"Without money you're nothing": poverty and health in Mexico from women's perspective

O objetivo do presente trabalho foi conhecer a vivência da pobreza em relação à assistência à saúde no caso de mulheres pobres mexicanas. Desenvolveu-se uma pesquisa qualitativa no México, realizando 40 entrevistas com mulheres entre 35 e 65 anos de idade. Detectaram-se três elementos centrais a respeito da vivência da pobreza e da assistência à saúde: a dependência socioeconômica para com a família; a noção de uma pertença social na vivência dos direitos de atenção à saúde, que se reflete na consideração e aceitação de que, devido a sua condição, somente podem ser atendidas em instituições filantrópicas; e a existência de mecanismos de sobrevivência diante de um evento de doença. Ao recuperar a experiência das mulheres pobres com relação à assistência à saúde, identificou-se que existe uma idéia clara de que, se tivessem contado com recursos econômicos suficientes, seus problemas de saúde teriam sido resolvidos de outra maneira. Também têm a convicção de que, por serem pobres, devem se conformar com uma atenção médica de má qualidade, e esta conformidade finalmente provoca sua resignação com o fato de perderem uma parte dos seus corpos, ou ainda mais esperarem a chegada da morte.El objetivo del presente trabajo fue conocer la vivencia de la pobreza en relación al cuidado y atención de la salud en el caso de mujeres pobres mexicanas. Se desarrolló una investigación cualitativa que se llevó a cabo en México. Se realizaron y analizaron cuarenta entrevistas que se aplicaron a mujeres entre 35 y 65 años de edad. Se detectaron tres elementos centrales con relación a la vivencia de la pobreza y el cuidado y atención de la salud: la dependencia socioeconómica hacia su familia; la noción de una pertenencia social en la vivencia de los derechos de atención a la salud que se refleja en la consideración y aceptación de que a ellas debido a su condición de pobreza sólo les corresponde ser atendidas en las instituciones de beneficencia pública; y la existencia de mecanismos de supervivencia frente a un evento de enfermedad. Al recuperar la experiencia de las mujeres pobres en su cuidado de salud se identificó lo siguiente: existe una clara idea de que si se hubiera contado con recursos económicos suficientes su problema de salud se hubiera resuelto de otra manera; también se tiene la convicción de que por ser pobres deben conformarse con una mala atención médica y, esta conformidad provoca que, finalmente, se resignen al hecho de, o bien perder una parte de su cuerpo, o, inclusive, a esperar la muerte.The objective of this qualitative study was to get to know poor Mexican women's experience of poverty in relation to health care. Forty-nine interviews were carried out with poor adult women in Mexico (between 35 and 65 years old). Three central elements were detected in relation to the women's experience of poverty and health care: their socio-economic dependence on their family; the notion of social belonging in their experience with health care rights, reflected in the idea and acceptance that, due to their poverty, they can only be attended at philanthropic institutions; and the existence of survival mechanisms when facing an illness. In recovering the experience of poor women in relation to their health care, we identified that there is a clear idea that, if women had had economic resources, their health problem would have been solved differently. They are also convinced that, due to being poor, they have to content themselves with bad-quality medical care. This conformity finally makes them resign to the fact of either loosing a part of their own body, or even just waiting for death

Asociación entre el trastorno por déficit de atención e hiperactividad y la rinitis alérgica: una revisión

El trastorno por déficit de atención e hiperactividad (TDAH) y la rinitis alérgica (RA) son diagnósticos frecuentes y con impacto en la calidad de vida de niños y adolescentes. Aunque desde hace varias décadas se ha reportado una posible asociación entre ambos trastornos, los resultados han sido inconsistentes. Se realizó una revisión de la literatura en PubMed y en Google Scholar que incluyó artículos de 1991 al 2014. Se encontró que en los últimos años, nuevos estudios han demostrado asociación entre el TDAH y la RA de manera más consistente que lo reportado con anterioridad. En la presente revisión, se describen también posibles mecanismos fisiopatológicos subyacentes e implicaciones terapéuticas de la asociación. Es importante que se realicen más investigaciones sobre la asociación entre ambos trastornos y se diluciden los mecanismos fisiopatológicos e implicaciones terapéuticas de la misma. ABSTRACT Attention-deficit/hyperactivity disorder (ADHD) and allergic rhinitis (AR) are common diagnoses that impact the quality of life of children and adolescents. Although for several decades a possible association between both disorders has been reported, these results have been inconsistent. We performed a literature search in PubMed and Google Scholar that includes articles from 1991 to 2014. We found that in recent years, new studies have demonstrated a more consistent association between ADHD and AR. Possible underlying pathophysiological mechanisms and therapeutic implications of this association are also described. It is important to continue studying the association between these disorders and dilucidate its physiopathology and therapeutic implications

