[Presence of women in medical publications in Chile]. / La mujer en las publicaciones científicas en Chile.

BACKGROUND: Despite recent initiatives and efforts, gender inequality still exists in medicine and academia. There is a higher proportion of male authors in international scientific publications. AIM: To compare the proportion of female and male authors in the scientific publications of the main medical journals in Chile. MATERIAL AND METHODS: We reviewed 1,643 Scientific articles published between 2015 and 2020 in two medical journals from Chile. Three authors analyzed the title, abstract, and authors of all published articles, recording the sex of the first author, co-authors, and corresponding author. RESULTS: The reviewed articles had a mean of 5.3 authors and there was a significant difference between men and women (a mean of 2.8 men and 2.4 women; p < 0.001). Forty-six percent (n = 761) of the articles had a female first author. In a higher proportion of papers, men completed both positions (1st and corresponding author) simultaneously. CONCLUSIONS: There are fewer female authors in scientific publications. Chile is one of the countries with a high rate of gender gap in the world. The underrepresentation of women in academia is an example of this.

Communication deficits in a case of a deletion in 7q31.1-q31.33 encompassing FOXP2.

Copy number variants (CNVs) found in individuals with communication deficits provide a valuable window to the genetic causes of problems with language and, more generally, to the genetic foundation of the human-specific ability to learn and use languages. This paper reports on the language and communication problems of a patient with a microduplication in 22q11.23 and a microdeletion in 7q31.1-q1.33 encompassing FOXP2. The proband exhibits severe speech problems and moderate comprehension deficits, whereas her pragmatic abilities are a relative strength, as she uses gestures quite competently to compensate for her expressive issues. This profile is compatible with the deficiencies found in patients with similar CNVs, particularly with people bearing microdeletions in 7q31.1-q31.33.

Repositioned Drugs for Chagas Disease Unveiled via Structure-Based Drug Repositioning.

Chagas disease, caused by the parasite Trypanosoma cruzi, affects millions of people in South America. The current treatments are limited, have severe side effects, and are only partially effective. Drug repositioning, defined as finding new indications for already approved drugs, has the potential to provide new therapeutic options for Chagas. In this work, we conducted a structure-based drug repositioning approach with over 130,000 3D protein structures to identify drugs that bind therapeutic Chagas targets and thus represent potential new Chagas treatments. The screening yielded over 500 molecules as hits, out of which 38 drugs were prioritized following a rigorous filtering process. About half of the latter were already known to have trypanocidal activity, while the others are novel to Chagas disease. Three of the new drug candidates-ciprofloxacin, naproxen, and folic acid-showed a growth inhibitory activity in the micromolar range when tested ex vivo on T. cruzi trypomastigotes, validating the prediction. We show that our drug repositioning approach is able to pinpoint relevant drug candidates at a fraction of the time and cost of a conventional screening. Furthermore, our results demonstrate the power and potential of structure-based drug repositioning in the context of neglected tropical diseases where the pharmaceutical industry has little financial interest in the development of new drugs.

Identification of the needs of individuals affected by COVID-19.

BACKGROUND: The optimal management of COVID-19 symptoms and their sequelae remains an important area of clinical research. Policy makers have little scientific data regarding the effects on the daily life of affected individuals and the identification of their needs. Such data are needed to inform effective care policy. METHODS: We studied 639 people with COVID-19 resident in France via an online questionnaire. They reported their symptoms, effects on daily life, and resulting needs, with particular focus on olfaction. RESULTS: The results indicate that a majority of participants viewed their symptoms as disabling, with symptoms affecting their physical and mental health, social and professional lives. 60% of the individuals reported having unmet medical, psychological and socio-professional support needs. Finally, affected individuals were concerned about the risk and invasiveness of possible treatments as shown by a preference for non-invasive intervention over surgery to cure anosmia. CONCLUSIONS: It is important that policy makers take these needs into consideration in order to assist affected individuals to regain a normal quality of life.

The impact of COVID-19 has been substantial, both on individuals' health and on society. Information is needed to understand the biological mechanisms underlying the illness and to provide appropriate support for people affected. This study uses data from an online questionnaire of adults diagnosed with COVID-19 to characterize symptoms, understand their impact on peoples' everyday lives, and determine the support that people need. Our over-arching analysis of symptoms experienced reveals that heart- and skin-related symptoms are linked to chronic illness, and symptoms related to the sense of smell may have a different underlying disease mechanism. Most respondents had a mild initial illness, but their symptoms were long-lasting and had a severe impact. Our findings show that sufferers need different kinds of support in order to regain a normal quality of life.

