Assessing Biomedical and Psychosocial Factors in a Cross-Sectional Study of School Dropouts Among Pregnant Adolescents and Young Mothers in Quito, Ecuador.

BACKGROUND: Over nearly three decades, Ecuador experienced a significant rise in adolescent motherhood. OBJECTIVES: By focusing on social, health, and psychological aspects, the research aims to reveal the complex factors influencing the decision to discontinue education. The emphasis on providing a platform for direct expression of personal experiences not only adds qualitative depth to the study but also ensures that the voices of those involved are heard authentically. METHODS: Employing a nonexperimental, descriptive, cross-sectional approach with qualitative and quantitative methods, the research delves into the interplay of biological, psychological, and social factors. Descriptive statistics, presented through tables and graphs, were used for variable analysis, complemented by inferential statistics to validate hypotheses. Focus group sessions, processed with ATLAS.ti (ATLAS.ti Scientific Software Development GmbH, Berlin, Germany) underwent a thorough review in workshops with Servicio de Atención Integral para Adolescentes (SAIA) experts. Adolescent participants were randomly recruited through the hospital's system. RESULTS: The findings unveiled a significant dropout rate among adolescents, where pregnancy was just one factor influencing their decision. Those discontinuing education often embraced a life project centered on motherhood and domestic roles, facing domestic violence and mental health disorders. In contrast, those persisting with education were driven by professional development, facing challenges but benefiting from family support. Despite unwanted pregnancies and low contraceptive use, many found personal growth and identity affirmation in motherhood. CONCLUSIONS: Our research highlights key insights into factors like pregnancy desire, contraception, reactions, and challenges. Urgent action is needed to address systemic problems and provide holistic support, acknowledging the resilience and validity of choices made by adolescent mothers in balancing motherhood with education and career goals.

Evidence of Oropouche Orthobunyavirus Infection, Colombia, 2017.

We describe an Oropouche orthobunyavirus infection in a women 28 years of age in Colombia. We confirmed the diagnosis by viral isolation, quantitative reverse transcription PCR, and phylogenetic analysis of the small, medium, and large genomic segments. The virus is related to a strain isolated in Ecuador in 2016.

A colorimetric bioassay for quantitation of both basal and insulin-induced glucose consumption in 3T3-L1 adipose cells.

INTRODUCTION: The quantitation of glucose consumption in animal cell cultures is mainly based on the use of radiolabeled or fluorescent analogues, resulting in expensive and tedious procedures, requiring special equipment and, sometimes, with potential health and environmental risks. OBJECTIVES: The objective of this work was to evaluate the application of a blood plasma colorimetric assay to quantify glucose consumption in in vitro cultures of adipose cells. METHODS: We worked with 3T3-L1 adipose cells differentiated by 7-8 days, which were exposed to different initial glucose concentrations (5.5, 2.8 and 1.4 mM) for variable times, either in the absence or the presence of 100 nM insulin. Using a commercial colorimetric glucose assay, extracellular glucose was determined, and glucose uptake was calculated as the difference between the initial and final glucose concentration. RESULTS: The colorimetric assay allowed us to quantify glucose uptake in our cell model, observing a linear response over time (r 2 ≥0.9303) to the different glucose concentrations, both in the basal and insulin-induced condition. The insulin-stimulated glucose consumption was higher than basal consumption at all glucose concentrations evaluated, but significant differences were observed at 120-, 360- and 480-min in glucose 5.5 mM (p ≤ 0.01, n = 5), and 240 min in glucose 1.4 mM (p ≤ 0.01, n = 5). A V max of 4.1 and 5.9 nmol/ml/min (basal and insulin-induced, respectively) and a K m of 1.1 mM (same in basal vs insulin-stimulated) were calculated. The bioassay was also useful in a pharmacological context: in glucose 1.4 mM, glucose consumption showed an effect that depended on insulin concentration, with a calculated EC50 of 18.4 ± 1.1 nM. CONCLUSIONS: A simple and low-cost bioassay is proposed to quantify glucose consumption in 3T3-L1 adipose cells.

CdTe Quantum Dots Modified with Cysteamine: A New Efficient Nanosensor for the Determination of Folic Acid.

In this paper, we report the synthesis, characterization, and application of a new fluorescent nanosensor based on water-soluble CdTe quantum dots (QDs) coated with cysteamine (CA) for the determination of folic acid (FA). CdTe/CA QDs were characterized by high-resolution transmission electron microscopy, the zeta potential, and Fourier-transform infrared (FT-IR), UV-visible, and fluorescence spectroscopy. CdTe QDs coated with mercaptopropionic acid (MPA) and glutathione (GSH) were prepared for comparison purposes. The effect of FA on the photoluminescence intensity of the three thiol-capped QDs at pH 8 was studied. Only CdTe/CA QDs showed a notable fluorescence quenching in the presence of FA. Then, a nanosensor based on the fluorescence quenching of the CdTe QDs at pH 8 was explored. Under optimum conditions, the calibration curve showed a linear fluorescence quenching response in a concentration range of FA from 0.16 to 16.4 µM (R2 = 0.9944), with a detection limit of 0.048 µM. A probable mechanism of fluorescence quenching was proposed. The nanosensor showed good selectivity over other possible interferences. This method has been applied for FA quantification in orange beverage samples with excellent results (recoveries from 98.3 to 103.9%). The good selectivity, sensitivity, low cost, and rapidity make CdTe /CA QDs a suitable nanosensor for FA determination.

