemográficas y económicas, afiliación al sistema general de salud, nivel de ingreso, responsabilidad en el hogar, propiedad de la vivienda, factores de riesgo ocupacionales y condiciones laborales. Como instrumento de recolección de información se utilizó la Encuesta del Ministerio de Salud para Trabajadores Informales. Resultados: la mayoría de vendedores de lotería y chance son mayores de 40 años, mujeres, casados o en unión libre. Se observó una baja afiliación a pensiones y riesgos laborales, y con ingresos inferiores a un salario mínimo legal mensual vigente en un 80%. Las condiciones de trabajo, sobre todo las ambientales y de seguridad, son precarias; aun así, la auto percepción de salud como mala o regular no supera el 50%. Conclusión: población muy vulnerable en cuanto a sus ingresos y condiciones futuras de ingreso para protección en la vejez.

Objective: To analyze the socio-demographic characteristics, health perception and occupational risks of the population of street lottery retailers in Villavicencio and Yopal. Materials and Methods: Descriptive, cross-sectional, and prospective study. The non-aleatory sample was made by 249 informal vendors. The variables studied were: socio-demographic and economic characteristics, affiliation to the general health system, level of income, home responsibility, homeownership, occupational risk factors and work conditions. As an instrument of data collection the Department of Health for Informal Workers Survey was used. Results: most of the lottery retailers are older than 40, women, married or cohabiting. A low affiliation to pension and occupational risks was observed, and with incomes lower than a monthly minimum wage valid in an 80%. The work conditions, most importantly the environment and security conditions, are precarious; nonetheless, the self-perception of health as bad or regular does not reach 50%. Conclusion: very vulnerable population regarding income and future conditions of income for old age protection.

Objetivo: analisar as características sócio-demográficas, percepção da saúde e riscos ocupacionais da população de vendedores ambulantes de loteria nas cidades de Villavicencio e Yopal na Colômbia. Materiais e Métodos: estudo descritivo, transversal e prospectivo. A amostragem não aleatória esteve integrada por 249 vendedores informais. As variáveis estudadas foram: características sóciodemográficas e económicas, afiliação à rede de saúde, nível de ingresso, responsabilidade no lar, casa própria ou não, fatores de risco ocupacionais e condições de trabalho. Como instrumento de recolecção de informação se utilizou a Pesquisa de Opinião do Ministério de Saúde para Trabalhadores Informais. Resultados: a maioria de vendedores de loteria são maiores de 40 anos, mulheres, casadas ou em união libre. Observou-se uma baixa afiliação a Fundo Social de Pensão e Riscos de Trabalho, e com ingressos inferiores a um salário mínimo legal mensal vigente num 80%. As condições de trabalho, sobre todo as ambientais e de seguridade, são precárias; ainda assim, a auto percepção de saúde como má ou regular não supera o 50%. Conclusão: população muito vulnerável em quanto a seus ingressos e condições futuras de ingresso para proteção na velhice

Barreras del personal de salud para el tamizaje de sífilis en mujeres embarazadas de la Red Los Andes, Bolivia / Health-worker barriers to syphilis screening in pregnant women in Bolivia, Los Andes network

RESUMEN Objetivo Identificar barreras del personal de salud por las cuales las embarazadas que asisten al control prenatal no se realizan el tamizaje de sífilis (Red de Salud Los Andes, Bolivia). Métodos Se realizaron 46 entrevistas semiestructuradas a proveedores de salud y se analizaron los registros de 249 expedientes clínicos de embarazadas de ocho establecimientos públicos de salud de la Red Los Andes. Resultados Entre las barreras del personal de salud para el tamizaje de sífilis en embarazadas se identificaron el tiempo insuficiente del personal para sensibilizar sobre el beneficio del tamizaje de sífilis, algunos mencionaron que las pruebas de sífilis se deberían hacer solo en centros donde atienden partos y tienen laboratorio, la poca comunicación entre el personal de la consulta médica y laboratorio, así como también problemas de abastecimiento de suministros y reactivos. En la revisión de expedientes clínicos se observó que 55,4% contaba con los resultados de laboratorio de sífilis en sus expedientes y solo 37,4% de historias clínicas perinatales contaba con registro de resultados de laboratorios. A través de las entrevistas, se pudo observar que los proveedores perciben que el tamizaje de sífilis se realiza al 100% de las embarazadas que asisten al control prenatal. Conclusión El tamizaje para sífilis no se está realizando según lo establecido en la estrategia de país para la eliminación de la sífilis congénita, y no llega a más de la mitad de embarazadas en control prenatal con registros en las historias clínicas perinatales. Esto no es percibido por los profesionales de la salud y puede transformarse en una barrera para el tamizaje de sífilis en mujeres embarazadas.