How to obtain an integrated picture of the molecular networks involved in adaptation to microgravity in different biological systems?

Periodically, the European Space Agency (ESA) updates scientific roadmaps in consultation with the scientific community. The ESA SciSpacE Science Community White Paper (SSCWP) 9, "Biology in Space and Analogue Environments", focusses in 5 main topic areas, aiming to address key community-identified knowledge gaps in Space Biology. Here we present one of the identified topic areas, which is also an unanswered question of life science research in Space: "How to Obtain an Integrated Picture of the Molecular Networks Involved in Adaptation to Microgravity in Different Biological Systems?" The manuscript reports the main gaps of knowledge which have been identified by the community in the above topic area as well as the approach the community indicates to address the gaps not yet bridged. Moreover, the relevance that these research activities might have for the space exploration programs and also for application in industrial and technological fields on Earth is briefly discussed.

How are cell and tissue structure and function influenced by gravity and what are the gravity perception mechanisms?

Progress in mechanobiology allowed us to better understand the important role of mechanical forces in the regulation of biological processes. Space research in the field of life sciences clearly showed that gravity plays a crucial role in biological processes. The space environment offers the unique opportunity to carry out experiments without gravity, helping us not only to understand the effects of gravitational alterations on biological systems but also the mechanisms underlying mechanoperception and cell/tissue response to mechanical and gravitational stresses. Despite the progress made so far, for future space exploration programs it is necessary to increase our knowledge on the mechanotransduction processes as well as on the molecular mechanisms underlying microgravity-induced cell and tissue alterations. This white paper reports the suggestions and recommendations of the SciSpacE Science Community for the elaboration of the section of the European Space Agency roadmap "Biology in Space and Analogue Environments" focusing on "How are cells and tissues influenced by gravity and what are the gravity perception mechanisms?" The knowledge gaps that prevent the Science Community from fully answering this question and the activities proposed to fill them are discussed.

[Antibiotic susceptibility patterns among Shigella sonnei, isolated during three different periods in Región Metropolitana, Chile]. / Patrones de susceptibilidad antimicrobiana de cepas de Shigella sonnei aisladas durante tres períodos diferentes en la Región Metropolitana, Chile.

BACKGROUND: Shigella sonnei gastroenteritis improves clinically and microbiologically with antibacterial treatment; however choosing a useful drug is a universal challenge because of in vitro susceptibility of S. sonnei frequently evolves to be resistant. OBJECTIVE: To evaluate in vitro susceptibility of S. sonnei strains isolated from patients attending at the Chilean Región Metropolitana and to know the evolution that resistant patterns of S. sonnei have experienced. MATERIAL: In this study, the antimicrobial susceptibility profile of 277 isolates of Shigella sonnei was compared. The analyzed periods of time were: period I (1995-1997) 85 strains; period II (2004-2006) 92 strains and period III (2008-2009) 100 strains, in Santiago, Chile. The method performed to analyze susceptibility patterns was the disc diffusion (Kirby-Bauer). RESULTS: The strains showed rates of resistance to ampicillin: period I, 85.8%; period II, 53.3%; period III, 100%, trimethoprim/sulfamethoxazole: period I, 50.5%; period, II 46.7%; period III, 100%, chloramphenicol: period I, 36.4%; period II, 12%; period III, 100% and tetracycline: period I, 38.8%; period II, 30.4%; period III, 100%. 98.9% of the strains showed susceptibility to quinolones. Significant differences were observed in patterns of antimicrobial resistance for both individuals and for multidrug resistance (≥ 3 antimicrobials) in the three periods (p < 0.001, χ2 test). Of all resistant strains, 17% were resistant to 1 or 2 antibiotics, while 65.7% showed a pattern of multidrug resistance; 100% of the period III strains presented multidrug resistance. CONCLUSION: These results showed the temporal resistance dynamics of S. sonnei circulating strains in the Chilean Región Metropolitana. Due to the endemic behavior of shigellosis in Chile, it is urgent to maintain permanent surveillance of antimicrobial resistance profiles to improve both prevention and treatment of shigellosis.

Economic impact of the use of patiromer in chronic kidney disease or heart failure for the treatment of chronic hyperkalemia in Spain.

