Structural and Interpersonal Benefits and Risks of Participation in HIV Research: Perspectives of Female Sex Workers in Guatemala

This study explored perceived benefits and risks of participation in HIV research among 33 female sex workers in Tecun Uman, Guatemala. Stigma associated with sex work and HIV was a critical barrier to research participation. Key benefits of participation included access to HIV/STI prevention and testing, as well as positive and trusting relationships between sex workers and research teams. Control exerted by managers had mixed influences on perceived research risks and benefits. Results underscore the critical need for HIV investigators to develop population-tailored procedures to reduce stigma, engage managers, and reinforce trusting, reciprocal relationships between sex work communities and researchers

HIV Diagnosis, Linkage to Care, and Retention among Men Who Have Sex with Men and Transgender Women in Guatemala City

Men who have sex with men (MSM) and transgender women are disproportionately affected by HIV in Guatemala, yet little is known about their experiences with diagnosis, linkage to care, and retention. We conducted qualitative interviews with 26 MSM and transgender women living with HIV in Guatemala City. HIV diagnosis experiences changed over time with increasing asymptomatic testing at non-governmental organizations. Fear of the physical and social impacts of HIV delayed testing, acceptance of diagnosis, and linkage to HIV care. These fears were driven by layered stigma and discrimination due to non-normative gender expressions and/or sexual orientation. Retention-specific determinants included HIV clinic dynamics and limited employment opportunities. There is an urgent need to improve support systems for early testing and linkage to care and to expand employment opportunities. Stigma and discrimination must be addressed at the family, clinic and contextual levels to reduce fear of diagnosis and improve access to care

Pretreatment of Real Wastewater from the Chocolate Manufacturing Industry through an Integrated Process of Electrocoagulation and Sand Filtration

En este artículo se analizó el efecto de un proceso acoplado de electrocoagulación y filtración, para remover partículas suspendidas en un agua residual procedente de una industria de chocolates.The purpose of this study was to evaluate the efficiency of removal of suspended solids in terms of turbidity, color, and chemical oxygen demand (COD) when integrating the electrocoagulation process using aluminum sacrificial anodes and the sand filtration process as a pretreatment of wastewater from the chocolate manufacturing plant in Toluca, México. Wastewater from the chocolate manufacturing industry used in this study is classified as nontoxic, but is characterized as having a high content of color (5952 ± 76 Pt-Co), turbidity (1648 ± 49 FAU), and COD (3608 ± 250 mg/L). Therefore, enhanced performance could be achieved by combining pretreatment techniques to increase the efficiencies of the physical, chemical, and biological treatments. In the integrated process, there was a turbidity reduction of 96.1 ± 0.2% and an increase in dissolved oxygen from 3.8 ± 0.05 mg/L (inlet sand filtration) to 6.05 ± 0.03 mg/L (outlet sand filtration) after 120 min of treatment. These results indicate good water quality necessary for all forms of elemental life. Color and COD removals were 98.2 ± 0.2% and 39.02 ± 2.2%, respectively, during the electrocoagulation process (0.2915 mA/cm2 current density and 120 min of treatment). The proposed integrated process could be an attractive alternative of pretreatment of real wastewater to increase water quality of conventional treatments

Malignant lymphoma of the oral cavity and the maxillofacial region: overall survival prognostic factors

Objective: To identify the overall survival and prognostic factors of malignant lymphoma of the oral cavity and the maxillofacial region. Study Design: Clinical records data were obtained in order to determine overall survival at 2 and 5 years, the individual survival percentage of each possible prognostic factor with the actuarial technique, and the survival regarding the possible prognostic factors with the actuarial technique and the Log-rank and Cox's regression tests. Results: Of 151 subjects, an overall survival was 60% at 2 years, and 45% at 5 years. The multivariate analysis demonstrated statistically significant differences for clinical stage (p=0.002), extranodal involvement (p=0.030), presence of human immunodeficiency virus (p=0.032), and presence of Epstein-Barr virus (p=0.010). Conclusion: The advanced clinical stage and the larger number of involved extranodular sites are related to a lower overall survival, as well as, the presence of previous infections such as the human immunodeficiency and the Epstein-Barr virus

Influence of Peer Support on HIV/STI Prevention and Safety Amongst International Migrant Sex Workers: A Qualitative Study at the Mexico-Guatemala Border

