The development, feasibility and acceptability of an Internet-based STI-HIV prevention intervention for young Chilean women.

BACKGROUND: Young Chilean women between 18 and 24 years of age are at high risk of contracting sexually transmitted infection (STI) and human immunodeficiency virus (HIV). The literature shows a shortage of STI-HIV prevention interventions focused on this specific high-risk population and a unique set of barriers to receiving prevention messages. Internet-based interventions are promising for delivering STI-HIV prevention interventions and avoiding barriers to services. AIMS: The study aimed to develop a culturally informed Internet-based STI-HIV prevention intervention for Chilean women between 18 and 24 years of age, to investigate its feasibility and acceptability, and to compile recommendations on what would make the intervention more acceptable and feasible for these women. METHODS: The development of the Internet intervention was facilitated by a process that featured consultation with content and technology experts. A pre-post test design was used to test the acceptability and feasibility of the intervention with 40 young Chilean women between 18 and 24 years of age. RESULTS: The intervention website consisted of four modules of content and activities that support learning. The intervention was feasible and acceptable for young Chilean women between 18 and 24 years of age. DISCUSSION AND CONCLUSION: This study demonstrated the value of engaging multiple expert panels to develop culturally informed and technology-based interventions. The results of this study support the feasibility and acceptability of conducting an Internet-based intervention with multiple sessions, yielding high participation rates in a population in which there are barriers to discussion of STI-HIV prevention and sex-related content. IMPLICATIONS FOR NURSING AND HEALTH POLICY: The outcomes have implications for nursing education and clinical practice and they can be used for the legal and judicial systems to promote or reinforce policies that encourage STI-HIV prevention strategies among women.

Allergy and acute leukaemia in children with Down syndrome: a population study. Report from the Mexican inter-institutional group for the identification of the causes of childhood leukaemia.

BACKGROUND: Allergies have been described as protective factors against the development of childhood acute leukaemia (AL). Our objective was to investigate the associations between allergy history and the development of AL and acute lymphoblastic leukaemia (ALL) in children with Down syndrome (DS). METHODS: A case-control study was performed in Mexico City. The cases (n=97) were diagnosed at nine public hospitals, and the controls (n=222) were recruited at institutions for children with DS. Odds ratios (OR) were calculated. RESULTS: Asthma was positively associated with AL development (OR=4.18; 95% confidence interval (CI): 1.47-11.87), whereas skin allergies were negatively associated (OR=0.42; 95% CI: 0.20-0.91). CONCLUSION: Our findings suggest that allergies and AL in children with DS share biological and immune mechanisms. To our knowledge, this is the first study reporting associations between allergies and AL in children with DS.

Seroprevalence of antibodies against the excreted antigen superoxide dismutase by Trypanosoma cruzi in dogs from the Yucatan Peninsula (Mexico).

Numerous studies have shown the role of dogs as a reservoir for the American trypanosomiasis, as the bridge connecting sylvatic and peridomestic cycles. The objective of this study was to determine the prevalence of American trypanosomiasis in the dog population (630 sera) from seven localities in the Yucatan Peninsula (city of Mérida and the towns of Molas, Playa del Carmen, Akumal, Xcalacoop, Xcalac and Xahuachol). These data are key for developing control measures for the disease. The sera were analysed to detect antibodies against Trypanosoma cruzi, using Fe-SOD excreted as the antigenic fraction by ELISA and Western blot as confirmation. The total prevalence found in the Yucatan Peninsula was some 14.76%, with 10.74% in the state of Yucatan (city of Mérida, towns of Molas and Xcalacoop) and 21.34% in the state of Quintana Roo (towns of Playa del Carmen, Akumal, Xcalac and Xahuachol). However, a more thorough epidemiological study of the dog population, both wild and urban, in the Yucatan Peninsula will be required to design a control strategy for these diseases, paying particular attention to the population affected and even broadening the study to other Mexican states as well as neighbouring countries. These results again confirm that iron-superoxide dismutase excreted by T. cruzi constitutes a good source of antigen for serodiagnosis in epidemiological studies.

Impact of Mano a Mano-Mujer, an HIV prevention intervention, on depressive symptoms among Chilean women.

