Flora alimenticia disponible para Apis mellifera (Himenoptera: Apidae) en un área de bosque serrano en Uruguay

Título alternativo : Flora alimentar disponível para Apis mellifera (Himenoptera: Apidae) em uma área de floresta de altitude no UruguaiKnowing the blooms is useful to predict the behavior of Apis mellifera (honeybee) colonies. The objective was to determine the floristic characteristics of a mountain forest in Uruguay from the beekeeping point of view. We made eight visits in every three sites surrounding the apiary, at 10-20 m, 500 m and 1500 m distance. The first visit determined the species, families, origin (native or exotic), and frequency of each taxon. In subsequent visits, we censed which ones remained in bloom (presence or absence). We assigned each species a value of one to five for abundance (A) and the duration of flowering (P), during two years. Using the Shannon Index the floristic diversity was established. A generalized linear model was employed to analyze flowering through the response variables: presence of flowering in winter, spring, summer and autumn, as well as flowering duration. We calculated a Shannon Index of 3.6, indicating high biodiversity. Then we correlated the findings of the survey and literature reports on the occurrence of each species in melissopalynological studies in mature and immature honey. The expression “Convertible Flora” was coined to identify the floral resources whose pollen is stored when no flower is available. These were Lithraea brasiliensis, Baccharis articulata, Baccharis trimera, Blepharocalyx salicifolius, Eugenia uniflora, Colletia Paradoxa, Oxalis sp., Scutia buxifolia, Jodina rhombifolia, Aloysia gratissima for the spring and autumn seasons (P <0.05). The expression “Support Flora” (P <0.05) is used to classify those resources that are found in immature honey and are almost absent in mature honey, and are used as nutrients during the colony expansion: Schinus engleri, Maytenus ilicifolia, Eryngium pandanifolium, Baccharis punctulata, Abutilon pauciflorum, Daphnopsis racemosa, Allophylus edulis, and Celtis tala. This flora classification allows planning the expected developments and yields of honey from a region to establish technological useful and efficient packages of honey harvests.El conocimiento de las floraciones es útil para predecir el comportamiento de las colonias de Apis mellifera (abeja de la miel). El objetivo fue determinar las características florísticas desde el punto de vista apícola de un bosque serrano en Uruguay. Realizamos ocho visitas en tres sitios aledaños a la colmena: a 10-20 m, 500 m y 1500 m de distancia. En la primera visita determinamos especies, familias, origen (nativo o exótico) y frecuencia de cada taxón. En visitas posteriores, censamos cuáles estaban florecidas (presencia o ausencia). Asignamos a cada especie un valor de uno a cinco para la abundancia (A) y la duración de la floración (P), durante dos años. Utilizamos el índice de Shannon para medir la diversidad florística. Se utilizó un modelo lineal generalizado para analizar la floración a través de las variables respuesta: presencia de floración en invierno, primavera, verano y otoño, así como duración de la floración. Calculamos un índice de Shannon de 3,6, lo que indica una alta biodiversidad. Luego correlacionamos los hallazgos de la prospección con datos de la literatura sobre la ocurrencia de cada especie en estudios melisopalinológicos en mieles maduras e inmaduras. Por último, definimos el término flora convertible para identificar los recursos florales cuyo polen se almacena cuando no hay ninguna flora disponible. Estas fueron Lithraea brasiliensis, Baccharis articulata, Baccharis trimera, Blepharocalyx salicifolius, Eugenia uniflora, Colletia Paradoxa, Oxalis sp., Scutia buxifolia, Jodina rhombifolia, Aloysia gratissima, para las temporadas de primavera y otoño (P<0.05). El término flora de soporte (P<0.05) lo definimos para clasificar aquellos recursos que se encuentran en la miel inmadura y están casi ausentes en la miel madura, y se utilizan como nutrientes durante la expansión de la colonia: Schinus engleri, Maytenus ilicifolia, Eryngium pandanifolium, Baccharis punctulata, Abutilon pauciflorum, Daphnopsis racemosa, Allophylus edulis y Celtis tala. Esta clasificación de la flora permite planificar los desarrollos y rendimientos de la miel esperados de una región, y establecer paquetes tecnológicos útiles y eficientes de cosechas de miel.O conhecimento das flores é útil para prever o comportamento de colônias de Apis mellifera (abelha do mel). O objetivo foi determinar as características florísticas de uma floresta montanhosa no Uruguai do ponto de vista apícola. Fizemos oito visitas em três locais no entorno do apiário: a 10-20m, 500m e 1500m de distância dele. A primeira visita determinou as espécies, famílias, origem (nativa ou exótica) e frequência de cada táxon. Nas visitas subsequentes, censuramos quais permaneceram em flor (presença ou ausência). Atribuímos a cada espécie um valor de um a cinco para abundância (A) e duração da floração (P), durante dois anos. Usando o Índice de Shannon, a diversidade florística foi estabelecida. Um modelo linear generalizado foi empregado para analisar a floração através das variáveis ​​resposta: presença de floração no inverno, primavera, verão e outono, bem como a duração da floração. Calculamos um Índice de Shannon de 3,6, indicando alta biodiversidade. Após correlacionar os achados do levantamento e relatos da literatura sobre a ocorrência de cada espécie em estudos melisopalinológicos em mel maduro e imaturo. O termo “Flora Conversível” foi cunhado para identificar os recursos florais cujo pólen é armazenado quando nenhuma flor está disponível. Estes foram Lithraea brasiliensis, Baccharis articulata, Baccharis trimera, Blepharocalyx salicifolius, Eugenia uniflora, Colletia Paradoxa, Oxalis sp., Scutia buxifolia, Jodina rhombifolia, Aloysia gratissima para as estações de primavera e outono (P <0,05). O termo “Flora de Apoio” (P <0,05) é usado para classificar os recursos encontrados no mel imaturo e quase ausentes no mel maduro e são usados ​​como nutrientes durante a expansão da colônia: Schinus engleri, Maytenus ilicifolia, Eryngium pandanifolium, Baccharis punctulata, Abutilon pauciflorum, Daphnopsis racemosa, Allophylus edulis and Celtis tala. Esta classificação da flora permite planejar os desenvolvimentos e rendimentos esperados do mel de uma região para estabelecer embalagens tecnológicas úteis e eficientes de colheita de mel

