Analysis of Inequalities and Inequities in Maternal Mortality in Chocó, Colombia.

We used a mixed design study to analyze the inequalities and inequities in Maternal Mortality (MM) for Chocó (Colombia) between 2010-2018. The quantitative component consisted of an analytical ecological design, where proportions, ratios, measures of central tendency and rates ratios, rate difference, Gini and concentration indices were calculated to measure inequalities. The qualitative component had a phenomenological and interpretive approach. One hundred thirty-one women died in Choco between 2010-2018. The Maternal Mortality Ratio was 224/100.000 live births. The Gini coefficient was 0.35, indicating inequality in the distribution of the number of MM with respect to live births. The health service offers have been concentrated in the private sector in urban areas (77%). The exercise of midwifery has played an important role in maternal and perinatal care processes, especially in territories where the State has been absent. Nevertheless, it occurs in complex circumstances such as the armed conflict, lack of transportation routes, and income deficits, affecting the timelines and care quality for these vulnerable groups. MM in Chocó has been a consequence of deficiencies in the health system and weaknesses in its infrastructure (absence of a high level of maternal-perinatal care). This is in addition to the territory's geographical characteristics, which increase vulnerability and health risks for women and their newborns. In Colombia, as well as in other countries, many maternal and newborn deaths are preventable because their causes are due to social injustices.

Sistematización de Experiencias: una reflexión sobre sus potencialidades para la salud pública

Objetivo: Presentar los resultados de una revisión sobre la investigación y metodología de Sistematización de Experiencias y su pertinencia en la salud pública. Métodos: Se realizó una revisión de literatura en dos etapas usando los siguientes operadores booleanos: "sistematización de experiencias" AND "metodología" OR "investigación" OR "salud" OR "educación popular" OR "trabajo social" OR "Latinoamérica" OR "Investigación Acción Participativa", en las bases de datos MedLine y Scielo, complementada con la búsqueda en el catálogo general de las bibliotecas de la Pontificia Universidad Javeriana y la Universidad Nacional de Colombia. Se dejó fecha e idioma abierto. Se empleó N-Vivo versión 12 para el procesamiento de la información. Resultados: Se obtuvieron 183 referencias, entre artículos, libros, literatura gris, tesis (pregrado, maestría o doctorado) y material audiovisual. De estos, se seleccionaron 88 para revisión de texto completo. Se generaron seis categorías relacionadas con la definición, metodología, instrumentos, objetivos, limites-tensiones y ventajas de la Sistematización de Experiencias. Conclusiones: La Sistematización de Experiencias es una metodología cualitativa surgida en el contexto latinoamericano que permite la reconstrucción de la historia y el conocimiento de las prácticas para fortalecer y transformar la realidad local. En el campo de la salud pública, la SE permite reinterpretar las nociones y problemáticas en salud de las personas y colectividades; comprender sus experiencias, necesidades y expectativas en salud; e identificar la agencia de las personas para mejorar e incidir en el bienestar y la calidad de vida de sus comunidades.

Objective: To show the results of a literature review about the investigation and methodology of Systematization of Experiences and its relevance in public health. Method: A literature review was carried out in two stages. The following Boolean operators were used: "systematization of experiences" AND "methodology" OR "research" OR "health" OR "popular education" OR "social work" OR "Latin America" OR "Participatory Action Research", in the MedLine and Scielo databases, was complemented by a search in the general catalog of the libraries of the Pontificia Universidad Javeriana and the Universidad Nacional de Colombia. Date and language were left open. N-Vivo version 12 was used for the processing and description of the information. Results: A total of 183 references were obtained from articles, books, gray literature, thesis (undergraduate, master's or doctorate) and audiovisual material. Of these, 88 were selected for full text review. Six categories were created related to the definition, methodology, instruments, objectives, limits-tensions and advantages of the Systematization of experiences. Conclusions: The Systematization of Experiences is a methodological strategy that contributes to qualitative research created within the context of Latin America, which allows us to recover the history and knowledge of practices while also strengthening and transforming the local reality. In the field of public health, it allows us to reinterpreting the notions and problems of individuals and communities; understanding their experiences, needs and expectations in health; and identify people's agency to improve and positively influence the well-being and quality of life of the community.

Procyanidins: From Agro-Industrial Waste to Food as Bioactive Molecules.

Procyanidins are an important group of bioactive molecules known for their benefits to human health. These compounds are promising in the treatment of chronic metabolic diseases such as cancer, diabetes, and cardiovascular disease, as they prevent cell damage related to oxidative stress. It is necessary to study effective extraction methods for the recovery of these components. In this review, advances in the recovery of procyanidins from agro-industrial wastes are presented, which are obtained through ultrasound-assisted extraction, microwave-assisted extraction, supercritical fluid extraction, pressurized fluid extraction and subcritical water extraction. Current trends focus on the extraction of procyanidins from seeds, peels, pomaces, leaves and bark in agro-industrial wastes, which are extracted by ultrasound. Some techniques have been coupled with environmentally friendly techniques. There are few studies focused on the extraction and evaluation of biological activities of procyanidins. The identification and quantification of these compounds are the result of the study of the polyphenolic profile of plant sources. Antioxidant, antibiotic, and anti-inflammatory activity are presented as the biological properties of greatest interest. Agro-industrial wastes can be an economical and easily accessible source for the extraction of procyanidins.