Worldwide, and in Chile, the number of women living with HIV is increasing. Depression is considered a factor that interferes with HIV prevention. Depression may reach 41% among low-income Chilean women. Depressed people are less willing to participate in behaviours that protect them against HIV. The aim of this study is to analyze the impact of Mano a Mano-Mujer (MM-M), and HIV prevention intervention, on depressive symptoms among Chilean women. A quasi-experimental design was used for this study. The research was conducted in Santiago, Chile; a total of 400 women participated in the study (intervention group, n=182; control group, n=218). The intervention was guided by the social-cognitive model and the primary health care model. The intervention consists of six 2-h sessions delivered in small groups. Sessions covered: HIV prevention, depression, partner's communication, and substance abuse. Face-to-face interviews were conducted at baseline and at 3-month follow-up. Chilean women who participated in MM-M significantly decreased, at 3 months follow up, their reported depressive symptoms. MM-M provided significant benefits for women's depression symptoms. In this study nurses participated as leaders for the screening of depressive symptoms and as facilitators of community interventions.

[HIV PREVENTION FOR HISPANIC WOMEN FIFTY YEARS AND OLDER.] / PREVENCION DE VIH PARA MUJERES HISPANAS DE 50 AÑOS Y MÁS.

INTRODUCTION: Hispanic women aged 50 and over (OHW) are a minority in the U.S. at high risk of acquiring HIV and the least studied group of population in relation to health, social characteristics and sexual behavior. OBJECTIVE: To investigate the factors that increase HIV risk among OHW with the purpose of developing or adapting an intervention appropriate for their "age and culture". METHODOLOGY: A cross-sectional descriptive study with a sample of 50 OHW, sexually active and who residing in Miami, Florida, U.S. A structured questionnaire was administered by trained bilingual interviewers (English/Spanish). Participants were recruited from different locations in South Florida. Data were analyzed using descriptive statistics, including central tendency and dispersion measures. RESULTS: OHW's mean age was 55.7 ± 6 years old (range 50-76 years old). All the OHW were in the menopause. HIV PREVENTION: OHW reported average levels of HIV knowledge and partner communication. In the sample OHW reported depression symptoms, intimate partner violence, negative attitudes towards people living with HIV and low perceived risk of acquiring HIV. OHW mentioned learning needs in topics related to HIV prevention and age changes. CONCLUSION: OHW are at risk of acquiring HIV and they have special needs in terms of HIV prevention.

Relevance of biofilms in pediatric tonsillar disease.

In this investigation, we study the relation between chronic inflammation of the tonsils, clinical features, and the presence of biofilms in the crypts in patients presenting with obstructive hypertrophy and recurrent upper airway pathology. Thirty-six patients who needed to undergo a tonsillectomy for obstructive reasons (aged 1 to 6 years), among which none of them had taken any antibiotics 30 days prior to surgery, were included. Samples were examined with hematoxylin-eosin and Gram staining, fluorescent microscopy, and confocal laser microscopy. The predominance of symptoms were those related to obstructive pathology rather than infection (p < 0.01). All patients had tonsillar hypertrophy (grade III or IV), but an association with adenoids hypertrophy was detected in 66.66% of cases (p < 0.05). 77.28% of tonsils presented biofilms in their crypts, but hypertrophy and tonsillar follicle number were not related to the presence or absence of biofilms. Here, we demonstrated that symptoms like harsh raucous sound, tonsillar and adenoids hypertrophy, apnea, and cervical adenopathies are clearly related to the presence of biofilm in tonsils. Our results allow us to propose that biofilms are involved in the pathogenesis of tonsils and adenoids hypertrophy. The prevention of biofilms formation should be focused in the early stages, attempting to restrain bacterial attachment to the respiratory mucosa.

Evidence of bacterial biofilms in nasal polyposis.

