Knowledge, Attitudes, and Perceptions of Maternity Care Providers on the Implementation of Calcium Supplementation during Pregnancy in Three Public Hospitals in Argentina: A Qualitative Study.

The aim of this study was to explore maternity care providers' knowledge, attitudes, and perceptions about the use of calcium supplements during pregnancy for the prevention of preeclampsia in three hospitals from Metropolitan Buenos Aires, Argentina. We conducted semi-structured interviews and followed a thematic analysis framework. Maternity care providers' knowledge, attitudes, and practices regarding calcium supplementation during pregnancy are linked to barriers to the potential implementation of calcium supplementation. Free provision of calcium supplements by the government, coupled with training that reinforces the scientific evidence supporting their use to prevent preeclampsia, along with documented recommendations from credible sources, would be crucial to ensure that health providers adopt the use of calcium supplements in antenatal care. Future studies should assess pregnant women and policymakers' perceptions about calcium supplementation during pregnancy, as well as local infrastructure to provide access to free-of-charge calcium supplements in antenatal care settings. Economic evaluation with local information could inform policymakers and advocate for the implementation of strategies to reduce preeclampsia.

Perceptions of Social Capital Before and After the Perpetration of Femicide, Homicide, and Other Serious Crimes: Evidence from Argentina.

Over the past two decades, femicide-the gender-based killing of women or girls-has become an issue of international concern. Yet relatively little data on perpetrators exist. Current research primarily focuses on individual risk factors with less attention on community and societal factors. We use a social capital approach to examine femicide by analyzing the extent to which crime perpetrators experience and perceive social punishment (exclusion) from their social networks. Using a quota sampling strategy, we administered a cross-sectional questionnaire to perpetrators of femicide (N = 71), male-male homicide (N = 73), and other serious crimes (N = 64) across four prisons in Buenos Aires, Argentina. Other crime perpetrators served as a control to the two lethal crime groups. Perceived social capital scores were assigned based on responses to two scales adapted from the World Bank's "Integrated Questionnaire for the Measurement of Social Capital." Before committing murder, femicide and homicide perpetrators' scores were not statistically different. Yet after the crime, femicide perpetrators retained significantly greater scores than homicide perpetrators. The perceived social capital scores of other crime perpetrators did not change after the commission of their crimes. As a secondary objective, we examined the individual and social contexts of femicide perpetrators. Most (85%) of the femicide perpetrators could name at least one other person in their social network whom they knew to be physically violent during disagreements with their partner, while 11% stated that "everyone" they knew used violence during disagreements. Although the penalty for committing femicide and homicide is ostensibly equivalent-a life sentence of 50 years-we found that the informal social punishment femicide perpetrators perceived is less severe than that experienced by homicide perpetrators. These data indicate a lack of social punishment for femicide, compared to other crimes, showing social legitimization of the crime. These findings support the development of community-level interventions to prevent femicide.

Comparison of ddRADseq and EUChip60K SNP genotyping systems for population genetics and genomic selection in Eucalyptus dunnii (Maiden).

Eucalyptus dunnii is one of the most important Eucalyptus species for short-fiber pulp production in regions where other species of the genus are affected by poor soil and climatic conditions. In this context, E. dunnii holds promise as a resource to address and adapt to the challenges of climate change. Despite its rapid growth and favorable wood properties for solid wood products, the advancement of its improvement remains in its early stages. In this work, we evaluated the performance of two single nucleotide polymorphism, (SNP), genotyping methods for population genetics analysis and Genomic Selection in E. dunnii. Double digest restriction-site associated DNA sequencing (ddRADseq) was compared with the EUChip60K array in 308 individuals from a provenance-progeny trial. The compared SNP set included 8,011 and 19,008 informative SNPs distributed along the 11 chromosomes, respectively. Although the two datasets differed in the percentage of missing data, genome coverage, minor allele frequency and estimated genetic diversity parameters, they revealed a similar genetic structure, showing two subpopulations with little differentiation between them, and low linkage disequilibrium. GS analyses were performed for eleven traits using Genomic Best Linear Unbiased Prediction (GBLUP) and a conventional pedigree-based model (ABLUP). Regardless of the SNP dataset, the predictive ability (PA) of GBLUP was better than that of ABLUP for six traits (Cellulose content, Total and Ethanolic extractives, Total and Klason lignin content and Syringyl and Guaiacyl lignin monomer ratio). When contrasting the SNP datasets used to estimate PAs, the GBLUP-EUChip60K model gave higher and significant PA values for six traits, meanwhile, the values estimated using ddRADseq gave higher values for three other traits. The PAs correlated positively with narrow sense heritabilities, with the highest correlations shown by the ABLUP and GBLUP-EUChip60K. The two genotyping methods, ddRADseq and EUChip60K, are generally comparable for population genetics and genomic prediction, demonstrating the utility of the former when subjected to rigorous SNP filtering. The results of this study provide a basis for future whole-genome studies using ddRADseq in non-model forest species for which SNP arrays have not yet been developed.

