Influence of glutathione-related genetic variants on the oxidative stress profile of Mexican patients with psychotic disorders

Objective: The clinical trajectories of patients with psychotic disorders have divergent outcomes, which may result in part from glutathione (GSH)-related high-risk genotypes. We aimed to determine pharmacokinetics of clozapine, GSH levels, GSH peroxidase (GPx) activity, gene variants involved in the synthesis and metabolism of GSH, and their association with psychotic disorders in Mexican patients on clozapine monotherapy and controls. Methods: The sample included 75 patients with psychotic disorders on clozapine therapy and 40 paired healthy controls. Plasma clozapine/N-desmethylclozapine, GSH concentrations, and GPx activity were determined, along with genotyping of GCLC and GSTP1 variants and copy number variations of GSTP1, GSTT1, and GSTM1. Clinical, molecular and biochemical data were analyzed with a logistic regression model. Results: GSH levels were significantly reduced and, conversely, GPx activity was higher among patients than controls. GCLC_GAG-7/9 genotype (OR = 4.3, 95%CI = 1.40-14.31, p = 0.019) and hetero-/homozygous genotypes of GCLC_rs761142 (OR = 6.09, 95%CI = 1.93-22.59, p = 0.003) were found to be risk factors for psychosis. The genetic variants were not related to clozapine/N-desmethylclozapine levels or metabolic ratio. Conclusions: GCLC variants were associated with the oxidative stress profile of patients with psychotic disorders, raising opportunities for intervention to improve their antioxidant defenses. Further studies with larger samples should explore this proposal.

Influence of glutathione-related genetic variants on the oxidative stress profile of Mexican patients with psychotic disorders.

OBJECTIVE: The clinical trajectories of patients with psychotic disorders have divergent outcomes, which may result in part from glutathione (GSH)-related high-risk genotypes. We aimed to determine pharmacokinetics of clozapine, GSH levels, GSH peroxidase (GPx) activity, gene variants involved in the synthesis and metabolism of GSH, and their association with psychotic disorders in Mexican patients on clozapine monotherapy and controls. METHODS: The sample included 75 patients with psychotic disorders on clozapine therapy and 40 paired healthy controls. Plasma clozapine/N-desmethylclozapine, GSH concentrations, and GPx activity were determined, along with genotyping of GCLC and GSTP1 variants and copy number variations of GSTP1, GSTT1, and GSTM1. Clinical, molecular and biochemical data were analyzed with a logistic regression model. RESULTS: GSH levels were significantly reduced and, conversely, GPx activity was higher in PD patients compared to controls. GCLC_GAG-7/9 genotype (OR=4.3, CI95=1.40-14.31, p=0.019) and hetero-/homozygous genotypes of GCLC_rs761142 (OR=6.09, CI95=1.93-22.59, p=0.003) were found as risk factors for psychosis. The genetic variants were not related to clozapine/N-desmethylclozapine levels or to metabolic ratio. CONCLUSIONS: GCLC variants were associated with the oxidative stress profile of PD patients raising opportunities for intervention to improve their antioxidant defenses. Further studies with larger samples should explore this proposal.

Leucism: the prevalent congenital malformation in the olive ridley sea turtle of northwestern Mexico.

Despite being the most abundant sea turtle in the world, the olive ridley turtle Lepidochelys olivacea is classified as Vulnerable by the IUCN. There is evidence of congenital malformations in hatchlings, and the associated causes are multifactorial, with both genetic and environmental sources. Santuario Playa Ceuta (SPC) is a sanctuary for the olive ridley, located at the northernmost region of its nesting range in the Mexican Pacific. The objective of this study was to identify and quantify the prevalence and severity of congenital malformations in olive ridley embryos/hatchlings in SPC during the 2017 nesting season. We collected 62907 eggs from 643 relocated nests that were moved to a hatchery, of which 4242 eggs with obvious development did not hatch and were analyzed for this study. Hatching success was 53.9%, with 22.5% of nests (n = 145) and 0.54% of eggs (n = 344) showing embryos or hatchlings with malformations. The nest severity index was 2.4 (range: 1-10) malformed embryos or hatchlings per nest, and the organism severity index was 1.4 (range: 1-7) malformations per malformed embryo or hatchling. Leucism was the most prevalent malformation (34.4%; 170/494 total observed), with the craniofacial region showing the greatest diversity of malformations (17/35 types). Given the geographical position of SPC, extreme environmental conditions (e.g. cold, heat, and dryness) could be one of the main causes of teratogenesis in this species. However, more studies are needed regarding the presence of contaminants, genetic factors, health assessments of nesting females, and malformation rates of nests that remain in situ versus those that are relocated.

