Elevation of Pulmonary Artery Pressure in Newborns from High-Altitude Pregnancies Complicated by Preeclampsia.

We hypothesized that fetal exposure to the oxidative stress induced by the combined challenge of preeclampsia (PE) and high altitude would induce a significant impairment in the development of pulmonary circulation. We conducted a prospective study in La Paz (Bolivia, mean altitude 3625 m) in which newborns from singleton pregnancies with and without PE were compared (PE group n = 69, control n = 70). We conducted an echocardiographic study in these infants at the median age of two days. The percentage of cesarean deliveries and small for gestational age (SGA) infants was significantly higher in the PE group. Heart rate, respiratory rate, and oxygen saturation did not vary significantly between groups. Estimated pulmonary arterial pressure and pulmonary vascular resistance were 30% higher in newborns exposed to PE and high altitude compared with those exposed only to high altitude. We also detected signs of right ventricular hypertrophy in infants subjected to both exposures. In conclusion, this study provides evidence that the combination of PE and pregnancy at high altitude induces subclinical alterations in the pulmonary circulation of the newborn. Follow-up of this cohort may provide us with valuable information on the potential increased susceptibility to developing pulmonary hypertension or other pulmonary and cardiovascular disorders.

Variation of intraocular pressure comparing rebound (TONOVET Plus®) and applanation (TONO-PEN VET®) tonometry in New Zealand rabbits treated with Amlodipine® / Variación de la presión intraocular comparando la tonometría de rebote (TONOVET Plus®) y aplanación (TONO-PEN VET®) en conejos de Nueva Zelanda tratados con Amlodipino® / Variação da pressão intraocular comparando a tonometria de rebote (TONOVET Plus®) e de aplanação (TONO-PEN VET®) em coelhos da Nova Zelândia tratados com Amlodipina®

Abstract Rabbits have played an important role in ophthalmological research processes, however in the environment there has been a deficiency of sensitive equipment in measurement of intraocular pressure for this species. To compare intraocular pressure (IOP) measured with rebound (TONOVET Plus®) and applanation (TONO-PEN VET®) tonometry in healthy New Zealand rabbits treated with Amlodipine. Twelve healthy male New Zealand white rabbits, 5 months old; two groups with 6 individuals were used in this study. The experimental group was given Amlodipine® at a dose of 5 mg/kg, once a day for a month. Blood pressure and intraocular pressure were measurement before treatment and 6 h after treatment in a period of one month. A trend is noted where the group of animals treated with amlodipine® presents lower values than the control group, both in systolic and diastolic pressure. The systolic pressure of the control group showed an average of 116.5 ± 7.9 mmHg and 117.4 ± 8.9 mmHg and the treatment group showed an average of 113.6 ± 7.9 mmHg and 111.8 ± 10.0 mmHg (pretreatment and posttreatment respectively). Tonometry: the values obtained using the TONOVET Plus® (19 ± 3 mmHg) are on average higher than the values obtained using the TONO-PEN VET® (17 ± 3 mmHg). It was possible to demonstrate the relationship between systemic blood pressure and intraocular pressure in New Zealand white rabbits. Rebound tonometry showed less variability in results than applanation tonometry. This study confirmed that both tonometers are reliable for measuring IOP in rabbits.

Resumen Los conejos han jugado un papel importante en los procesos de investigación oftalmológica, sin embargo, en el medio ha existido una deficiencia de equipos sensibles en la medición de la presión intraocular para esta especie. Para comparar la presión intraocular (PIO) medida con la tonometría de rebote (TONOVET Plus®) y aplanación (TONO-PEN VET®) en conejos Nueva Zelanda sanos y tratados con Amlodipino, fueron usados doce conejos Nueva Zelanda, machos, sanos, de 5 meses de edad y distribuidos en dos grupos con 6 individuos cada uno. El grupo experimental recibió Amlodipino® en una dosis de 5 mg/kg, una vez al día durante un mes. La presión arterial y la presión intraocular se midieron antes del tratamiento y 6 h después del tratamiento en un período de un mes. Se observa una tendencia donde el grupo de animales tratados con amlodipino® presenta valores más bajos que el grupo control, tanto en presión sistólica como diastólica. La presión sistólica del grupo control mostró un promedio de 116,5 ± 7,9 mmHg y 117,4 ± 8,9 mmHg y el grupo de tratamiento mostró un promedio de 113,6 ± 7,9 mmHg y 111,8 ± 10,0 mmHg (pretratamiento y postratamiento respectivamente). Tonometría: los valores obtenidos con el TONOVET Plus® (19 ± 3 mmHg) son en promedio superiores a los valores obtenidos con el TONO-PEN VET® (17 ± 3 mmHg). Fue posible demostrar la relación entre la presión arterial sistémica y la presión intraocular en conejos blancos Nueva Zelanda. La tonometría de rebote mostró menos variabilidad en los resultados que la tonometría de aplanamiento. Este estudio confirmó que ambos tonómetros son confiables para medir la PIO en conejos.

