Embracing Complexity: Variation in Faculty's Attitudes Toward Inclusive Measures of Gender and Sexuality in Social and Health Sciences Research.

In the absence of adequate measurement efforts, expansive gender and sexual identities will remain underexplored in quantitative social science and health research. We use primary survey data (N = 309) to identify factors associated with U.S.based social and health science faculty's attitudes toward inclusive gender and sexuality measures in participant-based research. Results suggest that political science faculty rated expansive gender and sexuality measures as less important to their own research, relative to psychology, sociology, and health sciences faculty. In addition, cisgender/heterosexual women and LGBTQ+ identifying faculty rate and apply these measures more positively compared to faculy who identify as cisgender/heterosexual men. Finally, faculty engaging in predominantly quantitative research, or in teaching-focused positions, had lower ratings of the importance of gender expansive measurement. Results suggest that while individual characteristics shape faculty's attitudes toward and use of inclusive gender and sexuality measures, disciplinary and academic contexts also matter.

Orbital Atherectomy of the Iliofemoral Arteries Facilitates Large-Bore Access Prior to Transfemoral Transcatheter Aortic Valve Replacement.

OBJECTIVES: To describe the use of orbital atherectomy to prepare iliofemoral vessels for large-bore access prior to transcatheter aortic valve replacement (TAVR). BACKGROUND: Transfemoral (TF)-TAVR has been shown to be at least equivalent to surgery. Nevertheless, many patients do not qualify for the TF approach due to severe iliofemoral occlusive disease. The use of an atherectomy device in order to facilitate TF-TAVR has only been reported in case reports. METHODS: We performed 1000 TAVR procedures from June 2017 to October 2019. Patient demographics, procedural characteristics, computed tomography characteristics, and short-term outcomes were recorded. Hostile access was defined as luminal size <5 mm, or <5.5 mm along with the presence of >270° calcification. The primary endpoint was the ability to successfully deliver a transcatheter valve via the intended pretreated access site. RESULTS: During the study period, 6 subjects (0.6%) required alternative access and 68 patients (6.8%) were considered to have a hostile iliofemoral anatomy that required vessel preparation prior to TAVR. Forty-eight patients (70.6%) had angioplasty only and 20 patients (29.4%) required atherectomy and angioplasty. Out of 20 patients treated with atherectomy, successful TF delivery of the valve was achieved in 19 patients (95%). There was no in-hospital mortality or stroke. There were no perforations. One subject required placement of a self-expandable stent due to severe dissection. CONCLUSION: Orbital atherectomy used for vessel preparation is a safe and very effective technique to facilitate TF-TAVR in patients with hostile peripheral anatomy.

How Should Health Professions Schools Partner With AI/AN Communities?

Many health professions education institutions exist on land once inhabited by American Indians and Alaska Natives (AI/AN). Land acknowledgment by these academic organizations is helpful, but collaborative support of AI/AN health is also needed. Because tribal-university partnerships in education are fewer than in research but just as important, this article considers health professions schools' responsibilities to offer students clinical rotations on tribal lands and to recruit AI/AN students. Such investment expands student educational opportunity, diversifies clinical workforces, and helps tribes improve health infrastructure and sustainability. This article also offers an adaptable roadmap for building such partnerships.

Cancer cases detected in the prevention and control service of a private cancer clinic in Peru.

PURPOSE: Describe the characteristics of patients seen at the Cancer Prevention and Control Service at a Peruvian private cancer clinic in 2014. PATIENTS AND METHODS: This retrospective clinical study analyzed the prevalence of 10 cancers and characteristics of patients seen at a private cancer center located in Lima, Peru. The study sample included 7680 adults, and data were collected from de-identified medical records. RESULTS: The average age of the patients was 44.71 years and 98,82% of them had private insurance. The majority of patients were women (67.69%). Our gross incidence rate of cancer was 35.16 per 100,000 in the Cancer Prevention and Control Service in 2014. Only 0.35% had cancer, and most of those diagnosed with cancer (77.78%) were diagnosed in the early stages, stages I and II. The two most common cancers observed were breast and thyroid cancer. CONCLUSIONS: The high rates of early, rather than late-stage diagnoses at this clinic are dramatically different than national rates. This difference may be because we are analyzing data from a prevention service seeing mainly patients with private insurance as opposed to national data, which consists primarily of patients seen in oncologic services with national insurance.

