Urban Transformations and Health: Methods for TrUST-a Natural Experiment Evaluating the Impacts of a Mass Transit Cable Car in Bogotá, Colombia.

Background: Cable cars provide urban mobility benefits for vulnerable populations. However, no evaluation has assessed cable cars' impact from a health perspective. TransMiCable in Bogotá, Colombia, provides a unique opportunity to (1) assess the effects of its implementation on the environmental and social determinants of health (microenvironment pollution, transport accessibility, physical environment, employment, social capital, and leisure time), physical activity, and health outcomes (health-related quality of life, respiratory diseases, and homicides); and (2) use citizen science methods to identify, prioritize, and communicate the most salient negative and positive features impacting health and quality of life in TransMiCable's area, as well as facilitate a consensus and advocacy-building change process among community members, policymakers, and academic researchers. Methods: TrUST (In Spanish: Transformaciones Urbanas y Salud: el caso de TransMiCable en Bogotá) is a quasi-experimental study using a mixed-methods approach. The intervention group includes adults from Ciudad Bolívar, the area of influence of TransMiCable. The control group includes adults from San Cristóbal, an area of future expansion for TransMiCable. A conceptual framework was developed through group-model building. Outcomes related to environmental and social determinants of health as well as health outcomes are assessed using questionnaires (health outcomes, physical activity, and perceptions), secondary data (crime and respiratory outcomes) use of portable devices (air pollution exposure and accelerometry), mobility tracking apps (for transport trajectories), and direct observation (parks). The Stanford Healthy Neighborhood Discovery Tool is being used to capture residents' perceptions of their physical and social environments as part of the citizen science component of the investigation. Discussion: TrUST is innovative in its use of a mixed-methods, and interdisciplinary research approach, and in its systematic engagement of citizens and policymakers throughout the design and evaluation process. This study will help to understand better how to maximize health benefits and minimize unintended negative consequences of TransMiCable.

Modulating sphingosine-1-phosphate receptors to improve chemotherapy efficacy against Ewing sarcoma.

Tumor vasculature is innately dysfunctional. Poorly functional tumor vessels inefficiently deliver chemotherapy to tumor cells; vessel hyper-permeability promotes chemotherapy delivery primarily to a tumor's periphery. Here, we identify a method for enhancing chemotherapy efficacy in Ewing sarcoma (ES) in mice by modulating tumor vessel permeability. Vessel permeability is partially controlled by the G protein-coupled Sphinosine-1-phosphate receptors 1 and 2 (S1PR1 and S1PR2) on endothelial cells. S1PR1 promotes endothelial cell junction integrity while S1PR2 destabilizes it. We hypothesize that an imbalance of S1PR1:S1PR2 is partially responsible for the dysfunctional vascular phenotype characteristic of ES and that by altering the balance in favor of S1PR1, ES vessel hyper-permeability can be reversed. In our study, we demonstrate that pharmacologic activation of S1PR1 by SEW2871 or inhibition of S1PR2 by JTE-013 caused more organized, mature and functional tumor vessels. Importantly, S1PR1 activation or S1PR2 inhibition improved antitumor efficacy. Our data suggests that pharmacologic targeting of S1PR1 and S1PR2 may be a useful adjuvant to standard chemotherapy for ES patients.

Exercise during preoperative therapy increases tumor vascularity in pancreatic tumor patients.

The efficacy of chemotherapy is reduced by dysfunctional tumor vasculature, which may limit chemotherapy delivery to tumors. Preclinical studies have shown that moderate aerobic exercise improves tumor vascular function and increases chemotherapy efficacy in mouse models, but the effect of exercise on human tumor vasculature has not yet been determined. Here, we demonstrate that exercise remodels the tumor vasculature, accelerates the regression, and delays the regrowth of pancreatic ductal adenocarcinoma in a patient-derived xenograft mouse model treated with gemcitabine. By evaluating pancreatic adenocarcinoma specimens from patients treated with preoperative chemotherapy or chemoradiation therapy, we also demonstrate for the first time that tumor vascular remodeling occurs in association with exercise in humans. Future studies will evaluate whether exercise-induced vascular remodeling improves gemcitabine or other chemotherapy efficacy in patients, as this study evaluated only changes in tumor vascular structure.