Caprylic acid in Vitex mollis fruit and its inhibitory activity against a thiabendazole-resistant Colletotrichum gloeosporioides strain.

BACKGROUND: Colletotrichum gloeosporioides causes anthracnose in a large number of crops. Synthetic fungicides are employed to prevent this disease, even though their effectiveness and safety is questionable. Thus, effective and innocuous antifungal compounds are proposed as natural alternatives against anthracnose. The hexane fraction of Vitex mollis pulp (HF-VM) reduces anthracnose incidence in papaya fruit; however, the active compounds and antifungal mechanism of HF-VM are unknown. The aims of this study were to characterize the activity of HF-VM sub-fractions (sHF1 -sHF7 ) against a thiabendazole-resistant Colletotrichum gloeosporioides strain, identify the chemical components and investigate the mechanism of the most active sub-fraction. RESULTS: The sHF3 showed the highest inhibitory activity against Colletotrichum gloeosporioides with a minimal inhibitory concentration (MIC) of 0.5 mg mL-1 , whereas thiabendazole (TBZ) had a MIC value higher than 2 mg mL-1 . The gas chromatography-mass spectrometry (GC-MS) analysis showed that the compounds in sHF3 were methyl 4-decenoate, caprylic acid, and 24-methylencycloartanol. These compounds are rarely found in fruits and are reported for the first time on Vitex species. The purified 24-methylencycloartanol was inactive (MIC > 0.5 mg mL-1 ). In contrast, the commercial standard of caprylic acid presented an elevated activity (MIC = 0.125 mg mL-1 ), indicating that this compound is the main one responsible for the antifungal properties of sHF3 . Furthermore, the sHF3 inhibited the spore germination and induced membrane disruption in both the spore and mycelium of Colletotrichum gloeosporioides. CONCLUSION: Vitex mollis fruit is a novel source of antifungal caprylic acid that could be employed as a marker to prepare standardized extracts with antifungal properties. © 2022 Society of Chemical Industry.

Leishmaniasis cutánea resistente al antimoniato de meglumina intramuscular / Resistance to Intramuscular Meglumine Antimoniate in Cutaneous Leishmaniasis

La leishmaniasis es una enfermedad causada por pará- sitos protozoarios del género Leishmania. Se clasifica como: cutánea, mucocutánea y visceral. De las ante- riores, la Leishmaniasis cutánea (LC) es la forma más común a nivel mundial, transmitida a humanos por la picadura del mosquito hembra, el cual pertenece a la familia Phlebotominae y Lutzomyia. La cutánea gene- ralmente se manifiesta clínicamente por presentar una pápula ulcerada con exudado seroso, con fondo limpio de aspecto granular y bordes hiperémicos y engrosados. Presentamos el caso de un adolescente de 16 años de edad, procedente de Aldea Peña Blanca Norte, San Pe- dro Sula, con lesión eritemato-costrosa, tumefacta no dolorosa de 2 meses de evolución, en pabellón auri- cular derecho. El paciente fue visto en consulta exter- na de Dermatología Pediátrica del Instituto Hondure- ño de Seguridad Social Regional del Norte (I.H.S.S.), recibiendo tratamiento con antibióticos sistémicos y tópicos (trimetoprim sulfametoxazol, mupirocina un- güento), por 7 días. Previamente había recibido varios tratamientos sistémicos orales y parenterales (amoxici- lina/ ácido clavulánico, dicloxacilina, penicilina benza- tínica, y aplicación tópica de ácido fusídico) sin obtener mejoría clínica alguna; se le envió a realizar microsco- pía directa con tinción de Giemsa de frotis obtenido de la lesión en el Centro de Salud "Miguel Paz Barahona", demostrando la presencia de amastigotes. Se inició al antimoniato de meglumina según esquema estableci- do por la Organización Mundial de la Salud (OMS) a razón de 20 mg/kg/día intramuscular por 30 días. Debido a la falla de tratamiento se deci- de utilizar itraconazol durante 3 meses con buena respuesta y sin efectos adversos...(AU)

Identification based on morphological and molecular characters of Phassus huebneri (Geyer) (Lepidoptera: Hepialidae), a ghost moth feeding on blackberry in Michoacán, Mexico: its biology and parasitoids.