Correction to: Cancer cases detected in the prevention and control service of a private cancer clinic in Peru.

[This corrects the article DOI: 10.1186/s13027-019-0259-0.].

Resistencia adquirida a inhibidores de tirosina kinasa de tercera generación en cáncer de pulmón de células no pequeñas / Resistance acquired to third generation tyrosine kinase inhibitors in non small cell lung cancer

La resistencia a inhibidores de tirosina kinasa (TKI) de tercera generación son un evento cada vez más frecuente en la práctica clínica, a pesar de ello, se desconoce aún los mecanismos exactos mediante los cuales las células tumorales desarrollan dicha resistencia permitiendo sus supervivencia. Se describe un caso de resistencia a osimertinib (AZD9291) en cáncer de pulmón de celulas no pequeñas, evidenciado por secuenciamiento genético (NGS) y su posible planteamiento terapéutico.

Resistance to third-generation tyrosine kinase inhibitors (TKI) is an increasingly frequent event in clinical practice; however, the exact mechanisms by which tumor cells develop such resistance allowing their survival are unknown. A case of resistance to osimertinib (AZD9291) in non small cell lung cancer, evidenced by next generation sequencing (NGS) and its possible therapeutic approach is described.

Missing the Mark? A Two Time Point Cohort Study Estimating Intestinal Parasite Prevalence in Informal Settlements in Lima, Peru.

Objectives: The World Health Organization's (WHO) recommendations list Peru as potentially needing prevention of soil-transmitted helminthiasis (STH). Prevalence of STH varies regionally and remains understudied in the newest informal settlements of the capital city, Lima. The purpose of this study was to evaluate the need for Mass Drug Administration (MDA) of antiparasitic drugs in the newest informal settlements of Lima. The aim of this study was to estimate the season-specific prevalence of STH to determine if these prevalence estimates met the WHO threshold for MDA in 3 informal settlements. Methods: A 2 time point cohort study was conducted among a sample of 140 children aged 1 to 10 years living in 3 purposively sampled informal settlements of Lima, Peru. Children were asked to provide 2 stool samples that were analyzed with the spontaneous sedimentation in tube technique. The season-specific prevalence proportions of MDA-targeted STH were estimated using a hidden (latent) Markov modeling approach to adjust for repeated measurements over the 2 seasons and the imperfect validity of the screening tests. Results: The prevalence of MDA targeted STH was low at 2.2% (95% confidence interval = 0.3% to 6%) and 3.8% (95% confidence interval = 0.7% to 9.3%) among children sampled in the summer and winter months, respectively, when using the most conservative estimate of test sensitivity. These estimates were below the WHO threshold for MDA (20%). Conclusions: Empiric treatment for STH by organizations active in the newest informal settlements is not supported by the data and could contribute to unnecessary medication exposures and poor allocation of resources.

Plasticizing Effects of Polyamines in Protein-Based Films.

Zeta potential and nanoparticle size were determined on film forming solutions of native and heat-denatured proteins of bitter vetch as a function of pH and of different concentrations of the polyamines spermidine and spermine, both in the absence and presence of the plasticizer glycerol. Our results showed that both polyamines decreased the negative zeta potential of all samples under pH 8.0 as a consequence of their ionic interaction with proteins. At the same time, they enhanced the dimension of nanoparticles under pH 8.0 as a result of macromolecular aggregations. By using native protein solutions, handleable films were obtained only from samples containing either a minimum of 33 mM glycerol or 4 mM spermidine, or both compounds together at lower glycerol concentrations. However, 2 mM spermidine was sufficient to obtain handleable film by using heat-treated samples without glycerol. Conversely, brittle materials were obtained by spermine alone, thus indicating that only spermidine was able to act as an ionic plasticizer. Lastly, both polyamines, mainly spermine, were found able to act as "glycerol-like" plasticizers at concentrations higher than 5 mM under experimental conditions at which their amino groups are undissociated. Our findings open new perspectives in obtaining protein-based films by using aliphatic polycations as components.

Polyamines as new cationic plasticizers for pectin-based edible films.

