Risk factors associated with iron deficiency anemia in children under 5 years of age attending a health center in Chachapoyas, Peru.

Study Design: Retrospective case-control study. Objective: To identify risk factors among sociodemographic, nutritional and health characteristics associated with iron deficiency anemia in children under five years of age, attending the growth and development clinic of the Nueve de Enero de Chachapoyas Health Center during 2019.  Methods: Two groups were formed, each consisting of 50 children. Group 1 (G1, cases) were children diagnosed with iron deficiency anemia and a control group (CG) of age-matched healthy children residing in the same jurisdiction. Data were collected from the medical records of the health center, in a structured record card based on the study variables: age, birth weight, parasitic diseases or associated symptomatologies such as diarrhea, frequency and type of feeding before and after six months of age. The data were grouped in contingency tables for the calculation of Odds Ratio (OR), and statistical significance was estimated by analysis of variance (ANOVA) with 95% confidence. Results: All the factors considered presented significant association p<0.05, with the exception of sex, with respect to the presence of anemia in children. With OR values of: under 32 months of age (OR=2.26, 95% CI 0.59-2.79), under 2900 g birth weight (OR=2.98, 95% CI 0.43-2.99), prolonged exclusive breastfeeding (OR=3.14, 95% CI 1. 55-3.88), early ablactation (OR=4.96, 95% CI 1.27-5.07), low consumption of foods of animal origin (3.5, 95% CI 1.18-3.61), low consumption of fruits and vegetables (2.33, 95% CI 0.86-2.63), among others. Conclusions: In the population of Chachapoyas, the factors considered in the study increase the risk of developing anemia in children under five years of age by more than 93%. Its probability of occurrence warrants a reevaluation of the strategies applied in the different programs or interventions carried out in the area for the control and prevention of anemia

Conocimiento en salud

El libro "Conocimiento en Salud" explora diversas dimensiones del conocimiento aplicado en el ámbito de la salud, abordando temas desde la identidad profesional hasta la responsabilidad social. Se enfatiza la importancia de la identidad profesional para los trabajadores de la salud, destacando cómo esta identidad se construye a través de la formación y la práctica profesional, lo que les permite enfrentarse con eficacia a diferentes situaciones y casos clínicos. La obra también analiza la responsabilidad social en el sector salud, subrayando la necesidad de que los profesionales se comprometan con el bienestar común y contribuyan a reducir las desigualdades en el acceso a los servicios de salud. Asimismo, se aborda la bioseguridad, resaltando su papel crucial en la protección tanto de los pacientes como de los profesionales, y se discute el manejo adecuado de la salud sexual, promoviendo el conocimiento como herramienta fundamental para la prevención de enfermedades y la promoción de la salud. El libro también trata temas actuales como la pandemia de COVID-19, evaluando el nivel de conocimientos sobre la enfermedad entre los profesionales de la salud y su impacto en la práctica clínica. En suma, este libro es una guía esencial que integra conceptos teóricos y prácticos, orientados a fortalecer las competencias de los profesionales de la salud y su rol en la mejora continua de los sistemas de atención sanitaria

Correlation between MMPs and their inhibitors in breast cancer tumor tissue specimens and in cell lines with different metastatic potential

Background: The metastatic disease rather than the primary tumor itself is responsible for death in most solid tumors, including breast cancer. The role of matrix metalloproteinases ( MMPs), tissue inhibitors of MMPs (TIMPs) and Reversion-inducing cysteine-rich protein with Kazal motifs ( RECK) in the metastatic process has previously been established. However, in all published studies only a limited number of MMPs/MMP inhibitors was analyzed in a limited number of cell lines. Here, we propose a more comprehensive approach by analyzing the expression levels of several MMPs (MMP-2, MMP-9 and MMP-14) and MMP inhibitors (TIMP-1, TIMP-2 and RECK) in different models ( five human breast cancer cell lines, 72 primary breast tumors and 30 adjacent normal tissues). Methods: We analyzed the expression levels of MMP-2, MMP-9 and MMP-14 and their inhibitors (TIMP-1, TIMP-2 and RECK) by quantitative RT-PCR (qRT-PCR) in five human breast cancer cell lines presenting increased invasiveness and metastatic potential, 72 primary breast tumors and 30 adjacent normal tissues. Moreover, the role of cell-extracellular matrix elements interactions in the regulation of expression and activity of MMPs and their inhibitors was analyzed by culturing these cell lines on plastic or on artificial ECM (Matrigel). Results: The results demonstrated that MMPs mRNA expression levels displayed a positive and statistically significant correlation with the transcriptional expression levels of their inhibitors both in the cell line models and in the tumor tissue samples. Furthermore, the expression of all MMP inhibitors was modulated by cell-Matrigel contact only in highly invasive and metastatic cell lines. The enzyme/inhibitor balance at the transcriptional level significantly favors the enzyme which is more evident in tumor than in adjacent non-tumor tissue samples. Conclusion: Our results suggest that the expression of MMPs and their inhibitors, at least at the transcriptional level, might be regulated by common factors and signaling pathways. Therefore, the multi-factorial analysis of these molecules could provide new and independent prognostic information contributing to the determination of more adequate therapy strategies for each patient.`Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Conselho Nacional de Pesquisa (CNPq)Financiadora de Estudos e Projetos (FINEP)Pro-Reitoria da Universidade de Sao Paulo (PRP-USP

