Role of MicroRNA-204 in Regulating the Hallmarks of Breast Cancer: An Update.

microRNA-204-5p (miR-204) is a small noncoding RNA with diverse regulatory roles in breast cancer (BC) development and progression. miR-204 is implicated in the instauration of fundamental traits acquired during the multistep development of BC, known as the hallmarks of cancer. It may act as a potent tumor suppressor by inhibiting key cellular processes like angiogenesis, vasculogenic mimicry, invasion, migration, and metastasis. It achieves this by targeting multiple master genes involved in these processes, including HIF-1α, ß-catenin, VEGFA, TGFBR2, FAK, FOXA1, among others. Additionally, miR-204 modulates signaling pathways like PI3K/AKT and interacts with HOTAIR and DSCAM-AS1 lncRNAs, further influencing tumor progression. Beyond its direct effects on tumor cells, miR-204 shapes the tumor microenvironment by regulating immune cell infiltration, suppressing pro-tumorigenic cytokine production, and potentially influencing immunotherapy response. Moreover, miR-204 plays a crucial role in metabolic reprogramming by directly suppressing metabolic genes within tumor cells, indirectly affecting metabolism through exosome signaling, and remodeling metabolic flux within the tumor microenvironment. This review aims to present an update on the current knowledge regarding the role of miR-204 in the hallmarks of BC. In conclusion, miR-204 is a potential therapeutic target and prognostic marker in BC, emphasizing the need for further research to fully elucidate its complex roles in orchestrating aggressive BC behavior.

Aspectos farmacológicos y adherencia al tratamiento antirretroviral en pacientes VIH

Introducción: La adherencia al tratamiento farmacológico favorece la supresión viral y reduce la resistencia a la terapia antirretroviral de gran actividad a largo plazo. Objetivo: Determinar la relación entre los aspectos farmacológicos y la adherencia al tratamiento antirretroviral de una IPS colombiana. Metodología: Estudio analítico transversal en pacientes con diagnóstico de VIH en tratamiento antirretroviral entre los años 2012 a 2020. Se utilizó un modelo de regresión logística binaria múltiple con fines explicativos. Resultados: Se analizaron 9835 pacientes donde la proporción de adherencia fue de 90 % y en el modelo ajustado se evaluó su relación con los antecedentes de no adherencia (ORa:0,52 IC95 °/o:0,40-0,66), grupo farmacológico (2 ITIAN + 1 IP u otro) (ORa:1,22 IC95 %:0,99-1,76), dos tomas al día (ORa:1,02 IC95 %:0,74-1,40), unidades al día (≥ 3) (ORa:0,69 IC95 %:0,47-1,02), reacciones adversas a medicamentos (ORa:0,56 IC95 °%:0,40-0,78), polimedicación (ORa:1,36 IC95 %:1,00-1,85), tiempo TAR (1 a 2 años) (ORa:1,63 IC95 %:1,27-2,09),tiempo TAR (6 a 12 meses) (ORa:1,66 IC95 %:1,27-2,18), tiempo TAR (<6 meses) (ORa:1,36 IC95 %:1,03-1,78), tasa de reclamación de los medicamentos (ORa:0,42 IC95 %:0,32-0,55) y antecedentes PRUM (ORa:0,11 IC95 %:0,09-0,14). Discusión: La proporción de adherencia obtenida es superior a lo descrito para otros países (entre 60-77 %); sin embargo se encuentra que los hallazgos correspondientes al efecto de las variables farmacológicas analizadas son acordes a lo descrito en estudios previos en el tema Conclusión: Los antecedentes de no adherencia, reacciones adversas, tasa de reclamación de los medicamentos y antecedentes de problemas relacionados con el uso de medicamentos son aspectos que reducen la probabilidad de adherencia; mientras que el mayor tiempo de uso del tratamiento aumenta la misma.

Introduction: Adherence to drug treatment promotes viral suppression and reduces long-term resistance to highly active antiretroviral therapy (HAART). Objective: To determine the relationship between the pharmacological aspects and adherence to antiretroviral treatment in a Colombian IPS. Methodology: Cross-sectional analytical study in patients with HIV on antiretroviral treatment between 2012 and 2020. A multiple binary logistic regression model was used for explanatory purposes. Results: A total of 9,835 patients were analyzed where the proportion of adherence was 90 % and in the adjusted model its relationship with history of non-adherence was assessed (ORa: 0,52 95 % CI: 0,40-0,66), pharmacological group (2 NRTI + 1 PI or other) (ORa: 1,22 95 % CI: 0,99-1,76), two doses per day (ORa: 1,02 95 % CI: 0,74-1,40), units per day (≥ 3 ) (ORa: 0,69 95 % CI: 0,47-1,02), adverse drug reactions (ORa: 0,56 95 % CI: 0,40-0,78), polypharmacy (ORa: 1,36 95 % CI : 1,00-1,85), ART time (1 to 2 years) (ORa: 1,63 95 % CI: 1,27-2,09), ART time (6 to 12 months) (ORa: 1,66 95 % CI: 1,27-2,18), ART time (<6 months) (ORa: 1,36 95 % CI: 1,03-1,78), inconsistency in the claim (ORa: 0,42 95 % CI: 0,32-0,55) and PRUM history (ORa: 0,11 95 % CI: 0,09-0,14). Discussion: The proportion of adherence obtained is higher than that described for other countries (between 60-77 %); however, the findings corresponding to the effect of the pharmacological variables analysed are in line with those described in previous studies on the subject. Conclusion: The history of non-adherence, adverse reactions, inconsistencies in the claim fill history and problems related to the use of medications are aspects that reduce the probability of adherence. While the longer time of use of the treatment increases adherence.