Genetic diversity and population structure of native maize populations in Latin America and the Caribbean.

This study describes the genetic diversity and population structure of 194 native maize populations from 23 countries of Latin America and the Caribbean. The germplasm, representing 131 distinct landraces, was genetically characterized as population bulks using 28 SSR markers. Three main groups of maize germplasm were identified. The first, the Mexico and Southern Andes group, highlights the Pre-Columbian and modern exchange of germplasm between North and South America. The second group, Mesoamerica lowland, supports the hypothesis that two separate human migration events could have contributed to Caribbean maize germplasm. The third, the Andean group, displayed early introduction of maize into the Andes, with little mixing since then, other than a regional interchange zone active in the past. Events and activities in the pre- and post-Columbian Americas including the development and expansion of pre-Columbian cultures and the arrival of Europeans to the Americas are discussed in relation to the history of maize migration from its point of domestication in Mesoamerica to South America and the Caribbean through sea and land routes.

Descripción clínica, social, laboral y de la percepción funcional individual en pacientes con ataque cerebrovascular / Clinical, social, occupational and of self: perception description of stroke patients

Introducción. El ataque cerebrovascular (ACV) es una entidad nosológica, que además de producir diferentes déficits funcionales y estructurales, origina diversos tipos de limitaciones funcionales y restricción en la participación social. objetivo. Describir las características clínicas, los aspectos sociales, laborales y la percepción funcional individual en pacientes con ACV, atendidos en una institución neurológica de Colombia. Materiales y Métodos. Estudio descriptivo en 81 pacientes, con tiempo de egreso hospitalario entre seis meses y dos años. Retrospectivamente se recolectaron datos de historia clínica, referente a signos y síntomas, y territorio vascular comprometido. Posteriormente se aplicó una encuesta de 19 preguntas abiertas sobre percepción, evolución y estado actual de discapacidad secundaria al evento.resultados. Se evaluaron 71,6% pacientes con ACV isquémico, 19.8% hemorrágico y 8,6% lacunar. El territorio más afectado fue cerebral media (58%). Los síntomas más frecuentes al ingreso fueron disartria y trastorno motor en extremidades. El 65,3% refirió mejoría subjetiva de la deficiencia motora. El 64,3% de los pacientes eran laboralmente activos antes del ACV, solo 10,7% continúan en su oficio previo.conclusIón. El tipo isquémico es la principal causa de ataque cerebrovascular agudo en esta institución. Las manifestaciones clínicas dadas por lateraciones motoras y del habla están acordes al teritorio vascular afectado. A pesar de la autopercepción de mejoría existe un impacto considerable en el ámbito laboral de esta población.

Introduction. In addition to different functional and structural deficits, cerebrovascular disease causes severaltypes of restrictions in social participation. Objective. The aim of this study was to describe the clinical, social and occupational characteristics as well as the self-perception in patients with cerebrovascular disease (stroke) attended in a neurological institution in Colombia. Materials and methods. 81 clinical records with stroke diagnosis and a hospital discharge time between 6 months and two years were evaluated. Date regarding sings, symptoms and vascular territory were collected. Additionally a 19 questions interview was applied asking about self-perception, course and current state of disability. Results. The distribution of patients was ischemic stroke 71,6%, hemorrhagic stroke 19.8% and lacunar infarction 8.6%. Right middle cerebral artery was the most frequently affected (58%). Motor deficit and dysarthria were the main complains at the admission time. 65.3% reported improvement of the motor deficit initially described. Before the stroke 64.3% wereoccupationally active, after the stroke only 10.7% kept their previous job. Conclusion. In this sample ischemic stroke was the most frequent cause of cerebrovascular disease. Alterations on the speaking and motor skills are explainable by the compromise of the right middle cerebral artery. In spite of the self - perception of improvement there is considerable impact on the occupational field.

