Longitudinal health survey of women from Venezuela in Colombia (ELSA-VENCOL): First report.

BACKGROUND: Colombia is currently the world's main recipient country for Venezuelan migrants, and women represent a high proportion of them. This article presents the first report of a cohort of Venezuelan migrant women entering Colombia through Cúcuta and its metropolitan area. The study aimed to describe the health status and access to healthcare services among Venezuelan migrant women in Colombia with irregular migration status, and to analyze changes in those conditions at a one-month follow-up. METHODS: We carried out a longitudinal cohort study of Venezuelan migrant women, 18 to 45 years, who entered Colombia with an irregular migration status. Study participants were recruited in Cúcuta and its metropolitan area. At baseline, we administered a structured questionnaire including sociodemographic characteristics, migration history, health history, access to health services, sexual and reproductive health, practice of early detection of cervical cancer and breast cancer, food insecurity, and depressive symptoms. The women were again contacted by phone one month later, between March and July 2021, and a second questionnaire was applied. RESULTS: A total of 2,298 women were included in the baseline measurement and 56.4% could be contacted again at the one-month follow-up. At the baseline, 23.0% of the participants reported a self-perceived health problem or condition in the past month and 29.5% in the past 6 months, and 14.5% evaluated their health as fair or poor. A significant increase was found in the percentage of women who reported a self-perceived health problem during the past month (from 23.1% to 31.4%; p<0.01); as well as in the share who reported moderate, severe, or extreme difficulty working or performing daily chores (from 5.5% to 11.0%; p = 0.03) and who rated their health as fair (from 13.0% to 31.2%; p<0.01). Meanwhile, the percentage of women with depressive symptoms decreased from 80.5% to 71.2% (p<0.01). CONCLUSION: This report presents initial information on the health status of Venezuelan migrant women in Colombia, and is a starting point for further longer longitudinal follow-ups to assess changes over time in health conditions.

Preeclampsia, Natural History, Genes, and miRNAs Associated with the Syndrome.

Preeclampsia (PE) is a hypertensive disease that affects pregnant women after 20 weeks of gestation. This disease is associated with an important risk of maternal and fetal mortality. PE is described as a placental pathology because, after delivery, most women recover normal arterial pressure. Poor invasion of the spiral arteries is a phenomenon well described in PE; this leads to a hypoxic uterine bed and imbalance of antiangiogenic and proangiogenic factors in the uteroplacental region, which in turn triggers the disease phenotype. The causes of the pathology are unclear; nevertheless, numerous approaches, including next-generation sequencing, association, and case control and miRNA studies, have shed light on the genetic/molecular basis of PE. These studies help us better understand the disease to advance new treatment strategies.

A Pharmacogenetic Study of CYP2C19 in Acute Coronary Syndrome Patients of Colombian Origin Reveals New Polymorphisms Potentially Related to Clopidogrel Therapy.

Clopidogrel, an oral platelet P2Y12 receptor blocker, is used in the treatment of acute coronary syndrome. Interindividual variability in treatment response and the occurrence of adverse effects has been attributed to genetic variants in CYP2C19. The analysis of relevant pharmacogenes in ethnically heterogeneous and poorly studied populations contributes to the implementation of personalized medicine. We analyzed the coding and regulatory regions of CYP2C19 in 166 patients with acute coronary syndrome (ACS) treated with clopidogrel. The allele frequencies of CYP2C19 alleles *1, *2, *4, *17, *27 and *33 alleles were 86.1%, 7.2%, 0.3%, 10.2%, 0.3% and 0.3%, respectively. A new potentially pathogenic mutation (p.L15H) and five intronic variants with potential splicing effects were detected. In 14.4% of the patients, a new haplotype in strong linkage disequilibrium was identified. The clinical outcome indicated that 13.5% of the patients presented adverse drugs reactions with a predominance of bleeding while 25% of these patients were carriers of at least one polymorphic allele. We propose that new regulatory single-nucleotide variants (SNVs) might potentially influence the response to clopidogrel in Colombian individuals.

Sentinel Lymph Node Biopsy in Breast Cancer with 99mTc-Tilmanocept: A Multicenter Study on Real-Life Use of a Novel Tracer.