Larvae of an unidentified Lepidopteran hepialid were found boring stems and crown roots of blackberry (Rubus sp.) in Michoacán, Mexico. In this study, the morphological and molecular identification of larvae and adults of this insect was performed. Preliminary aspects of biology, including information on parasitoids associated to larval stage, are also recorded. A total of 109 larvae of various instars were collected and three were reared to adult. The two females and one male were identified as Phassus huebneri (Geyer) (Lepidoptera: Hepialidae) following morphological characters. This identification was corroborated by comparing the cytochrome oxidase I (COI) barcode of two field-collected larvae (IIAFL1 and IIAFL2) with sequences of Phassus spp. obtained from GenBank. A Neighbor-Joining similarity analysis yielded a phenogram with two subclades. The first subclade grouped the IIAFL1 and IIAFL2 sequences with two other Mexican sequences categorized as P. huebneri, whereas in the second subclade other species belonging to the genus Phassus from Guatemala and Costa Rica were grouped together. Larval development of nine instars took about 14 months. Larvae reached a maximum length of 10 cm. The pupal stage lasted 39-41 days. Each of the two females laid over 1,000 unfertilized eggs within a period of 48 h. Larvae were parasitized by Dinera grisescens Fallen (Diptera: Tachinidae) and another unidentified Dinera sp. This study provides additional evidences on the distribution pattern of P. huebneri in western Mexico and presents the first record of this species feeding on one of the most economically important crops in Mexico.

Genetic Regulation of Redox Balance in ß-Thalassemia Trait.

ß-Thalassemia (ß-thal) trait is a heterogeneous group of genetic defects leading to decreased ß-globin production, ineffective erythropoiesis, and oxidative stress. The aim is to evaluate the cytoprotective response, at transcriptional and systemic levels, of the variations of global redox balance in ß-thal trait patients. Sixty-six subjects (40 healthy and 26 with ß-thal trait) were analyzed at the Universidad Nacional de Tucumán, Tucumán, Argentina, between 2016 and 2017. The following parameters were evaluated: complete blood count, iron status, hemoglobin (Hb) electrophoresis, Hb A2, thiobarbituric acid reactive species (TBARS), serum catalase (CAT), and superoxide dismutase (SOD) activity, FOXO3a, NRF2, SOD, PRDX2, CAT, interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) gene expression. The ß-thal trait group showed a decrease in Hb levels, MCV, and MCH with higher TBARS levels. The SOD activity was significantly increased by 32.0% in ß-thal trait patients respect to the control group. Relative expression of NRF2 was 4.7-fold higher in ß-thal trait than in the control group, while FOXO3a expression was similar in both groups. The SOD, PRDX2, and proinflammatory cytokines transcriptional expression was significantly upregulated in ß-thal trait patients. This is the first study on the genetic regulation of redox balance in ß-thal trait patients in which interesting modifications were observed in the transcript levels of some redox regulators that could be associated with changes in the erythrocyte proteome in this disorder. A better understanding of the pathophysiological mechanisms present in these heterozygous patients would allow adequate therapy in situations such as growth, pregnancy, or high performance sports, favoring a personalized treatment.

An ultrasensitive Cystatin C renal failure immunosensor based on a PPy/CNT electrochemical capacitor grafted on interdigitated electrode.

An interdigitated immunosensor for Cystatin C detection based on polypyrrole/carbon nanotube electrochemical capacitor is described. Cystatin C (CysC) is powerful biomarker for early acute renal failure and one predictive for cardiovascular risk, sepsis, cancer and death. Recently, electrochemical immunosensors based on interdigitated electrodes (IDE) have been successfully focused on development of point-of-care testing, due to their miniaturization facilities and higher sensitivity as compared with the screen-printed electrochemical sensing. Herein, a polypyrrole/carbon nanotube nanoyhibrid film was grafted on two gold fingers by electropolymerization obtaining a supercapacitor. Anti-CysC antibodies were immobilized on the IDE by covalent entrapment via ethylenediamine bifunctional agent, followed by glycine blocking in acid and alkaline medium. Under low frequency, capacitive effect of antigen-antibody interaction were observed by double layer capacitance, and analytical responses of this IDE immunosensor to CysC serum were obtained by changes on phase angle a linear range up to 300 ng/mL. The cutoff was calculated for serum samples showing a total reducing of non-specific binding at approximately 28 ng/mL CysC. This immunosensor based on interdigitated electrode (IDE) is a potential tools as portable device,with possibility to use as a practical and rapid test for CysC diagnostic in samples of serum.

A retrospective chart review study describing metastatic melanoma patients profile and treatment patterns in Spain.

