Virulence Genes of Helicobacter pylori Increase the Risk of Premalignant Gastric Lesions in a Colombian Population.

Background: Genetic variability of Helicobacter pylori is associated with various gastrointestinal diseases; however, little is known about interaction with sociodemographic in the development of premalignant lesions in Colombian patients. Methods: An analytical study was conducted including cases (patients with gastric atrophy, intestinal metaplasia, and gastric dysplasia) and controls (patients with nonatrophic gastritis). Sociodemographic information was obtained using a questionnaire. Histopathological diagnosis was performed according to the Sydney System. The cagA and vacA genotypes were established using polymerase chain reaction in paraffin blocks. The effect of each variable on the study outcome (premalignant lesion) is presented as odds ratio (OR) and 95% CI. A p value of <0.05 was considered as statistically significant. Results: The vacA/s1m1 genotype increases the risk of developing premalignant lesions of the stomach (OR: 3.05, 95% IC: 1.57-5.91, p=0.001). Age and educational level showed a positive interaction with the s1m1 genotype (adjusted OR: 3.68, 95% CI: 1.73-7.82, p=0.001). The cagA genotype was not correlated to the development of premalignant lesions of the stomach (OR: 1.32, 95% CI: 0.90-1.94, p=0.151). Conclusions: The vacA genotype, age, and educational level are indicators of the risk of developing premalignant lesions of the stomach in the study population. Significance Statement. Genetic variability of H. pylori and sociodemographic information could be used to predict the risk of premalignant lesions in stomach in Colombian population.

Evolutionary Traits and Genomic Surveillance of SARS-CoV-2 in South America.

Since the zoonotic event from which SARS-CoV-2 started infecting humans late in 2019, the virus has caused more than 5 million deaths and has infected over 500 million people around the world. The pandemic has had a severe impact on social and economic activities, with greater repercussions in low-income countries. South America, with almost 5% of the world's population, has reckoned with almost a fifth of the total people infected and more than 26% (>1/4) of the deceased. Fortunately, the full genome structure and sequence of SARS-CoV-2 have been rapidly obtained and studied thanks to all the scientific efforts and data sharing around the world. Such molecular analysis of SARS-CoV-2 dynamics showed that rates of mutation, similar to other members of the Coronaviridae family, along with natural selection forces, could result in the emergence of new variants; few of them might be of high consequence. However, this is a serious threat to controlling the pandemic and, of course, enduring the process of returning to normalization with the implicit monetary cost of such a contingency. The lack of updated knowledge in South America justifies the need to develop a structured genomic surveillance program of current and emerging SARS-CoV-2 variants. The modeling of the molecular events and microevolution of the virus will contribute to making better decisions on public health management of the pandemic and developing accurate treatments and more efficient vaccines.

Prevalence and risk factors associated with peripheral arterial disease in an adult population from Colombia / Prevalencia y factores de riesgo asociados a la enfermedad arterial periférica en una población adulta de Colombia

Abstract Background: Cardiovascular diseases (CVD) are the most important cause of mortality in Latin America, while peripheral arterial disease (PAD) is the third leading cause of atherosclerotic cardiovascular morbidity. Objective: To establish the prevalence of PAD and the distribution of traditional CVD risk factors in a population from the Department of Cauca, Colombia. Methods: A cross-sectional study was conducted on a total of 10,000 subjects aged ≥40 years, from 36 municipalities. An ankle-brachial index (ABI) ≤ 0.9 in either leg was used as diagnostic criterion of PAD. Results: Overall PAD prevalence was 4.4% (4.7% females vs. 4.0% males), with diabetes being the most prevalent risk factor (23%). Among individuals self-reporting a history of acute myocardial infarction or stroke, PAD prevalence was 31.0% and 8.1%, respectively. After adjusting for potential confounders, PAD was significantly associated with hypertension (OR 4.6; 95% CI; 3.42-6.20), diabetes (4.3; 3.17-5.75), dyslipidaemia (3.1; 2.50-3.88), obesity (1.8; 1.37-2.30), and cigarette smoking (1.6; 1.26-1.94). Analysis for the interaction of risk factors showed that diabetes, dyslipidaemia, and obesity accounted for 13.2 times the risk for PAD (6.9-25.4), and when adding hypertension to the model, the risk effect was the highest (17.2; 8.4-35.1). Conclusions: Hypertension, diabetes, dyslipidaemia, and obesity, but not smoking were strong predictors of PAD. ABI measurement should be routinely performed as a screening test in intermediate and high-risk patients for CVD prevention. This could lead to an early intervention and follow-up on populations at risk, thus, contributing to improve strategies for reducing CVD burden. © 2017 Published by Masson Doyma México S.A. on behalf of Instituto Nacional de Cardiología Ignacio Chávez. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).

