Socioeconomic Inequalities in Alcohol and Tobacco Consumption: A National Ecological Study in Mexican Adolescents.

Alcohol and cigarettes are the psychoactive substances that adolescents use most frequently. When both addictions are combined, they carry the worst burden of disease globally. The objective of this study was to identify whether socioeconomic factors correlate with alcohol and tobacco consumption in Mexican adolescents aged 10 years or more and to establish the relationship in the consumption between the two substances. This ecological study utilized data describing alcohol and tobacco consumption among adolescents aged 10-16 years (n = 48,837 ≈ N = 11,621,100). Having ever consumed any alcohol-containing beverage constituted alcohol consumption. Smoking a cigarette within 30 days constituted cigarette consumption. For both variables, the state-level percentages reported in the survey were used. Diverse socioeconomic variables were collected from official sources. Data on the prevalence of tobacco use and alcohol consumption were entered into an Excel database estimated for each of the states of the Mexican Republic, as well as the socioeconomic variables. We performed the analysis using Stata 14. Consumption prevalence was 15.0% for alcohol and 4.2% for tobacco. Alcohol consumption was not correlated with any studied socioeconomic variable (p > 0.05). The prevalence of tobacco consumption among elementary school students correlated (p < 0.05) with the portion of the population living in private dwellings without sewage, drainage, or sanitation (r = 0.3853). The prevalence of tobacco consumption among middle-school adolescents correlated with the portion of the employed population that earned up to two minimum wages (r = 0.3960), the percentage in poverty by income 2008 (r = 0.4754) and 2010 (r = 0.4531), and the percentage in extreme poverty by income 2008 (r = 0.4612) and 2010 (r = 0.4291). Positive correlations were found between tobacco consumption and alcohol consumption among both elementary (r = 0.5762, p=0.0006) and middle-school children (r = 0.7016, p=0.0000). These results suggest that certain socioeconomic factors correlate with tobacco consumption but not alcohol consumption. A correlation between alcohol consumption and tobacco consumption was observed. The results can be used for developing interventions in adolescents.

Surveillance of Shiga toxin-producing Escherichia coli associated bloody diarrhea in Argentina.

In Argentina, hemolytic uremic syndrome (HUS) caused by Shiga toxin-producing Escherichia coli (STEC-HUS) infection is endemic, and reliable data about prevalence and risk factors have been available since 2000. However, information about STEC-associated bloody diarrhea (BD) is limited. A prospective study was performed during the period October 2018-June 2019 in seven tertiary-hospitals and 18 referral units from different regions, aiming to determine (i) the frequency of STEC-positive BD cases in 714 children aged 1-9 years of age and (ii) the rate of progression of bloody diarrhea to HUS. The number and regional distribution of STEC-HUS cases in the same hospitals and during the same period were also assessed. Twenty-nine (4.1%) of the BD patients were STEC-positive, as determined by the Shiga Toxin Quik Chek (STQC) test and/or the multiplex polymerase chain reaction (mPCR) assay. The highest frequencies were found in the Southern region (Neuquén, 8.7%; Bahía Blanca, 7.9%), in children between 12 and 23 month of age (8.8%), during summertime. Four (13.8%) cases progressed to HUS, three to nine days after diarrhea onset. Twenty-seven STEC-HUS in children under 5 years of age (77.8%) were enrolled, 51.9% were female; 44% were Stx-positive by STQC and all by mPCR. The most common serotypes were O157:H7 and O145:H28 and the prevalent genotypes, both among BD and HUS cases, were stx2a-only or -associated. Considering the endemic behavior of HUS and its high incidence, these data show that the rate of STEC-positive cases is low among BD patients. However, the early recognition of STEC-positive cases is important for patient monitoring and initiation of supportive treatment.

Healing of implants installed in over- or under-prepared sites--an experimental study in dogs.

