Socioeconomic determinants of participation in cancer screening in Argentina: A cross-sectional study

Low socioeconomic status is associated with late cancer diagnosis and mortality in Argentina. It is important that cancer screening services are accessible to the whole population so that cancer can be detected early. Our aim in this study was to investigate socioeconomic determinants for the disparities in the use of breast, cervical, and colorectal cancer screening services in Argentina, and to measure the country progress in reducing differences in cancer screening participation across socioeconomic levels. We performed a secondary analysis of cross-sectional data from the 2018 National Survey of Risk Factors of Argentina. The sample included data from 49,170 households. We also compared the results with data from the 2013 wave of the same survey in order to assess progress on cancer screening participation across income and education categories. Income, education, health insurance, disability, and marital status were associated with cancer screening underuse in Argentina. Comparison between 2013 and 2018 demonstrated that there has been some progress towards increasing cancer screening uptake, but this increase is not equitably distributed across the population. To further reduce disparities in cancer participation across socioeconomic levels, cancer screening programs in Argentina should reinforce strategies to become more accessible to all. It is important to proactively reach those populations that are underusers of cancer screening and ensure that barriers that stop people from accessing cancer screening are explored and adequately addressed

Socioeconomic determinants of cancer screening utilisation in Latin America: A systematic review

Introduction Cancer incidence and mortality in Latin America are rising. While effective cancer screening services, accessible to the whole population and enabling early cancer detection are needed, existing research shows the existence of disparities in screening uptake in the region. Objective We conducted a systematic review to investigate the socioeconomic determinants for the disparities in the use of breast, cervical and colorectal cancer screening services in Latin America. Methods We searched for studies reporting on socioeconomic determinants impacting on access to breast, cervical and colorectal cancer screening, published from 2009 through 2018. The studies that qualified for inclusion contained original analyses on utilisation of breast, cervical and colorectal cancer screening across socioeconomic levels in Latin America. For each study, paired reviewers performed a quality analysis followed by detailed review and data extraction. Results Twenty-four articles that met the eligibility criteria and were of sufficient quality were included in this review. Thirteen of the included articles were written in English, eight in Portuguese and three in Spanish, and they reported on the use of breast or cervical cancer screening. No studies were found on the socioeconomic determinants regarding the utilisation of colorectal cancer screening in Latin America. Low income, low education level, lack of health insurance and single marital status were all found to be determinants of underuse of breast and cervical cancer screening services. Conclusions Cancer screening programs in the region must prioritize reaching those populations that underuse cancer screening services to ensure equitable access to preventive services. It is important to develop national screening programmes that are accessible to all (including uninsured people) through, for example, the use of mobile units for mammography and self-screening methods

Exenatide Improves Bone Quality in a Murine Model of Genetically Inherited Type 2 Diabetes Mellitus

Type 2 diabetes mellitus (T2DM) is associated with skeletal complications, including an increased risk of fractures. Reduced blood supply and bone strength may contribute to this skeletal fragility. We hypothesized that long-term administration of Exenatide, a glucagon- like peptide-1 receptor agonist, would improve bone architecture and strength of T2DM mice by increasing blood flow to bone, thereby stimulating bone formation. In this study, we used a model of obesity and severe T2DM, the leptin receptor-deficient db/db mouse to assess alterations in bone quality and hindlimb blood flow and to examine the beneficial effects of 4 weeks administration of Exenatide. As expected, diabetic mice showed marked alterations in bone structure, remodeling and strength, and basal vascular tone compared with lean mice. Exenatide treatment improved trabecular bone mass and architecture by increasing bone formation rate, but only in diabetic mice. Although there was no effect on hindlimb perfusion at the end of this treatment, exenatide administration acutely increased tibial blood flow. While Exenatide treatment did not restore the impaired bone strength, intrinsic properties of the matrix, such as collagen maturity, were improved. The effects of Exenatide on in vitro bone formation were further investigated in primary osteoblasts cultured under high-glucose conditions, showing that Exenatide reversed the impairment in bone formation induced by glucose. In conclusion, Exenatide improves trabecular bone mass by increasing bone formation and could protect against the development of skeletal complications associated with T2DM

Sugar sweetened beverage consumption in the early years and implications for type 2 diabetes: A sub-Saharan Africa context

This article has been accepted for publication and will appear in a revised form, subsequent to peer review and/or editorial input by Cambridge University Press, in Proceedings of the Nutrition Society published by Cambridge University Press. Copyright Nutrition Society / Cambridge University Press.This review aims to explore trends of early consumption of sugar-sweetened beverages (SSBs) in Sub-Saharan Africa (SSA), within the context of growing child and adolescent obesity and escalating type-2 diabetes prevalence. We explore efforts to mitigate these, drawing on examples from Africa and elsewhere. SSBs including carbonated drinks and fruit juices, play a contributory role in the development of obesity and associated non-communicable diseases. SSA is an attractive market for beverage companies owing to its rapid economic growth, growing middle class and youthful populations. SSBs already contribute significantly to total sugar and energy consumption in SSA where a plethora of marketing techniques targeted at younger people are utilised to ensure brand recognition and influence purchasing and brand loyalty. Coupled with a general lack of nutrition knowledge or engagement with preventative health, this can lead to frequent consumption of sugary drinks at a young age. Many high and some middle income countries public health efforts address increasing prevalence of obesity and type-2 diabetes by focussing on strategies to encourage reduction in sugar consumption via health policy and public education campaigns. However, similar efforts are not as developed or forthcoming in low-income countries. Health care systems across SSA are ill-prepared to cope with epidemic proportions of non-communicable diseases, particularly when contextualized with the ongoing battle with infectious diseases. We conclude that greater efforts by governments and the nutrition community to educate the public on the health effects of increased and excessive consumption of SSBs are necessary to help address this issue