Anti-Müllerian hormone and inhibin B levels as markers of premature ovarian aging and transition to menopause in type 1 diabetes mellitus

BACKGROUNDSerum anti-Müllerian hormone (AMH) levels decrease early during the transition to menopause and women with type 1 diabetes mellitus (DM1) experience menopause at a younger age. We hypothesized that older women with DM1 will have lower AMH levels than controls.METHODSWe studied ovarian function in women with DM1 (n = 66) and healthy controls (n = 58), all 33 years (4.1 ± 4.2 versus 9.5 ± 7.9 pmol/l, mean ± SD, P = 0.006). A higher proportion of women with DM1 showed AMH levels in the menopausal range compared with controls (16.7 versus 3.4, respectively, P = 0.02). For all patients, those with DM1 exhibited lower inhibin B levels than controls (89.3 ± 51.7 versus 113.2 ± 76.0 ng/ml, P < 0.05). FSH and estradiol were similar in both groups. Regression analysis showed an earlier decline in AMH levels in women with DM1 than controls. Even after age adjustment, DM1 was a significant factor for the determination of inhibin B and AMH levels.CONCLUSIONSLower AMH levels in women with DM1 during the fourth decade of life suggest the presence of an earlier decline in the ovarian follicle pool in these women. Further studies are needed to evaluate the mechanism of this complication.Fil: Soto, Néstor. San Borja Arriarán Clinical Hospital; ChileFil: Iñiguez, Germán. Universidad de Chile; ChileFil: López, Patricia. Universidad de Chile; ChileFil: Larenas, Gladys. Universidad de La Frontera; ChileFil: Mujica, Verónica. Hospital Regional de Talca; Chile. Universidad de Talca; ChileFil: Rey, Rodolfo Alberto. Gobierno de la Ciudad de Buenos Aires. Hospital General de Niños "Ricardo Gutiérrez"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Codner, Ethel. Universidad de Chile; Chil