99mTc-tilmanocept is a novel radiopharmaceutical for sentinel lymph node (SLN) biopsy in breast cancer. Our aim was to describe results with 99mTc-tilmanocept in a heterogeneous group of breast cancer patients scheduled for SLN biopsy. Methods: Radiotracer preparation followed the manufacturer's indications. Local protocols for SLN detection within 9 participant centers were not changed for the entire duration of the study. In total, 344 patients with T1-T4, N0-N2 breast cancer (352 lesions) were included. Superficial (intradermal or periareolar) or deep (peritumoral or intratumoral) injections were performed. The doses were adjusted depending on the scheduled time for surgery. Results: Lymphoscintigraphy was able to depict at least 1 SLN in 339 of 352 breast lesions (96.3%), and the intraoperative SLN detection rate reached 97.2%. On univariable analysis, SLN detection rates did not differ by age, clinical T or N stage, tumor location, histologic subtype, or prior neoadjuvant therapy. Lymphoscintigraphy showed higher SLN detection in patients with a normal weight (body mass index < 25) than in those who were overweight or obese (body mass index ≥ 25), at 99.2% versus 94.6%, respectively (P = 0.031). The proportion of patients with preoperative lymphoscintigraphic detection or excised SLNs was higher with superficial than deep injections. Reinjected cases were significantly lower when superficial injection was chosen first (P < 0.001). Injection site and the tumor markers human epidermal growth factor receptor 2 and estrogen receptor had an impact on preoperative SLN visualization and intraoperative localization. In 80 cases, SLN biopsy resulted in a positive lymph node. During a mean follow-up of 19 mo, no axillary recurrences were observed. Conclusion: Whatever the protocol, 99mTc-tilmanocept showed good results in a heterogeneous breast cancer population, although the best results were achieved when a superficial injection was chosen.

Análisis comparativo de la cinética de liberación de diclofenaco sódico a partir de matrices hidrofílicas en medios de disolución convencionales y biorrelevantes / A comparative analysis of the release kinetics of sodium diclofenac from hydrophilic matrices in conventional dissolution media and biorelevant media is carried out

Se utilizaron dos polímeros hidrofílicos comúnmente empleados en la formulación de matrices de liberación extendida, hidroxipropil-metil-celulosa (HPMC, hipromelosa) y óxido de polietileno (PEO), junto con celulosa microcristalina y lactosa, con el objetivo de estudiar la cinética de liberación del diclofenaco sódico en los aparatos II y III de la USP, en un medio de disolución compendial y en medios biorrelevantes. La cinética de liberación predominante en el aparato II fue uno y en el aparato III, cero. El valor de las constantes n y k aplicando la ley del exponente, indicaron tanto para el aparato II como para el III, que no se presenta el efecto "burst" y que el mecanismo predominante en la liberación del fármaco, es la relajación y la erosión del polímero. Los resultados sugieren que la metodología de disolución en un medio biorrelevante es apropiada para discriminar entre formulaciones y para predecir el desempeño in vivo de tabletas de liberación extendida de diclofenaco sódico.

Two hydrophilic polymers commonly employed on the development of extended release products, hydroxypropyl-methyl-cellulose (HPMC, hypromellose) and polyethylene oxide (PEO) were formulated with microcrystalline cellulose or lactose in order to investigate the release kinetics of sodium diclofenac on USP apparatus II and III using a compendial or biorelevant media, respectively. The dominant release kinetic on apparatus II was first order and zero on apparatus III. The values of the kinetic constant (k) and the release exponent (n) from the Power Law Model indicated that there was no burst effect in none of the studied formulations, relaxation and polymer erosion was the dominant mechanism of drug release in both methods. The results suggest that biorelevant dissolution methodology is appropriate for the discrimination of formulations and prediction of in vivo performance of MR diclofenac sodium matrices.

Análisis del efecto del pH en la cinética de liberación de la teofilina en un medicamento de liberación programada: Parte I. Microgránulos encapsulados recubiertos con goma laca / Analysis of the effect of pH on the release kinetics of theophylline from a pharmaceutical dosage form for controlled delivery of drug. Part I: Capsulated microgranules covered with shellac guam

En los medicamentos de liberación modificada de administración peroral, es importante garantizar que la liberación del principio activo, sea independiente del pH, para evitar variaciones significativas en los niveles sanguíneos, que puedan conducir a fallas terapéuticas, o a manifestaciones de toxicidad. Uno de los medicamentos que más se comercializa en formas de liberación modificada es la teofilina, existiendo en el mercado más de una docena de marcas de diversos sistemas de entrega como tabletas, cápsulas con pellets o con microgránulos y en varias concentraciones como 100, 125, 200 y 300 mg. En este trabajo se presentan los resultados de un producto comercializado como microgránulos encapsulados con 125 y 300 mg de teofilina. Se evaluó la liberación de la teofilina a 8 valores de pH que cubren las condiciones del tracto gastrointestinal. Se encontró que la liberación de la teofilina se ajusta a lo establecido en la USP 25 para los ensayos 2 y 4, pero tanto la cinética como la velocidad de liberación son altamente dependientes del pH. Para valores de pH por debajo de 6.4 el proceso de liberación se ajusta a un modelo de primer orden cinético con una vida media de disolución que va de 161 min. hasta 247 min. a medida que el pH se acidifica. Para un pH de 6.4 a 8.0 la disolución de la teofilina se ajusta a un modelo de orden cero y la vida media de disolución disminuye de 92 a 27 minutos, en la medida que el pH se vuelve más alcalino