The Role of ncRNAs in the Immune Dysregulation of Preeclampsia.

The main complications causing practically 75% of all maternal deaths are severe bleeding, infections, and high blood pressure during pregnancy (preeclampsia (PE) and eclampsia). The usefulness of ncRNAs as clinical biomarkers has been explored in an extensive range of human diseases including pregnancy-related diseases such as PE. Immunological dysregulation show that the Th1/17:Th2/Treg ratio is "central and causal" to PE. However, there is evidence of the involvement of placenta-expressed miRNAs and lncRNAs in the immunological regulation of crucial processes of placenta development and function during pregnancy. Abnormal expression of these molecules is related to immune physiopathological processes that occur in PE. Therefore, this work aims to describe the importance of miRNAs and lncRNAs in immune dysregulation in PE. Interestingly, multiple ncRNAS are involved in the immune dysregulation of PE participating in type 1 immune response regulation, immune microenvironment regulation in placenta promoting inflammatory factors, trophoblast cell invasion in women with Early-Onset PE (EOPE), placental development, and angiogenesis, promotion of population of M1 and M2, proliferation, invasion, and migration of placental trophoblast cells, and promotion of invasion and autophagy through vias such as PI3K/AKT/mTOR, VEGF/VEGFR1, and TLR9/STAT3.

The Two Faces of Immune-Related lncRNAs in Head and Neck Squamous Cell Carcinoma.

Head and neck squamous cell carcinoma (HNSCC) is a group of cancers originating from the mucosal epithelium in the oral cavity, larynx, oropharynx, nasopharynx, and hypopharynx. Molecular factors can be key in the diagnosis, prognosis, and treatment of HNSCC patients. Long non-coding RNAs (lncRNAs) are molecular regulators composed of 200 to 100,000 nucleotides that act on the modulation of genes that activate signaling pathways associated with oncogenic processes such as proliferation, migration, invasion, and metastasis in tumor cells. However, up until now, few studies have discussed the participation of lncRNAs in modeling the tumor microenvironment (TME) to generate a protumor or antitumor environment. Nevertheless, some immune-related lncRNAs have clinical relevance, since AL139158.2, AL031985.3, AC104794.2, AC099343.3, AL357519.1, SBDSP1, AS1AC108010.1, and TM4SF19-AS1 have been associated with overall survival (OS). MANCR is also related to poor OS and disease-specific survival. MiR31HG, TM4SF19-AS1, and LINC01123 are associated with poor prognosis. Meanwhile, LINC02195 and TRG-AS1 overexpression is associated with favorable prognosis. Moreover, ANRIL lncRNA induces resistance to cisplatin by inhibiting apoptosis. A superior understanding of the molecular mechanisms of lncRNAs that modify the characteristics of TME could contribute to increasing the efficacy of immunotherapy.

Exposición intrauterina a disruptores endocrinos (ftalatos): fuentes de exposición y cuantificación de metabolitos urinarios / Intrauterine exposure to endocrine disruptors (phthalates): sources of exposure and quantification of urinary metabolites

Introducción: Los ftalatos son disruptores endocrinos usados en la fabricación de múltiples productos de la industria, principalmente plásticos. El periodo fetal representa la principal ventana de vulnerabilidad, y la exposición a ftalatos en esta etapa de vida genera efectos adversos fetales y postnatales. El biomarcador más fiable para medición de ftalatos es la orina. Objetivo: Caracterizar las diferentes fuentes de exposición a disruptores endocrinos y cuantificar la concentración urinaria de ftalatos en gestantes. Materiales y métodos: Estudio transversal, observacional y descriptivo que incluye 400 gestantes que asistieron a control prenatal en las instituciones de salud Génesis y Metrosalud (Medellín-Colombia). Se caracterizaron fuentes de exposición, se recolectó muestras de orina de todas las gestantes, y cuantificó la concentración de ftalatos de 38 mujeres. Resultados: Las medias geométricas de ftalato Di(2-ethylhexyl)phthalate(DEHP), Mono-n-butyl phthalate(MnBP), Mono-2-ethyl-5-hydroxyhexyl phthalate(MEHHP) y Mono-2-ethyl-5-oxohexyl phthalate(MEOHP) fueron 162,72µg/L, 58,5 µg/L, 33,93µg/L y 31,63µg/L respectivamente. Conclusiones: La mayoría de las gestantes evaluadas han estado expuestas a lo largo de su vida a fuentes potenciales de disruptores endocrinos, presentes en químicos domésticos, tabaco y uso frecuente de cosméticos faciales y corporales. Las concentraciones de MnBP, MEHHP y MEOHP en orina de las participantes, fueron superiores a los hallazgos a nivel mundial.