Resultados de la cirugia minimamente invasiva y la cirugia abierta tipo scarf para la correccion del hallux valgus moderado y severo: Estudio observacional retrospectivo / Results of minimally invasive surgery versus scarf osteotomy for correcting moderate and severe hallux valgus. Retrospective observational study

Introducción: Cuando el dolor asociado a deformidad en hallux valgus es el principal sintoma y el tratamiento conservador no es eficaz, esta indicada la cirugia. El objetivo de este articulo fue evaluar nuestra experiencia con la tecnica minimamente invasiva y la osteotomia tipo scarf, mediante la escala AOFAS, radiografias con la correccion del angulo intermetatarsiano, el angulo metatarsofalangico, la escala Regnauld y los criterios de Reynolds. Materiales y Métodos: Estudio observacional descriptivo de tipo cohorte retrospectiva. Se incluyeron los pies operados mediante las tecnicas minimamente invasiva y tipo scarf. Se revisaron los datos clinicos preoperatorios, y a los 3 y 6 meses de la cirugia, sobre funcionalidad, hallazgos imagenologicos de tres angulos, y las clasificaciones de Reynolds y Regnauld. Resultados: Se incluyeron 123 pacientes en quienes se realizaron 150 procedimientos: cirugia minimamente invasiva (44,7%) y tipo scarf (55,3%). La mediana de edad era de 56 anos (RIC 42-61), el 88,6% eran mujeres. No hubo diferencias entre el preoperatorio inmediato, y a los 3 y 6 meses para el angulo intermetatarsiano entre las dos tecnicas; sin embargo, el angulo metatarsofalangico se corrigio (p <0,001) y el puntaje AOFAS fue mejor a los 3 meses con la cirugia minimamente invasiva (p <0,001). Conclusiones: Ambas tecnicas corrigen la deformidad a valores normales. Con la tecnica minimamente invasiva, la correccion fue mayor y el puntaje AOFAS resulto mejor. La incidencia de complicaciones agudas fue similar. Se necesitan ensayos clinicos sobre este tema para confirmar los hallazgos de este estudio. Nivel de Evidencia: III

Introduction: When pain associated with hallux valgus deformity is the main symptom and traditional treatment is not effective, then surgery is indicated. The aim of the study was to evaluate our experience with minimally invasive technique and scarf osteotomy using AOFAS scale and radiologically intermetatarsal angle correction, metatarsophalangeal angle, Regnauld scale and Reynolds criteria. Methods: Retrospective cohort observational study. Feet treated with minimally invasive technique and scarf osteotomy were included. Preoperative clinical data and those obtained at 3 and 6 months after surgery were reviewed to evaluate functionality, image findings on three angles, and Reynolds and Regnauld classifications. Results: A total of 123 patients were included, and 150 procedures were performed: minimally invasive surgery (44.7%) and scarf osteotomy (55.3%). Average age was 56 years (IQR 42-61), and 88.6% were women. No differences were observed at the immediate preoperative period, 3 months and 6 months for intermetatarsal angle between both techniques; however metatarsophalangeal angle was corrected (p<0.001) and AOFAS score (p<0.001) was better 3 months after the minimally invasive surgery. Conclusions: Both techniques provide correction to normal values. Minimally invasive technique achieved higher correction levels and a better AOFAS score. Incidence of acute complications was similar. Clinical studies on this issue are necessary to confirm these findings. Level of Evidence: III

Genetic diversity and antimicrobial activity of lactic acid bacteria in the preparation of traditional fermented potato product 'tunta'.

Fermentation microorganisms, lactic acid bacteria (LAB) and yeast from 12 samples of tunta production chain were quantified, from the native potatoes used by the process fermentation of potatoes in the river up to the final product. During fermentation, the LAB population steadily increased from 3 to 4 to 8 log CFU/g during the first 8 days in the river and the yeast population increased from 2 to 3 to 3-4 log CFU/g. Overall, 115 LAB strains were isolated using a culture-dependent method. Molecular techniques and 16S rRNA gene sequencing enabled the identification of native species. In LAB isolates, members of the Lactobacillaceae (64%), Leuconostocaceae (9%) and Enterococcaceae (2%) families were identified. The most prevalent LAB species in the tunta production chain was Lactobacillus curvatus, followed by Leuconostoc mesenteroides and Lactobacillus sakei, Lactobacillus brevis and Enterococcus mundtii were also present. Only 13 LAB strains showed anti-listerial activity, and one of them, identified as En. mundtii DSM 4838T [MG031213], produced antimicrobial compounds that were determined to be proteins after treatment with proteolytic enzymes. Based on these results, we suggest that traditional fermented product-derived LAB strains from specific environments could be selected and used for technological application to control pathogenic bacteria and naturally protect food from post-harvest deleterious microbiota.