Why? How Perpetrators of Male-Male Homicide Explain the Crime.

This paper identifies the explanatory narratives used by perpetrators of male-male homicide in Buenos Aires (Argentina) to make sense of this crime. Drawing upon narrative criminology and masculinities theories, this study enquires into the rationalisations of perpetrators, considering their emic terms, rationalities and stories. Fieldwork was conducted between 2016 and 2020, and a convenience sample strategy was employed for participant recruitment. The analysis is based upon seventy-three narrative-biographical interviews with offenders, and field observations in prisons and homes of former convicts. The corpus was analysed following an inductive thematic coding strategy using Atlas.Ti. Eight narratives were typified, considering how men talked about agency and change, and the explanatory locus of the stories: 'rebel', 'affected', 'idiot', 'either him or me', 'repeating the story', 'gang', 'betrayed' and 'victim'. These accounts revealed two paradoxes about violence perpetration storytelling and its discursive management: men can commit a homicide and present themselves as not responsible for it and, simultaneously, they use, reconfigure and negotiate expert theories and scientific labels to explain away, excuse and justify lethal violence. This study argues that accounts are not merely neutralisation strategies, but the rationalisations of the perpetrators' experiences, and the foundation for how they relate to and inhabit penal institutions. This paper contributes to the understanding of how those explanations shape past and future actions, and how masculinities, biographical processes and violence performance are interconnected.

Development and validation of the food allergy severity score.

BACKGROUND: The heterogeneity and lack of validation of existing severity scores for food allergic reactions limit standardization of case management and research advances. We aimed to develop and validate a severity score for food allergic reactions. METHODS: Following a multidisciplinary experts consensus, it was decided to develop a food allergy severity score (FASS) with ordinal (oFASS) and numerical (nFASS) formats. oFASS with 3 and 5 grades were generated through expert consensus, and nFASS by mathematical modeling. Evaluation was performed in the EuroPrevall outpatient clinic cohort (8232 food reactions) by logistic regression with request of emergency care and medications used as outcomes. Discrimination, classification, and calibration were calculated. Bootstrapping internal validation was followed by external validation (logistic regression) in 5 cohorts (3622 food reactions). Correlation of nFASS with the severity classification done by expert allergy clinicians by Best-Worst Scaling of 32 food reactions was calculated. RESULTS: oFASS and nFASS map consistently, with nFASS having greater granularity. With the outcomes emergency care, adrenaline and critical medical treatment, oFASS and nFASS had a good discrimination (receiver operating characteristic area under the curve [ROC-AUC]>0.80), classification (sensitivity 0.87-0.92, specificity 0.73-0.78), and calibration. Bootstrapping over ROC-AUC showed negligible biases (1.0 × 10-6 -1.23 × 10-3 ). In external validation, nFASS performed best with higher ROC-AUC. nFASS was strongly correlated (R 0.89) to best-worst scoring of 334 expert clinicians. CONCLUSION: FASS is a validated and reliable method to measure severity of food allergic reactions. The ordinal and numerical versions that map onto each other are suitable for use by different stakeholders in different settings.

Nucleus-Independent Chemical Shift (NICS) as a Criterion for the Design of New Antifungal Benzofuranones.

The assertion made by Wu et al. that aromaticity may have considerable implications for molecular design motivated us to use nucleus-independent chemical shifts (NICS) as an aromaticity criterion to evaluate the antifungal activity of two series of indol-4-ones. A linear regression analysis of NICS and antifungal activity showed that both tested variables were significantly related (p < 0.05); when aromaticity increased, the antifungal activity decreased for series I and increased for series II. To verify the validity of the obtained equations, a new set of 44 benzofuran-4-ones was designed by replacing the nitrogen atom of the five-membered ring with oxygen in indol-4-ones. The NICS(0) and NICS(1) of benzofuran-4-ones were calculated and used to predict their biological activities using the previous equations. A set of 10 benzofuran-4-ones was synthesized and tested in eight human pathogenic fungi, showing the validity of the equations. The minimum inhibitory concentration (MIC) in yeasts was 31.25 µg·mL-1 for Candida glabrata, Candida krusei and Candida guilliermondii with compounds 15-32, 15-15 and 15-1. The MIC for filamentous fungi was 1.95 µg·mL-1 for Aspergillus niger for compounds 15-1, 15-33 and 15-34. The results obtained support the use of NICS in the molecular design of compounds with antifungal activity.

Analysis of Volatile Molecules Present in the Secretome of the Fungal Pathogen Candida glabrata.

