Improvements in habitability and housing satisfaction after dwelling regeneration in social housing complexes. The RUCAS study.

Housing is a pressing problem worldwide and a key determinant of health and wellbeing. The right to adequate housing, as a pillar of the right to an adequate standard of living, means more than a roof to live under. Adequate means the dwelling must fulfill material functions and psychosocial functions, thus contributing to dwellers health and wellbeing. Social housing policies aim to fulfill the right to housing, but frequently fail in fulfilling the right to it being adequate. This study capitalizes on the implementation of a national urban regeneration program in two social housing villas in central Chile (one in Santiago, in the central valley, the other in Viña del Mar, a coastal city) to run a natural experiment assessing the impact of dwelling renovation on several dimensions of perceived habitability and housing satisfaction among the -mostly female-household homemakers. We use 5 waves of survey data collected with a step-wedge design to estimate the association between a time-varying exposure status (the intervention) and 7 binary outcomes for habitability and 5 for housing dissatisfaction, including overall housing satisfaction. We use Poisson regression models with robust variance and a random intercept at the respondent level. At baseline, reports of poor habitability and dissatisfaction across all features were markedly high, the highest levels of dissatisfaction being with acoustic insulation and dwelling size in both villas, and with indoor temperature in Santiago. The intervention resulted in statistically significant and markedly large improvements in reported habitability and dissatisfaction relative to those housing components targeted by the intervention, as well as with overall dwelling satisfaction in both study cases. Implications are, first, that the policy response to quantitative housing deficits must not overlook housing quality; second, that housing renovation appears as a promising intervention for qualitative housing crises; third, that while improvements in habitability and satisfaction are specific to the interventions in place, overall housing satisfaction can improve in more limited, tailored, dwelling renovation interventions. Social housing renovation in Latin America appears as a promising intervention to improve quality of life among the urban poor dwellers and reduce inequalities in health related to housing conditions.

Tratamiento quirúrgico de la enfermedad pilonidal sacrocoxígea. Experiencia de un centro en los últimos 4 años

Objetivo: Evaluar los resultados a largo plazo en el tratamiento quirúrgico de la enfermedad pilonidal sacrocoxígea (EPS), comparando las diferentes técnicas quirúrgicas utilizadas, complicaciones, tiempo de cicatrización y recidiva. Material y Método: Estudio trasversal retrospectivo. Se revisaron las fichas de los pacientes intervenidos por EPS entre enero 2017 hasta agosto 2021. Para el seguimiento se obtuvo la información desde los registros de los controles periódicos en nuestro centro y aquellos que no continuaron con estos controles se contactaron telefónicamente. Resultados: Se recopilaron 309 casos, con una media de seguimiento de 15,6 meses. Las técnicas más utilizadas para la fase crónica de EPS fueron marsupialización y Karydakis, con tiempo de cicatrización completa de 54,5 y 18,2 días, respectivamente. La presencia de complicaciones prolongó el tiempo de cicatrización en 46,5 días en Karydakis, con mínimo impacto en marsupialización. La tasa de recidiva fue menor en Karydakis y en etapa aguda cuando se realiza destechamiento y legrado. La profilaxis antibiótica no afectó el riesgo de complicaciones postoperatorias. Discusión: El desarrollo de complicaciones postoperatorias tiene mayor impacto en la cicatrización de la técnica cerrada que en la abierta, siendo esta última más tolerante en cuanto a la cicatrización frente a complicaciones. Conclusión: La intervención con técnica de Karydakis logra la cicatrización de la herida operatorio en menor tiempo que la marsupialización, sin embargo, al desarrollar complicaciones, este tiempo aumenta 3,5 veces más. La recurrencia fue menor en Karydakis. En absceso se recomienda el desteche y legrado por sobre el drenaje exclusivo

Aim: To evaluate long-term results in the surgical treatment of sacrococcygeal pilonidal disease (SPD) comparing the different surgical techniques used, complications, healing time and recurrence. Material and Method: Retrospective cross-sectional study. The files of the patients operated on for EPS between January 2017 and August 2021 were reviewed. For follow-up, information was obtained from the records of the periodic controls in our center; those who did not continue with these controls were contacted by telephone. Results: 309 cases were collected, with a mean follow-up of 15.6 months. The most used techniques for the chronic phase of EPS were marsupialization and Karydakis, achieving complete wound healing in 54.5 and 18.2 days, respectively. The presence of complications prolonged the healing time by 46.5 days in Karydakis, with minimal impact on marsupialization. The recurrence rate was lower in Karydakis and in the acute stage when unroofing and curettage were performed. Antibiotic prophylaxis did not increase the risk of postoperative complications. Discussion: The development of postoperative complications has a greater impact on the healing of the closed technique than in the open technique, the last one seems to be more tolerant in terms of healing in the presence of complications. Conclusion: The intervention with the Karydakis technique achieves healing of the surgical wound in less time than marsupialization, however, when complications develop, this time increases 3.5 times more. Recurrence was lower in Karydakis. In abscess weaning and curettage is recommended over the exclusive drainage.