Resumen Antecedentes: Las enfermedades cardiovasculares (ECV) son la causa más importante de mortalidad en América Latina, mientras que la enfermedad arterial periférica (EAP) es la tercera causa de morbilidad cardiovascular aterosclerótica. Objetivos: Establecer la prevalencia de la EAP y la distribución de factores de riesgo tradicionales para ECV en una población del departamento del Cauca, Colombia. Métodos: Se realizó un estudio de corte transversal en un total de 10,000 sujetos ≥ 40 años de 36 municipios. Un índice tobillo-brazo ≤ 0.9 en cualquiera de las piernas fue utilizado como criterio de diagnóstico para EAP. Resultados: La prevalencia de EAP fue del 4.4% (4.7% en mujeres vs. 4% en hombres), siendo la diabetes el factor de riesgo más prevalente (23%). Entre los individuos con autorreporte de infarto agudo de miocardio y accidente cerebrovascular, la prevalencia de EAP fue del 31% y 8,1%, respectivamente. Después del ajuste por potenciales factores de confusión, la EAP estuvo asociada significativamente con hipertensión (OR: 4.6; IC 95%: 3.42-6.20), diabetes (4.3; 3.17-5.75), dislipidemia (3.1; 2.50-3.88), obesidad (1.8; 1.37-2.30) y consumo de cigarrillo (1.6; 1.26-1.94). El análisis de interacción entre los factores de riesgo mostró que diabetes, dislipidemia y obesidad presentaron 13.2 veces más riesgo para EAP (6.9-25.4), y cuando se agregó hipertensión al modelo, el riesgo fue el más alto (17.2; 8.4-35.1). Conclusiones: La medición del índice tobillo-brazo debe realizarse de forma rutinaria en pacientes con riesgo intermedio/alto como prueba de cribado para la prevención de ECV, permitiendo la intervención temprana y el seguimiento de las poblaciones en situación de riesgo. © 2017 Publicado por Masson Doyma México S.A. en nombre de Instituto Nacional de Cardiología Ignacio Chávez. Este es un artículo Open Access bajo la licencia CC BY-NC-ND (http:// creativecommons.org/licenses/by-nc-nd/4.0/).

Prevalence and risk factors associated with peripheral arterial disease in an adult population from Colombia.

BACKGROUND: Cardiovascular diseases (CVD) are the most important cause of mortality in Latin America, while peripheral arterial disease (PAD) is the third leading cause of atherosclerotic cardiovascular morbidity. OBJECTIVE: To establish the prevalence of PAD and the distribution of traditional CVD risk factors in a population from the Department of Cauca, Colombia. METHODS: A cross-sectional study was conducted on a total of 10,000 subjects aged ≥40 years, from 36 municipalities. An ankle-brachial index (ABI) ≤ 0.9 in either leg was used as diagnostic criterion of PAD. RESULTS: Overall PAD prevalence was 4.4% (4.7% females vs. 4.0% males), with diabetes being the most prevalent risk factor (23%). Among individuals self-reporting a history of acute myocardial infarction or stroke, PAD prevalence was 31.0% and 8.1%, respectively. After adjusting for potential confounders, PAD was significantly associated with hypertension (OR 4.6; 95% CI; 3.42-6.20), diabetes (4.3; 3.17-5.75), dyslipidaemia (3.1; 2.50-3.88), obesity (1.8; 1.37-2.30), and cigarette smoking (1.6; 1.26-1.94). Analysis for the interaction of risk factors showed that diabetes, dyslipidaemia, and obesity accounted for 13.2 times the risk for PAD (6.9-25.4), and when adding hypertension to the model, the risk effect was the highest (17.2; 8.4-35.1). CONCLUSIONS: Hypertension, diabetes, dyslipidaemia, and obesity, but not smoking were strong predictors of PAD. ABI measurement should be routinely performed as a screening test in intermediate and high-risk patients for CVD prevention. This could lead to an early intervention and follow-up on populations at risk, thus, contributing to improve strategies for reducing CVD burden.

Frecuencia de mutaciones de la nitrorreductasa RdxA de Helicobacter pylori para la activación del metronidazol en una población del departamento del Cauca, Colombia / Frequency of Helicobacter pylori nitroreductase RdxA mutations for metronidazole activation in a population in the Cauca Department, Colombia

