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Este artículo pretende identificar cómo se desarrolló la convivencia entre las prácticas médicas indígenas y españolas en el Chile del primer siglo de conquista. En relación con la metodología de esta investigación, se han revisado todas las fuentes primarias disponibles que registran la experiencia de conquistadores y religiosos en el Chile de la época, y se buscó en ellas registros de intercambio, convivencia y diálogos interculturales en el ámbito médico. Los resultados muestran numerosos registros históricos de convivencia entre ambas culturas en el ámbito sanitario, cuyas formas y detalles se explicitan en este artículo. Concluimos que las diferencias que separaban a ambas culturas se manifestaban principalmente en otros aspectos, no así en lo médico, donde existió intercambio de saberes, valoración cultural, coincidencias, hibridez e incluso prácticas conjuntas.

A literature review disclosed that even under very strict caries preventive control, in young Swedish people many initial approximal lesions slowly progress. A study was performed to investigate if the same trend could be seen in young Danish adults. In 1996 a group of Danish military conscripts were investigated clinically and radiographically. Based on the radiographs, one lesion with radiolucency up to one third in the dentine was randomly selected from each conscript. Contact was established with these former conscripts in 2002 and radiographs taken around 2002 were used to investigate the state of the selected lesions in terms of regression, stabilization or progression. It was observed that about 60% of the selected lesions had progressed during the 5 to 6 year period. Therefore there was a need to look for other preventive measures than those traditionally used in a Danish context, such as instructions in flossing and local application of fluoride. Looking through the literature, it was realized that sealing of occlusal lesions was highly effective but this procedure was not used on approximal surfaces. The next step was to investigate if it was technically possible to seal approximal lesions and if so what material should be used. A laboratory study was conducted in which 6 dental materials were compared in relation to: their handling, presence at the surface of the lesion, and ability to penetrate into a lesion. Based on that study Gluma One Bond® (Heraeus Kulzer) was selected to be used in further studies. The final step was an 18-month clinical investigation to evaluate the effect of sealing approximal lesions. About 80 young adults from Denmark and Colombia participated in this investigation; each had at least 2 initial approximal lesions. One lesion was selected for sealing; the other one acted as control. Baseline radiographs were taken by means of special equipment so new radiographs could be taken in the same position after 18 months. The sealing procedure was performed in accordance with the guideline designed in the laboratory study. The patient was instructed to floss all sealed and non-sealed approximal lesions. Radiographs were used to assess caries progression in the test and control lesions in three ways: by comparing baseline with final scoring of the lesions on the individual conventional radiographs, by reading the conventional radiographs as pairs and finally using subtraction radiography of digitized images. The examiner was blind to lesion type (test or control) for all comparisons and also blind to whether radiographs were baseline or follow up in the case of examinations of the single radiographs and paired comparison. Repeat assessment of the radiographs was conducted on 20% of the radiographs and the subtraction images. For the paired comparison of radiographs and subtraction radiography assessment significantly more control lesions progressed (47.2%; 85%) than test lesions (22.2%; 43%) (P-values<0.05). For the independent examination of the radiographs a similar pattern was seen but the difference between the two groups was not statistically significant (P=0.06). In conclusion, many approximal lesions seemed to progress on young adults irrespective of the preventive regime they were advised to take. This study has developed and investigated a technique for sealing early approximal lesions which seems to be more effective at preventing lesion progression than conventional interventions such as brushing and flossing. There is a need however, for defining more precisely criteria at selecting lesions to be sealed; for developing better materials in terms of better penetration skill and that they stay there, and for clinical investigations which evaluate the long term effect of sealing the approximal lesions.

Objetivo: en este artículo se quiere discutir la manera en que el concepto de pueblo fue incorporado a las reflexiones de los médicos colombianos entre 1870 y 1920. Además, busca entender las circunstancias que motivaron ese ejercicio de enunciación y proponer un análisis que resalte el carácter cultural del conocimiento científico. Desarrollo: partiendo de la revisión de literatura médica publicada durante ese periodo, el artículo indaga por las principales estrategias empleadas por los médicos para describir al pueblo, y señala que se trató de un ejercicio derivado de las dinámicas políticas, sociales y culturales que entonces impactaron el quehacer de la medicina en Colombia. Posteriormente, muestra la manera en que el perfil del pueblo, compuesto por las figuras del indio y del negro, emergió como una preocupación científica, que se articuló a una serie de marcadores físicos, raciales, morales e intelectuales preexistentes. Conclusiones: el artículo propone que la incorporación del pueblo a las reflexiones médicas señaladas hizo parte de un intento por diagnosticarlo desde las herramientas científicas que fue incorporando la medicina finalizando el siglo XIX; sin embargo, ese ejercicio no significó el abandono de nociones y categorías arraigadas en el contexto sociocultural propio del gremio médico.

