Prevalencia de anemia ferropénica y factores asociados en embarazadas peruanas / Prevalence of iron deficiency anemia and associated factors in Peruvian pregnant women

Objetivo: Evaluar la prevalencia de la anemia ferropénica y los factores asociados en embarazadas peruanas, 2021. Métodos: Estudio observacional de diseño transversal retrospectivo y analítico, por medio de un análisis secundario de la base de datos de la Encuesta Demográfica y de Salud Familiar a 1070 gestantes para evaluar la anemia y sus posibles factores. Se realizó un análisis estadístico con una regresión logística binaria y multivariada. Resultados: La prevalencia de anemia en las gestantes fue de 29,7% y se asoció con el trabajo actual de la gestante (PRa: 0,53), el trabajo de la pareja en ventas o servicios (PRa: 4,15), el segundo trimestre de gestación (PRa: 2,07), la obesidad (PRa: 0,48) y el consumo de agua de la naturaleza (PRa: 2,23). Conclusiones: La prevalencia de anemia en Perú revela un problema moderado de salud pública y sus factores asociados son el trabajo de la pareja en ventas, el estar en el segundo trimestre de gestación y al consumo de agua de la naturaleza. Asimismo, los factores con menos posibilidad a tener anemia son el trabajo actual de la gestante y la obesidad. Por ende, las políticas y programas multidisciplinarios deben enfocarse a estos factores.(AU)

Objective: To evaluate the prevalence of iron deficiency anemia and associated factors in Peruvian pregnant women, 2021. Methods: Observational study of retrospective and analytical cross-sectional design, through a secondary analysis of the database of the Demographic and Family Health Survey of 1070 pregnant women to evaluate anemia and its possible factors. A statistical analysis was performed with a binary and multivariate logistic regression. Results: The prevalence of anemia in pregnant women was 29.7% and was associated with the current job of the pregnant woman (PRa: 0.53), the job of the partner in sales or services (PRa: 4.15), the second trimester of gestation (PRa: 2.07), obesity (PRa: 0.48) and water consumption from nature (PRa: 2.23). Conclusions: The prevalence of anemia in Peru reveals a moderate public health problem and its associated factors are the work of the couple in sales, being in the second trimester of pregnancy and the consumption of water from nature. Likewise, the factors with the least possibility of having anemia are the current job of the pregnant woman and obesity. Therefore, multidisciplinary policies and programs should focus on these factors.(AU)

Latin American Association for the study of the liver (ALEH) practice guidance for the diagnosis and treatment of non-alcoholic fatty liver disease.

Non-alcoholic fatty liver disease (NAFLD) currently represents an epidemic worldwide. NAFLD is the most frequently diagnosed chronic liver disease, affecting 20-30% of the general population. Furthermore, its prevalence is predicted to increase exponentially in the next decades, concomitantly with the global epidemic of obesity, type 2 diabetes mellitus (T2DM), and sedentary lifestyle. NAFLD is a clinical syndrome that encompasses a wide spectrum of associated diseases and hepatic complications such as hepatocellular carcinoma (HCC). Moreover, this disease is believed to become the main indication for liver transplantation in the near future. Since NAFLD management represents a growing challenge for primary care physicians, the Asociación Latinoamericana para el Estudio del Hígado (ALEH) has decided to organize this Practice Guidance for the Diagnosis and Treatment of Non-Alcoholic Fatty Liver Disease, written by Latin-American specialists in different clinical areas, and destined to general practitioners, internal medicine specialists, endocrinologists, diabetologists, gastroenterologists, and hepatologists. The main purpose of this document is to improve patient care and awareness of NAFLD. The information provided in this guidance may also be useful in assisting stakeholders in the decision-making process related to NAFLD. Since new evidence is constantly emerging on different aspects of the disease, updates to this guideline will be required in future.

Risk Factors for Proliferative Diabetic Retinopathy in African Americans with Type 2 Diabetes.