Alteraciones neuropsiquiátricas en menores de 18 años expuestos a opioides en el periodo prenatal: Revisión Narrativa

El consumo de opioides ha venido incrementando en los últimos años, generando una crisis de salud pública que afecta a todo tipo de población. El uso de sustancias opiáceas ilegales en embarazadas también está en incremento, por lo que, en la práctica clínica se evidencian con mayor frecuencia resultados neonatales adversos como el síndrome de abstinencia neonatal (NAS). Adicionalmente, los niños expuestos prenatalmente a estas sustancias pueden sufrir alteraciones cognitivas, motoras o psiquiátricas durante el transcurso de su vida. Este artículo tiene como objetivo proporcionar una revisión de la literatura actualizada acerca del uso de opioides durante el embarazo y las consecuencias para los niños expuestos a estas sustancias.

Opioid consumption has increased greatly in recent years, creating a public health crisis that affects all types of population. The use of illegal opiates amongst pregnant women has also risen, causing a surge in the frequency in which adverse neonatal outcomes, such as Neonatal Abstinence Syndrome (NAS), are seen in clinical practice. Furthermore, children exposed prenatally to these substances have cognitive, motor and psychiatric adverse outcomes throughout their lifetime. This article's objective is to provide an updated literature review about opioid use during pregnancy and its consequences on children exposed in-utero.

Antimicrobial effect of Moringa oleifera seed powder against Vibrio cholerae isolated from the rearing water of shrimp (Penaeus vannamei) postlarvae.

Shrimp farming has experienced rising costs as a result of disease outbreaks associated with Vibrio spp. Suitable strategies for disease prevention and control are therefore urgently needed. This study aimed to evaluate the antimicrobial effect of Moringa oleifera seed powder against Vibrio cholerae in the rearing water of Pacific white shrimp (Penaeus vannamei) postlarvae. In vitro assays included the determination of minimum inhibitory concentration (MIC) of M. oleifera seed powder against V. cholerae, whereas in vivo assays included the effect of M. oleifera seed powder on bacterial load and water quality parameters in the rearing tanks, as well as its effect on shrimp postlarvae survival. M. oleifera seed powder inhibited the growth of V. cholerae with MIC values of 62·5 µg ml-1 . Moreover, seawater pH of treated tanks (8·66) was significantly lower (P < 0·01) than pH of the control tanks (9·02), whereas the visibility of treated tanks (37·08 cm) was significantly higher (P < 0·01) as compared to control tanks (35·37 cm). Likewise, V. cholerae load was significantly reduced (P < 0·01) from 4·7 × 104 to 3·1 × 103  CFU per ml in tanks treated with M. oleifera seed powder. Altogether, this study demonstrates the antimicrobial activity of M. oleifera against V. cholerae in shrimp culture.

A ten-year monitoring of essential and non-essential elements in the dolphinfish Coryphaena hippurus from the southern Gulf of California.

The concentrations of As, Cd, Cu, Pb and Zn were measured in muscle tissue of Coryphaena hippurus captured in the southern Gulf of California to determine inter-annual variations and their relation with environmental parameters for the period 2006-2015; additionally, health risk to consumers was assessed according to levels of studied elements and rate of fish consumption in northwest Mexico. During 2014 and 2015 the levels of As, Cd, Cu, and Zn were significantly lower than the rest of the years; in the case of As, it was also significantly lower in 2010. Oceanic Niño Index was negatively correlated with Zn concentrations in fish, while sea surface temperature was negatively correlated with Zn, Pb and Cd concentrations in dolphinfish. The simultaneous occurrence of the analyzed elements in muscle of dolphinfish indicated that health effects on consumers are not likely to occur; nevertheless, fishermen with elevated fish consumption might be at risk.

Efficacy of Virtual Reality in Neurorehabilitation of Spinal Cord Injury Patients: A Systematic Review / Eficacia de la Realidad Virtual en la Neurorrehabilitación de Pacientes con Lesión de Médula Espinal: una Revisión Sistemática

ABSTRACT This systematic review (SR) analyzed the effectiveness of interventions using virtual reality (VR) technology as a neurorehabilitation therapy in people with spinal cord injury (SCI). The SR was developed under the guidelines of the PRISMA statement and the recommendations of the Cochrane Collaboration, along with the PEDro and National Institute of Health scales to assess the risk of bias and methodological quality. The Cochrane, IEEE, BVS/LILACS, MEDLINE/PubMed, and Web of Science databases were browsed to identify studies that, between 2010 and 2020, evaluated the efficacy of these therapies. Out of 353 retrieved studies, 11 were finally selected after the application of the defined inclusion and exclusion criteria. These articles presented good methodological quality as they were mostly controlled clinical trials that analyzed mixed therapies with conventional therapies. Interventions based on non-immersive or immersive VR technology that achieved functional motor, balance, and psycho-emotional health improvement with positive effects on motivation, self-confidence, commitment, and active participation were identified in a total sample of 155 SCI patients. It was concluded that such VR technology is an effective tool of neurorehabilitation complementary to conventional therapies, which promotes functional improvement in SCI patients both in the clinic and at home.