OBJECTIVE: To study bone healing at implants installed with different insertion torques. MATERIAL AND METHODS: In six Labrador dogs, all mandibular premolars and first molars were extracted. After 4 months of healing, flaps were elevated, and two implant sites were prepared at each side of the mandible. In the right side of the mandible, the distal sites were prepared conventionally, while the mesial sites were over-prepared by 0.2 mm. As a consequence, a final insertion torque of ~30 Ncm at the distal and a minimal insertion torque close to 0 Ncm at the mesial sites were obtained. In the left sides of the mandible, however, the recipient sites were underprepared by 0.3 mm resulting in an insertion torque of ≥ 70 Ncm at both implants. Cover screws were applied, and flaps sutured to fully submerge the experimental sites. After 4 months, the animals were sacrificed and ground sections obtained for histological evaluation. RESULTS: The mineralized bone-to-implant contact was in the range of 55.2-62.1%, displaying the highest value at implants with ~30 Ncm insertion torque and the lowest value at the implant sites with close to 0 Ncm insertion torque. No statistically significant differences were revealed. Bone density was in the range of 43.4-54.9%, yielding the highest value at implants with ≥ 70 Ncm insertion torque and the lowest at the implant sites with close to 0 Ncm insertion torque. The difference between the sites of ~30 Ncm and the corresponding ≥ 70 Ncm insertion torque reached statistical significance. CONCLUSIONS: Similar amounts of osseointegration were obtained irrespective of the insertion torque applied. Moreover, implants installed in sites with close to 0 Ncm insertion torque may properly osseointegrate as well.

Influence of immediate loading on healing of implants installed with different insertion torques--an experimental study in dogs.

OBJECTIVE: To evaluate the influence of different insertion torques on healing of implants loaded immediately or left unloaded. MATERIAL AND METHODS: In six Labrador dogs, all mandibular premolars and molars were extracted. After 4 months of healing, flaps were elevated, and two implant sites were prepared at each side of the mandible. The distal sites were prepared conventionally while the mesial sites were underprepared by 0.3 mm. As a consequence, different final insertion torques of about 30 Ncm at the distal and >70 Ncm at the mesial sites were recorded. Healing abutments were applied to the left and transmucosal abutments to the right side. Flaps were sutured, crown preparation of the upper right second and third premolars was performed, and impressions were taken. Within 24 h, crowns were cemented both to implants and teeth in the right side of the mouth. After 4 months, the animals were sacrificed and ground sections obtained for histological evaluation. RESULTS: A higher buccal bony crestal resorption and a more apical position of the coronal level of osseointegration were found at the loaded compared with the unloaded sites. MBIC% and percentages of peri-implant mineralized tissue (MB%) were higher at the loaded compared with the unloaded sites. Moreover, a higher MBIC% was found at the lower compared with the higher final insertion torque. CONCLUSIONS: Immediate loading does not seem to have a negative effect on osseointegration. High torque values for the immediate loading procedures were not necessary. Probably, low torque values, were sufficient to obtain primary stability and hence may provide better osseointegration than high torque value.

Genotypic characterization of Escherichia coli O157:H7 strains that cause diarrhea and hemolytic uremic syndrome in Neuquén, Argentina.

Shiga toxin-producing Escherichia coli (STEC) are important food-borne pathogens associated with cases of diarrhea, hemorrhagic colitis and hemolytic uremic syndrome (HUS). E. coli O157:H7 is the dominant serotype in Argentina and also in Neuquén Province, in which HUS incidence is above the national average, with a maximum of 28.6 cases per 100,000 children less than 5 years old reported in 1998. The aim of this study was to characterize a collection of 70 STEC O157 strains isolated from patients with diarrhea and HUS treated in the province of Neuquén, Argentina, between 1998 and 2011. All strains harbored eae, ehxA, rfbO157, and fliCH7 genes, and stx2a/stx2c (78.7%) was the predominant genotype. A total of 64 (91.4%) STEC O157 strains belonged to the hypervirulent clade 8 tested using both 4 and 32 SNP typing schemes. The strains showed the highest values reported in the literature for 6 of the 7 virulence determinants described in the TW14359 O157 strain associated with the raw spinach outbreak in the U.S. in 2006. Clade 8 strains were strongly associated with two of them: ECSP_3286, factor encoding an outer membrane protein that facilitates the transport of the heme complex (P=0.001), and in particular extracellular factor ECSP_2870/2872, coding proteins related to adaptation to plant hosts (P=0.000004). The q933 allele, which has been related to high toxin production, was present in 97.1% of the strains studied for the anti-terminator Q gene. In summary, this study describes, for the first time in Argentina, the almost exclusive circulation of strains belonging to the hypervirulent clade 8, and also the presence of putative virulence factors in higher frequencies than those reported worldwide. These data may help to understand the causes of the particular epidemiological situation related to HUS in Neuquén Province.

Longitudinal Serological Surveillance for COVID-19 Antibodies after Infection and Vaccination.