INTRODUCTION: The pathogeny of chronic rhinosinusitis with nasal polyposis (CRS/NP) has not been elucidated. Bacterial exotoxins have been implicated in many inflammatory chronic diseases, such as chronic otitis, chronic tonsillitis, cholesteatomas, and more recently CRS/NP. We propose that the bacteria in CRS/NP are not only present in a planktonic state, but also occur in microbial communities as biofilms. OBJECTIVE: To determine and characterize the presence of biofilms in CRS/NP. METHODS: We performed a prospective study in 12 patients undergoing endoscopic sinus surgery for nasal polyposis. Ten patients without CRS/NP who underwent septoplasty were included as a control group. Tissue samples were obtained from the inferior turbinate mucosae. The bacteria were isolated and typified and the material was examined in vitro using a spectrophotometer, and in vivo using optical microscopy and confocal scanning laser microscopy. RESULTS: Moderate to high in vitro biofilm-forming capacity was detected in 9 out of 12 patients with CRS/NP (mean [SD] optical density values of between 0.284 [0.017] and 3.337 [0.029]). The microorganisms isolated were Staphylococcus (5 patients), Streptococcus viridans, Pseudomonas aeruginosa, Enterococcus faecalis and Streptococcus viridans/Corynebacterium. Biofilms were demonstrated in vivo in 2 patients and no biofilm structures were evident in any of the controls. CONCLUSION: This study demonstrates the presence of bacterial biofilms in patients with CRS/NP. This chronic inflammatory factor might contribute to nasal mucosa damage, increased inflammatory cells in tissue, and the subsequent hyperplasic process.

Anatomía clínica del pie plano / Clinical anatomy of the flat foot

El objetivo del presente trabajo pretende corroborar la existencia de variedades anatómicas que favorecen lalaxitud del tendón del músculo tibial posterior encargado de mantener el arco interno del pie provocando así unaplanamiento del mismo, conformando el pie plano del adulto. La debilidad del arco interno de la bóveda plantar del pie puede ser originada por causas congénitas o adquiridas, dentro de las que podemos citar la laxitud tendinosa y la presencia de huesos supernumerarios. Este arco interno está conformado por una parte ósea; Calcáneo, astrágalo, escafoides, los tres cuneiformes y los tres primeros metatarsianos con sus respectivas falanges y por una parte tendinosa constituida por tendón del músculo tibial posterior. Materiales y Método: El estudio comparativo se realizó con veinte pacientes con diagnóstico previo de pie plano, 14 del sexo femenino y 6 del sexo masculino, con edades que oscilaron entre los 40 y 70 años que asistieron al Servicio de Flebología y Linfología del Hospital Nacional de Clínicas. Resultados: los resultados obtenidos demostraron que del total de disecciones en; 62,50 % de los casos el tendón del músculo tibial posterior se insertaba de forma clásica, en el 31,25 % se observó que el tendón discurría por la cara interna y superior del escafoides y no por el borde inferior del mismo como es lo habitual. En un 6,25 % de los casos se encontró un hueso supernumerario escafoides accesorio (o tibial externo). La comparación anátomo- clínica arrojó que del 100% de pacientes con pie plano, el 70 % presentó clínica de disfunción del tibial posterior. Conclusiones: los datos obtenidos confirman la presencia de variedades anatómicas que comprometen al músculo tibial posterior y que repercuten directamente en la incidencia del pie plano del adulto, una patología que es de considerable frecuencia en nuestro medio y de asidua consulta médica.

The objective of the present work tries to corroborate the existence of anatomical varieties that encouragelaxity in the tendon responsible for maintaining the arch of the foot causing a flattening of the same, forming the adultflatfoot.-The weakness of the internal arc of the plantar vault of the foot can be originated by congenital or acquiredcauses, within which we can cite the tendon laxity and the presence of supernumerary bones. This inner arc consists of a bony part; Calcaneous, talus, navicular, the three cuneiforms and the first three metatarsals their phalanxes andone part consisting of tendon of tibialis posterior tendon.- Materials and Method: we used for this study 16 anatomical parts 10% formaldehyde, 8 female and 8 male, aged ranging between 50 and 60, taken at random, stuffed with classic instrumental dissection belonging to the chair of normal anatomy and comparative study with twenty patients with a previous diagnosis of flat foot, 14 females and 6 males with ages ranging from 40 and 70 who attended the service Phlebology and Lymph logy National Clinical Hospital. Results: the results showed that of all dissections in; 62.50% of the cases the tendon of tibialis posterior wasinserted in a classic, 31.25% in the tendon was noted that flowed through the inside and top of the scaphoid and notRevista Argentina de MorfologíaRev Arg Morfol 2009; 1: 8-12 9by the bottom edge as usual. and 6.25% was found for the presence of an accessory navicular bone supernumerary(or tibia). Anatomic-clinical comparisons daring that 100% of patients with flat feet, 70% clinical accuse posteriortibial dysfunction. Conclusions: the data obtained allow us confirm the existence of anatomical varieties which compromise theposterior tibial muscle and affecting the incidence adult flat foot, a condition which is of considerable frequency in our diligent and medical consultation.