Introduction: Phthalates are endocrine disruptors used in the manufacture of various industrial products, mainly plastics. The fetal period represents the principal window of vulnerability, and the exposure to Phthalates in this stage of life generates adverse fetal and post-natal effects. The most reliable biomarker for the assessment of Phthalates is urine. Objective: To characterize the different exposure sources of endocrine disruptors and quantify the urinary concentration of Phthalates in pregnant women. Materials and methods: A cross-sectional, observational, and descriptive study which included 400 pregnant women who received prenatal care in the Genesis and Metrosalud health institutions (Medellín-Colombia). Exposure sources were characterized and urine samples were collected from all pregnant women and the Phthalate concentration was quantified in 38 women. Results: The geometric measures of Phthalate Di(2-ethylhexyl)phthalate(DEHP), Mono-n-butyl phthalate(MnBP), Mono-2-ethyl-5-hydroxyhexyl phthalate(MEHHP) and Mono-2-ethyl-5-oxohexyl phthalate(MEOHP) were 162.72µg/L, 58.5 µg/L, 33.93µg/L and 31.63µg/L respectively. Conclusions: The majority of pregnant women that were evaluated were exposed to potential sources of endocrine disruptors throughout their life, which are present in household chemicals, tobacco, and frequent use of facial and body cosmetics. The concentrations of MnBP, MEHHP y MEOHP in urine of participants were higher than those found worldwide.

Emerging role of lncRNAs in drug resistance mechanisms in head and neck squamous cell carcinoma.

Head and neck squamous cell carcinoma (HNSCC) originates in the squamous cell lining the mucosal surfaces of the head and neck region, including the oral cavity, nasopharynx, tonsils, oropharynx, larynx, and hypopharynx. The heterogeneity, anatomical, and functional characteristics of the patient make the HNSCC a complex and difficult-to-treat disease, leading to a poor survival rate and a decreased quality of life due to the loss of important physiologic functions and aggressive surgical injury. Alteration of driver-oncogenic and tumor-suppressing lncRNAs has recently been recently in HNSCC to obtain possible biomarkers for diagnostic, prognostic, and therapeutic approaches. This review provides current knowledge about the implication of lncRNAs in drug resistance mechanisms in HNSCC. Chemotherapy resistance is a major therapeutic challenge in HNSCC in which lncRNAs are implicated. Lately, it has been shown that lncRNAs involved in autophagy induced by chemotherapy and epithelial-mesenchymal transition (EMT) can act as mechanisms of resistance to anticancer drugs. Conversely, lncRNAs involved in mesenchymal-epithelial transition (MET) are related to chemosensitivity and inhibition of invasiveness of drug-resistant cells. In this regard, long non-coding RNAs (lncRNAs) play a pivotal role in both processes and are important for cancer detection, progression, diagnosis, therapy response, and prognostic values. As the involvement of more lncRNAs is elucidated in chemoresistance mechanisms, an improvement in diagnostic and prognostic tools could promote an advance in targeted and specific therapies in precision oncology.

Therapeutic failure in moderate and severe psoriasis patients in a health institution - a transversal study of prevalence and demographic determinants.

BACKGROUND: Psoriasis is a chronic disease that seriously impacts quality of life. There are known genetic and environmental factors that influence its onset and progression. Even though there is no cure for it, there are a variety of treatments available today to control its symptoms, although many of them fail to do so substantially. OBJECTIVE: To identify the association of multiple sociodemographic, clinical, and pharmacological factors with therapeutic failure. METHODS: Observational, descriptive, cross-sectional, retrospective, and analytical study of therapeutic failure in patients with moderate or severe psoriasis between 2020 and 2021 was performed. RESULTS: In total 1051 patients with moderate or severe psoriasis were evaluated. Gender (ORa: 0.579 CI 95%: 0.382-0.878), type of therapy (biologic or non-biologic; ORa: 1.939 CI 95%: 1.242-3.027), age (ORa: 1.018 CI 95%: 1.003-1.034), days of treatment (ORa: 1 CI 95%: 0.999-1) and DLQI (ORa: 1.212 CI 95%: 1.172-1.253) are significantly associated with therapeutic failure. CONCLUSION: Being male and receiving biologic therapy are associated with a higher incidence of therapeutic failure in the treatment of moderate or severe psoriasis. The increase in DLQI increase in the probability of failure, and mayor age or days of treatment decrease in the probability of failure.

More Evidence of the Link of Interleukin-6 and Interleukin-10 with Critical COVID-19: A Report in Mexican Patients.

BACKGROUND: According to the World Health Organization, Mexico presents one of the highest mortality rates due to coronavirus disease 2019 (COVID-19). The "cytokine storm" phenomenon has been proposed as a pathological hallmark of severe COVID-19. OBJECTIVE: To determine the association of serum cytokine levels with COVID-19 severity. METHODS: We studied the cytokines IL-2, IL-4, IL-6, IL-10, TNF-α, and the IFN-γ serum levels through flow cytometry in 56 COVID-19 patients (24 critical and 32 non-critical) from Northwest Mexico. RESULTS: We observed a significant increase in the IL-6 and the IL-10 levels in the sera of critical patients. These cytokines were also associated with mechanical ventilation necessity and death, IL-6 showing AUC values above 0.7 for both variables; and correlated with Na+, creatinine, and platelet levels. On the other hand, no association was found between IL-2, IL-4, TNF-α, and IFN-γ with tested variables. CONCLUSION: Our results corroborate previous observations regarding IL-6 and IL-10 involvement in the severity of COVID-19.