NIR-Emitting Alloyed CdTeSe QDs and Organic Dye Assemblies: A Nontoxic, Stable, and Efficient FRET System.

In the present work, we synthesize Near Infrared (NIR)-emitting alloyed mercaptopropionic acid (MPA)-capped CdTeSe quantum dots (QDs) in a single-step one-hour process, without the use of an inert atmosphere or any pyrophoric ligands. The quantum dots are water soluble, non-toxic, and highly photostable and have high quantum yields (QYs) up to 84%. The alloyed MPA-capped CdTeSe QDs exhibit a red-shifted emission, whose color can be tuned between visible and NIR regions (608-750 nm) by controlling the Te:Se molar ratio in the precursor mixtures and/or changing the time reaction. The MPA-capped QDs were characterized by UV-visible absorption spectroscopy, fluorescence spectroscopy, transmission electron microscopy (TEM), energy dispersive X-ray spectroscopy (EDS), and zeta potential measurements. Photostability studies were performed by irradiating the QDs with a high-power xenon lamp. The ternary MPA-CdTeSe QDs showed greater photostability than the corresponding binary MPA-CdTe QDs. We report the Förster resonance energy transfer (FRET) from the MPA-capped CdTeSe QDs as energy donors and Cyanine5 NHS-ester (Cy5) dye as an energy acceptor with efficiency (E) up to 95%. The distance between the QDs and dye (r), the Förster distance (R0), and the binding constant (K) are reported. Additionally, cytocompatibility and cell internalization experiments conducted on human cancer cells (HeLa) cells revealed that alloyed MPA-capped CdTeSe QDs are more cytocompatible than MPA-capped CdTe QDs and are capable of ordering homogeneously all over the cytoplasm, which allows their use as potential safe, green donors for biological FRET applications.

Optimal control approach for establishing wMelPop Wolbachia infection among wild Aedes aegypti populations.

Wolbachia-based biocontrol has recently emerged as a potential method for prevention and control of dengue and other vector-borne diseases. Major vector species, such as Aedes aegypti females, when deliberately infected with Wolbachia become less capable of getting viral infections and transmitting the virus to human hosts. In this paper, we propose an explicit sex-structured population model that describes an interaction of uninfected (wild) male and female mosquitoes and those deliberately infected with wMelPop strain of Wolbachia in the same locality. This particular strain of Wolbachia is regarded as the best blocker of dengue and other arboviral infections. However, wMelPop strain of Wolbachia also causes the loss of individual fitness in Aedes aegypti mosquitoes. Our model allows for natural introduction of the decision (or control) variable, and we apply the optimal control approach to simulate wMelPop Wolbachia infestation of wild Aedes aegypti populations. The control action consists in continuous periodic releases of mosquitoes previously infected with wMelPop strain of Wolbachia in laboratory conditions. The ultimate purpose of control is to find a tradeoff between reaching the population replacement in minimum time and with minimum cost of the control effort. This approach also allows us to estimate the number of Wolbachia-carrying mosquitoes to be released in day-by-day control action. The proposed method of biological control is safe to human health, does not contaminate the environment, does not make harm to non-target species, and preserves their interaction with mosquitoes in the ecosystem.

Auditory Processing Performance of the Middle-Aged and Elderly: Auditory or Cognitive Decline?

BACKGROUND: Despite the well-established relationship between aging and auditory processing decline, identifying the extent to which age effect is the main factor on auditory processing performance remains a great challenge due to the co-occurrence of age-related hearing loss and age-related cognitive decline as potential confounding factors. PURPOSE: To investigate the effects of age-related hearing loss and working memory on the clinical evaluation of auditory processing of middle-aged and elderly. RESEARCH DESIGN: Cross-sectional study. STUDY SAMPLE: A total of 77 adults between 50 and 70 yr of age were invited to participate in the study. DATA COLLECTION AND ANALYSIS: The participants were recruited from a larger study that focused on the assessment and management of sensory and cognitive skills in elderly participants. Only participants with normal hearing or mild-to-moderate age-related hearing loss, with no evidence of cognitive, psychological, or neurological conditions were included. Speech-in-noise, dichotic digit, and frequency pattern tests were conducted as well as a working memory test. The hearing loss effect was investigated using an audibility index, calculated from the audiometric threshold. The performance on the digit span test was used to investigate working memory effects. Both hearing loss and working memory effects were investigated via correlation and regression analyses, partialling out age effects. The significance level was set at p < 0.05. RESULTS: The results demonstrated that, while hearing loss was associated to the speech-in-noise performance, working memory was associated to the frequency pattern and dichotic digit performances. Regression analyses confirmed the relative contribution of hearing loss to the variance in speech-in-noise and working memory test to the variance in frequency pattern and dichotic digit test performance. CONCLUSIONS: The performance decline of the elderly in auditory processing tests may be partially attributable to the working memory performance and, consequently, to the cognitive decline exhibited by this population. Mild-to-moderate hearing loss seems to affect performance on specific auditory processing tasks, such as speech in noise, reinforcing the idea that auditory processing disorder in the elderly might also be associated to auditory peripheral deficits.