Sorption of lead in soil as a function of pH: a study case in México.

Reactions of lead sorption onto soil are largely affected by properties and composition of soil and its solution. In this study, the lead sorption onto regosol eutric soil from Francisco I. Madero, Zacatecas, Mexico is evaluated at different pH values. Soil samples were suspended in lead solutions of 10, 25, 50, 100, 150, 200, 300, and 400 mg/l (as Pb(NO3)2). The pH was adjusted at 2, 3, 4, and 5.5 with nitric acid for each of the lead solution concentrations. In all the cases the ionic strength was I=0.09 M with calcium nitrate. The solid-liquid-ratios were fixed in 1:100 and 1:200 g/ml. The results show that lead sorption increases when pH increases. Experimental isotherms were adjusted by both Langmuir and Freundlich models. The Langmuir affinity parameter, K, indicates that the lead sorption capacity of Francisco I. Madero soils is largely perceptible to pH changes.

Insemination time and dilution rate of cooled and chilled ram semen affects fertility.

Adult Merino ewes (n=448) were apportioned into two groups and inseminated with: extended at 30 degrees C with skim milk and stored for 6h at 15 degrees C (cooled semen) or extended with skim milk-citrate trisodium with egg yolk and stored for 24h at 5 degrees C (chilled semen). Each group was further subdivided according to the time of cervical insemination at 42, 46 and 50h after pessary (MAP-60 mg) removal and according to the dilution of the semen (120 x 10(6) spermatozoa in 0.05, 0.1 and 0.2 ml). The pregnancy rate after insemination with cooled semen was 50% better than that after chilled semen (56.7 vs. 37.5%; P<0.001). Pregnancy rate was not affected by the volume of insemination; however, there was a tendency of increased lambing rate with an insemination dose of 0.1 cc (1:2, dilution), especially when the ewes were inseminated with cooled semen. The effect of time on insemination was significant only in ewes inseminated with chilled semen at 5 degrees C (P<0.01). Insemination carried out 46 h after pessary removal resulted in higher pregnancy and lambing rate (36.5, 31.1; 52.0, 45.3; and 24.0, 20.0 at 42, 46 and 50h, respectively). Pregnancy of ewes inseminated with chilled semen at 46 h after pessary removal was similar to that obtained using cooled semen (52.0 vs. 56.7%). From this study, it is concluded that advancing the time of insemination with chilled semen at 5 degrees C improves pregnancy and that the lambing obtained under these conditions is similar to the one obtained with cooled semen.

A note on the effect of continuous ram presence on estrus onset, estrus duration and ovulation time in estrus synchronized ewes.

During fall season, 18 multiparous Corriedale ewes were divided into two equal groups for the continuous (CON) and intermittent (INT) presence of a ram. Estrus was synchronized with fluorgestone acetate intravaginal sponges that were left 14 days, plus an injection of 200&mgr;g of a prostaglandin F-2alpha analog at sponge removal. Estrus was detected three times a day (at 6 a.m., 2 p.m. and 10 p.m.) by using rams with harnessess and markers. Ovulation time was determined by laparoscopy, starting 24h after estrus detection. Estrus onset was (mean+/-S.E.M.) 32.9+/-1.6 and 45.3+/-4.4h for the CON and INT groups, respectively (P<0.01). Estrus duration was 31.1+/-0.9 and 30.2+/-1.2h, for the same groups, respectively (P>0.05). Ovulation time and the interval from sponge removal to ovulation (ISRO) for the CON and INT groups was 29.0+/-1.5, 62.0+/-2.0, 26.7+/-1.3 and 72.0+/-4.2h, respectively. Ovulation time was not different (P>0.05), but ISRO was shown to be different between treatments (P<0.05). It is concluded that the continuous presence of a ram after sponge removal hastens estrus onset and reduces the interval between sponge removal and ovulation, without modifying estrus duration and time between estrus onset and ovulation.

