RESUMEN
Environmental exposures and gene-exposure interactions are the major causes of some diseases. Early-life exposome studies are needed to elucidate the role of environmental exposures and their complex interactions with biological mechanisms involved in childhood health. This study aimed to determine the contribution of early-life exposome to DNA damage and the modifying effect of genetic polymorphisms involved in air pollutants metabolism, antioxidant defense, and DNA repair. We conducted a cohort study in 416 Colombian children under five years. Blood samples at baseline were collected to measure DNA damage by the Comet assay and to determine GSTT1, GSTM1, CYP1A1, H2AX, OGG1, and SOD2 genetic polymorphisms. The exposome was estimated using geographic information systems, remote sensing, LUR models, and questionnaires. The association exposome-DNA damage was estimated using the Elastic Net linear regression with log link. Our results suggest that exposure to PM2.5 one year before the blood draw (BBD) (0.83, 95 %CI: 0.76; 0.91), soft drinks consumption (0.94, 0.89; 0.98), and GSTM1 null genotype (0.05, 0.01; 0.36) diminished the DNA damage, whereas exposure to PM2.5 one-week BBD (1.18, 1.06; 1.32), NO2 lag-5 days BBD (1.27, 1.18; 1.36), in-house cockroaches (1.10, 1.00; 1.21) at the recruitment, crowding at home (1.34, 1.08; 1.67) at the recruitment, cereal consumption (1.11, 1.04; 1.19) and H2AX (AG/GG vs. AA) (1.44, 1.11; 1.88) increased the DNA damage. The interactions between H2AX (AG/GG vs. AA) genotypes with crowding and PM2.5 one week BBD, GSTM1 (null vs. present) with humidity at the first year of life, and OGG1 (SC/CC vs. SS) with walkability at the first year of life were significant. The early-life exposome contributes to elucidating the effect of environmental exposures on DNA damage in Colombian children under five years old. The exposome-DNA damage effect appears to be modulated by genetic variants in DNA repair and antioxidant defense enzymes.
RESUMEN
BACKGROUND: Air pollution contains a mixture of different pollutants from multiple sources. However, the interaction of these pollutants with other environmental exposures, as well as their harmful effects on children under five in tropical countries, is not well known. OBJECTIVE: This study aims to characterize the external exposome (ambient and indoor exposures) and its contribution to clinical respiratory and early biological effects in children. MATERIALS AND METHODS: A cohort study will be conducted on children under five (n = 500) with a one-year follow-up. Enrolled children will be followed monthly (phone call) and at months 6 and 12 (in person) post-enrolment with upper and lower Acute Respiratory Infections (ARI) examinations, asthma development, asthma control, and genotoxic damage. The asthma diagnosis will be pediatric pulmonologist-based and a standardized protocol will be used. Exposure, effect, and susceptibility biomarkers will be measured on buccal cells samples. For environmental exposures PM2.5 will be sampled, and questionnaires, geographic information, dispersion models and Land Use Regression models for PM2.5 and NO2 will be used. Different statistical methods that include Bayesian and machine learning techniques will be used for the ambient and indoor exposures-and outcomes. This study was approved by the ethics committee at Universidad Pontificia Bolivariana. EXPECTED STUDY OUTCOMES/FINDINGS: To estimate i) The toxic effect of particulate matter transcending the approach based on pollutant concentration levels; ii) The risk of developing an upper and lower ARI, based on different exposure windows; iii) A baseline of early biological damage in children under five, and describe its progression after a one-year follow-up; and iv) How physical and chemical PM2.5 characteristics influence toxicity and children's health.