The impact of COVID-19 is still felt around the world, and more information is needed regarding infection risk, vaccination responses, and the timing of booster vaccinations. We aimed to evaluate the association of vaccination with closely followed, longitudinal antibody titers and COVID-19 infection events. We conducted a natural history study in a convenience cohort in an ambulatory research unit. We measured anti-nucleocapsid and anti-spike antibody levels every 3 months for 1 year and captured weekly reports of medically confirmed COVID-19 infections. We analyzed the association of antibody titers with infection events as well as the association of the decision to receive vaccination with social, medical, and behavioral characteristics. 629 subjects were followed for 1 year, and 82.8% of them were vaccinated. 90 cases of medically confirmed COVID-19 infection were reported. Notable findings from our study include: an association of vaccination choice with social distancing, a qualitatively different anti-spike response in participants receiving the Ad26.COV2.S vaccine compared to those receiving mRNA vaccines, a muted anti-nucleocapsid response in breakthrough infections compared to unvaccinated infections, and the identification of a low antibody titer threshold associated with the risk of breakthrough infections. We conclude that, in a real-life setting, vaccination and social distancing behavior are positively correlated. The observed effect of vaccination in preventing COVID-19 may include both vaccine-mediated protection and the associated more cautious behavior exhibited by vaccinated individuals. In addition, we identified an antibody threshold associated with breakthrough infections in mRNA vaccinees, and this threshold may be used in medical decision-making regarding the timing of booster vaccinations. Therefore, our data may aid in the refinement of vaccination strategies during the COVID-19 pandemic. IMPORTANCE The COVID-19 pandemic continues to impact societies and health care systems worldwide and is continuously evolving. Immunity via vaccination or prior infection is the first and most important line of defense against COVID-19. We still do not have complete information on how vaccination-induced or infection-induced antibody titers change with time or on how this information can be used to guide decisions regarding booster vaccination. In a longitudinal observational study of a cohort of 629 subjects, 82% of breakthrough infections in vaccinees occurred when their anti-spike antibody titers were below 3,000 AU/mL. Our findings suggest that there may be an antibody threshold associated with breakthrough infections and that this threshold could possibly be used to aid decision-making regarding booster vaccinations. In addition, the use of anti-nucleocapsid antibody tiers may significantly underestimate the prevalence of breakthrough infections in vaccinated individuals.

The Launch of A Girl's First Period Study: Demystifying Reproductive Hormone Profiles in Adolescent Girls.

Limited data exist on the reproductive hormone dynamics that govern the transition from menarche to the establishment of the mature ovulatory cycles of a fertile young woman. It is also unclear how environmental and lifestyle factors could modulate this transition in contemporary girls. Here, we introduce A Girl's First Period Study, an ambitious longitudinal study aimed at charting the early post-menarchal course of a cohort of healthy girls in the Triangle region of North Carolina.

Socioeconomic Inequalities and Toothbrushing Frequency among Schoolchildren Aged 6 to 12 Years in a Multi-Site Study of Mexican Cities: A Cross-Sectional Study.

Periodic toothbrushing is the most common, effective, and reliable way to mechanically remove biofilm from oral tissues. The objective of the present study was to determine the association between toothbrushing frequency and socioeconomic position for schoolchildren between 6 and 12 years of age in four cities in Mexico. A cross-sectional study was conducted on 500 Mexican schoolchildren between 6 and 12 years of age from public schools in four Mexican cities. Questionnaires were administered to the parents/guardians of the schoolchildren to obtain the variables included in the study. The dependent variable was toothbrushing frequency, dichotomized as: 0 = less than twice a day and 1 = at least twice a day. The analysis was performed in Stata. The average age of the schoolchildren was 8.9 ± 1.9 years; 50.4% were female. The prevalence of toothbrushing was 52.8% (at least twice a day) (95% CI = 48.4−57.1). In the multivariate model, the variables associated (p < 0.05) with toothbrushing frequency were older age of the schoolchild (OR = 1.14); younger age of the mother (OR = 0.93); being a girl (OR = 1.70); being enrolled in Seguro Popular (OR = 0.69); being in a household that was owned (OR = 2.43); and being a schoolchild who lived in a home that owned a car (OR = 1.31). The prevalence of toothbrushing at least twice a day was just over 50% in these Mexican children. We found demographic and socioeconomic variables to be associated with toothbrushing. Based on socioeconomic variables that were associated with toothbrushing frequency­such as health insurance, home ownership and the household owning a car­the results of the present study confirm the existence of health inequalities in toothbrushing frequency.