RESUMEN Esta revisión sistemática (RS) analizó la eficacia de las intervenciones que utilizan la tecnología de realidad virtual (RV) como terapia de neurorrehabilitación en personas con lesión de médula espinal (LME). La RS fue desarrollada bajo los lineamientos de la declaración PRISMA y las recomendaciones de la Colaboración Cochrane, junto con las escalas de PEDro y del National Institute of Health para evaluar el riego de sesgo y la calidad metodológica. Se revisaron las bases de Cochrane, IEEE, BVS/LILACS, MEDLINE/PubMed y Web of Science para identificar estudios que, entre 2010 y 2020, evaluaron la eficacia de dichas terapias. De 353 estudios recuperados, 11 fueron finalmente seleccionados tras la aplicación de los criterios de inclusión y exclusión definidos. Dichos artículos presentaron una buena calidad metodológica, al ser mayormente ensayos clínicos controlados que analizaron terapias mixtas con terapias convencionales. Se identificaron intervenciones basadas en tecnología de RV no inmersiva o inmersiva que lograron una mejora funcional motora, de equilibrio y de salud psico-emocional con efectos positivos de motivación, seguridad, compromiso y activa participación en una muestra total de 155 pacientes con LME. Se concluyó que dicha tecnología de RV es una herramienta eficaz de neurorrehabilitación complementaria a las terapias convencionales, al promover una mejora funcional en pacientes con LME tanto en la clínica como en casa.

Effect of Pleurotus agaves mushroom addition on the physicochemical and sensory properties of blue maize tortillas produced with traditional and ecological nixtamalization.

The physicochemical, nutritional and sensory properties of flours, doughs and tortillas made with traditional nixtamalization (TN) and ecological nixtamalization (EN) and enriched (9%) with the traditional maguey mushroom (Pleurotus agaves) were analysed. EN resulted in flours and tortillas having a greater content of bioactive compounds than that of TN flours, which represents a production process of maize tortillas containing high amounts of antioxidants. The addition of mushrooms to EN flours improved their sensory properties, whereas the addition of mushrooms to TN flours decreased them. The amount of P. agaves added to tortillas was equivalent to 3% enrichment with ß-glucans. The edible mushroom P. agaves, highly appreciated in many Mexican regions, improved the nutritional and sensory quality of blue maize tortillas when added to flours prepared by EN. A new product was developed using local traditional foods of complementary nutritional value.

Sociocultural stressors across the perinatal period and risk for postpartum depressive symptoms in women of Mexican descent.

OBJECTIVES: In the United States, women of Mexican descent are affected by postpartum depression at disproportionate rates, often two to three times higher than the general population. Sociocultural stressors may contribute to this disparity. Traditionally, these stressors are measured at a single time point, and it is unknown if sociocultural stressors change from pregnancy to the postnatal period and if they are related to postpartum depressive symptoms. METHOD: Pregnant women of Mexican descent (N = 159) were assessed for acculturation (Mexican and Anglo orientation), perceived discrimination, acculturative stress, perceived stress, and depressive symptoms during the first trimester and postpartum period. RESULTS: Women reported increases in Mexican orientation, t(126) = -3.503, p = .01, and decreases in acculturative stress, t(159) = -3.503, p < .001, and perceived stress, t(159) = 6.332, p < .001, from pregnancy to postpartum. Only increases in Mexican orientation were associated with less postpartum depressive symptoms (R² = 0.050, B = -2.210, SE = 0.996, t = -2.120, p = .028), even when controlling for covariates. In addition, postnatal measurements of elevated acculturative stress and less Mexican orientation (R² = 0.127, B = 0.133, SE = 0.036, t = 3.721, p < .001; B = -2.194, SE = 0.769, t = -2.853, p < .001, respectively) were associated with more postpartum depressive symptoms; however, only Mexican orientation remained significant after covariates. CONCLUSIONS: Sociocultural stressors change across the perinatal period and contribute to postpartum depressive symptoms. Findings implicate a need for consideration of sociocultural stressors in postpartum depression prevention. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Utilization of naproxen by Amycolatopsis sp. Poz 14 and detection of the enzymes involved in the degradation metabolic pathway.

