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INTRODUCCIÓN: la automedicación es un acto irresponsable bajo condiciones fisiológicamente normales, aún más lo es cuando unapaciente está embarazada, cuando la fisiología se ve alterada para recibir una nueva vida. La OMS estima que la automedicación tieneuna prevalencia mayor al 50% sin embargo no existen cifras exactas sobre este tópico. En Colombia no existen datos sobreautomedicación en el embarazo.OBJETIVO: establecer datos claros en una clínica de la ciudad de Cartagena sobre la prevalencia de mujeres embarazadas que realizanautomedicación.METODOLÓGICA: estudio observacional descriptivo de corte transversal con 375 mujeres embarazadas o puerperio mediato querecibieron atención en la Clínica Maternidad Rafael Calvo (CMRC) en el periodo comprendido entre marzo y mayo de 2011, las cualesaccedieron ser encuestadas con previo consentimiento informado.RESULTADOS: la frecuencia de automedicación en mujeres embarazadas y puerperio mediato que fueron atendidas en la CMRC fuede 28,3%. El 39,2% no tenía conocimiento sobre qué es automedicación. Los medicamentos más utilizados para automedicarsefueron: Acetaminofen (46,7%), AINES (23%), Hidróxido de Aluminio (10,8%) y Vitaminas (7,19%). El trimestre en el que más seautomedicaron fue el I trimestre (44,4%) y el síntoma más frecuente que llevaba a la automedicación fue la cefalea (46,21%), seguidade malestar estomacal (13,63%).CONCLUSIÓN: la automedicación es un problema de salud pública y por los resultados obtenidos observamos que las mujeresembarazadas no son ajenas a esta realidad. No se encontraron estudios sobre automedicación en el embarazo en una búsqueda enbases de datos como MDconsult, Biblioteca Cochrane, OMS, WSMI y ScienceDirect.

Abstract Background Renal epithelial tumors are morphologically, biologically, and clinically heterogeneous. Different morphologic subtypes require specific management due to markedly different prognosis and response to therapy. Each common subtype has characteristic chromosomal gains and losses, including some with prognostic value. However, copy number information has not been readily accessible for clinical purposes and thus has not been routinely used in the diagnostic evaluation of these tumors. This information can be useful for classification of tumors with complex or challenging morphology. 'Virtual karyotypes' generated using SNP arrays can readily detect characteristic chromosomal lesions in paraffin embedded renal tumors and can be used to correctly categorize the common subtypes with performance characteristics that are amenable for routine clinical use. Methods To investigate the use of virtual karyotypes for diagnostically challenging renal epithelial tumors, we evaluated 25 archived renal neoplasms where sub-classification could not be definitively rendered based on morphology and other ancillary studies. We generated virtual karyotypes with the Affymetrix 10 K 2.0 mapping array platform and identified the presence of genomic lesions across all 22 autosomes. Results In 91% of challenging cases the virtual karyotype unambiguously detected the presence or absence of chromosomal aberrations characteristic of one of the common subtypes of renal epithelial tumors, while immunohistochemistry and fluorescent in situ hybridization had no or limited utility in the diagnosis of these tumors. Conclusion These results show that virtual karyotypes generated by SNP arrays can be used as a practical ancillary study for the classification of renal epithelial tumors with complex or ambiguous morphology.

Aim: In this study, PLGA nanoparticles (PNPs) emulsified in Pluronic F127 (F127)/Lecithin (LEC) were designed to load Itacitinib (ITA), a selective JAK1 inhibitor, for targeting human monocytes. Materials & methods: The physicochemical characteristics of empty and ITA-loaded F127/LEC PNPs were analyzed. The binding and internalization of NPs in leukocytes were evaluated. The effect of NPs on monocyte activation and JAK1 inhibition was assessed. Results: F127/LEC PNPs were selectively bound and internalized by monocytes, sparing other leukocytes. ITA-F127/LEC PNPs significantly dampened monocyte activation. They also inhibited the monocyte's ability to promote T-cell proliferation and inhibited proinflammatory cytokine production. Conclusion: ITA-loaded F127/LEC PNPs showed potential for monocyte-targeted therapy, offering new avenues for disease treatment.