Factores maternos asociados al peso del recién nacido en una IPS de Medellín, Colombia, 2018 / Maternal Factors Associated with Newborn Weight in a IPS in Medellin, Colombia, 2018

Resumen Antecedentes: la variabilidad en el peso del recién nacido, ya sea como bajo peso o macrosomía, puede ocasionar morbimortalidad infantil y materna, además de ser un predictor del estado de salud a lo largo de la vida. Objetivo: determinar factores sociodemográficos, antecedentes patológicos, exposición a sustancias psicoactivas, actividad física y características alimentarias de la madre relacionados con el peso de recién nacidos en una IPS de Medellín, Colombia, en 2018. Materiales y métodos: estudio de cohorte con información de madres seguidas hasta el nacimiento de los bebés. Resultados: la edad promedio de las madres fue de 24±6 años, el peso promedio del recién nacido fue de 3150 g. Embarazo previo, consumo de lácteos y derivados, consumo de proteínas y de suplementos dietarios fueron factores presentes en madres de recién nacidos con mayor peso. Haber fumado alguna vez en la vida, antecedente de preeclampsia, parto previo, aborto en el último embarazo y consumo de alimentos ultraprocesados se presentaron en madres de recién nacidos con menor peso. Conclusiones: se recomienda a las gestantes limitar el consumo de alimentos ultraprocesados, supervisar el consumo de lácteos y derivados, proteínas y suplementos dietarios en madres con embarazos previos, antecedente de preeclampsia, abortos o hábitos como haber fumado.

Abstract Background: The variability in newborn birthweight, whether low birth weight or macrosomia, can contribute to maternal and infant morbidity and mortality as well as be a predictor of lifelong health. Objective: Determine socio-demographic factors, pathologic history, exposure to psychoactive substances, physical activity levels, and maternal diet as related to birth weight in newborns an in IPS in Medellin, Colombia 2018. Materials and Methods: Cohort study using maternal information obtained from following a sample of mothers of newborns until their infant's birth. Results: Average age of the mothers was 24±6 years and average newborn birthweight was 3150g. Previous pregnancies, consumption of dairy products, intake of protein, and use of dietary supplements were factors present in mothers of newborns with higher birthweight. Having ever smoked, history of preeclampsia, previous delivery, abortion in previous pregnancy, and intake of ultra-high processed foods (UHPF) were factors found among mothers whose infants had lower birthweight. Conclusions: It is recommended that pregnant women limit intake of highly processed foods, supervise their intake of dairy products, protein and dietary supplements in women who have had previous pregnancies, history of preeclampsia, abortions, or who have ever smoked.

Incidencia y determinantes demográficos de la leucemia linfoide aguda en pacientes con cáncer pediátrico, Antioquia / Incidence and demographic determinants of lymphocytic leukemia in pediatric patients with cancer, Antioquia

Introducción: En el mundo las leucemias agudas son los tumores más frecuentes en la edad pediátrica, de gran interés por sus implicaciones en el niño y su familia. Objetivo: Identificar la incidencia de leucemia linfoide aguda y su asociación con determinantes demográficos en pacientes con cáncer pediátrico, Antioquia, 2017. Materiales y métodos: Estudio observacional, descriptivo, transversal, retrospectivo con intención analítica, sobre la incidencia de leucemia linfoide aguda (LLA) y su asociación con determinantes demográficos no causales de pacientes con cáncer infantil, en 190 registros del Sistema de Vigilancia en Salud Pública (SIVIGILA). Resultados: Las tasas de incidencia de cáncer infantil y LLA fueron 10 casos y 4 casos por cada 100.000 habitantes ≤18 años respectivamente. Las variables asociadas a LLA son: ser hombre (RPa: 1,02 IC95%: 0,52 - 2,02), residencia rural (RPa: 1,59 IC95%: 0,55 - 4,56), afiliación al régimen subsidiado (RPa: 1,41 IC95%: 0,68 - 2,92), edad ≥ 9 años (RPa: 0,76 IC95%: 0,38 - 1,50) y oportunidad diagnóstica confirmatoria ≥ 16 días (RPa: 0,34 IC95%: 0,10 - 1,15). Conclusiones: Ser hombre, vivir en zona rural y estar afiliado al régimen subsidiado, está relacionado con la incidencia de leucemia linfoide aguda.

Introduction: Acute leukemias are the most frequent pediatric malignancies worldwide that have led to a great interest due to their implications for children and their families. Objective: To identify the incidence of acute lymphocytic leukemia and its association with demographic determinants in pediatric cancer patients from Antioquia (Colombia) in 2017. Materials and methods: An observational, descriptive, cross-sectional, retrospective study was carried out with an analytical approach to identify the incidence of acute lymphocytic leukemia (ALL) and its association with non-causal demographic determinants in patients with pediatric cancer. 190 records from the Public Health Surveillance System (SIVIGILA) were analyzed. Results: The incidence rates of childhood cancer and ALL were 10 and 4 cases per 100,000 inhabitants ≤18 years of age, respectively. The variables associated with ALL are: being male (APR: 1.02 95% CI: 0.52 - 2.02); living in rural areas (APR: 1.59 95% CI: 0.55 - 4.56); being affiliated to the subsidized regime (APR: 1.41 95% CI: 0.68 - 2.92); being ≥ 9 years of age (APR: 0.76 95% CI: 0.38 - 1.50); and having a confirmatory diagnosis after 16 days (APR: 0.34 95% CI: 0.10 - 1.15). Conclusions: The variables related to acute lymphocytic leukemia are: being a man; living in rural areas; and being affiliated to the subsidized regime.

