Characterization of the dietary and sociodemographic profile of a group of Colombian vegetarian women in childbearing age during the period 2021-2022 / Caracterização do perfil alimentar e sociodemográfico de um grupo de mulheres vegetarianas colombianas em idade fértil no período 2021-2022

ABSTRACT Objective To determine the dietary and sociodemographic profile of vegetarian women of childbearing age (18 and 49 years) from the Valle de Aburrá Metropolitan Area in 2021-2022 Methods Through an online survey, 232 vegetarian and vegan women of childbearing age (18 to 49 years) from the Valle de Aburrá Metropolitan Area were surveyed regarding their sociodemographic characteristics, amount of time following this eating pattern and, type and reason for choosing vegetarianism, physical activity, use of nutritional supplements and frequency of consumption of certain food groups. Descriptive analyses, association of variables with the type of vegetarianism and multinomial regression models were performed. Results A total of 232 vegetarian women were surveyed: 60.8% were between 18 and 30 years of age and belonged mainly to the middle class. According to the type of diet, 68.1% used an ovo-lacto-vegetarian diet, 18.1% were vegan, 9.0% lacto-vegetarian and 4.8% ovo-vegetarian. Among the factors evaluated in their potential relationship with the different types of vegetarianism, it is highlighted that vitamin B12 supplementation presents a statistically significant association when using veganism as a comparison category. Conclusion According to the results, among young female adults the vegetarian eating style predominates, without significant differences as to the educational level, adequate levels of physical activity in most of the population; there was a higher prevalence of ovo-lacto-vegetarianism. Vitamin B12 supplementation was significantly higher in the vegan population, indicating that ovo-lacto and ovo-vegetarian populations may be at high risk of vitamin B12 deficiency.

RESUMO Objetivo O estudo objetivou determinar a associação entre o perfil sociodemográfico e alimentar de mulheres vegetarianas em idade fértil (18 a 49 anos) na região metropolitana de Valle de Aburrá (Colômbia) em 2021-2022. Métodos Por meio de um questionário online, 232 mulheres vegetarianas e veganas em idade fértil (18 a 49 anos) pertencentes à região metropolitana de Valle de Aburrá foram entrevistadas sobre suas características sociodemográficas, tempo, tipo e motivo da escolha do vegetarianismo, atividade física, consumo de suplementos nutricionais e frequência de consumo dos grupos dos alimentos. Foi realizada análise descritiva, associação das variáveis com o tipo de vegetarianismo e modelos de regressão multinomial. Resultados Foram entrevistadas 232 mulheres vegetarianas: 60,8% tinham entre 18 e 30 anos e pertencem principalmente à classe social média. De acordo com o tipo de dieta, 68,1% tinham uma dieta ovolactovegetariana; 18,1%, vegana; 9%, lactovegetariana; e 4,8%, ovovegetariana. Entre os fatores avaliados em sua possível relação com os diferentes tipos de vegetarianismo, destaca-se que a suplementação de vitamina B12 apresenta associação estatisticamente significativa ao ter o veganismo como categoria de comparação. Conclusão De acordo com os resultados, entre mulheres adultas jovens, predomina o estilo alimentar vegetariano, sem diferença significativa observada no nível de escolaridade e níveis adequados de atividade física na maioria da população; há também maior prevalência de ovolactovegetarianismo. A suplementação de vitamina B12 é significativamente maior na população vegana, indicando um alto risco de deficiência nas populações ovolacto e ovovegetarianas.

Association between VDR Gene Polymorphisms and Melanoma Susceptibility in a Colombian Population.

BACKGROUND: The vitamin D receptor (VDR) is responsible for mediating the effects of vitamin D through regulation of other gene transcriptions. There are several polymorphisms that alter the gene expression or the function of this protein. We aimed to analyze the association between two SNPs  of VDR gene and melanoma cancer in Colombian patients. METHODS: We included 120 healthy individual as controls and 120 melanoma cancer patients as cases . Patients in both groups were matched in terms of gender and age. The genotyping of rs731236 and rs2228570 polymorphisms was performed using PCR-RFLP. The SNPStats program was used to carry out the statistical analysis through a logistic regression model. RESULTS: Under dominant model, we found that rs2228570 polymorphism was associated with melanoma cancer risk (C/C vs C/T-T/T, OR: 5.10, 95% CI: 2.85-9.14), whereas rs731236 polymorphism was associated with a protective effect against this cancer (T/T vs T/C, OR: 0.27, 95% CI: 0.14-0.53). CONCLUSION: Our results suggested that both polymorphisms were involved in the development of melanoma cancer, increasing or decreasing this risk.

Invenciones frente a lo traumático de la violencia: memoria afirmativa de un pueblo afrocolombiano / Invenções contra o traumático da violência: memória afirmativa de um povo afro-colombiano / Inventions against the traumatic of violence: affirmative memory of an afro-colombian people

Resumen La memoria colectiva afirmativa se compone de significados y emociones positivas que por efecto del recuerdo enlazan a una comunidad. El propósito de este estudio fue conocer la memoria afirmativa de la comunidad afrocolombiana de La Balsa, Cauca, que vivió el conflicto armado durante diez años. Es un estudio cualitativo descriptivo que utilizó la técnica de entrevistas individuales con 6 personas y grupos focales con 99 personas. Se realizó un análisis de contenido. Como hallazgos encontramos que los balseños otorgan un papel decisivo a su memoria afirmativa, que exalta sus orígenes ancestrales, familiares, sus prácticas culturales, la etno educación y procesos vigorosos de organización social, que les otorgó un nuevo lugar como agentes sociales. Se concluye que la memoria afirmativa proporciona recursos simbólicos y emocionales para que las comunidades inventen formas de resistencia ciudadana y se reparen de situaciones de violencia, como el caso de la comunidad balseña.