Zeta potential and particle size were determined on pectin aqueous solutions as a function of pH and the effects of calcium ions, putrescine and spermidine on pectin film forming solutions and derived films were studied. Ca(2+) and polyamines were found to differently influence pectin zeta potential as well as thickness and mechanical and barrier properties of pectin films prepared at pH 7.5 either in the presence or absence of the plasticizer glycerol. In particular, Ca(2+) was found to increase film tensile strength and elongation at break only in the presence of glycerol and did not affect film thickness and permeability to both water vapor and CO2. Conversely, increasing polyamine concentrations progressively reduced film tensile strength and markedly enhanced film thickness, elongation at break and permeability to water vapor and CO2, both in the presence and absence of glycerol. Our findings indicate that polyamines give rise to a structural organization of the heteropolysaccharide different from that determined by calcium ions, previously described as "egg box" model, and suggest their possible application as plasticizers to produce pectin-based "bioplastics" with different features.

t(14;18) Translocation: A predictive blood biomarker for follicular lymphoma.

PURPOSE: The (14;18) translocation constitutes both a genetic hallmark and critical early event in the natural history of follicular lymphoma (FL). However, t(14;18) is also detectable in the blood of otherwise healthy persons, and its relationship with progression to disease remains unclear. Here we sought to determine whether t(14;18)-positive cells in healthy individuals represent tumor precursors and whether their detection could be used as an early predictor for FL. PARTICIPANTS AND METHODS: Among 520,000 healthy participants enrolled onto the EPIC (European Prospective Investigation Into Cancer and Nutrition) cohort, we identified 100 who developed FL 2 to 161 months after enrollment. Prediagnostic blood from these and 218 controls were screened for t(14;18) using sensitive polymerase chain reaction-based assays. Results were subsequently validated in an independent cohort (65 case participants; 128 controls). Clonal relationships between t(14;18) cells and FL were also assessed by molecular backtracking of paired prediagnostic blood and tumor samples. RESULTS: Clonal analysis of t(14;18) junctions in paired prediagnostic blood versus tumor samples demonstrated that progression to FL occurred from t(14;18)-positive committed precursors. Furthermore, healthy participants at enrollment who developed FL up to 15 years later showed a markedly higher t(14;18) prevalence and frequency than controls (P < .001). Altogether, we estimated a 23-fold higher risk of subsequent FL in blood samples associated with a frequency > 10(-4) (odds ratio, 23.17; 95% CI, 9.98 to 67.31; P < .001). Remarkably, risk estimates remained high and significant up to 15 years before diagnosis. CONCLUSION: High t(14;18) frequency in blood from healthy individuals defines the first predictive biomarker for FL, effective years before diagnosis.

La Medicina Basada en la Evidencia: ¿mejoró la medicina que practicamos y enseñamos? / Evidence-based Medicine: has it improved the medicine we practice and teach?

En los últimos años la práctica y la enseñanza médica han incorporado en forma progresiva y creciente el concepto de medicina basada en la evidencia (MBE). La misma se define como la utilización de la mejor evidencia proveniente de la investigación clínica para la toma de decisiones en el manejo del paciente individual. Esta propuesta de cambio en la manera de practicar y enseñar la medicina clínica es, en parte, consecuencia del vertiginoso avance de la investigación científica, particularmente en las últimas décadas, aunque el costo creciente involucrado en la atención de los pacientes ha jugado también un rol importante en su desarrollo y consolidación. La MBE implica la integración de la preparación y experiencia del médico con la mejor evidencia clínica externa accesible, proveniente de la investigación sistemática, proporcionando una visión más crítica en la toma de decisiones clínicas, para ofrecer atención de calidad óptima al paciente, evitando errores en cada una de las diferentes etapas del proceso de diagnóstico y tratamiento. En ausencia de información recolectada sistemáticamente, no es fácil llegar a una conclusión sobre los efectos de la MBE en la práctica y la enseñanza de la medicina en nuestro medio. Sin duda contamos hoy con mayor evidencia científica, incluyendo aquella relacionada a los problemas de salud infantil, y también se ha producido un avance vertiginoso en la tecnología que nos permite acceder a dicha información en tiempo real, a la cabecera del paciente. Sin embargo, si deseamos de veras lograr una mejor medicina, basada en la ciencia y en el respeto a la salud como un derecho que nos asiste a todos, hay necesidad de romper definitivamente con el paradigma predominante de una medicina jerárquica, poco dada a la discusión y a la justificación de las decisiones clínicas, de aprovechar la mejora sustancial ocurrida en el acceso a la evidencia disponible, y de mostrar mayor disposición a compartir amigable y respetuosamente dicha justificación con nuestros pacientes. Del mismo modo, hay la necesidad imperiosa de promover la investigación, la creatividad y el espíritu crítico en todos los niveles de la educación, para contribuir a la evidencia global que permita que la medicina clínica y la salud pública continúen avanzando.