Guia para uso do imunodiagnóstico em ovinos aplicado à vigilância epidemiológica da equinococose cística

Cystic echinococcosis (CE) is a parasitic zoonosis caused by Echinococcus granulosus sensu lato. Immunodiagnostic techniques such as Western blot (WB) or enzyme-linked immunosorbent assay (ELISA), with different antigens, can be applied to the diagnosis of CE sheep for epidemiological surveillance purposes in control programs. However, its use is limited by the existence of antigenic cross-reactivity between different species of taeniidae present in sheep. Despite this, the usefulness of establishing surveillance systems based on the identification of infection present in a livestock establishment, known as the Epidemiological Unit (UE), has been postulated. A new ELISA diagnostic technique has been developed and validated using the recombinant EgAgB8/2 antigen for the detection of antibodies against E. granulosus, estimating an OD 0.496 as the cut-off value that optimizes diagnostic sensitivity and specificity. To determine the infection in the EU, a Bayesian model was built, executed with a Monte Carlo Markov chain algorithm, which allowed defining the sample sizes for different expected prevalences to ensure that at least two of the samples are truly positive. In this way, the system can be used to identify the prevalence of infection in the area under control measured as a percentage of EU with the presence of infected sheep (infection present) or individually identify the EU with present transmission, given by presence of infected lambs, on which control measures should be intensified.La equinococosis quística (EQ) es una zoonosis parasitaria causada por Echinococcus granulosus sensu lato. Técnicas inmunodiagnósticas como Western blot (WB) o el enzimoinmunoensayo (ELISA), con distintos antígenos, pueden ser aplicadas al diagnóstico de la EQ ovina con fin tales de vigilancia epidemiológica en programas de control. Sin embargo, hay limitación para su uso por la existencia de reacción cruzada antigénica entre diferentes especies de taeniidaes presentes en el ovino. A pesar de ello se ha postulado la utilidad de establecer sistemas de vigilancia basados en la identificación de infección presenteen un establecimiento ganadero, a lo que se denomina Unidad Epidemiológica (UE). Una nueva técnica diagnóstica de ELISA ha sido desarrollada y validada utilizando el antígeno EgAgB8/2 recombinante, para detección de anticuerpos contra E. granulosus, estimándose una DO 0.496 como el valor de corte que optimiza la sensibilidad y especificidad. Para la determinación de la infección en UE se construyó un modelo bayesiano ejecutado con un algoritmo de cadena de Markov Monte Carlo que permitió definir los tamaños de muestra para diferentes prevalencias esperadas para asegurar que al menos dos de las muestras sean verdaderamente positivas. De tal forma, el sistema puede ser usado para identificar la prevalencia de la infección en el área bajo control medida como porcentaje de UE con ovinos infectados (infección presente) o identificar individualmente las UE con transmisión presente, dada por la existencia de corderos infectados, sobre las que se deben intensificar las medidas de control.A equinococose cística (CK) é uma zoonose parasitária causada porEchinococcus granulosus sensu lato. Técnicas de imunodiagnóstico como western blot (WB) ou ensaio imunoenzimático (ELISA), com diferentes antígenos, podem ser aplicadas no diagnóstico da DQ ovina para fins de vigilância epidemiológica em programas de controle. No entanto, seu uso é limitado pela existência de reação cruzada antigênica entre diferentes espécies de taeniidae presentes em ovinos. Apesar disso, postula-se a utilidade de estabelecer sistemas de vigilância baseados na identificação de infecção presente em um estabelecimento pecuário, conhecido como Unidade Epidemiológica (UE). Uma nova técnica de diagnóstico ELISA foi desenvolvida e validada utilizando o antígeno recombinante EgAgB8/2 para a detecção de anticorpos contra E. granulosus, estimando uma DO 0,496 como valor de corte que otimiza a sensibilidade e especificidade. Para determinar a infecção na UE, foi construído um modelo Bayesiano, executado com um algoritmo de cadeia de Monte Carlo Markov, que permitiu definir os tamanhos das amostras para diferentes prevalências esperadas para garantir que pelo menos duas das amostras sejam verdadeiramente positivas. Desta forma, o sistema pode ser utilizado para identificar a prevalência de infecção na área sob controle medida em porcentagem da UE com ovinos infectados (infecção presente) ou identificar individualmente a UE com transmissão presente, dada a existência de cordeiros infectados, em quais medidas de controle devem ser intensificadas.infectados, em quais medidas de controle devem ser intensificadas