Candida albicans, Candida glabrata, Candida parapsilosis and Candida tropicalis are the four most common human fungal pathogens isolated that can cause superficial and invasive infections. It has been shown that specific metabolites present in the secretomes of these fungal pathogens are important for their virulence. C. glabrata is the second most common isolate world-wide and has an innate resistance to azoles, xenobiotics and oxidative stress that allows this fungal pathogen to evade the immune response and persist within the host. Here, we analyzed and compared the C. glabrata secretome with those of C. albicans, C. parapsilosis, C. tropicalis and the non-pathogenic yeast Saccharomyces cerevisiae. In C. glabrata, we identified a different number of metabolites depending on the growth media: 12 in synthetic complete media (SC), 27 in SC-glutamic acid and 23 in rich media (YPD). C. glabrata specific metabolites are 1-dodecene (0.09 ± 0.11%), 2,5-dimethylundecane (1.01 ± 0.19%), 3,7-dimethyldecane (0.14 ± 0.15%), and octadecane (0.4 ± 0.53%). The metabolites that are shared with C. albicans, C. glabrata, C. parapsilosis, C. tropicalis and S. cerevisiae are phenylethanol, which is synthesized from phenylalanine, and eicosane and nonanoic acid (identified as trimethylsilyl ester), which are synthesized from fatty acid metabolism. Phenylethanol is the most abundant metabolite in all fungi tested: 26.36 ± 17.42% (C. glabrata), 46.77 ± 15.58% (C. albicans), 49.76 ± 18.43% (C. tropicalis), 5.72 ± 0.66% (C. parapsilosis.) and 44.58 ± 27.91% (S. cerevisiae). The analysis of C. glabrata's secretome will allow us to further our understanding of the possible role these metabolites could play in its virulence.

The impact of neighbourhood crime on mental health: A systematic review and meta-analysis.

BACKGROUND: Growing evidence indicates that the residential neighbourhood contributes to the complex aetiology of mental disorders. Although local crime and violence, key neighbourhood stressors, may be linked to mental health through direct and indirect pathways, studies are inconclusive. This systematic review and meta-analysis aimed to synthetize the evidence on the association between neighbourhood crime and individual-level mental health problems. METHOD: We searched 11 electronic databases, grey literature and reference lists to identify relevant studies published before September 14, 2020. Studies were included if they reported confounder-adjusted associations between objective or perceived area-level crime and anxiety, depression, psychosis or psychological distress/internalising symptoms in non-clinical samples. Effect measures were first converted into Fisher's z-s, pooled with three-level random-effects meta-analyses, and then transformed into Pearson's correlation coefficients. Univariate and multivariate mixed-effects models were used to explore between-study heterogeneity. RESULTS: We identified 63 studies reporting associations between neighbourhood crime and residents' mental health. Pooled associations were significant for depression (r = 0.04, 95% CI 0.03-0.06), psychological distress (r = 0.04, 95% CI 0.02-0.06), anxiety (r = 0.05, 95% CI 0.01-0.10), and psychosis (r = 0.04, 95% CI 0.01-0.07). Moderator analysis for depression and psychological distress identified stronger associations with perceived crime measurement and weaker in studies adjusted for area-level deprivation. Importantly, even after accounting for study characteristics, neighbourhood crime remained significantly linked to depression and psychological distress. Findings on anxiety and psychosis were limited due to low number of included studies. CONCLUSIONS: Neighbourhood crime is an important contextual predictor of mental health with implications for prevention and policy. Area-based crime interventions targeting the determinants of crime, prevention and service allocation to high crime neighbourhoods may have public mental health benefits. Future research should investigate the causal pathways between crime exposure and mental health, identify vulnerably groups and explore policy opportunities for buffering against the detrimental effect of neighbourhood stressors.

Single-dose oral challenges to validate eliciting doses in children with cow's milk allergy.

BACKGROUND: There is increasing interest in the use of eliciting doses (EDs) to inform allergen risk management. The ED can be estimated from the distribution of threshold doses for allergic subjects undergoing food challenges within a specified population. Estimated ED05 values for cow's milk (the dose expected to cause objective allergic symptoms in 5% of the milk-allergic population) range from 0.5 mg to 13.9 mg cow's milk protein. We undertook a single-dose challenge study to validate a predicted ED05 for cow's milk of 0.5 mg protein. METHODS: Participants were recruited from 4 clinical centres. Predetermined criteria were used to identify patients reacting to 0.5 mg cow's milk protein (approximately 0.015 mL of fresh cow's milk). Children over 1 year underwent formal challenge to cow's milk to confirm clinical reactivity. RESULTS: 172 children (median age 6.0 (IQR 0.7-11) years, 57% male) were included in this analysis. Twelve (7.0%, 95% CI 3.7%-11.9%) children experienced objective symptoms that met the predetermined criteria. One participant had mild anaphylaxis that responded to a single dose of adrenaline, the remainder experienced only mild symptoms with no treatment required. We did not identify any baseline predictors of sensitization that were associated with objective reactivity to the single-dose challenge using 0.5 mg cow's milk protein. CONCLUSIONS: These data support an estimated ED05 for cow's milk of 0.5 mg protein. Values for ED05 above 0.5 mg for cow's milk protein proposed for allergen risk management need to be reviewed.