RESUMEN Introducción. La resistencia al metronidazol es un factor clave relacionado con el fracaso del tratamiento contra la infección por Helicobacter pylori asociada, principalmente, con mutaciones en la nitrorreductasa RdxA. A pesar de su importancia, los estudios sobre esta proteína son aún incipientes en Popayán, Colombia. Objetivo. Evaluar la frecuencia de las mutaciones en la nitrorreductasa RdxA en una población de pacientes con enfermedad gastrointestinal por H. pylori. Materiales y métodos. El ADN de 170 biopsias gástricas se amplificó mediante reacción en cadena de la polimerasa (PCR) para detectar las mutaciones en la nitrorreductasa RdxA. Se analizaron las secuencias traducidas a aminoácidos y se compararon con la cepa de referencia 26695. Resultados. La frecuencia de mutaciones de la nitrorreductasa RdxA en la población de estudio fue de 78 %. Su distribución más frecuente se detectó en las posiciones D59N (en 153 muestras), R131K (en 101 muestras), R90K (en 97 muestras), A118T (en 42 muestras), I160F (en 32 muestras), H97T (en 26 muestras) y en los codones de parada Q50*; D59*; E75*; C159* y I160* en cinco, una, tres, diez y seis muestras, respectivamente. El genotipo de virulencia más frecuente fue el vacAs1/m1 negativo para cagA (48,6 %). Conclusiones. La gran frecuencia de mutaciones en la nitrorreductasa RdxA en aislamientos de H. pylori en Popayán sugiere que los tratamientos empíricos con metronidazol no serían una opción válida para su erradicación en pacientes de la población estudiada.

ABSTRACT Introduction: Resistance to metronidazole is a key factor associated with Helicobacter pylori treatment failure. Even though resistance is mostly associated with RdxA nitroreductase mutations, studies of this H. pylori protein in Popayán (Colombia) are still incipient. Objective: To evaluate the frequency of mutations in the RdxA nitroreductase in a population of patients with H. pylori-positive gastrointestinal disease. Materials and methods: We amplified the DNA of 170 gastric biopsies by PCR to detect mutations in the RdxA nitroreductase. An analysis of DNA sequences translated into amino acid sequences was done and then compared to the reference strain 26695. Results: The frequency of RdxA nitroreductase mutations in this study population was 78%. Its most frequent distribution was found in positions D59N (153 samples), R131K (101 samples), R90K (97 samples), A118T (42 samples), I160F (32 samples) and H97T (26 samples), and meaningful stop codons Q50*, D59*; E75*, C159* and I160* in five, one, three, ten and six samples, respectively. The most common virulence genotype was vacAs1/m1 cagA negative (48.6 %). Conclusions: The high frequency of RdxA nitroreductase mutations in H. pylori isolates in Popayán (Colombia) indicates that empirical therapy with metronidazole may not be a valid option for the eradication of H. pylori in patients of the studied population.

Open Dataset for the Automatic Recognition of Sedentary Behaviors.

BACKGROUND: Sedentarism is associated with the development of noncommunicable diseases (NCD) such as cardiovascular diseases (CVD), type 2 diabetes, and cancer. Therefore, the identification of specific sedentary behaviors (TV viewing, sitting at work, driving, relaxing, etc.) is especially relevant for planning personalized prevention programs. OBJECTIVE: To build and evaluate a public a dataset for the automatic recognition (classification) of sedentary behaviors. RESULTS: The dataset included data from 30 subjects, who performed 23 sedentary behaviors while wearing a commercial wearable on the wrist, a smartphone on the hip and another in the thigh. Bluetooth Low Energy (BLE) beacons were used in order to improve the automatic classification of different sedentary behaviors. The study also compared six well know data mining classification techniques in order to identify the more precise method of solving the classification problem of the 23 defined behaviors. CONCLUSIONS: A better classification accuracy was obtained using the Random Forest algorithm and when data were collected from the phone on the hip. Furthermore, the use of beacons as a reference for obtaining the symbolic location of the individual improved the precision of the classification.

Development of a metabolic syndrome personal health record system.

According to the International Diabetes Federation (IDF), a quarter of the world population is affected with metabolic syndrome (MS). The paper describes the development process of a Personal Health Record System (PHR) for the management of MS. Following the recommendations of ISO 9241-210:2010, a PHR for the promotion of physical activity and healthy nutrition was implemented.

Prevalencia y factores de riesgo asociados a alteraciones comunicativas en vendedores ambulantes de Popayán, Colombia / Communicative disorder prevalence and associated risk factors regarding informal workers in Popayan, Colombia