Análisis filogenético de secuencias suramericanas del gen ns1 del serotipo dengue-2, relacionadas con sangrado clínico severo / Phylogenetic analysis of South American sequences of the nonstructural protein-1 (ns1) of dengue serotype 2 associated with severe clinical bleeding

Objetivo Comparar secuencias de nucleótidos y de aminoácidos de la proteína no estructural 1-NS1 de cepas DENV-2, aisladas de pacientes febriles de diferentes países suramericanos, que cursaron cuadros clínicos con severidad o sin ella. Materiales y Métodos El análisis filogenético fue realizado a partir de 28 secuencias moleculares completas (1 056 pb) del gen NS1 del serotipo DENV-2. Se realizó un análisis filogenético bayesiano utilizando el software MrBayes v.3.2.0, con el modelo SYM+G y un análisis filogenético con el método Neighbor-Joining con el modelo Jukes-Cantor. Además, las secuencias de aminoácidos fueron alineadas y comparadas entre sí, mediante el programa Clustal W incluido en el software MEGA v. 5.2. Resultados En las secuencias de aminoácidos asociadas a sangrado, la sustitución más frecuente fue isoleucina→ treonina, en la posición 93. Estas secuencias presentaron un mayor porcentaje (94,6 %) de homología de aminoácidos de la proteína NS1 en comparación con el porcentaje de homología (74 %) de los aislamientos DENV-2 no asociados a sangrado. Se identificaron cinco clados que agrupan la mayoría de las secuencias analizadas (19/24; 79,2 %) con valores de probabilidad posterior mayores o iguales al 58 %. Siete (87,5 %) secuencias asociadas a sangrado se relacionan filogenéticamente dentro de los clados 4 y 5, con valores de probabilidad posterior del 58 % y 97 %, respectivamente. Conclusión No se encontraron características filogenéticas ni tampoco diferencias entre las secuencias de aminoácidos de la proteína NS1-DENV-2 estudiadas, que pudieran ser relacionadas, de manera directa, con la severidad de la enfermedad.(AU)

Objective The objective of this in silico study was to compare nucleotide and amino acids DENV-2-NS1 sequences isolated from febrile patients, with and without disease severity, from different South American countries. Matherials and Methods A bayesian MCMC phylogenetic analysis was carried out using 28 complete sequences of the gene NS1 of the DENV-2 serotype (1 056 bp), using MrBayes v.3.2.0 software, with the model SYM+G (2.5 million generations). We also carried out a phylogenetic analysis with Neighbor-Joining method (Jukes-Cantor model). In addition, the amino acids sequences were aligned and compared with each other, using Clustal W included in MEGA v.5.2 software. Results In the amino acids sequences associated with bleeding, the most frequent substitution was isoleucine → threonine at posicion 93. These sequences showed a high percentage (94.6 %) of amino acid homology in comparison with the percentage of amino acids homology (74 %) of DENV-2 isolates not associated with bleeding. Five clades were identified that group the vast majority of the DENV-2-NS1 sequences analyzed (19/24; 79.2 %) with posterior probability values greater than or equal to 58 %. Seven sequences (87.5 %) associated with bleeding were phylogenetically related within clades 4 and 5, the posterior probability values were 58 % and 97 %, respectively. Conclusion Neither phylogenetic characteristics nor differences between amino acids of the DENV-2-NS1 sequences studied were found that could be associated directly with severity of the disease.(AU)

[Phylogenetic analysis of South American sequences of the nonstructural protein-1 (ns1) of dengue serotype 2 associated with severe clinical bleeding]. / Análisis filogenético de secuencias suramericanas del gen ns1 del serotipo dengue-2, relacionadas con sangrado clínico severo.

Objective The objective of this in silico study was to compare nucleotide and amino acids DENV-2-NS1 sequences isolated from febrile patients, with and without disease severity, from different South American countries. Matherials and Methods A bayesian MCMC phylogenetic analysis was carried out using 28 complete sequences of the gene NS1 of the DENV-2 serotype (1 056 bp), using MrBayes v.3.2.0 software, with the model SYM+G (2.5 million generations). We also carried out a phylogenetic analysis with Neighbor-Joining method (Jukes-Cantor model). In addition, the amino acids sequences were aligned and compared with each other, using Clustal W included in MEGA v.5.2 software. Results In the amino acids sequences associated with bleeding, the most frequent substitution was isoleucine → threonine at posicion 93. These sequences showed a high percentage (94.6 %) of amino acid homology in comparison with the percentage of amino acids homology (74 %) of DENV-2 isolates not associated with bleeding. Five clades were identified that group the vast majority of the DENV-2-NS1 sequences analyzed (19/24; 79.2 %) with posterior probability values greater than or equal to 58 %. Seven sequences (87.5 %) associated with bleeding were phylogenetically related within clades 4 and 5, the posterior probability values were 58 % and 97 %, respectively. Conclusion Neither phylogenetic characteristics nor differences between amino acids of the DENV-2-NS1 sequences studied were found that could be associated directly with severity of the disease.