Resumo A memória coletiva afirmativa é composta de significados positivos e emoções que, através do efeito da memória, ligam uma comunidade. O objetivo deste estudo foi conhecer a memória afirmativo da comunidade afro-colombiana de La Balsa, Cauca, que viveu o conflito armado colombiano durante dez anos. Trata-se de um estudo descritivo qualitativo, que utilizou a técnica de entrevistas individuais com 6 pessoas e grupos focais com 99 pessoas. Uma análise de conteúdo foi realizada. Entre os resultados, se tem que os "balseños" concedem um rol decisivo à sua memória afirmativa, exaltando suas origens ancestrais e familiares, práticas culturais, educação étnica e processos vigorosos de organização social que lhes deu um novo lugar como agentes sociais. A principal conclusão foi que a memória afirmativa fornece recursos simbólicos e emocionais para que as comunidades inventem formas de resistência cidadã e reparem as situações de violência, como no caso da comunidade "balseña".

Abstract The affirmative collective memory is composed of positive meanings and emotions that, as a result of memory, link a community. The purpose of this study was to know the affirmative memory of the Afro-Colombian community of La Balsa, Cauca, which lived through the armed conflict for ten years. It is a descriptive qualitative study that used the technique of individual interviews with 6 people and focal groups with 99 people. A content analysis was carried out. We find that the balseños give a decisive role to their affirmative memory, which exalts their ancestral and family origins, their cultural practices, ethno-education and vigorous processes of social organization, which gave them a new place as social agents. It is concluded that affirmative memory provides symbolic and emotional resources for the communities to invent forms of citizen resistance and recover from situations of violence, such as the case of the "Balseña" community.

Change in health profile of refugees resettling in New Zealand, 1980-2014.

AIM: To update data previously published on the health profile of the refugees resettling in New Zealand, and to draw attention to the change in health profile over time, with a decline of infectious disease/deficiencies, and a rise of non-communicable diseases, a worldwide phenomenon. METHOD: Comparative data was extracted from (1) written annual reports prepared by medical officers at the Mangere Refugee Resettlement Centre (1978-1991), (2) a Microsoft ACCESS patient management system between 1995 and 1999 and (3) a MEDTECH patient management system between 2010 and 2014. RESULTS: Over the period 1979-2014, the rate of infectious diseases has declined markedly in resettling refugees, and the rate of non-communicable diseases has increased. For example, the incidence of tuberculosis has decreased from 4% to 0.2%, gut parasites from more than 40% to, in some intakes, 15% and iron deficiency from 22% to 10%, while the diabetes rate has gone from 0.1% to 2.7%. CONCLUSION: While management of unfamiliar infectious diseases and deficiencies (especially vitamin D) still remains an important part of the management of refugee health, their management usually involves limited time and expense, and their burden is much less than before. However, refugees now resettling in New Zealand and the rest of the world often present with familiar non-communicable diseases that require long-term management.

Morphological evaluation of the distal medial striate artery. A study with cadaveric material / Evaluación morfológica de la arteria estriada medial distal. Un estudio con material cadavérico

Abstract Objective: To evaluate the morphology of the distal medial striated artery, taking into account biometric variables useful for clinical and surgical management. Methods: A descriptive transversal study was performed with a sample of brains, who underwent autopsy at the Institute of Legal Medicine and Forensic Sciences of Bucaramanga-Colombia, which were evaluated using the perfusion technique of vascular structures with polyester resin. Results: The distal medial striated artery was presented in 1.4% and 4.2% duplicated in the right and left hemispheres respectively. Agenesis was presented in 2.8% in the left hemisphere. Its origin was 44.6% of the anterior cerebral artery junction site with the anterior communicating artery and was observed in 6 cases (4.2%) presented with a common trunk with the orbitofrontal artery. The main qualitative finding was the sinuous trajectory that was observed in 57.7% on the right side and 45.1% in the left hemisphere. Also, an important alteration found at the biometric analysis was hypoplasia that could be related to the decreased blood supply to the basal nuclei. The diameter was 0.5 ± 0.2 mm and its total length was 20.3 ± 4.1 mm. Conclusions: The topographical knowledge of this structure determines the vulnerability of its morphology because it can complicate surgical procedures performed in the anterior segment of the arterial circle of the brain. Besides, the observed collateral circulation contributes to the blood supply and the perfect functionality of the subcortical nervous structures.