Use of the CUSUM and Shewhart control chart methods to identify changes of public health significance using childhood blood lead surveillance data.

BACKGROUND: Local, state, and national childhood blood lead surveillance is based on healthcare providers and clinical laboratories reporting test results to public health departments. Increased interest in detecting blood lead level (BLL) patterns and changes of potential public health significance in a timely manner has highlighted the need for surveillance systems to rapidly detect and investigate these events. OBJECTIVE: Decrease the time to detect changes in surveillance patterns by using an alerting algorithm developed and assessed through historical child blood lead surveillance data analysis. METHODS: We applied geographic and temporal data-aggregation strategies on childhood blood lead surveillance data and developed a novel alerting algorithm. The alerting algorithm employed a modified cumulative summary/Shewhart algorithm, initially applied on 113 months of data from two jurisdictions with a known increase in the proportion of children <6 years of age with BLLs =>5 µg/dl. RESULTS: Alert signals retrospectively identified time periods in two jurisdictions where a known change in the proportion of children <6 years of age with BLLs >=5 µg/dl occurred. Additionally, we identified alert signals among six of the 18 (33%) randomly selected counties assessed where no previously known or suspected pattern changes existed. CONCLUSION: The modified cumulative summary/Shewhart algorithm provides a framework for enhanced blood lead surveillance by identifying changes in the proportion of children with BLLs >=5 µg/dl. The algorithm has the potential to alert public health officials to changes requiring further important public health investigation.

Cell Survival Is Regulated via SOX9/BCL2L1 Axis in HCT-116 Colorectal Cancer Cell Line.

Colorectal cancer (CRC) is one of the most frequent types of malignancies and one of the major causes of cancer-related death worldwide. Sex-determining region Y (SRY)-box 9 protein (SOX9) is a member of the SOX family of transcription factors which are involved in the regulation of differentiation and development. Recently, several reports suggest an important role of SOX9 in tumorigenesis since its overexpression correlates with tumor progression and poor outcome in several types of cancer; however, its role in CRC is not clear until now. Therefore, in this work, we searched for novel SOX9-regulated genes involved in cell survival of CRC. We silenced SOX9 in the poorly differentiated HCT-116 cell line, using a specific siRNA, to identify differential expressed genes by DNA microarrays and analyzed the role or candidate genes in apoptosis and autophagy. Transcriptome analysis showed that diverse cellular pathways, associated with CRC carcinogenesis such as Wnt/ß-catenin, MAPK, TGF-ß, and mTOR, were modulated after SOX9 silencing. Interestingly, we found that SOX9 silencing promotes downregulation of BCL2L1 and overexpression of CASP3, proteins related to apoptosis, which was further confirmed in SW-480, a moderated-differentiated cell line, but not in HT-29, well-differentiated cell line. Moreover, inhibition of BCL2L1 by ABT-737 (BH3 mimetic) in SOX9-silenced HCT-116 cells resulted in an increased apoptosis percentage. However, downregulation of BCL2L1 was not enough to induce autophagy. This is the first report, suggesting that cell survival in poorly and moderated-differentiated CRC cells lines is regulated by SOX9/BCL2L1 axis, but not in well-differentiated cell lines.

Sperm physiology varies according to ultradian and infradian rhythms.

The spermatozoon must be physiologically prepared to fertilize the egg, process called capacitation. Human sperm samples are heterogeneous in their ability to capacitate themselves, which leads to variability between samples from the same or different donors, and even along the seasons. Here we studied sperm variation in the capacitation state according to the ability of capacitated spermatozoa to acrosome react upon stimulation (% ARi) and to be recruited by chemotaxis (% Chex). Both indirect indicators of sperm capacitation increased along the incubation time with fluctuations. Those capacitated sperm recruited by chemotaxis showed an ultradian rhythm with a cycle every 2 h, which might be influenced by unknown intrinsic sperm factors. Two infradian rhythms of 12 months for the % ARi and of 6 months for % Chex were observed, which are associated with the joint action of temperature and photoperiod. Thus, to avoid false negative results, human sperm samples are recommended to be incubated for a long period (e.g. 18 h) preferably in spring time. This innovative point of view would lead to better comprehend human reproductive biology and to think experimental designs in the light of sperm cyclicity or to improve sperm aptitude for clinical purposes.