Resilience and risk: childhood and uncertainty in the AIDS epidemic.

In a study of depression and risk among HIV-affected young people (children whose parents are infected with or have died from HIV/AIDS), subjects did not report high risk sexual or substance use behavior. Findings are attributed to parental participation in a community-based HIV service program that provides parents with HIV prevention education and long term social and emotional support. Multi-generational community based models of prevention that include parents as critical elements of instruction may also be effective in substance abuse treatment programs and in programs for children who experience difficulty in school.

Simultaneous kinetic-spectrophotometric determination of levodopa and benserazide by bi- and three-way partial least squares calibration.

A procedure for the simultaneous kinetic-spectrophotometric determination of levodopa (I) and benserazide (II), from their oxidation reaction with KIO(4) in an acidic medium, is described. Both species instantly oxidize, giving rise to compounds which present maximum values of absorbance close to 400 nm. In the presence of an excess of the oxidizing agent, the levodopa derivative evolves to form the corresponding aminochrome (lambda(m)=480 nm), while the benserazide derivative decomposes to yield colorless compounds. The appearance of new compounds, with absorption bands in the region of 500-700 nm, is additionally seen upon adding the oxidizing agent to a mixture of I and II. These compounds also evolve decomposing and forming colorless products. In spite of the complexity of the system studied, the calibration by bi-linear partial least squares (PLS) as well as by three-way partial least squares (nPLS) permit the quantification of both analytes with a precision on the order of 0.7% for levodopa and of 1.5% for benserazide. nPLS also allows for the qualitative interpretation of the phenomena which occur. The proposed method is applied to the quantification of I and II in the commercial, pharmaceutical preparation Madopar, using high performance liquid chromatography (HPLC) as the analytical reference technique.

Sperm production, testicular size, serum gonadotropins and testosterone levels in Merino and Corriedale breeds.

The relationships between testis size, hormone secretion and sperm production were studied during the spring (December) and autumn (May) in rams of two breeds with different breeding seasons and body weights (Corriedale and Australian Merino) maintained on native pastures and under natural photoperiods in Uruguay. Blood samples were collected at 20-min intervals during a 260-360-min period in 13 rams (four Corriedale, nine Australian Merino) during the late spring and autumn. Rams were weighed and testis size was estimated by orchimetry at each time period. Sperm production was estimated during a 2-week period, 2 months before blood collection and during each week following every blood collection. There was no relationship between testicular size and sperm production measured at the same time, nor between live weight and sperm production. In contrast, testicular volume during the late spring was correlated with sperm production in the autumn (r = 0.65; P = 0.02). The autumn serum LH was higher in Corriedale than in Merino rams. LH pulsatility was unaffected by season, but LH pulse frequency tended to be higher in Corriedale than in Merino rams, particularly in the late spring (2.37 versus 1.56 pulses/6 h; P = 0.08). Serum testosterone concentration was similar in both breeds and seasons. FSH levels were higher in the late spring than in the autumn in both breeds (Corriedale: 2.83 +/- 0.48 versus 2.17 +/- 0.24 ng x mL(-1); Merino: 2.23 +/- 0.24 versus 1.88 +/- 0.17 ng x mL(-1)). FSH and testosterone concentrations during the late spring were positively correlated with autumn sperm production (P = 0.07 and P = 0.03, respectively). In conclusion, the present experiment suggests that LH secretion is not a good parameter for the prediction of sperm production. In contrast, in our conditions (breeds and native pastures) testicular size and testosterone or FSH concentrations from the late spring may be used to predict sperm production in the autumn.

Kinetic spectrophotometric determination of hydrocortisone acetate in a pharmaceutical preparation by use of partial least-squares regression.

