Embarazo no deseado en adolescentes: problemática social permanente. Caso: El Calvario

Este artículo presenta una investigación realizada en uno de los sectores más deprimidos de la ciudad de Santiago de Cali: El Calvario. Se aborda una de las problemáticas más complejas a la que se exponen los adolescentes del sector, como son los embarazos no deseados, presentando las principales causas del problema, sus consecuencias y sugiriendo algunas posibles soluciones. Además, se evidencian los mecanismos que utilizan para prevenir y/o evitar este tipo de embarazos y se indaga acerca de la posibilidad real de acceso a programas de promoción y prevenciónThis article presents an investigation of one of the poorest sectors of the city of Santiago de Cali: El Calvario. It addresses one of the most complex problems to which adolescents are exposed to in this sector, such as unwanted pregnancies, presenting the main causes of the problem, its consequences and suggesting some possible solutions. Additionally, it shows the mechanisms used to prevent or avoid this type of pregnancy and investigates the real possibility of access to promotion and prevention program

Predictors of remission and low disease activity state in systemic Lupus erythematosus: data from a multiethnic, multinational latin American cohort

Objective: To determine the predictors of remission and low disease activity state (LDAS) in patients with systemic lupus erythematosus (SLE). Methods. Three disease activity states were defined: Remission = SLE Disease Activity Index (SLEDAI) = 0 and prednisone 4 and/or prednisone > 7.5 mg/day and/or immunosuppressants (induction dose). Antimalarials were allowed in all groups. Patients with at least 2 SLEDAI reported and not optimally controlled at entry were included in these analyses. Outcomes were remission and LDAS. Multivariable Cox regression models (stepwise selection procedure) were performed for remission and for LDAS. Results. Of 1480 patients, 902 were non-optimally controlled at entry; among them, 196 patients achieved remission (21.7%) and 314 achieved LDAS (34.8%). Variables predictive of a higher probability of remission were the absence of mucocutaneous manifestations (HR 1.571, 95% CI 1.064-2.320), absence of renal involvement (HR 1.487, 95% CI 1.067-2.073), and absence of hematologic involvement (HR 1.354, 95% CI 1.005-1.825); the use of immunosuppressive drugs before the baseline visit (HR 1.468, 95% CI 1.025-2.105); and a lower SLEDAI score at entry (HR 1.028, 95% CI 1.006-1.051 per 1-unit decrease). These variables were predictive of LDAS: older age at entry, per 5-year increase (HR 1.050, 95% CI 1.004-1.098); absence of mucocutaneous manifestations (HR 1.401, 95% CI 1.016-1.930) and renal involvement (HR 1.344, 95% CI 1.049-1.721); and lower SLEDAI score at entry (HR 1.025, 95% CI 1.009-1.042). Conclusion. Absence of mucocutaneous, renal, and hematologic involvement, use of immunosuppressive drugs, and lower disease activity early in the course of the disease were predictive of remission in patients with SLE; older age was predictive of LDAS.46101299130

Genomic Insights into the Ancestry and Demographic History of South America

<div><p>South America has a complex demographic history shaped by multiple migration and admixture events in pre- and post-colonial times. Settled over 14,000 years ago by Native Americans, South America has experienced migrations of European and African individuals, similar to other regions in the Americas. However, the timing and magnitude of these events resulted in markedly different patterns of admixture throughout Latin America. We use genome-wide SNP data for 437 admixed individuals from 5 countries (Colombia, Ecuador, Peru, Chile, and Argentina) to explore the population structure and demographic history of South American Latinos. We combined these data with population reference panels from Africa, Asia, Europe and the Americas to perform global ancestry analysis and infer the subcontinental origin of the European and Native American ancestry components of the admixed individuals. By applying ancestry-specific PCA analyses we find that most of the European ancestry in South American Latinos is from the Iberian Peninsula; however, many individuals trace their ancestry back to Italy, especially within Argentina. We find a strong gradient in the Native American ancestry component of South American Latinos associated with country of origin and the geography of local indigenous populations. For example, Native American genomic segments in Peruvians show greater affinities with Andean indigenous peoples like Quechua and Aymara, whereas Native American haplotypes from Colombians tend to cluster with Amazonian and coastal tribes from northern South America. Using ancestry tract length analysis we modeled post-colonial South American migration history as the youngest in Latin America during European colonization (9–14 generations ago), with an additional strong pulse of European migration occurring between 3 and 9 generations ago. These genetic footprints can impact our understanding of population-level differences in biomedical traits and, thus, inform future medical genetic studies in the region.</p></div

Global ancestry analysis of South American populations.

<p>(a) Principal Components Analysis of admixed individuals and continental reference panels. Each individual is represented as a point colored by country, region, or continent of origin. (b) Map of sampled populations. Countries of origin for admixed South Americans are highlighted and colored as in (a). (c) ADMIXTURE plot of admixed individuals and continental reference panels. Each individual is represented as a thin vertical bar. The colors represent the proportion of ancestry assigned to each cluster for each individual. <i>K</i> = 4 and <i>K</i> = 13 models are shown above, <i>K</i> = 2 through <i>K</i> = 15 models are available in <a href="http://www.plosgenetics.org/article/info:doi/10.1371/journal.pgen.1005602#pgen.1005602.s004" target="_blank">S4</a> and <a href="http://www.plosgenetics.org/article/info:doi/10.1371/journal.pgen.1005602#pgen.1005602.s005" target="_blank">S5</a> Figs.</p

Global ancestry proportions estimated through ADMIXTURE K = 4.

<p>Global ancestry proportions estimated through ADMIXTURE K = 4.</p

European ancestry specific analysis.

<p>(a) European Ancestry Specific PCA of haploid genomes from Colombia and Ecuador with greater than 25% estimated European ancestry combined with 2,882 haploid genomes from the POPRES data set. Admixed Latino individuals are shown in shades of grey, while European individuals are colored according to region and represented as a two-character country code. (b) European Ancestry Specific PCA of haploid genomes from Peru, Chile, and Argentina with greater than 25% estimated European ancestry combined with the same reference European data set as in (a). The inset map shows the color-coded regions within Europe of the POPRES reference panel. To maximize SNP overlap between data sets, ASPCA analyses were performed separately for each subset of South American Latino populations (see <a href="http://www.plosgenetics.org/article/info:doi/10.1371/journal.pgen.1005602#sec008" target="_blank">Methods</a>).</p

Native American ancestry specific analysis.

<p>Native American Ancestry Specific PCA of all Latino haploid genomes with greater than 25% estimated Native American ancestry. Each masked haploid genome from admixed individuals is represented by a single point colored by population of origin. Native American haploid genomes are plotted as the first three letters of the population name and colored according to the regional groupings. The approximate sampling location for each of the Native American parental populations is shown on the map of Latin America.</p