Anti-inflammatory and antitumor activities of the chloroform extract and anti-inflammatory effect of the three diterpenes isolated from Salvia ballotiflora Benth.

BACKGROUND: Drugs used for the treatment of diseases associated with chronic inflammation, such as cancer and rheumatoid arthritis have the potential to cause undesirable side-effects, which might result in patients ending treatment prematurely. However, plants are a viable option for the treatment of inflammatory diseases. In this study, we assessed the in vivo and in vitro anti-inflammatory activity, and the antitumor effects of the chloroform extract of Salvia ballotiflora (ECL). The pro-apoptotic effects of ECL in CT26 cells were also determined. METHODS: The chloroform extract of Salvia ballotiflora (ECL) was standardized using 19-deoxyicetexone (DEOX) as a phytochemical marker. The anti-inflammatory activity of ECL was determined on acute and chronic inflammatory models using the TPA-induced mouse ear edema assay. The antitumor activity of ECL was evaluated by the subcutaneous inoculation of CT26 cells on the back of Balb/c mice. In vitro CT26 cell death induced by ECL was determined by Annexin V/propidium iodide staining assay using flow cytometry. ECL and the diterpenes isolated from the chloroform extract included 19-deoxyicetexone (DEOX), icetexone (ICT), and 7,20-dihydroanastomosine (DAM), which were tested in LPS-stimulated J774A.1 macrophages to quantify pro-inflammatory cytokine levels. The in vitro anti-arthritic activity of ECL was determined using the bovine serum protein (BSP) denaturation assay. RESULTS: ECL exerted anti-inflammatory activities in acute (84% of inhibition, 2 mg/ear) and chronic models (62.71%, at 100 mg/kg). ECL showed antitumor activity at 200 mg/kg and 300 mg/kg, reducing tumor volume by 30 and 40%, respectively. ECL (9.5 µg/mL) induced in vitro apoptosis in CT26 cells by 29.1% (48 h of treatment) and 93.9% (72 h of treatment). ECL (10 µg/ml) decreased levels of NO (53.7%), pro-inflammatory cytokines IL-6 (44.9%), IL-1ß (71.9%), and TNF-α (40.1%), but increased the production of the anti-inflammatory cytokine IL-10 (44%). The diterpenes DEOX, ICT, and DAM decreased levels of NO (38.34, 47.63, 67.15%), IL-6 (57.84, 60.45, 44.26%), and TNF-α (38.90, 31.30, 32.83%), respectively. ECL showed in vitro antiarthritic activity (IC50 = 482.65 µg/mL). CONCLUSIONS: ECL exhibited anti-inflammatory and anti-tumor activities. Furthermore, the diterpenes DEOX, DAM, and ICT showed anti-inflammatory activity by reducing levels of NO, TNF-α, and IL-6.

Quantification of pyrazinamide, isoniazid, acetyl-isoniazid, and rifampicin by a high-performance liquid chromatography method in human plasma from patients with tuberculosis.

The aim of this study was to establish and validate an alternative high-performance liquid chromatography method for simultaneous quantification of pyrazinamide, isoniazid, acetyl-isoniazid and rifampicin in plasma of patients under treatment for tuberculosis. The performed method was lineal (r2  > 0.99) in the range of 2.00-50.00 µg/mL for pyrazinamide, 0.50-20.00 µg/mL for both acetyl-isoniazid and isoniazid, and 1.20-25.00 µg/mL for rifampicin. Precision and trueness were demonstrated with coefficient of variation < 15% and deviations < 15%, respectively, for quality controls samples. The lower limits of quantification were 2.00, 0.50, 0.50, and 1.20 µg/mL for pyrazinamide, isoniazid, acetyl-isoniazid and rifampicin, respectively. The method was applied for the analysis of plasma from patients with tuberculosis. This method allowed ensuring reliable quantification of the target compounds and their pharmacokinetics parameters. In general, the mean values of maximum concentration of each antituberculosis drug were located within their respective reference therapeutic ranges. However, patients with sub-therapeutic plasma concentrations of isoniazid and rifampicin were detected. This is the first analytical technique that simultaneously quantifies isoniazid, acetyl-isoniazid, rifampicin, and pyrazinamide concentrations from plasma samples by high-performance liquid chromatography with ultraviolet/visible. The proposed method could be applied for therapeutic drug monitoring and pharmacokinetics studies of the four compounds throughout the treatment of tuberculosis patients.