Purpose: This study investigates the clinical impact of electronic patient-reported outcome (ePRO) monitoring apps/web interfaces, aimed at symptom-management, in cancer patients undergoing outpatient systemic antineoplastic treatment. Additionally, it explores the advantages offered by these applications, including their functionalities and healthcare team-initiated follow-up programmes., Methods: A systematic literature review was conducted using a predefined search strategy in MEDLINE. Inclusion criteria encompassed primary studies assessing symptom burden through at-home ePRO surveys in adult cancer patients receiving outpatient systemic antineoplastic treatment, whenever health outcomes were evaluated. Exclusion criteria excluded telemedicine-based interventions other than ePRO questionnaires and non-primary articles or study protocols. To evaluate the potential bias in the included studies, an exhaustive quality assessment was conducted, as an additional inclusion filter., Results: Among 246 identified articles, 227 were excluded for non-compliance with inclusion/exclusion criteria. Of the remaining 19 articles, only eight met the rigorous validity assessment and were included for detailed examination and data extraction, presented in attached tables., Conclusion: This review provides compelling evidence of ePRO monitoring's positive clinical impact across diverse cancer settings, encompassing various cancer types, including early and metastatic stages. These systems are crucial in enabling timely interventions and reducing communication barriers, among other functionalities. While areas for future ePRO innovation are identified, the primary limitation lies in comparing clinical outcomes of reviewed articles, due to scale variability and study population heterogeneity. To conclude, our results reaffirm the transformative potential of ePRO apps in oncology and their pivotal role in shaping the future of cancer care., Competing Interests: Competing interests: None declared., (© European Association of Hospital Pharmacists 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: This study tested the hypothesis that a neuroprotective combined therapy based on epidermal growth factor (EGF) and growth hormone-releasing hexapeptide (GHRP6) could be safe for acute ischemic stroke patients, admitting up to 30% of serious adverse events (SAE) with proven causality., Methods: A multi-centric, randomized, open-label, controlled, phase I-II clinical trial with parallel groups was conducted (July 2017 to January 2018). Patients aged 18-80 years with a computed tomography-confirmed ischemic stroke and less than 12 h from the onset of symptoms were randomly assigned to the study groups I (75 μg rEGF + 3.5 mg GHRP6 i.v., n=10), II (75 μg rEGF + 5 mg GHRP6 i.v., n=10), or III (standard care control, n=16). Combined therapy was given BID for 7 days. The primary endpoint was safety over 6 months. Secondary endpoints included neurological (NIHSS) and functional [Barthel index and modified Rankin scale (mRS)] outcomes., Results: The study population had a mean age of 66 ± 11 years, with 21 men (58.3%), a baseline median NIHSS score of 9 (95% CI: 8-11), and a mean time to treatment of 7.3 ± 2.8 h. Analyses were conducted on an intention-to-treat basis. SAEs were reported in 9 of 16 (56.2%) patients in the control group, 3 of 10 (30%) patients in Group I (odds ratio (OR): 0.33; 95% CI: 0.06-1.78), and 2 of 10 (20%) patients in Group II (OR: 0.19; 95% CI: 0.03-1.22); only two events in one patient in Group I were attributed to the intervention treatment. Compliance with the study hypothesis was greater than 0.90 in each group. Patients treated with EGF + GHRP6 had a favorable neurological and functional evolution at both 90 and 180 days, as evidenced by the inferential analysis of NIHSS, Barthel, and mRS and by their moderate to strong effect size. At 6 months, proportion analysis evidenced a higher survival rate for patients treated with the combined therapy. Ancillary analysis including merged treated groups and utility-weighted mRS also showed a benefit of this combined therapy., Conclusion: EGF + GHRP6 therapy was safe. The functional benefits of treatment in this study supported a Phase III study., Clinical Trial Registration: RPCEC00000214 of the Cuban Public Registry of Clinical Trials, Unique identifier: IG/CIGB-845I/IC/1601., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Hernández-Bernal, Estenoz-García, Gutiérrez-Ronquillo, Martín-Bauta, Catasús-Álvarez, Gutiérrez-Castillo, Guevara-Rodríguez, Castro-Jeréz, Fuentes-González, Pinto-Cruz, Valenzuela-Silva, Muzio-González, Pérez-Saad, Subirós-Martínez, Guillén-Nieto and Garcia-del-Barco-Herrera.)