Resumen Objetivo: Evaluar la morfología de la arteria estriada medial distal, teniendo en cuenta variables biométricas útiles para el manejo clínico y quirúrgico. Métodos: Estudio descriptivo transversal con una muestra de cerebros que fueron sometidos a autopsia en el Instituto de Medicina Legal y Ciencias Forenses de Bucaramanga-Colombia, fueron evaluados mediante la técnica de perfusión de estructuras vasculares con resina de poliéster. Resultados: La arteria estriada medial distal se presentó en 1.4% y 4.2% duplicada en el hemisferio derecho e izquierdo respectivamente. Agenesia se presentó en 2.8% en el hemisferio izquierdo. Su origen fue 44.6% del sitio de unión de la arteria cerebral anterior con la arteria comunicante anterior y se observó en 6 casos (4.2%) que presentaban un tronco común con la arteria orbitofrontal. El hallazgo principal fue la trayectoria sinuosa que se observó en 57.7% en el lado derecho y 45.1% en el hemisferio izquierdo. También una alteración importante encontrada en el análisis biométrico fue la hipoplasia que podría estar relacionada con la disminución del suministro de sangre a los núcleos basales. El diámetro fue de 0.5 ±0.2 mm y su longitud total fue de 20.3 ±4.1 mm. Conclusiones: El conocimiento topográfico de esta estructura determina la vulnerabilidad de su morfología, porque puede complicar los procedimientos quirúrgicos realizados en el segmento anterior del círculo arterial del cerebro. Además, la circulación colateral observada contribuye al riego sanguíneo y al perfecto funcionamiento de las estructuras nerviosas subcorticales.

Prevalencia de sintomatología ansiosa y depresiva en migrantes colombianos en Chile

Background: Migratory processes may affect mental health. Data on the health status of migrants are necessary for an adequate public health approach. Aim: To describe the prevalence of anxious and depressive symptoms in Colombian migrants living in Chile and to compare it with the Chilean population. Material and Methods: Beck and BDI scales for depression and BAI anxiety scale were applied to 1,932 participants living in Arica, Antofagasta and Santiago. Of these, 976 participants (51% women) aged 35 ± 10 years were first generation Colombian migrants and 956 participants aged 34 ± 14 years were Chilean. Results: The scores for depressive and anxious symptoms were higher in Chileans than in Colombians. Women reported worse mental health in both groups. Chilean and Colombian respondents residing in Arica and Antofagasta had a higher degree of anxiety and depression than their counterparts residing in Santiago. Conclusions: Chileans have worse mental health indicators than Colombian migrants. There are differences by sex and city of residence.

Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer Is Associated with Indigenous American Ancestry in Latin American Women.

Women of Latin American origin in the United States are more likely to be diagnosed with advanced breast cancer and have a higher risk of mortality than non-Hispanic White women. Studies in U.S. Latinas and Latin American women have reported a high incidence of HER2 positive (+) tumors; however, the factors contributing to this observation are unknown. Genome-wide genotype data for 1,312 patients from the Peruvian Genetics and Genomics of Breast Cancer Study (PEGEN-BC) were used to estimate genetic ancestry. We tested the association between HER2 status and genetic ancestry using logistic and multinomial logistic regression models. Findings were replicated in 616 samples from Mexico and Colombia. Average Indigenous American (IA) ancestry differed by subtype. In multivariate models, the odds of having an HER2+ tumor increased by a factor of 1.20 with every 10% increase in IA ancestry proportion (95% CI, 1.07-1.35; P = 0.001). The association between HER2 status and IA ancestry was independently replicated in samples from Mexico and Colombia. Results suggest that the high prevalence of HER2+ tumors in Latinas could be due in part to the presence of population-specific genetic variant(s) affecting HER2 expression in breast cancer. SIGNIFICANCE: The positive association between Indigenous American genetic ancestry and HER2+ breast cancer suggests that the high incidence of HER2+ subtypes in Latinas might be due to population and subtype-specific genetic risk variants.

Análisis de la variabilidad genética de una muestra de la población de Bogotá: hacia la constitución de un mapa de haplotipos / Genetic variability analysis in a population from Bogotá: Towards a haplotype map

Resumen Introducción. Los proyectos del mapa de haplotipos (HapMap) y de los 1.000 genomas han sido fundamentales para la compresión del componente genético de las enfermedades comunes y los fenotipos normales. Sin embargo, la variabilidad genética colombiana incluida en estos proyectos no es representativa del país. Objetivo. Contribuir al conocimiento de la variabilidad genética de la población colombiana a partir del estudio genómico de una muestra de individuos de Bogotá. Materiales y métodos. Se genotipificaron 2'372.784 marcadores genéticos de 32 individuos nacidos en Bogotá y de padres originarios de la misma ciudad utilizando la plataforma Illumina™. Los niveles de variabilidad genética se determinaron y se compararon con los datos disponibles de otras poblaciones del proyecto de los 1.000 genomas. Resultados. Los individuos analizados presentaron una variabilidad genética semejante a la de poblaciones con las que comparten ancestros. No obstante, a pesar de la poca diferenciación genética detectada en la población de Bogotá y en la de Medellín, el análisis de los componentes principales sugiere una composición genética diferente en las dos poblaciones. Conclusiones. El análisis genómico de la muestra de Bogotá permitió detectar similitudes y diferencias con otras poblaciones americanas. El aumento de tamaño de la muestra bogotana y la inclusión de muestras de otras regiones del país permitirán una mejor compresión de la variabilidad genética en Colombia, lo cual es fundamental para los estudios de salud humana, y la prevención y el tratamiento de enfermedades comunes en el país.