Promjene moždane hemodinamike za vrijeme slušanja glazbe: funkcionalna transkranijska Doppler studija

Studies have shown that the perception of musical information differs between musically educated and musically non-educated individuals. The aim of the study was to determine the time course and lateralization of changes in mean blood flow velocity (MBFV) in the middle cerebral artery (MCA) during auditory stimulation between musically educated and musically non-educated listeners as well as between sexes. Using transcranial Doppler (TCD), MBFV was assessed in 61 healthy right-handed subjects (18 musical educated and 43 musically non-educated). The ability to play an instrument was considered the minimum criterion for musical education. In both musically educated and non-educated groups, left MCA was activated earlier (p=0.013) and had higher MBFV (p=0.046). In the right MCA, habituation was obtained earlier in musically non-educated than in musically educated group (p=0.019). Female listeners had a shorter activation time of MBFV in the left MCA than in the right MCA (p=0.002), while in males no difference was found. Male listeners had a longer first activation time in the left MCA (p=0.003) and higher first maximal amplitude in the right MCA (p=0.038) than female listeners. Also, the time of activation of MBFV in the left MCA was longer in male than in female listeners (p=0.013). Study results suggest that music perception requires bilateral activation of cerebral hemispheres. The left hemisphere is firstly and predominantly activated regardless of musical education, whereas the right hemisphere is associative and is connected to the experience of music. Results from this study indicated sex differences in the perception. To confirm our preliminary results, further studies involving larger groups are needed.Studije su pokazale da se percepcija glazbe razlikuje između glazbeno obrazovanih i glazbeno neobrazovanih osoba. Svrha studije je bila utvrditi vremenski slijed i lateralizaciju promjena u srednjoj vrijednosti strujanja krvi (SBSK) u arteriji cerebri mediji (ACM) kako između glazbeno obrazovanih i glazbeno neobrazovanih ispitanika, tako i između spolova za vrijeme slušne stimulacije. Kod 61 zdravog dešnjaka (18 glazbeno obrazovanih, 43 glazbeno neobrazovanih) pratila se SBSK pomoću transkranijskog Dopplera (TCD). Sposobnost sviranja instrumenta je bio minimalni kriterij glazbene izobrazbe. U objema skupinama glazbeno obrazovanih i glazbeno neobrazovanih ispitanika lijeva ACM se aktivirala ranije (p=0,013), a SBSK je bila viša u lijevoj ACM (p=0,046). Nije bilo razlike u habituaciji u lijevoj ACM između ovih dviju skupina. U desnoj ACM je kod glazbeno neobrazovanih došlo ranije do habituacije nego kod glazbeno obrazovanih (p=0,019). Kod žena je zabilježena brža aktivacija SBSK u lijevoj ACM nego u desnoj (p=0,002), dok kod muškaraca nije nađena razlika. Muški ispitanici su imali duže razdoblje prve aktivacije u lijevoj ACM (p=0,003) i višu amplitudu prve reakcije u desnoj ACM (p=0,038) nego ispitanice. Vrijeme reakcije SBSK u lijevoj ACM je također bilo duže u muških nego u ženskih ispitanika (p=0,013). Naši rezultati upućuju na to da je za percepciju glazbe potrebna aktivacija obiju hemisfera. Pretežito i prvenstveno se aktivira lijeva moždana hemisfera bez obzira na glazbenu izobrazbu, dok desna moždana hemisfera ima više asocijativnu funkciju i povezana je s glazbenim iskustvom. Kod muškaraca i žena su uz pomoć funkcionalnog TCD također zabilježene razlike u precepciji. Za potvrdu ovih preliminarnih rezultata našega istraživanja potrebno je proširiti istraživanje na veći broj ispitanika

Promjene moždane hemodinamike za vrijeme slušanja glazbe: funkcionalna transkranijska Doppler studija