A new level of regulation in gluconeogenesis: metabolic state modulates the intracellular localization of aldolase B and its interaction with liver fructose-1,6-bisphosphatase.

Understanding how glucose metabolism is finely regulated at molecular and cellular levels in the liver is critical for knowing its relationship to related pathologies, such as diabetes. In order to gain insight into the regulation of glucose metabolism, we studied the liver-expressed isoforms aldolase B and fructose-1,6-bisphosphatase-1 (FBPase-1), key enzymes in gluconeogenesis, analysing their cellular localization in hepatocytes under different metabolic conditions and their protein-protein interaction in vitro and in vivo. We observed that glucose, insulin, glucagon and adrenaline differentially modulate the intracellular distribution of aldolase B and FBPase-1. Interestingly, the in vitro protein-protein interaction analysis between aldolase B and FBPase-1 showed a specific and regulable interaction between them, whereas aldolase A (muscle isozyme) and FBPase-1 showed no interaction. The affinity of the aldolase B and FBPase-1 complex was modulated by intermediate metabolites, but only in the presence of K(+). We observed a decreased association constant in the presence of adenosine monophosphate, fructose-2,6-bisphosphate, fructose-6-phosphate and inhibitory concentrations of fructose-1,6-bisphosphate. Conversely, the association constant of the complex increased in the presence of dihydroxyacetone phosphate (DHAP) and non-inhibitory concentrations of fructose-1,6-bisphosphate. Notably, in vivo FRET studies confirmed the interaction between aldolase B and FBPase-1. Also, the co-expression of aldolase B and FBPase-1 in cultured cells suggested that FBPase-1 guides the cellular localization of aldolase B. Our results provide further evidence that metabolic conditions modulate aldolase B and FBPase-1 activity at the cellular level through the regulation of their interaction, suggesting that their association confers a catalytic advantage for both enzymes.

Salud sexual y reproductiva en estudiantes universitarios de una institución de educación superior en Colombia / Sexual and reproductive health in university students at an institution of higher learning in Colombia

Objetivo Investigar en una universidad estatal del Caribe colombianoel estado de la salud sexual y reproductiva especialmente conocimientos sobre Enfermedades de Transmisión Sexual (ETS), fertilidad, sexualidad, embarazo y violencia. Métodos Estudio transversal tipo encuesta. Se seleccionaron estudiantes matriculados en el segundo período de 2010 que llenaron voluntariamente la encuesta. Los datos cualitativos fueron tabulados y graficados usando medidas de tendencia central para variables cuantitativas. Resultados La población tenía alrededor de 20 años de edad, provenía de la zona urbana (57,9%; IC95%=54,7-61,1), predominantemente heterosexual (89,7%) con edad de inicio de vida sexual antes de los 18 años, con 11,8 % de promiscuidad que usaba principalmente el preservativo como Método de Planificación Familiar (MPF) (55 %). Aunque poseían información previa sobre salud sexual, MPF y ETS, no se comportaban acorde con ello, por la desinformación sobre formas de transmisión del VIH, bajo nivel de realización de pruebas serológicas para ETS, así como conductas de riesgo (sexo/alcohol/drogas). El 12,3% tuvo antecedente de embarazo, violencia física (21,6%) y sexual (4,6%) con un predominante silencio de las víctimas de abuso sexual (61,8%). Conclusiones La muestra refleja la población universitaria de esta región del país. Se planea organizar un programa con apoyo médico y psicológico que permita disminuir los índices de ETS, embarazos no planificados, preparando al adolescente en esta importante etapa de su vida, sirviendo de modelo para otras universidades latinoamericanas.

Objective To investigate the state of sexual and reproductive health in students at a public university in the Colombian Caribbean, with an emphasis on sexually transmitted diseases (STDs), fertility, sexuality, pregnancy and violence. Methods Cross-sectional survey study. University students, enrolled in the second semester of 2010 and who completed a self-administered survey based on the Reproductive Health survey of the Pan American Health Organization, were selected. Qualitative data was tabulated and graphed using measures of central tendency for quantitative variables. Results The age of population studied was around 20 years old, came from the urban area (57.9 %; IC95 %=54.7-61.1), was predominantly heterosexual (89.7 %), with an age of initiation of sexual activity of less than 18 years old, 11.8 % promiscuity, mainly using the condom as a Family Planning Method (FPM) (55 %). Although they had prior information on sexual health, STDs and FPMs, they did not behave according to this due to low education about HIV transmission routes, low incidence of serological tests for STDs, and high risk behavior (sex/alcohol/drugs). It was observed that 12.3 % had a history of pregnancy, physical violence (21.6 %) and sexual violence (4.6 %) with a predominant silence from the victims of sexual abuse (61.8 %). Conclusion The sample reflects the student population in this region of Colombia. We plan to organize a health program with medical and psychological support to reduce the rates of STDs and unplanned pregnancies, preparing the adolescent for this important step in their life and serving as a model for other Latin American universities.