Asunto(s)
Contaminantes Atmosféricos , Contaminación del Aire , Asma , Contaminantes Ambientales , Exposoma , Humanos , Niño , Estudios de Cohortes , Contaminantes Atmosféricos/toxicidad , Contaminantes Atmosféricos/análisis , Teorema de Bayes , Mucosa Bucal/química , Contaminación del Aire/análisis , Material Particulado/análisis , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/análisis , Asma/inducido químicamente , Asma/epidemiologíaRESUMEN
OBJECTIVE: To determine the factors associated with virologic failure n HIV patients on antiretroviral treatment treated in a Colombian health institution. METHOD: This was a cross-sectional observational retrospective analytical study of HIV patients receiving antiretroviral treatment between 20072020. Sociodemographic, pharmacological and clinical variables were collected, including viral load, adherence, and the medication possession ratio. For statistical analysis, crude and adjusted odds ratios and confidence intervals were obtained. RESULTS: In a population of 5,406 patients, the proportion of virologic failure was 16.7%. Moreover, in the adjusted model, an association was found between virologic failure and time on treatment greater than one year, medication possession ratio under 80%, failure to claim medications from the pharmacy due to dose omission or discontinuation, adherence under 85%, CD4 count under 500, total cholesterol levels above 201 mg/dL, high density lipoproteins under 39 mg/dL and presence of mycosis. CONCLUSIONS: In our cohort of HIV patients, short treatment periods, CD4 counts under 200, a low medication possession ratio, failure to timely claim medications from the pharmacy due to omission or discontinuation, and a lower degree of adherence were factors related to virologic failure.
OBJETIVO: Determinar los factores asociados al fracaso virológico en pacientes con el virus de la inmunodeficiencia humana con tratamiento antirretroviral atendidos en una institución de salud colombiana.Método: Estudio transversal, observacional, retrospectivo y analítico en pacientes con el virus de la inmunodeficiencia humana con tratamiento antirretroviral entre 2007-2020. Se recogieron variables Sociodemográficas, farmacológicas y clínicas, incluyendo la carga viral, el grado de adherencia y la tasa de reclamación de medicamentos. Para el análisis estadístico se obtuvieron las odds ratio crudas y ajustadas y los intervalos de confianza. RESULTADOS: De una población de 5.406 pacientes, la proporción de fracaso virológico fue de 16,7% y en el modelo ajustado se encontró asociación entre el fracaso virológico con el tiempo en el tratamiento mayor a un año, la tasa de posesión de la reclamación inferior al 80%, la no reclamación oportuna por omisión o suspensión, la adherencia inferior al 85%, el recuento de CD4 inferior a 500, niveles de colesterol total mayores de 201 mg/dl, lipoproteína de alta densidad menor de 39 mg/dl y presencia de micosis. CONCLUSIONES: En nuestra cohorte de pacientes con el virus de la Inmunodeficiencia humana, un menor tiempo en tratamiento, un recuento de CD4 menor de 200, una baja tasa de reclamación de los medicamentos, así como la no reclamación oportuna por omisión y suspensión y un menor grado de adherencia son factores que se relacionan con el fracaso virológico.
Asunto(s)
Fármacos Anti-VIH , Infecciones por VIH , Fármacos Anti-VIH/uso terapéutico , Terapia Antirretroviral Altamente Activa , Recuento de Linfocito CD4 , Colesterol/uso terapéutico , Estudios Transversales , Infecciones por VIH/tratamiento farmacológico , Humanos , Lipoproteínas/uso terapéutico , Cumplimiento de la Medicación , Estudios Retrospectivos , Insuficiencia del Tratamiento , Carga ViralRESUMEN
Objetivo: Determinar los factores asociados al fracaso virológico enpacientes con el virus de la inmunodeficiencia humana con tratamientoantirretroviral atendidos en una institución de salud colombiana.Método: Estudio transversal, observacional, retrospectivo y analítico enpacientes con el virus de la inmunodeficiencia humana con tratamientoantirretroviral entre 2007-2020. Se recogieron variables sociodemográficas,farmacológicas y clínicas, incluyendo la carga viral, el grado de adherenciay la tasa de reclamación de medicamentos. Para el análisis estadístico seobtuvieron las odds ratio crudas y ajustadas y los intervalos de confianza.Resultados: De una población de 5.406 pacientes, la proporción defracaso virológico fue de 16,7% y en el modelo ajustado se encontró asociación entre el fracaso virológico con el tiempo en el tratamiento mayora un año, la tasa de posesión de la reclamación inferior al 80%, la noreclamación oportuna por omisión o suspensión, la adherencia inferior al85%, el recuento de CD4 inferior a 500, niveles de colesterol total mayores de 201 mg/dl, lipoproteína de alta densidad menor de 39 mg/dl ypresencia de micosis.Conclusiones: En nuestra cohorte de pacientes con el virus de la inmunodeficiencia humana, un menor tiempo en tratamiento, un recuento deCD4 menor de 200, una baja tasa de reclamación de los medicamentos,así como la no reclamación oportuna por omisión y suspensión y un menorgrado de adherencia son factores que se relacionan con el fracaso virológico. (AU)