Exposición a Bisfenol A (BPA) en mujeres embarazadas y su relación con la obesidad en sus hijos: Revisión Sistemática / Pregnant Women's Exposure to Bisphenol A (BPA) and its Relation to their Children's Obesity: A systematic Review / Exposição ao bisfenol a (BPA) em mulheres engravidadas e a sua relação com a obesidade em seus filhos: uma revisão sistemática

Resumen Introducción: El bisfenol A (BPA) es un contaminante químico no persistente que altera el funcionamiento normal del sistema endocrino. Se sugiere que la exposición prenatal a BPA se asocia con la obesidad en la descendencia. Objetivo: Revisar la literatura sobre la exposición al BPA en mujeres embarazadas y su relación con la obesidad en sus hijos. Metodología: Revisión sistemática de acuerdo a la guía PRISMA, donde se realizaron búsquedas en las bases de datos Pubmed, ScienceDirect, Clinical Key, Medline, Ebsco y Scielo y el motor de búsqueda Google Scholar hasta 30 de abril de 2017 por dos investigadores independientes que utilizaron iguales términos de búsqueda. Se incluyeron estudios prospectivos de cohorte realizados que midieron el BPA en la orina materna. Resultados: Se incluyeron 5 estudios con tamaños de muestra que varían entre 297 y 757 binomios madre e hijo, se encontró asociación positiva entre la exposición prenatal a BPA con la circunferencia de cintura en niños de cuatro años β: 0.28 (IC95%:0.01 a 0.57) y el índice de masa grasa β: 0.31 (IC95%: 0.01 a 0.60) en dos de los estudios. Además, se observaron asociaciones positivas y/o negativas no significativas con índice de masa corporal y su puntaje Z, porcentaje de grasa, sobrepeso/obesidad, peso y talla al nacer, porcentaje de masa grasa. Conclusión: Los resultados del cuerpo existente de estudios epidemiológicos de cohorte, limita las afirmaciones sobre un vínculo causal entre la exposición prenatal BPA y la obesidad postnatal.

Abstract Introduction: Bisphenol A (BPA) is a non-persistent chemical pollutant which alters the normal functioning of the endocrine system. It is suggested that prenatal exposure is related to descendant obesity. Objective: Review literature on pregnant women's exposure to BPA and the relation to their children's obesity. Methodology: Systematic review in accordance with PRISMA guidelines. Searches were conducted on databases including Pubmed, ScienceDirect, Clinical Key, Medline, Ebsco and Scielo and Google Scholar search engine until April 30, 2017 by two independent researchers that used the same search terms. Prospective cohort conducted studies were included because they measured BPA in maternal urine. Results: Five studies were included with sample sizes ranging from 297 to 757 mother-child binomials. The review found a positive association between prenatal BPA exposure with 4-year-old children's waist circumference β: 0.28 (95% CI :0.01 to 0.57) and the fat mass index β: 0.31 (95%CI: 0.01 to 0.60) in two of the studies. non-significant positive and/or negative associations where observed with body mass index z-scores, overweight/ obesity, weight and size at birth, body mass percentage. Conclusion: The results of cohort epidemiological studies constrain statements regarding a causal link between prenatal BPA exposure and postnatal obesity.

Resumo Introdução: O bisfenol A (BPA) é um contaminante químico não persistente que altera o funcionamento normal do sistema endócrino. Se sugere que a exposição pré-natal se associa com a obesidade na descendência. Objetivo: Revisar a literatura sobre a exposição ao BPA em mulheres engravidadas e a sua relação com a obesidade em seus filhos. Metodologia: Revisão sistemática de acordo com a guia PRISMA. Se realizaram pesquisas nas bases de dados Pubmed, ScienceDirect, Clinical Key, Medline, Ebsco e Scielo e o motor de pesquisa Google Scholar até o 30 de Abril de 2017 por dois investigadores independentes que utilizaram os mesmos termos de busca. Se incluíram estudos prospectivos de coorte realizados que calcularam o BPA na urina materna. Resultados: Se incluíram 5 estudos com tamanhos de amostra entre 297 e 757 binômios mãe e filho, se encontrou associação positiva entre a exposição pré-natal a BPA com a circunferência de cintura em meninos de quatro anos β: 0.28 (IC95%:0.01 a 0.57) e o índice de massa de gordura β: 0.31 (IC95%: 0.01 a 0.60) em dois dos estudos. Se enxergaram associações positivas e/ou negativas não significativas com índice de massa corporal e a sua pontuação Z, porcentagem de gordura, sobrepeso/obesidade, peso e dimensão ao nascer, porcentagem de massa de gordura. Conclusão: Os resultados de estudos epidemiológicos de coorte, limita as afirmações sobre um vínculo causal entre a exposição pré-natal BPA e a obesidade pós-natal.

Efecto de las isoflavonas de la soja en la salud ósea de adultos y niños / The effects of soybean isoflavones over the bone health of adult and children

Las isoflavonas de la soja son metabolitos secundarios conocidos como fitoestrógenos por su similitud estructural con el 17b-estradiol. La daidzeina y la genisteina son las principales isoflavonas de la soja. Debido a su capacidad de unión a los receptores de estrógeno (RE) >son consideradas moduladores selectivos de los receptores de estrógenos (MSRE). El consumo dietario de isoflavonas es relacionado con la disminución de los síntomas de la menopausia, prevención de enfermedades cardiovasculares y de otras enfermedades crónicas como la diabetes mellitus. Las isoflavonas han sido propuestas también para el tratamiento de algunos tipos de cáncer y la prevención de la osteoporosis; sin embargo, existe gran controversia sobre los posibles efectos estrogénicos en niños púberes y prepúberes alimentados con fórmulas a base de proteína de soja. El objetivo de este trabajo es presentar una revisión sistemática de la química de las isoflavonas de la soja y sus efectos sobre la salud del hueso en adultos y niños.