Resumo Os coelhos têm desempenhado um papel importante nos processos de pesquisa oftalmológica, porém no meio tem havido uma deficiência de equipamentos sensíveis na medida da pressão intraocular para esta espécie. Comparar a pressão intraocular (PIO) medida com tonometria de rebote (TONOVET Plus®) e de aplanação (TONO-PEN VET®) em coelhos saudáveis da Nova Zelândia tratados com Amlodipina®. Foram utilizados neste estudo doze coelhos brancos da Nova Zelândia, machos saudáveis, 5 meses de idade; distribuído em dois grupos com 6 indivíduos cada um. O grupo experimental recebeu Amlodipina® na dose de 5 mg / kg, uma vez ao dia durante um mês. A pressão arterial e a pressão intraocular foram medidas antes do tratamento e 6 horas após o tratamento em um período de um mês. Nota-se uma tendência onde o grupo de animais tratados com amlodipina® apresenta valores inferiores ao grupo controle, tanto na pressão sistólica quanto na diastólica. A pressão sistólica do grupo controle apresentou média de 116,5 ± 7,9 mmHg e 117,4 ± 8,9 mmHg e o grupo tratamento apresentou média de 113,6 ± 7,9 mmHg e 111,8 ± 10,0 mmHg (pré-tratamento e pós-tratamento, respectivamente). Tonometria: os valores obtidos com o TONOVET Plus® (19 ± 3 mmHg) são em média superiores aos valores obtidos com o TONO-PEN VET® (17 ± 3 mmHg). Foi possível demonstrar a relação entre a pressão arterial sistêmica e a pressão intraocular em coelhos brancos da Nova Zelândia. A tonometria de rebote mostrou menos variabilidade nos resultados do que a tonometria de aplanação. Este estudo confirmou que ambos os tonômetros são confiáveis para medir a PIO em coelhos.

Diffuse Reflectance Parameters of Treated Leishmaniasis Cutaneous Ulcers and Association with Histopathologies in an Animal Model: A Proof of Concept.

Cutaneous leishmaniasis (CL) is a parasitic disease that produces chronic skin ulcers. Although it has a worldwide presence, it is a neglected disease that still requires novel tools for its management. In order to study the use of optical tools in CL, this article presents a preliminary study of the correlation between CL histopathological and optical parameters. Optical parameters correspond to absorption and scattering coefficients obtained from diffuse reflectance spectra of treated CL in golden hamsters. Independently, histopathological data were collected from the same hamsters. As a result, after Spearman correlation and the Kruskal-Wallis test, inverse correlation was found between absorption/scattering optical parameters and inflammatory histopathological values, such as the scattering parameter related to the diameter of fibroblasts with the histopathological parameters of fibrosis, polymorphonuclear neutrophils, lymphocytes, plasmocytes, hyperplasia, and Leishmania, and the absorption parameter oxygen saturation showed a relation with the granulation tissue histopathological parameter. These correlations agree with the expected behavior of tissue composition during the healing process in CL. The results correspond to a proof of concept that shows that optical diffuse reflectance-based tools and methods could be considered as an alternative to assist in CL diagnosis and treatment follow-up.

Estimation of Biological Parameters of Cutaneous Ulcers Caused by Leishmaniasis in an Animal Model Using Diffuse Reflectance Spectroscopy.