Objective: To determine the factors associated with virologic failurein HIV patients on antiretroviral treatment treated in a Colombian healthinstitution.Method: This was a cross-sectional observational retrospective analytical study of HIV patients receiving antiretroviral treatment between2007-2020. Sociodemographic, pharmacological and clinical variableswere collected, including viral load, adherence, and the medication possession ratio. For statistical analysis, crude and adjusted odds ratios andconfidence intervals were obtained.Results: In a population of 5,406 patients, the proportion of virologicfailure was 16.7%. Moreover, in the adjusted model, an association wasfound between virologic failure and time on treatment greater than oneyear, medication possession ratio under 80%, failure to claim medications from the pharmacy due to dose omission or discontinuation, adherence under 85%, CD4 count under 500, total cholesterol levels above201 mg/dL, high density lipoproteins under 39 mg/dL and presence ofmycosis.Conclusions: In our cohort of HIV patients, short treatment periods, CD4counts under 200, a low medication possession ratio, failure to timelyclaim medications from the pharmacy due to omission or discontinuation,and a lower degree of adherence were factors related to virologic failure. (AU)
Asunto(s)
Humanos , Terapia Antirretroviral Altamente Activa , Recuento de Linfocito CD4 , Colesterol/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Insuficiencia del Tratamiento , Estudios Transversales , Lipoproteínas/uso terapéuticoRESUMEN
Este trabajo se propone debatir el concepto y la práctica que orienta la promoción de la participación juvenil en los programas y proyectos implementados por el Estado y las organizaciones no gubernamentales (ONGs), en donde la participación de los jóvenes como beneficiarios ocupa un lugar central como objetivo, estrategia y criterio rector. Bajo estas premisas, la participación juvenil, circulando alrededor del restringido espacio de decisión de los objetivos y actividades de los proyectos institucionales, se concibe con un enfoque psicosocial más que político, que enfatiza la solución individualista, orientada al cambio de actitudes y valores en la medida en que los jóvenes contribuyen a la solución de sus problemas inmediatos, adquiriendo de esta manera las cualificaciones necesarias para incorporarse a un proceso de desarrollo tácitamente aceptado. El texto analiza las vinculaciones entre la condición juvenil y la forma-estado del capitalismo actual, destacando la relación entre las políticas públicas de juventud y una determinada y limitada concepción de la democracia y de la participación ciudadana, procurando establecer los puntos de cuestionamiento a sus proposiciones y desarrollar algunos fundamentos para una práctica socialmente transformadora en la promoción de la participación de los jóvenes.
This paper is going to debate the concept and the practice that orients the promotion of the youthful participation in the programs and projects implemented by the State and the not-governmental organizations (NGO's), in where the participation of the youths fulfills a central place like objective, strategy and criteria. Under these premises, the youthful participation, limited by the objectives and activities of the institutional projects, conceives itself with an approach social-psychological more than political, that emphasizes the individual solution oriented to the change of attitudes and values in the measure in that contributes to the solution of his immediate problems, acquiring of this way the necessary competences. The text analyzes the bonds between the youthful condition and the role of the State in your capitalist-form, standing out the relation between the politics of youth and a determined and restricted conception of the democracy and of the civic participation, seeking to establish the weaknesses of this position and the possible bases of a practice socially transformer for the promotion of the youthful participation.