The concept of evidence-based medicine (EBM) has been increasingly incorporated in medicine practice and teaching. In the clinical arena it is defined as the use of the best available scientific evidence coming from clinical research for decision-making purposes, when facing individual patients. This paradigm change in the way medicine is taught and practiced has been due in part to the accelerated progress in scientific research, particularly in the last few decades, albeit the increasing costs involved in care of patients also played an important role in its development and consolidation. EBM involves integration of clinical expertise with the available external evidence, and provides a more critical approach to clinical problems, reducing error probabilities in different phases of the clinical process. It is not easy to reach a definitive conclusion about its impact on teaching and practice of medicine in our setting, due to the lack of systematic impact research in this area. At global level, we undoubtedly have available greater scientific evidence now, including the child health field. These scenarios, along with the amazing technological advances we are witnessing allow us to use relevant bedside clinical information. However, if we are really looking for a better medicine based on sound information but also on genuine respect to health as a basic human right, we should intensify our efforts to break once and for all with the paradigm of an authoritarian medicine, suspicious of any dissent, and reluctant to justify adequately any clinical decision made. We should additionally take advantage of the highly improved access to scientific information, and we should be willing to share such justifications with our patients in a friendly and respectful way. Similarly, we badly need to actively promote research, creativity and critical thinking at all educational levels, so we can make a real and significant contribution to the advancement of clinical medicine and public health.

Coffee and tea consumption and the risk of ovarian cancer: a prospective cohort study and updated meta-analysis.

BACKGROUND: In 2007 the World Cancer Research Fund Report concluded that there was limited and inconsistent evidence for an effect of coffee and tea consumption on the risk of epithelial ovarian cancer (EOC). OBJECTIVE: In the European Prospective Investigation into Cancer and Nutrition (EPIC), we aimed to investigate whether coffee intakes, tea intakes, or both are associated with the risk of EOC. DESIGN: All women participating in the EPIC (n = 330,849) were included in this study. Data on coffee and tea consumption were collected through validated food-frequency questionnaires at baseline. HRs and 95% CIs were estimated by using Cox proportional hazards models. Furthermore, we performed an updated meta-analysis of all previous prospective studies until April 2011 by comparing the highest and lowest coffee- and tea-consumption categories as well as by using dose-response random-effects meta-regression analyses. RESULTS: During a median follow-up of 11.7 y, 1244 women developed EOC. No association was observed between the risk of EOC and coffee consumption [HR: 1.05 (95% CI: 0.75, 1.46) for the top quintile compared with no intake] or tea consumption [HR: 1.07 (95% CI: 0.78, 1.45) for the top quintile compared with no intake]. This lack of association between coffee and tea intake and EOC risk was confirmed by the results of our meta-analysis. CONCLUSION: Epidemiologic studies do not provide sufficient evidence to support an association between coffee and tea consumption and risk of ovarian cancer.

Validity of a short questionnaire to assess physical activity in 10 European countries.