INTRODUCTION: Chronic hyperkalemia has negative consequences in the medium and long term, and determines the suspension of nephro and cardioprotective drugs, such as renin-angiotensin-aldosterone system inhibitors (RAASi). There is an alternative to the suspension or dose reduction of these treatments: the administration of potassium chelators. The aim of this study is to estimate the economic impact of the use of patiromer in patients with chronic kidney disease (CKD) or heart failure (HF) and hyperkalemia in Spain. MATERIALS AND METHOD: The annual economic impact of the use of patiromer has been estimated from the perspective of the Spanish society. Two scenarios were compared: patients with CKD or HF and hyperkalemia treated with and without patiromer. The costs have been updated to 2020 euros, using the Health Consumer Price Index. Direct healthcare costs related to the use of resources (treatment with RAASi, CKD progression, cardiovascular events and hospitalization due to hyperkalemia), direct non-healthcare costs (informal care: costs derived from time dedicated by patient's relatives), the indirect costs (productivity loss), as well as an intangible cost (due to premature mortality) were considered. A deterministic sensitivity analysis was performed to validate the robustness of the study results. RESULTS: The mean annual cost per patient in the scenario without patiromer is €9,834.09 and €10,739.37 in CKD and HF, respectively. The use of patiromer would lead to cost savings of over 30% in both diseases. The greatest savings in CKD come from the delay in the progression of CKD. While in the case of HF, 80.1% of these savings come from premature mortality reduction. The sensitivity analyses carried out show the robustness of the results, obtaining savings in all cases. CONCLUSIONS: The incorporation of patiromer allows better control of hyperkalemia and, as a consequence, maintain treatment with RAASi in patients with CKD or HF. This would generate a 32% of annual savings in Spain (€3,127 in CKD; €3,466 in HF). The results support the positive contribution of patiromer to health cost in patients with only CKD or in patients with only HF.

How do gravity alterations affect animal and human systems at a cellular/tissue level?

The present white paper concerns the indications and recommendations of the SciSpacE Science Community to make progress in filling the gaps of knowledge that prevent us from answering the question: "How Do Gravity Alterations Affect Animal and Human Systems at a Cellular/Tissue Level?" This is one of the five major scientific issues of the ESA roadmap "Biology in Space and Analogue Environments". Despite the many studies conducted so far on spaceflight adaptation mechanisms and related pathophysiological alterations observed in astronauts, we are not yet able to elaborate a synthetic integrated model of the many changes occurring at different system and functional levels. Consequently, it is difficult to develop credible models for predicting long-term consequences of human adaptation to the space environment, as well as to implement medical support plans for long-term missions and a strategy for preventing the possible health risks due to prolonged exposure to spaceflight beyond the low Earth orbit (LEO). The research activities suggested by the scientific community have the aim to overcome these problems by striving to connect biological and physiological aspects in a more holistic view of space adaptation effects.

A Systematic Review on the Impact of the Social Confinement on People with Autism Spectrum Disorder and Their Caregivers during the COVID-19 Pandemic.

The COVID-19 pandemic had imposed a variety of containment measures on the general population for prolonged periods. Confinement has had, and still has, social, economic, educational, health, and psychological consequences on the entire population. OBJECTIVE: In this article, a systematic search has been performed based on studies carried out since the beginning of the pandemic, regarding the impact of these containment measures on the autism spectrum disorder (ASD) population and their caregivers. METHOD: We consulted six databases (i.e., PubMed, Medline, Embase, Scopus, Web of Science, and Science Direct) and selected ten studies that met the inclusion criteria. The chosen studies have been classified according to their theoretical focus, methodology, and target population. RESULTS: We found an increase in stress and a decrease in psychological well-being among individuals diagnosed with ASD (i.e., parents and caregivers). Additionally, in studies focused on children, youth, and adults with ASD diagnosis, the results are contradictory depending on variables such as age, ASD severity, or type of family structure. CONCLUSIONS: The results show that the consequences of quarantine and social confinement are quite contradictory and depend on variables such as age, ASD severity, and family features.

Reacción paradojal secundaria a ingesta accidental de benzodiazepinas. Serie de casos / Paradoxical reaction secondary to accidental ingestion of benzodiazepines. Case series