Studies have shown that the perception of musical information differs between musically educated and musically non-educated individuals. The aim of the study was to determine the time course and lateralization of changes in mean blood flow velocity (MBFV) in the middle cerebral artery (MCA) during auditory stimulation between musically educated and musically non-educated listeners as well as between sexes. Using transcranial Doppler (TCD), MBFV was assessed in 61 healthy right-handed subjects (18 musical educated and 43 musically non-educated). The ability to play an instrument was considered the minimum criterion for musical education. In both musically educated and non-educated groups, left MCA was activated earlier (p=0.013) and had higher MBFV (p=0.046). In the right MCA, habituation was obtained earlier in musically non-educated than in musically educated group (p=0.019). Female listeners had a shorter activation time of MBFV in the left MCA than in the right MCA (p=0.002), while in males no difference was found. Male listeners had a longer first activation time in the left MCA (p=0.003) and higher first maximal amplitude in the right MCA (p=0.038) than female listeners. Also, the time of activation of MBFV in the left MCA was longer in male than in female listeners (p=0.013). Study results suggest that music perception requires bilateral activation of cerebral hemispheres. The left hemisphere is firstly and predominantly activated regardless of musical education, whereas the right hemisphere is associative and is connected to the experience of music. Results from this study indicated sex differences in the perception. To confirm our preliminary results, further studies involving larger groups are needed.Studije su pokazale da se percepcija glazbe razlikuje između glazbeno obrazovanih i glazbeno neobrazovanih osoba. Svrha studije je bila utvrditi vremenski slijed i lateralizaciju promjena u srednjoj vrijednosti strujanja krvi (SBSK) u arteriji cerebri mediji (ACM) kako između glazbeno obrazovanih i glazbeno neobrazovanih ispitanika, tako i između spolova za vrijeme slušne stimulacije. Kod 61 zdravog dešnjaka (18 glazbeno obrazovanih, 43 glazbeno neobrazovanih) pratila se SBSK pomoću transkranijskog Dopplera (TCD). Sposobnost sviranja instrumenta je bio minimalni kriterij glazbene izobrazbe. U objema skupinama glazbeno obrazovanih i glazbeno neobrazovanih ispitanika lijeva ACM se aktivirala ranije (p=0,013), a SBSK je bila viša u lijevoj ACM (p=0,046). Nije bilo razlike u habituaciji u lijevoj ACM između ovih dviju skupina. U desnoj ACM je kod glazbeno neobrazovanih došlo ranije do habituacije nego kod glazbeno obrazovanih (p=0,019). Kod žena je zabilježena brža aktivacija SBSK u lijevoj ACM nego u desnoj (p=0,002), dok kod muškaraca nije nađena razlika. Muški ispitanici su imali duže razdoblje prve aktivacije u lijevoj ACM (p=0,003) i višu amplitudu prve reakcije u desnoj ACM (p=0,038) nego ispitanice. Vrijeme reakcije SBSK u lijevoj ACM je također bilo duže u muških nego u ženskih ispitanika (p=0,013). Naši rezultati upućuju na to da je za percepciju glazbe potrebna aktivacija obiju hemisfera. Pretežito i prvenstveno se aktivira lijeva moždana hemisfera bez obzira na glazbenu izobrazbu, dok desna moždana hemisfera ima više asocijativnu funkciju i povezana je s glazbenim iskustvom. Kod muškaraca i žena su uz pomoć funkcionalnog TCD također zabilježene razlike u precepciji. Za potvrdu ovih preliminarnih rezultata našega istraživanja potrebno je proširiti istraživanje na veći broj ispitanika

Prevalencia de respiración oral y su efecto en el desempeño escolar en niños con alergia respiratoria