Factors Associated with Self-Report of Type 2 Diabetes Mellitus in Adults Seeking Dental Care in a Developing Country.

The aims of the present study were to identify the prevalence and risk indicators of type 2 diabetes mellitus (T2DM) in urban-based Mexican adults seeking care in a university-based triage/intake dental clinic, and to develop a predictive model. A cross-sectional study was conducted on 3354 medical/dental records of adults who sought care at the triage/intake dental clinics of a public university. The dependent variable was self-report of a previous diagnosis of T2DM made by a physician. Several socio-demographic and socioeconomic covariates were included, as well as others related to oral and general health. A multivariate binary logistic regression model was generated. We subsequently calculated well-known statistical measures employed to evaluate discrimination (classification) using an (adjusted) multivariate logistic regression model (goodness-of-fit test). The average age of patients was 42.5 ± 16.1 years old and the majority were female (64.1%). The prevalence of T2DM was 10.7% (95%CI = 9.7−11.8). In the final multivariate model, the variables associated (p < 0.05) with the presence of T2DM were older age (40 to 59 years old, OR = 2.00; 60 to 95 years old, OR = 2.78), having any type of health insurance (OR = 2.33), having high blood pressure (OR = 1.70), being obese (OR = 1.41), and having a functional dentition (OR = 0.68). Although the global fit of the model and the calibration tests were adequate, the sensitivity (0.0%) and positive predictive (0.0%) values were not. The specificity (100%) and negative predictive (89.3%) values, as well as the correctly classified (89.3%) value, were adequate. The area under the ROC curve, close to 0.70, was modest. In conclusion, a prevalence of T2DM of 10.7% in this sample of Mexican adults seeking dental care was similar to national figures. Clinical (blood pressure, BMI and functional dentition), demographic (age), and socioeconomic (health insurance) variables were found to be associated with T2DM. The dental setting could be appropriate for implementing preventive actions focused on identifying and helping to reduce the burden of T2DM in the population.

Somatic Genetic Mosaicism in the Apolipoprotein E-null Mouse Aorta.

In addition to genetic and epigenetic inheritance, somatic variation may contribute to cardiovascular disease (CVD) risk. CVD-associated somatic mutations have been reported in human clonal hematopoiesis, but evidence in the atheroma is lacking. To probe for somatic variation in atherosclerosis, we sought single-nucleotide private variants (PVs) in whole-exome sequencing (WES) data of aorta, liver, and skeletal muscle of two C57BL/6J coisogenic male ApoE null/wild-type (WT) sibling pairs, and RNA-seq data of one of the two pairs. Relative to the C57BL/6 reference genome, we identified 9 and 11 ApoE null aorta- and liver-specific PVs that were shared by all WES and RNA-seq datasets. Corresponding PVs in WT sibling aorta and liver were 1 and 0, respectively, and not overlapping with ApoE null PVs. Pyrosequencing analysis of 4 representative PVs in 17 ApoE null aortas and livers confirmed tissue-specific shifts toward the alternative allele, in addition to significant deviations from mendelian allele ratios. Notably, all aorta and liver PVs were present in the dbSNP database and were predominantly transition mutations within atherosclerosis-related genes. The majority of PVs were in discrete clusters approximately 3 Mb and 65 to 73 Mb away from hypermutable immunoglobin loci in chromosome 6. These features were largely shared with previously reported CVD-associated somatic mutations in human clonal hematopoiesis. The observation that SNPs exhibit tissue-specific somatic DNA mosaicism in ApoE null mice is potentially relevant for genetic association study design. The proximity of PVs to hypermutable loci suggests testable mechanistic hypotheses.

[Direct immunofluorescence assay performance in diagnosis of the Influenza A(H1N1) virus]. / Desempeño de la prueba de inmunofluorescencia directa en el diagnóstico del virus Influenza A(H1N1).