Resumen Globalmente, los fármacos son el tipo de agente más frecuentemente implicado en las intoxicaciones pediátricas y las Ben-zodiacepinas el grupo farmacológico más frecuente. La reacción paradojal, secundaria a la exposición a Benzodiacepinas se caracteriza por la presencia de signosintomatología contraria a los efectos sedativos hipnóticos esperados, pudiendo presentarse con inquietud, ansiedad, hostilidad y alteraciones de la conducta, entre otros. La mayoría de los trabajos hallados acerca de este síndrome en pediatría lo describen secundario a Midazolam endovenoso, en contexto de sedación consciente para la realización de diferentes procedimientos. Las causas por los cuales se puede generar este fenómeno de desinhibición no han sido clarificadas, postulándose tres hipótesis: la desregulación colinérgica central, el aumento del tono gabaérgico en el sistema límbico, tálamo e hipotálamo y el desbalance de serotonina. Se expone una serie de 15 pacientes de entre 1 año y 5 años, expuestos accidentalmente a Benzodiacepinas, principalmente Clonazepam y Lorazepam, a fin de describir las características de esta reacción. En esta serie se observó con latencia breve y duración variable, de hasta 11 horas, la presencia en orden de frecuencia, de: ansiedad, irritabilidad, gritos, hostilidad y conductas agresivas, llanto inconsolable, incapacidad de contención por familiares, conductas irracionales, excitación psicomotriz, desinhibición emocional, alucinaciones y aumento de locuacidad, asociado frecuentemente a ataxia.

Abstract Globally, medicines are the most frequently toxins involved in pediatric poisonings, and Benzodiazepines are the most fre-quent pharmacological group in those poisonings. The paradoxical reaction, secondary to Benzodiazepines exposure, is characterized by the presence of contrary expected sedative-hypnotic effects, and may present with restlessness, increased anxiety, hostility, and behav-ioral alterations, among others. The studies we found about this syndrome in pediatric patients describe it most frequently secondary to endovenous Midazolam, in the context of the conscious sedation to perform different procedures. The reasons why this reaction is generated have not been clarified, three hypotheses are postulated: the central cholinergic dysregulation, the increased Gabaergic tone in the limbic system, thalamus and hypothalamus and the serotonin imbalance. A series of 15 patients, between 1 year and 5 years old, accidentally exposed to Benzodiazepines, mainly Clonazepam and Lorazepam, to describe the characteristics of the paradoxical reaction secondary to Benzodiazepines exposure. In this case series, we observed with short latency and variable duration, up to 11 hours, the presence in order of frequency of: anxiety, irritability, screams, hostility and aggressive behaviors, inconsolable crying, inability to con-tain by their family members, irrational behaviors and psychomotor excitement, emotional disinhibition, hallucinations and increased talkativeness, frequently associated with ataxia.

Impacto económico del uso de patiromer en enfermedad renal crónica o insuficiencia cardíaca para el tratamiento de la hiperpotasemia crónica en España / Economic impact of the use of patiromer in chronic kidney disease or heart failure for the treatment of chronic hyperkalemia in Spain

Introducción La hiperpotasemia crónica tiene consecuencias negativas a medio y largo plazo, condicionando generalmente la suspensión de fármacos nefro y cardioprotectores, en pacientes con enfermedad renal crónica (ERC) e insuficiencia cardíaca (IC), como son los inhibidores del sistema renina-angiotensina-aldosterona. Existe una alternativa a la suspensión o reducción de dosis de estos tratamientos y es la administración de quelantes del potasio. El objetivo de este estudio es estimar el impacto económico que supondría el uso de patiromer en pacientes con ERC o IC e hiperpotasemia en España. Material y métodos Se ha estimado el impacto económico anual del uso de patiromer desde la perspectiva de la sociedad española, comparando 2 escenarios: pacientes con ERC o IC e hiperpotasemia tratada con patiromer y sin patiromer. Los costes se han actualizado a euros de 2020, utilizando el índice de precios de consumo de Sanidad. Se han considerado los costes directos sanitarios relacionados con el uso de recursos (el tratamiento con inhibidores del sistema renina-angiotensina-aldosterona, la progresión de la ERC, los eventos cardiovasculares y la hospitalización por hiperpotasemia), los costes directos no sanitarios (cuidados informales: costes derivados del tiempo de dedicación por parte de los familiares del paciente), los costes indirectos (pérdidas de productividad laboral), así como un coste intangible (por mortalidad prematura). Se realizó un análisis de sensibilidad determinístico para validar la consistencia de los resultados del estudio. Resultados El coste medio anual por paciente en el escenario sin patiromer es de 9.834,09 € y 10.739,37 € en ERC e IC, respectivamente. El uso de patiromer supondría un ahorro de costes superior al 30% en ambas enfermedades. En el caso de la ERC, el mayor ahorro procede del retraso de la progresión de la ERC (AU)