Susceptibilidad antimicrobiana y genotipificación de Pseudomonas aeruginosa de pacientes con fibrosis quística y otras patologías en Cartagena (Colombia) / Antimicrobial susceptibility and genotypification of Pseudomonas aeruginosa from cystic fibrosis patients and other diseases in Cartagena (Colombia)

Objetivo: el objetivo de este estudio fue analizar el genotipo y susceptibilidad antimicrobiana de Pseudomonas aeruginosa de pacientes con fibrosis quística y otras patologías. Materiales y métodos: se analizaron 20 aislados de pacientes con fibrosis quística y 20 de pacientes con otras enfermedades por medio de la prueba de susceptibilidad antimicrobiana por microdilución en caldo y técnica del ADN polimorfo amplificado aleatorio. Resultados: se observó que los aislados de pacientes con fibrosis quística presentaron mayor resistencia (56 %) en comparación con aislados de pacientes sin fibrosis quística (25 %). Los antimicrobianos más efectivos en ambos grupos fueron cefepima, ceftriaxona y meropenem. Desde el punto de vista genotípico, se observa heterogeneidad entre las cepas de pacientes con fibrosis quística y dos grupos con cepas idénticas de origen hospitalario, lo que sugiere una posible transmisión cruzada. Conclusión: Concluimos que los porcentajes de resistencia de Pseudomonas aeruginosa en este estudio son altas, y este hallazgo se acentúa en el caso de pacientes con fibrosis quística, lo cual deja muy pocas opciones de tratamiento. La tipificación por técnica del ADN polimórfico amplificado aleatorio permitió conocer la variabilidad de genotipos para tener control sobre la transmisión de cepas, lo cual constituye un tópico de importancia en el sistema de salud y el mejoramiento de la calidad de vida de los pacientes.

Objective: Our aim was to analyze genotype and antimicrobial susceptibility of Pseudo-monas aeruginosa from cystic fibrosis patients and other diseases. Materials and methods: We analyzed 20 isolates from cystic fibrosis patients and 20 from patients with other diseases by dilution antimicrobial susceptibility test and random amplified polymorphic DNA technique. Results: We found that isolates from cystic fibrosis patients had higher resistance (56 %) than isolates from patients without cystic fibrosis (26 %). The most effective antimicrobi-als in both groups were cefepime, ceftriaxone and meropenem. With regard to the geno-type, we observed heterogeneity between strains from cystic fibrosis patients and two clus-ters with identical strains from hospital origin, suggesting a possible cross transmission. Conclusion: We concluded that the resistance rate of Pseudomonas aeruginosa in this study was high and this finding is accentuated in patients with cystic fibrosis, leaving few treatment options. Typification by random amplified polymorphic DNA technique allowed us to know the variability of genotypes to control strain transmission; this is an important topic to optimize health services and the quality of life of our patients.

[Sexual and reproductive health in university students at an institution of higher learning in Colombia]. / Salud sexual y reproductiva en estudiantes universitarios de una institución de educación superior en Colombia.

OBJECTIVE: To investigate the state of sexual and reproductive health in students at a public university in the Colombian Caribbean, with an emphasis on sexually transmitted diseases (STDs), fertility, sexuality, pregnancy and violence. METHODS: Cross-sectional survey study. University students, enrolled in the second semester of 2010 and who completed a self-administered survey based on the Reproductive Health survey of the Pan American Health Organization, were selected. Qualitative data was tabulated and graphed using measures of central tendency for quantitative variables. RESULTS: The age of population studied was around 20 years old, came from the urban area (57.9 %; IC95 %=54.7-61.1), was predominantly heterosexual (89.7 %), with an age of initiation of sexual activity of less than 18 years old, 11.8 % promiscuity, mainly using the condom as a Family Planning Method (FPM) (55 %). Although they had prior information on sexual health, STDs and FPMs, they did not behave according to this due to low education about HIV transmission routes, low incidence of serological tests for STDs, and high risk behavior (sex/alcohol/drugs). It was observed that 12.3 % had a history of pregnancy, physical violence (21.6 %) and sexual violence (4.6 %) with a predominant silence from the victims of sexual abuse (61.8 %). CONCLUSION: The sample reflects the student population in this region of Colombia. We plan to organize a health program with medical and psychological support to reduce the rates of STDs and unplanned pregnancies, preparing the adolescent for this important step in their life and serving as a model for other Latin American universities.