Del suicidio al homicidio: una revisión narrativa de la bibliografía sobre mortalidad por "causas externas" en Argentina / Do suicídio ao homicídio: uma revisão narrativa da bibliografia sobre mortalidade por "causas externas" na Argentina / From Suicide to Homicide: A Literature Review of Mortality Owing to "Externai Causes" in Argentina

Resumen Introducción: el artículo presenta una revisión bibliográfica de los artículos científicos sobre muertes violentas en Argentina, publicados entre 2001 y 2016, con el objetivo de describir temas, áreas de conocimiento, disciplinas y metodologías; además, se indaga en qué medida la producción académica capta, interpreta y/o instala las violencias como problema sanitario. Materiales y métodos: se relevaron artículos en soporte digital publicados en revistas indizadas en BVS, PubMed, Redalyc, SciELO y Scopus. El corpus final incluyó 72 artículos. Se desarrolló un análisis cuanticualitativo siguiendo la síntesis interpretativa crítica. Resultados: se encontró que la bibliografía: a) aborda predominantemente la violencia física; b) se enmarca principalmente dentro de las ciencias médicas; c) tiene objetivos descriptivos; d) se caracteriza por tener alcances geográficos nacionales e institucionales; e) parte de datos primarios para el abordaje empírico, y f) emplea mayoritariamente metodologías de análisis cuantitativas. La mayoría de los artículos aborda el suicidio, y en los estudios sobre homicidio aparece un área de vacancia desde la perspectiva de los homicidas. Si bien estos aspectos describen estructuralmente esta bibliografía, se encontraron núcleos temáticos con características diferentes. Es escaso el uso de estadísticas nacionales para dar cuenta de la relevancia epidemiológica de "las violencias". Conclusión: la recurrencia de definiciones y taxonomías de organismos internacionales (principalmente, la Organización Mundial de la Salud) sobre salud y violencia da cuenta de su posición discursiva dominante. Se plantea la necesidad de realizar otros estudios de este tipo, en diferentes países de la región, a fin de tematizar y problematizar la producción académica sobre muertes violentas.

Abstract Introduction: This literature review collected scientific papers about violent deaths in Argentina, published between 2001 and 2016. The objectives are to describe the topics, fields of knowledge, disciplines, and methodologies of the papers and analyze the extent in which the academic production captures, interprets, and/or establishes violence as a public health problem. Materials and Methods: A total of 72 digital-format papers from scientific journal indexed in BVS, PubMed, Redalyc, SciELO, and Scopus were collected. A quantitative and qualitative strategy was developed, following the Critical Interpretive Synthesis framework. Results: The review indicated that the literature (a) is predominantly focused on physical violence, (b) is mainly produced by the Medical Sciences, (c) has descriptive objectives, (d) is characterized by having national and institutional geographical scopes, (e) uses primary data to study empirically the phenomena, and (f) mainly employs quantitative analysis methodologies. Most of the papers studied suicide, and the ones that analyzed homicide usually neglected to study the perpetrators' perspective. These aspects structurally describe the literature, yet distinctive thematic subfields were found, with heterogeneous features. The use of national statistics is scarce to indicate the epidemiological relevance of violence. Conclusion: The frequent recurrence of definitions and taxonomies of international organizations (mainly, World Health Organization) in the definition of health and violence indicates the dominant discursive position of these organizations in certain fields of knowledge.

Resumo Introdução: se apresenta uma revisão bibliográfica dos artigos científicos sobre mortes violentas na Argentina, publicados entre 2001 e 2016, com o objetivo de descrever temas, áreas de conhecimento, disciplinas e metodologias de tais artigos; para além, indaga-se em que medida a produção acadêmica capta, interpreta e/ou instala as violências como problema sanitário. Materiais e métodos: se revelaram artigos em formato digital publicados em revistas indexadas em BVS, PubMed, Redalyc, SciELO e Scopus. O corpus final incluiu 72 artigos. Se desenvolve uma análise quanti-qualitativa seguindo a síntese interpretativa crítica. Resultados: Se encontrou que a bibliografia: a) aborda predominantemente a violência física; b) se enquadra principalmente dentro das ciências médicas; c) tem objetivos descritivos; d) se caracteriza por ter alcances geográficos nacionais e, em segundo lugar, institucionais; e) parte de dados primários para a abordagem empírica, e f) emprega maioritariamente metodologias de análise quantitativas. A maioria dos artigos abordam o suicídio e, nos estudos sobre homicídio aparece uma área de vacância a perspectiva dos homicidas. Embora estes aspetos descrevem estruturalmente esta bibliografia, se encontraram núcleos temáticos com características diferentes. É escasso o uso de estatísticas nacionais para dar conta da relevância epidemiológica "das violências". Conclusão: a recorrência de definições e taxonomías de organismos internacionais (principalmente, Organização Mundial da Saúde) sobre saúde e violência dá conta de sua posição discursiva dominante. Se apresenta a necessidade de realizar outros estudos deste tipo, em diferentes países da região, com o objetivo de tematizar e proble-matizar a produção acadêmica sobre mortes violentas.