The pollution of aquatic environments by drugs is a problem for which scarce research has been conducted in regards of their removal. Amycolatopsis sp. Poz 14 presents the ability to biotransformation naphthalene at high efficiency, therefore, in this work this bacterium was proposed as an assimilator of naproxen and carbamazepine. Growth curves at different concentrations of naproxen and carbamazepine showed that Amycolatopsis sp. Poz 14 is able to utilize these drugs at a concentration of 50 mg L-1 as a source of carbon and energy. At higher concentrations, the bacterial growth was inhibited. The transformation kinetics of naproxen showed the total elimination of the compound in 18 days, but carbamazepine was only eliminated in 19.9%. The supplementation with cometabolites such as yeast extract and naphthalene (structure similar to naproxen) at 50 mg L-1, showed that the yeast extract shortened the naproxen elimination to 6 days and reached a higher global consumption rate compared to the naphthalene cometabolite. The biotransformation of carbamazepine was not improved by the addition of cometabolites. The partial sequencing of the genome of Amycolatopsis sp. Poz 14 detected genes encoding putative enzymes for the degradation of cyclic aromatic compounds and the activities of aromatic monooxygenase, catechol 1,2-dioxygenase and gentisate 1,2-dioxygenase exhibited their involving in the naproxen biodegradation. The HPLC-MS analysis detected the 5-methoxysalicylic acid at the end of the biotransformation kinetics. This work demonstrates that Amycolatopsis sp. Poz 14 utilizes naproxen and transforms it to 5-methoxysalicylic acid which is the initial compound for the catechol and gentisic acid metabolic pathway.

Plasma membrane damage repair is mediated by an acid sphingomyelinase in Entamoeba histolytica.

Entamoeba histolytica is a pathogen that during its infective process confronts the host defenses, which damages the amoebic plasma membrane (PM), resulting in the loss of viability. However, it is unknown whether amoebic trophozoites are able to repair their PM when it is damaged. Acid sphingomyelinases (aSMases) have been reported in mammalian cells to promote endocytosis and removal of PM lesions. In this work, six predicted amoebic genes encoding for aSMases were found to be transcribed in the HM1:IMSS strain, finding that the EhaSM6 gene is the most transcribed in basal growth conditions and rendered a functional protein. The secreted aSMase activity detected was stimulated by Mg+2 and inhibited by Co+2. Trophozoites that overexpress the EhaSM6 gene (HM1-SM6HA) exhibit an increase of 2-fold in the secreted aSMase activity. This transfectant trophozoites exposed to pore-forming molecules (SLO, Magainin, ß-Defensin 2 and human complement) exhibited an increase from 6 to 25-fold in the secreted aSMase activity which correlated with higher amoebic viability in a Ca+2 dependent process. However, other agents that affect the PM such as hydrogen peroxide also induced an increase of secreted aSMase, but to a lesser extent. The aSMase6 enzyme is N- and C-terminal processed. Confocal and transmission electron microscopy showed that trophozoites treated with SLO presented a migration of lysosomes containing the aSMase towards the PM, inducing the formation of membrane patches and endosomes in the control strain. These cellular structures were increased in the overexpressing strain, indicating the involvement of the aSMase6 in the PM injury repair. The pore-forming molecules induced an increase in the expression of EhaSM1, 2, 5 and 6 genes, meanwhile, hydrogen peroxide induced an increase in all of them. In all the conditions evaluated, the EhaSM6 gene exhibited the highest levels of induction. Overall, these novel findings show that the aSMase6 enzyme from E. histolytica promotes the repair of the PM damaged with pore-forming molecules to prevent losing cell integrity. This novel system could act when encountered with the lytic defense systems of the host.

Assessment of dietary exposure to aflatoxin B1 from corn arepas in Colombia.

The aim of this research was to evaluate dietary exposure to aflatoxin B1 (AFB1) in corn arepas in Colombia. In addition, in this study an assessment considering compliance to the maximum level of AFB1 (4 µg kg-1) for this food was conducted. AFB1 concentration data in corn arepas were obtained from 168 samples. The samples were collected from factories in 16 departments in Colombia. AFB1 was quantified by High-Performance Liquid Chromatography with a fluorescence detector. Consumption data and body weight (b.w.) were measured from the 2005 Colombian National Survey of Nutritional Status. Probabilistic estimates were made by Monte Carlo simulation of dietary exposure and margin of exposure (MOE) segmented by age group. The results showed that 27% of corn arepa samples were contaminated with AFB1, with an average concentration of 15.1 µg kg-1 and a maximum value of 111.1 µg kg-1. The stochastic dietary exposure assessment showed that the age group most exposed was children between 4 and 8 years old (10.014 ng (kg b.w. day)-1). In addition, the MOE values for all age groups were lower than 10,000, indicating a potential risk for consumers. However, in the scenario where AFB1 concentration level complies with the maximum limit of 4 µg kg-1 AFB1, the level of concern could be reduced for the adult population between 14 and 64 years old because the MOE value is above 10,000.

Chitosan/copper nanocomposites: Correlation between electrical and antibacterial properties.

Correlation between electrical and antibacterial properties of chitosan/copper nanocomposites (CS/CuNPs) is investigated. We aim at achieving the minimum CuNPs concentration in a CS-matrix while keeping high antibacterial activity. UV-vis, TEM and XRD measurements confirms the formation of polygonal metallic CuNPs (ca. 30-50 nm). Interactions between NH2/OH groups of CS and CuNPs were determined by FTIR and XPS suggesting Cu chelation-induced mechanism during the CuNPs formation. DC electrical conductivity measurements reveals a percolation threshold at CuNPs volumetric concentration of ca. 0.143%. Antibacterial assays against Gram-positive bacteria and DC measurements helps correlate the antibacterial potency to the electron transfer between the negatively charged bacteria and CuNPs. Our study suggests that nanocomposite's maximum antibacterial activity is obtained below the electrical percolation threshold at extremely low CuNPs concentrations; this fact may prove useful in the design of nontoxic nanocomposites for biomedical applications.

Fabrication and in vitro behavior of dual-function chitosan/silver nanocomposites for potential wound dressing applications.

We report the synthesis and in vitro evaluation of dual-function chitosan-silver nanoparticles (CTS-AgNPs) films with potential applications as wound dressings. We attempted to formulate nanocomposite films with appropriate AgNPs concentrations to simultaneously display antibacterial activity and suitability for cell culture. Nanocomposites were obtained by CTS-mediated in situ chemical reduction of AgNO3. Circular-shape AgNPs (sizes ca. 7-50 nm) well distributed within the CTS matrices were obtained in concentrations from 0.018 to 0.573 wt%. Efficacy (bacteriostatic and bactericidal properties) of CTS-AgNPs films to decrease planktonic and biofilm bacterial growth was AgNPs concentration- and bacteria strain-dependent. Films showed significant antibacterial activity against Gram-negative E. coli and P. aeruginosa and Gram-positive S. aureus. Antibacterial activity against S. epidermidis was moderated. Films suitability for cell culture was characterized using primary human fibroblasts (HF). HF displayed cell viability higher than 90% and the characteristic fusiform morphology of adhered fibroblast upon culture on films with AgNPs concentration ≤ 0.036 wt%. HF cultured on these films also showed positive expression of tropoelastin, procollagen type I and Ki-67, characteristic proteins of extracellular matrix and proliferative cells, respectively. In vitro assays demonstrated that cytocompatibility/antibacterial properties decreased/increased as silver concentration increased, suggesting that CTS-AgNPS nanocomposite films with ≈0.04-0.20 wt% might be considered as potential temporary dual-function wound dressings.

Deficiencia e insuficiencia de vitamina D en mujeres post cirugía bariátrica Roux en Y / Vitamin D deficiency and insufficiency among women with Roux-en-Y bariatric surgery / Deficiência e Insuficiência de vitamina D em mulheres post cirurgia bariátrica Roux em Y

Objetivo Determinar la relación entre la falta de seguimiento, adherencia al tratamiento con multivitamínicos y niveles séricos de 25-OH vitamina D (Vit-D) en mujeres post-cirugía BPRY, en la UNEME de la ciudad de Tijuana, Baja California, México. Métodos Estudio Transversal analítico que incluyó mujeres post-cirugía BPRY (GCa, n=13), con Obesidad Mórbida (GOM, n=13) y mujeres aparentemente sanas (GCo, n=13). Posterior a la autorización mediante consentimiento informado escrito, se realizó una historia clínica, valoración antropométrica, aplicación del instrumento de medición y en una segunda cita se tomó una muestra sanguínea para la cuantificación de Vit-D. El instrumento de medición fue validado mediante Kappa de Cohen mayor al 80% y alfa de Cronbach de 1. El análisis estadístico de los datos se realizó mediante pruebas de diferencia de medias t de Student y ANOVA donde se consideró una p < 0.05 en una prueba a dos colas. Se determinó prevalencia, significancia estadística de la falta de adherencia y seguimiento en relación a los niveles de Vit-D. Resultados La prevalencia de falta de adherencia al tratamiento multivitamínico en estas mujeres con post-cirugía BPRY fue de 85% y la falta de seguimiento post quirúrgico que incluye pruebas de laboratorio de micronutrientes fue del 100%. Se encontró una diferencia estadísticamente significativa entre las medias de los niveles de Vit-D entre las mujeres con y sin adherencia al multivitamínico p < 0.05, IC 95%. Conclusiones Se demostró que la falta de adherencia y seguimiento al tratamiento con multivitamínicos son factores de riesgo para la insuficiencia y deficiencia de Vit-D en pacientes con post-cirugía BPRY.