By 25 April 2009, less than one month after the first human with Influenza A(H1N1) virus was detected in Mexico, the disease had already spread to more than 40 countries, with over 10,000 cases reported. Due to its unpredictability, this type of virus requires appropriate, reliable, and safe diagnostic methods that are also accessible to clinical laboratories. Through the analysis of 291 samples taken from patients with suspected Influenza A(H1N1) virus infection in Neuquén, Argentina, this study compares the two diagnostic methods used simultaneously: direct immunofluorescence assay (DFA) and real-time polymerase chain reaction (RT-PCR). DFA had a sensitivity of 44.4%, a specificity of 99.6%, a positive predictive value of 95.2%, and a negative predictive value of 90.7%. Positive results obtained with this method can be considered true positives. A negative result does not rule out the presence of the virus. In this case, the sample should be examined by RT-PCR. Out of a total of 291 samples, there were 45 positive results with RT-PCR and 21 positive results with DFA.

Neighborhoods' Evaluation: Influence on Well-Being Variables.

The influence of neighborhood characteristics on residents' well-being and residential satisfaction has been widely studied, and has presented considerable variability. This study analyses the extent to which neighborhood resources influence variables relating to well-being, and examines the relationship between neighborhood resources and residents' perceptions. The study was structured over two phases: (1) the neighborhood resources were evaluated, and (2) 252 neighborhood residents was interviewed. The results have shown that the observation by independent observers of neighborhood resources is connected to residents' perceptions of their neighborhood. Residents' perceptions of their neighborhoods is associated with indicators of well-being, and residential satisfaction. Also, the reasons for living in the neighborhood appear to be connected to the observed availability of resources and the perception of it. Wellbeing and residential satisfaction are the outcome of multiple aspects that are not limited to structural and material elements of neighborhoods.

Presence of Streptococcus dentisani in the dental plaque of children from different Colombian cities.

Streptococcus dentisani has been identified as an oral cavity probiotic due to its beneficial characteristics. One of its beneficial features is the production of bacteriocins, which inhibit the growth of cariogenic bacteria, and another is its buffering capacity through the production of ammonium from arginine. The purpose of this study was to determine the presence of S. dentisani in the dental plaque of Colombian children and whether the presence of this bacterium is related to oral health and other conditions. Dental plaque and information on diet and oral hygiene habits were collected from children between 6 and 12 years of age from four Colombian cities, divided into caries-free children (International Caries Detection and Assessment System [ICDAS] 0, Decayed Missing Filled Teeth index [DMFT] 0), children with ICDAS 1 and 2, and children with ICDAS >3. Plaque DNA was extracted and quantified, and real-time polymerase chain reaction was performed using specific primers. This bacterium was identified in all samples, with a median of 0.46 cells/ng DNA (interquartile range [IQR] 0.13-1.02), without finding significant differences between the groups (P > 0.05). In caries-free children, a median of 0.45 cells/ng DNA (IQR 0.14-1.23) was found. In children with ICDAS 1 and 2, the median was 0.49 cells/ng DNA (IQR 0.11-0.97), and in children with ICDAS >3, the median was 0.35 cells/ng DNA (IQR 0.12-1.07). However, statistically significant differences were found in the origin of children (P < 0.01), the use of fluoride-containing products (P < 0.01), and the frequency of food intake (P < 0.05). In conclusion, the presence of S. dentisani was quantified in children from four Colombian cities, without finding significant differences in oral health status. Nevertheless, three conditions showed a possible relationship with S. dentisani.

Prevalence and dissemination of the Ser315Thr substitution within the KatG enzyme in isoniazid-resistant strains of Mycobacterium tuberculosis isolated in Uruguay.

The aim of this study was to determine the prevalence of Ser315Thr substitution in isoniazid (INH)-resistant strains of Mycobacterium tuberculosis in Uruguay. The katG gene of 62 INH-resistant strains was analysed by an RFLP-PCR assay. PCR products were digested with MspI to detect Ser315Thr and Arg463Leu substitutions. A total of 16 of the 62 (26 %) INH-resistant strains analysed had a Ser315Thr substitution. Only one INH-resistant strain had an Arg463Leu substitution and two strains had a deletion in katG. Of the 16 strains with Ser315Thr, 15 showed different profiles using a double-repetitive-element PCR assay, demonstrating that there was no local dissemination of any particular strain. These findings are in agreement with published data from regions where the prevalence of tuberculosis (TB) is intermediate and may be due in part to the success of the local TB control programme.

Selection of an optimal RNA transfection reagent and comparison to electroporation for the delivery of viral RNA.