Cutaneous leishmaniasis (CL) is a neglected tropical disease that requires novel tools for its understanding, diagnosis, and treatment follow-up. In the cases of other cutaneous pathologies, such as cancer or cutaneous ulcers due to diabetes, optical diffuse reflectance-based tools and methods are widely used for the investigation of those illnesses. These types of tools and methods offer the possibility to develop portable diagnosis and treatment follow-up systems. In this article, we propose the use of a three-layer diffuse reflectance model for the study of the formation of cutaneous ulcers caused by CL. The proposed model together with an inverse-modeling procedure were used in the evaluation of diffuse-reflectance spectral signatures acquired from cutaneous ulcers formed in the dorsal area of 21 golden hamsters inoculated with Leishmanisis braziliensis. As result, the quantification of the model's variables related to the main biological parameters of skin were obtained, such as: diameter and volumetric fraction of keratinocytes, collagen; volumetric fraction of hemoglobin, and oxygen saturation. Those parameters show statistically significant differences among the different stages of the CL ulcer formation. We found that these differences are coherent with histopathological manifestations reported in the literature for the main phases of CL formation.

Exploring the use of nonmedical sources of prescription drugs among immigrant Latinos in the rural Southeastern USA.

BACKGROUND: Little is known about access to medicine among immigrant Latinos in the United States (US). This study explored access to, and use of, prescription drugs obtained from nonmedical sources among recently arrived, Spanish-speaking immigrant Latinos in rural North Carolina (NC). METHODS: Our community-based participatory research partnership collected, analyzed, and interpreted data from individual in-depth interviews with Latino community members and rural health service providers. A purposive sample of 30 community members, including traditional healers, religious leaders, transgender Latinos, heterosexual Latino men and women, and Latino gay men, were interviewed to gain emic ("insider") perspectives on use of nonmedical sources of prescription drugs. Six local Latino health service providers also were interviewed to gain etic ("outsider") perspectives on use. RESULTS: Participants described the roles of tiendas (grocers), family, and social networks in accessing treatment advice and prescription drugs. They described health care expectations among immigrants and contingencies for accessing prescription drugs in the US. Prescription medicines (eg, antibiotics, hormones, Viagra, analgesics), injection equipment (eg, syringes), and medical advice were identified as readily available from nonmedical sources. CONCLUSIONS: Increased access to formalized health care and effective health education initiatives are needed to meet the challenges facing immigrant Latinos.

Latino men who have sex with men and HIV in the rural south-eastern USA: findings from ethnographic in-depth interviews.

A community-based participatory research partnership explored HIV risk and potentially effective intervention characteristics to reduce exposure and transmission among immigrant Latino men who have sex with men living in the rural south-eastern USA. Twenty-one participants enrolled and completed a total of 62 ethnographic in-depth interviews. Mean age was 31 (range 18-48) years and English-language proficiency was limited; 18 participants were from Mexico. Four participants reported having sex with men and women during the past three months; two participants self-identified as male-to-female transgender. Qualitative themes that emerged included a lack of accurate information about HIV and prevention; the influence of social-political contexts to sexual risk; and barriers to healthcare services. We also identified eight characteristics of potentially effective interventions for HIV prevention. Our findings suggest that socio-political contexts must be additional targets of change to reduce and eliminate HIV health disparities experienced by immigrant Latino men who have sex with men.

Outcomes from a community-based, participatory lay health adviser HIV/STD prevention intervention for recently arrived immigrant Latino men in rural North Carolina.

Latinos in the United States are at increased risk for HIV and sexually transmitted disease (STD) infection. We evaluated the efficacy of a pilot lay health adviser (LHA) intervention designed to increase condom use and HIV testing among Latino men. Fifteen LHAs (mean age = 35.6; range 23-60 years) from 15 Latino soccer teams were trained and worked with their teammates for 18 months. Another 15 teams served as the control group. Data were collected at baseline and at 18 months post-LHA training from a random sample of teammates from intervention and control teams. Data were collected from 222 men (mean age = 29 years) who participated in one of the 30 teams. Relative to the control condition, participants in the intervention reported more consistent condom use in the 30 days preceding follow-up (unadjusted analysis, intervention, 65.6% vs. control, 41.3%; p < .001). Participants in the intervention were more likely to report condom use (adjusted odds ratio [AOR] = 2.3; confidence interval [CI = 1.2-4.3) and HIV testing (AOR = 2.5; CI = 1.5-4.3). LHA interventions for Latino men that are developed in partnership with community members, rely on male-centered intrapersonal networks, and are culturally congruent can enhance preventive behaviors and may reduce HIV infection.