PURPOSE: To assess personal and demographic risk factors for proliferative diabetic retinopathy in African Americans with type 2 diabetes. METHODS: In this prospective, non-interventional, cross-sectional case-control study, 380 African Americans with type 2 diabetes were enrolled. Participants were recruited prospectively and had to have either: (1) absence of diabetic retinopathy after ≥10 years of type 2 diabetes, or (2) presence of proliferative diabetic retinopathy when enrolled. Dilated, 7-field fundus photographs were graded using the Early Treatment Diabetic Retinopathy Study scale. Covariates including hemoglobin A1C (HbA1C), blood pressure, height, weight and waist circumference were collected prospectively. Multivariate regression models adjusted for age, sex and site were constructed to assess associations between risk factors and proliferative diabetic retinopathy. RESULTS: Proliferative diabetic retinopathy was associated with longer duration of diabetes (odds ratio, OR, 1.62, p < 0.001), higher systolic blood pressure (OR 1.65, p < 0.001) and insulin use (OR 6.65, p < 0.001) in the multivariate regression analysis. HbA1C was associated with proliferative diabetic retinopathy in the univariate analysis (OR 1.31, p = 0.002) but was no longer significant in the multivariate analysis. CONCLUSIONS: In this case-control study of African Americans with type 2 diabetes, duration of diabetes, systolic hypertension and insulin use were strong risk factors for the development of proliferative diabetic retinopathy. Interestingly, HbA1C did not confer additional risk in this cohort.

African Ancestry Analysis and Admixture Genetic Mapping for Proliferative Diabetic Retinopathy in African Americans.

PURPOSE: To examine the relationship between proportion of African ancestry (PAA) and proliferative diabetic retinopathy (PDR) and to identify genetic loci associated with PDR using admixture mapping in African Americans with type 2 diabetes (T2D). METHODS: Between 1993 and 2013, 1440 participants enrolled in four different studies had fundus photographs graded using the Early Treatment Diabetic Retinopathy Study scale. Cases (n = 305) had PDR while controls (n = 1135) had nonproliferative diabetic retinopathy (DR) or no DR. Covariates included diabetes duration, hemoglobin A1C, systolic blood pressure, income, and education. Genotyping was performed on the Affymetrix platform. The association between PAA and PDR was evaluated using logistic regression. Genome-wide admixture scanning was performed using ANCESTRYMAP software. RESULTS: In the univariate analysis, PDR was associated with increased PAA (odds ratio [OR] = 1.36, 95% confidence interval [CI] = 1.16-1.59, P = 0.0002). In multivariate regression adjusting for traditional DR risk factors, income and education, the association between PAA and PDR was attenuated and no longer significant (OR = 1.21, 95% CI = 0.59-2.47, P = 0.61). For the admixture analyses, the maximum genome-wide score was 1.44 on chromosome 1. CONCLUSIONS: In this largest study of PDR in African Americans with T2D to date, an association between PAA and PDR is not present after adjustment for clinical, demographic, and socioeconomic factors. No genome-wide significant locus (defined as having a locus-genome statistic > 5) was identified with admixture analysis. Further analyses with even larger sample sizes are needed to definitively assess if any admixture signal for DR is present.

The study to understand the genetics of the acute response to metformin and glipizide in humans (SUGAR-MGH): design of a pharmacogenetic resource for type 2 diabetes.

OBJECTIVE: Genome-wide association studies have uncovered a large number of genetic variants associated with type 2 diabetes or related phenotypes. In many cases the causal gene or polymorphism has not been identified, and its impact on response to anti-hyperglycemic medications is unknown. The Study to Understand the Genetics of the Acute Response to Metformin and Glipizide in Humans (SUGAR-MGH, NCT01762046) is a novel resource of genetic and biochemical data following glipizide and metformin administration. We describe recruitment, enrollment, and phenotyping procedures and preliminary results for the first 668 of our planned 1,000 participants enriched for individuals at risk of requiring anti-diabetic therapy in the future. METHODS: All individuals are challenged with 5 mg glipizide × 1; twice daily 500 mg metformin × 2 days; and 75-g oral glucose tolerance test following metformin. Genetic variants associated with glycemic traits and blood glucose, insulin, and other hormones at baseline and following each intervention are measured. RESULTS: Approximately 50% of the cohort is female and 30% belong to an ethnic minority group. Following glipizide administration, peak insulin occurred at 60 minutes and trough glucose at 120 minutes. Thirty percent of participants experienced non-severe symptomatic hypoglycemia and required rescue with oral glucose. Following metformin administration, fasting glucose and insulin were reduced. Common genetic variants were associated with fasting glucose levels. CONCLUSIONS: SUGAR-MGH represents a viable pharmacogenetic resource which, when completed, will serve to characterize genetic influences on pharmacological perturbations, and help establish the functional relevance of newly discovered genetic loci to therapy of type 2 diabetes. TRIAL REGISTRATION: ClinicalTrials.gov NCT01762046.