Comparación de la salud oral integral de pacientes usuarios y no usuarios GES 60 años hospitalizados

General objective: Compare indicators for integral oral health status between users and non-users of the Integral Oral Health program for 60-year-old adults (GES-60 years). Material and methods: Cross-sectional observational study was conducted. Surveys were conducted at the Hospital Parroquial from San Bernardo, including patients 60 years old or older, between the years 2015 and 2019. Outcome: A total of 944 were included surveys. Regarding the knowledge and use of the GES-60 years, 105 declared to know about it, and 60 declared to have used it (57%). &nbsp;In users, oral hygiene was higher and statistically significant (Proportion test; p=0.009). The sample was divided into positive and negative oral health self-perception. Also in three variables: periodontal disease (PD), PD with tobacco consumption and PD with diabetes. Only the positive perception group showed differences regarding the three variables and the use of the GES-60 years. (Proportion test; p&lt;0.0001). In the DMFT index, there were only differences regarding the number of fillings and use of the GES-60 years (Mann Whitney test; p&lt;0.0001), not in terms of the number of decayed teeth. Benefit users received the superior prosthesis they needed. Discussion: A small percentage of patients know and use the benefit. Users brush their teeth more, but perhaps poorly. The GES-60 years meets the rehabilitative aspect, since the number of fillings and the use of removable prostheses increased, but education didn´t have influence on periodontal disease or its risk factors. Key words: Elderly, public health, dentistryObjetivo general: Comparar indicadores de salud oral integral entre usuarios y no usuarios del Programa Salud Oral Integral para adultos de 60 años (GES-60 años). Material y método: Estudio transversal de encuestas realizadas por internos de Odontología de la Universidad de los Andes a pacientes del Hospital Parroquial de San Bernardo con 60 años o más durante los años 2015-2019. Resultados: Se incluyeron 944 encuestas. Respecto del conocimiento y uso del GES-60 años, 105 declararon conocerlo y de ellos 60 lo utilizaron (57%). En los usuarios la higiene oral fue mayor y estadísticamente significativa (Test de proporciones; p=0,009). La muestra se dividió en autopercepción de salud oral positiva y negativa. También en tres variables: enfermedad periodontal (EP), EP con tabaquismo y EP con diabetes. Solo el grupo de percepción positiva mostró diferencias con respecto a las tres variables y el uso del GES-60 años. (Test de proporciones; p&lt;0,0001). En el índice COPD, solo hubo diferencias respecto del número de obturaciones y uso del GES-60 años (Test de Mann Whitney; p&lt;0,0001), no en cuanto al número de lesiones de caries. Los usuarios del beneficio recibieron la prótesis superior que necesitaban. Discusión: Un reducido porcentaje de pacientes conoce y usa el beneficio. Los usuarios se cepillan más, pero tal vez de forma deficiente. El GES-60 años cumple con el aspecto rehabilitador, ya que aumentó el número de obturaciones y el uso de prótesis removibles, pero la educación no influyó sobre la enfermedad periodontal ni sus factores de riesgo. Palabras clave: Garantías Explícitas en Salud (GES), Salud Oral, adultos 60 años

Patrón de comportamiento tipo A, ira y enfermedades cardiovasculares (ECV) en población urbana chilena