Objective To determine the interrelationships among lack of compliance, multi-vitamin treatment adherence, and serum levels of 25-OH vitamin D among women with Roux-en-Y bariatric surgery in the UNEME of Tijuana, Baja California, Mexico. Methods This is an analytical and transversal study on women with Roux-en-Y bariatric surgery (GCa, n=13) with morbid obesity (GOM, n=13), and apparently healthy women (GCo, n=13). After the corresponding written informed consents, in a first appointment, the medical record, the anthropometric assessment, and the administration of the instrument were performed, while in a second appointment, blood samples were taken in order to measure the vitamin D levels. The assessment instrument was validated through a Cohen Kappa greater than 80% and a Cronbach Alpha of 1. Student's t test and two-tailed, p < 0.05 ANOVAS were calculated. Results While a lack of adherence to multi-vitamin treatment was found in 85% of the women, a lack of post-surgical follow-up, including micro-nutrients lab tests, was found in 100%. A statistically significant difference between the mean vitamin D levels of women with and without multi-vitamin treatment adherence was found (p < 0.05, CI 95%). Conclusions It was demonstrated that the lack of adherence to multi-vitamin treatments is a vitamin D deficiency risk factor among patients with Roux-en-Y bariatric surgery.

Objetivo Determinar a relação entre a falta de seguimento, aderência ao tratamento com multivitamínicos e niveis séricos de 25-OH vitamina D (Vit-D) em mulheres post-cirurgia BPRY, na UNEME da cidade de Tijuana, Baja California, México. Métodos. Estudo Transversal analítico que incluiu mulheres post-cirurgia BPRY (GCa, n=13), com Obesidade Mórbida (GOM, n=13) e mulheres aparentemente saudáveis (GCo, n=13). Posterior à autorização mediante consentimento informado escrito, realizou-se uma história clínica, avaliação antropométrica, aplicação do instrumento de medição e em uma segunda consulta tomou-se uma amostra sanguínea para a quantificação de Vit-D. O instrumento de medição foi validado mediante Kappa de Cohen maior a 80% e alfa de Cronbach de 1. A análise estatística dos dados realizou-se mediante probas de diferencia de média t de Student e ANOVA onde se considerou uma p < 0.05 em um teste bilateral. Determinou-se prevalência, significância estatística da falta de aderência e seguimento em relação aos níveis de Vit-D. Resultados A falta de aderência ao tratamento multivitamínico nestas mulheres bariátricas foi de 85% e a falta de seguimento post cirúrgico que inclui testes de laboratório de micronutrientes foi de 100%. Encontrou-se uma diferença estatisticamente significativa entre a média dos níveis de Vit-D entre as mulheres com e sem aderência no multivitamínico p < 0.05, IC 95%. Conclusões . Demostrou-se que a falta de aderência e seguimento no tratamento com multivitamínicos são fatores de risco para a insuficiência e deficiência de Vit-D em pacientes bariátricos.

Association between the Increase in Body Mass Index and Medical Absenteeism in a Peruvian Mining Population.

BACKGROUND: Obesity and overweight are associated with work absenteeism of medical cause. However, there is little knowledge on the relationship between incremental body mass index (BMI) and absenteeism. OBJECTIVE: To assess the effect of annual increase in BMI on amount of prolonged absenteeism. METHODS: Data from a longitudinal historical cohort of workers of a mining camp in Peru between 2006 and 2014 were used for the analysis. Prolonged absenteeism of 30 days or more in one year was chosen as the dependent variable; annual increase in BMI was considered as the explanatory variable. Regression analysis with generalized estimating equation was used to determine the relative risk adjusted for age, sex and type of work. RESULTS: There were 1347 cases of medical leave reported with a median of 6 days. Of all cases of medical leave, 11% of those who had an annual increase in BMI and 6% of those who maintained their BMI were cases of prolonged absenteeism. Prolonged absenteeism significantly increased in workers who had an annual increment in BMI (adj RR 1.16, 95% CI 1.05 to 1.29). CONCLUSION: The annual increase in BMI was marginally associated with prolonged absenteeism. Temporal increment in BMI, regardless of the baseline BMI, may be an independent determinant of the work absenteeism of medical cause.

Prenatal lead exposure in relation to age at menarche: results from a longitudinal study in Mexico City.