The FDA Funding Crisis.

The role of the Food and Drug Administration (FDA) is to ensure the safety of prescription and nonprescription drugs, dietary supplements, and the food supply, representing more than 20% of US consumer spending. The increased need to monitor imported drugs, drug products and foods, drug shortages, and compounding pharmacies bring the adequacy of FDA funding into question. Performing even at status quo cannot be accomplished if responsibilities increase without equitable funding increases: both from the federal government and fees imposed on FDA-regulated industries. Additionally, scientific advancement, new legislation, and new industries are continually increasing the FDA workload, necessitating commensurate budget increases.

Role of ATG16L, NOD2 and IL23R in Crohn's disease pathogenesis.

Inflammatory bowel disease is a group of diseases that includes Crohn's disease (CD) and ulcerative colitis. CD is characterized as a chronic inflammatory disease of the gastrointestinal tract, ranging from the mouth to the anus. Although there are gross pathological and histological similarities between CD and Johne's disease of cattle, the cause of CD remains controversial. It is vital to understand fully the cause of this disease because it affects approximately 500,000 people in North America and Europe. It ranges from 27 to 48 cases per 100,000 people. There are many theories on the cause of CD ranging from possible association with environmental factors including microorganisms to imbalance in the intestinal normal flora of the patients. Regardless of the environmental trigger, there is strong evidence that a genetic disposition is a major key in acquiring CD. Many studies have proven the link between mutations in the ATG16L, NOD2/CARD15, IBD5, CTLA4, TNFSF15 and IL23R genes, and CD. The purpose of this review is to examine all genetic aspects and theories of CD, including up to date multiple population studies performed worldwide.

Tratamiento de las basuras y su impacto en el medio ambiente desde el punto de vista de las amas de casa

Presenta aspectos importantes relacionados al tema como políticas, leyes, economía y medio ambiente en el Paraguay. Describe el tratamiento cotidiano de lasbasuras, causas, destino consecuencias y reciclaje realizado por las amas de casa

A mulher e a moradia / Women and housing

Traz â tona os problemas que afetam as mulheres pobres que vivem nas åreas urbanas. Analisa a política de habitaçäo e saneamento implementada durante mais de 20 anos pelo Governo Federal através do Banco Nacional de Habitaçäo--BNH e, atualmente, da Caixa Econômica Federal--CEF. Quando discute algumas experiências empreendidas no campo da habitaçäo popular, destaca a participaçäo das mulheres e a sua decisiva contribuiçäo para o desenvolvimento daqueles projetos. Identificando os principais problemas vividos pelas mulheres de baixa renda no enfrentamento das dificuldades de moradia, fornece subsídios para a elaboraçäo de diretrizes de trabalho dos Governos Municipais. Ao delinear os obstáculos mais relevantes, subjacentes å implementaçäo de políticas habitacionais, fornece elementos para a incorporaçäo de um tratamento adeqado ås questôes de gênero e de eqüidade na oferta de habitaçäo e de serviços urbanos para a populaçäo de baixa renda

Parte III: Mulheres trabalhando: Apresentaçäo / Section III: Women working: Presentation

Estuda o assunto mulher e saneamento propiciando uma primeira troca de experiências no contexto brasileiro estimulada por iniciativas semelhantes desenvolvidas em outros países