ABSTRACT Objective Identify health-worker barriers that keep pregnant women who receive prenatal care from being screened for syphilis (Los Andes Health Network, Bolivia). Methods Semi-structured interviews were done with 46 health care providers and 249 clinical health records of pregnant women were analyzed in eight public health facilities in the Los Andes network. Results Health-worker barriers to syphilis screening in pregnant women included lack of time by personnel to raise awareness of the benefit of syphilis screening; some mentioned that syphilis tests should only be done in facilities that attend deliveries and have a laboratory; lack of communication between clinicians and laboratory personnel; and problems with provision of supplies and reagents. The clinical record review found that only 55.4% contained syphilis laboratory results and only 37.4% of perinatal clinical histories had records of laboratory results. The interviews found that providers believe that syphilis screening is done in 100% of pregnant women receiving prenatal care. Conclusion Syphilis screening is not being done according to Bolivia’s strategy for the elimination of congenital syphilis, and is not done on more than half of pregnant women in prenatal care with perinatal clinical history records. This is not perceived by health professionals and can become a barrier to syphilis screening in pregnant women.

Embarazo en adolescentes de Jalisco, México: una mirada desde la marginación social / Adolescent pregnancy in Jalisco Mexico: a view from social marginalization

Objetivo: Analizar las condiciones socioculturales, atención prenatal y obstétrica, y del recién nacido, en mujeres adolescentes embarazadas residentes de municipios con muy alta y muy baja marginación, en Jalisco, México durante 2014. Diseño: Estudio cuantitativo, descriptivo transversal. Institución. Secretaría de Salud Jalisco. Participantes: Adolescentes residentes de municipios de muy alta y de muy baja marginación. Metodología: Se revisaron certificados de nacimientos de adolescentes residentes de Jalisco atendidas de parto durante 2014, 140 fueron adolescentes residentes de municipios de muy alta marginación y 21 004 de municipios de muy baja marginación. Principales medidas de resultados: Análisis univariado de condiciones socioculturales, atención prenatal y obstétrica, además de datos del recién nacido. Resultados: Se registraron 28 178 nacimientos; de muy alta marginación (Grupo 1) fueron n=140 (0,5%) y de muy baja marginación (Grupo 2) fueron n=21 004 (74,5%). Del Grupo 1, la media de edad fue 17,1 años, 18,5% tenía 15 años o menos, 41,4% primaria o menos, media del número de embarazos fue 1,35; 20% no recibió atención prenatal, la media del número de consultas era 3,1, el 91% tuvo resolución obstétrica por parto normal, la media del peso de recién nacido fue 3 032,10 gramos. Del Grupo 2 la media de la edad fue 17,5 años, 22,7% era soltera, media del número de embarazos 1,34, media del número de consultas 6,7; el 45,2% tuvo resolución obstétrica por cesárea y la media del peso de recién nacidos fue 3 101,67 gramos. Conclusiones: Existieron diferencias porcentuales y de medias entre los grupos, en características socioculturales (escolaridad, estado civil y seguridad social) y las relacionadas con atención prenatal y obstétrica (control prenatal y resolución del embarazo).