Introduction Chronic hyperkalemia has negative consequences in the medium and long term, and determines the suspension of nephro and cardioprotective drugs, such as renin–angiotensin–aldosterone system inhibitors (RAASi). There is an alternative to the suspension or dose reduction of these treatments: the administration of potassium chelators. The aim of this study is to estimate the economic impact of the use of patiromer in patients with chronic kidney disease (CKD) or heart failure (HF) and hyperkalemia in Spain. Materials and method The annual economic impact of the use of patiromer has been estimated from the perspective of the Spanish society. Two scenarios were compared: patients with CKD or HF and hyperkalemia treated with and without patiromer. The costs have been updated to 2020 euros, using the Health Consumer Price Index. Direct healthcare costs related to the use of resources (treatment with RAASi, CKD progression, cardiovascular events and hospitalization due to hyperkalemia), direct non-healthcare costs (informal care: costs derived from time dedicated by patient's relatives), the indirect costs (productivity loss), as well as an intangible cost (due to premature mortality) were considered. A deterministic sensitivity analysis was performed to validate the robustness of the study results. Results The mean annual cost per patient in the scenario without patiromer is €9834.09 and €10,739.37 in CKD and HF, respectively. The use of patiromer would lead to cost savings of over 30% in both diseases. The greatest savings in CKD come from the delay in the progression of CKD. While in the case of HF, 80.1% of these savings come from premature mortality reduction. The sensitivity analyses carried out show the robustness of the results, obtaining savings in all cases (AU)

Sex-dependent infection causes nonadditive effects on kissing bug fecundity.

The influence of parasites on host reproduction has been widely studied in natural and experimental conditions. Most studies, however, have evaluated the parasite impact on female hosts only, neglecting the contribution of males for host reproduction. This omission is unfortunate as sex-dependent infection may have important implications for host-parasite associations. Here, we evaluate for the first time the independent and nonindependent effects of gender infection on host reproductive success using the kissing bug Mepraia spinolai and the protozoan Trypanosoma cruzi as model system. We set up four crossing treatments including the following: (1) both genders infected, (2) both genders uninfected, (3) males infected-females uninfected, and (4) males uninfected-females infected, using fecundity measures as response variables. Interactive effects of infection between sexes were prevalent. Uninfected females produced more and heavier eggs when crossed with uninfected than infected males. Uninfected males, in turn, sired more eggs and nymphs when crossed with uninfected than infected females. Unexpectedly, infected males sired more nymphs when crossed with infected than uninfected females. These results can be explained by the effect of parasitism on host body size. As infection reduced size in both genders, infection on one sex only creates body size mismatches and mating constraints that are not present in pairs with the same infection status. Our results indicate the fitness impact of parasitism was contingent on the infection status of genders and mediated by body size. As the fecundity impact of parasitism cannot be estimated independently for each gender, inferences based only on female host infection run the risk of providing biased estimates of parasite-mediated impact on host reproduction.

La mujer en las publicaciones científicas en Chile / Presence of women in medical publications in Chile

BACKGROUND: Despite recent initiatives and efforts, gender inequality still exists in medicine and academia. There is a higher proportion of male authors in international scientific publications. AIM: To compare the proportion of female and male authors in the scientific publications of the main medical journals in Chile. Material and Methods: We reviewed 1,643 Scientific articles published between 2015 and 2020 in two medical journals from Chile. Three authors analyzed the title, abstract, and authors of all published articles, recording the sex of the first author, co-authors, and corresponding author. RESULTS: The reviewed articles had a mean of 5.3 authors and there was a significant difference between men and women (a mean of 2.8 men and 2.4 women; p < 0.001). Forty-six percent (n = 761) of the articles had a female first author. In a higher proportion of papers, men completed both positions (1st and corresponding author) simultaneously. CONCLUSIONS: There are fewer female authors in scientific publications. Chile is one of the countries with a high rate of gender gap in the world. The underrepresentation of women in academia is an example of this.

Dermatitis por Paederus. Acerca de tres casos / Paederus dermatitis. About three cases

Resumen La "dermatitis por Paederus", es una dermatitis vesicante secundaria al contacto con coleópteros de este género. Se describen más de 600 especies de Paederus, con predominio en áreas tropicales y subtropicales, varias de ellas se asocian a dermatitis. Al ser apretado o aplastado contra la piel, la hemolinfa que contiene paederina, lesiona la epidermis, por medio del bloqueo de la mitosis de células epiteliales basales y células suprabasales. Se exponen tres casos clínicos dermatológicos con lesiones características compatibles con "dermatitis por Paederus". Se realiza además una revisión bibliográfica sobre el tema, a fin de exponer los puntos más importantes de esta patología de gran interés médico y que representa en muchas ocasiones desafíos diagnósticos.

