Immune system gene polymorphisms associated with severe dengue in Latin America: a systematic review

One of the main challenges in the clinical management of dengue is the early identification of cases that could progress to severe forms of the disease. A biomarker that may enable this identification is the presence of genetic polymorphisms in genes associated with immune responses. The objective of this study was to perform a systematic review of the Latin American literature on these genes. An electronic literature search was carried out in PubMed, Scopus, Lilacs, and the Virtual Health Library, and reference lists of systematic reviews in the area. Case-control studies conducted in Latin American countries examining at least one form of genetic polymorphism related to immune responses against severe dengue were included. In total, 424 articles were identified and 26 were included in this systematic review. Of the 26 selected articles, 16 reported polymorphisms associated with the risk of developing severe dengue (Risk); Similarly, 16 articles reported polymorphisms associated with a decreased risk of severe dengue (Protective). The final analysis revealed that multiple polymorphisms in immune system genes were early markers of the progression of dengue in Latin Americans and found that polymorphisms of the TNF-alpha gene may have a critical role in dengue pathogenesis

Factores asociados a la inactividad física en adolescentes colombianos: Estudio transversal

Introducción. La inactividad física es uno de los principales riesgos para enfermedades crónicas. Esta situación en adolescentes y jóvenes se ha convertido en un tema prioritario en la salud pública global. Objetivo. Explorar la asociación entre la inactividad física con los estilos de vida, factores demográficos, actividades sedentarias, sobrepeso y obesidad en adolescentes escolarizados en Sabaneta, 2017. Métodos. Estudio transversal, ejecutado en 7 instituciones educativas con una muestra probabilística aleatoria de 246 estudiantes. Se aplicó el test de Pérez Rojas García para la valoración de inactividad física. Se estimó un modelo lineal generalizado de familia binomial y link logit para estimar los OR crudos y ajustados para la asociación de las variables de interés y la inactividad física. Se acompañaron con los intervalos de confianza del 95%. Resultados. La prevalencia de inactividad física fue de 62,6%. La posibilidad de inactividad física fue mayor en las mujeres, personas con sobrepeso y obesidad, estudiantes con consumo de licor o cafeína, y entres quienes se dedicaron a usar el computador o estudiar más de 6 horas diarias. Entre los estudiantes de estrato bajo, delgados, con consumo de psicoactivos y que leen más de 6 horas al día la probabilidad de inactividad se redujo. Conclusiones. La prevalencia alta de inactividad física, obesidad y sobrepeso entre adolescentes fue alta. Los factores asociados son en su mayoría modificables, representando una oportunidad de mejora

Reproducibility of reading a set of cervical cytology smears in four specialized centers in Medellin, Antioquia

ABSTRACT: o assess the degree of reproducibility in the reading of cervical cytology smears among four specialized reading centers at Medellin, Colombia. Methodology: 181 cervical cytology smears from a study on the prevalence of cytological abnormalities in Pueblorrico, a town located in the southwestern region of the state of Antioquia in Colombia, were re-read by four specialized centers in Medellin. Each center was asked to conduct a blind routine reading of the smears to avoid disclosure of information between centers. The reproducibility was measured by percentage agreement and kappa. Results: of 181 smears only 55 matched across all 4 centers, with an overall concordance rate of 30% and an overall kappa of 0.31. According to Fleiss scale, poor reproducibility was observed. The concordance between pairs of centers ranged between 0.3 y 0.7. Discussion: there is a high variability in the interpretation of cytological results among centers in Medellin. It is necessary to implement training processes and to unify readings for cervical cytology criteria.RESUMEN:Avaluar el grado de reproducibilidad en la lectura de placas de citología cérvico-uterina entre cuatro centros de lectura especializados de la ciudad de Medellín, Colombia. Metodología: 181 placas de citología cérvico-uterina provenientes de un estudio de prevalencia de anormalidades citológicas en Pueblorrico, Antioquia, se sometieron a lectura en cuatro centros especializados de Medellín. Se le pidió a cada centro que realizara una lectura rutinaria manteniendo el estudio en ciego por medio de recodificación de las placas, evitando que se filtrara información entre centros. Se calculó la concordancia general y el índice kappa de Fleiss. Resultados: de las 181 placas, sólo en 55 placas los 4 centros concordaron en el resultado, obteniéndose un porcentaje de concordancia global del 30% y un índice kappa global de 0,31. Según la escala de Fleiss, se observó una baja reproducibilidad en la lectura de las placas citológicas entre los cuatro centros involucrados en el estudio. La concordancia por pares de centros presentó índices de kappa entre 0,3 a 0,7. Discusión: existe una alta variabilidad en la interpretación de los resultados citológicos entre los centros estudiados. Es necesario implementar procesos de entrenamiento y unificación de criterios de lecturas de la citología cervical en nuestro medio