Background: Janus kinase inhibitors (jakinibs) are immunomodulators used for treating malignancies, autoimmune diseases, and immunodeficiencies. However, they induce adverse effects such as thrombosis, lymphocytosis, and neutropenia that could be mediated by extracellular vesicles (EVs). These particles are cell membrane-derived structures that transport cellular and environmental molecules and participate in intercellular communication. Jakinibs can modify the content of EVs and enable them to modulate the activity of different components of the immune response., Objective: to evaluate the interactions between immune system components of healthy individuals and EVs derived from monocytic and lymphoid lineage cells generated in the presence of baricitinib (BARI) and itacitinib (ITA) and their possible effects., Methods: EVs were isolated from monocytes (M) and lymphocytes (L) of healthy individuals, as well as from U937 (U) and Jurkat (J) cells exposed to non-cytotoxic concentrations of BARI, ITA, and dimethyl sulfoxide (DMSO; vehicle control). The binding to and engulfment of EVs by peripheral blood leukocytes of healthy individuals were analyzed by flow cytometry using CFSE-stained EVs and anti-CD45-PeCy7 mAb-labeled whole blood. The effect of EVs on respiratory burst, T-cell activation and proliferation, cytokine synthesis, and platelet aggregation was evaluated. Respiratory burst was assessed in PMA-stimulated neutrophils by the dihydrorhodamine (DHR) test and flow cytometry. T-cell activation and proliferation and cytokine production were assessed in CFSE-stained PBMC cultures stimulated with PHA; expression of the T-cell activation markers CD25 and CD69 and T-cell proliferation were analyzed by flow cytometry, and the cytokine levels were quantified in culture supernatants by Luminex assays. Platelet aggregation was analyzed in platelet-rich plasma (PRP) samples by light transmission aggregometry. The EVs' fatty acid (FA) profile was analyzed using methyl ester derivatization followed by gas chromatography., Results: ITA exposure during the generation of EVs modified the size of the EVs released; however, treatment with DMSO and BARI did not alter the size of EVs generated from U937 and Jurkat cells. Circulating neutrophils, lymphocytes, and monocytes showed a 2-fold greater tendency to internalize ITA-U-EVs than their respective DMSO control. The neutrophil respiratory burst was attenuated in greater extent by M-EVs than by L-EVs. Autologous ITA- M -EVs reduced T-cell proliferation by decreasing IL-2 levels and CD25 expression independently of CD69. A higher accumulation of pro-inflammatory cytokines was observed in PHA-stimulated PBMC cultures exposed to M-EVs than to L-EVs; this difference may be related to the higher myristate content of M-EVs. Platelet aggregation increased in the presence of ITA-L/M-EVs by a mechanism presumably dependent on the high arachidonic acid content of the vesicles., Conclusions: Cellular origin and jakinib exposure modify the FA profile of EVs, enabling them, in turn, to modulate neutrophil respiratory burst, T-cell proliferation, and platelet aggregation. The increased T-cell proliferation induced by BARI-L/M-EVs could explain the lymphocytosis observed in patients treated with BARI. The higher proportion of arachidonic acid in the FA content of ITA-L/M-EVs could be related to the thrombosis described in patients treated with ITA. EVs also induced a decrease in the respiratory burst of neutrophils., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Mauricio Rojas Lopez reports financial support (Minciencias Code 111584467267 - Contract 925-2019 and UdeA Sostenibilidad-CODI), statistical analysis, travel, and publication support were provided by 10.13039/501100005278University of Antioquia. Mauricio Rojas Lopez reports a relationship with University of Antioquia that includes: employment. In relation to potential conflicts of interest, I want to declare that I currently hold no editorial positions in any journal, and my primary professional activity is teaching in the field of Immunology at the Faculty of Medicine. I have no financial relationships or direct collaborations with the authors involved in this manuscript, and my involvement in the review will be solely based on the scientific quality of the presented work.I am committed to ensuring an impartial and objective evaluation of this manuscript, without undue influence from any relationship or activity that could be perceived as a conflict of interest. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)