PURPOSE: To describe patient characteristics by disease stage, resectability status and current treatment management after first diagnosis of IIIB to IV1c advanced (AM)/metastatic melanoma (MM). METHODS/PATIENTS: Multicentre, retrospective study based on data from medical charts of patients > 18 years at MM first diagnosis, visited by oncologists at 4 reference centres in Spain: Hospital Universitario Gregorio Marañón (Madrid), Hospital General de Valencia (Valencia), Clínica Universidad de Navarra (Pamplona), and Hospital Clínic (Barcelona). RESULTS: Metastatic non-visceral melanoma (IIIB, IIIC, IV M1a) was reported in 139 (48.6%) patients and 40.9% (n = 117) were diagnosed with IV-M1c disease. 160 (55.9%) metastases were resectable. Available therapies under clinical practice were used in 210 patients; 74 were treated under clinical trials (CT). Intention-to-cure surgery (47.6%) was the most common treatment at time of MM diagnosis. Systemic (45.1% overall) therapy included chemo-, targeted- and immunotherapy (19.6%, 14.3%, 8.4%, respectively). At time of data collection, 26 patients were still alive and 120 had progressed to IV-M1c. Median overall survival (OS) was significantly larger in IIIB patients, 28.9 m (25.2-32.7); the shortest for IV-M1c patients, 11.0 m (8.7-13.3). CONCLUSIONS: Novel treatments are undoubtedly a major step forward in AM/MM, however these are often only available in the CT setting because early stages of development or country-specific regulations. Further prospective studies and multifactorial analysis should be performed to clearly identify possible clinical associations for outcome in Spanish patients with AM/MM.

Estrategia de intervención psicológica para modificar estilos de vidas en el adulto mayor. CMF No.40. Yara / Strategy of psychological intervention to modify lifestyles in the elderly. MFO No.40. Yara

Introducción: el ancestral interés de los humanos por vivir el mayor número de años posible, unido al creciente desarrollo de la ciencia y la técnica, sustentan la tendencia actual que considera que importante es vivir más años, es esencial que estos transcurran con la mejor calidad de vida posible. Objetivos: implementar una estrategia de intervención psicológica para modificar el estilo de vida que favorezca el proceso de envejecimiento humano con calidad en el adulto mayor. Método: se realizó un estudio de intervenciónpsicológica en el adulto mayor para modificar el estilo de vida. Se aplicó una guía para medir el estilo de vida y el test psicológico inventario de Beck para medir depresión, para evaluar la efectividad de la estrategia se aplicó la prueba estadística para la diferencias de proporciones con un nivel de significación del 5 por ciento. Resultados: se obtuvo como resultado que inicialmente se diagnosticó en ambos sexos un estilo de vida poco saludable, con predominio de la depresión leve y moderada, al finalizar el estudio se modificó el estado emocional de los pacientes que se ubicaron en estado no depresivo. El trabajo refleja los resultados de la estrategia de intervención, los que validan la idea a defender y demuestran el cumplimiento del objetivo propuesto en el mismo. Conclusiones: la estrategia de intervención aplicada permitió modificar como elementos del estilo de vida hacia una categoría de buena las variables: condición física, hábitos alimentarios, sexualidad, autocuidado, uso del tiempo libre y estado emocional (AU)

Introduction: the ancestral human interest to live as many years as possible, along with the increasing development of science and technology, support the present trend considering that if it is important to live longer, it is also essential that all years elapse with the best quality of life possible. Objectives: to implement a strategy of psychological intervention to modify the lifestyle that favors the human aging process with quality in the elderly. Method: it was performed a study of psychological intervention in the elderly to change the lifestyle. It was applied a guide to measure the lifestyle and the psychological inventory test of Beck to measure the depression; to evaluate the effectiveness of the strategy it was applied a statistical test for the difference in proportions with a significance level of 5 percent. Results:it was initially diagnosed an unhealthy lifestyle in both sexes, with a predominantly mild and moderate depression, at the end of the study it was modified the emotional state of patients that were located in non-depressive state. The work reflects the results of the intervention strategy, which validates the idea and demonstrates compliance with the proposed objective. Conclusions: the intervention strategy modified as elements of the lifestyle towards a good category the following variables: fitness, feeding habits, sexuality, self-care, use of leisure time and emotional state(EU)

An ultrasensitive human cardiac troponin T graphene screen-printed electrode based on electropolymerized-molecularly imprinted conducting polymer.

A nano-molecularly imprinted polymer (N-MIP) assembled on a screen-printed electrode for the cardiac troponin T (cTnT) was developed. The biomimetic surface was obtained by a co-polymer matrix assembled on the reduced graphene oxide (RGO) electrode surface. The cTnT active sites were engineered using pyrrole and carboxylated pyrrole that was one-step electropolymerized jointly with cTnT by cyclic voltammetry. The stepwise preparation of the biomimetic surface was characterized by cyclic and differential pulse voltammetries using the ferrocyanide/ferricyanide as redox probe. Structural and morphological characterization was also performed. The optimal relation of pyrrole and pyrrole-3-acid carboxylic to perform the cTnT biomimetic nanosurface was obtained at 1:5 ratio. The analytical performance of cTnT N-MIP performed by differential pulse voltammetry showed a linear range from 0.01 to 0.1 ngmL(-1) (r=0.995, p«0.01), with a very low limit of detection (0.006 ngmL(-1)). The synergic effect of conductive polymer and graphene forming 3D structures of reactive sites resulted in a N-MIP with excellent affinity to cTnT binding (KD=7.3 10(-13) molL(-1)). The N-MIP proposed is based on a simple method of antibody obtaining with a large potential for point-of-care testing applications.