Abstract: Sexual reproduction depends on the transmission of exactly one copy of each chromosome by the maternal and paternal gametes. This is accomplished during meiosis when diploid progenitors undergo two consecutive rounds of chromosome segregation following a single round of DNA replication. In most organisms, this relies on the establishment of bivalent chromosomes consisting of replicated parental homologues physically linked at sites of meiotic recombination. In female mammals, bivalents are formed during fetal development when the lifetime stock of primordial-stage oocytes is established. However, they are not resolved until shortly before ovulation. Extending this period beyond ~35 years results in a dramatic increase in embryo aneuploidy. Depletion of the lifetime stock of oocytes during ageing culminates in menopause. Our previous studies indicate that Rec8-containing cohesin complexes also become depleted from oocyte chromosomes during female ageing. Consistent with cohesin’s role in maintaining chromosome structure, depletion of Rec8 is associated with destabilisation of bivalents chromosomes. Nevertheless, the mechanisms and timing of cohesin depletion remain unknown. Here, I investigated the possibility that age-related cohesion depletion is a consequence of leaky inhibition of the protease separase, which cleaves Rec8 during anaphase. I found that oocyte-specific deletion of separase did not prevent depletion of oocyte cohesin during female ageing. I, therefore, conclude that age-related depletion occurs by a separaseindependent mechanism. I next investigated the timing, during oogenesis, at which cohesin loss occurs. I found that cohesin is predominantly lost at the primordial stage before oocytes are recruited for growth. In addition, using an oocyte-specific deletion of Pten, I determined that this occurs independently of the decline in the ovarian stock of primordial-stage oocytes. Together, these results indicate that age-related cohesin depletion occurs at the primordial stage by a separase-independent mechanism. Other possible of mechanisms of cohesin depletion include protein damage and/or agerelated deterioration of chromatin structure. From a clinical perspective, my work suggests that “rejuvenation’ of fertility by activating the residual pool of primordial oocytes is unlikely to be successful in older women.

Abstract: Background: Although Latin American migrants (LAMs) are one of the fastest-growing migrant populations in England, they still face health barriers that make them unaware of their HIV status, leading to late HIV diagnosis, AIDS, and even death. Thus, this study aims to assess the differences in HIV outcomes among newly HIV-diagnosed LAMs compared to other England populations. Methods: Data on new HIV/AIDS diagnoses in the UK during the 2011-2020 period were obtained from the HIV and AIDS New Diagnoses and Deaths Database (HANDD) and the HIV and AIDS Reporting System (HARS). Potential associations between the region of birth and late HIV diagnosis, AIDS at HIV diagnosis, and mortality were analysed by logistic regression. Furthermore, a comparison between LAMs and the main populations living in the UK was examined. Lastly, a descriptive trend analysis was made. Results: From 2011 to 2020, 47,828 new HIV diagnoses were reported in the UK, with almost a third (29.2%) being late diagnoses. Over half of new diagnoses (52%) were made in migrants, LAMs representing 9.3% of those diagnoses. In general, newly diagnosed HIV LAMs are not more likely to be diagnosed late than UK residents (aRRR: 1.02; 95%CI: 0.90–1.15). However, some subgroups are more likely to be diagnosed late than their UK counterparts (e.g., 15-24 years old). Regarding AIDS and mortality, LAMs are less likely to be diagnosed with AIDS (aOR: 0.50; 95%CI: 0.35–0.71) or die by any cause (aOR: 0.29; 95%CI: 0.16–0.52) than UK residents. Finally, the number of new HIV diagnoses among LAMs increased in those ten years, but the number of late diagnoses remained nearly constant. Conclusions: Although the current HIV epidemiological situation of LAMs living in the UK is not troublesome, the expansion of the LAM population and their increasing number of new HIV diagnoses could become a public health challenge in the coming years. Therefore, to accomplish the 2030 zero HIV transmission goal, it is necessary to integrate the migrant community into future public policies and categorise them as the ‘sixth’ HIV key population in the UK.