The GLP-1 Receptor Agonist Exenatide Ameliorates Bone Composition and Tissue Material Properties in High Fat Fed Diabetic Mice

Type 2 diabetes mellitus (T2DM) has recently been recognized as a significant risk factor for bone fragility. Careful investigations of bone mechanical properties in human studies suggested possible alterations of bone composition, although this axis has poorly been investigated. The main aim of this study was to evaluate the impact of high fat diet-induced diabetes and therapy using the clinically approved GLP-1 receptor agonist, exenatide, on tissue bone mechanical properties and compositional parameters. Male mice had free access to high fat diet for 16 weeks to induce diabetes prior to commencement of the study. Exenatide was administered twice daily by i.p. injection at a dose of 25 nmol/kg for 52 days. Normal and high fat diet fed (HFD) mice injected with saline were used as controls. Bone mechanical properties was assessed at the organ level by 3-point bending and at the tissue level by nanoindentation. Bone microarchitecture was investigated by microcomputed tomography and bone composition was evaluated by Fourier transform infrared imaging. HFD mice exhibited profound alterations of bone mechanical properties at both the organ and tissue level. Collagen maturity as well as trabecular and cortical bone microarchitectures were abnormal. Administration of exenatide, led to clear ameliorations in bone mechanical properties at the organ and tissue levels by modifications of both cortical microarchitecture and bone compositional parameters (collagen maturity, mineral crystallinity, carbonate/phosphate ratio, acid phosphate content). These results bring new light on the mode of action of exenatide in bone physiology and demonstrate the value of GLP-1 mimetics in the treatment of fragility fractures in diabetes

Mammography Services Quality Assurance: Baseline Standards for Latin America and the Caribbean

Fil: Barr, Helen. No especifíca;Fil: Blanco, Susana Alicia Ana. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Ministerio de Salud. Instituto Nacional del Cáncer; ArgentinaFil: Butler, Priscilla. No especifíca;Fil: da Paz, María Angela. No especifíca;Fil: Fleitas, Ileana. No especifíca;Fil: Craig, George. No especifíca;Fil: Jimenez, Pablo. No especifíca;Fil: Luciani, Silvana. No especifíca;Fil: Manrique, Javier. No especifíca;Fil: Mazal, Jonathan. No especifíca;Fil: Medlen, Kayiba. No especifíca;Fil: MIller, Colie. No especifíca;Fil: Mora, Patricia. No especifíca;Fil: Valdez Moreno, Martha Elena. No especifíca;Fil: Mosodeen, Murrie. No especifíca;Fil: Mysler, Gustavo. No especifíca;Fil: Nuche-Berenguer, Bernardo. No especifíca;Fil: Pastel, Mary. No especifíca;Fil: Pinochet, Miguel. No especifíca;Fil: Sisney, Gale. No especifíca;Fil: Ruiz Trejo, Cesar. No especifíca;Fil: Saraiya, Mona. No especifíca;Fil: Solis, Esteban. No especifíca;Fil: Swann, Phillip. No especifíca

Frecuencia, predictores, e impacto pronóstico del aneurisma de la arteria pulmonar en la hipertensión arterial pulmonar

Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 25-02-2022La hipertensión arterial pulmonar (HAP) es una enfermedad rara e incapacitante, que se asocia a una importante reducción de la supervivencia de los pacientes afectados, así como a una marcada reducción de su calidad de vida. En los últimos años, y gracias a la aparición de terapias específicas para esta enfermedad, la supervivencia de los pacientes de HAP ha mejorado notablemente. Esta mejoría en la supervivencia ha condicionado que muchos de estos pacientes se conviertan en pacientes crónicos, con la aparición de comorbilidades asociadas al envejecimiento y nuevas condiciones secundarias a su enfermedad que previamente se desconocían o ignoraban. El aneurisma de la arteria pulmonar (AAP) definido como una dilatación de la arteria pulmonar (AP) por encima de 40 mm, es una de estas condiciones cuyo diagnóstico (y el de sus complicaciones asociadas), se ha incrementado de forma paralela a la mejoría de la supervivencia de los pacientes con HAP. El objetivo de este trabajo es describir las características epidemiológicas del AAP en pacientes con HAP, identificar los factores que condicionan su desarrollo y evaluar el impacto que genera sobre la calidad de vida y la supervivencia de estos pacientes...Pulmonary arterial hypertension (PAH) is a rare and limiting disease associated with a significant survival's shortening, as well as a marked reduction in patients' quality of life. In recent years, after the appearance of specific therapies, the survival of PAH patients has improved remarkably.This improvement in patients' survival has made many patients become chronic patients, with the appearance of comorbidities associated with ageing and new conditions secondary to their disease that were previously unknown or even ignored.Pulmonary artery aneurysm (PAA), defined as a dilation of the main pulmonary artery (PA) above 40 mm, is one of these conditions whose diagnosis (and that of its associated complications) has increased in parallel with the improvement PAH patients' survival.We aim to describe the epidemiological characteristics of PAA in patients with PAH, to identify the factors that condition its development, and to evaluate the impact it causes on the quality of life and survival of these patients...Fac. de MedicinaTRUEunpu

Efecto de GLP-1 y EX-4 sobre el metabolismo óseo, en estados de resistencia a insulina y diabetes: mecanismos de acción

Tesis doctoral inédita leída en la Universidad Autónoma de Madrid, Facultad de Ciencias, Departamento de Biología. Fecha de lectura: 19-06-200