Modificación de conocimiento sobre salud ambiental en estudiantes de 9º grado / Modification of knowledge on environmental health in 9th graders

Introducción: como todos los seres vivos, los seres humanos dependen del medio ambiente que los rodea, para satisfacer sus necesidades de salud y supervivencia. Objetivo: implementar un programa de intervención educativo sobre salud ambiental en los estudiantes de 9º grado de la escuela secundaria básica Pedro Véliz Hernández, de Yara correspondiente al curso escolar 2013-2014. Método: estudio experimental de intervención educativa, para modificar conocimientos sobre salud ambiental, en 203 estudiantes de 9º grado de la ESBU Pedro Véliz Hernández, del área de salud del policlínico Luis E. de la Paz,Yara, curso escolar 2013-2014. Se aplicó un cuestionario inicial, que permitió la detección de necesidades de aprendizaje, se diseñó un programa educativo, que estuvo compuesto por cinco encuentros por cada grupo, con tres frecuencias semanales y duración de una hora, se emplearon técnicas participativas que hicieron más entendibles los temas impartidos y se efectuó la evaluación final con el mismo instrumento inicial. Resultados: se alcanzó menos del 80 por ciento de conocimientos correctos en los alumnos, situación que se modificó después de la capacitación, pues se obtuvo más del 90 por ciento de conocimientos acertados en todas las variables evaluadas. Se recomienda la extensión de estos tipos de estudios a otros centros escolares para contribuir a la formación de una cultura ambientalista, en aras de lograr la participación de los estudiantes en los problemas locales y de la comunidad.Conclusiones: el programa educativo resultó efectivo pues logró modificar los conocimientos que sobre la salud ambiental tenían los estudiantes de 9ºgrado(AU)

Introduction: as all living things, human beings depend on environmentsurrounds, in order to fulfill his needs of health and survival. Objective: implementing an intervention educational program on environmental health for 9th graders from Pedro Véliz Hernandez high school, Yara municipality corresponding to the school year 2013-2014. Method:experimental study of educational intervention, to modify knowledge on environmental health, in 203 9th graders from Pedro Véliz Hernandez high school, from health area, Luis E. de la Paz polyclinic, Yara, school period 2013-2014. It was applied an initial questionnaire, for the detection of learning needs, it was designed an educational program, composed byfive meetings for each group with three weekly frequencies, an hour duration, there were used communicative techniques that did understandable the given topics, and a final evaluation employing the same initial instrument took effect. Results: less than 80 percent of correct knowledge in students was achieved, situation that was modified after receiving the training, it was obtained more than 90 percent of knowledge guessed in all evaluated variables. It is recommended the extension of these types of studies to other school centers to contribute to the formation of an environmentalculture, to achieve students participation in local and community problems. Conclusions: it proved the effectiveness because we could modifyknowledge on environmental health 9thgraders had(EU)

[Kidney transplant patients without social protection in health: what do patients say about the economic hardships and impact?]. / Viviendo con trasplante renal, sin protección social en salud: ¿Qué dicen los enfermos sobre las dificultades económicas que enfrentan y sus efectos?

Kidney transplant is the optimal treatment for renal disease according to biomedical criteria, but the technology is highly expensive. The aim of this article was to examine the economic hardships experienced by kidney transplant patients and the impact on their lives, specifically when they lack social protection in health. The article reports on a qualitative study conducted in Mexico. Twenty-one kidney transplant patients participated. Semi-structured interviews were performed and submitted to content analysis. Patients experience extreme economic hardship due to the high cost of renal therapies, particularly medicines. Such economic problems adversely affect their condition, since many patients report difficulties in maintaining their immunosuppressant medication, attending medical appointments, and curtailing household expenditures, further aggravated by loss of earnings. In conclusion, kidney transplantation is associated with patients' impoverishment when they lack social protection in health. A protection system is urgently needed for this group.

Molecular characterization and phenotypical study of ß-thalassemia in Tucumán, Argentina.

