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Several studies have examined the association of externalizing polygenic scores (PGS) with externalizing symptoms in samples of European ancestry. However, less is known about the associations of externalizing polygenic vulnerability in relation to phenotypic externalizing disorders among individuals of different ancestries, such as Mexican youth. Here, we leveraged the largest genome-wide association study on externalizing behaviors that included over 1 million individuals of European ancestry to examine associations of externalizing PGS with a range of externalizing disorders in Mexican adolescents, and investigated whether adversity exposure in childhood moderated these associations. Participants (N = 1064; age range 12-17 years old; 58.8% female) were adolescents recruited for a general population survey on adolescent mental health in the Mexico City Metropolitan region and were genotyped. Childhood adversity exposure and externalizing disorders, specifically attention-deficit hyperactivity disorder (ADHD), conduct disorder, oppositional defiant disorder, and substance use disorder, were assessed via the computer-assisted World Mental Health Composite International Diagnostic Interview for adolescents. A greater externalizing PGS was associated with a greater odds of any externalizing disorder (OR = 1.29 [1.12, 1.48]; p < 0.01) and ADHD (OR = 1.40 [1.15, 1.70]; p < 0.01) in the whole sample, and in females in particular. There were no main effects of the externalizing PGS on conduct disorder, oppositional defiant disorder, or substance use disorder, nor did adversity exposure moderate these associations. Our results suggest that greater genetic propensity for externalizing disorders is associated with increased odds of any externalizing disorders and ADHD among Mexican adolescents, furthering our understanding of externalizing disorder manifestation in this population.

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RESUMEN Introducción: En la región del Caribe colombiano es escasa la evidencia sobre infección de pie diabético que apoye la toma de decisiones basada en datos propios y se desconoce el comportamiento microbiológico actual de este tipo de infección. Métodos: Estudio corte transversal que incluyó pacientes con infección de pie diabético atendidos en un hospital de referencia de tercer nivel de la región del Caribe colombiano, entre septiembre de 2021 y mayo de 2022. Se extrajeron datos sociodemográficos, clínicos y microbiológicos del paciente y su infección. Se realizó un análisis descriptivo y cálculo de razón de prevalencia (RP), para identificar factores asociados con desenlaces desfavorables. Resultados: Un total de 149 pacientes fueron incluidos. El 61,8 % de la muestra era de sexo masculino, con una mediana de edad de 61 años. Predominó la infección moderada a severa (67,8 %). Pseudomona aeruginosa (18,1%), Escherichia coli (13,5 %) y Staphylococcus aureus (12,8 %), fueron los agentes más frecuentes encontrados. El 44,2 % de los microorganismos demostró resistencia. El tabaquismo (p <0,001), antecedente de amputación (p <0,001), la cronicidad de la úlcera (p <0,001) y el ingreso a cuidado intensivo (p <0,001) se asociaron significativamente con mortalidad, amputación, resistencia microbiana y diagnóstico de osteomielitis por imagen. Conclusión: En la región del Caribe colombiano, la infección por pie diabético es predominante en hombres de mediana edad, con presentación moderada a severa, causada principalmente por bacterias gramnegativas y enterobacterias y, el tabaquismo y el ingreso a cuidado intensivo son los factores asociados de manera más significativa a desenlaces desfavorables.

ABSTRACT Introduction: In the Colombian Caribbean region, there is scarce evidence on diabetic foot infection to support decision making based on the patient's own data, and the current microbiological behavior of this type of infection is unknown. Methods: Cross-sectional study that included patients with diabetic foot infection treated at a third level referral hospital in the Colombian Caribbean region, between September 2021 and May 2022. Sociodemographic, clinical and microbiological data on the patient and his infection were extracted. A descriptive analysis and prevalence ratio (PR) calculation were performed to identify factors associated with unfavorable outcomes. Results: A total of 149 patients were included. The 61.8% of the sample was male, with a median age of 61 years. Moderate to severe infection predominated (67.8 %). Pseudomona aeruginosa (18.1 %), Escherichia coli (13.5 %), and Staphylococcus aureus (12.8 %) were the most frequent agents found. 44.2 % of the microorganisms showed resistance. Smoking (p <0.001), history of amputation (p <0.001), chronicity of ulcer (p <0.001) and admission to intensive care (p <0.001) were significantly associated with mortality, amputation, microbial resistance and diagnosis of osteomyelitis by imaging Conclusions: In the Colombian Caribbean region, diabetic foot infection is predominant in middle-aged men, with moderate to severe presentation, mainly caused by gram-negative bacteria and enterobacteria, and smoking and admission to intensive care are the factors most significantly associated with unfavorable outcomes.