Animal and cross-sectional epidemiological studies suggest that prenatal lead exposure is related to delayed menarche, but this has not been confirmed in longitudinal studies. We analyzed this association among 200 girls from Mexico City who were followed since the first trimester of gestation. Maternal blood lead levels were analyzed once during each trimester of pregnancy, and daughters were asked about their first menstrual cycle at a visit between the ages of 9.8 and 18.1 years. We estimated hazard ratios (HRs) and 95% confidence intervals (CI) for probability of menarche over the follow-up period using interval-censored Cox models, comparing those with prenatal blood lead level ⩾5 µg/dl to those with prenatal blood lead <5 µg/dl. We also estimated HRs and 95% CI with conventional Cox regression models, which utilized the self-reported age at menarche. In adjusted analyses, we accounted for maternal age, maternal parity, maternal education, and prenatal calcium treatment status. Across trimesters, 36-47% of mothers had blood lead levels ⩾5 µg/dl. Using interval-censored models, we found that during the second trimester only, girls with ⩾5 µg/dl prenatal blood lead had a later age at menarche compared with girls with prenatal blood lead levels <5 µg/dl (confounder-adjusted HR=0.59, 95% CI 0.28-0.90; P=0.05). Associations were in a similar direction, although not statistically significant, in the conventional Cox regression models, potentially indicating measurement error in the self-recalled age at menarche. In summary, higher prenatal lead exposure during the second trimester could be related to later onset of sexual maturation.

Exposure to Bisphenol A and phthalates metabolites in the third trimester of pregnancy and BMI trajectories.

BACKGROUND: Bisphenol A (BPA) and phthalates metabolites are linked to a variety of adverse health consequences but studies have not explored their association with growth trajectories. OBJECTIVE: Explore body mass index (BMI) trajectories for tertile exposures to BPA and phthalates metabolites in the third trimester of pregnancy. METHODS: We constructed BMI (kg/m2 ) trajectories from birth to 14 years in a birth cohort of 249 children from Mexico City using tertiles of third trimester maternal urinary concentrations of BPA and phthalates metabolites. Fractional age polynomials and mixed effects models were fit separately by sex. Predicted models were plotted for each metabolite tertile with the covariates mother's education and BMI centered at average values. RESULTS: Highest predicted BMI trajectories for female children were observed for third tertile exposure to the phthalate metabolite mono(2-ethyl-5-carboxypentyl) phthalate. In male children, first tertile exposure to mono-isobutyl phthalate and monobenzyl phthalate and second tertile exposure to mono(2-ethylhexyl) phthalate and mono(2-ethyl-5-hydroxyhexyl) phthalate predicted the highest BMI trajectory by adolescence. There was no relationshsip between BPA and child growth trajectory. CONCLUSIONS: These results suggest sex-specific differences in BMI trajectories by levels of metabolite exposure. Additional studies are needed to consider growth through adolescence in assessing the association of pregnancy exposures on child's BMI.

Correlación entre hiperfiltración glomerular y proteinuria en pacientes fumadores de mediana edad sin otras comorbilidades / Correlation between glomerular hyperfiltration and proteinuria in medium age smoking patients with no other comorbidities

Resumen ANTECEDENTES: En México los reportes mencionan entre 114 y 122 decesos diarios asociados con el tabaquismo. En 2011, Hallan y Orth publicaron los resultados de un seguimiento a 10 años de más de 65,000 participantes, concluyeron que el riesgo de insuficiencia renal es tres a cuatro veces mayor en fumadores que en no fumadores. OBJETIVO: Demostrar que el consumo del tabaco en pacientes sin comorbilidades puede favorecer la hiperfiltración glomerular, aumentado así el riesgo de enfermedad renal crónica. MATERIAL Y MÉTODO: Estudio transversal analítico, prospectivo, efectuado con pacientes del Hospital General Xoco, que se dividieron en dos grupos. Se tomaron muestras de sangre para obtener las concentraciones séricas de creatinina y urea; con las fórmulas MDRD y CKD EPI se estimó la tasa de filtración glomerular. El análisis estadístico se realizó con el programa SPSS V21. RESULTADOS: Se incluyeron 152 pacientes. La mayoría de la población fumadora tenía dependencia alta con 20 casos y prevalencia de 27%, con valor de p = 0.023 para la tasa de filtración glomerular por la fórmula MDRD y p = 0.006 por CKD-EPI, con diferencias estadísticamente significativas. Se demostró una correlación positiva estadísticamente significativa (r = 0.413, p < 0.01) entre el índice tabáquico y la tasa de filtración glomerular medida por MDRD. De igual manera, se encontró correlación positiva estadísticamente significativa (r = 0.238, p = 0.041) entre el índice tabáquico y la tasa de filtración glomerular medida por CKD-EPI. CONCLUSIÓN: El tabaquismo condiciona mayor hiperfiltración glomerular en comparación con los no fumadores; esta relación es dosis-dependiente.