The main hereditary hemoglobin (Hb) disorder in Argentina is ß-thalassemia (ß-thal). Molecular studies performed in the center of the country exhibited a marked prevalence of the codon 39 (C > T) and IVS-I-110 (G > A) mutations. The northwest region of Argentina has a different demographic history characterized by an important Spanish influx. Seventy-one ß-thal carriers attending the Instituto de Bioquímica Aplicada, Tucumán, Argentina, were investigated for ß-globin gene mutations by real-time polymerase chain reaction (RT-PCR). To examine the genotype-phenotype relationship, mean corpuscular volume (MCV), mean corpuscular Hb (MCH) and Hb A2 were measured. In order to recognize ß-thal, Mentzer Index, Shine & Lal and Red Cell Distribution Width Index (RDWI), were calculated. The ethnic background of subjects revealed that 82.0% of the population was of Italian, Spanish and Arab origin. Seven mutations were detected: codon 39 (45.0%), IVS-I-1 (G > A) (22.5%), IVS-I-110 (16.3%), IVS-II-1 (G > A) (4.1%), IVS-I-1 (G > T) (2.0%), IVS-I-6 (T > C) (2.0%) and IVS-II-745 (G > C) (2.0%). In three families (6.1%), ß-thal mutations were not determined. These results differed from other Argentinian studies because at present codon 39 and IVS-I-1 are the most prevalent; MCV, MCH and Hb A2 did not correlate with the type of mutation (ß(0)/ß(+)). Values of MCV (67.0 fL) and Hb A2 (4.85%) were unable to discriminate between them. Significant differences (p < 0.05) in MCV, MCH and Shine & Lal were observed between the undetermined group and the three most common mutations. These data show different patterns of ß-thal mutations in the center and northwest regions of Argentina. Differences might represent the influence of Spanish immigration.

Viviendo con trasplante renal, sin protección social en salud: ¿Qué dicen los enfermos sobre las dificultades económicas que enfrentan y sus efectos? / Kidney transplant patients without social protection in health: what do patients say about the economic hardships and impact? / Viver com transplante renal sem proteção social em saúde: o que os pacientes dizem sobre as dificuldades econômicas e os seus efeitos?

El trasplante es el mejor tratamiento para la insuficiencia renal, de acuerdo con la biomedicina; sin embargo, es una tecnología cara. Este artículo examina las dificultades económicas y sus efectos en personas con trasplante renal, pero sin protección social en salud. Para el estudio se desarrolló una investigación cualitativa en México. Participaron 21 pacientes trasplantados; se aplicaron entrevistas semiestructuradas, y se realizó un análisis de contenido. Los resultados muestran que las personas enfermas enfrentan dificultades económicas, debido a los costes de las terapias renales, particularmente, de las medicinas. Todo ello tiene efectos negativos: las personas con pocos recursos dejan el tratamiento con medicamentos, abandonan el protocolo, no asisten a las consultas médicas y disminuyen los gastos domésticos, incluyendo el de alimentación; además de suponer una merma en los ingresos familiares. En conclusión, el trasplante renal empobrece a las personas enfermas sin protección social en salud; es urgente la implementación de un sistema de protección social para esta población.

Kidney transplant is the optimal treatment for renal disease according to biomedical criteria, but the technology is highly expensive. The aim of this article was to examine the economic hardships experienced by kidney transplant patients and the impact on their lives, specifically when they lack social protection in health. The article reports on a qualitative study conducted in Mexico. Twenty-one kidney transplant patients participated. Semi-structured interviews were performed and submitted to content analysis. Patients experience extreme economic hardship due to the high cost of renal therapies, particularly medicines. Such economic problems adversely affect their condition, since many patients report difficulties in maintaining their immunosuppressant medication, attending medical appointments, and curtailing household expenditures, further aggravated by loss of earnings. In conclusion, kidney transplantation is associated with patients’ impoverishment when they lack social protection in health. A protection system is urgently needed for this group.

O transplante é o melhor tratamento para a insuficiência renal de acordo com a biomedicina; mas é uma tecnologia cara. Este artigo examina as dificuldades econômicas e os seus efeitos em pessoas com transplante renal, mas sem proteção social em saúde. Uma pesquisa qualitativa foi desenvolvida no México. Participaram 21 doentes transplantados; aplicaram-se entrevistas semiestruturadas, e foi realizada análise de conteúdo. Os resultados mostram que as pessoas doentes enfrentam dificuldades econômicas devido aos custos das terapias renais, particularmente das medicinas. Tudo isso tem efeitos negativos: as pessoas com poucos recursos abandonam o tratamento medicamentoso, deixam o protocolo, não comparecem às consultas médicas e diminuem as despensas domésticas, incluindo a comida; além da perda de ingressos. Em conclusão, o transplante renal empobrece as pessoas doentes sem proteção social em saúde; é urgente a implementação de um sistema de proteção social a esta população.