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El objetivo de este artículo consiste en dar a conocer un perfil social, económico y demográfico de la población registrada con SISBÉN en el Hospital Departamental Psiquiátrico Universitario del Valle (HDPUV) entre el 2009 y el 2018, cuyo diagnóstico se encuentra dentro del grupo de los trastornos del humor (correspondiente al espectro de códigos del CIE-10 que va desde F30 a F39, episodio maníaco, trastorno bipolar, episodio depresivo, trastorno depresivo recurrente, trastorno del humor persistente, otros trastornos del humor, trastorno del humor sin especificación). Se optó por un trabajo en el que se complementó la información entre las bases de datos del SISBÉN de Cali y la del HDPUV para profundizar en datos sobre pobreza y vulnerabilidad de las personas que son potenciales beneficiarios de programas sociales estatales. Se identificaron 5.280 pacientes diagnosticados con trastornos del humor, en su mayoría mujeres (70,4 %) en condiciones de vulnerabilidad económicas, sociales y de acceso a servicios de salud, que representan otro factor más de riesgo para su salud mental.

The aim of this article is to provide a social, economic and demographic profile of the population registered with SISBÉN at the Hospital Departamental Psiquiátrico Universitario del Valle (HDPUV) between 2009 and 2018, whose diagnosis is within the group of mood disorders, (corresponding to the spectrum of ICD- 10 codes ranging from F30 to F39, manic episode, bipolar disorder, depressive episode, recurrent depressive disorder, persistent mood disorder, other mood disorders, mood disorder without specification). We opted for a study in which we complemented the information between the Cali SISBÉN and HDPUV databases to deepen in data on poverty and vulnerability of people who are potential beneficiaries of state social programs. We identified 5,280 patients diagnosed with mood disorders, mostly women (70.4%) in conditions of economic, social and access to health services vulnerability, which represent yet another risk factor for their mental health.

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Objetivos: Determinar los programas y proyectos de investigación e intervención, incluyendo diagnósticos de salud, entre Abril de 2001 a Diciembre del 2007, en la Provincia de Tucumán, Argentina. Materiales y Métodos: Para los proyectos de investigación científica en salud se utilizó la base de datos del Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) y la Universidad Nacional de Tucumán (UNT). Para las investigaciones socio-sanitarias se realizaron entrevistas a actores claves involucrados en la gestión del conocimiento, funcionarios del gobierno del Ministerio de Salud y de la Secretaría de Ciencia y Técnica de Innovación Productiva de la Provincia, Ministerio de Desarrollo Social y a autoridades del Sistema Provincial de Salud. Resultados: Medicina representó el 4,9% del total de Proyectos financiados por la Universidad y el 1,9% del total de Programas aprobados por la Secretaría de Ciencia y Técnica de la UNT. Una situación similar se describe para nuestra provincia en relación a los subsidios otorgados por CONICET con el 2% del total de financiamiento. La Investigación Clínica y Epidemiológica fueron los temas más investigados de acuerdo a la clasificación presentada. De acuerdo con la encuesta, el 32% de los entrevistados opinó que “articula bastante” la investigación científica con los programas de la Atención Primaria de la Salud. Conclusiones: Hay escaso conocimiento sobre los proyectos de investigación en salud financiados por entidades públicas en las diferentes áreas geográficas estudiadas (Metropolitana, Agroindustrial y SILOS). Se observó que a nivel institucional universitario el área de Ciencias de la Salud y especialmente Medicina, es un área de vacancia.