Objective: To analyze the sociocultural conditions, prenatal and obstetrical care, and data of the newborn, in pregnant young women residing in municipalities with very high and very low marginalization in Jalisco, Mexico, in 2014. Design: Quantitative, descriptive cross-sectional study. Institution: Jalisco Health Secretariat. Participants: Adolescents residents of both highly and very low marginalization municipalities. Methodology: Birth certificates of 140 adolescents residing in highly marginalized municipalities (Group 1) and 21 004 residing in municipalities with very low marginalization (Group 2) in Jalisco, Mexico, and who delivered a child during 2014, were reviewed. Main outcome measures: Univariate analysis of social and cultural conditions, prenatal and obstetrical care, data of the newborn. Results: From 28 178 births, 140 (0.5%) adolescents belonged to highly marginalized births (Group 1) and 21 004 (74.5%) occurred in adolescentes of very low marginalization adolescents (Group 2). The average age in Group 1 was 17.1 years, 18.5% were 15 years or less; 41.4% had elementary school or care, the mean number of pregnancies was 1.35; 20% did not receive prenatal care, the mean number of consultations was 3.1, 91% had normal delivery, the average newborn birth weight was 3 032.10 grams. The second group's mean age was 17,5 years , 22.7 % were single, the average number of pregnancies 1.34, the mean number of consultations 6.6 , 45.2% had caesarean section, and the average weight of newborns was 3 101.67 grams. Conclusions: There were differences between groups in sociocultural characteristics (education, marital status and social security) and those related to prenatal and obstetrical care (prenatal and pregnancy resolution).

Lessons learned in evaluating the Familias Fuertes program in three countries in Latin America / Lecciones aprendidas al evaluar el programa Familias Fuertes en tres países de América Latina

This report describes 1) the evaluation of the Familias Fuertes primary prevention program in three countries (Bolivia, Colombia, and Ecuador) and 2) the effect of program participation on parenting practices. Familias Fuertes was implemented in Bolivia (10 groups, 96 parents), Colombia (12 groups, 173 parents), and Ecuador (five groups, 42 parents) to prevent the initiation and reduce the prevalence of health-compromising behaviors among adolescents by strengthening family relationships and enhancing parenting skills. The program consists of seven group sessions (for 6-12 families) designed for parents/caregivers and their 10-14-year-old child. Parents/caregivers answered a survey before the first session and at the completion of the program. The survey measured two important mediating constructs: "positive parenting" and "parental hostility." The Pan American Health Organization provided training for facilitators. After the program, parents/caregivers from all three countries reported significantly higher mean scores for "positive parenting" and significantly lower mean scores for "parental hostility" than at the pre-test. "Positive parenting" practices paired with low "parental hostility" are fundamental to strengthening the relationship between parents/caregivers and the children and reducing adolescents' health-compromising behaviors. More research is needed to examine the long-term impact of the program on adolescent behaviors.

Este informe describe 1) la evaluación del programa de prevención primaria Familias Fuertes en tres países (Bolivia, Colombia y Ecuador) y 2) el efecto de la participación en el programa sobre las prácticas de crianza. El programa Familias Fuertes se llevó a cabo en Bolivia (10 grupos, 96 padres), Colombia (12 grupos, 173 padres) y Ecuador (5 grupos, 42 padres) para prevenir el inicio y reducir la prevalencia de comportamientos que constituyen un riesgo para la salud de los adolescentes, mediante el fortalecimiento de las relaciones familiares y la mejora de las habilidades de crianza. El programa consta de siete sesiones de grupo (para 6 a 12 familias) dirigidas a padres o cuidadores y sus hijos de 10 a 14 años de edad. Los padres o cuidadores respondieron a una encuesta antes de la primera sesión y al término del programa. La encuesta midió dos conceptos importantes: la "crianza positiva" y la "hostilidad parental". La Organización Panamericana de la Salud capacitó a los facilitadores. Después del programa, los padres o cuidadores de los tres países presentaron puntuaciones ­ medias significativamente mayores en "crianza positiva" y significativamente menores en "hostilidad parental" que en la encuesta previa. La prácticas de "crianza positiva" asociadas con una baja "hostilidad parental" son fundamentales para fortalecer la relación entre los padres o cuidadores y los niños, y reducen los comportamientos que constituyen un riesgo para la salud de los adolescentes. Es necesaria una investigación más amplia para analizar la repercusión a largo plazo del programa sobre los comportamientos de los adolescentes.