Chagas cardiomyopathy (CCC) is associated with coagulation disorders that frequently culminate in thrombotic events, contributing to increased mortality rates in this clinical condition. Considering the demonstrated effect that extracellular vesicles (EVs) have on regulating inflammatory processes, coagulation, and angiogenesis, the present study aims to characterize plasma EVs and their relationship with coagulation disorders in patients with CCC. A total of 78 patients were assessed with 46.1% (36/78) representing the CCC group, 8.9% (7/78) with cardiomyopathy unrelated to Chagas disease (CM group), and 44.8% (35/78) comprising the control group, which included individuals without cardiomyopathy and negative for T. cruzi infection. Plasma EVs concentration (EVs/mL) for each individual was evaluated by flow cytometry, along with the proportion of EVs expressing PSGL-1 (PSGL-1+ EVs), Tissue Factor (TF + EVs), and CD41a (CD41a + EVs). The ability of EVs to induce platelet aggregation was evaluated by spectrophotometry. We also evaluated other prothrombotic biomarkers, including platelet count, activated partial thromboplastin time (PTT), prothrombin time (PT), and D-dimer levels. The results revealed elevated D-dimer levels in the CCC group, accompanied by a decrease in the count of EVs per mL of plasma and a significant increase in the proportion of PSGL-1+ EVs ( P  < .05) compared to the control group. Other parameters did not exhibit significant differences between groups. The elevated levels of PSGL-1+ EVs in the CCC group may be attributed to myocardial inflammatory processes, which, upon interaction with platelet-derived P-selectin, could promote thrombus formation, as indicated by the increased D-dimer levels in this group., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: B cells are pivotal in systemic lupus erythematosus and autoimmune disease pathogenesis. Materials & methods: To address this, Nile Red-labeled polylactic acid nanoparticles (NR-PLA NPs) loaded with the JAK inhibitor baricitinib (BARI), specifically targeting JAK1 and JAK2 in B cells, were developed. Results: Physicochemical characterization confirmed NP stability over 30 days. NR-PLA NPs were selectively bound and internalized by CD19 + B cells, sparing other leukocytes. In contrast to NR-PLA NPs, BARI-NR-PLA NPs significantly dampened B-cell activation, proliferation and plasma cell differentiation in healthy controls. They also inhibited key cytokine production. These effects often surpassed those of equimolar-free BARI. Conclusion: This study underscores the potential of PLA NPs to regulate autoreactive B cells, offering a novel therapeutic avenue for autoimmune diseases.

Autoimmune diseases are chronic conditions that result from an inadequate immune response to self-antigens and affect many people worldwide. Their signs, symptoms, and clinical severity change throughout the course of the disease, therefore the diagnosis and treatment of autoimmune diseases are major challenges. Current diagnostic tools are often invasive and tend to identify the issue at advanced stages. Moreover, the available treatments for autoimmune diseases do not typically lead to complete remission and are associated with numerous side effects upon long-term usage. A promising strategy is the use of nanoparticles that can be used as contrast agents in diagnostic imaging techniques to detect specific cells present at the inflammatory infiltrates in tissues that are not easily accessible by biopsy. In addition, NPs can be designed to deliver drugs to a cell population or tissue. Considering the significant role played by monocytes in the development of chronic inflammatory conditions and their emergence as a target for extracorporeal monitoring and precise interventions, this review focuses on recent advancements in nanoparticle-based strategies for diagnosing and treating autoimmune diseases, with a particular emphasis on targeting monocyte populations., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors. Published by Elsevier Ltd.)