Aim: To determine programs and projects of research and intervention, including diagnosis of health, during April 2001 to December 2007, in the Province of Tucuman, Argentina. Material and Methods: Data were obtained from public organisms of the Province of Tucuman. For research in health were used the data base of the National Scientific and Technical Research Council - Argentina (CONICET) and the National University of Tucuman (UNT). For research in Health and social care were realized interviews to key actors directly involved in knowledge management, Government officials of the Ministry of Health and the Secretary of Science and Technology of Productive Innovation of the Province of Tucuman, and Ministry of Social Development and the officials of the Health System of Tucuman. Results: Medicine accounted 4.9% of all projects funded by the University and 1.9% of total approved by the Ministry of Science and Technology of UNT. A similar situation is described for our province in relation to grants from CONICET with the 2% of total funding. Clinical and Epidemiological Research were the most investigated according to the classification presented. According to the survey, 32% of respondents felt that “articulates quite” the scientific research programs with Primary Health Care. Conclusions: There is little knowledge about health research projects funded by public entities in different geographical areas studied (Metropolitan, Agroindustrial and SILOS). It was noted that in a university institutional area, Health Sciences, and Medicine in particular, is an area of vacancy.

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Background: There is an association between arsenic exposure and prostatic cancer mortality. Aim: To analyze and to compare the serum levels of total prostatic specific antigen (TPSA) in asymptomatic men of a rural zone, exposed and not exposed to high concentrations of arsenic (As) in drinking water. Material and Methods: The study included 161 men that were subjected to a clinical evaluation, serum TPSA determination and a trans rectal ultrasonography. Exposed and non-exposed subjects were divided in groups GA, GB and GC according to TPSA levels (<4 ng/ml, 4.1-10 ng/ml and >10.1 ng/ml respectively). Results: Exposed and non-exposed subjects had similar TPSA levels. Among exposed subjects, 88.2, 8,8 and 3% were ascribed to groups GA, GB and GC respectively. The figures for non-exposed subjects were 90. 6, 6,3 and 3,1%. The area under the receiver operating characteristic (ROC) curve for TPSA in exposed and non-exposed subjects was 0.64 (95% confidence intervals (CI) 0.40-0.9) and 0.71 (95% CI 0.6-0.8) respectively. Conclusions: No differences in TPSA levels between subjects exposed and non-exposed to arsenic were observed in this study.

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BACKGROUND: There is an association between arsenic exposure and prostatic cancer mortality. AIM: To analyze and to compare the serum levels of total prostatic specific antigEn (TPSA) in asymptomatic men of a rural zone, exposed and not exposed to high concentrations of arsenic (As) in drinking water. MATERIAL AND METHODS: The study included 161 men that were subjected to a clinical evaluation, serum TPSA determination and a trans rectal ultrasonography. Exposed and non-exposed subjects were divided in groups GA, GB and GC according to TPSA levels (<4 ng/ml, 4.1-10 ng/ml and >10.1 ng/ml respectively). RESULTS: Exposed and non-exposed subjects had similar TPSA levels. Among exposed subjects, 88.2, 8,8 and 3% were ascribed to groups GA, GB and GC respectively. The figures for non-exposed subjects were 90. 6, 6,3 and 3,1%. The area under the receiver operating characteristic (ROC) curve for TPSA in exposed and non-exposed subjects was 0.64 (95% confidence intervals (CI) 0.40-0.9) and 0.71 (95% CI 0.6-0.8) respectively. CONCLUSIONS: No differences in TPSA levels between subjects exposed and non-exposed to arsenic were observed in this study.

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El objetivo de esta investigación fue evaluar los niveles del ácido siálico (S) y enzimas hepáticas en individuos que consumieron agua con arsénico (As) relacionándolos con la presencia ("I con H") o no de hepatomegalia ("I sin H"). Se incluyeron 200 individuos, 85 correspondieron al Grupo Control (GC), 32 "I con H" y 83 "I sin H" quienes habían consumido agua con niveles mayores a 0,01 mg/L. Se les tomó una muestra de sangre venosa y se les realizó el dosaje del S y de las enzimas alaninaninotransferasa (ALT), aspartatoaminotransferasa (AST), fosfatasa alcalina (FAL), gamma glutamil transferasa (GGT), bilirrubina directa (BD) y total (BT), lactato deshidrogenasa (LDH) y 5' nucleotidasa (5'Nu). En los individuos que consumieron agua contaminada se encontró un aumento de los niveles del S. En el grupo "I con H", la FAL, la GGT y la LDH se encontraron aumentadas. En el grupo "I sin H", la GGT y la LDH tuvieron niveles elevados. En los individuos expuestos al As, no se encontraron alteraciones en los otros parámetros bioquímicos estudiados y la prevalencia de hepatomegalia no fue significativa. Los cambios bioquímicos encontrados fueron compatibles con la presencia de un patrón colestásico. Estos datos muestran que la concentración del S sérico podría servir como un indicador de exposición al arsénico que podría ser utilizado en forma conjunta con otros marcadores.