Metallothionein-1 and nitric oxide expression are inversely correlated in a murine model of Chagas disease

Chagas disease, caused by Trypanosoma cruzi, represents an endemic among Latin America countries. The participation of free radicals, especially nitric oxide (NO), has been demonstrated in the pathophysiology of seropositive individuals with T. cruzi. In Chagas disease, increased NO contributes to the development of cardiomyopathy and megacolon. Metallothioneins (MTs) are efficient free radicals scavengers of NO in vitro and in vivo. Here, we developed a murine model of the chronic phase of Chagas disease using endemic T. cruzi RyCH1 in BALB/c mice, which were divided into four groups: infected non-treated (Inf), infected N-monomethyl-L-arginine treated (Inf L-NAME), non-infected L-NAME treated and non-infected vehicle-treated. We determined blood parasitaemia and NO levels, the extent of parasite nests in tissues and liver MT-I expression levels. It was observed that NO levels were increasing in Inf mice in a time-dependent manner. Inf L-NAME mice had fewer T. cruzi nests in cardiac and skeletal muscle with decreased blood NO levels at day 135 post infection. This affect was negatively correlated with an increase of MT-I expression (r = -0.8462, p < 0.0001). In conclusion, we determined that in Chagas disease, an unknown inhibitory mechanism reduces MT-I expression, allowing augmented NO levels.

Metallothionein-1 and nitric oxide expression are inversely correlated in a murine model of Chagas disease.

Chagas disease, caused by Trypanosoma cruzi, represents an endemic among Latin America countries. The participation of free radicals, especially nitric oxide (NO), has been demonstrated in the pathophysiology of seropositive individuals with T. cruzi. In Chagas disease, increased NO contributes to the development of cardiomyopathy and megacolon. Metallothioneins (MTs) are efficient free radicals scavengers of NO in vitro and in vivo. Here, we developed a murine model of the chronic phase of Chagas disease using endemic T. cruzi RyCH1 in BALB/c mice, which were divided into four groups: infected non-treated (Inf), infected N-monomethyl-L-arginine treated (Inf L-NAME), non-infected L-NAME treated and non-infected vehicle-treated. We determined blood parasitaemia and NO levels, the extent of parasite nests in tissues and liver MT-I expression levels. It was observed that NO levels were increasing in Inf mice in a time-dependent manner. Inf L-NAME mice had fewer T. cruzi nests in cardiac and skeletal muscle with decreased blood NO levels at day 135 post infection. This affect was negatively correlated with an increase of MT-I expression (r = -0.8462, p < 0.0001). In conclusion, we determined that in Chagas disease, an unknown inhibitory mechanism reduces MT-I expression, allowing augmented NO levels.

Lessons learned in evaluating the Familias Fuertes program in three countries in Latin America.

This report describes 1) the evaluation of the Familias Fuertes primary prevention program in three countries (Bolivia, Colombia, and Ecuador) and 2) the effect of program participation on parenting practices. Familias Fuertes was implemented in Bolivia (10 groups, 96 parents), Colombia (12 groups, 173 parents), and Ecuador (five groups, 42 parents) to prevent the initiation and reduce the prevalence of health-compromising behaviors among adolescents by strengthening family relationships and enhancing parenting skills. The program consists of seven group sessions (for 6-12 families) designed for parents/caregivers and their 10-14-year-old child. Parents/caregivers answered a survey before the first session and at the completion of the program. The survey measured two important mediating constructs: "positive parenting" and "parental hostility." The Pan American Health Organization provided training for facilitators. After the program, parents/caregivers from all three countries reported significantly higher mean scores for "positive parenting" and significantly lower mean scores for "parental hostility" than at the pre-test. "Positive parenting" practices paired with low "parental hostility" are fundamental to strengthening the relationship between parents/caregivers and the children and reducing adolescents' health-compromising behaviors. More research is needed to examine the long-term impact of the program on adolescent behaviors.