Objetivo Determinar la prevalencia de alteraciones en la audición, función respiratoria y vocal y su asociación con ciertos factores de riesgo en vendedores ambulantes de la ciudad de Popayán, Colombia. Métodos Estudio descriptivo de corte transversal en 186 vendedores ambulantes. Después de la firma del consentimiento informado, se aplicó una encuesta para obtener datos sobre variables sociodemográficas y comunicativas. Posteriormente, los trabajadores fueron evaluados mediante la aplicación de pruebas de audiometría tonal, funcionalidad respiratoria y perfil vocal de Wilson. El análisis estadístico se realizó en SPSS v. 19.0. Resultados Ser mayor de 30 años (OR 5,84; IC95 % 2,85-12,00), poseer nivel educativo (2,81; 1,22-6,44) y estrato socioeconómico bajos (4,54; 1,89-10,91), y el tiempo de trabajo prolongado (2,64; 1,27-5,06) estuvieron asociados a alteraciones en la función auditiva. Alteraciones en la función respiratoria estuvieron asociadas a ser mujer (1,83; 1,00-3,34) y tiempo de trabajo prolongado (2,04; 1,11-3,74). Para la función vocal, ser mayor de 30 años (3,36; IC 1,33-3,51) y el nivel educativo bajo (3,67; 1,05-12,76) fueron factores de riesgo. Los antecedentes comunicativos relacionados con alteraciones auditivas, respiratorias y de la voz fueron dolor de oído, hipertrofia de amígdalas, trauma, reflujo gastroesofágico, tos frecuente, emociones fuertes y gritar. Conclusiones Se evidencia que las alteraciones en el sistema comunicativo en los vendedores ambulantes está asociada con ciertos factores de riesgo sociodemográficos y comunicativos. Esta información constituye una línea de base para mejorar las estrategias de promoción de la salud y prevención de la enfermedad en esta población.(AU)

Objective Determining the prevalence of alterations in informal workers’ audition, respiratory and vocal functions and their association with certain risk factors in Popayan, Colombia. Methods This was a descriptive, cross-sectional study of 186 informal workers (i.e. people selling things in the street). After signing an informed consent form, an interview was held to obtain data regarding sociodemographic and communicative variables. The workers were then evaluated using tests for tone audiometry, respiratory function and Wilson's voice profile. SPSS (v.19.0) was used for statistical analysis. Results Being older than 30 years of age (OR 5.84: 2.85-12.00 95%CI), having a poor educational level (2.81: 1.22-6.44 95%CI) and low socioeconomic status (4.54:1.89-10.91 95%CI) and prolonged working hours (2.64: 1.27-5.06 95%CI) were associated with auditive function disorders. Respiratory function disorders were associated with being female (1.83; 1.00-3.34 95%CI) and having prolonged working hours (2.04: 1.11-3.74 95%CI). Regarding vocal function, being over 30 years-old (3.36: 1.33-3.51 95%CI) and having a low educational level (3.67; 1.05-12.76 95%CI) were risk factors. Communicative factors related to auditive, respiratory and voice disorder were ear pain, hypertrophic tonsils, trauma, gastro-esophageal reflux, frequent cough, strong emotions and screaming. Conclusions It is evident that alterations in informal workers’ communicative system are associated with certain sociodemographic and communicative risk factors. This information provides a baseline for improving healthcare promotion and disease prevention strategies aimed at this population.(AU)

Design and implementation of a personal health record system for diabetes mellitus type 2 monitoring.

The objective of this paper is to describe the design and implementation of a Personal Health Record System (PHR-S) for supporting monitoring of blood glucose in diabetes mellitus type 2 patients. The paper describes a survey applied in order to elicit the specific ICT needs of Diabetes Mellitus Type 2 patients. Based on the requirements, a web application "GlucoseDataManager" was implanted and integrated into a local deployed IndivoHealth PHR-S platform.

[Communicative disorder prevalence and associated risk factors regarding informal workers in Popayan, Colombia]. / Prevalencia y factores de riesgo asociados a alteraciones comunicativas en vendedores ambulantes de Popayán, Colombia.

OBJECTIVE: Determining the prevalence of alterations in informal workers’ audition, respiratory and vocal functions and their association with certain risk factors in Popayan, Colombia. METHODS: This was a descriptive, cross-sectional study of 186 informal workers (i.e. people selling things in the street). After signing an informed consent form, an interview was held to obtain data regarding sociodemographic and communicative variables. The workers were then evaluated using tests for tone audiometry, respiratory function and Wilson's voice profile. SPSS (v.19.0) was used for statistical analysis. RESULTS: Being older than 30 years of age (OR 5.84: 2.85-12.00 95%CI), having a poor educational level (2.81: 1.22-6.44 95%CI) and low socioeconomic status (4.54:1.89-10.91 95%CI) and prolonged working hours (2.64: 1.27-5.06 95%CI) were associated with auditive function disorders. Respiratory function disorders were associated with being female (1.83; 1.00-3.34 95%CI) and having prolonged working hours (2.04: 1.11-3.74 95%CI). Regarding vocal function, being over 30 years-old (3.36: 1.33-3.51 95%CI) and having a low educational level (3.67; 1.05-12.76 95%CI) were risk factors. Communicative factors related to auditive, respiratory and voice disorder were ear pain, hypertrophic tonsils, trauma, gastro-esophageal reflux, frequent cough, strong emotions and screaming. CONCLUSIONS: It is evident that alterations in informal workers'’ communicative system are associated with certain sociodemographic and communicative risk factors. This information provides a baseline for improving healthcare promotion and disease prevention strategies aimed at this population.