The soy isoflavones are secondary metabolites known as phytoestrogens because of its structural similarity to 17b-estradiol. Genistein and Daidzein are the main soy isoflavones. Due their binding ability to estrogen receptors (ER) they are considered as selective estrogen receptor modulators (SERM). The dietary intake of isoflavones has been associated with decreasing menopause symptoms, prevention of cardiovascular disease and some chronic diseases such as diabetes mellitus. Also, the isoflavones have been proposed for the treatment of certain kind of cancer and osteoporosis prevention, but there is a lot of controversy about the possible estrogenic effects in pubertal and prepubertal children who have been fed with soy protein-based formulas. The aim of this research is to present a systematic review of the soy isoflavone chemistry and their effects on bone health in adults and children.

[Social, demographic, family and economic factors related to adolescent pregnancy in the urban area of Briceño, 2012]. / Factores sociales, demográficos, familiares y económicos relacionados con el embarazo en adolescentes,área urbana, Briceño, 2012.

OBJECTIVE: To establish the relationship between the social, demographic, economic and family with pregnancy in adolescents 13 to 19 years in urban areas in the municipality of Briceño, 2012, for the purpose of obtaining information for the formulation of public health policies sexual and reproductive health. Methods: Cross sectional study, conducted in the urban area of Antioquia Briceño, between April and May 2012. A survey was conducted to gather information on factors: social, demographic, economic and family. Implemented a logistic regression model. RESULTS: The adolescents who were 193 survey respondents. Factors associated by multivariate analysis with increased risk of teenage pregnancy were age (OR: 8.33 CI, 1.82 to 38.14), socioeconomic status (OR: 12.52 CI, 1.58 to 98, 91), occupation (OR: 7.60 CI 3.0 to 19.27), living with a partner (OR: 17.47 CI, 3.63 to 83.94), early initiation of sex (OR: 1.95 CI, 0.69 to 5.5), the number of sexual partners (OR: 1.70 CI, 0.74 to 3.86), the father's education level (OR: 3.05 CI 1.01 to 9.22), the fact of having been raped (OR: 3.66 CI, 1.12 to 11.96) and family income (OR: 3.98 CI, 1,45-10, 92). CONCLUSIONS: The study found that age, socioeconomic status, occupation, living with the couple, early initiation of sexual intercourse, number of sexual partners, the educational level of the father, having been raped and the family income were associated with teenage pregnancy in the urban area of Briceño.

Factores sociales, demográficos, familiares y económicos relacionados con el embarazo en adolescentes,área urbana, Briceño, 2012 / Social, demographic, family and economic factors related to adolescent pregnancy in the urban area of Briceño, 2012

Objetivo Establecer la relación entre los factores sociales, demográficos, familiares y económicos con el embarazo en adolescentes de 13 a 19 años delárea urbana en el municipio de Briceño, 2012, con el propósito de obtener información para la formulación de políticas públicas en salud sexual y reproductiva. Métodos Estudio Cross sectional, realizado en elárea urbana del municipio de Briceño, Antioquia, entre Abril y Mayo de 2012. Se aplicó una encuesta dirigida a buscar información sobre factores: sociales, demográficos, familiares y económicos. Se implementó un modelo de regresión logística. Resultados Las adolescentes que respondieron las encuestas fueron 193. Los factores asociados mediante el análisis multivariado con mayor riesgo de embarazo adolescente Fueron: la edad (OR: 8,33 IC; 1,82-38,14), el estrato socioeconómico (OR: 12,52 IC; 1,58-98,91), la ocupación (OR: 7,60 IC: 3,0-19,27), la convivencia con la pareja (OR: 17,47 IC; 3,63-83,94), el inicio temprano de las relaciones sexuales (OR: 1,95 IC; 0,69-5,5), el número de compañeros sexuales (OR: 1,70 IC; 0,74-3,86), el nivel de escolaridad del padre (OR: 3,05 IC: 1,01-9,22), el hecho de haber sido violada (OR: 3,66 IC; 1,12-11,96) y los ingresos económicos familiares (OR: 3,98 IC; 1,45-10,92). Conclusiones El estudio encontró que la edad, el estrato socioeconómico, la ocupación, la convivencia con la pareja, el inicio temprano de las relaciones sexuales, el número de compañeros sexuales, el nivel de escolaridad del padre, haber sido violada y los ingresos económicos familiares estaban asociados con el embarazo en adolescentes en elárea urbana del municipio de Briceño.