Abstract Introduction: The HapMap and the 1000 Genomes projects have been important for understanding the genetic component of common diseases and normal phenotypes. However, the Colombian genetic variability included in these projects is not fully representative of our country. Objective: To contribute to the knowledge of the Colombian genetic variability through the genomic study of a sample of individuals from Bogotá. Materials and methods: A total of 2,372,784 genetic markers were genotyped in 32 individuals born in Bogotá whose parents are from the same region, using the Illumina™ platform. The genetic variability levels were determined and compared with the data available from other populations of the 1000 Genomes Project. Results: The genetic variability detected in the individuals from Bogotá was similar to those with shared ancestry. However, despite the low levels of genetic differentiation between Bogotá and Medellín, populations the principal component analysis suggested a different genetic composition in them. Conclusions: Our genomic analysis of a Bogotá sample allowed us to detect similarities and differences with other American populations. The increase of the Bogotá sample and the inclusion of samples from other regions of the country will improve our understanding of the genetic variability in Colombia, essential for studies of human health and the prevention and treatment of common diseases in our country.

Health Characteristics of the Wayuu Indigenous People.

INTRODUCTION: The identified number of isolated populations with unique medical characteristics is growing. These populations are difficult to study. Civil-military humanitarian operations are part of our medical force readiness training, and are also a venue through which unique populations can be simultaneously served and evaluated. Continuing Promise 2017 was a collaborative effort between the US Navy, non-governmental organizations, and the Colombian Ministry of Health, Navy and Army to provide primary medical care to the Wayuu indigenous people in the La Guajira Department of Colombia. MATERIALS AND METHODS: In the course of providing primary care services, demographic and health data of the Wayuu people were collected. Descriptive statistics were used to generate averages, and t-tests were used to compare Wayuu means with age and gender matched US means for weight and age in children and blood pressure in adults. Observational data on skin afflictions and arthritis were also collected. This project was approved by Naval Medical Center Portsmouth Institutional Review Board. RESULTS: Although the Wayuu live in an arid desert with chronic sun exposure, they have no apparent affliction from squamous cell carcinoma or melanoma. They live almost exclusively through manual labor, yet rarely develop osteoarthritic joint disease. Their incidence of hypertension is 35% lower than their US age and gender matched cohort. Although their region is known for extreme poverty and malnutrition, their weight-for-age curve from 2 months through 17 years is similar to their US cohort. CONCLUSIONS: This study is the first to document the general health characteristics of the Wayuu people. It demonstrates that in addition to providing important readiness training to our own personnel, humanitarian missions can provide medical care and explore unique, isolated populations. Although retrospective and limited in size, it can be used to shape future medical missions to their region, and will hopefully stimulate formal research into their remarkable characteristics.

Una mirada de la salud desde la participación social en población dispersa del Pacífico Colombiano / A Look of Health from Social Participation in Sparsely Populated Colombian Pacific

Introducción: La participación social comunitaria se define como el derecho a una significativa participación en toma de decisiones acerca de la salud, la política y la planificación, la atención y el tratamiento, en donde la comunidad se compromete individual o colectivamente. Objetivo: Describir el concepto de salud desde la percepción de la comunidad. Métodos: Estudio cualitativo, exploratorio y descriptivo mediante grupos focales y entrevistas individuales a líderes de dos comunidades del Litoral Pacífico Colombiano que participan del proyecto Viabilidad de desarrollar un modelo basado en atención primaria en salud para municipios con alta dispersión rural del litoral pacífico. Resultados: La gran mayoría de actores perciben la salud desde diversas miradas, llegando a un consenso desde la participación comunitaria para priorizar necesidades y sugerir propuestas de intervención. Dentro de la concepción que la salud se describe que la salud es un derecho, es bienestar, estar limpio, lavarse las manos, es no ir al médico, es estar bien, es tener casa, es comer bien, sentirse bien, estar aliviado, es larga vida entre otras. Conceptos que parte de creencias, costumbres de su propia cultura y que se ve deteriorada por factores externos como, falta de compromiso del estado dentro del sistema de salud en poblaciones apartadas del país. Conclusión: La existencia de la participación social comunitaria para el logro alcanzado revela el potencial de los interesados de participar activamente de la conceptualización de la salud y adquirir su auto responsabilidad al cuidado desde los determinantes sociales(AU)

Introduction: Social community participation is defined as the right to a significant participation in decision making concerning health, policy and planning, care and treatment, where community is committed as a group or as individuals. Objective: To describe the concept of health from the community perspective. Methods: A qualitative, exploratory and descriptive study was carried out through focus groups and individual interviews with leaders of two communities of the Colombian Pacific Coast participating in the project Feasibility of developing a model based on primary health care for municipalities with high rural dispersion of the Pacific coast. Results: The vast majority of actors perceive health from different perspectives, reaching a consensus from community participation to prioritize needs and suggest intervention proposals. Within the conception that health is described that health is a right, is well-being, to be clean, to wash one's hands, is not to go to the doctor, is to be well, is to have a house, is to eat well, to feel good, to be relieved, it is long life among others. These concepts that part of beliefs, traditions of their own culture, which is deteriorated by external factors such as lack of state commitment with the health system in remote populations of the country. Conclusion: The existence of community social participation for what was achieved reveals the potential of the interested parties to actively participate in the conceptualization of health and acquire their self-responsibility in care from the social determinants(AU)

Mujeres que deciden interrumpir su embarazo: ¿cómo son percibidas por un grupo de profesionales en Colombia? / Mulheres que decidem interromper sua gravidez: como são percebidas por um grupo de profissionais na Colômbia? / Women who decide to have an abortion: what a group of health professionals in colombia think about them?

