Design of ß-Keto Esters with Antibacterial Activity: Synthesis, In Vitro Evaluation, and Theoretical Assessment of Their Reactivity and Quorum-Sensing Inhibition Capacity.

This work proposes the design of ß-keto esters as antibacterial compounds. The design was based on the structure of the autoinducer of bacterial quorum sensing, N-(3-oxo-hexanoyl)-l-homoserine lactone (3-oxo-C6-HSL). Eight ß-keto ester analogues were synthesised with good yields and were spectroscopically characterised, showing that the compounds were only present in their ß-keto ester tautomer form. We carried out a computational analysis of the reactivity and ADME (absorption, distribution, metabolism, and excretion) properties of the compounds as well as molecular docking and molecular dynamics calculations with the LasR and LuxS quorum-sensing (QS) proteins, which are involved in bacterial resistance to antibiotics. The results show that all the compounds exhibit reliable ADME properties and that only compound 7 can present electrophile toxicity. The theoretical reactivity study shows that compounds 6 and 8 present a differential local reactivity regarding the rest of the series. Compound 8 presents the most promising potential in terms of its ability to interact with the LasR and LuxS QS proteins efficiently according to its molecular docking and molecular dynamics calculations. An initial in vitro antimicrobial screening was performed against the human pathogenic bacteria Pseudomonas aeruginosa and Staphylococcus aureus as well as the phytopathogenic bacteria Pseudomonas syringae and Agrobacterium tumefaciens. Compounds 6 and 8 exhibit the most promising results in the in vitro antimicrobial screening against the panel of bacteria studied.

Evaluación de la carga laboral en residentes Chilenos de especialidades y subespecialidades médicas / Workload assessment in Chilean residents of specialties and medical subspecialties

Introducción: La sobrecarga laboral horaria es un importante problema en los programas de especialización médica. Se asocia a mayor prevalencia de depresión, burnout, deserción, e impacta en la calidad de vida de los residentes. Nuestro objetivo fue cuantificar las horas semanales de carga laboral horaria en residentes de especialidad y subespecialidad de la Pontificia Universidad Católica de Chile (PUC). Métodos: Se realizó una encuesta electrónica a los residentes de especialidad y subespecialidad de la Pontificia Universidad Católica de Chile (2013). Esta incluyó autorreporte de horas semanales trabajadas (jornada habitual, turnos presenciales y turnos de llamada). Para el análisis se consideraron solo las horas presenciales (jornada habitual y turnos presenciales Resultados: se obtuvieron 415 respuestas (tasa de respuesta 86%). Los residentes de especialidad reportaron una jornada de 52,8 ± 20,3 horas semanales más un promedio de 22,6 ± 22,5 horas de turnos presenciales semanales. Los residentes de programas de subespecialidad reportaron una jornada de 55,9 ± 22,2 horas semanales más un promedio de 23 ± 3,9 horas de turnos presenciales semanales. De los 53 programas evaluados, el 22,6 por ciento sobrepasó el límite recomendado por la Dirección de Postgrado PUC (80 horas semanales). Cinco programas reportaron 90-100 horas semanales (todas especialidades o subespecialidades quirúrgicas) y 7 programas reportaron 80-90 horas semanales (3 subespecialidades médicas, 1 subespecialidad quirúrgica, 2 especialidades médicas y 1 especialidad quirúrgica). Conclusión: los residentes de especialidades y subespecialidades médicas en la Pontificia Universidad Católica de Chile están sometidos a una carga horaria significativa. Los programas quirúrgicos presentaron la mayor sobrecarga horaria presencial, con un promedio mayor al recomendado a nivel internacional. (AU)

Introduction: Residents work hours' overload constitutes an important problem in medical postgraduate residency programs. It has been associated to an increased prevalence of depression, burnout, attrition and affects quality of life of residents. The aim of our study was to quantify the duty hours in residents of specialty and subspecialty at the Pontificia Universidad Católica de Chile (PUC). Methods: An electronic survey was performed to residents of specialty and subspecialty at PUC (2013). It included an auto report of the duty hours worked in a week (regular working day, night shifts and on call shifts). We only included for analysis the face hours (regular working day and night shifts). Results: 415 surveys were answered (response rate 86percent). Specialty residents reported 52.8 ± 20.3 regular working hours per week plus an average of 22.6 ± 22.5 hours of night shifts. Subspecialty residents reported 55.9 ± 22.2 regular working hours per week plus an average of 23 ± 3.9 hours of night shifts. From the 53 evaluated programs, 22.6 percent exceeded the limit recommended in the PUC Postgraduate Office (80 hours per week). Five programs reported 90-100 hours per week (all were surgical specialties and subspecialties) and 7 programs reported 80-90 hours per week (3 medical subspecialties, 1 surgical subspecialty, 2 medical specialties and 1 surgical specialty). Conclusion: The residents of specialty and subspecialty from medical postgraduate programs at PUC are subject to a significant workload. The surgical programs present the highest time workload, with a greater average than the internationally recommended.(AU)

[Health and humanization Diploma: the value of reflection and face to face learning]. / Diplomado de salud y humanización: el valor de la reflexión y el aprendizaje presencial.