Epidemiología de la infección nosocomial en la unidad neonatal Hospital de San José, Bogotá dc. Marzo - Agosto de 2009 / Epidemiology of nosocomial infection in neonatal units Hospital de San José, Bogotá DC. March - August 2009

La infección nosocomial es un problema grave de salud en el país, con alta mortalidad neonatal, numerosas complicaciones, secuelas irreversibles y elevados costos y estancia hospitalaria. Se describen los factores de riesgo en el Hospital de San José (prevalencia, agentes etiológicos y mortalidad) y se comparan con la epidemiología extrainstitucional. Estudio observacional descriptivo longitudinal en los pacientes que ingresaron a la unidad neonatal procedentes de la sala de partos entre marzo y agosto de 2009. Se usó un formato de registro diario de los recién nacidos que cumplían los criterios de inclusión con seguimiento hasta el egreso. Se recolectaron 200 pacientes, 31 con sospecha clínica de infección nosocomial (53 casos) 26.5%. Se tuvieron en cuenta variables cualitativas y cuantitativas, analizadas como factores de riesgo y se cruzaron con infección nosocomial. Se encontró una prevalencia más baja de infección nosocomial confirmada con respecto a estadísticas de otras instituciones (5.5%) y los gérmenes aislados fueron similares. La mayor frecuencia fue en recién nacidos a término, sugiriendo que los factores de riesgo son prevenibles, modificables y no se relacionan con los inherentes a la condición desfavorable del pretérmino y/o bajo peso al nacer. Es necesario realizar un estudio más prolongado y con mayor población para obtener resultados con significancia estadística...

Nosocomial infection is a major health problem in our country, associated to high neonatal mortality rate, numerous complications, irreversible sequelae, high costs and longer hospital stay. The risk factors at Hospital de San José (prevalence, etiologic agents and mortality rates) are described and compared with extra institutional epidemiology. An observational longitudinal descriptive study was conducted on neonates transferred from the delivery room to the neonatal unit between March and August 2009. A daily record format of the newborns that fulfilled the inclusion criteria was used and follow-up was conducted until they were discharged. Two hundred patients were collected, 31 with clinical suspicion of a nosocomial infection (53 cases) 26.5%. Qualitative and quantitative variables were considered and analyzed as risk factors and crossed with nosocomial infection. The prevalence rate of confirmed nosocomial infection observed was lower than that observed in statistic records of other institutions (5.5%) and the microorganisms isolated were similar. Frequency was greater in full term infants suggesting risk factors may be prevented, modified and are not related to the inherent unfavorable conditions of preterm/low weight at birth neonates. A more prolonged study including a larger population must be conducted in order to obtain statistically significant results...

Determinación de marcadores genéticos en pacientes con diabetes tipo I y población sana

Se estudiaron 26 pacientes diabéticos insulino-dependientes y 56 individuos sanos de la ciudad de Medellín. Se utilizaron 240 antisueros para las clases I y II del complejo mayor de histocompatibilidad, utilizando la técnica de microlinfocitotoxicidad de Terasaki. Los antígenos HLA de la clase II también se analizaron siguiendo los protocolos del XI Taller Internacional de Histocompatibilidad, amplificando el DNA por medio de la técnica de PCR y las hibridaciones se hicieron con sondas de oligonucleótidos seleccionados para HLA-DRB1, DQA1, DQB1. En los antígenos de la clase I, el HLA B18 se identificó en el 46 porciento de los pacientes comparado con 12.5 porciento de los controles; el riesgo relativo (RR) fue de 3.7. Lo contrario ocurrió con el B44, que se determinó en 7.6 porciento de los enfermos y en 25 porciento de los sanos. En cuanto a los antígenos de clase II, los alelos DRB1*0405 y *0301 se encontraron asociados a suceptibilidad, con un RR de 61.3 y 6.6, respectivamente.

Neumocistosis

La neumocistosis se ha convertido en poco tiempo en una entidad clínica de gran importancia principalmente como consecuencia de la aparición del Síndrome de Inmunodeficiencia adquirida, situación en la cual se comporta como una de las infecciones oportunistas más frecuentes. Debido a que era una entidad poco frecuente, el personal de la salud no está muy familiarizado con la misma y dado que tiene una tendencia hacia el aumento constante, se hace necesario que todo el equipo de salud tenga un nivel de conocimiento adecuado de la enfermedad. Se presenta una revisión actualizada del tema basada en las publicaciones más recientes y puesta en términos muy precisos y prácticos para que pueda ser de utilidad general