Prevalencia de anticoncepción en mujeres en edad fértil de Sabaneta, Antioquia

Objetivo: Determinar la prevalencia de anticoncepción en mujeres en edad fértil del municipio de Sabaneta y sus posibles factores asociados. Métodos: se realizó un estudio de corte transversal en mujeres del municipio de Sabaneta a través de un muestreo estratificado por zona y grupo etario, posterior a este, se realizó un muestreo aleatorio sistemático; se incluyeron 354 mujeres. La recolección de la información se hizo mediante una encuesta. En cuanto al análisis de los datos se utilizó el OR con su IC (95%) y prueba de Chi Cuadrado (X2) con un valor p significativo <0,05. Resultados: la prevalencia de anticoncepción encontrada fue del 62%, el método más común fue la esterilización femenina con un 35,6%. Conclusión: el uso de métodos anticonceptivos en las mujeres del municipio de Sabaneta es menor a la media nacional, y esta posiblemente influenciada por la edad, el estado civil, el nivel educativo. Objective: To determine the prevalence of contraception among fertile women in the municipality of Sabaneta and its possible associated factors. Methods: we performed a cross-sectional study on women of the municipality of Sabaneta, a stratified sampling was carried out by zone and age group, then a systematic sampling; 354 women were included. Data were collected through a survey. OR with its CI (95%) and Chi-squared test (X2) were used for data analysis with a significant p value <0.05. Results: the prevalence of contraception was 62%. Female sterilization was the most frequently used method (35.6%). Conclusion: the use of contraceptive methods among women in Sabaneta is lower than the national average and may be affected by age, marital status, educational level

Burden of undiagnosed hypertension and its associated factors: A challenge for primary health care in urban Colombia.

BackgroundArterial hypertension is one of the most prevalent chronic, non-communicable diseases and the leading preventable risk factor for cardiovascular disease (CVD) and all-cause mortality worldwide. Although its primary causes and consequences are preventable, it often remains undiagnosed. Consequently, this study aims to determine the prevalence and factors associated with normotensive, diagnosed, and undiagnosed hypertension in adults.MethodsA cross-sectional, population-based study was conducted in Sabaneta, Colombia, between 2021 and 2022, with 286 adults aged 18 and older. Stratified and systematic random sampling methods were employed. The World Health Organization STEP survey and the Perez Rojas test were utilized to assess behavioral risk factors and sedentary lifestyles. Body mass index, waist circumference, and arterial tension were measured using standardized instruments. The prevalence of hypertension was then estimated. Risk factors influencing normotensive, diagnosed, and undiagnosed hypertension were analyzed using multinomial regression. The outcome variable comprised three categories: normotensive (reference category), diagnosed hypertension, and undiagnosed hypertension. The multinomial regression coefficients were exponentiated and are presented as relative risk ratios (RRR) with 95% confidence intervals (CI). The model was adjusted for sex and sample weight per neighborhood.ResultsThe study revealed a hypertension prevalence of 38.5% and an undiagnosed hypertension rate of 50.9%. Those with undiagnosed hypertension were predominantly adults over 60 years (RRR = 0.68; 95% CI: 0.53-0.86), individuals with an elementary school education (RRR = 1.75; 95% CI: 1.27-2.42), those physically active (RRR = 1.52; 95% CI: 1.22-1.89), without prior diagnoses of chronic comorbidities (RRR = 1.42; 95% CI: 1.12-1.82), and with obesity (RRR = 2.25; 95% CI: 1.63-3.11) or overweight conditions (RRR = 1.70; 95% CI: 1.334-2.15).ConclusionsUndiagnosed hypertension was significant among populations without risk conditions. There is an urgent need for community-based early detection and education strategies to mitigate this issue