To accurately examine associations of physical activity (PA) with disease outcomes, a valid method of assessing free-living activity is required. We examined the validity of a brief PA questionnaire (PAQ) used in the European Prospective Investigation into Cancer and Nutrition (EPIC). PA energy expenditure (PAEE) and time spent in moderate and vigorous physical activity (MVPA) was measured in 1,941 healthy individuals from 10 European countries using individually-calibrated combined heart-rate and movement sensing. Participants also completed the short EPIC-PAQ, which refers to past year's activity. Pearson (r) and Spearman (σ) correlation coefficients were calculated for each country, and random effects meta-analysis was used to calculate the combined correlation across countries to estimate the validity of two previously- and one newly-derived ordered, categorical PA indices ("Cambridge index", "total PA index", and "recreational index") that categorized individuals as inactive, moderately inactive, moderately active, or active. The strongest associations with PAEE and MVPA were observed for the Cambridge index (r = 0.33 and r = 0.25, respectively). No significant heterogeneity by country was observed for this index (I(2) = 36.3%, P = 0.12; I(2) = 0.0%, P = 0.85), whereas heterogeneity was suggested for other indices (I(2) > 48%, P < 0.05, I(2) > 47%, P < 0.05). PAEE increased linearly across self-reported PA categories (P for trend <0.001), with an average difference of approximately 460 kJ/d for men and 365 kJ/d for women, between categories of the Cambridge index. The EPIC-PAQ is suitable for categorizing European men and women into four distinct categories of overall physical activity. The difference in PAEE between categories may be useful when estimating effect sizes from observational research.

Uso del tiempo libre en actividades deportivas como factor protector frente al consumo de drogas entre escolares peruanos de educación secundaria / Use of leisure time in sports as a protective factor against drug use in Peruvian teenagers

Objetivo: Determinar si el uso de tiempo libre en actividades deportivas (UTLD) está asociado al consumo de drogas legales e ilícitas en escolares peruanos. Métodos: Estudio analítico transversal, consistente en el sub-análisis de la base de datos del II Estudio Nacional: Prevención y Consumo de Drogas en Estudiantes de secundaria, 2007, realizada por la Comisión Nacional para el Desarrollo y Vida sin Drogas (DEVIDA). Se determinó la frecuencia del UTLD en los escolares encuestados según las características de sexo, año de estudio, tipo de colegio y tipo de colegio según sexo. Así mismo, se determinó la asociación entre el UTLD y el antecedente de consumo de drogas el último año. Resultados: Se entrevistaron 5 647 estudiantes, con una edad promedio de 14.9 ± 1.5 años, el 74.9% provenía de colegios públicos y el 40% pertenecía a colegios de la ciudad de Lima (capital del Perú). El 22% de escolares refirió UTLD, siendo mayor en varones que en mujeres. Los alumnos que usan su tiempo libre en actividades deportivas tienen 9% menos probabilidad de haber consumido alguna droga legal (alcohol o tabaco, OR=0.91 [IC95% 0.90-0.91]), mientras que la probabilidad de haber consumido drogas ilegales es 34% menor (OR=0.66 [IC95% 0.65-0.68]). Conclusiones: El uso de tiempo libre en actividades deportivas esta asociado significativamente a una menor frecuencia de consumo de alcohol, tabaco y drogas ilícitas en estudiantes de secundaria peruanos, lo que debería tomarse en cuenta en las estrategias de prevención de consumo de drogas en adolescentes.

Objective: To determine whether the use of free time in sports (UFTS) is associated with the consumption of licit and illicit drugs Peruvian children. Material and Methods: cross-sectional study, sub-analysis of the data base of the II Estudio Nacional: Prevención y Consumo de Drogas en Estudiantes de Secundaria, 2007, conducted by the Comisión Nacional para el Desarrollo y Vida sin Drogas (DEVIDA). We determined the frequency of UFTS on the surveyed schoolchildren, according to the characteristics of sex, year of study, type of school and type of school by sex. Furthermore, we investigated the association between UFTS and history of drug use on the last year. Results: 5647 students were interviewed, (average age: 14.9 ± 1.5 years), 74.9% came from public schools and 40% came from schools in the city of Lima (Peruvian capital). 22% of school children reported UFTS, being higher in males than females. Students who use their free time in sports has 9% less likely to consumed any legal drug (alcohol or snuff, OR = 0.91 [95% CI 0.90 to 0.91]), while the probability of having used illegal drugs is 34% lower (OR = 0.66 [95% CI 0.65 to 0.68]). Conclusions: The use of free time in sports is associated with significantly lower rates of alcohol consumption, snuff and illicit drugs in Peruvian high school students, which should be taken into account in strategies to prevent drug use in adolescents.