Antecedentes: El asma y la rinitis alérgica (RA) se han relacionado con alteraciones craneofaciales debido a la alta frecuencia de respiración oral en ambas patologías. Pacientes y métodos: Se realizó un estudio observacional y prospectivo de enero a diciembre del 2007 en pacientes de 6 a 15 años vistos por primera vez con alergia respiratoria. Después del examen físico completo, se realizó un cuestionario para determinar somnolencia diurna, ronquido y desempeño académico. Resultados: Se incluyeron 107 pacientes, 42 hombres y 65 mujeres. 80.4% tenían rinitis alérgica y 19.6% rinitis alérgica y asma. Los eventos de ronquido se clasificaron como leve (1-2 veces/semana) el 10.3%, moderado (3-5 veces /semana) 16.8% y como roncadores habituales (> 6 veces / semana) el 9.3%. El resto no roncaba (63.6%). La somnolencia diurna fue investigada por la facilidad de los niños de quedarse dormidos cuando viajaban en coche (23.4%), en la escuela (2.8%), al hacer tarea (4.7%) o mientras veían televisión (6.5%). Los pacientes con 3 o más alteraciones físicas fueron clasificados como respiradores orales, correspondiendo a un 29% (n=31). En el área académica el 92% de los niños con calificaciones reprobatorias pertenecieron al grupo de los respiradores orales. Las calificaciones buenas en conducta fueron más frecuentes en los respiradores nasales que en los orales (80% vs 20%,) (p < 0.001). Conclusión: La prevalencia de respiradores orales en pacientes de primera vez con diagnóstico de rinitis alérgica con o sin asma fue del 29%. El desempeño escolar (académico y de conducta) es menor en pacientes respiradores orales. Abstract: Introduction: Allergic rhinitis and asthma have been associated with craniofacial abnormalities due to the high frequency of oral breathing in both pathologies. Methods and materials: We conducted an observational prospective study from January to December 2007. Patients seen for the fist time, diagnosed with respiratory allergies between 6 and 15 years of age were included. After a complete history and physical examination, after that they answered a questionnaire inquiring about snoring characteristics, day-time sleepiness, and academic performance. Results: One hundred and seven patients were included, 42 males (39.3%) and 65 females (60.7%). Allergic rhinitis was the most prevalent diagnosis in 80.4% (86) of the cases, followed by allergic rhinitis and asthma in 18.6%. The snoring events were classified as mild (1–2 times/week) which represented 10.3%, moderate (3–5 times/week), which were 16.8 %, and habitual snorers (>6 times/week), which were 9.3 %, and 68 (63.6%) did not snore. Daytime somnolence was classified in groups as follows: ease of falling asleep while traveling by car (23.4% of all patients), at school (2.8%), while doing homework (4.7%) or watching TV (6.5%). Patients were classified as oral breathers if they had 3 or more physical findings, corresponding to a 29% (n=31). In the academic area, 92% of the children with failing grades belonged to the oral breathers. Good behavior grades were better in the nasal breathers group when compared with oral breathers (80% vs. 20%) (p < 0.001). Conclusion: The prevalence of oral breathing in first time patients with an allergic rhinitis diagnosis, with or without asthma, was 29%. Poor school performance (academic and behavioral) is worse in oral breathers

Comparison of Risk Factors for Developing Liver Fibrosis in Subjects With and Without Metabolic Syndrome: A Cohort Study.

Background: Metabolic syndrome (MS), a combination of diabetes, high blood pressure and obesity, is a well-known risk factor for developing non-alcoholic fatty liver disease, condition that can lead to serious liver damage such as liver fibrosis (LF), which is characterized by excessive deposition of connective tissue, progressing to cirrhosis and hepatocellular carcinoma. Nevertheless, subjects without MS may also develop LF. Non-invasive LF predictors based upon anthropometric and biochemical data have been reported. Aim: To compare anthropometric, genetic, and biochemical parameters in subjects with or without MS, and at risk for developing liver fibrosis. Methods: A randomized sample of 200 individuals was taken from the 2015 Nuevo León State Health Survey. Inclusion criteria were age ≥18 and a previously stored blood sample. According to the parameters obtained, subjects were classified as either with or without MS and their NAFLD fibrosis score was calculated considering variables such as age, BMI, glycemia, albumin, platelets, and AST/ALT ratio, to establish a high or low risk of LF. Comparisons of weight, age, BMI, blood glucose, total cholesterol, triglycerides, platelets, albumin, AST/ALT ratio, and HDL were made between groups. DNA was extracted from stored blood samples and genotyped, using q-PCR, according to variants in four genes related to: fatty acid (FA) metabolism (PNPLA3, rs738409), adipocyte differentiation (PLIN2, rs35568725), glucose metabolism (GCKR, rs1260326 and rs780094), and BMI (UCP2, rs659366). Statistical analysis was performed with SPSS v.22. A p value &lt;0.05 was taken as level of significance. Results: A total of 134 subjects were included and divided into four groups (n): With MS+ high risk (35), With MS+ low risk (34), Without MS+ high risk (32), Without MS+ low risk (33). Table 1 shows the main significative findings. Higher age, low platelet count, and increased AST/ALT ratio, were significantly different in high risk subjects, independently of the presence of MS. No association between the polymorphisms and risk for fibrosis was found. In subjects at high risk for LF, statistical significance was found for high cholesterol blood levels (OR= 20.0 (95%CI 2.87;139.38) in carriers of the T allele of GCKR rs780094 polymorphism. Conclusion: Aging, thrombocytopenia, and increased transaminases, the last two indicators of liver disfunction, were found as important risk factors for LF in subjects without metabolic syndrome. None of the genetic variants analyzed resulted associated to risk of LF, although sample size could be a factor. GCKR rs780094 variant was found related with risk for hypercholesterolemia, even though dyslipidemia was not found associated with risk of LF in the present study.&nbsp;&nbsp

Risk factors and molecular mechanisms associated with trimethoprim–sulfamethoxazole resistance in Stenotrophomonas maltophilia in Mexico