What do men who serve as lay health advisers really do?: Immigrant Latino men share their experiences as Navegantes to prevent HIV.

HoMBReS was a lay health adviser (LHA) intervention designed to reduce sexual risk among recently arrived, nonEnglish-speaking Latino men who were members of a multicounty soccer league in central NC. Our community-based participatory research (CBPR) partnership collected, analyzed, and interpreted qualitative life-story narratives to characterize the roles of male LHAs known as Navegantes. Nine Navegantes were interviewed. Their mean age was 39 years (range: 26-62 years); six were from Mexico and three from El Salvador. Navegantes described the function and facilitators of serving as LHAs and identified leverage points for future HIV and STD prevention strategies. They highlighted psychosocial and sociocultural influences on HIV risk, settings for risky behavior, and personal changes from serving as Navegantes. This study provides preliminary evidence that an LHA approach is feasible and appropriate for Latino men, and can be effective in reaching men who might otherwise be difficult to reach.

Correlates of dietary intake among men involved in the MAN for Health study.

The clustering of diet and other lifestyle behaviors and their psychosocial correlates were examined among 455 Latino and African American men in the U.S. Southeast. Men were recruited by male community health workers and surveys were self-administered in a group format. Latino men were younger, less educated, and more likely to be employed than African American men and reported a lower household income and larger household size. Fruit and vegetable consumption was associated with physical activity (p < or = .001). A more positive attitude toward health was associated with meeting vegetable dietary guidelines (p < or = .05) and consuming fast food less frequently (p < or = .01). Active coping was associated with meeting fruit and vegetable dietary guidelines (p < or = .01 and p < or = .001, respectively), and avoidant coping was associated with greater fast-food consumption (p < or = .001). Latino fast-food consumption was associated with binge drinking (p < or = .001). This research provides evidence for tailoring dietary intervention for men of color.

Sexual and alcohol risk behaviours of immigrant Latino men in the South-eastern USA.

Little is known about the intersections of immigration, masculinity and sexual risk behaviours among recently arrived Latino men in the USA. Nine immigrant Latino men from three urban housing communities in the South-eastern USA used photovoice to identify and explore their lived experiences. From the participants' photographs and words, thirteen themes emerged within four domains. The immigration experience and sociocultural norms and expectations of masculinity were factors identified decreasing Latino men's sense of power and increasing stress, which lead to sexual risk. Latino community strengths and general community strengths were factors that participants identified as promoting health and preventing risk. These themes influenced the development of a conceptual model to explain risk among immigrant Latino men. This model requires further exploration and may prove useful in intervention development.

Characteristics of immigrant Latino men who utilize formal healthcare services: baseline findings from the HoMBReS study.

Despite the burgeoning immigrant Hispanic/Latino community in the southeastern United States, little is known about the utilization of healthcare services by this population. We sought to identify demographic, behavioral and psychosocial characteristics of immigrant Hispanic/Latino men who report utilizing formal healthcare services. Using an interviewer-administered assessment, data were collected from a random sample of members of a multicounty adult Latino men's soccer league in North Carolina. Of the 222 participants, the mean (+/-SD) age was 29.8 +/-8.3, with a range of 18-71 years. More than half of the sample reported Mexico as their country of origin and grade < or =8 as their highest level of education. The mean length of time living in the United States was 8.8 (+/- 7.6) years. An increased likelihood of reporting having ever utilized formal healthcare services associated with decreased perceived barriers to utilization, increased acculturation, increased adherence to traditional notions of masculinity and increased coping. Effective strategies to increase the utilization of formal healthcare services among Hispanic/Latino men may include diffusing information about the availability of services and how to access services and linking healthcare utilization with positive aspects of what it means to be a man.

The power and the promise: working with communities to analyze data, interpret findings, and get to outcomes.

