Medición de las condiciones habitacionales: una propuesta metodológica para analizar desigualdades inter e intraterritorios urbanos

La medición de las condiciones habitacionales de un territorio resulta de especial interés para la implementación de políticas públicas. Los métodos tradicionales se concentran en la medición de los déficits y dejan de lado aquella parte de la población que se encuentra cerca del umbral. Con base en propuestas específicas, estándares de organismos internacionales, legislación nacional y la importante participación de especialistas, en este estudio se genera una metodología cuantitativa, que evita esa pérdida de información al incluir a toda la población de un territorio, asignándole un puntaje a cada persona de acuerdo a las características del hogar que habita. Para validar la propuesta, se presenta una aplicación con datos de Argentina, donde se constata su versatilidad, dado que permite detectar problemáticas particulares en cada dimensión, y también consigue analizar el nivel promedio, la distribución intra e interterritorios y la pérdida de bienestar por desigualdad.The measurement of the housing conditions of a territory is particularly important for the implementation of public policies. Traditional methods focus on the measurement of deficits and leave aside that part of the population which is closer to the threshold. Based on specific proposals, the standards of international organizations, national legislation, and a significant participation of specialists, this study proposes a quantitative methodology, which avoids said loss of information by including the entire population of a territory, assigning a score to each person according to the characteristics of the household they live in. To validate this proposal, we present an application with data from Argentina, where its versatility is verified given that it allows for the detection of issues in each dimension while also getting to analyze the average level, the intra and interterritorial distribution, and the welfare loss due to inequality.Fil: Actis Di Pasquale, Eugenio. Universidad Nacional de Mar del Plata. Facultad de Ciencias Económicas y Sociales; Argentina

Immunomodulatory Therapy Reduces the Severity of Placental Lesions in Chronic Histiocytic Intervillositis

From Frontiers via Jisc Publications RouterHistory: collection 2021, received 2021-08-04, accepted 2021-09-23, epub 2021-10-18Publication status: PublishedChronic histiocytic intervillositis (CHI) is a rare, but highly recurrent inflammatory placental lesion wherein maternal macrophages infiltrate the intervillous space. Pregnancies with CHI are at high risk of fetal growth restriction, miscarriage or stillbirth. Presently, the diagnosis can only be made after histopathological examination of the placenta. Given its proposed immunological etiology, current treatments include aspirin, heparin, and immunomodulatory agents. However, the rationale for these medications is largely based upon small case series and reports as there is a lack of larger studies investigating treatment efficacy. Therefore, this study sought to determine whether inclusion of immunomodulatory medications was effective at reducing the severity of lesions and improving pregnancy outcomes in subsequent pregnancies. Thirty-three women with a history of CHI in at least one pregnancy (index case) were identified retrospectively through medical records. Twenty-eight participants presented with a first subsequent pregnancy and a further 11 with a second subsequent pregnancy at a specialist clinic for pregnancy after loss. Data on maternal demographics, medical history, medication, pregnancy outcome, and placental pathology was collected and compared between pregnancies. Twenty-seven (69%) subsequent pregnancies were treated with at least one or both of prednisolone and hydroxychloroquine. Inclusion of at least one immunomodulatory agent in treatment regimen resulted in an almost 25% increase in overall livebirth rate (61.5 vs. 86.2%). In women treated with immunomodulatory medication a greater proportion of placentas had reduced severity of lesions compared to those treated without (86.7 vs. 33.3%, respectively). A reduction in CHI severity was associated with a 62.3% improvement in livebirth rate compared to those where severity remained unchanged in relation to the index case. These data provide preliminary evidence that the use of immunomodulatory medication in the management of CHI improves histopathological lesions and the chance of livebirth in subsequent pregnancies. Due to CHI's rarity and ethical and feasibility issues, randomized controlled trials in affected women are challenging to conduct. As a result, collaboration between centers is required in future to increase study sample sizes and elucidate the mechanisms of hydroxychloroquine and prednisolone in reducing pathology

Primers used for real time PCR analyses.

<p>Primers used for real time PCR analyses.</p

Effect of betamethasone on chemokine mRNA expression by choriodecidual explants.

<p>(A) CCL2, (B) CCL3, (C) CCL4, (D) CCL5, (E) CXCL8, (F) CXCL10. Data are fold change from vehicle control, n = 7 per treatment. Data are median and interquartile range, *p<0.05, **p<0.01 compared to vehicle control (Wilcoxon Signed Rank test).</p

Choriodecidual CC chemokine mRNA expression in the four study groups.

<p>Chemokine mRNA expression was normalised to RPL13 mRNA expression levels. (A) CCL2, (B) CCL3, (C) CCL4, (D) CCL5, (E) CCL8, (F) CCL18. Individual replicates and the median are shown, n = 10–14/study group. TNL = Term not in labour, TL = Term labour, PTL = Preterm labour and PTLI = Preterm labour with infection. Data are median and interquartile range, *p<0.05 **p<0.01 (Kruskall-Wallis with Dunn’s post hoc test).</p

Correlations between choriodecidual chemokine mRNA/protein expression and leukocyte subtypes present in decidua.

<p>Spearman’s correlation.</p>*<p>p<0.05,</p>**<p>p<0.01,</p>**<p>p<0.001.</p

Summary of changes in chemokine mRNA and protein expression in term and preterm labour.

<p>TL = term labour, TNL = term not in labour, PTL = preterm labour, NC = no change, – = not examined.</p>*<p>p<0.05,</p>**<p>p<0.01.</p

Choriodecidual CXC and CX3C chemokine mRNA expression in the four study groups.

<p>Chemokine mRNA expression was normalised to RPL13 mRNA expression levels. (A) CXCL1, (B) CXCL6, (C) CXCL8, (D) CXCL9, (E) CXCL10, (F) CX3CL1. Individual replicates and the median are shown, n = 10–14/study group. TNL = Term not in labour, TIL- Term labour, PTL = Preterm labour and PTLI = Preterm labour with infection. Data are median and interquartile range, *p<0.05 **p<0.01, ***p<0.001 (Kruskall-Wallis with Dunn’s post hoc test).</p

Chemokine mRNA profiles during term and preterm labour.

<p>Chemokine mRNA profiles during term and preterm labour.</p