[The prevalence of abnormal cytology and inflammation and their association with risk factors for uterine cervical neoplasms in Cauca, Colombia]. / Prevalencia de citología anormal e inflamación y su asociación con factores de riesgo para neoplasias del cuello uterino en el Cauca, Colombia.

OBJECTIVES: Establishing the prevalence of abnormal and inflammation cytology reports and its association with risks factors for uterine cervical neoplasms amongst females from the Cauca department in Colombia. METHODOLOGY: After signing a consent-form, females were interviewed using a questionnaire to collect socio-demographic and clinical data, including reproductive history, sexual activity, cytology history and smoking habits. Cytology was then taken for analysis and classification according to the 2001 Bethesda System. A total of 1,735 females were recruited for the study. RESULTS: According to the cytology report, 1061 women had normal cytology (61 %), 36 abnormal cytology (2 %) and 638 reactive cellular changes associated with inflammation (37 %). The results indicated that having sexual intercourse at an early age, multiparity, using hormonal contraceptives and not having annual cytology screening were associated with abnormal cytology reports. CONCLUSIONS: These results provided valuable information for public health institutions for developing better screening programmes to prevent risks of uterine cervical neoplasms amongst females from our region and throughout Colombia.

Mayor frecuencia de aberraciones cromosómicas en linfocitos expuestos o no a mitomicina C, de mujeres posmenopáusicas obesas en comparación con mujeres no obesas del departamento del Cauca, Colombia / High frequency of chromosome aberrations observed in lymphocytes in postmenopausal obese women

Introducción. Los estudios epidemiológicos indican que la obesidad está asociada en el 25 al 30 % con varios tipos de cáncer. Objetivo. Evaluar la frecuencia de aberraciones cromosómicas en linfocitos de mujeres posmenopáusicas obesas y no obesas, mediante la prueba de reto celular (challenge assay) como biomarcador de inestabilidad genómica. Materiales y métodos. Cuarenta mujeres posmenopáusicas fueron incluidas en el estudio (20 obesas y 20 no obesas). Los grupos fueron pareados según edad (± 5 años) y procedencia. Después de la firma voluntaria del consentimiento informado, las mujeres fueron entrevistadas y se les tomó una muestra de 5 ml de sangre periférica. Se establecieron cultivos de linfocitos con tratamiento con mitomicina C y sin él (prueba de reto celular) y, posteriormente, se registró la frecuencia de aberraciones cromosómicas para cada grupo y tratamiento. Resultados. En general, las mujeres obesas presentaron una mayor frecuencia de aberraciones cromosómicas en comparación con las no obesas. Después de exponer los cultivos celulares a mitomicina C, las mujeres obesas presentaron un incremento en el número de aberraciones cromosómicas totales en comparación con las no obesas (3,74±0,63 Vs. 2,70±0,61; p=0,001). Conclusiones. La mayor frecuencia de aberraciones cromosómicas en los linfocitos de mujeres posmenopáusicas obesas que en no obesas, sugiere diferencias en la capacidad de reparación del ADN, lo cual podría explicar la asociación entre la inestabilidad genómica y la mayor incidencia de cáncer en esta población.

Introduction. Epidemiological studies indicate that obesity is associated with an increased risk of 20-25% with several types of cancer. Objective. The frequency of chromosome aberrations was evaluated in lymphocytes from postmenopausal obese and non-obese women. Materials and methods. Twenty obese and 20 non-obese women, all post-menopause, were recruited. The groups were matched according to age (± 5 years) and place of origin. After signing the consent form, women were interviewed using a structured questionnaire, and a blood sample (5 ml) was drawn into vacutainer tubes. From each sample, lymphocyte cell cultures were established with and without mitomycin C (challenge assay). Afterwards, the frequency of chromosome aberrations were recorded for each group and treatment. Data were analyzed using the statistical program SPSS, v. 14.0. Results. Obese women had a higher frequency of chromosome aberrations when compared with non-obese women. After exposing the cell cultures to mitomycin C, obese women presented an increase in the number of total chromosome aberrations in comparison to non-obese women (3.7± 0.6 vs. 2.70±0.6; p=0.001). Conclusions. The higher frequency of chromosome aberrations in lymphocytes from postmenopausal obese women compared to non-obese women suggested differences in the DNA repair capacity. This may indicate an association between genomic instability and the higher incidence of cancer in this population.

[High frequency of chromosome aberrations observed in lymphocytes in postmenopausal obese women]. / Mayor frecuencia de aberraciones cromosómicas en linfocitos expuestos o no a mitomicina C, de mujeres posmenopáusicas obesas en comparación con mujeres no obesas del departamento del Cauca, Colombia.