Resumen Este artículo presenta los resultados de una investigación cualitativa, que intentó comprender la percepción de 15 médicos del servicio de Ginecobstetricia de una Institución Prestadora de Servicios de Salud (IPS) en Bogotá-Colombia, sobre las mujeres que, amparadas por la Sentencia C-355 de 2006, interrumpieron su gestación. El muestreo fue teórico y su tamaño se determinó por el criterio de saturación de la información. Los datos se recolectaron mediante entrevistas a profundidad, analizadas mediante una propuesta fenomenológica. Los profesionales perciben de diferente manera a las mujeres, de acuerdo con la razón que tienen para optar por la interrupción. Asimismo, perciben que las realidades personales, sociales y familiares de las mujeres tienen más peso que las creencias religiosas en la decisión de interrumpir la gestación. Se hace importante la socialización de la Sentencia y la promoción de estrategias que apoyen a las mujeres en este proceso.

Resumo Este artigo apresenta os resultados de uma pesquisa qualitativa que tentou entender a percepção de 15 profissionais do serviço de ginecologia de uma Instituição de Prestação de Serviços de Saúde em Bogotá-Colômbia sobre as mulheres que, amparadas pela Sentença C-355 de 2006, interromperam sua gestação. A amostragem foi teórica e seu tamanho foi determinado pelo critério de saturação da informação. Os dados foram coletados através de entrevistas detalhadas, analisadas através de uma proposta fenomenológica. Os resultados indicam que os profissionais percebem as mulheres de forma diferente de acordo com a razão pela qual devem optar pela interrupção. Eles também percebem as realidades pessoais, sociais e familiares das mulheres como mais prementes que as crenças religiosas na decisão de interromper a gravidez. A socialização da Sentença e a promoção de estratégias que apoiam as mulheres neste processo mostraram-se importantes.

Abstract This paper presents findings of a qualitative research exploring physicians' perceptions about women who had an abortion in conditions covered by the Colombian Law (Sentence C-355 of 2006). The research was performed in the Service of Gynecology & Obstetrics in Bogotá-Colombia. The participants were selected according to a theoretical sampling scheme and the sample was determined by data saturation criteria. The data was collected through in-depth interviews and analyzed following a phenomenological approach. The results show the professionals perceive women differently, according to the reason for the pregnancy interruption. They also perceive personal, social and family experiences of these women as outweighing religious beliefs in their choice for an abortion. The socialization of the Colombian Sentence C-355 of 2006 and its related legislation, as well as promotion of strategies to support women's decisions to abort are also important.

Immunohistochemical identification of nail matrix melanocytes.

BACKGROUND: No previous studies have been conducted to determine the normal number of nail matrix melanocytes in Latin American individuals. The objective of this work was to determine the number of melanocytes per linear millimetre present in the nail matrix and the nail bed in samples obtained from Colombian individuals. METHODS: Twenty-six unilateral biopsies were taken from 19 cadavers subjected to clinical and medico-legal autopsies. These biopsy samples were processed with conventional histotechnology and immunohistochemistry (IHC) with anti-HMB-45 and anti-MiTF. Three sets of photographs (HE, HMB-45 and MiTF) were taken of each biopsy sample and independently assessed by three pathologists. Each observer counted the number of melanocytes present in 1 linear mm of the nail matrix or bed. RESULTS: We found an average of 4.6 melanocytes x linear mm with H & E staining, 9.8 with HMB-45 and 12.4 with MiTF. CONCLUSIONS: The use of IHC significantly increases and facilitates the identification of melanocytes in unilateral biopsies. Our IHC counts exceed the averages found in the literature. This finding warrants new studies to verify whether the Colombian population presents higher numbers of melanocytes in the nail matrix than other populations or whether the observed increase is a result of the use of MiTF.

Condiciones de seguridad alimentaria en una comunidad indígena de Colombia / Conditions of food security in an indigenous community of Colombia / Condições de segurança alimentar em uma comunidade indígena da Colômbia

Resumen La seguridad alimentaria se consigue cuando todas las personas, en todo momento, tienen acceso físico y económico a suficiente alimento, seguro y nutritivo, para satisfacer sus necesidades alimenticias y sus preferencias, con el objeto de llevar una vida activa y sana. Objetivo: Explorar condiciones de seguridad alimentaria en los comuneros del Resguardo Indígena La Gabriela. Método: Estudio cualitativo, de alcance exploratorio, que aplicó las técnicas de foto-voz y grupos de discusión. Se efectuó análisis de contenido. Resultados: Las condiciones de seguridad alimentaria de la comunidad indígena La Gabriela están asociadas al territorio y a prácticas alimentarias modificadas por influencia externa, lo cual afecta su autonomía generando dependencia a cadenas comerciales estimuladas por el libre mercado. Es preciso formular políticas que fortalezcan las creencias, costumbres y tradiciones ancestrales, lo cual requiere mayor atención por parte de las entidades estatales y los gobiernos.