Reflexividad, autonomía y consentimiento. Un análisis de las experiencias de mujeres en la búsqueda de un parto fisiológico en la Ciudad de Buenos Aires / Reflexividade, autonomia e consentimento. Uma análise das experiências de mulheres na busca por um parto fisiológico na Cidade de Buenos Aires / Reflexivity, autonomy and consent. An analysis of womens experiences in the search for a physiological birth in the City of Buenos Aires

Resumen En este artículo se analiza el uso del consentimiento informado en torno a partos y nacimientos, mediante el análisis de las estrategias que efectúan las mujeres gestantes de la Ciudad de Buenos Aires en pos del reconocimiento de sus cuerpos, sus bebés, la fisiología de sus partos y el respeto por sus decisiones informadas. A partir de una investigación etnográfica, se analizan las tensiones que experimentan en sus intentos por hacer respetar sus necesidades, derechos y elecciones. Diferentes estrategias (directivas anticipadas, plan de parto, etc.) son desplegadas por las mujeres para efectivizar su protagonismo en las decisiones médicas respecto de sus partos. Este trabajo sugiere que el consentimiento informado no solo es un procedimiento médico formal que utilizan los/as médicos/as para avalar sus decisiones y dejar por sentado la aceptación del paciente, sino que se trata de una herramienta por la cual las mujeres se apropian y movilizan en sus interacciones con el sistema de salud.

Resumo Este artigo analisa o uso do consentimento informado em torno de partos e nascimentos, analisando as estratégias adotadas por gestantes na cidade de Buenos Aires, a fim de reconhecer seus corpos, seus bebês, a fisiologia de seus nascimentos e respeito por suas decisões informadas. A partir de uma investigação etnográfica, são analisadas as tensões que elas experimentam em suas tentativas de reforçar suas necessidades, direitos e escolhas. Estratégias diferentes (diretrizes antecipadas, plano de parto, etc.) são adotadas pelas mulheres para desempenhar seu papel nas decisões médicas sobre seus partos. Este artigo sugere que o consentimento informado não é apenas um procedimento médico formal que os/as médicos/as usam para apoiar suas decisões e dar como certa a aceitação da paciente, mas que é uma ferramenta pela qual as mulheres se apropriam e mobilizam suas interações com o sistema de saúde.

Abstract This paper inquires about the use of informed consent in childbirths and labours, analysing the strategies employed by pregnant women in Buenos Aires Capital City in pursuit of the recognition of their bodies, their babies, the physiology of their labours and the respect of their informed choices. In the context of an ethnographic study, the tensions that women experience in their attempts to make their needs, rights and decisions respected are analyzed. Different strategies (advance healthcare directive, birth plans, etc.) are devised by women to secure their central position in the decision-making related to their labours. This study suggests that informed consent is not only a formal medical procedure that physicians use to support their decision and have a written document of the patient's agreement, but also a tool used by women to seize control of their interactions in the health-care system.

Immediate reactions with glatiramer acetate: Diagnosis of allergy and desensitization protocols.

PURPOSE OF REVIEW: Diverse adverse events have been associated with administration of glatiramer acetate (GA), mainly local reactions at the injection site. Other, less frequent generalized reactions include isolated postinjection reactions and anaphylaxis, which may lead to discontinuation of GA. RECENT FINDINGS: Close collaboration between the allergy and neurology departments is needed to study adverse reactions to GA. The allergy study should include a detailed history and skin prick and intradermal tests with GA and, if possible, determination of specific IgE levels. Furthermore, the implication of other drugs should be ruled out. SUMMARY: An accurate diagnosis of reactions to GA is essential if we are to confirm or rule out allergy to GA. When an allergy diagnosis is confirmed or firmly suspected based on clinical evidence, desensitization protocols are increasingly seen as safe methods for reintroduction of GA.

Oral Food Challenge in Food Protein-Induced Enterocolitis Syndrome by Fish: Is There Any Room for Improvement?