INVO procedure: minimally invasive IVF as an alternative treatment option for infertile couples.

Intravaginal culture (IVC), also called INVO (intravaginal culture of oocytes), is an assisted reproduction procedure where oocyte fertilization and early embryo development are carried out within a gas permeable air-free plastic device, placed into the maternal vaginal cavity for incubation. In the present study we assessed the outcome of the INVO procedure, using the recently designed INVOcell device, in combination with a mild ovarian stimulation protocol. A total of 125 cycles were performed. On average 6.5 oocytes per cycle were retrieved, and a mean of 4.2 were placed per INVOcell device. The cleavage rate obtained after the INVO culture was 63%. The procedure yielded 40%, 31.2%, and 24% of clinical pregnancy, live birth, and single live birth rates per cycle, respectively. Our results suggest that the INVO procedure is an effective alternative treatment option in assisted reproduction that shows comparable results to those reported for existing IVF techniques.

Coexistencia de Pseudomonas aeruginosa y Candida albicans en infecciones nosocomiales en Cartagena de Indias (Colombia) / Coexistence of Pseudomonas Aeruginosa and Candida albicans in hospital-acquired infections in Cartagena (Colombia)

Las infecciones nosocomiales constituyen un importante problema de salud, cuyos factores de riesgo son hospitalizaciones prolongadas, procedimientos invasivos y tratamientos antimicrobianos de amplio espectro. Pseudomonas aeruginosa y Candida albicans son microorganismos frecuentemente aislados del tracto respiratorio de pacientes gravemente enfermos. Se ha demostrado que estos patógenos pueden tener una interacción de gran significancia en donde las características morfológicas y de virulencia de cada microorganismo se modulan mutuamente aumentando significativamente el riesgo y la severidad de las infecciones urinarias y respiratorias produciendo una alta morbimortalidad. El objetivo de este trabajo fue ilustrar las características microbiológicas y clínicas que son resultado de la presencia conjunta de P. aeruginosa y C. albicans en pacientes gravemente enfermos en hospitales de Cartagena de Indias (Colombia). En todos los casos se destaca un proceso bacteriano inicial, en este caso causado por P. aeruginosa, que fue tratado de acuerdo a la susceptibilidad antimicrobiana encontrada y al disminuir el agente bacteriano responsable se dio lugar al crecimiento de C. albicans y al desarrollo de una nueva infección que empeoró la condición clínica de estos pacientes. Las infecciones conjuntas entre P. aeruginosa y C. albicans siempre se deben sospechar en un paciente hospitalizado, especialmente en unidades de cuidados intensivos y cuando hagan uso de sondas, catéteres y otros materiales para estudios invasivos, pues estos microorganismos son de naturaleza oportunista y claramente pueden empeorar el pronóstico y llevar a complicaciones a pacientes que han sido hospitalizado por causas diferentes o enfermedades de baja complejidad, prolongando el tiempo de hospitalización y aumentando costos.

Producción científica sobre cáncer cérvico-uterino y de mama en Colombia, 1994-2004. Estudio según la Base de Productos Nacionales X-ACTA de Colciencias / Scientific production on cervix and breast cancers in Colombia, 1994-2004. A study based on Colciencias’ National Products Index (X-acta)

Objetivo: caracterizar el conocimiento producido sobre cáncer cérvico-uterino y de mama en Colombia en el período 1994-2004, y reflexionar sobre él. Metodología: estudio llevado a cabo entre 2005 y 2008 a partir de la Base de Productos Nacionales de Colciencias X-acta, que se consultó utilizando descriptores estandarizados. Se organizaron tres grupos de artículos según las revistas en que fueron publicados: nacionales indexadas (T1), nacionales no indexadas (T2) y extranjeras (T3). Se construyeron grupos temáticos y se establecieron categorías. Resultados: se identificaron 175 artículos que llevaban en el título las palabras cáncer, carcinoma o adenocarcinoma. De estos, 34 se refieren a cáncer en el aparato reproductor femenino (cérvix, útero y ovario) (CUO) y 9 a cáncer de mama o seno (CS) para un total de 43, que corresponden al 24,6% de los 175 identificados sobre el tema del cáncer. Conclusiones: hubo predominio de la publicación en revistas extranjeras (22/43; 51,2%) y en revistas nacionales no indexadas (11/43; 25,6%), lo cual genera dificultades de acceso a la información. Además, cabe hacer énfasis en la necesidad de producir conocimientos sobre los aspectos genéticos, moleculares y clínicos de los cánceres de cérvix y mama y en la de aplicarlos a la salud sexual y reproductiva; también es pertinente insistir en la formación de profesionales capaces de preocuparse integralmente por los pacientes y sus familias. Es necesario mejorar los sistemas de registro, la definición de prioridades de investigación en salud y revisar los mecanismos por los cuales se financian los proyectos. Predominan los estudios biomédicos y se nota la carencia de trabajos centrados en otras disciplinas como la antropología y la psicología, que serían útiles para superar la brecha entre los enfoques clínico y biológico, por una parte, y, por otra, la comprensión más humanizada del problema del cáncer, de su impacto sobre la vida sexual y reproductiva y de la experiencia de los cuidadores familiares.