Although the intent of community-based participatory research (CBPR) is to include community voices in all phases of a research initiative, community partners appear less frequently engaged in data analysis and interpretation than in other research phases. Using 4 brief case studies, each with a different data collection methodology, we provide examples of how community members participated in data analysis, interpretation, or both, thereby strengthening community capacity and providing unique insight. The roles and skills of the community and academic partners were different from but complementary to each other. We suggest that including community partners in data analysis and interpretation, while lengthening project time, enriches insights and findings and consequently should be a focus of the next generation of CBPR initiatives.

Condom use among heterosexual immigrant Latino men in the southeastern United States.

Latinos in the United States have been disproportionately affected by the intersecting epidemics of HIV and sexually transmitted diseases (STDs). We examined correlates of condom use among adult heterosexual Latino men who are members of a large multicounty soccer league in rural North Carolina. Of 222 participants, the mean (+/-SD) age was 29.8 (+/-8.3) years. Approximately 60% reported Mexico as their country of origin, 60% reported Grade 8 or below as their highest level of education, and 50% reported using condoms during their most recent vaginal intercourse episodes. Adjusting for relationship status, multivariable logistic regression identified four correlates of condom use: having sought health care information from family members (adjusted odds ratio [AOR]=3.68; 95% confidence interval [CI]=1.48-9.13); greater knowledge of HIV transmission and prevention (AOR = 2.61; CI = 1.23-5.54); greater condom use self-efficacy (AOR = 4.45; 95% CI = 2.12-9.36); and greater adherence to traditional masculine norms (AOR = 2.10; 95% CI = 1.02-4.33). Our findings underscore the need for innovative and targeted HIV and STD prevention programming among the emerging Latino community in the southeastern United States.

Exploring Latino men's HIV risk using community-based participatory research.

OBJECTIVES: To explore sociocultural determinants of HIV risk and identify potential intervention approaches among adult Latino men. METHODS: Using community-based participatory research for study design and implementation and data analysis, 7 focus groups were conducted with members of a soccer league in central North Carolina. RESULTS: Five themes emerged, including perceived barriers to accessing health care, the role of hegemonic masculinity in risk, and potentially effective intervention approaches to health promotion and disease prevention. CONCLUSIONS: Latino soccer leagues may provide an effective social network with which to partner to design, implement, and evaluate interventions to reduce sexual risk among Latino men, who have been inaccessible in conventional HIV/ STD prevention programs.

Using community-based participatory research to develop an intervention to reduce HIV and STD infections among Latino men.

Although the Latino community living in the United States has been disproportionately affected by the intersecting epidemics of HIV and sexually transmitted diseases (STDs), the development, implementation, and evaluation of HIV and STD prevention interventions designed to reduce infection among Latinos lags behind prevention efforts targeting other communities. HoMBReS: Hombres Manteniendo Bienestar y Relaciones Saludables is a sexual risk reduction intervention designed to reduce HIV and STD infection among recently arrived, non-English-speaking Latino men who are members of a multicounty Latino soccer league in central North Carolina, a region of the United States with both the fastest growing Latino population and disproportionate HIV and STD infection rates. HoMBReS was developed in partnership with the local Latino community using community-based participatory research (CBPR). We describe (a) the CBPR partnership history and further expansion; (b) the development of the intervention through the integration of collected formative data, theoretical considerations, and findings from the scientific literature; and (c) lessons learned while using a CBPR approach to develop HoMBReS.

Preventing HIV infection among young immigrant Latino men: results from focus groups using community-based participatory research.

Latinos in the United States have been disproportionately affected by the intersecting epidemics of HIV and sexually transmitted diseases (STDs). Using a community-based participatory research (CBPR) approach to problem identification and exploration, a total of 74 Latino men (mean age 22.3, range 18-37) residing in an urban city in northwest North Carolina participated in one of eight focus groups on sexual health. Among the findings of this study, >75% of participants reported Mexico as their country of origin; other participants reported being from Central and South American countries. Qualitative data analysis identified 13 themes, which were grouped into the following three domains: 1) psychosocial factors identified as influencing sexual risk health behaviors; 2) system-level barriers to sexual health; and 3) characteristics of potentially effective HIV prevention intervention approaches. The study findings suggest that community-based, male-centered interpersonal networks that provide individual and group education and skill-building and incorporate curanderos (Latino healers) and bilingual experts may be important elements of potentially effective intervention approaches to reach Latino men, who have been inaccessible to conventional HIV prevention programs.