The aim of this study was to estimate the occurrence of Bartonella spp. per household in cats and the risk factors for Bartonella spp. positivity in cats and their owners from Valdivia, Chile. A total of 464 cats (distributed within 324 households) and 326 humans (control group [ n  = 112] and cat owner [ n  = 214]) distributed in 262 households were sampled. From the cat owners (n = 214), 128 humans were in households where the cat was also sampled, totaling 84 households with dual sampling. Real-time PCR (qPCR) was used for Bartonella spp. detection in blood from cats and humans, and immunofluorescent immunoassay (IFA) anti- Bartonella henselae was performed in human serum samples. Out of the total of 324 households, 20.43% presented at least one Bartonella positive cat. From the households with dual sampling, 29.7% (25/84) presented at least one qPCR- Bartonella spp. positive cat. However, Bartonella DNA was not amplified in humans, and in 7.3% (6/82) of the households was found at least one of the cat's owners exposed to B. henselae . Cats younger than one year (Odds Ratio (OR) = 5.3), non-neutered (OR 3.46), sampled at home (OR 5.82), and with improper application of tick/flea control products (OR 3.13) showed a higher risk for Bartonella spp. presence. Humans with occupational exposure involving animal contact, were more likely to exhibit B. henselae seropositivity (OR 7.5). Bartonella spp. was present in the cats a moderate number of households, but Bartonella DNA was not detected in owners' blood, inferring that there is a low risk of recent human infection in the studied population., Competing Interests: The authors declare that there is no conflict of interest., (© 2023 The Authors.)

Background: Cardiac myofibrillary dysfunction, which can be measure by echocardiographical strain value, represents an early subclinical manifestation of heart failure. Epicardial Adipose tissue (EAT) is related to low degree inflammation and oxidative damage in the adjacent tissue., Aim: To explore whether EAT affects early myocardial dysfunction, as assessed strain values., Methods: Case-Control design. Patients lacking clinical significant heart failure, thyroid or renal disease or malignant abnormalities were included. Clinical-demographic and biochemical data were collected. EAT and myofibril deformation were measured by echocardiography., Results: A total of 71 patients were analyzed, and further subdivided according to type 2 Diabetes Mellitus (t2DM). Higher strain value (higher than -22.4%cut-off value) was associated with male sex and higher anthropometric and metabolic risk measures; particularly those with t2DM. Higher EAT was also associated higher strain value (AUC = 0.92 ± 0.06, p = 0.004), and further correlation was evidenced (rho = 0.488, p < 0.001), with significant influence of t2DM., Conclusion: EAT was related to strain value, suggesting the influence of cardiac adipose tissue on the deformability of cardiac myofibril, with a more significant effect in the population with t2DM., (© 2022. The Author(s).)