Programa de Intervención Educativa para modificar los conocimientos de pacientes diabéticos tipo 2, Yara 2012 / Educative intervention program to modify the knowledge of type 2 diabetic patients. Yara 2012

Introducción: las personas con Diabetes tienen una mortalidad dos veces mayor que la población general. Una mejoría en su cuidado aumentaría su esperanza de vida. Objetivo: evaluar la efectividad de una estrategia de intervención educativa en el nivel de los conocimientos de los pacientes diabéticos tipo 2. Método: se realizó un estudio de intervención educativa en pacientes diabéticos tipo 2 en una muestra de 46 pacientes de un universo de 76 diabéticos pertenecientes al CMF # 30, área de salud Yara, durante el período de septiembre 2010-abril 2011. Para determinar el nivel de conocimientos se aplicó una guía diseñada por la autora antes y después de la intervención. Los datos para su análisis fueron reflejados en tablas. El grupo de edad más afectado fue el de 60 años y más, el sexo femenino y el nivel de escolaridad de primaria sin terminar, con un tiempo de evolución de la enfermedad de 5 a 10 años. Resultados: los factores de riesgo más importantes fueron: antecedentes familiares de diabetes, hipertensión, malos hábitos alimentarios. Conclusiones: el nivel de conocimientos fue insuficiente; posterior a la intervención ambos sexos lograron modificar sus conocimientos, demostrándose efectividad en la estrategia de intervención propuesta(AU)

Introduction: people with Diabetes have a greater mortality than the general population. An improvement in their care would increase their expectation of life. Objective: to evaluate the effectiveness of an educative intervention strategy in the level of knowledge of the type 2 diabetic patients. Method: it was performed an educative intervention study in type 2 diabetic patients in a sample of 46 patients out of 76 diabetic from the MFO # 30 in Yaras Health Care Area, during the period of September 2010-April 2011. To determine the level of knowledge, it was applied a guide designed by the authoress before and after the participation. The data for its analysis were evidenced in charts. The most affected group of age was 60 and older, the female sex and the unfinished junior high school level, with a time of evolution of the disease out of 5 to 10 years. Results: the most important risk factors were: family backgrounds of diabetes, hypertension, and bad alimentary habits. Conclusions: the level of knowledge was insufficient, after the intervention both sexes modified their knowledge, proving effectiveness in the strategy of the participation proposed(EU)

Achievements and barriers in the organ donation process: a critical analysis of donation coordinators' discourse.

CONTEXT: Donation coordinators play an important role in the success or failure of organ donation and transplant programs. Nevertheless, these professionals' perspectives and practices have hardly been explored, particularly in low- and middle-income countries. OBJECTIVE: To examine donation coordinators' discourse on the organ donation process and the barriers they perceive. DESIGN: A critical qualitative study was carried out in Guadalajara, Mexico. SETTING AND PARTICIPANTS: Twelve donation coordinators from public and private hospitals participated. DATA GATHERING AND ANALYSIS: Data were gathered by using semistructured interviews and critical discourse analysis. RESULTS: Participants indicated that partial results have been achieved in deceased organ donation. Concomitantly, multiple obstacles have adversely affected the process and outcomes: at the structural level, the fragmentation of the health system and the scarcity of financial and material resources; at the relational level, nonegalitarian relationships between coordinators and hospital personnel; at the ideational level, the transplant domain and its specialists overshadow the donation domain and its coordinators. Negative images are associated with donation coordinators. CONCLUSIONS: Organ donation faces structural, relational, and ideational barriers; hence, complex interventions should be undertaken. Donation coordinators also should be recognized by the health system.

Barreras de Bioseguridad en el Laboratorio de Microbiología Yara, 2012 / Biosecurity Barriers at the Laboratory of Microbiology in Yara, 2012

En los Laboratorios de Microbiología el riesgo biológico es alto, de ahí la necesidad de establecer y cumplir las normas de bioseguridad. Por lo que se realizó una investigación en el Laboratorio de Microbiología de Yara, con el objetivo de identificar el funcionamiento de las barreras de contención. Se caracterizó el laboratorio en cuanto a la distribución de los locales, número de personas que trabajan y nivel de riesgo. La determinación de las condiciones estructurales del laboratorio se realizó mediante la inspección al laboratorio, para lo que se tuvo en cuenta una guía observacional según los lineamientos de bioseguridad para las instalaciones de salud, 2010. La evaluación del conocimiento acerca de las barreras de contención se aplicó mediante cuestionario, basada en los criterios de seguridad biológica establecidos en el manual de bioseguridad (OMS, Ginebra 2005), además de la observación del trabajo práctico en el laboratorio, con el propósito de detectar la aplicación de las medidas de bioseguridad en el mismo(AU)