Abstract Food security is achieved when all people, at all times, have physical and economic access to sufficient food, safe and nutritious, to meet their dietary needs and preferences, in order to lead an active and healthy life. Objective: To explore conditions of food security in the community members of the La Gabriela Indigenous Reserve. Method: Qualitative study, of exploratory scope, that applied the techniques of photo-voice and discussion groups. Content analysis was carried out. Results: The food security conditions of the La Gabriela indigenous community are associated to the territory and food practices modified by external influence, which affects their autonomy generating dependence on commercial chains stimulated by the free market. It is necessary to formulate policies that strengthen ancestral beliefs, customs and traditions, which requires greater attention on the part of state entities and governments.

Resumo A segurança alimentar é alcançada quando todas as pessoas, em todos os momentos, têm acesso físico e econômico a alimentos suficientes, seguros e nutritivos, para satisfazer suas necessidades e preferências alimentares, a fim de levar uma vida ativa e saudável. Objetivo: Explorar as condições de segurança alimentar dos membros da comunidade da Reserva Indígena La Gabriela. Método: Estudo qualitativo, de abrangência exploratória, que aplicou as técnicas de foto-voz e grupos de discussão. Realizou-se análise de conteúdo. Resultados: As condições de segurança alimentar da comunidade indígena La Gabriela estão associadas ao território e às práticas alimentares modificadas por influência externa, o que afeta sua autonomia, gerando dependência de cadeias comerciais estimuladas pelo mercado livre. É necessário formular políticas que fortaleçam crenças, costumes e tradições ancestrais, o que requer maior atenção por parte das entidades e governos estaduais.

Biometría de dientes anteriores en mestizos: proporción largo/ancho intradental / Biometry of anterior teeth in mestizos: intradental long / wide ratio

Las proporciones largo/ancho intradental han sido propuestas en más de once diferentes modelos a la fecha pero no se han estudiando en población mestiza Colombiana. Se utilizaron modelos de agrupamiento jerárquico (K-Means) para entender cual explica mejor la distribución de los datos. También se analizaron co-variables de sexo, edad y atrición leve para evaluar su influencia sobre la distribución general. Fueron utilizadas fotografías estandarizadas de dientes anteriores de 274 individuos de ambos sexos con dientes completamente erupcionados y sanos. Las mediciones fueron realizadas con programas informáticos calibrados (error de 0,05 mm). Se utilizó la prueba Chi Cuadrado para demostrar que las co-variables el sexo (valor de p= 0,09), edad (valor de p= 0,54) y atrición leve (valor de p= 0,32) no tuvieron impacto en la distribución de las proporciones dentales. Con respecto al análisis de conglomerados a través de las K-Means, se identificaron dos grupos diferenciados en toda la muestra: proporciones verticales (dientes mas largos) y proporciones horizontales (dientes mas anchos). Un tercer grupo solapado entre las dos tendencias lo denominamos de proporciones balanceadas. No hay un modelo de proporción intradental universal que pueda describir toda la población, pero fue posible encontrar un conjunto de modelos para los diferentes subgrupos de población. Los ideales estéticos se encuentran en abierta interpretación. Los patrones absolutos son imprácticos en biología ya que no predicen la complejidad de esta.

The intradental length / width ratios have been proposed in more than eleven different models to date. However they have not been studied in the Colombian Mestizo population. Hierarchical clustering models (K-Means) were used to understand which best explains the distribution of the data. Co-variables of sex, age, and mild attrition were also analyzed to assess their influence on overall distribution. Standardized photographs of anterior teeth of 274 individuals of both sexes with fully erupted and healthy teeth were used. Measurements were taken with calibrated software (error of 0.05 mm). Chi square test was used to show that the co-variables sex (p value = 0.09), age (p value = 0.54) and mild attrition (p value = 0.32) had no impact In the distribution of dental proportions. With respect to the analysis of conglomerates through the K-Means, two distinct groups were identified throughout the sample: Vertical proportions (longer teeth) and horizontal proportions (wider teeth). A third group overlapping the two trends we called balanced proportions. There is no universal intraday proportion model that can describe the entire population, but it was possible to find a set of models for different population subgroups. Aesthetic ideals are in open interpretation. Absolute patterns are impractical in biology because they do not predict the complexity of biology.

Actividad antibacteriana del extracto total de hojas de Cucurbita moschata Duchesne (Ahuyama) / Antibacterial activity of total extract from leaves of Cucurbita moschata Duchesne (ahuyama)

Introduction: Cucurbita moschata Duchesne (ahuyama) is grown across America as well as in the Middle East and Europe. It has been used as alternative medicine since ancient times. In the northern section of the department of Bolívar, Colombia, the plant is used by peasants to treat skin infections, hence our interest in conducting this study. Objective: Evaluate the antibacterial activity of total extract from leaves ofC. moschata against Staphylococcus aureus, Klebsiella pneumoniae and Escherichia coli. Methods: Fresh leaves of C. moschata were classified taxonomically using standard methods. The leaves were dried in an oven and pulverized in a blade mill. Extraction was performed by cold solid-liquid percolation and concentration in a rotary evaporator. Antibacterial activity of the ethanolic and hexanic extracts was evaluated in vitro against methicillin-resistant Staphylococcus aureus, Escherichia coli and Klebsiella pneumoniae, using the minimum inhibitory concentration (MIC) method, in compliance with guidelines from the Clinical and Laboratory Standards Institute (CLSI). Results: The hexanic extract caused significant inhibition from dilution 0.16 µg/mL for S. aureus strain ATCC 43300, and from dilution 19.5 µg/mL for strain ATCC 25923 (MSSA). The ethanolic and hexanic extracts significantly inhibited the growth of the clinical E. coli strain, whereas no significant inhibition was observed for K. pneumoniae at any of the concentrations tested. Conclusions: For the first time it was shown that the total hexanic extract of leaves of C. moschata had the greatest inhibition power against clinical strains of S. aureus and E. coli. The antimicrobial potential of this native species from the Colombian Caribbean has been recognized, and it is recommended to conduct assays with a larger number of human pathogens(AU)