The objective is to determine the relationship between physical fitness, anthropometric measures, and biological maturation as they relate to technical performance in small-sided games (SSGs) of continuous and fractioned regimes. Methodology: A crossover-design study in which 12 children participated in two regimens of SSG (continuous and fractional). At the beginning of the study, all children were evaluated using physical fitness tests (horizontal jump test, vertical jump, cardiorespiratory fitness, and agility), anthropometric profile (weight, height, Body Mass Index (BMI), and waist circumference (WC)), and biological maturation (peak years of growth velocity). All sessions were recorded and analyzed with the Performance Assessment in Team Sports instrument, and at the end of each game each child was asked to answer a scale of enjoyment for physical activity. Results: The results of the paired samples t-test showed no significant differences in the measures of technical performance and perceived enjoyment for the continuous and fractional regimens of SSGs (p > 0.05). The correlation results showed that technical performance in the continuous and fractional regimes was related to agility, horizontal jump, and height, while biological maturation was only related to technical performance in the fractional regimen of SSGs. Perceived enjoyment showed a negative relationship with weight, height, BMI, and WC. Conclusion: The fractional and continuous regimens of SSGs implemented in this study induced similar technical demands and enjoyment. Furthermore, the results suggest that physical fitness, anthropometric profile, and biological maturation may influence the technical performance and enjoyment of SSGs.

Soil contamination with petroleum hydrocarbons affects plants and rhizospheric microorganisms. Microbial activity participates in important biochemical processes that stimulate, together with plants, the modification of toxic compounds for organisms. A nine-month experiment was set up to study the effect over time of oil on plant height (cm), formation of new plants, plant matter production (gravimetry), and population of rhizospheric microorganisms (serial dilution) in the sedge Eleocharis palustris. Removal of total petroleum hydrocarbons (soxhlet and gravimetry) from the soil was also evaluated. The means of the evaluated variables registered significant statistical differences (Duncan, p < 0.05) regarding the age of the plant and the amount of crude oil. There was a high correlation between oil and plant height (0.848) and with new plants (0.994). 60 mg oil dose promoted the greatest statistical difference in the amounts of roots and plant biomass (p < 0.05). E. palustris exposed to 60 and 75 mg of oil stimulated high densities of microalgae, actinomycetes, fungi, hydrocarbonoclastic bacteria and Pseudomonas spp; the overall ratio was 2:1 relative to natural attenuation. Plant and microorganism variables evaluated registered physiological and microbiological hormetic indices ≥1, showing a positive linear relationship. Natural attenuation was more efficient in removing crude oil. We conclude that E. palustris is tolerant to oil exposure. It is suggested to combine it with natural attenuation for the optimization of soils contaminated with crude oil., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Introduction: There is a wide variety of functional tests and scales for the assessment of different aspects in the adaptation of amputees, but there is still no consensus on which are the most appropriate., Objectives: To describe the measures of correlation and association among three functional tests for lower-limb amputees and to define the most appropriate for this assessment. To assess general satisfaction in lower-limb prostheses users and its association with the functional tests., Methods: We included 83 unilateral lower-limb amputees who were users of low-cost exoskeletal prostheses. The instruments employed were the Houghton scale, the Prosthesis Evaluation Questionnaire - Mobility Scale (PEQ-MS) and the 2-minute walk test (2MWT). The statistical analysis was performed using the chi-square test and Spearman's correlation coefficient., Results: The functional tests evaluated had an acceptable correlation and association with each other, but the Spearman correlation between the Houghton scale and the 2MWT was of greater significance (whole sample: r=0.56; below-knee amputees: r=0.53). The association measures did not achieve statistically significant results for above-knee amputees or for general satisfaction., Conclusions: The Houghton Scale and the 2MWT showed a good correlation and association with each other, becoming possible first-line instruments for the follow-up of exoskeletal lower limb prosthesis users. No significant association was identified between satisfaction and the instruments measured., (Copyright © 2020 Sociedad Española de Rehabilitación y Medicina Física. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Elevated levels of circulating microparticles (MPs) and molecules of the complement system have been reported in patients with systemic lupus erythematosus (SLE). Moreover, microparticles isolated from patients with SLE (SLE-MPs) contain higher levels of damage-associated molecular patterns (DAMPs) than MPs from healthy controls (CMPs). We hypothesize that the uptake of MPs by monocytes could contribute to the chronic inflammatory processes observed in patients with SLE. Therefore, the aim of this study was to evaluate the expression of activation markers, production of proinflammatory mediators, and activation of the NF-κB signaling pathway in monocytes treated with CMPs and SLE-MPs., Methodology: Monocytes isolated from healthy individuals were pretreated or not with pyrrolidine dithiocarbamate (PDTC) and cultured with CMPs and SLE-MPs. The cell surface expression of CD69 and HLA-DR were evaluated by flow cytometry; cytokine and eicosanoid levels were quantified in culture supernatants by Cytokine Bead Array and ELISA, respectively; and the NF-κB activation was evaluated by Western blot and epifluorescence microscopy., Results: The cell surface expression of HLA-DR and CD69, and the supernatant levels of IL-6, IL-1β, PGE2, and LTB4 were higher in cultures of monocytes treated with SLE-MPs than CMPs. These responses were blocked in the presence of PDTC, a pharmacological inhibitor of the NF-κB pathway, with concomitant reduction of IκBα and cytoplasmic p65, and increased nuclear translocation of p65., Conclusions: The present findings indicate that significant uptake of SLE-MPs by monocytes results in activation, production of inflammatory mediators, and triggering of the NF-κB signaling pathway., Competing Interests: The authors declare no conflict of interest., (© 2020 Published by Elsevier Ltd.)