At Microbiology Laboratories, the biological risk is high, from that point it comes the need to establish and to obey the biosegurity standards. With that, purpose it was accomplished an investigation at the Laboratory of Microbiology in Yara in order to identify the functioning of the retaining barriers. The laboratory was characterized according to the distribution of places, number of persons that work and the risk level. The determination of the structural conditions of the laboratory was performed by means of the laboratory inspection and it was take into account an observational guide according to the biosecurty structures for every health institution in 2010. The evaluation of knowledge about the retaining barriers was applied through a Questionnaire, based on the criteria of biological security stablished in the biosecurity manual (OMS, Geneva 2005), in addition to the observation of practical work at the laboratory, in order to detect the application of biosecurity measures on it(EU)

Caracterización de la vaginosis bacteriana en edad reproductiva en el área de salud de Yara / Characterization of bacterial vaginosis in the reproductive age in the health area Yara

El presente trabajo se desarrolló en el laboratorio de Microbiología ubicado en el municipio de Yara, provincia Granma, donde se analizaron muestras de exudados vaginales a todas las pacientes que acudieron al laboratorio con la indicación médica de este tipo de complementario, el universo estuvo comprendido por 440 pacientes del área de salud de Yara, con los objetivos de identificar a los agentes causales más frecuentes de infecciones vaginales, principalmente Gardnerella, como causa de vaginosis bacteriana. Los datos para el estudio fueron: edad de comienzo de las relaciones sexuales, estado conyugal, uso de preservativo y área residencial. Para el análisis de los datos se aplicaron medidas de frecuencia relativa (porcentual) y se expresan a través de tablas para su mejor comprensión. Nuestros resultados indicaron que los agentes más frecuentes encontrados son Gardnerella vaginalis y Mobiluncus spp, siendo éste un indicador de la vaginosis bacteriana, el grupo etáreo más afectado fue el de 14-19 años(AU)

The present work was developed at the Microbiology laboratory located in Yara's municipality of Granma province, where there were examined signs of vaginal exudations to all of the patients that came to the laboratory with the medical indication of these complementary tests. The universe was made by 440 patients of the health area of Yara, with the objectives to identify the most frequent cause agents of vaginal infections, principally Gardnerella as the cause of bacterial vaginosis. The data for the research were: age of the beginning of sexual relations, conjugal status, use of condoms and residential area. For the analysis of the data there were applied measures of relative frequency (percentage) and they were evidenced through charts for their better understanding. Our results indicated that the more frequent agents met are Gardnerella vaginalis and Mobiluncus spp, being this one a bacterial vaginosis's indicator, the most affected etharian group was between 14-19 years(EU)

Investigación cualitativa en salud: una revisión crítica de la producción bibliográfica en México / Qualitative health research: a critical review of recent work in Mexico

OBJETIVO: Examinar críticamente la producción bibliográfica sobre la investigación cualitativa en salud (ICS) en México. MATERIAL Y MÉTODOS: Revisión de 128 trabajos publicados en la década del 2000 al 2009. Su búsqueda y recuperación se hizo mediante consulta de índices, buscadores y bases de datos, así como consultando a académicos. Se hizo análisis de frecuencias y de contenido. RESULTADOS: La producción en este campo se incrementa notoriamente en el periodo analizado, se difunde a nivel nacional e internacional y aparece mayoritariamente en revistas de salud pública y medicina social. Su consolidación, no obstante, dista de ser realidad dada su concentración institucional, territorial y temática, su dependencia de la teoría fundamentada, su olvido de temas sanitarios y actores importantes y su impacto marginal en el campo científico. CONCLUSIONES: La investigación cualitativa en salud logra avances en México pero enfrenta serios desafíos para consolidarse. Varias propuestas se presentan para fortalecerla.

OBJECTIVE: This paper critically examines recent work on qualitative health research (QHR) in Mexico. MATERIAL AND METHODS: A review was conducted of 128 articles published between 2000 and 2009. A literature search was done drawing together a verse of indexes, search engine, data bases and citations, as well as interviewing researchers. A frequency and content analysis was carried out. RESULTS: QHR has expanded significantly, both nationally and internationally, and papers published in public health and social medicine journals. However, several factors impede its consolidation: the institutional, territorial and thematic concentration of studies, the dependency on grounded theory, the selective nature of the research topics and populations; and its marginal scientific impact. CONCLUSIONS: QHR has grown in México, but its consolidation faces serious challenges. Several proposals are discussed that could strengthen the field.