Uso de la miel en el manejo de las úlceras crónicas de miembros inferiores en el adulto. Revisión sistemática / Use of honey in the management of chronic leg ulcers in adults. Systematic review. / Uso de mel no tratamento de úlceras crônicas dos membros inferiores no adulto. Revisão sistemática

Introducción: las úlceras en miembros inferiores hacen parte de las enfermedades crónicas que afectan a la población mundial, las cuales generan deterioro en la calidad de vida de quienes las padecen. La miel es un alimento natural utili-zado a lo largo de la historia de la humanidad con fines curativos para el manejo de las lesiones en la piel; sin embargo, el beneficio de su uso en el tratamiento de las úlceras de miembros inferiores no ha sido definido, ya que la evidencia actual es controversial. Objetivo: evaluar la mejor evidencia científica disponible para determinar los beneficios de la miel en el tratamiento de las úlceras crónicas de miembros inferiores en la población adulta. Metodología: se realizó una revisión sistemática de la literatura de ensayos clínicos controlados, aleatorizados en las bases de datos PubMed, Ovid, ProQuest, EBSCO, BIREME. Se incluyeron 9 ensayos clínicos controlados. Se evaluó la calidad metodológica según los parámetros de PeDro y se utilizaron criterios de la colaboración Cochrane para definir la presencia de sesgos de cada estudio. Resultados: ocho de los 9 estudios incluidos reportaron desenlaces favorables en el uso de la miel. Los estudios conta- ron con buena calidad metodológica en su desarrollo, pero evidenciaron un riesgo poco claro de sesgo. Conclusión: la evidencia disponible no permite establecer la utilidad de la miel en el manejo de las úlceras de miembros inferiores. La evidencia actual muestra poca claridad en términos de sesgos, por lo que es necesario realizar nuevos ensayos clínicos, con mejores criterios de intervención, para poder establecer el beneficio del uso de la miel en esta enfermedad

Background: Leg ulcer are part of chronic diseases that affect word population, generating a big burden in quality of life. Honey is a natural food used along humanity history as a topic medicine for skin conditions. The benefits of using honey as a treatment of chronic leg ulcers has not been clarified because off controversial evidence. Objectives: This review assess the best scientific evidence to establish the benefits of using honey in chronic leg ulcers in adult population. Methods: A systematic Review of randomized clinical trials was made in PubMed, Ovid, ProQuest, EBSCO and BIREME databases. 9 controlled clinical trials were included. Methodological quality was assessed using PeDro criteria. Risk of bias was assessed using Cochrane parameters. Results: Eight of nine clinical trials included reported beneficial outcomes using honey in chronical leg ulcers treatment. Trials were made with good methodological quality however their had unclear risk of bias. Conclusion: Available evidence does not let define the usefulness of applying honey in chronic leg ulcers. Data is unclear in terms of bias; thus, it is necessary to perform new randomized clinical trials with better intervention criteria to define if using topical honey in chronic leg ulcers is beneficial or not compared with conventional treatment

Introdução: as úlceras nos membros inferiores fazem parte das doenças crônicas que afetam a po- pulação mundial, as quais geram deterioração na qualidade de vida daqueles que sofrem com elas. O mel é um alimento natural usado ao longo da história da humanidade para fins de cura no tratamento de lesões de pele; no entanto, o benefício de seu uso no tratamento de úlceras nos membros inferio- res não foi definido, pois a evidência atual é controversa. Objetivo: avaliar a melhor evidência científica disponível para determinar os benefícios do mel no tratamento de úlceras crônicas de membros inferiores na população adulta. Metodologia: foi realizada uma revisão sistemática da literatura de ensaios clínicos controlados, randomizados nas bases de dados PubMed, Ovid, ProQuest, EBSCO, BIREME. Nove ensaios clínicos controlados foram incluídos. A qualidade metodológica foi avaliada de acordo com os parâmetros PeDro e os critérios da Cochrane Collaboration foram utilizados para definir a presença de viés em cada estudo. Resultados: Oito dos 9 estudos incluídos relataram resultados favoráveis no uso do mel. Os estudos tiveram boa qualidade metodológica em seu desenvolvimento, mas mostraram um risco claro de viés. Conclusão: a evidência disponível não permite estabelecer a utilidade do mel no manejo de úlceras nos membros inferiores. A evidência atual mostra pouca clareza em termos de vieses, portanto, é ne- cessário realizar novos ensaios clínicos, com melhores critérios de intervenção, a fim de estabelecer o benefício do uso do mel nesta doença.