INTRODUCTION: Epidemiological studies indicate that obesity is associated with an increased risk of 20-25% with several types of cancer. OBJECTIVE: The frequency of chromosome aberrations was evaluated in lymphocytes from postmenopausal obese and non-obese women. MATERIALS AND METHODS: Twenty obese and 20 non-obese women, all post-menopause, were recruited. The groups were matched according to age (± 5 years) and place of origin. After signing the consent form, women were interviewed using a structured questionnaire, and a blood sample (5 ml) was drawn into vacutainer tubes. From each sample, lymphocyte cell cultures were established with and without mitomycin C (challenge assay). Afterwards, the frequency of chromosome aberrations were recorded for each group and treatment. Data were analyzed using the statistical program SPSS, v. 14.0. RESULTS: Obese women had a higher frequency of chromosome aberrations when compared with non-obese women. After exposing the cell cultures to mitomycin C, obese women presented an increase in the number of total chromosome aberrations in comparison to non-obese women (3.7± 0.6 vs. 2.70±0.6; p=0.001). CONCLUSIONS: The higher frequency of chromosome aberrations in lymphocytes from postmenopausal obese women compared to non-obese women suggested differences in the DNA repair capacity. This may indicate an association between genomic instability and the higher incidence of cancer in this population.

Prevalencia de citología anormal e inflamación y su asociación con factores de riesgo para neoplasias del cuello uterino en el Cauca, Colombia / The prevalence of abnormal cytology and inflammation and their association with risk factors for uterine cervical neoplasms in Cauca, Colombia

Objetivos Establecer la prevalencia del resultado de citología anormal e inflamación y su asociación con factores de riesgo para neoplasias del cuello uterino en mujeres del departamento del Cauca, Colombia. Metodología Después de la Arma voluntaria del consentimiento informado, las mujeres fueron entrevistadas a través de un cuestionario para colectar variables de tipo sociodemográfico y clínico, incluyendo historia reproductiva, actividad sexual, historia de citología y hábito de fumar. Posteriormente, se procedió a la toma de la citología para su análisis y clasificación según el sistema Bethesda 2001. Un total de 1735 mujeres fueron reclutadas para este estudio. Resultados Acorde con el resultado de citología, 1061 mujeres presentaron citología normal (61 %), 36 citología anormal (2 %) y 638 cambios celulares reactivos asociados a inflamación (37 %). Los resultados indican que tener relaciones sexuales a temprana edad, la multiparidad, el uso de anticonceptivos hormonales y no realizarse la citología anualmente fueron factores de riesgo asociados a citología anormal. Conclusiones Estos resultados brindan información valiosa a las instituciones de salud pública para desarrollar mejores programas de cribado para la prevención de neoplasias del cuello uterino en mujeres de la región y el país.

Objectives Establishing the prevalence of abnormal and inflammation cytology reports and its association with risks factors for uterine cervical neoplasms amongst females from the Cauca department in Colombia. Methodology After signing a consent-form, females were interviewed using a questionnaire to collect socio-demographic and clinical data, including reproductive history, sexual activity, cytology history and smoking habits. Cytology was then taken for analysis and classification according to the 2001 Bethesda System. A total of 1,735 females were recruited for the study. Results According to the cytology report, 1061 women had normal cytology (61 %), 36 abnormal cytology (2 %) and 638 reactive cellular changes associated with inflammation (37 %). The results indicated that having sexual intercourse at an early age, multiparity, using hormonal contraceptives and not having annual cytology screening were associated with abnormal cytology reports. Conclusions These results provided valuable information for public health institutions for developing better screening programmes to prevent risks of uterine cervical neoplasms amongst females from our region and throughout Colombia.

Chromosome aberrations in peripheral blood lymphocytes of high-risk HPV-infected women with HGSIL.

Genomic instability is one of the main characteristics of malignant tumors, including HPV-induced cervical cancer. The aim of this study was to explore the use of assessing chromosome aberrations (CA) in peripheral blood lymphocytes as a biomarker for genomic instability in high-risk HPV-infected women with high-grade squamous intraepithelial lesions (HGSIL). A total of 120 women were recruited for this study, following cytology/colposcopy evaluation and HPV DNA detection. The study groups consisted of 30 HPV(+) women with histologically confirmed cervical intraepithelial neoplasia grade 2/3 and 30 HPV(+) women with carcinoma in situ (CIS). Two control groups, including 30 women HPV(-) and 30 women HPV(+), were recruited among women who were reported as cytology negative. Lymphocyte cell cultures were established for 52 hr, and 100 complete metaphase cells were evaluated per subject for CA analysis. The results show that women with CIS had significantly higher frequencies of both aneuploidy (0.67 +/- 0.20 vs. 0.14 +/- 0.08, P = 0.020) and tetraploidy (0.88 +/- 0.23 vs. 0.17 +/- 0.08, P = 0.013) in comparison with HPV(-) controls. These findings suggest the usefulness of peripheral blood lymphocytes to detect genomic instability associated with HPV-induced HGSIL.