Un aumento de las enfermedades cardiovasculares (ECV)mundialmente, la existencia de un porcentaje m&aacute;s alto que el promedio nacional de &eacute;stas para la regi&oacute;n de Maule (Chile), y una atenci&oacute;n incrementada en el an&aacute;lisis de factores psicol&oacute;gicos, motivan el an&aacute;lisis del Patr&oacute;n de Comportamiento Tipo A (PCTA) y la ira respecto de las ECV. Se trabaj&oacute; con 1007 participantes de 18 a 74 a&ntilde;os (ciudadanos de Talca, Chile), mayoritariamente mujeres, quienes respondieron un cuestionario (informaci&oacute;n sociodemogr&aacute;fica, h&aacute;bitos alimentarios y de estilo de vida), la Escala Retiro de Patr&oacute;n de Conducta tipo A (ERCTAa), y el Inventario de Ira de Novaco. Se les midi&oacute; peso, masa corporal, presi&oacute;n arterial y sangre, como factores de riesgo cardiovascular. Los participantes son altamente sedentarios (79.9%), tab&aacute;quicos (53.6%), hipercolesterol&eacute;micos (44.5%), con sobrepeso (40.7%) y obesidad (32.6%), un cuarto de los cuales presenta hiperglicemia e hipertensi&oacute;n y con PCTA equirepartido seg&uacute;n sexo. Es la ausencia de PCTA (&oacute; presencia de PCTB) la que aparece asociada a factores tradicionales de riesgo cardiovascular (FRCV). La ira alta se presenta m&aacute;s en mujeres que en hombres (2.1% vs. 0.3%; c2(3) = 27.99,

The Role of Propolis in Oxidative Stress and Lipid Metabolism: A Randomized Controlled Trial

Although there is evidence of the benefits of propolis on human health, the vast majority of studies have been conducted using animal models. The present study includes the chemical characterization and clinical evaluation of the effects of the oral administration of propolis solution on the oxidative status and modulation of lipids in a human population in Talca, Chile. Chemical characterization of propolis, total phenol, flavonoids, and total antioxidant capacity were determined by ORAC. Identification of phenols and flavonoids in propolis was assessed by HPLC-DAD. A double-blind, placebo-controlled clinical trial was conducted. Subjects provided informed consent form and the Bioethics Committee of the Universidad de Talca approved protocol. Eligible subjects (n=67) were randomized in two groups: propolis (n=35) and placebo (n=32). All subjects were evaluated at 0 (baseline), 45, and 90 days. In the propolis group, we observed that increases in HDL-c went from 53.9 ± 11.9 to 65.8 ± 16.7 mg/dL (p<0.001) from baseline to 90 days. Compared to placebo subjects, consumption of propolis induced a net increase in GSH levels (p<0.0001) and a decrease (p<0.001) in TBARS levels for the propolis group. Our findings indicate potential benefits of propolis use in human health. The use of propolis appears to have positive effects on oxidative status and improvement of HDL-c, both of which contribute to a reduced risk of cardiovascular disease

Vacinação com EG95 contra a equinococose cística ovina na província de Río Negro: análise de 12 anos de trabalho

Cystic echinococcosis (CE) is a zoonosis caused by species of the complex Echinococcus granulosus, sensu lato in their larval stage. It is an endemic disease in the province of Río Negro, where lamb vaccination with EG95 was incorporated in 2009 with very good results: in fact, it contributed to a significant drop in prevalence of infection in diverse hosts. However, impact studies have revealed the need to improve understanding of local epidemiology. The objective was to identify causes which can still generate infection in dogs. In indigenous reserves comprised within the area of lamb vaccination with 3 doses of EG95, prevalence in adult caprines and ovines was determined by necropsy and serology (ELISA). Through serology, infection rates in vaccinated and non-vaccinated ovines were significantly different (p= 0.0004), as well as between non-vaccinated ovines and goats (p= 0.0013); on the other hand, infection rate differences between vaccinated sheep and non-vaccinated goats turned out non-significant (p= 0.254). Through necropsy, such difference between vaccinated and non-vaccinated ovines turned out significant (p= 0.0016); between non-vaccinated ovines and non-vaccinated goats, it proved non-significant (p= 0.23). With reference to epidemiology and control along the period 2018- 2022, vaccination strategy was maintained, and 2 extra deworming tasks were introduced, performed by the vaccination team. Assessment of animal slaughter for consumption in 41 producers showed that 21 of them slaughter a monthly average of 18 goats, and 36 in all slaughter 35 old sheep. Design and implementation of programme resulted cost-effective, since it was possible to maintain them over time, with clear impact on prevalence decrease in diverse hostsEquinococosis quística (EQ) es una enfermedad zoonótica causada por el estadío larval del complejo Echinococcus granulosus sensu lato. En el año 2009 en la Provincia de Rio Negro se agregó la vacunación&nbsp; de corderos con EG95, la desparasitación de perros con praziquantel lográndose disminuir la prevalencia de la infección en los diferentes hospederos. Sin embargo, los estudios de impacto señalaron la necesidad de mejorar la comprensión de la epidemiologia local. Objetivo: identificar causas que pueden generar aun infección en los perros Materiales y métodos: se determinó la prevalencia de EQ en caprinos y ovinos adultos mediante necropsia y por serología (ELISA). El análisis epidemiológico se completó con una encuesta a los productores sobre hábitos de faena para consumo. Resultados: Mediante serología. las diferencias en la tasa de infección entre ovinos vacunados y no vacunados resulto significativa (p=0.0004); entre ovinos no vacunados y cabras no vacunadas resultosignificativa (p= 0.0013) y entre ovejas vacunadas y cabras no vacunadas resultaron no significativas (p= 0.254). Mediante necropsia las diferencias en la tasa de infección entre ovinos vacunados y no vacunados resulto significativa (p=0.0016); entre ovinos no vacunados y cabras no vacunadas resulto significativa (p= 0.0016 y entre ovejas vacunadas y cabras no vacunadas resultaron no significativas (p= 0.23). El relevamiento de la faena de animales para consumo en 41 productores mostro que 21 faenan en promedio 18 cabras mensuales y entre 36 faenan 35 ovejas viejas mensuales Conclusión: El diseño y la implementación del programa resultaron costo – efectivas, en tanto ha podido sostenerse a través del tiempo demostrando impacto en la disminución de la prevalencia en los distintos hospedadoresA equinococose cística (EQ) é uma zoonose causada pela fase larval do complexo Echinococcus granulosus sensu lato. Em 2009, na Província de Rio Negro, foram adicionadas a vacinação de cordeiros com EG95 e a desparasitação de cães com praziquantel, obtendo-se uma redução na prevalência da infecção nos diferentes hospedeiros. No entanto, os estudos de impacto apontaram para a necessidade de melhorar o entendimento da epidemiologia local. Objetivo: identificar causas que ainda podem gerar infecção em cães. Materiais e métodos: a prevalência de EQ em caprinos e ovinos adultos foi determinada por necropsia e por sorologia (ELISA). A análise epidemiológica foi completada com um levantamento dos produtores sobre os hábitos de abate para consumo. Resultados: Por sorologia. as diferenças na taxa de infecção entre ovinos vacinados e não vacinados foram significativas (p=0,0004); entre ovinos não vacinados e caprinos não vacinados foi significativo (p= 0,0013) e entre ovinos vacinados e caprinos não vacinados não foi significativo (p= 0,254). Pela necropsia, as diferenças na taxa de infecção entre ovinos vacinados e não vacinados foram significativas (p=0,0016); entre ovinos não vacinados e caprinos não vacinados foi significativa (p= 0,0016 e entre ovinos vacinados e caprinos não vacinados não foi significativa (p= 0,23). O levantamento do abates em média 18 cabras mensais e entre 36 abatem 35 ovelhas velhas mensalmente. Conclusão: O desenho e a implementação do programa foram custo- efetivos, pois se manteve ao longo do tempo, mostrando impacto na diminuição da prevalência em diferentes acolhimentosde animais para consumo em 41 produtores mostrou que 21 abate

Ethnic group inequalities in coverage with reproductive, maternal and child health interventions:cross-sectional analyses of national surveys in 16 Latin American and Caribbean countries

Background Latin American and Caribbean populations include three main ethnic groups: indigenous people, people of African descent, and people of European descent. We investigated ethnic inequalities among these groups in population coverage with reproductive, maternal, newborn, and child health interventions. Methods We analysed 16 standardised, nationally representative surveys carried out from 2004 to 2015 in Latin America and the Caribbean that provided information on ethnicity or a proxy indicator (household language or skin colour) and on coverage of reproductive, maternal, newborn, and child health interventions. We selected four outcomes: coverage with modern contraception, antenatal care coverage (defined as four or more antenatal visits), and skilled attendants at birth for women aged 15-49 years; and coverage with three doses of diphtheria-pertussis-tetanus (DPT3) vaccine among children aged 12-23 months. We classified women and children as indigenous, of African descent, or other ancestry (reference group) on the basis of their self-reported ethnicity or language. Mediating variables included wealth quintiles (based on household asset indices), woman's education, and urban-rural residence. We calculated crude and adjusted coverage ratios using Poisson regression. Findings Ethnic gaps in coverage varied substantially from country to country. In most countries, coverage with modern contraception (median coverage ratio 0.82, IQR 0.66-0.92), antenatal care (0.86, 0.75-0.94), and skilled birth attendants (0.75, 0.68-0.92) was lower among indigenous women than in the reference group. Only three countries (Nicaragua, Panama, and Paraguay) showed significant gaps in DPT3 coverage between the indigenous and the reference groups. The differences were attenuated but persisted after adjustment for wealth, education, and residence. Women and children of African descent showed similar coverage to the reference group in most countries. Interpretation The lower coverage levels for indigenous women are pervasive, and cannot be explained solely by differences in wealth, education, or residence. Interventions delivered at community level-such as vaccines-show less inequality than those requiring access to services, such as birth attendance. Regular monitoring of ethnic inequalities is essential to evaluate existing initiatives aimed at the inclusion of minorities and to plan effective multisectoral policies and programmes.Entidad financiadora: Bill & Melinda Gates Foundation; Wellcome Trus

Propolis as an Adjuvant in the Healing of Human Diabetic Foot Wounds Receiving Care in the Diagnostic and Treatment Centre from the Regional Hospital of Talca

Objective. Diabetic foot wounds are a relevant diabetes complication and a major health problem. It has been described that propolis has health benefits due to its anti-inflammatory, antioxidant, and support in the healing process. The current study assessed the effect of propolis as an adjuvant in the healing of human diabetic foot ulcers. This was evaluated in a randomized placebo-controlled study of subjects receiving care in the Diagnostic and Treatment Centre from the Regional Hospital of Talca, Chile. Research Design and Methods. Randomized subjects received ambulatory healing treatment for diabetes foot wounds with propolis spray (3%), which was applied to cover the entire wound surface each time it was dressed from week 0 until cicatrization or 8 weeks as a maximum. Two serum samples were taken (day 0 and end of the study) for cytokine and oxidative stress analyses. Also, macro- and microscopy were analyzed in the process of wound healing. Results. The study comprised 31 subjects with type 2 diabetes in treatment for diabetic foot wounds in the Diagnostic and Treatment Centre from the Regional Hospital of Talca. Propolis promotes a reduction of the wound’s area by an average of 4 cm2, related to an increase in the connective tissue deposit compared to the control. Also, propolis increased the glutathione (GSH) and GSH/glutathione disulfide (GSSG) ratio (p<0.02), depleted tumor necrosis factor- (TNF-) α, and increased interleukin- (IL-) 10 levels. Topical propolis did not modify the biochemical parameters in the serum of the studied subjects. Conclusions. The topical use of propolis turned out to be an interesting therapeutic strategy as an adjuvant in the care of diabetes foot wounds due to its ability to improve and promote healing based on its anti-inflammatory and antioxidant profile. This trial is registered with NCT03649243