BACKGROUND: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated gastrointestinal food hypersensitivity usually due to cow's milk or soy. Among the solid foods, rice is one of the most causative foods worldwide, but it varies depending on the geographic area. In the Mediterranean countries, fish is one of the most important triggers of FPIES. There is not a specific biological marker for the disease that allows us to confirm the diagnosis or to predict when tolerance to the offending food has been achieved, so all patients with a FPIES diagnosis undergo an oral food challenge (OFC) at least once. The OFC is a risky procedure and many patients develop severe symptoms. OBJECTIVE: We sought to evaluate the safety of a new OFC protocol in children with fish-FPIES. METHODS: A retrospective study was performed over a 22-year period (1996-2018). We compared two methodologies used in the OFC: Method 1 that consisted in giving several doses during the same day versus Method 2 that consisted in giving a unique dose per day on 2 or three non-consecutive days. RESULTS: A total of 75 positive OFC with fish done in 40 children were included. Forty-three (57.3%) OFC were performed following Method 1 and 32 (42.7%) with Method 2.The severity of the symptoms of the OFC done with Method 1 was mostly moderate (41.9%) followed by severe (39.5%) and mild (18.6%). The adverse reactions with Method 2 were mostly mild (68.8%) and only 18.8 and 12.5% presented moderate or severe symptoms, respectively. CONCLUSIONS: OFC performed in children with fish-FPIES are risky and many patients develop moderate or severe symptoms after this procedure. We propose a new protocol that has demonstrated to improve safety.

Young population, sexually-transmitted diseases and rights. National and regional scenario in Argentina. / Jóvenes, enfermedades de transmisión sexual y derechos. Panorama nacional y regional en Argentina.

In the context of social and demographic studies of sexual and reproductive health, this paper discusses the situation of young people in Argentina, emphasizing the problems revolving around Sexually Transmitted Diseases (STDs) and the compliance with sexual rights. This work aims to study the calendars and characteristics of the onset of sexual life in young Argentinean people and to describe the current situation of knowledge, practices, and access related to sexual life. Based on data from the National Survey on Sexual and Reproductive Health ( 2013) we worked with the universe of young people between 15 and 29 years of age (n = 2,084 women, n = 1,872 men, without weighting) and analyzed the differences in the calendars of the onset of sexual life, as well as the knowledge and prevention of STDs by gender sex, age groups, household income and geographical regions.A national scenario was found featuring marked tendencies in the calendars of first sexual intercourse by gender sex, as well as in the knowledge about STDs. However, the analysis by region and household income in each gendersex showed high heterogeneities, which would indicate certain limitations in the access to sexual education and the effective compliance of people's rights, as well as an increased risk to contracting STDs in specific social groups.

En el marco de los estudios sociales y demográficos sobre salud sexual y reproductiva, este artículo se interroga sobre la situación de los jóvenes en Argentina, poniendo foco en la problemática de las Enfermedades de Transmisión Sexual (ETS) y en el alcance de los derechos sexuales. Los objetivos son indagar en los calendarios y características del inicio de la vida sexual de jóvenes argentinos e indagar en la situación actual de conocimientos, prácticas y acceso a educación sexual. A partir de los datos de la Encuesta Nacional sobre Salud Sexual y Reproductiva (2013) se trabajó con el universo de jóvenes de 15 a 29 años de edad (n = 2084 mujeres; n = 1872 hombres, sin ponderar) y se analizaron las diferencias de los calendarios del inicio de la vida sexual, así como el conocimiento y prevención de las ETS por sexo, grupos de edades, ingreso de los hogares y regiones geográficas. Se encontró un panorama nacional con tendencias marcadas en los calendarios de primera relación sexual fundamentalmente por sexo, así como sobre los conocimientos sobre ETS. No obstante, el análisis diferenciado por región e ingreso del hogar en cada sexo mostró grandes heterogeneidades que indicarían limitaciones en el acceso a educación sexual y el efectivo cumplimiento de derechos de la población, así como un riesgo acentuado de contraer ETS en ciertos grupos sociales.

Jóvenes, enfermedades de transmisión sexual y derechos. Panorama nacional y regional en Argentina / Young population, sexually-transmitted diseases and rights. National and regional scenario in Argentina

Resumen En el marco de los estudios sociales y demográficos sobre salud sexual y reproductiva, este artículo se interroga sobre la situación de los jóvenes en Argentina, poniendo foco en la problemática de las Enfermedades de Transmisión Sexual (ETS) y en el alcance de los derechos sexuales. Los objetivos son indagar en los calendarios y características del inicio de la vida sexual de jóvenes argentinos e indagar en la situación actual de conocimientos, prácticas y acceso a educación sexual. A partir de los datos de la Encuesta Nacional sobre Salud Sexual y Reproductiva (2013) se trabajó con el universo de jóvenes de 15 a 29 años de edad (n = 2084 mujeres; n = 1872 hombres, sin ponderar) y se analizaron las diferencias de los calendarios del inicio de la vida sexual, así como el conocimiento y prevención de las ETS por sexo, grupos de edades, ingreso de los hogares y regiones geográficas. Se encontró un panorama nacional con tendencias marcadas en los calendarios de primera relación sexual fundamentalmente por sexo, así como sobre los conocimientos sobre ETS. No obstante, el análisis diferenciado por región e ingreso del hogar en cada sexo mostró grandes heterogeneidades que indicarían limitaciones en el acceso a educación sexual y el efectivo cumplimiento de derechos de la población, así como un riesgo acentuado de contraer ETS en ciertos grupos sociales.