Políticas de población y desarrollo municipal / Policies of population and municipal development

La ponencia llamó la atención sobre los siguientes aspectos: la UPPIA se halla elaborando una guía de políticas de población en el desarrollo municipal con la finalidad de que las variables demográficas se integren en los planes de desarrollo municipal, de modo que éstas contribuyan a obtener una mayor claridad y precisión sobre su situación presente y futura de su desarrollo, definan sus políticas de población específicas en el marco autónomo que les corresponde y éstas sean integradas transversalmente en el marco de la planificación participativa y de este modo se fortalezcan las capacidades y competencias locales para definir sus prioridades en el desarrollo local

Consideraciones reproductivas de la población boliviana / Reproductive considerations of the bolivian population

En el presente estudio se muestra el análisis realizado sobre la situación actual y una visión futura de la prevalencia anticonceptiva en Bolivia con sus contenidos de conocimiento y uso de métodos

Situación de la planificación familiar en Bolivia: Análisis Nacional

En Bolivia, existe una elevada proporción de mujeres que conocen métodos anticonceptivos, siendo este conocimiento más elevado en las ciudades que en el campo, y en la región de los Llanos que en los Valles y el Altiplano. Los métodos más conocidos son: DIU, píldora y esterilización femenina, pero en ningún caso el porcentaje de cada uno supera el 55%. La inyección presenta tambien un nivel de conocimiento importante. Sin embargo, el conocimiento del condón y diafragma es relativamente muy reducido y aún mucho más la esterilización masculina. Cuanto menor es el grado de instrucción de las mujeres, menor es el conocimiento que tienen sobre los métodos modernos de anticoncepción. Es así que entre las mujeres sin instrucción, apenas el 32% conoce algún método moderno. Por el contrario, las mujeres con una instrucción de nivel medio a mayor, más del 95% declara conocer alguno. Del 30% de mujeres unidas que declararon estar usando métodos anticonceptivos, sólo el 12% hace uso de métodos modernos y el 18% acude a practicas tradicionales. Entre las usuarias de contextos urbanos (39%), el 18% declararon el uso de métodos modernos, y entre las ususarias de contextos rurales (19%), apenas el 5% tiene acceso a los indicados métodos. No obstante, el problema estriba en la brecha entre la alta proporción de conocedoras (68%) y la muy baja proporción de usuarias de los métodos modernos (12%). Pese a ello, en las ciudades se presentan condiciones algo mejores que en los contextos rurales. Particularizando a las usuarias de métodos modernos (12%), el DIU y la Esterilización Femenina alcanza al 75% (39 y 36%, respectivamente). Tanto en las ciudades como en el campo, estos métodos son los de mayor uso, con porcentajes casi similares al anotado; sin embargo en el contexto rural la esterilización femenina asume dimensiones mayores que en las ciudades (41%) aunque en el marco de una reducida magnitud de usuarias del Altiplano y los Valles se distinguen por el uso del DIU, principalmente, y la esterilización femenina; y las de los Llanos por la esterilización femenina, principalmente, y luego la píldora. Respecto a las usuarias de métodos tradicionales, la gran mayoria practica la abstinencia periódica (90%); y las demás se distribuyen entre las que hacen uso de otros métodos del mismo tipo. Las mujeres con muy bajos niveles de instrucción acceden a la esterilización femenina con una mayor recurrencia. Por el contrario, el DIU es el método de mayor uso en las mujeres con un nivel medio o más. Según el número de hijos, la distribución del uso es como sigue: la píldora es el método más significativo en aquellas que no los tienen; el DIU entre las que tienen de 1 a 3 hijos; y la esterilización entre las que tienen más de 3 hijos. En relación a las fuentes de suministro de métodos anticonceptivos modernos, de manera general, las instituciones privadas son las principales proveedoras, seguida del Ministerio de Previsión Social y Salud Pública, las farmacias, Cajas de Seguro Social y, finalmente los Centros de Planificación Familiar.

Automatización y regulación PID con autómatas programables

Diseñar y construir un laboratorio donde se pueda experimentar con procesos de control y regulación industriales. Utilizando controladores lógicos programables y la regulación PID.