Summary "Paederus dermatitis" is a vesicant dermatitis secondary to contact with this beetle. There are more than 600 species of Paederus described, with a predominance in tropical and subtropical areas, some of these are associated with dermatitis. When they are pressed or crushed against the skin, releases secretions with pederin, that causes an injury in the epidermis, by mitosis blocking of basal and suprabasal epithelial cells. This article describes three dermatological clinical cases with charac-teristic lesions compatible with "Paederus dermatitis". In addition a bibliographic review is presented in order to expose the most important points of this medical interest pathology, that frequently represents diagnostic challenges.

[Orality and writing: argumentation in children with attention deficit hyperactivity disorder]. / Oralidad y escritura: argumentación en niños con trastorno por déficit de atención/hiperactividad.

INTRODUCTION: This work takes a deeper look at the differences in the linguistic competence of children with attention deficit hyperactivity disorder (ADHD) in terms of both orality and writing. AIMS: The purpose of this study is to check whether, in oral tasks, these children present the same problems related to inhibition and self-regulation as those pointed out in research working with written data. Likewise it seeks to describe those problems (lack of appropriateness, inappropriate production) as they appear in our oral data. PATIENTS AND METHODS: A written and an oral argumentation produced by 25 participants between 9 and 11 years of age were analysed. In the written task, the children wrote their argumentations, and in the oral task their argumentative interaction with a collaborator was videotaped and later the types of arguments used in each case (logical, fallacies, sanctioning or moralist) were analysed. RESULTS: There is an obvious difference between the results in the two tests, which suggests the need to review the verbal evaluation mechanisms and to complete the written results with oral skill tests. The problems normally associated with written tasks do not appear in oral language; participants are able to follow the discursive thread and to provide new arguments related with the topic. CONCLUSIONS: The data obtained highlight the added difficulty of a written task for children with ADHD, the reliability of the oral results with regard to linguistic skills, and the need to use both types of data in evaluations.

TITLE: Oralidad y escritura: argumentacion en niños con trastorno por deficit de atencion/hiperactividad.Introduccion. Este trabajo profundiza en las diferencias de competencia linguistica de niños con trastorno por deficit de atencion/hiperactividad (TDAH) en oralidad y escritura. Objetivos. Verificar si estos niños presentan en las tareas orales los mismos problemas de control inhibitorio y de autorregulacion que se han señalado en investigaciones basadas en datos escritos, y describir tales problemas (falta de adecuacion, produccion inadecuada) segun aparecen en nuestros datos orales. Pacientes y metodos. Se analiza una argumentacion escrita y otra oral de 25 participantes entre 9 y 11 años. En la tarea escrita los niños redactaron sus argumentaciones y en la tarea oral se filmo su interaccion argumentativa con una colaboradora; se analizo en cada caso el tipo de argumentaciones utilizadas (logicas, falaces, de sancion o moralistas). Resultados. Se comprueba la diferencia evidente entre los resultados de las dos pruebas, lo que indica la necesidad de revisar los mecanismos de evaluacion verbal y de completar los resultados escritos con pruebas de destreza oral. Los problemas normalmente asociados a las tareas escritas no aparecen en lenguaje oral; los participantes son capaces de seguir el hilo discursivo y aportar nuevas argumentaciones relacionadas con el tema. Conclusiones. Los datos analizados ponen de manifiesto la dificultad adicional que supone la tarea escrita para los niños con TDAH, la fiabilidad de los resultados orales respecto a las habilidades linguisticas y la necesidad de usar ambos tipos de datos en la evaluacion.

[Syntactic and textual complexity in children with attention deficit hyperactivity disorder]. / Complejidad sintactica y textual en ninos con trastorno por deficit de atencion/hiperactividad.

INTRODUCTION AND AIMS: . In this work we analyse the syntax used by children diagnosed with attention deficit hyperactivity disorder (ADHD) when writing texts with a narrative and argumentative superstructure. The basic data analysed are the ratio of syntactic complexity and the relative distribution of verb tenses, assuming that in fusional languages like Spanish the TAM system (tense, aspect, mode) is the direct linguistic correlate of the executive functions related with the management of temporality. SUBJECTS AND METHODS: Children between 8 and 13 years of age were asked to write narrative and argumentative texts; data were obtained in clinical contexts. The use of complex syntactic structures and verb conjugation were analysed both quantitatively and qualitatively. RESULTS AND CONCLUSIONS: The children with ADHD displayed lower values in terms of levels of syntactic complexity and used fewer subordinate clauses than the children in the control group in both types of texts. As far as verb tenses are concerned, they used a higher proportion of prototypical tenses, that is to say, the present simple in argumentation and the imperfect indicative in narrative texts.