Pooled analysis of studies on DNA adducts and dietary vitamins.

OBJECTIVES: There is some evidence that dietary components that are rich in antioxidant and vitamins are inversely associated with DNA adduct levels induced by environmental carcinogens such as polycyclic aromatic hydrocarbons, although the epidemiologic data are inconsistent. This study addresses the association between vitamins, DNA adducts and smoking. METHODS: A combined analysis of individual data on the association between bulky DNA adducts and dietary vitamins was conducted. A Medline search was performed to identify studies on healthy subjects in which smoking and vitamins intake information were available, and bulky DNA adducts were measured in peripheral blood with 32P-postlabelling. Eight published studies met the eligibility criteria, and individual data from 7 data sets including 2758 subjects were obtained. GSTM1 and GSTT1 were also available on all the subjects. RESULTS: Vitamin E was inversely significantly associated with DNA adducts after adjustment for possible confounding factors. Vitamins A and C were not independent predictors of DNA adducts. A stratified analysis showed that vitamin A had a significant inverse association with DNA adducts in ever smokers only. CONCLUSIONS: This result is relevant to planning any future chemo-preventive interventions directed to high risk subgroups of the population, for cancer prevention.

Uso de recursos sanitarios para tratar la leucemia mieloide crónica en Perú / Use of healthcare resources for treating chronic myeloid leukemia in Peru

En el presente artículo original se describen y comentan los datos aportados por un grupo de oncohematólogos, acerca del uso actual de los recursos sanitarios para el tratamiento de la leucemia mieloide crónica y de los eventos adversos relacionados con ésta, en Perú. Mediante la técnica de consenso Mini Delphi, los panelistas lograron elevado grado de acuerdo sobre los temas de interés. A modo de síntesis, se observó distribución de los recursos generales disponibles acorde con las necesidades de cada fase de la leucemia y en adhesión a las pautas terapéuticas internacionales, aunque se detectaron algunas instancias que podrían optimizarse. Resultó evidente la notable disminución de la realización de trasplantes de médula ósea, en Perú. Esta información puede constituir un punto de partida para futuros estudios adicionales en el contexto de la práctica clínica en Latinoamérica. Además, aplicada a modelos farmacoeconómicos apropiados, los datos podrían agilizar la toma de decisiones acorde a la realidad local, por parte de los distintos responsables de los sistemas de salud, para permitir a los enfermos con LMC acceder a las opciones terapéuticas más ventajosas y, aún más trascendente, mejorar su calidad de vida y supervivencia.

This original article details and discusses the information provided by a group of hematologists, about the current use of health resourcesin the management of chronic myeloid leukemia and its treatment related adverse events in Peru. By applying the Mini Delphi consensus technique, a high degree of agreement about the issues of interest was reached among the faculty. To summarize, although it was noticed that the allocation of health resources matches the requirement for each phase in the management of leukemia and it adheres to international guidelines, some topics that could be optimized were identified. A remarkable reduction of bone marrow transplant procedures was evident. These data may represent a starting point for further studies in the clinical practice setting in Latin America. Moreover, using appropriate pharmacoeconomic models, the information obtained may speed up the decision making process according to the local circumstances by those responsible for sanitary assistance, allowing patients with CML to reach the most convenient therapeutic options and, more importantly, improving their quality of life and survival.

Calidad del sueño, somnolencia diurna e higiene del sueño en el Centro del Adulto Mayor Mirones, EsSalud, Lima, Perú / Sleep quality, daily sleepiness and sleep hygiene at ôCentro del Adulto Mayorõ in Lima, Perú