A kinetic spectrophotometric method for the determination of hydrocortisone acetate based on its condensation with isonicotinic acid hydrazide is proposed. The method is applied to the determination of hydrocortisone acetate in a commercially available pharmaceutical preparation, presented as a pomade, that also contains another corticosteroid and additional active compounds. The operating procedure involves dissolving the pomade in chloroform and the addition of the reagent solution directly to the cuvette, in this way avoiding the previous extraction of analytes from the insoluble pomade matrix required by the alternative HPLC procedure. Calibration is performed by partial least-squares regression, using absorbance or first derivative spectra values recorded each minute during the first 30 min of reaction. Use of first derivative spectra overcomes possible scattered light problems produced by excipients precipitating, and produced slightly better results than absorbance data. The relative standard deviation obtained for 11 replicates analysed on different days was approx. 1.5%. The proposed method improves both accuracy and precision of the classical initial rate method and the precision of the HPLC procedure.

Características de accesibilidad al Hospital Materno Infantil German Urquidi / Caracteristics and accesibility to the Hospital Materno Infantil German Urquidi

Se estudiaron características de accesibilidad a la Consulta Externa del Hospital Materno-infantil Germán Urquidi en 266 personas. Las mismas que manifestaron su conformidad con la distancia, el estado del camino, el tiempo y los precios que cancelaron para su atención médica, laboratorio, farmacia y otros; aunque un 30 por ciento lo calificó de caro. Introducción. Presentación de los resultados. Datos generales. Característica geográfica. Característica económica. Características sociales. Interpretación. Conclusiones. Recomendaciones. Bibliografía. Anexos. Addendum

[Recombinant therapeutic vaccines against cancer of the uterine cervix]. / Vacunas terapéuticas recombinantes contra el cáncer del cuello uterino.

Several mechanism to evade the immune system are induced during cervical cancer development, including the decrease of expression of class I HLA molecules and secretion of specific cytokines by tumoral cells. Consequently, the stimulation of cytotoxic (CTL) and helper (TH) T lymphocytes, as well as the natural killer (NK) cells and macrophages is very poor. The induction of immune response against tumors needs the stimulation of multiple components of the immune system: systemic stimulation of CTL and TH against Human Papilloma Virus epitopes and directly in the tumor the secretion of specific cytokines to increase the antigen processing and presentation of tumoral targets, and the stimulation of lymphocyte, NK cells and macrophages that infiltrate tumors.

["Carcinoma of the gallbladder." Clinicopathologic study of 25 cases]. / "Carcinoma de la vesícula biliar". Estudio clínico-patológico de 25 casos.

We revised the clinical histories of 25 patients with histopathologic diagnostic proved of primary carcinoma of the gallbladder in 4 hospitals of the Trujillo state. 18 patients (72%) were female and 7 males (28%) with a female to male ratio of 2.6. The average age of the patients was 59 years with a range of 46-73 years. An elevated percentage of the patients presented abdominal, pain, weight loss and jaundice. The cholecystectomy and the biliary laparatomy with take of biopsy were the surgical procedures more frequently performed. The histologic type of carcinoma of the gallbladder more frequent in this study was the adenocarcinoma present in 80% of the patients.

Función del laboratorio de microbiología: utilización adecuada de los antibióticos / Role of microbiology laboratory in the rational use of antibiotics

Se revisa el papel del laboratorio de microbiologia en la producción de información estandarizada de estudios desensibilidad antibiótica. Se propone el metodo de Kirby-Bauer como una forma confiable y de bajo costo para ser utilizada en nuestro medio. Se señala, sin embargo, que esta tecnica debe utilizarse mediante un estricto control de calidad con el fin de evitar resultados equivocos. Se destaca asi mismo la importancia de usar en el antibiograma grupos de antibióticos especificos para el tipo de germen o sitio de origen de la muestra, asi: grampositivos, gramnegativos, orinas, pseudomonas y germenes multirresistentes. Se presentan, ademas, los resultados de los estudios de sensibilidad realizados en 1.557 cepas de germenes gramnegativos, 653 grampositivos y en 372 gramnegativos multirresistentes, entre junio de 1988 y diciembre de 1989.