The aim of this study was to investígate the relationship between the levels of serum sialic acid (S) and hepatic enzymes in individuáis who drink As contaminated water. Two hundred individuáis were selected: 85 were the control group, 32 presented hepatomegaly (I with H) and 83 did not present hepatomegaly (I without H) who had consumed drinking water containing As levels higher than O.Ol mg/L. Blood samples were collected for the determination of S and hepatic enzymes in serum: alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (FAL), gamma glutamil transpeptidase (GGT), direct (BD) and total bilirrubin (BT), lactate deshydrogenase (LDH) and 5'nucleotldase (5'Nu). The populatlon exposed to As in drinking water presented high levels of S, FAL, GGT, LDH and GGT, LDH were increased in I with H and I without H respectively. No significant changes were observed in the other parameters studied. Prevalence of hepatomegaly was not significantly higher and the hepatic biochemical changes were related with the presence of cholestasis in As-exposed people. These data show that people with high As level intake would have an increased sialoprotein replacement which could be an marker with other one of the alterations caused by arsenic.

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Se determinó la contaminación con Arsénico (As) en agua de bebida en Leales (L) y Graneros (G) (Tucumán), y se relacionó el nivel de contaminación con la profundidad de los pozos y la presencia de signos dermatológicos. La determinación de As fue realizada por el método cuantitativo de Gutzei modificado. Se entrevistaron 122 individuos, se evaluaron los signos dermatológicos de arsenicismo. El 9,3% y 34,7% de 140 muestras de L y 95 de G respectivamente tienen niveles permitidos. Las concentraciones promedios en L fueron 0,112; 0,087 y 0,096 mg/L para la profundidad menor a 10; 11 a 25 y mayor a 25 metros respectivamente. No se encontró diferencia entre las distintas profundidades. Las concentraciones promedios en Graneros fueron 0,163; 0,045; 0,405; 0,056 mg/L para los pozos menor a 10; 11 a 25 con concentraciones moderadamente y marcadamente elevadas, y mayor a 25 metros respectivamente. Se encontraron diferencias entre las concentraciones de As y la profundidad de los pozos. El 12,4% de los 89 individuos examinados de L y el 39,4% de los 33 individuos de G presentaron signos dermatológicos. Es una patología de alta prevalencia en áreas deprimidas del noroeste argentino, se vincula a una inadecuada provisión de agua, es un problema de alta importancia socio-sanitaria por su magnitud; su severidad real y potencial y su evitabilidad.

The aim of this work was to investigate the contamination with Arsenic (As) in drinking water in Leales (L) and Graneros (G) (Tucumán), the relationship between the level of pollution and the depth of the wells, and the presence of cutaneous signs. The determination of As was made by the quantitative method of modified Gutzei. A hundred and twenty-two individuals were selected. A total of 9.3% and 34.7% of 140 samples of L and 95 of G respectively have allowed levels.The average concentrations in L were 0.112; 0.087 and 0.096 mg/L for depths lower than 10; 11 to 25 meters, and higher than 25 meters respectively. No difference was found between the different depths. The average concentrations in G were 0.163; 0.045; 0.405; 0.056 mg/L for the wells lower than 10; 11 to 25: meters with concentrations moderately and markedly raised, and higher than 25 meters respectively. Differences were found between the concentrations of As and the depth of the wells. A total of 12.4% of 89 of L and 39.4% of 33 individuals examined of G showed cutaneous signs. This pathology is of high importance in depressed areas of the Argentina, is linked to an inadequate provision of water.

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El presente trabajo procura analizar el grado de desarrollo de la estrategia de APS en el Primer Nivel de Atención de las Provincias de Catamarca, Santiago del Estero, Misiones y Córdoba, así como en la Ciudad de Córdoba. Para esto se propuso los siguientes objetivos: evaluar el grado de desarrollo de la estrategia de APS en los efectores del primer nivel de atención.; conocer la correspondencia entre implementación de políticas sanitarias locales y grado de desarrollo de la estrategia de APS.; establecer relaciones entre implementación de políticas sanitarias locales, capacidad de gestión de los efectores del primer nivel de atención y desarrollo de la APS; formular recomendaciones destinadas a fortalecer la capacidad de gestión de los Centros de Salud del Primer Nivel de Atención. U

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