Abstract: The evolution of multidrug resistance in Klebsiella species in response to selective pressure and the extent to which this may be reversible is not fully understood. The spread of carbapenemresistant Enterobacteriaceae (CRE) is considered a public health threat by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC). As such, more studies are needed to understand the evolution of antibiotic resistance mechanisms to determine if it is possible to reverse this trend. Highlighted In this study, a comprehensive characterisation of a clinical Klebsiella quasipneumoniae isolate called FK688 is performed. The FK688 strain is resistant to multiple antibiotics, including third-generation cephalosporins and carbapenems and caused a bloodstream infection in a hospitalised patient. A combinational approach of genomic, enzymatic, and machine learning analyses did not uncover any carbapenemase-encoding genes in FK688. Rather, this research showed that epistatic changes are necessary for FK688 to acquire a CRE phenotype. Evolution experiments demonstrated the fitness burden associated with antimicrobial resistance determinants and the reversion to a carbapenem-susceptible phenotype in an antibiotic-free environment. Fitness assays showed that a low concentration of ceftazidime selects for a ?- lactamase gene and can potentiate evolution to carbapenem resistance by a single-step mutation in the porin OmpK36. This study demonstrated the importance of epistatic events and how variation in drug exposure can shape the evolutionary pathway to antibiotic resistance in bacteria.

Background and aim: Mental health services in Colombia have had a complex history shaped by 50 of years armed conflict, disproportionate clinical approach and social factors such as stigma. Nevertheless, recent global tendencies and interventions have suggested basing mental health services on communities and the recovery approach and considering the social determinants of mental health during planning. Colombia has involved these approaches in its legal and practical framework in recent years, but multiple internal and external factors have retarded an accurate implementation. This systematic review aims to contribute to mental health services understanding in Colombia, offering an implementation research approach. Methods: A comprehensive strategy search was developed to include peer-reviewed studies where mental health services were mentioned or described. The review was conducted in five databases (Medline (OVID), PubMed, Scopus, Scielo and BVS), three languages (English, Spanish & Portuguese) and was limited to the last ten years. Moreover, it followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and used the Consolidated Framework for Implementation Research (CFIR) to identify barriers and facilitators during the implementation of mental health services. Results: Twelve articles were selected. The principal reported barriers were lack of coordination, workloads, and funding. Implementation differences between public and private settings were significant and repeatedly reported. On the other hand, good planning strategies and the involvement of communities, stakeholders, users, and external champions facilitated implementation. Remarkable efforts to adopt community-based mental health services were described as well. Conclusions: Overall, this review offers significant insight into current mental health services, their implementation status, and principal barriers to effective implementation. It is suggested to continue applying community and recovery approaches in mental health services, but also to improve coordination between all actors (e.g., public and private organisations, non-governmental organisations (NGOs), and users and their families).