Introducción: los trastornos del sueño en el adulto mayor se caracterizan por tener una frecuencia alta, significativa afección de la calidad de vida y por un pobre reconocimiento por parte del médico. Objetivos: determinar la calidad del sueño, la frecuencia de somnolencia diurna y la higiene del sueño de los adultos mayores en un Centro del Adulto Mayor en Lima. Material y método: se entrevistó a 73 adultos mayores que acudían a un Centro del Adulto Mayor. Se utilizó el cuestionario de calidad de sueño de Pittsburgh, la escala de somnolencia de Epworth y el índice de higiene del sueño modificado, previamente validados. Resultados: el 74 por ciento de los participantes (54 personas) presentaba una mala calidad de sueño, el análisis de los componentes mostró una auto percepción de calidad del sueño bastante mala y muymala en el 9,6 por ciento (7 personas), una latencia del sueño prolongada en el 20,2 por ciento de los participantes (14 personas), una duración total del sueño considerada como bastante mala y muy mala en el 24,7 por ciento (18 personas) y un 52,1 por ciento (38 personas) tuvo una eficiencia subjetiva de sueño menor al 85 por ciento. La frecuencia de somnolencia diurna fue de 38,4 por ciento (28 personas). El 75,3 por ciento (55 personas) tenía una mala higiene del sueño y se encontró que el 74,1 por ciento de los participantes que tenían una mala calidad de sueño presentaban una mala higiene del sueño, aunque la asociación no fue significativa. Conclusiones: los adultos mayores de un Centro del Adulto Mayor en Lima, tienen una alta frecuencia de mala calidad de sueño de somnolenciadiurna y de mala higiene del sueño.

Background: Sleep disorders in the elderly are quite frequent, they significantly affect their quality of life, and sometimes these conditions are poorly recognized by physicians. Objective: To determine sleep quality, the frequency of daily sleepiness and sleep hygiene in elderly at an Elderly Daycare Center in Lima, Peru. Material and methods: 73 elderly persons in an Elderly Daycare Center were interviewed using the previously validated Pittsburgh Sleep QualityQuestionnaire, the Epworth Sleepiness Scale and the modified Sleep Hygiene Index. Results: 74 per cent (54 persons) of participants were found to have a poor sleep quality, the component analysis showed that 9,6 per cent of interviewees perceived their sleep quality as poor and very poor(7 persons), 20,2 per cent reported prolonged sleep latency (14 persons),24,7 per cent reported poor and very poor sleep duration (18 persons), and 52,1 per cent had a less than 85 per cent subjective sleep efficiency (38 persons). Diurnal sleepiness frequency was found in 38,4 per cent of all participants (28 persons). 75,3 per cent reported poor sleep hygiene (55 persons) and 74,1 per cent those with poor sleep quality also had poor sleep hygiene, but this relationship did not reach statistical significance. Conclusion: Persons in this Elderly Daycare Center in Lima, Peru have a high frequency of poor sleep quality, they also commonly report daily sleepiness and a high rate of poor sleep hygiene.

fac-Aqua-dichloridotris(tetra-methyl-ene sulfoxide-κS)ruthenium(II).

The title mol-ecule, [RuCl(2)(C(4)H(8)OS)(3)(H(2)O)], is the isomer with the two chloride ligands cis and the three S-coordinated tetra-methyl-ene sulfoxide ligands facial relative to the Ru(II) center. The Ru-Cl distances are 2.4161 (7) and 2.4317 (7) Å, the Ru-O distance is 2.1540 (19) Å, and the Ru-S distances are in the range 2.2254 (8)-2.2657 (7) Å, with the shortest being that trans to the aqua ligand. The coordinated water mol-ecule forms inter-molecular hydrogen bonds with Cl and sulfoxide O atoms.

Validation of biomarkers for the study of environmental carcinogens: a review.

There is a need for validation of biomarkers. Our aim is to review published work on the validation of selected biomarkers: bulky DNA adducts, N-nitroso compounds, 1-hydroxypyrene, and oxidative damage to DNA. A systematic literature search in PubMed was performed. Information on the variability and reliability of the laboratory tests used for biomarkers measurements was collected. For the evaluation of the evidence on validation we referred to the ACCE criteria. Little is known about intraindividual variation of DNA adduct measurements, but measurements have a good repeatability irrespective of the technique used for their identification; reproducibility improved after the correction for a laboratory factor. A high-sensitivity method is available for the measurement of 1-hydroxypyrene in urine. There is consensus on validation of biomarkers of oxidative damage DNA based on the comet assay and chromatographic measurement in blood while urinary measurements by chromatographic assays are well validated, and ELISA-based assays appear to lack specificity. Immunoassays for the quantification of adducts of N-nitroso compounds are useful for large epidemiological studies, given their sensitivity, the small amount of DNA required and their potential for rapid and high-throughput analysis.