Purpose: Studies document the substantial underutilization of mental health services by US Latinos in young adulthood. Rates of service use are higher in childhood, raising questions about whether mental health service use during childhood may facilitate access to services later in life. This article examines the extent to which utilization of mental health services in childhood is predictive of utilization in young adulthood among US Latinos., Methods: Data come from the Boricua Youth Study, a longitudinal study of Puerto Rican youth at two sites (South Bronx, New York, and the standard metropolitan area of San Juan, Puerto Rico). Data were collected in three waves during childhood (ages 5-13; surveyed 1 year apart), with an approximately 11-year follow-up in young adulthood (ages 16-29). In childhood, parents reported on youth mental health service use (Waves 1-3). In Wave 4, as youth transitioned to young adults (N = 2004), they reported on their past year mental health service use., Results: Whereas 30.2% of parents reported their child received mental health services, only 3.5% of young adults reported mental health service use in the past year. After controlling for young adult disorders and their severity, childhood disorders were associated with increased likelihood of mental health service use in young adulthood. Childhood mental health service use was also associated with young adult service use; however, this association attenuated when controlling for childhood disorders., Conclusion: Findings suggest the importance of specifically considering childhood disorders in understanding mechanisms for improving access to mental health services among Latino young adults.

Lynch syndrome (LS) is associated with the highest risk of colorectal (CRC) and several extracolonic cancers. In our effort to characterize LS families from Latin America, this study aimed to describe the spectrum of neoplasms and cancer risk by gender, age and gene, and survival in 34 Chilean LS families. Of them, 59% harbored path&#95;MLH1 , 23% path&#95;MSH2 , 12% path&#95;PMS2 and 6% path&#95;EPCAM variants. A total of 866 individuals at risk were identified, of which 213 (24.6%) developed 308 neoplasms. In males, CRC was the most common cancer (72.6%), while females showed a greater frequency of extracolonic cancers (58.4%), including uterus and breast ( p < 0.0001). The cumulative incidence of extracolonic cancers was higher in females than males ( p = 0.001). Path&#95;MLH1 variants are significantly more associated with the development of CRC than extracolonic tumors (59.5% vs. 40.5%) when compared to path&#95;MSH2 (47.5% vs. 52.5%) variants ( p = 0.05018). The cumulative incidence of CRC was higher in path&#95;MLH1 / path&#95;MSH2 carriers compared to path&#95;PMS2 carriers ( p = 0.03). In addition, path&#95;MSH2 carriers showed higher risk of extracolonic tumors ( p = 0.002). In conclusion, this study provides a snapshot of the LS profile from Chile and the current LS-associated diagnostic practice and output in Chile. Categorizing cancer risks associated with each population is relevant in the genetic counselling of LS patients.