[Cardiovascular disease risk factors in people working at a Colombian health institution]. / Factores de Riesgo para Enfermedad Cardiovascular en Trabajadores de una Institución Prestadora de Servicios de Salud, Colombia.

OBJECTIVE: Establishing the prevalence of recognised biological and behavioural cardiovascular disease (CVD) risk factors in a population of workers at a health institution in Popayán, Colombia. METHODS: An observational descriptive study was conducted, 96 employees being interviewed to obtain information regarding their socio-demographic characteristics, tobacco and alcohol consumption, physical activity, eating habits and personal and family history of CVD. Each worker's standardised glycaemia, serum lipids, arterial blood pressure and body mass index were measured. RESULTS: There was 12,5% behavioural risk factor prevalence for smoking, 58,3 % for alcohol consumption, 56,3 % physical inactivity during free time and 82,3 % atherogenic diet; biological risk factor prevalence was 11,5 % hypertension, 45,8 % being overweight, 1 % diabetes, 61,5 % dyslipidaemia and 58,3 % family history of CVD. It was also found that the risk of hypertension was significantly higher in males, in individuals >40 years, in people having >25 BMI and in smokers. Regarding dyslipidaemia, the risk was higher in males and in >40 year old individuals. The risk of being overweight and obese was significantly associated with smoking and alcohol consumption. CONCLUSION: Although this is an institution having an asymptomatic and relatively young population (25-55 years), action should be taken towards modifying lifestyles to reduce CVD risk in the affected population due to the high prevalence of biological and behavioural risk factors.

Factores de Riesgo para Enfermedad Cardiovascular en Trabajadores de una Institución Prestadora de Servicios de Salud, Colombia / Cardiovascular disease risk factors in people working at a Colombian health institution

Objetivo Establecer la prevalencia de reconocidos factores de riesgo biológico y comportamental para enfermedad cardiovascular (ECV) en una población de trabajadores de una Institución Prestadora de Servicios de Salud (IPS) de la ciudad de Popayán, Colombia. Métodos Se realizó un estudio observacional descriptivo, encuestando a 96 trabajadores para obtener información sobre características sociodemográficas, consumo de tabaco y alcohol, actividad física, hábitos alimentarios, y antecedentes personales y familiares para ECV. Además, a cada trabajador se le realizó medición estandarizada de glicemia, lípidos séricos, tensión arterial e índice de masa corporal. Resultados La prevalencia de factores de riesgo de tipo comportamental fue: tabaquismo 12,5 por ciento, consumo de bebidas alcohólicas 58,3 por ciento, inactividad física en el tiempo libre 56,3 por ciento, y dieta aterogénica 82,3 por ciento. La prevalencia para factores de riesgo de tipo biológico fue: hipertensión arterial (HTA) 11,5 por ciento, sobrepeso 45,8 por ciento, diabetes 1 por ciento, dislipidemia 61,5 por ciento, y antecedentes familiares de ECV 58,3 por ciento. Adicionalmente, se encontró que el riesgo de HTA fue significativamente mayor en hombres, en individuos >40 años, en personas con un IMC >25, y en fumadores. En cuanto a la dislipidemia, el riesgo fue mayor en hombres y en individuos >40 años. Por su parte, el riesgo de sobrepeso y obesidad se asoció significativamente con el tabaquismo y el consumo de alcohol. Conclusión En vista de la alta prevalencia de los factores de riesgo biológicos y ligados al comportamiento en la IPS de Popayán y aunque ésta es una institución de salud con una población asintomática y relativamente joven (25-55 años), se hace necesario tomar acciones encaminadas a modificar los estilos de vida para disminuir en forma importante el riesgo de ECV en la población afectada.

Objective Establishing the prevalence of recognised biological and behavioural cardiovascular disease (CVD) risk factors in a population of workers at a health institution in Popayán, Colombia. Methods An observational descriptive study was conducted, 96 employees being interviewed to obtain information regarding their socio-demographic characteristics, tobacco and alcohol consumption, physical activity, eating habits and personal and family history of CVD. Each worker's standardised glycaemia, serum lipids, arterial blood pressure and body mass index were measured. Results There was 12,5 percent behavioural risk factor prevalence for smoking, 58,3 percent for alcohol consumption, 56,3 percent physical inactivity during free time and 82,3 percent atherogenic diet; biological risk factor prevalence was 11,5 percent hypertension, 45,8 percent being overweight, 1 percent diabetes, 61,5 percent dyslipidaemia and 58,3 percent family history of CVD. It was also found that the risk of hypertension was significantly higher in males, in individuals >40 years, in people having >25 BMI and in smokers. Regarding dyslipidaemia, the risk was higher in males and in >40 year old individuals. The risk of being overweight and obese was significantly associated with smoking and alcohol consumption. Conclusion Although this is an institution having an asymptomatic and relatively young population (25-55 years), action should be taken towards modifying lifestyles to reduce CVD risk in the affected population due to the high prevalence of biological and behavioural risk factors.