Patrones de susceptibilidad antimicrobiana de cepas de Shigella sonnei aisladas durante tres períodos diferentes en la Región Metropolitana, Chile / Antibiotic susceptibility patterns among Shigella sonnei, isolated during three different periods in Región Metropolitana, Chile

Background: Shigella sonnei gastroenteritis improves clinically and microbiologically with antibacterial treatment; however choosing a useful drug is a universal challenge because of in vitro susceptibility of S. sonnei frequently evolves to be resistant. Objective: To evaluate in vitro susceptibility of S. sonnei strains isolated from patients attending at the Chilean Región Metropolitana and to know the evolution that resistant patterns of S. sonnei have experienced. Material: In this study, the antimicrobial susceptibility profile of 277 isolates of Shigella sonnei was compared. The analyzed periods of time were: period I (1995-1997) 85 strains; period II (2004-2006) 92 strains and period III (2008-2009) 100 strains, in Santiago, Chile. The method performed to analyze susceptibility patterns was the disc diffusion (Kirby-Bauer). Results: The strains showed rates of resistance to ampicillin: period I, 85.8%; period II, 53.3%; period III, 100%, trimethoprim/sulfamethoxazole: period I, 50.5%; period, II 46.7%; period III, 100%, chloramphenicol: period I, 36.4%; period II, 12%; period III, 100% and tetracycline: period I, 38.8%; period II, 30.4%; period III, 100%. 98.9% of the strains showed susceptibility to quinolones. Significant differences were observed in patterns of antimicrobial resistance for both individuals and for multidrug resistance (≥ 3 antimicrobials) in the three periods (p < 0.001, χ2 test). Of all resistant strains, 17% were resistant to 1 or 2 antibiotics, while 65.7% showed a pattern of multidrug resistance; 100% of the period III strains presented multidrug resistance. Conclusion: These results showed the temporal resistance dynamics of S. sonnei circulating strains in the Chilean Región Metropolitana. Due to the endemic behavior of shigellosis in Chile, it is urgent to maintain permanent surveillance of antimicrobial resistance profiles to improve both prevention and treatment of shigellosis.

Introducción: La infección entérica producida por Shigella sonnei mejora clínicamente y microbiológicamente con antibioterapia; sin embargo, la elección del antimicrobiano es un problema universal pues la susceptibilidad in vitro de S. sonnei evoluciona frecuentemente hacia la resistencia. Objetivo: Evaluar la susceptibilidad in vitro a antimicrobianos de S. sonnei y conocer la evolución que han experimentado los patrones de resistencia de cepas aisladas de cuadros clínicos en pacientes de la Región Metropolitana, Chile. Material y Métodos: Se comparó el perfil de susceptibilidad a antimicrobianos, de 277 cepas clínicas de S. sonnei aisladas durante tres períodos: período I (1995-1997) 85 cepas; período II (2004-2006) 92 cepas y período III (2008-2009) 100 cepas, en Santiago, Chile. El perfil de susceptibilidad a antimicrobianos se determinó mediante test de difusión en agar. Resultados: Las tasas de resistencia de las cepas en los periodos I, II y III respectivamente fueron: ampicilina: 85,8%; 53,3%; 100%, cotrimoxazol: 50,5%; 46,7%; 100%, cloranfenicol: 36,4%; 12%; 100% y tetraciclina: 38,8%; 30,4%; 100%. El 98,9% de las cepas fue susceptible a quinolonas. Se observó diferencias significativas en los porcentajes de resistencia para antimicrobianos individuales y multi-resistencia (≥ 3 antimicrobianos) en los tres períodos (p < 0,001; Test de χ2). De las cepas resistentes, 17% presentó resistencia a uno ó dos antimicrobianos, 65,7% mostró multi-resistencia antimicrobiana. El 100% de las cepas del período III presentó multi-resistencia. Discusión: Estos resultados evidencian la dinámica temporal de la resistencia en cepas de S. sonnei circulantes en la Región Metropolitana. Dado que en Chile la shigelosis tiene un carácter endémico, es prioritario mantener una vigilancia constante de los perfiles de resistencia a antimicrobianos, para mejorar la prevención y el tratamiento de la shigelosis.