Objective: to characterize the knowledge produced in Colombia on cervix and breast cancers during the period 1994-2004, and to ponder it. Methodology: the study was carried out between 2005 and 2008 consulting X-acta, a Colombian database, by means of standardized describers. Articles found were classified according to the journal of publication, namely: Colombian indexed journals (T1), Colombian non-indexed journals (T2), and foreign journals (T3). Groups and categories were defined according to subject matters. Results: 175 papers were identified under the headings cancer, carcinoma and adenocarcinoma. Out of them, 34 dealt with cancer in the female reproductive tract (cervix, uterus, ovaries), and 9 with breast cancer. They totaled 43 papers (24.6% of the 175 on cancer.) Conclusions: There was a trend to publish in foreign journals (22 papers; 51.2%) and in non-indexed Colombian journals (11; 25.6%); because of this trend there are difficulties in accessing to the information. Emphasis should be placed on the need to produce knowledge on the genetic, molecular and clinical aspects of cervix and breast cancers, as well as on its application to sexual and reproductive health. It is also pertinent to insist on the need to form professionals for the integral care of patients and their families. Systems of registration of projects, priorities for health research and mechanisms of financing should be improved. There is a predominance of biomedical studies and a lack of works based on other disciplines, such as anthropology and psychology, that would be useful to bridge the gap between the clinical and biological approaches, on the one hand, and, on the other, the humanized understanding of the cancer problem, its impact on sexual and reproductive health and the experiences of familial caregivers.

Primary retroperitoneal lipoma: a soft tissue pathology heresy?: report of a case with classic histologic, cytogenetics, and molecular genetic features.

Adipose tissue tumors of the retroperitoneum showing no identifiable cytologic atypia are usually classified as lipomalike well-differentiated liposarcoma. Whether a subset of these tumors represents true examples of retroperitoneal lipoma remains a controversial subject, because the diagnostic liposarcoma cells may be of difficult identification, even after extensive sampling. Herein, we describe a large retroperitoneal lipoma with classic histopathologic, cytogenetic, molecular cytogenetic, and molecular genetic features. Extensive morphologic inspection showed no evidence of cytologic atypia. Cytogenetic analysis performed on fresh tissue material revealed the classic lipoma chromosome t(3;12)(q27;q14-15). Fluorescence in situ hybridization on multiple sections excluded the presence of MDM2 and CDK4 amplification, but showed HMGA2 balanced rearrangement in most cells. Reverse-transcriptase polymerase chain reaction followed by sequencing analysis confirmed the presence of the HMGA2-LPP fusion gene, a characteristic and the most common fusion product found in lipoma. The patient has been followed for 2.5 years without evidence of recurrence or metastasis. These results indicate that retroperitoneal lipomata do exist, but their diagnosis must rely on stringent histologic, cytogenetic, and molecular genetic analysis.

La medición de la resiliencia / Measurement of resilience

Objetivo: Identificar técnicas e instrumentos utilizados para la medición de la resiliencia. Materiales y Métodos: Se realizó revisión bibliográfica en Internet bajo el descriptor medición de resiliencia. Se seleccionaron los estudios que abordaban el problema de la construcción de métodos para la medición de resiliencia. Resultados: La revisión muestra que las técnicas e instrumentos para la medición de la resiliencia pueden agruparse en tres tipos: pruebas proyectivas, pruebas psicométricas y pruebas de imaginología. Está agrupación se corresponde con los principales enfoques teóricos que permiten una aproximación al concepto de resiliencia. Las que más desarrollo muestran son las pruebas psicométricas, algunas de las cuales podrían ser utilizadas con éxito en otros estudios sobre el tema. Sin embargo, tanto las pruebas proyectivas como las nacientes pruebasde imaginología, tienen un potencial interesante para la aproximación al concepto sobre todo en los trabajos de orden clínico y cualitativo. Discusión: Los múltiples factores que intervienen en la resiliencia y las distintas aproximaciones teóricas al concepto dificultan el proceso de construcción y medición. Al abordar esta tarea los investigadores se ven en la necesidad de tomar posición frente a una de las definiciones existentes sobre resiliencia, lo cual los obliga a dejar de lado otros aspectos importantes del concepto. Conclusión: Sehace necesario realizar investigaciones con diseños metodológicos mixtos para profundizar en la comprensión del fenómeno resiliente, de tal manera que se pueda obtener un consenso más amplio e integrativo sobre el concepto y, a partir de ahí, avanzar en el diseño deinstrumentos capaces de medir de manera más integral los aspectos involucrados en la resiliencia.