Abstract BACKGROUND: In Mexico the reports mention between 114 and 122 daily deaths associated with smoking. In 2011, Hallan and Orth published the results of a 10-year follow-up of more than 65,000 participants, concluding that the risk of developing renal failure is 3 to 4 times higher in smokers than in non-smokers. OBJECTIVE: To demonstrate how the use of tobacco in patients without comorbidities may favor glomerular hyperfiltration, thus increasing the risk of chronic kidney disease. MATERIAL AND METHOD: A cross-sectional, analytical, prospective study was conducted with patients from the Xoco General Hospital, Mexico City; they were divided into 2 groups. Blood samples were taken to obtain the serum creatinine and urea values, using the MDRD and CKD formulas. EPI estimated the glomerular filtration rate. Statistical analysis was performed with the SPSS V21 program. RESULTS: There were included 152 patients. Majority of the smoking population had high dependence with 20 cases and a prevalence of 27%. With a value of p = 0.023 for glomerular filtration rate (GFR) by MDRD and p = 0.006 for CKD-EPI. They had statistically significant differences. A statistically significant positive correlation (r = 0.413, p < 0.01) between the smoking index and the GFR measured by MDRD was demonstrated in this study. Statistically significant positive correlation (r = 0.238, p = 0.041) was also found between smoking index and GFR measured by CKD-EPI. CONCLUSION: Smoking causes high glomerular hyperfiltration compared to not-smoking subjects; this relation is dosis-dependent.

Combined antibacterial/tissue regeneration response in thermal burns promoted by functional chitosan/silver nanocomposites.

We report the combined antibacterial/tissue regeneration responses to thermal burns promoted by functional chitosan/silver nanocomposites (CS/nAg) with ultralow silver content (0.018wt.%, 7-30nm). Our approach allows one to produce CS/nAg nanocomposites without silver nanoparticles (nAg) agglomeration, with bactericide potency higher than 1wt.% of nAg (ca. 10nm) content and, promoting the healing process in controlled thermal burns. CS/nAg films exhibit high antibacterial activity against S. aureus and P. aeruginosa after 1.5h of incubation, demonstrating the bacterial penetration into hydrated films and their interaction with nAg. Additionally, exceptional healing of induced thermal burns was obtained by increasing myofibroblasts, collagen remodeling, and blood vessel neoformation. These factors are associated with epiderma regeneration after 7days of treatment with no nAg release. Our results corroborate the controlled synthesis of nAg embedded in CS matrix with combined antibacterial/biocompatibility properties aiming to produce functional nanocomposites with potential use in wound dressing and health care applications.

Preparación y Caracterización de Nanocompositos Quitosano-Cobre con Actividad Antibacteriana para aplicaciones en Ingeniería de Tejidos / Preparation and characterization of Copper Chitosan Nanocomposites with Antibacterial Activity for Applications in Tissue Engineering

RESUMEN: El presente trabajo describe la preparación de nanocompositos formulados a partir de quitosano (QS)/nanopartículas de cobre (nCu) con características antibacterianas y aplicación potencial en ingeniería de tejidos. Para ello, se prepararon nanocompositos mediante mezclado en solución asistido con ultrasonido con el objetivo de incrementar la dispersión de la carga nanométrica en el biopolímero. El análisis de FTIR demostró que la presencia de nCu en la matriz de QS favorece la interacción del nCu con los grupos amino/hidroxilo de la molécula del QS. Se determinó mediante UV-Vis que los nanocompositos QS/nCu presentan absorción asociada con la presencia de nanopartículas y la posible liberación de iones Cu2+ en medio líquido. Mediante AFM se determinó que el QS hidratado forma una malla con microporos, que puede favorecer la penetración de bacterias en el nanocomposito y su interacción con las nCu. Finalmente, se determinó el efecto antibacteriano del material al contacto con la bacteria Staphylococcus aureus, en donde se presenta una actividad antibacteriana superior al 90% entre los 90 y 180 min de interacción. Dichos resultados sugieren que es posible obtener nanomateriales antibacterianos biocompatibles para su posible aplicación en ingeniería tisular.

ABSTRACT: The Present work describes the preparation of nanocomposites based on chitosan (QS)/copper nanoparticles (nCu) with antibacterial properties and potential application in tissue engineering. For this purpose, nanocomposites were prepared by solution blending with ultrasound assisted, aiming to increase the nanoparticles dispersion in the biopolymer. FTIR analyses demonstrates that nCu supported in QS increase their interaction of nanoparticles with amine/hydroxyl groups of QS molecule. UV-Vis analyses demonstrates that QS/nCu nanocomposites have an absorption signal associated with the presence of nanoparticles and the possible Cu2+ ions release in liquid media. AFM analyses shown that hydrated QS form a mesh with micro pores, improving the bacterial penetration and the direct contact with nCu. This behavior was corroborated by antibacterial assays, where QS/nCu nanocomposites shown an antibacterial activity higher than 90% between 90-180 minutes of interaction. Our results suggest that is possible to obtain combined antibacterial/biocompatible nanomaterials with potential application in tissue engineering.