Individual and combined soy isoflavones exert differential effects on metastatic cancer progression

To investigate the effects soy isoflavones in established cancers, the role of genistein, daidzein, and combined soy isoflavones was studied on progression of subcutaneous tumors in nude mice created from green fluorescent protein (GFP) tagged-MDA-MB-435 cells. Following tumor establishment, mice were gavaged with vehicle or genistein or daidzein at 10 mg/kg body weight (BW) or a combination of genistein (10 mg/kg BW), daidzein (9 mg/kg BW), and glycitein (1 mg/kg BW) three times per week. Tumor progression was quantified by whole body fluorescence image analysis followed by microscopic image analysis of excised organs for metastases. Results show that daidzein increased while genistein decreased mammary tumor growth by 38 and 33% respectively, compared to vehicle. Daidzein increased lung and heart metastases while genistein decreased bone and liver metastases. Combined soy isoflavones did not affect primary tumor growth but increased metastasis to all organs tested, which include lung, liver, heart, kidney, and bones. Phosphoinositide-3-kinase (PI3-K) pathway real time PCR array analysis and western blotting of excised tumors demonstrate that genistein significantly downregulated 10/84 genes, including the Rho GTPases RHOA, RAC1, and CDC42 and their effector PAK1. Daidzein significantly upregulated 9/84 genes that regulate proliferation and protein synthesis including EIF4G1, eIF4E, and survivin protein levels. Combined soy treatment significantly increased gene and protein levels of EIF4E and decreased TIRAP gene expression. Differential regulation of Rho GTPases, initiation factors, and survivin may account for the disparate responses of breast cancers to genistein and daidzein diets. This study indicates that consumption of soy foods may increase metastasis

2 nd Brazilian Consensus on Chagas Disease, 2015

Abstract Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research

Practical guidelines for rigor and reproducibility in preclinical and clinical studies on cardioprotection

The potential for ischemic preconditioning to reduce infarct size was first recognized more than 30 years ago. Despite extension of the concept to ischemic postconditioning and remote ischemic conditioning and literally thousands of experimental studies in various species and models which identified a multitude of signaling steps, so far there is only a single and very recent study, which has unequivocally translated cardioprotection to improved clinical outcome as the primary endpoint in patients. Many potential reasons for this disappointing lack of clinical translation of cardioprotection have been proposed, including lack of rigor and reproducibility in preclinical studies, and poor design and conduct of clinical trials. There is, however, universal agreement that robust preclinical data are a mandatory prerequisite to initiate a meaningful clinical trial. In this context, it is disconcerting that the CAESAR consortium (Consortium for preclinicAl assESsment of cARdioprotective therapies) in a highly standardized multi-center approach of preclinical studies identified only ischemic preconditioning, but not nitrite or sildenafil, when given as adjunct to reperfusion, to reduce infarct size. However, ischemic preconditioning—due to its very nature—can only be used in elective interventions, and not in acute myocardial infarction. Therefore, better strategies to identify robust and reproducible strategies of cardioprotection, which can subsequently be tested in clinical trials must be developed. We refer to the recent guidelines for experimental models of myocardial ischemia and infarction, and aim to provide now practical guidelines to ensure rigor and reproducibility in preclinical and clinical studies on cardioprotection. In line with the above guideline, we define rigor as standardized state-of-the-art design, conduct and reporting of a study, which is then a prerequisite for reproducibility, i.e. replication of results by another laboratory when performing exactly the same experiment

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Risk factors associated with iron deficiency anemia in children under 5 years of age attending a health center in Chachapoyas, Peru.

Study Design: Retrospective case-control study. Objective: To identify risk factors among sociodemographic, nutritional and health characteristics associated with iron deficiency anemia in children under five years of age, attending the growth and development clinic of the Nueve de Enero de Chachapoyas Health Center during 2019.  Methods: Two groups were formed, each consisting of 50 children. Group 1 (G1, cases) were children diagnosed with iron deficiency anemia and a control group (CG) of age-matched healthy children residing in the same jurisdiction. Data were collected from the medical records of the health center, in a structured record card based on the study variables: age, birth weight, parasitic diseases or associated symptomatologies such as diarrhea, frequency and type of feeding before and after six months of age. The data were grouped in contingency tables for the calculation of Odds Ratio (OR), and statistical significance was estimated by analysis of variance (ANOVA) with 95% confidence. Results: All the factors considered presented significant association p&lt;0.05, with the exception of sex, with respect to the presence of anemia in children. With OR values of: under 32 months of age (OR=2.26, 95% CI 0.59-2.79), under 2900 g birth weight (OR=2.98, 95% CI 0.43-2.99), prolonged exclusive breastfeeding (OR=3.14, 95% CI 1. 55-3.88), early ablactation (OR=4.96, 95% CI 1.27-5.07), low consumption of foods of animal origin (3.5, 95% CI 1.18-3.61), low consumption of fruits and vegetables (2.33, 95% CI 0.86-2.63), among others. Conclusions: In the population of Chachapoyas, the factors considered in the study increase the risk of developing anemia in children under five years of age by more than 93%. Its probability of occurrence warrants a reevaluation of the strategies applied in the different programs or interventions carried out in the area for the control and prevention of anemia.</jats:p