Introducción: Cucurbita moschata Duchesne (Ahuyama) es cultivada en toda América, así como en Medio Oriente y Europa. Es utilizada desde la antigüedad como medicina alternativa. En la zona norte del departamento de Bolívar-Colombia es empleada por los campesinos para tratar infecciones en la piel, lo que generó el interés por desarrollar esta investigación. Objetivo: evaluar la actividad antibacteriana del extracto total de hojas de C. moschata frente a Staphylococcus aureus, Klebsiella pneumoniae y Escherichia coli. Métodos: hojas frescas de C. moschata fueron clasificadas taxonómicamente de acuerdo a métodos estándares. La obtención de los extractos se realizó por secado en horno, pulverización en molino de cuchilla, extracción por percolación sólido-líquido en frío y concentración en evaporador rotatorio. La actividad antibacteriana de los extractos etanólicos y hexánicos se evaluó in vitro frente a Staphylococcus aureus meticilino resistente, Escherichia coli y Klebsiella pneumoniae, mediante el método de Concentración Inhibitoria Mínima (CIM), siguiendo los lineamientos establecidos por Clinical and Laboratory Standards Institute (CLSI). Resultados: el extracto hexánico generó inhibición significativa desde la dilución 0,16 µg/mL para la cepa de S. aureus ATCC 43300. Para la cepa ATCC 25923 (MSSA) el extracto hexánico generó inhibición significativa desde la dilución 19,5 µg/mL. Los extractos etanólico y hexánico inhibieron significativamente el crecimiento de la cepa clínica de E. coli., mientras que para K. pneumoniae no hubo inhibición significativa en ninguna de las concentraciones evaluadas. Conclusiones: se demostró por primera vez que el extracto hexánico total de hojas de C. moschata tuvo el mayor poder de inhibición frente a las cepas clínicas de S. aureus y E. coli. Se reconoce el potencial antimicrobiano de esta especie autóctona de la costa del Caribe colombiano y se recomienda realizar ensayos en un número mayor de patógenos humanos(AU)

Personal and cultural identity development in recently immigrated Hispanic adolescents: Links with psychosocial functioning.

OBJECTIVES: This study examined directionality between personal (i.e., coherence and confusion) and cultural identity (i.e., ethnic and U.S.) as well as their additive effects on psychosocial functioning in a sample of recently immigrated Hispanic adolescents. METHOD: The sample consisted of 302 recent (<5 years) immigrant Hispanic adolescents (53% boys; Mage = 14.51 years at baseline; SD = .88 years) from Miami and Los Angeles who participated in a longitudinal study. RESULTS: Results indicated a bidirectional relationship between personal identity coherence and both ethnic and U.S. identity. Ethnic and U.S. affirmation/commitment (A/C) positively and indirectly predicted optimism and negatively predicted rule breaking and aggression through coherence. However, confusion predicted lower self-esteem and optimism and higher depressive symptoms, rule breaking, unprotected sex, and cigarette use. Results further indicated significant site differences. In Los Angeles (but not Miami), ethnic A/C also negatively predicted confusion. CONCLUSION: Given the direct effects of coherence and confusion on nearly every outcome, it may be beneficial for interventions to target personal identity. However, in contexts such as Los Angeles, which has at least some ambivalence toward recently immigrated Hispanic adolescents, it may be more beneficial for interventions to also target cultural identity to reduce confusion and thus promote positive development. (PsycINFO Database Record

Validation of trauma scales: ISS, NISS, RTS and TRISS for predicting mortality in a Colombian population.

BACKGROUND: Our purpose was to validate the performance of the ISS, NISS, RTS and TRISS scales as predictors of mortality in a population of trauma patients in a Latin American setting. MATERIALS AND METHODS: Subjects older than 15 years with diagnosis of trauma, lesions in two or more body areas according to the AIS and whose initial attention was at the hospital in the first 24 h were included. The main outcome was inpatient mortality. Secondary outcomes were admission to the intensive care unit, requirement of mechanical ventilation and length of stay. A logistic regression model for hospital mortality was fitted with each of the scales as an independent variable, and its predictive accuracy was evaluated through discrimination and calibration statistics. RESULTS: Between January 2007 and July 2015, 4085 subjects were enrolled in the study. 84.2% (n = 3442) were male, the mean age was 36 years (SD = 16), and the most common trauma mechanism was blunt type (80.1%; n = 3273). The medians of ISS, NISS, TRISS and RTS were: 14 (IQR = 10-21), 17 (IQR = 11-27), 4.21 (IQR = 2.95-5.05) and 7.84 (IQR = 6.90-7.84), respectively. Mortality was 9.3%, and the discrimination for ISS, NISS, TRISS and RTS was: AUC 0.85, 0.89, 0.86 and 0.92, respectively. No one scale had appropriate calibration. CONCLUSION: Determining the severity of trauma is an essential tool to guide treatment and establish the necessary resources for attention. In a Colombian population from a capital city, trauma scales have adequate performance for the prediction of mortality in patients with trauma.