Abstract: Objective: To describe the prevalence pattern of anemia among Indigenous children in Latin America. Methods: PRISMA guidelines were followed. Records were identified from the databases PubMed, Google Scholar, and Lilacs by two independent researchers between May and June 2021. Studies were included if the following criteria were met: a) studied Indigenous people b) was about children (from 0 to 12 years old); c) reported a prevalence estimate of anemia; d) had been conducted in any of the countries of Latin America; e) was published either in English, Portuguese, or Spanish; f) is a peer-reviewed article; and g) was published at any date. Results: Out of 2,401 unique records retrieved, 42 articles met the inclusion criteria. A total of 39 different Indigenous communities were analyzed in the articles, and in 21 of them (54.0%) child anemia was a severe public health problem (prevalence ? 40%). Those communities were the Aymara (Bolivia); Aruak, Guaraní, Kamaiurá, Karapotó, Karibe, Kaxinanuá, Ma-cro-Jê, Suruí, Terena, Xavante (Brazil); Cabécar (Costa Rica), Achuar, Aguaruna, Awajún, Urarina, Yomybato (Peru); Piaroa and Yucpa (Venezuela); and Quechua (Peru and Bolivia). Children below two years had the highest prevalence of anemia (between 16.2% and 86.1%). Among Indigenous people, risk factors for anemia include nutrition, poor living conditions, access to health services, racism, and discrimination. Bolivia and Guatemala are scarcely studied, despite having the highest proportion of Indigenous communities in Latin America. Conclusions: Anemia constitutes a poorly documented public health problem among Indigenous children in 21 Indigenous communities in Bolivia, Brazil, Colombia, Costa Rica, Ecuador, Guatemala, Mexico, and Peru. In all Indigenous communities included in this study child anemia was an issue, especially in younger children. Resumen: Objetivo: Describir el patrón de prevalencia de anemia en niños indígenas de América Latina. Métodos: Se siguieron las directrices PRISMA. Los registros fueron identificados en las bases de datos PubMed, Google Scholar y Lilacs por dos investigadores independientes entre mayo y junio de 2021. Los estudios se incluyeron si cumplían los siguientes criterios: a) estudiaban a indígenas; b) eran sobre niños (de 0 a 12 años); c) reportaban una estimación de prevalencia de anemia; d) se habían realizado en cualquiera de los países de América Latina; e) se publicaron en inglés, portugués o español; f) eran artículos revisados por pares; y g) se publicaron en cualquier fecha. Resultados: De los 2.401 registros únicos recuperados, 42 artículos cumplían los criterios de inclusión. Un total de 39 comunidades indígenas diferentes fueron analizadas en los artículos, y en 21 de ellas (54,0%) la anemia infantil era un problema grave de salud pública (prevalencia ? 40%). Esas comunidades eran aymara (Bolivia); aruak, guaraní, kamaiurá, karapotó, karibe, kaxinanuá, macro- jê, suruí, terena, xavante (Brasil); cabécar (Costa Rica), achuar, aguaruna, awajún, urarina, yomybato (Perú); piaroa y yucpa (Venezuela); y quechua (Perú y Bolivia). Los niños menores de dos años presentaban la mayor prevalencia de anemia (entre el 16,2% y el 86,1%). Entre los indígenas, los factores de riesgo de la anemia son la nutrición, las malas condiciones de vida, el acceso a los servicios sanitarios, el racismo y la discriminación. Bolivia y Guatemala están escasamente estudiados, a pesar de tener la mayor proporción de comunidades indígenas de América Latina. Conclusiones: La anemia constituye un problema de salud pública poco documentado entre los niños indígenas de 21 comunidades indígenas de Bolivia, Brasil, Colombia, Costa Rica, Ecuador, Guatemala, México y Perú. En todas las comunidades indígenas incluidas en este estudio, la anemia infantil era un problema, especialmente en los niños más pequeños.

Abstract: At the present time, climate change and antimicrobial resistance are considered as the most critical threats, affecting human, animal, plant, and environmental health. Although these terms may initially appear different, they are interconnected and share similarities in their causes (human interventions and natural cycles), health, and societal consequences. Climate change is associated through direct and indirect pathways with an increase in infectious diseases. Nonetheless, the association between global warming and antimicrobial resistance requires a comprehensive summary of evidence exploring it. Methods: A literature review was conducted to identify and describe the association between climate change and the rapid emergence and spread of antimicrobial resistance. The search was conducted in the following databases: PubMed, Web of Science, Scopus, Embase, Epistemonikos, and Google Scholar. The search period was restricted to articles published from January 2010 to June 2021. Additionally, a snowballing approach was conducted to identify any additional papers. Data extraction included study location, weather factors, environmental elements, antibiotics, and bacteria analysed, as well as the results. Results: 29 articles were included (ten literature or systematic reviews, eight experimental, six ecological, four observational, and one quasi-experimental). In terms of location, all the studies were conducted in countries between 35° and 75° north latitude. The results suggested some evidence of the effects of climate change (alterations in temperature, precipitation, and humidity) on the emergence and rapid spread of antimicrobial resistance in different environments (water, soil, cryosphere, and air). Temperature was described as a main effect of climate change that had effects on antibiotic resistance (increasing bacteria growth, altering metabolism, inducing crossprotection, and facilitating horizontal gene transfer between bacteria). Additionally, results also described the association between altered rain patterns and humidity and antimicrobial resistance, through the runoff of antibiotic molecules or the transport of antibiotic resistance mechanisms to other areas. Conclusions: This literature review has underscored the association between climate change and antimicrobial resistance. According to the results shown in the selected studies, the alterations in weather factors resulting from climate change have varying effects on the emergence and spread of antibiotic resistance. However, further research is imperative to decipher the complex interactions between other environmental processes, pollutants, patterns of antibiotic consumption, wastewater, animal migration, and regions below the latitudes covered in this literature review.