The initiation of viral RNA replication by the transfection of viral RNA is an integral tool in dissecting the life cycles, susceptibility, and pathogenesis of numerous RNA viruses. Many different transfection methods deliver viral RNA into mammalian cells, including DEAE-dextran and lipid-based reagents, but electroporation is one of the most popular methods. Unfortunately, electroporation suffers from many limitations, including high cell death, serum-free transfection conditions, and requires many cells and relatively large amounts of RNA. To optimize and facilitate the introduction of viral RNAs into mammalian cells, different commercially available RNA transfection reagents were compared for their ability to deliver yellow fever virus (YFV) and hepatitis C virus (HCV) RNA replicons into Huh7 cells. The performance of the commercial transfection reagents was also compared directly to electroporation. When properly optimized, certain reagents were superior to electroporation, with much less cell death, less RNA required and increased transfection efficiency. The factors associated with high efficiency transfection, and the advantage of being able to deliver RNA in the presence of serum are discussed.

Mothers massaging their newborns with lotion versus no lotion enhances mothers' and newborns' sleep.

Sleep is frequently interrupted in newborns and their mothers. Massage therapy is noted to facilitate sleep in adults and infants. Infant massage has also been more effective with oil versus no oil. In this study 76 mothers of newborns were randomly assigned to a massage with lotion versus a massage without lotion group and a non-massage control group. The mothers were then taught a simple newborn massage and were asked to massage their newborns daily for 15min at bedtime for one month. The Brief Infant Sleep Questionnaire was adapted for newborns and for mothers, and the mothers completed the questionnaires on their newborns' and their own sleep behaviors (the same behaviors for both mothers and newborns). The 3 groups were compared on the mothers' and their newborns' sleep behavior changes from birth to one month. By the last day of the study, the lotion massage group versus the other two groups showed a shorter latency to sleep and longer sleep for the mothers and fewer nightwakings and longer sleep for their infants. This may relate to the lotion group mothers massaging their infants more frequently as the number of massages was correlated with the total time sleeping and negatively correlated with nightwakings for both the mothers and the infants on the last day of the study. And, the mothers' and the infants' sleep behaviors were significantly correlated.

Knee arthritis pain is reduced and range of motion is increased following moderate pressure massage therapy.

BACKGROUND: The literature on massage therapy effects on knee pain suggests that pain was reduced based on self-report, but little is known about range of motion (ROM) effects. METHODS: Medical School staff and faculty who had knee arthritis pain were randomly assigned to a moderate pressure massage therapy or a waitlist control group (24 per group). Self-reports included the WOMAC (pain, stiffness and function) and the Pittsburgh Sleep Quality Index. ROM and ROM-related pain were assessed before and after the last sessions. RESULTS: The massage group showed an immediate post-massage increase in ROM and a decrease in ROM-associated pain. On the last versus the first day of the study, the massage group showed greater increases in ROM and decreases in ROM-related pain as well as less self-reported pain and sleep disturbances than the waitlist control group. DISCUSSION: These data highlight the effectiveness of moderate pressure massage therapy for increasing ROM and lessening ROM-related pain and long-term pain and sleep disturbances.

Psychosocial factors and mental work load: a reality perceived by nurses in intensive care units.

OBJECTIVE: To analyse the perception of psychosocial factors and mental workload of nurses who work in intensive care units. It is hypothesised that nurses in these units could perceive psychosocial risks, manifesting in a high mental work load. The psychosocial dimension related to the position's cognitive demands is hypothesised to mostly explain mental work load. METHOD: Quantitative study, with a descriptive, cross-sectional, and comparative design. A total of 91% of the intensive care unit populations of three Chilean hospitals was surveyed, corresponding to 111 nurses. The instruments utilised included (A) a biosociodemographic history questionnaire; (b) the SUSESO-ISTAS 21 questionnaire; and (c) the Mental Work Load Subjective Scale (ESCAM, in Spanish). RESULTS: In total, 64% and 57% of participants perceived high levels of exposure to the psychosocial risks Psychosocial demands and Double shift, respectively. In addition, a medium-high level of overall mental load was observed. Positive and significant correlations between some of the SUSESO-ISTAS 21 and ESCAM dimensions were obtained. Using a regression analysis, it was determined that three dimensions of the psychosocial risk questionnaire helped to explain 38% of the overall mental load. CONCLUSION: Intensive care unit nurses felt that inadequate psychosocial factors and mental work overload existed in several of the tested dimensions.

The DNA methylation drift of the atherosclerotic aorta increases with lesion progression.