Out-of-Sync Cancer Care: Health Insurance Companies, Biomedical Practices, and Clinical Time in Colombia.

I discuss the physical wearing out of low-income cancer patients in the aftermath of the neoliberal restructuring of the Colombian health care system in 1993. The settings for this struggle are the hospitals and the health insurance companies; the actors are bodies with cancer, the physicians who diagnose people with cancer, and the relatives who care for them. I show how most low-income patients, instead of accessing complete anticancer treatments in a timely fashion, have to negotiate and confront health insurance companies and profit-making. This results in a wait, where the time needs of the bureaucracy of the health care system and the time needs of patients' bodies are discordant, at a cost to patients.

AfroColombian ethnicity, a paradoxical protective factor against Dengue / La etnia afrocolombiana, factor protector paradójico contra el Dengue

Abstract Introduction: Dengue is a priority public health problem. During epidemics in Cuba and Haiti, ethnic African descendant population had lower risk of dengue, and the ethnic factor was proposed as a protective one. Objective: To determine the relation between the Dengue's cumulative incidence and the Afro-Colombian proportion in communities of Cali, during the epidemic of 2013. Methods: This study was conducted in Cali, Colombia. The design was ecological, using information from the National Census 2005 projected to 2013, from the National Administrative Department of Statistics (DANE), and the National Epidemiological Surveillance System. It was obtained the Pearson´s correlation coefficient between cumulative incidence and the proportion of Afro-Colombian population by communities. Additionally, the cumulative incidences of dengue were evaluated in two zones with different proportion of Afro-Colombian population. The association was also evaluated for aggregation bias, confounding by social variables, and interaction by area of ​​residence. Results: Dengue´s cumulative incidence was significantly lower for Afro-Colombians regardless of the proportion of Afro-Colombian population in the area of residence. The relative risk of dengue between non-Afro-Colombians and Afro-Colombians was 9.4 (95% CI=8.4-10.6) in zones with high proportion of Afro-Colombian population, while the relative risk of dengue was 4.0 (95% CI :3.6 - 4.4) in the zone with lower proportion of Afro-Colombian population. There was no evidence of aggregation bias or confounding in the association by social variables. Conclusions: The Afro-Colombian population had a significantly lower risk of getting dengue and its complications, compared with the non-Afro-Colombian population. The non-Afro-Colombian populations living in areas with a high proportion of Afro-Colombians increase their risk of dengue more than double, suggesting an asymptomatic viremic environment...(AU)

Resumen Introducción: el dengue es un problema prioritario en salud pública. Durante epidemias en Cuba y Haití, la población étnica afro-descendiente tuvo menor riesgo de dengue. Por ello, se propuso el factor étnico como protector. Objetivo: Determinar la relación entre la incidencia acumulada de dengue y la proporción de población Afrocolombiana de Cali, durante la epidemia de 2013. Métodos: Este estudio se realizó en Cali, Colombia. El diseño fue ecológico, con información del Censo Nacional 2005 y su proyección a 2013 del DANE y del Sistema de entre las incidencias acumuladas de dengue y la proporción de afrocolombianos, según comunidades. Adicionalmente, fueron evaluadas las incidencias acumuladas de dos zonas con diferente proporción de habitantes afrocolombianos. También se evaluó la presencia del sesgo de agregación, de confusión por variables sociales y de interacción según la zona de residencia. Resultados: Para afrocolombianos, la incidencia acumulada de dengue fue significativamente menor, independientemente de la proporción de población afrocolombiana en la zona de residencia. El riesgo relativo de dengue entre no-afrocolombianos y afrocolombianos fue 9.4 (IC 95%= 8.4-10.6) en la zona con más alta proporción de población afrocolombiana, mientras que el riesgo relativo fue 4.0 (IC 95%= 3.6-4.4) en la zona de más baja proporción de población afrocolombiana. No se evidenció sesgo de agregación ni confusión de la asociación por variables sociales. Conclusiones: La población afrocolombiana presentó un riesgo significativamente menor de enfermar por dengue y sus complicaciones en comparación con no-afrocolombianos. La población no-afrocolombiana que reside en zonas con alta proporción de población afrocolombiana aumenta el riesgo de dengue a más del doble, lo cual sugiere un entorno virémico asintomático...(AU)

Salud mental y estrés por aculturación en inmigrantes sudamericanos en el norte de Chile / Mental health and stress by acculturation in immigrants from South America in northern Chile

Background: Coping with changes brought about by immigration and social circumstances that often characterize this process may cause mental health problems. Aim: To analyze the relationship between acculturation stress and mental health symptoms in South American immigrants residing in Antofagasta, Chile. Material and Methods: The OQ questionnaire, which assesses mental health and the acculturation stress questionnaire from Ruiz, were answered by 431 immigrants (53.8% Colombian and 46.2% Peruvian) aged between 18 and 65 years old. Results: The major source of acculturation stress was distance from origin, followed by difficulties in social relationships and perceived discrimination and rejection. About 50% of respondents had elevated levels of discomfort in their life, with mental health problems derived from their adjustment to social roles and relationships. There was a high correlation between acculturation stress levels and severity of mental health symptoms. Conclusions: Immigrants are exposed to high levels of stress resulting in a negative impact on their mental health.