Background Migrant women engaged in precarious employment, such as sex work, frequently face pronounced social isolation alongside other barriers to health and human rights. Although peer support has been identified as a critical HIV and violence prevention intervention for sex workers, little is known about access to peer support or its role in shaping health and social outcomes for migrant sex workers. This article analyses the role of peer support in shaping vulnerability and resilience related to HIV/STI prevention and violence among international migrant sex workers at the Mexico-Guatemala border.  Methods This qualitative study is based on 31 semi-structured interviews conducted with international migrant sex workers in the Mexico-Guatemala border communities of Tapachula, Mexico and Tecún Umán and Quetzaltenango, Guatemala. Results Peer support was found to be critical for reducing social isolation; improving access to HIV/STI knowledge, prevention and resources; and mitigating workplace violence, particularly at the initial stages of migration and sex work. Peer support was especially critical for countering social isolation, and peers represented a valuable source of HIV/STI prevention knowledge and resources (e.g., condoms), as well as essential safety supports in the workplace. However, challenges to accessing peer support were noted, including difficulties establishing long-lasting relationships and other forms of social participation due to frequent mobility, as well as tensions among peers within some work environments. Variations in access to peer support related to country of work, work environment, sex work and migration stage, and sex work experience were also identified.  Conclusions Results indicate that peer-led and community empowerment interventions represent a promising strategy for promoting the health, safety and human rights of migrant sex workers. Tailored community empowerment interventions addressing the unique migration-related contexts and challenges faced by migrant sex workers should be a focus of future community-based research, alongside promotion of broader structural changes

Acne Keloidalis Nuchae: A Multicenter Retrospective Study of 142 Hispanic Patients

Introduction: Acne keloidalis nuchae (AKN) is a primary cicatricial alopecia with mixed infiltrate. It is more common in African or persons of African descent. Objectives: Our objective was to describe the epidemiology and clinical and trichoscopic presentations of AKN in a large series of Hispanic patients. Methods: This was a retrospective study from 10 different dermatological centers in Argentina, Colombia, Mexico, and Peru. Patients with a clinical diagnosis of AKN treated by 12 dermatologists experienced in trichology from 2018 to 2022 were included. The Umar classification system was used to determine severity. Results: We identified 142 patients with AKN: 98% were male (n=140) with a mean age of 32 years; 108 patients had a previous history of trauma to the nuchal area (76%, p50 months of evolution were mainly classified in classes III and IV compared to patients with an evolution of <50 months (30%, n=9 vs. 14%, n=15; p=0.019; respectively). Conclusion: AKN should be considered in the differential diagnosis in the Hispanic population. Advanced stages of the disease are correlated with chronic evolution

Una perspectiva multidisciplinaria

Derivado de la necesidad de fomentar la investigación multidisciplinaria, la Facultad de Economía de la Universidad Autónoma del Estado de México llevó a cabo los días 8 y 9 de septiembre de 2016, el VIII Coloquio de Investigación intitulado “Desarrollo económico, regional y sustentable”. En este magno evento se presentaron 36 ponencias agrupadas en cinco mesas de trabajo: sectores productivos, crecimiento económico y mercado de trabajo; tecnología, innovación y organizaciones; desigualdad regional, pobreza y migración; economía financiera e internacional; y medio ambiente y sociedad. Del material expuesto en el VIII Coloquio, se eligieron 16 investigaciones, mismas que integran este libro. Los estudios presentados en cada uno de los subsiguientes capítulos fueron seleccionados de acuerdo a un proceso de rigurosidad científica, siendo sometidos a dictamen por pares ciegos a partir de la integración de un Comité Académico de expertos. Lo anterior con la finalidad de proporcionar al lector un material de investigación de calidad y solidez científica respecto a temas de trascendencia vinculados con los sectores productivos, la innovación, las organizaciones, la responsabilidad social, la desigualdad, la educación y el medioambiente.Consecuencia de la apertura de los mercados y los preceptos competitivos dictados por la globalización, se manifiesta la necesidad de vincular los diversos saberes provenientes de las ciencias naturales y sociales, con el fin de complementar el conocimiento y generar nuevas formas de visualizar el entorno. A raíz de ello, la investigación multidisciplinaria asume un papel cada vez más importante en los círculos académicos, empresariales y gubernamentales. En este marco, entra en desuso la visualización del individuo como un sujeto atomístico desvinculado del medio ambiente que le rodea. El objetivo de este libro es otorgar una visión multidisciplinaria al estudio de temas económicos incorporando visiones teóricas y empíricas procedentes de las ciencias sociales y naturales. La obra está compuesta por 16 capítulos agrupados en cuatro secciones. La primera parte, conglomera cinco capítulos en torno a los tópicos sectores productivos y crecimiento económico.Facultad de Economía. Universidad Autónoma del Estado de Méxic

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely