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PURPOSE: Identify the incidence and risk factors for acute kidney injury (AKI) following total knee arthroplasty (TKA) with and without tourniquet. MATERIAL AND METHODS: 100 patients were randomized into two groups. Postoperative AKI was defined as the postoperative creatinine level 0.3 mg/dl compared with baseline. Potential variables associated with AKI were analyzed by multivariate logistic regression model to identify the AKI risk factors in TKA patients with and without tourniquet. RESULTS: AKI rate was 22%, tourniquet use (OR = 2.66, p = 0.014), blood loss > 500 cm3 (OR = 3.99, p = 0.001), postoperative Hb < 10 g/dl (OR = 2.68, p = 0.008), blood transfusions (OR = 2.86, p = 0.012) and diabetes (OR = 2.80, p = 0.006) were associated with increased risk of postoperative AKI. CONCLUSIONS: The use of tourniquet should be indicated with caution and should not be used routinely in patients with other risk factors for the development of acute kidney dysfunction, other measures to achieve trans-surgical hemostasis should be implemented in our environment to reduce the incidence of acute kidney dysfunction related to the use of the tourniquet.

PROPÓSITO: Identificar la incidencia y factores de riesgo para lesión renal aguda (LRA) después de la artroplastia total de rodilla (ATR) con y sin uso de torniquete. MATERIAL Y MÉTODOS: Se dividieron 100 pacientes en dos grupos. Se definió la LRA como una elevación postoperatoria de la creatinina 0.3 mg/dl comparada con el nivel basal preoperatorio. Las potenciales variables asociadas con la DRA fueron analizadas con un modelo de regresión logística multivariada para identificar los factores de riesgo de DRA en pacientes sometidos a ATR con y sin torniquete. RESULTADOS: La incidencia de LRA fue de 22%. El uso de torniquete (OR = 2.66, p = 0.014), pérdida sanguínea > 500 cm3 (OR = 3.99, p = 0.001), Hb postoperatoria < 10 g/dl (OR = 2.68, p = 0.008), transfusión sanguínea (OR = 2.86, p = 0.012) y la diabetes (OR = 2.80, p = 0.006) fueron asociados a un mayor riesgo postoperatorio de LRA. CONCLUSIONES: El uso de torniquete debe estar indicado con precaución y no debe utilizarse de forma rutinaria en pacientes con otros factores de riesgo para el desarrollo de disfunción renal aguda, otras medidas para lograr la hemostasia transquirúrgica deben implementarse en nuestro entorno para reducir la incidencia de disfunción renal aguda relacionada con el uso del torniquete.

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BACKGROUND: Low vaccination rates and under-detection of pertussis infections in adolescents and young adults have an impact on the transmission of pertussis to infants. In this study, the proportion of adolescents and young adults with IgG antibodies against B. pertussis antigens, representing recent infection or vaccination, was estimated in a population-based probabilistic survey in Mexico. METHODS: Sera and data from 1,581 subjects, including 1,102 adolescents and 479 young adults (10-19 and 20-25 years old, respectively) randomly selected from Mexico's 2012 National Health and Nutrition Survey, were analyzed. IgG antibodies against pertussis toxin (PT) were measured with the CDC/FDA ELISA. A subset of 234 samples was additionally tested with Bp-IgG PT ELISA kit (EUROIMMUN AG, Lubeck, Germany). Threshold values from corresponding test kits were used to identify recent infection or vaccination. RESULTS: Overall anti-PT IgG seroprevalence was 3.9% (95% CI: 2.3-6.3); 3.1% (95% CI: 1.9-5.0) in adolescents, and 4.9% (95% CI: 2.2-11) in young adults. Seroprevalence did not significantly vary by sex, socioeconomic status, region or rural/urban location. Compared to the CDC/FDA ELISA, the EUROIMMUN test showed a 76% sensitivity and 88% specificity. The weighted estimates represent a considerable burden of recent infection in adolescents and young adults; however, most adolescents and adults were seronegative and, therefore, susceptible to pertussis infection. CONCLUSION: Since booster vaccination to B. pertussis after toddlerhood is not recommended in the Mexican national policy, anti-PT IgG seropositivity may be reasonably attributed to recent infection. Assessing pertussis seroprevalence requires careful consideration of the diagnostic test threshold interpretation and epidemiological model used.

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BACKGROUND: HIV incidence can be estimated with cross-sectional studies using clinical, serological, and molecular data. Worldwide, HIV incidence data in only men who have sex with men (MSM) are scarce and principally focus on those with healthcare or under treatment. However, better estimates can be obtained through studies with national representativeness. The objective was to estimate the prevalence, incidence, and factors associated with acquiring HIV in a national sample of MSM who attend meeting places, considering geographical regions. METHODS: A nationally representative survey of MSM attending meeting places was performed in Mexico. Participants answered a questionnaire, and a dried blood spot (DBS) was collected. Samples were classified as recent infections using an algorithm with HIV status, antiretroviral therapy, and the result of BED-EIA assay. Parameters were analysed considering regions and demographic and sexual behaviour characteristics. RESULTS: The national HIV prevalence was 17.4% with regional differences; the highest prevalence (20.7%) was found in Mexico City, and the lowest prevalence was found in the West region (11.5%). The incidence was 9.4 per 100 p/y, with regional values from 6.2 to 13.2 for the Northeast and the Centre regions, respectively. Age, age at sexual debut, low wealth index, and rewarded sex were associated with HIV prevalence. Centre region, use of private clinics as health services, and having sex exclusively with men were associated with recent HIV infections. CONCLUSIONS: The incidence and prevalence showed regional differences, suggesting a difference in the dynamics of HIV transmission; some regions have a greater case accumulation, and others have a greater rate of new infections. Understanding this dynamic will allow developing health programs focused on HIV prevention or treating people already living with HIV.

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Abstract: Purpose: Identify the incidence and risk factors for acute kidney injury (AKI) following total knee arthroplasty (TKA) with and without tourniquet. Material and methods: 100 patients were randomized into two groups. Postoperative AKI was defined as the postoperative creatinine level ≥ 0.3 mg/dl compared with baseline. Potential variables associated with AKI were analyzed by multivariate logistic regression model to identify the AKI risk factors in TKA patients with and without tourniquet. Results: AKI rate was 22%, tourniquet use (OR = 2.66, p = 0.014), blood loss > 500 cm3 (OR = 3.99, p = 0.001), postoperative Hb < 10 g/dl (OR = 2.68, p = 0.008), blood transfusions (OR = 2.86, p = 0.012) and diabetes (OR = 2.80, p = 0.006) were associated with increased risk of postoperative AKI. Conclusions: The use of tourniquet should be indicated with caution and should not be used routinely in patients with other risk factors for the development of acute kidney dysfunction, other measures to achieve trans-surgical hemostasis should be implemented in our environment to reduce the incidence of acute kidney dysfunction related to the use of the tourniquet.

Resumen: Propósito: Identificar la incidencia y factores de riesgo para lesión renal aguda (LRA) después de la artroplastia total de rodilla (ATR) con y sin uso de torniquete. Material y métodos: Se dividieron 100 pacientes en dos grupos. Se definió la LRA como una elevación postoperatoria de la creatinina ≥ 0.3 mg/dl comparada con el nivel basal preoperatorio. Las potenciales variables asociadas con la DRA fueron analizadas con un modelo de regresión logística multivariada para identificar los factores de riesgo de DRA en pacientes sometidos a ATR con y sin torniquete. Resultados: La incidencia de LRA fue de 22%. El uso de torniquete (OR = 2.66, p = 0.014), pérdida sanguínea > 500 cm3 (OR = 3.99, p = 0.001), Hb postoperatoria < 10 g/dl (OR = 2.68, p = 0.008), transfusión sanguínea (OR = 2.86, p = 0.012) y la diabetes (OR = 2.80, p = 0.006) fueron asociados a un mayor riesgo postoperatorio de LRA. Conclusiones: El uso de torniquete debe estar indicado con precaución y no debe utilizarse de forma rutinaria en pacientes con otros factores de riesgo para el desarrollo de disfunción renal aguda, otras medidas para lograr la hemostasia transquirúrgica deben implementarse en nuestro entorno para reducir la incidencia de disfunción renal aguda relacionada con el uso del torniquete.

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The aim is to determine the prevalence of active infection by herpes simplex virus type 2 (HSV-2) among Mexican women with high-risk human papillomavirus (HR-HPV) cervical infection, recruited from public gynecology and colposcopy services. In a cross-sectional study, HSV-2 antibodies, HSV-2 DNA, and HR-HPV DNA were quantified. Significant differences in HSV-2 seroprevalence and HSV-2 active infection rates were found between negative and positive HR-HPV cases. HSV-2 seroprevalence was 28.15% and 16.1% (P = .0001), while HSV-2 active infection rates were 6.83% and 0.62% (P = .001) for positive and negative HR-HPV groups, respectively. The risk of HSV-2 seropositivity was 1.7 times greater for HR-HPV-positive cases (P = .02). Similarly, HR-HPV-positive cases were nine times more likely to have an HSV-2 active infection than HR-HPV-negative cases (P = .03). High HSV-2/h-HPV coinfection rates were observed among women recruited from public gynecology and colposcopy services. The main factors related to an HSV-2 active infection are a history of risky sexual behavior and HR-HPV infection. The prevalence of HSV-2 active infection among positive HR-HPV subjects indicate that these infections constitute an important group of STIs in Mexico.

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INTRODUCTION: Obesity is a chronic disease that affects adults as well as children and is associated with insulin resistance, type 2 diabetes and cardiovascular disease. One of the reasons for the presence of low-grade inflammation in these patients could be that adipose tissue of the obese produces proin flammatory molecules that favor the development of atherosclerosis. OBJECTIVE: To determine serum levels of soluble CD40 ligand (sCD40L), monocyte chemoattractant protein 1 (MCP-1), interleukin 6 (IL-6), Tumor Necrosis Factor alpha (TNF-α) and high sensitivity CRP (hsCRP), in an obese chil dren population compared to a control group, also to analyze the correlation of these molecules with the anthropometric and metabolic variables. PATIENTS AND METHOD: A cross-sectional, observational study was carried out on 37 obese children, aged 8 to 12 years, and 20 children with normal weight. Serum levels of sCD40L, MCP-1, IL-6, TNF-α and hsCRP were determined. Data were expressed as the median and interquartil range and Spearman coefficient was used to investigate correlations between variables. RESULTS: Compared to the control group, obese children presented significantly higher values of sCD40L, MCP-1, IL-6, TNF-α, and hsCRP than control group. Body mass index and waist circumference correlated positively with sCD40L and MCP-1. CONCLUSION: Elevated levels of the studied molecules studied suggest the presence of low-grade inflammation associated with obesity in this population.

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INTRODUCCIÓN: La presencia de un estado de inflamación de bajo grado en niños obesos, se debería, entre otros factores, a que el tejido adiposo de los obesos produce moléculas proinflamatorias que contribuyen al desarrollo de aterosclerosis. OBJETIVO: Determinar en una población de niños obesos los niveles séricos de ligando CD-40 soluble (sCD40L), proteína quimioatractante de monocitos 1 (MCP-1), interleuquina 6 (IL-6), Factor de Necrosis tumoral a (TNF-a) y Proteína C Reactiva ultrasensible (PCR-us), comparados con un grupo control y analizar la correlación de estas moléculas con las variables antropométricas y metabólicas. PACIENTES Y MÉTODO: Estudio transversal de 37 niños obesos de 8 a 12 años y 20 niños con peso normal. A todos los pacientes se les realizó una historia clínica consignando edad, peso, talla, IMC, circunferencia de cintura, estadios de Tanner y antecedentes familiares. Se determinaron los niveles séricos de sCD40L, MCP-1, IL-6, TNF-a y PCR-us mediante ELISA, PCR-us por quimioluminiscencia, glucemia, insulina plasmática, perfil lipídico y se calculó el índice HOMA. Los datos se expresaron como la mediana y rango intercuartil y se utilizó el coeficiente de Spearman para investigar las correlaciones entre variables. RESULTADOS: Los niños obesos presentaron valores significativamente mayores de sCD40L, MCP-1, IL-6, TNF-a, PCR-us que los niños controles. El índice de masa corporal y la circunferencia de cintura se correlacionaron positivamente con sCD40L y MCP-1. CONCLUSIÓN: Los niveles elevados de las moléculas estudiadas sugieren la presencia de inflamación de bajo grado asociada a obesidad en esta población.

INTRODUCTION: Obesity is a chronic disease that affects adults as well as children and is associated with insulin resistance, type 2 diabetes and cardiovascular disease. One of the reasons for the presence of low-grade inflammation in these patients could be that adipose tissue of the obese produces proin flammatory molecules that favor the development of atherosclerosis. OBJECTIVE: To determine serum levels of soluble CD40 ligand (sCD40L), monocyte chemoattractant protein 1 (MCP-1), interleukin 6 (IL-6), Tumor Necrosis Factor alpha (TNF-Α) and high sensitivity CRP (hsCRP), in an obese chil dren population compared to a control group, also to analyze the correlation of these molecules with the anthropometric and metabolic variables. PATIENTS AND METHOD: A cross-sectional, observational study was carried out on 37 obese children, aged 8 to 12 years, and 20 children with normal weight. Serum levels of sCD40L, MCP-1, IL-6, TNF-Α and hsCRP were determined. Data were expressed as the median and interquartil range and Spearman coefficient was used to investigate correlations between variables. RESULTS: Compared to the control group, obese children presented significantly higher values of sCD40L, MCP-1, IL-6, TNF-Α, and hsCRP than control group. Body mass index and waist circumference correlated positively with sCD40L and MCP-1. CONCLUSION: Elevated levels of the studied molecules studied suggest the presence of low-grade inflammation associated with obesity in this population.

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The pollen:ovule ratio (P/O) has traditionally been used as a rough estimator of plant breeding systems. It has been shown that plant breeding systems are associated with particular floral traits. In this study, we determined the P/O in 21 Leguminosae species from Argentina and explored relationships between P/O and taxonomic position, flower size, floral rewards, pollen presentation and pollination mechanisms. According to the results, 15 out of the 21 species classified were obligate xenogamous, although some of them have been recorded as facultative xenogamous in previous studies. There was a significant effect of taxonomic position (genus), reward type and pollination mechanism on P/O. Species offering only nectar as a floral reward (which were species with a brush mechanism) had a significantly lower P/O than species offering pollen or pollen and nectar. Species with the brush pollination mechanism had the lowest P/O, while species with valvular and pump mechanism had the highest P/O. However, pollen presentation (primary and secondary) and flower size did not have a significant effect on P/O. Our results demonstrate that P/O variability is determined by taxonomic position and pollination mechanism in this plant group.

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Tuberculous pleurisy is a naturally occurring site of Mycobacterium tuberculosis (Mtb) infection. Herein, we describe the expression of activation, natural killer (NK) and cell migration markers, as well as effector functions from gammadeltaT cells in peripheral blood (PB) and pleural effusion (PE) from tuberculosis patients (TB). We observed a decreased percentage of circulating gammadeltaT from TB patients and differential expression of NK as well as of chemokine receptors on PB and PE. Two subsets of gammadeltaT cells were differentiated by the CD3/gammadeltaT cell receptor (gammadeltaTCR) complex. The gammadeltaTCR(low) subset had a higher CD3 to TCR ratio and was enriched in Vdelta2(+) cells, whereas most Vdelta1(+) cells belonged to the gammadeltaTCR(high) subset. In PB from TB, most gammadeltaTCR(high) were CD45RA(+)CCR7(-) and gammadeltaTCR(low) were CD45RA(+/-)CCR7(+)CXCR3(+). In the pleural space the proportion of CD45RA(-)CCR7(+)CXCR3(+) cells was higher. Neither spontaneous nor Mtb-induced interferon (IFN)-gamma production was observed in PB-gammadeltaT cells from TB; however, PE-gammadeltaT cells showed a strong response. Both PB- and PE-gammadelta T cells expressed surface CD107a upon stimulation with Mtb. Notably, PE-gammadeltaTCR(low) cells were the most potent effector cells. Thus, gammadeltaT cells from PB would acquire a further activated phenotype within the site of Mtb infection and exert full effector functions. As gammadeltaT cells produce IFN-gamma within the pleural space, they would be expected to play a beneficial role in tuberculous pleurisy by helping to maintain a T helper type 1 profile.

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Toll-like receptors (TLRs) have emerged as critical players in immunity. They are capable of sensing organisms ranging from protozoa to bacteria, fungi or viruses upon detection of the pathogen as well as recognizing endogenous ligands, and triggering transduction pathways. Following activation of the innate immune system, strong inflammatory signals are generated inducing inflammation and activation of the adaptive immune response. However, the deregulation of TLRs signaling pathways may be conducive to the pathogenesis of many infectious diseases. Therefore, innate and adaptive immunity are not simply sequential and complementary mechanisms of resistance to pathogen, they regulate each other through cellular contacts and the secretion of soluble mediators. Herein, we summarize recent findings on TLRs signaling in infectious diseases and how pathogens have developed strategies to evade these pathways. In this context, a potential modulation of the innate immune response could have therapeutic benefit through the development of new drugs as well as vaccination strategies to be employed in infectious diseases.

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La presente investigación se realizó para estimar, según referencia de los médicos residentes, la frecuencia con que han sufrido situaciones de violencia, ya sea física, psicológica o sexual, durante su formación y establecer quiénes han sido los perpetradores de estos actos, dado que investigaciones previas sugieren que son frecuentes los maltratos durante ese período. Se entregó una encuesta anónima autoadministrada a todos los residentes de tres hospitales de Buenos Aires. Esta encuesta describía 13 situaciones de maltrato y 10 posibles perpetradores. Respondieron la encuesta 322 residentes (55% mujeres), el 72% correspondía a residencias de orientación clínica, el 22% a quirúrgicas y el 6% a diagnósticas. El 89% de los residentes refirió haber recibido algún tipo de maltrato señalando en promedio ocho ítems cada uno. No se encontraron diferencias entre los centros participantes. El 75% de los residentes refirió haber sufrido críticas por no realizar tareas administrativas, 64% haber recibido gritos, 57% haber sido humillado en público por sus errores, 13% haber sido amenazado con sufrir perjuicios físicos, 10% haber recibido comentarios no deseados de índole sexual, 7% haber sido expuesto a material de contenido pornográfico sin haberlo solicitado, 15% refirió haber sufrido golpes, empujones y 10% haber sufrido discriminación religiosa o racial. Los responsables del maltrato referidos con mayor frecuencia fueron: residentes superiores (26%), jefes de residentes (19%), médicos de planta (14%), jefes de sala (8%) y enfermeros (8%). Existe una alta prevalencia de maltrato dentro de la residencia, siendo los principales responsables los residentes de años superiores. Sería necesario un enfoque multidisciplinario para enfrentar este problema. . (AU)

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According to Pan American Health Organization nearly 50% of women suffer chronic domestic violence in Latin America. We evaluated the prevalence of gender based violence (GBV) in women assisted in a University Outpatient Clinic in Buenos Aires. We used a survey originally developed by the International Planned Parenthood Federation (IPPF) in Spanish. The survey was distributed to a consecutive sample of women more than 18 years of age who attended the clinic. Participants were randomized to fill out the questionnaire anonymously (self-administered) or during an interview with the physician in order to test the sensitivity of these two different modalities of data collection. Of 360 eligible women 270, (75%) completed the questionnaire. The respondents had a median age of 45.4 years, only 33% had more than 7 years of formal education and 48% did not live with a partner. Of the 270 respondents, 120 (44%) women reported mistreatment at least once during their lifetime. Of these, 108 (40%) reported psychological GBV, 53 physical GBV and 45 reported sexual GBV. Most of the respondents suffered more than one type of violence. 46 (17%) women reported sexual abuse during childhood, 219 (81%) of participants never had been asked by their physician about domestic violence. Women interviewed by the physician reported GBV more frequently than those completing the self-administered survey (p <0.005). The survey developed by the IPPF is considered a useful tool for screening in a clinical setting.

De acuerdo a la Organización de la Salud, en América Latina cerca del 50% de las mujeres sufren violencia doméstica crónica. Se realizó esta investigación con el objetivo de estimar la prevalencia de violencia basada en género (VBG) en las mujeres que se atienden en el Programa de Medicina Interna General (PMIG) y comparar la frecuencia de detección de VBG bajo diferentes modalidades de encuesta. Se utilizó una muestra consecutiva de mujeres mayores de 18 años de edad que concurren al PMIG y aceptaron participar. Se utilizó la encuesta para detección de VBG desarrollada por la International Planning Parenthood Foundation. La mitad de la población completó la encuesta en forma anónima y a solas, y a la otra mitad el médico tratante le entregó el cuestionario al final de la consulta. Se repartieron 360 encuestas, se recuperaron 270. La edad promedio de la población fue 45.4 años, el 33 % poseía mas de 7 años de educación formal, el 48% no convivía en situación de pareja, el 56% tenía trabajo. Ciento veinte mujeres (44.4%) refirieron haber sufrido algún tipo de violencia en su vida. Ciento ocho informaron violencia psicológica, 53 violencia física y 45 violencia sexual. Cuarenta y seis mujeres (17.5%) relataron haber sufrido violencia sexual en la niñez. Cuarenta (14.8%) refirieron sufrir violencia en la actualidad. Las mujeres que respondieron la encuesta en forma anónima referían haber sufrido VBG con una frecuencia significativamente menor que las otras (P < 0.005). Al 93%de las encuestadas (219 mujeres) ningún médico les había preguntado sobre VBG en su vida. En conclusión,existe una alta prevalencia de VBG en la población encuestada.

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La presente investigación se realizó para estimar, según referencia de los médicos residentes, la frecuencia con que han sufrido situaciones de violencia, ya sea física, psicológica o sexual, durante su formación y establecer quiénes han sido los perpetradores de estos actos, dado que investigaciones previas sugieren que son frecuentes los maltratos durante ese período. Se entregó una encuesta anónima autoadministrada a todos los residentes de tres hospitales de Buenos Aires. Esta encuesta describía 13 situaciones de maltrato y 10 posibles perpetradores. Respondieron la encuesta 322 residentes (55% mujeres), el 72% correspondía a residencias de orientación clínica, el 22% a quirúrgicas y el 6% a diagnósticas. El 89% de los residentes refirió haber recibido algún tipo de maltrato señalando en promedio ocho ítems cada uno. No se encontraron diferencias entre los centros participantes. El 75% de los residentes refirió haber sufrido críticas por no realizar tareas administrativas, 64% haber recibido gritos, 57% haber sido humillado en público por sus errores, 13% haber sido amenazado con sufrir perjuicios físicos, 10% haber recibido comentarios no deseados de índole sexual, 7% haber sido expuesto a material de contenido pornográfico sin haberlo solicitado, 15% refirió haber sufrido golpes, empujones y 10% haber sufrido discriminación religiosa o racial. Los responsables del maltrato referidos con mayor frecuencia fueron: residentes superiores (26%), jefes de residentes (19%), médicos de planta (14%), jefes de sala (8%) y enfermeros (8%). Existe una alta prevalencia de maltrato dentro de la residencia, siendo los principales responsables los residentes de años superiores. Sería necesario un enfoque multidisciplinario para enfrentar este problema. .

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Activation of T cells requires both TCR-specific ligation and costimulation through accessory molecules during T cell priming. IFNgamma is a key cytokine responsible for macrophage activation during Mycobacterium tuberculosis (Mtb) infection while IL-10 is associated with suppression of cell mediated immunity in intracellular infection. In this paper we evaluated the role of IFNgamma and IL-10 on the function of cytotoxic T cells (CTL) and on the modulation of costimulatory molecules in healthy controls and patients with active tuberculosis (TB). gamma-irradiated-Mtb (i-Mtb) induced IL-10 production from CD14(+) cells from TB patients. Moreover, CD3(+) T cells of patients with advanced disease also produced IL-10 after i-Mtb stimulation. In healthy donors, IL-10 decreased the lytic activity of CD4(+) and CD8(+) T cells whereas it increased gammadelta-mediated cytotoxicity. Furthermore, we found that the presence of IL-10 induced a loss of the alternative processing pathways of antigen presentation along with a down-regulation of the expression of costimulatory molecule expression on monocytes and macrophages from healthy individuals. Conversely, neutralization of endogenous IL-10 or addition of IFNgamma to either effector or target cells from TB patients induced a strong lytic activity mediated by CD8(+) CTL together with an up-regulation of CD54 and CD86 expression on target cells. Moreover, we observed that macrophages from TB patients could use alternative pathways for i-Mtb presentation. Taken together, our results demonstrate that the presence of IL-10 during Mtb infection might contribute to mycobacteria persistence inside host macrophages through a mechanism that involved inhibition of MHC-restricted cytotoxicity against infected macrophages.

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El documento presenta la experiencia de los Proyectos Productivos de Mujeres(PPM) que fue iniciada como proyecto piloto, su ejecución permitirá extraer lineamientos para mejorar las intervensiones futuras con las mujere rurales, dar pautas para establecer lineas de acción para la incorporación de género en proyectos de desarrollo del progrma y extraer insumos que contribuyan a las políticas públicas en materia de género, desarrollo rural y agrícola

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El documento presenta la experiencia de los Proyectos Productivos de Mujeres(PPM) que fue iniciada como proyecto piloto, su ejecución permitirá extraer lineamientos para mejorar las intervensiones futuras con las mujere rurales, dar pautas para establecer lineas de acción para la incorporación de género en proyectos de desarrollo del progrma y extraer insumos que contribuyan a las políticas públicas en materia de género, desarrollo rural y agrícola

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Protection against intracellular pathogens such as Mycobacterium leprae is critically dependent on the function of NK cells at early stages of the immune response and on Th1 cells at later stages. In the present report we evaluated the role of IL-18 and IL-13, two cytokines that can influence NK cell activity, in the generation of M. leprae-derived hsp65-cytotoxic T lymphocytes (CTL) from peripheral blood mononuclear cells (PBMC) of leprosy patients. We demonstrated that IL-18 modulates hsp65-induced CTL generation and collaborates with IL-12 for this effect. In paucibacillary (PB) patients and normal controls (N) depletion of NK cells reduces the cytolytic activity. Under these conditions, IL-12 cannot up-regulate this CTL generation, while, in contrast, IL-18 increases the cytotoxic activity both in the presence or absence of NK cells. IL-13 down-regulates the hsp65-induced CTL generation and counteracts the positive effect of IL-18. The negative effect of IL-13 is observed in the early stages of the response, suggesting that this cytokine affects IFNgamma production by NK cells. mRNA coding for IFNgamma is induced by IL-18 and reduced in the presence of IL-13, when PBMC from N or PB patients are stimulated with hsp65. Neutralization of IL-13 in PBMC from multibacillary (MB) leprosy patients induces the production of IFNgamma protein by lymphocytes. A modulatory role on the generation of hsp65 induced CTL is demonstrated for IL-18 and IL-13 and this effect takes place through the production of IFNgamma.

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According to Pan American Health Organization nearly 50% of women suffer chronic domestic violence in Latin America. We evaluated the prevalence of gender based violence (GBV) in women assisted in a University Outpatient Clinic in Buenos Aires. We used a survey originally developed by the International Planned Parenthood Federation (IPPF) in Spanish. The survey was distributed to a consecutive sample of women more than 18 years of age who attended the clinic. Participants were randomized to fill out the questionnaire anonymously (self-administered) or during an interview with the physician in order to test the sensitivity of these two different modalities of data collection. Of 360 eligible women 270, (75%) completed the questionnaire. The respondents had a median age of 45.4 years, only 33% had more than 7 years of formal education and 48% did not live with a partner. Of the 270 respondents, 120 (44%) women reported mistreatment at least once during their lifetime. Of these, 108 (40%) reported psychological GBV, 53 physical GBV and 45 reported sexual GBV. Most of the respondents suffered more than one type of violence. 46 (17%) women reported sexual abuse during childhood, 219 (81%) of participants never had been asked by their physician about domestic violence. Women interviewed by the physician reported GBV more frequently than those completing the self-administered survey (p <0.005). The survey developed by the IPPF is considered a useful tool for screening in a clinical setting.(AU)

De acuerdo a la Organización de la Salud, en América Latina cerca del 50% de las mujeres sufren violencia doméstica crónica. Se realizó esta investigación con el objetivo de estimar la prevalencia de violencia basada en género (VBG) en las mujeres que se atienden en el Programa de Medicina Interna General (PMIG) y comparar la frecuencia de detección de VBG bajo diferentes modalidades de encuesta. Se utilizó una muestra consecutiva de mujeres mayores de 18 años de edad que concurren al PMIG y aceptaron participar. Se utilizó la encuesta para detección de VBG desarrollada por la International Planning Parenthood Foundation. La mitad de la población completó la encuesta en forma anónima y a solas, y a la otra mitad el médico tratante le entregó el cuestionario al final de la consulta. Se repartieron 360 encuestas, se recuperaron 270. La edad promedio de la población fue 45.4 años, el 33 % poseía mas de 7 años de educación formal, el 48% no convivía en situación de pareja, el 56% tenía trabajo. Ciento veinte mujeres (44.4%) refirieron haber sufrido algún tipo de violencia en su vida. Ciento ocho informaron violencia psicológica, 53 violencia física y 45 violencia sexual. Cuarenta y seis mujeres (17.5%) relataron haber sufrido violencia sexual en la niñez. Cuarenta (14.8%) refirieron sufrir violencia en la actualidad. Las mujeres que respondieron la encuesta en forma anónima referían haber sufrido VBG con una frecuencia significativamente menor que las otras (P < 0.005). Al 93%de las encuestadas (219 mujeres) ningún médico les había preguntado sobre VBG en su vida. En conclusión,existe una alta prevalencia de VBG en la población encuestada.(AU)

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Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis where formyl peptides, which are cleavage products of bacterial and mitochondrial proteins, are present. In this study, we demonstrated that interferon gamma (IFN)-gamma and interleukin (IL)-10 induced the overexpression of the receptor for the Fc portion of IgG I (FcgammaRI) in monocytes from tuberculosis (TB) patients, showing that these cells respond to IFN-gamma and IL-10 signals. We also demonstrated that lower doses of IL-10 render monocytes from TB patients less responsive to higher doses of the cytokine. Although the prototypic formyl peptide N-formyl-methionyl-leucyl-phenylalanine (FMLP) is a well-known proinflammatory agonist, we have demonstrated previously that preincubation of monocytes with FMLP inhibited the up-regulation of FcgammaRI induced by IFN-gamma or IL-10. This effect was not observed in monocytes from TB patients. FMLP also induced the down-regulation of the expression of FcgammaRI in monocytes that had been activated already with IFN-gamma. However, this effect of FMLP was not observed in monocytes from TB patients and supernatants from monocytes obtained from these patients were incapable of inducing the down-regulation of FcgammaRI. In contrast to normal donors, supernatants from FMLP-treated neutrophils from TB patients did not modify the basal level of expression of FcgammaRI in monocytes from normal donors. In conclusion, in this study we demonstrated the existence of two novel mechanisms that may contribute to the pathological effects generated by M. tuberculosis: the enhancement of FcgammaRI in response to IFN-gamma and IL-10, and the unresponsiveness to the anti-inflammatory effects induced by formyl peptides.

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