BACKGROUND: In a rapidly changing culture like ours, with emphasis on productivity, there is a strong need to find the meaning of health care work using learning instances that privilege reflection and face to face contact with others. The Diploma in Health and Humanization (DSH), was developed as an interdisciplinary space for training on issues related to humanization. AIM: To analyze the experience of DSH aiming to identify the elements that students considered key factors for the success of the program. MATERIAL AND METHODS: We conducted a focus group with DSH graduates, identifying factors associated with satisfaction. Transcripts were coded and analyzed by two independent reviewers. RESULTS: DSH graduates valued a safe space, personal interaction, dialogue and respect as learning tools of the DSH. They also appreciates the opportunity to have emotional interactions among students and between them and the teacher as well as the opportunity to share personal stories and their own search for meaning. DISCUSSION: DSH is a learning experience in which their graduates value the ability to think about their vocation and the affective interaction with peers and teachers. We hope to contribute to the development of face to face courses in the area of humanization. Face to face methodology is an excellent teaching technique for contents related to the meaning of work, and more specifically, to a group of learners that require affective communication and a personal connection of their work with their own values and beliefs.

Diplomado de salud y humanización: el valor de la reflexión y el aprendizaje presencial / Health and humanization Diploma: the value of reflection and face to face learning

Background: In a rapidly changing culture like ours, with emphasis on productivity, there is a strong need to find the meaning of health care work using learning instances that privilege reflection and face to face contact with others. The Diploma in Health and Humanization (DSH), was developed as an interdisciplinary space for training on issues related to humanization. Aim: To analyze the experience of DSH aiming to identify the elements that students considered key factors for the success of the program. Material and Methods: We conducted a focus group with DSH graduates, identifying factors associated with satisfaction. Transcripts were coded and analyzed by two independent reviewers. Results: DSH graduates valued a safe space, personal interaction, dialogue and respect as learning tools of the DSH. They also appreciates the opportunity to have emotional interactions among students and between them and the teacher as well as the opportunity to share personal stories and their own search for meaning. Discussion: DSH is a learning experience in which their graduates value the ability to think about their vocation and the affective interaction with peers and teachers. We hope to contribute to the development of face to face courses in the area of humanization. Face to face methodology is an excellent teaching technique for contents related to the meaning of work, and more specifically, to a group of learners that require affective communication and a personal connection of their work with their own values and beliefs.

Anisakid parasites in commercial hake ceviche in southern Chile.

The objective of this research was to determine the occurrence of anisakid nematode larvae in hake ceviche sold in restaurants in Valdivia (39°48'S, 73°14'W) and Niebla (39°49'S, 73°22'W), Chile. Between August and November 2012, 78 portions of ceviche were collected (6 from each of the 13 restaurants that sell this product). Each portion was weighed and divided into approximately 30-g samples, which were placed in petri dishes with 0.15 M NaCl. All samples were manually shredded and then examined with a stereomicroscope. Muscles of 41 southern hake (Merluccius australis), a fish sold fresh in Valdivia, also were examined by candling to determine the presence of anisakid larvae. The presence of Pseudoterranova larvae in ceviche sold in Chile was identified for the first time. The pH of ceviche ranges from 4.1 to 4.8, which favors the presence of viable anisakid larvae that tolerate the acid pH similar to that found in the stomach of their mammalian host. No significant differences (P > 0.05) in the prevalence, mean abundance, and mean density of anisakid larvae in ceviche were found between localities. Larvae were detected in ceviche from 3 of 6 restaurants in Valdivia and 4 of 7 restaurants in Niebla. Of the 78 examined portions of ceviche, 21.8% had larvae. The prevalence of viable larvae was 16.7 and 7.1% in the examined portions from Valdivia and Niebla, respectively. In the 41 hake muscle samples from Valdivia, the prevalence (4.9%), mean abundance (0.1), and mean density (0.03) was the same for Pseudoterranova and Anisakis larvae. No inspection processes or pretreatments are currently in place for raw fish to achieve safe conditions for ceviche in restaurants from Valdivia and Niebla.

Cost-efficiency of a brief family intervention for somatoform patients in primary care.

We sought to determine the cost-efficiency of a brief family intervention program for patients with somatoform disorder. Two hundred fifty-six somatoform patients from 7 centers of primary care in Chile were randomly assigned to either brief family intervention (BFI) or treatment as usual. The experimental group presented a significant cost reduction (p = .001) 6 months and 12 months after the intervention, with lower costs than the control group on all measured variables and no decrease in patient satisfaction. Our results suggest that BFI might be a cost-efficient way of meeting the needs of somatoform patients. Replications in other cultural contexts and dismantling studies to identify the effective ingredients of BFI are recommended.