Environmental risk factors for prevention and molecular intervention of cervical cancer.

Cervical cancer (CC) is potentially the most preventable and treatable cancer in human but it is a leading cause for cancer morbidity and mortality in women around the world. Therefore, more innovative prevention and treatment protocols need to be developed and implemented. With better understanding of the etiology of the disease, specific prevention protocols that involve life-style modifications to minimize the impact of environmental risk factors can be developed. It may be necessary to implement unique modification protocols for different countries. In addition, antiviral vaccine is a highly promising prevention approach. With respect to therapy, the development of more specific protocols that have fewer side effects is needed. With the availability of sophisticated molecular techniques, a new generation of targeted approach that has the potential to generate outstanding efficacy is being tested. Using the siRNA technology against the expression of human papillomavirus oncogenes, specific biological pathways that are essential to the growth and survival of the CC cells can be interrupted. Another promising approach is the molecular intervention of the estrogen pathway by blocking the expression of estrogen receptors. These molecular techniques may work by reactivating endogenous regulatory processes, e.g., the core apoptotic machinery, that can cause self-destruction of the CC cells, thus providing potentially effective molecular therapy. These topics are discussed in this review.

[Papillomavirus and factors associated with high-risk, cervical intraepithelial neoplasia in Cauca, Colombia]. / Papilomavirus y factores asociados a neoplasia intraepitelial cervical de alto grado en Cauca, Colombia.

OBJECTIVE: Evaluating the role of the main factors associated with high-risk cervical intraepithelial neoplasia in women from the Cauca Department in Colombia. METHODOLOGY: After signing a consent-form, women were interviewed to obtain socio-demographic and lifestyle data. A cervical biopsy was performed on each woman for histopathological diagnosis (cases) and a sample of exfoliated cells (cases and controls) to extract DNA for HPV detection by polymerase chain reaction. A total of 98 cases and 109 controls, matched by age and ethnicity, were recruited for the study. RESULTS: The study confirmed association between HPV and the risk of cervical neoplasia (OR = 19.0; 95% CI = 8.20-44.2). The data suggested that multiparity (OR = 4.1; 95% CI = 1.62-10.6) and exposure to carcinogens present in wood-smoke (OR = 7.3; 95% CI = 3.00-19.4) are important co-factors for cervical neoplasia given the presence of HPV. CONCLUSIONS: These results provide valuable information for public health institutions to develop better cervical neoplasia prevention programmes.

Exposure to wood smoke, HPV infection, and genetic susceptibility for cervical neoplasia among women in Colombia.

Cervical cancer is the second leading cause of death from cancer among women in Colombia (16/100,000). Infection with high-risk human papillomavirus (HPV) plays a major role in the etiology of high-grade squamous intraepithelial lesions (HSILs). Exposure to chemical agents may be a cofactor for tumor induction, and individual genetic differences in the metabolism of these chemical agents may affect the susceptibility of individuals towards the development of HSIL. In this case-control study, a total of 91 cases with HSIL and 92 healthy controls, frequency-matched by age and place of origin, were recruited, and their frequencies of CYP2E1, GSTM1, and GSTT1 polymorphism were determined. We then evaluated the association of these polymorphisms, by themselves and in combination with wood smoke exposure and HPV-infection status, with the risk of HSIL. The results indicate that GSTM1 and GSTT1 polymorphism were not associated with HSIL, although a small increase in risk was observed for individuals who were GSTT1 null (OR = 1.4, 95% CI = 0.57-3.44). Contrary to other investigations, the c2/c2 variant of the CYP2E1 gene was associated with a significant increase in risk after adjusting for wood smoke exposure (OR = 6.3, 95% CI = 1.10-36.38) or wood smoke exposure and HPV-infection status (OR = 10.7, 95% CI = 1.76-65.58). Wood smoke exposure also increased the risk of HSIL among CYP2E1 c2/c2 HPV-positive women (OR = 3.3, CI = 0.50-22.50); however, the increase did not achieve statistical significance. Our study provides tantalizing evidence that genetic differences in the metabolism of wood smoke carcinogens, particularly metabolism by CYP2E1, may confer susceptibility for HSIL development. Further investigations with larger populations will be needed to confirm this association, which may provide important information for improving cervical cancer prevention programs.