Abstract Purpose. Stenotrophomonas maltophilia is a multidrug-resistant opportunistic pathogen causing an increasing number of nosocomial infections. Our aim was to evaluate the risk factors and mechanisms associated with trimethoprim– sulfamethoxazole (SXT) resistance in S. maltophilia infections in Mexico. Methodology. Clinical isolates and patients’ demographic and clinical data were collected from February 2007 to August 2015 in two tertiary-care hospitals in Mexico. Antimicrobial susceptibility and analysis of sul and SmeABC and SmeDEF efflux pump overexpression were performed in all isolates. Results/Key findings. In the 9-year period, 196 patients infected with S. maltophilia were identified. Most patients were male, and the mean age was 46.2years. The mean Charlson score was 1.42, and the most frequent comorbidities were arterial hypertension (26.7%), type 2 diabetes (21.2%) and cerebral infarction (11.6%). High drug resistance to meropenem (93.4%), gentamicin (55.1%), ceftazidime (52.3%), cefotaxime (51.5%), amikacin (42.3%) and cefepime (32.1%), and lower resistance to ciprofloxacin (26.0%), SXT (25.0%), chloramphenicol (14.3%) and levofloxacin (2.6%) were detected. SXT resistance was not associated with the sul genes. SmeABC overexpression was associated with gentamicin (P=0.001) and levofloxacin resistance (P=0.041), whereas SmeDEF overexpression was associated with ceftazidime resistance (P=0.003). Prolonged hospitalization (�15days) was an independent risk factor for SXT-resistant S. maltophilia infections (OR=3.05; 95%CI=1.12– 8.86; P=0.029). Conclusion. Given the high SXT resistance rate, SXT is not an effective first-line therapy for our patients; instead, levofloxacin could be used as an appropriate therapeutic option against S. maltophilia infections

Biological characterization of a biodegradable scaffold for common bile duct replacement in an experimental model

Background: The nanofiber scaffolds achieved by the electrospinning technique have been used to develop several biological tissues, the nanofibers obtained by electrospinning procure a favorable microenvironment to mimic the extracellular matrix. Methods: Study type was of experimental. Study conducted at National Autonomous University of Mexico, from May 2018- May 2022. The protocol was approved by the research and ethics commissions of the UNAM school of medicine. A viscoelastic solution of polylactic-co-glycolic acid (PLGA) and polycaprolactone (PCL) in a 70:30 ratio and gelatin (Gel) in an 80:20 ratio was prepared while a dynamic collector was used with the electrospinning technique. Results: Mechanical and biological tests were carried out on the scaffold obtained by electrospinning; the resultant scaffold achieves good mechanical matching and structural similarity between the graft and the extrahepatic bile duct. Conclusions: In this study we managed to create a porous, biocompatible scaffold with good cell adhesion and proliferation, potentially applicable to tissue engineering, especially for the replacement of tubular organs such as blood vessels, bile ducts, and urethra

AB Aur, a Rosetta stone for studies of planet formation (I): chemical study of a planet-forming disk

AB Aur is a Herbig Ae star that hosts a prototypical transition disk. The disk shows a plethora of features connected with planet formation mechanisms. Understanding the physical and chemical characteristics of these features is crucial to advancing our knowledge of planet formation. We aim to characterize the gaseous disk around the Herbig Ae star AB Aur. A complete spectroscopic study was performed using NOEMA to determine the physical and chemical conditions. We present new observations of the continuum and 12CO, 13CO, C18O, H2CO, and SO lines. We used the integrated intensity maps and stacked spectra to derive estimates of the disk temperature. By combining our 13CO and C18O observations, we computed the gas-to-dust ratio along the disk. We also derived column density maps for the different species and used them to compute abundance maps. The results of our observations were compared with Nautilus astrochemical models. We detected continuum emission in a ring that extends from 0.6 to 2.0 arcsec, peaking at 0.97 and with a strong azimuthal asymmetry. The molecules observed show different spatial distributions, and the peaks of the distributions are not correlated with the binding energy. Using H2CO and SO lines, we derived a mean disk temperature of 39 K. We derived a gas-to-dust ratio that ranges from 10 to 40. The comparison with Nautilus models favors a disk with a low gas-to-dust ratio (40) and prominent sulfur depletion. From a very complete spectroscopic study of the prototypical disk around AB Aur, we derived, for the first time, the gas temperature and the gas-to-dust ratio along the disk, providing information that is essential to constraining hydrodynamical simulations.Moreover, we explored the gas chemistry and, in particular, the sulfur depletion. The derived sulfur depletion is dependent on the assumed C/O ratio. Our data are better explained with C/O ~ 0.7 and S/H=8e-8.Comment: 13 figures, 6 table