Objective To establish the relationship between the social, demographic, economic and family with pregnancy in adolescents 13 to 19 years in urban areas in the municipality of Briceño, 2012, for the purpose of obtaining information for the formulation of public health policies sexual and reproductive health. Methods Cross sectional study, conducted in the urban area of Antioquia Briceño, between April and May 2012. A survey was conducted to gather information on factors: social, demographic, economic and family. Implemented a logistic regression model. Results The adolescents who were 193 survey respondents. Factors associated by multivariate analysis with increased risk of teenage pregnancy were age (OR: 8.33 CI, 1.82 to 38.14), socioeconomic status (OR: 12.52 CI, 1.58 to 98, 91), occupation (OR: 7.60 CI 3.0 to 19.27), living with a partner (OR: 17.47 CI, 3.63 to 83.94), early initiation of sex (OR: 1.95 CI, 0.69 to 5.5), the number of sexual partners (OR: 1.70 CI, 0.74 to 3.86), the father's education level (OR: 3.05 CI 1.01 to 9.22), the fact of having been raped (OR: 3.66 CI, 1.12 to 11.96) and family income (OR: 3.98 CI, 1,45-10, 92). Conclusions The study found that age, socioeconomic status, occupation, living with the couple, early initiation of sexual intercourse, number of sexual partners, the educational level of the father, having been raped and the family income were associated with teenage pregnancy in the urban area of Briceño.

Compresión carotídea manual externa: una opción de tratamiento para la fístula carótido-cavernosa / External manual carotid compression: an option of ztreatmentfor carotid-cavernous fistula

Las fistulas durales arteriovenosas intracraneales pueden ocurrir en cualquier parte dentro de la duramadre. Los pacientes pueden estar clínicamente asintomáticos o experimentar desde leves síntomas hasta hemorragias catastróficas, según la localización y el patrón de drenaje de la fístula. En la fístula del seno cavernoso, hay ramas durales de las arterias carótida interna o externa que se comunican con el seno cavernoso. La compresión manual externa de la carótida es una técnica no invasiva para el tratamiento de esta clase de fístula. Algunos pacientes con fístula arteriovenosa del seno cavernoso pueden presentar resolución completa mediante esta opción terapéutica.

Impact of surgeon selection on access placement and survival following preoperative mapping in the "Fistula First" era.

According to the "Fistula First Initiative" surgeon selection should be based on best outcomes, willingness, and ability to provide access services. This analysis presents arteriovenous access placement and outcomes in 75 patients when surgery was performed by one of two dedicated high-volume vascular access surgeons (community [surgeon I] and academic medical center [surgeon II]). Preoperative vascular mapping was performed in all the patients. Demographic characteristics were similar except that patients referred to surgeon I (n = 40) were older (52.7 +/- 16.2 years vs. 45.4 +/- 13.7 years; p = 0.04) and tended to have more previously failed accesses (50% vs. 29%; p = 0.06) and black race (65% vs. 43%; p = 0.055) including a history of previously failed accesses (50% for surgeon I and 29% for surgeon II; p = 0.06). Similarly, there was no significant difference in the size of forearm ([surgeon I: 2.0 +/- 1.0 mm], [surgeon II: 1.9 +/- 0.8 mm]; p = 0.45) or upper arm veins (cephalic vein: surgeon I = 3.2 +/- 1.4 mm, surgeon II = 2.9 +/- 1.2 mm, p = 0.34; basilic vein: surgeon I = 5.0 +/- 1.2 mm, surgeon II = 4.7 +/- 1.3 mm, p = 0.25). Fistulae placement occurred in 98% vs. 71% (p = 0.001) for surgeon I and II, respectively. Characteristics predictive of fistula placement over an arteriovenous graft were surgeon selection (odds ratio [OR] = 19.52; p = 0.01) and no history of diabetes (OR = 7.61; p = 0.016). Kaplan-Meier analysis revealed 6 and 12 months overall access survival rates of 82%, 58% and 82% and 47% for surgeon I and II, respectively (p = 0.007). This analysis demonstrates that surgeon selection can have a significant impact on the rate of fistula placement and its overall survival despite similar findings on preoperative vascular mapping.

Accuracy of physical examination in the detection of arteriovenous graft stenosis.

Physical examination has recently been demonstrated to detect vascular access stenosis in patients with arteriovenous fistulae. However, its accuracy in the identification of stenoses when compared with the gold standard (angiography) in patients with arteriovenous grafts has not been studied in a systematic fashion. We conducted a prospective study to examine the accuracy of physical examination in the detection of stenotic lesions when compared with angiography. Forty-three consecutive cases referred for an arteriovenous graft dysfunction were included in this analysis. Preprocedure physical examination was performed. The findings of the examination and diagnosis were recorded and secured in a sealed envelope. Angiography from the feeding artery to the right atrium was performed. The images were reviewed by an independent interventionalist with expertise in endovascular dialysis access procedures and the diagnosis was rendered. The reviewer was blinded to the physical examination. Cohen's Kappa was used as a measurement of the level of agreement beyond chance between the diagnosis made by physical examination and angiography. There was a strong agreement between the physical examination and the angiography in the diagnosis of vein-graft anastomotic stenosis (kappa = 0.52). The sensitivity and specificity for this lesion was 57% and 89%, respectively. There was a moderate agreement beyond chance regarding the diagnosis of intragraft (kappa = 0.43) and inflow stenoses (kappa = 0.40). The sensitivity and specificity for the intragraft and inflow stenosis was 100%, 73% and 33%, 73%; respectively. The findings of this study demonstrate that physical examination can assist in the detection and localization of stenoses in arteriovenous grafts.