BACKGROUND: Atherosclerosis severity-independent alterations in DNA methylation, a reversible and highly regulated DNA modification, have been detected in aortic atheromas, thus supporting the hypothesis that epigenetic mechanisms participate in the pathogenesis of atherosclerosis. One yet unaddressed issue is whether the progression of atherosclerosis is associated with an increase in DNA methylation drift in the vascular tissue. The purpose of the study was to identify CpG methylation profiles that vary with the progression of atherosclerosis in the human aorta. METHODS: We interrogated a set of donor-matched atherosclerotic and normal aortic samples ranging from histological grade III to VII, with a high-density (>450,000 CpG sites) DNA methylation microarray. RESULTS: We detected a correlation between histological grade and intra-pair differential methylation for 1,985 autosomal CpGs, the vast majority of which drifted towards hypermethylation with lesion progression. The identified CpG loci map to genes that are regulated by known critical transcription factors involved in atherosclerosis and participate in inflammatory and immune responses. Functional relevance was corroborated by crossing the DNA methylation profiles with expression data obtained in the same human aorta sample set, by a transcriptome-wide analysis of murine atherosclerotic aortas and from available public databases. CONCLUSIONS: Our work identifies for the first time atherosclerosis progression-specific DNA methylation profiles in the vascular tissue. These findings provide potential novel markers of lesion severity and targets to counteract the progression of the atheroma.

Especialistas graduados en el Instituto Nacional de Higiene "Rafael Rangel", tutoría y trabajos especiales de grado en el área de vigilancia sanitaria de medicamentos durante el periodo 2007 ­ 2014 / Specialists graduated in the National Institute of Hygiene "Rafael Rangel", tutorship and degree theses in the area of drug sanitary vigilance, period 2007 ­ 2014

El Instituto Nacional de Higiene "Rafael Rangel" (INHRR) inició las actividades académicas de la Especialización en Vigilancia Sanitaria de Medicamentos en septiembre de 2007. En los primeros ocho años de actividad, el Instituto ha concluido tres cohortes de especialistas. El objetivo del presente trabajo fue presentar una descripción de los especialistas graduados en el INHRR, los tutores y los trabajos especiales de grado (TEG) en el área de vigilancia sanitaria de medicamentos durante el periodo 2007 ­ 2014. Para ello, se realizó una investigación documental y de tipo descriptiva, revisando los expedientes resguardados en los archivos de la Coordinación de Postgrado de la Gerencia de Docencia e Investigación del INHRR. Con este programa de postgrado, el Instituto graduó a 27 especialistas en vigilancia sanitaria de medicamentos con un elevado índice académico (17,1 puntos). La mayoría de los egresados de la especialización fueron mujeres farmacéuticas egresadas de la Universidad Central de Venezuela, quienes laboraban en entes públicos al momento de iniciar el programa. El 70% de los TEG defendidos se realizaron dentro de dos de las líneas de investigación que lleva adelante la Gerencia Sectorial de Registro y Control del INHRR, a saber: las buenas prácticas regulatorias y la farmacovigilancia. Catorce profesionales fueron los encargados de dirigir los TEG, bajo la figura de tutor: dos se destacaron por haber dirigido el 44% de los TEG y otros dos por ser egresados de la especialización. Solo el 29% de los tutores fueron externos al Instituto

The National Institute of Hygiene "Rafael Rangel" (INHRR) began the academic activities of the Drug Sanitary Vigilance Specialization in September 2007. In the first eight years, the Institute has graduated three cohorts of specialists. The aim of this work was to present a description of the specialists graduated in the INHRR, their advisors and degree theses (DT) in the field of drug sanitary vigilance, during the period 2007 ­ 2014. Documentary and descriptive research were carried out; reviewing the records kept in the Postgraduate Coordination archives of the Management for Teaching and Research, INHRR. With this program, the Institute graduated 27 specialists in drug sanitary vigilance with a high academic score (17.1 points). Most of the specialists were female pharmacists graduated from the Central University of Venezuela, who worked in public entities when the program began. Seventy percent of the PT was conducted in two of the research lines carried out by the Management of Control and Registry, INHRR, namely: good regulatory practices and pharmacovigilance. Fourteen professionals supervised the PT, under the figure of tutor. Two tutors excelled for supervising 44% of the PT and another two tutors for being graduates of the specialization. Only 29% of the tutors were external to the Institute