Abstract In the context of social and demographic studies of sexual and reproductive health, this paper discusses the situation of young people in Argentina, emphasizing the problems revolving around Sexually Transmitted Diseases (STDs) and the compliance with sexual rights. This work aims to study the calendars and characteristics of the onset of sexual life in young Argentinean people and to describe the current situation of knowledge, practices, and access related to sexual life. Based on data from the National Survey on Sexual and Reproductive Health ( 2013) we worked with the universe of young people between 15 and 29 years of age (n = 2,084 women, n = 1,872 men, without weighting) and analyzed the differences in the calendars of the onset of sexual life, as well as the knowledge and prevention of STDs by gender sex, age groups, household income and geographical regions.A national scenario was found featuring marked tendencies in the calendars of first sexual intercourse by gender sex, as well as in the knowledge about STDs. However, the analysis by region and household income in each gendersex showed high heterogeneities, which would indicate certain limitations in the access to sexual education and the effective compliance of people's rights, as well as an increased risk to contracting STDs in specific social groups.

Anti-inflammatory and antinociceptive effects of tilifodiolide, isolated from Salvia tiliifolia Vahl (Lamiaceae).

Salvia tiliifolia Vahl (Lamiaceae) is used for the empirical treatment of pain and inflammation. The diterpenoid tilifodiolide (TFD) was isolated from Salvia tiliifolia. The in vitro anti-inflammatory effects of TFD (0.1-200 µM) were assessed using murine macrophages stimulated with LPS and estimating the levels of pro-inflammatory mediators for 48 h. The in vivo anti-inflammatory activity of TFD was assessed using the carrageenan-induced paw edema test for 6 h. The antinociceptive effects of TFD were evaluated using the formalin test and the acetic acid induced-writhing test. The effects of TFD on locomotor activity were assessed using the open field test and the rotarod test. TFD inhibited the production of TNF-α (IC50 = 5.66 µM) and IL-6 (IC50 = 1.21 µM) in macrophages. TFD (200 mg/kg) showed anti-inflammatory effects with similar activity compared to 10 mg/kg indomethacin. The administration of TFD induced antinociception in the phase 1 (ED50 = 48.2 mg/kg) and the phase 2 (ED50 = 28.9 mg/kg) of the formalin test. In the acetic acid assay, TFD showed antinociceptive effects (ED50 = 32.3 mg/kg) with similar potency compared to naproxen (ED50 = 36.2 mg/kg). In the presence of different inhibitors in the acetic acid assay, only the co-administration of TFD and naloxone reverted the antinociceptive activity shown by TFD alone. TFD did not affect locomotor activity in mice. TFD exerts in vitro and in vivo anti-inflammatory activity and in vivo antinociceptive effects.

Multi-omics analysis points to altered platelet functions in severe food-associated respiratory allergy.

BACKGROUND: Prevalence and severity of allergic diseases have increased worldwide. To date, respiratory allergy phenotypes are not fully characterized and, along with inflammation progression, treatment is increasingly complex and expensive. Profilin sensitization constitutes a good model to study the progression of allergic inflammation. Our aim was to identify the underlying mechanisms and the associated biomarkers of this progression, focusing on severe phenotypes, using transcriptomics and metabolomics. METHODS: Twenty-five subjects were included in the study. Plasma samples were analyzed using gas and liquid chromatography coupled to mass spectrometry (GC-MS and LC-MS, respectively). Individuals were classified in four groups-"nonallergic," "mild," "moderate," and "severe"-based on their clinical history, their response to an oral challenge test with profilin, and after a refinement using a mathematical metabolomic model. PBMCs were used for microarray analysis. RESULTS: We found a set of transcripts and metabolites that were specific for the "severe" phenotype. By metabolomics, a decrease in carbohydrates and pyruvate and an increase in lactate were detected, suggesting aerobic glycolysis. Other metabolites were incremented in "severe" group: lysophospholipids, sphingosine-1-phosphate, sphinganine-1-phosphate, and lauric, myristic, palmitic, and oleic fatty acids. On the other hand, carnitines were decreased along severity. Significant transcripts in the "severe" group were found to be downregulated and were associated with platelet functions, protein synthesis, histone modification, and fatty acid metabolism. CONCLUSION: We have found evidence that points to the association of severe allergic inflammation with platelet functions alteration, together with reduced protein synthesis, and switch of immune cells to aerobic glycolysis.

Enfermedad de Castleman cervical pediátrica / Castleman's disease in the paediatric neck

No disponible