Prevalencia de infección por micobacterias en primates en cautiverio y en los trabajadores de centros de atención de fauna silvestre y zoológicos en el departamento de Antioquia, 2009

Objetivo: determinar la prevalencia de infección y/o enfermedad por micobacterias en primates cautivos y en personal que trabaja en centros de atención de fauna silvestre y zoológicos en Antioquia.

Razones jurídicas para incluir la homeopatía en el Plan Obligatorio de Salud / Legal reasons for including homeopathy in the Mandatory Health Plan

El Estado como obligado a garantizar a los Colombianos el Derecho a la Seguridad Social, consagra un Plan Obligatorio de Salud en el que incluye varios servicios y medicamentos. Sin embargo no incluye tratamientos alternativos o medicina homeopática, bajo el entendido de que no reúne los requisitos para hacer parte de este plan, es por ello que mediante este trabajo de grado se pretende probar no sólo que dicha rama de la medicina reúne los requisitos legales para pertenecer al POS sino que su inclusión podría tener beneficios para la salud de los asociados, en la medida en que permite un trato más digno y personalizado al paciente, además de permitir al Estado realizar un control eficaz sobre el ejercicio de esta profesión ya que la falta del mismo podría causar graves consecuencias sanitarias si no es ejercida debidamente.

Trypanosoma cruzi strains isolated from human, vector, and animal reservoir in the same endemic region in Mexico and typed as T. cruzi I, discrete typing unit 1 exhibit considerable biological diversity.

In this study, three strains of Trypanosoma cruzi were isolated at the same time and in the same endemic region in Mexico from a human patient with chronic chagasic cardiomyopathy (RyC-H); vector (Triatoma barberi) (RyC-V); and rodent reservoir (Peromyscus peromyscus) (RyC-R). The three strains were characterized by multilocus enzyme electrophoresis, random amplified polymorphic DNA, and by pathological profiles in experimental animals (biodemes). Based on the analysis of genetic markers the three parasite strains were typed as belonging to T. cruzi I major group, discrete typing unit 1. The pathological profile of RyC-H and RyC-V strains indicated medium virulence and low mortality and, accordingly, the strains should be considered as belonging to biodeme Type III. On the other hand, the parasites from RyC-R strain induced more severe inflammatory processes and high mortality (> 40%) and were considered as belonging to biodeme Type II. The relationship between genotypes and biological characteristics in T. cruzi strains is still debated and not clearly understood. An expert committee recommended in 1999 that Biodeme Type III would correspond to T. cruzi I group, whereas Biodeme Type II, to T. cruzi II group. Our findings suggest that, at least for Mexican isolates, this correlation does not stand and that biological characteristics such as pathogenicity and virulence could be determined by factors different from those identified in the genotypic characterization.

Trypanosoma cruzi strains isolated from human, vector, and animal reservoir in the same endemic region in Mexico and typed as T. cruzi I, discrete typing unit 1 exhibit considerable biological diversity

In this study, three strains of Trypanosoma cruzi were isolated at the same time and in the same endemic region in Mexico from a human patient with chronic chagasic cardiomyopathy (RyC-H); vector (Triatoma barberi) (RyC-V); and rodent reservoir (Peromyscus peromyscus) (RyC-R). The three strains were characterized by multilocus enzyme electrophoresis, random amplified polymorphic DNA, and by pathological profiles in experimental animals (biodemes). Based on the analysis of genetic markers the three parasite strains were typed as belonging to T. cruzi I major group, discrete typing unit 1. The pathological profile of RyC-H and RyC-V strains indicated medium virulence and low mortality and, accordingly, the strains should be considered as belonging to biodeme Type III. On the other hand, the parasites from RyC-R strain induced more severe inflammatory processes and high mortality (> 40 percent) and were considered as belonging to biodeme Type II. The relationship between genotypes and biological characteristics in T. cruzi strains is still debated and not clearly understood. An expert committee recommended in 1999 that Biodeme Type III would correspond to T. cruzi I group, whereas Biodeme Type II, to T. cruzi II group. Our findings suggest that, at least for Mexican isolates, this correlation does not stand and that biological characteristics such as pathogenicity and virulence could be determined by factors different from those identified in the genotypic characterization