Oralidad y escritura: argumentación en niños con trastorno por déficit de atención/hiperactividad / Orality and writing: argumentation in children with attention deficit hyperactivity disorder

Introducción. Este trabajo profundiza en las diferencias de competencia lingüística de niños con trastorno por déficit de atención/hiperactividad (TDAH) en oralidad y escritura. Objetivos. Verificar si estos niños presentan en las tareas orales los mismos problemas de control inhibitorio y de autorregulación que se han señalado en investigaciones basadas en datos escritos, y describir tales problemas (falta de adecuación, producción inadecuada) según aparecen en nuestros datos orales. Pacientes y métodos. Se analiza una argumentación escrita y otra oral de 25 participantes entre 9 y 11 años. En la tarea escrita los niños redactaron sus argumentaciones y en la tarea oral se filmó su interacción argumentativa con una colaboradora; se analizó en cada caso el tipo de argumentaciones utilizadas (lógicas, falaces, de sanción o moralistas). Resultados. Se comprueba la diferencia evidente entre los resultados de las dos pruebas, lo que indica la necesidad de revisar los mecanismos de evaluación verbal y de completar los resultados escritos con pruebas de destreza oral. Los problemas normalmente asociados a las tareas escritas no aparecen en lenguaje oral; los participantes son capaces de seguir el hilo discursivo y aportar nuevas argumentaciones relacionadas con el tema. Conclusiones. Los datos analizados ponen de manifiesto la dificultad adicional que supone la tarea escrita para los niños con TDAH, la fiabilidad de los resultados orales respecto a las habilidades lingüísticas y la necesidad de usar ambos tipos de datos en la evaluación (AU)

Introduction. This work takes a deeper look at the differences in the linguistic competence of children with attention deficit hyperactivity disorder (ADHD) in terms of both orality and writing. Aims. The purpose of this study is to check whether, in oral tasks, these children present the same problems related to inhibition and self-regulation as those pointed out in research working with written data. Likewise it seeks to describe those problems (lack of appropriateness, inappropriate production) as they appear in our oral data. Patients and methods. A written and an oral argumentation produced by 25 participants between 9 and 11 years of age were analysed. In the written task, the children wrote their argumentations, and in the oral task their argumentative interaction with a collaborator was videotaped and later the types of arguments used in each case (logical, fallacies, sanctioning or moralist) were analysed. Results. There is an obvious difference between the results in the two tests, which suggests the need to review the verbal evaluation mechanisms and to complete the written results with oral skill tests. The problems normally associated with written tasks do not appear in oral language; participants are able to follow the discursive thread and to provide new arguments related with the topic. Conclusions. The data obtained highlight the added difficulty of a written task for children with ADHD, the reliability of the oral results with regard to linguistic skills, and the need to use both types of data in evaluations (AU)

Complejidad sintáctica y textual en niños con trastorno por déficit de atención/hiperactividad / Syntactic and textual complexity in children with attention deficit hyperactivity disorder

Introducción y objetivos. En este trabajo se analiza la sintaxis utilizada por niños con diagnóstico de trastorno por déficit de atención/hiperactividad (TDAH) en la redacción de textos de superestructura narrativa y argumentativa. Los datos básicos analizados son la ratio de complejidad sintáctica y la distribución relativa de los tiempos verbales, asumiendo que en las lenguas fusionantes como el español el sistema TAM (tiempo, aspecto, modo) es el correlato lingüístico directo de las funciones ejecutivas relacionadas con la gestión de la temporalidad. Sujetos y métodos. Se solicitó a niños de entre 8 y 13 años la elaboración de textos narrativos y argumentativos escritos; los datos se obtuvieron en contextos clínicos. Se analizó cualitativa y cuantitativamente la utilización de estructuras sintácticas complejas y de la conjugación verbal. Resultados y conclusiones. Los niños con TDAH desarrollan valores menores en los niveles de complejidad sintáctica y utilizan menos subordinadas que los niños del grupo control en ambos tipos de texto; por lo que se refiere a los tiempos verbales, emplean en mayor proporción los tiempos prototípicos, es decir, presente de indicativo en la argumentación e imperfecto de indicativo en la narración (AU)

Introduction and aims. In this work we analyse the syntax used by children diagnosed with attention deficit hyperactivity disorder (ADHD) when writing texts with a narrative and argumentative superstructure. The basic data analysed are the ratio of syntactic complexity and the relative distribution of verb tenses, assuming that in fusional languages like Spanish the TAM system (tense, aspect, mode) is the direct linguistic correlate of the executive functions related with the management of temporality. Subjects and methods. Children between 8 and 13 years of age were asked to write narrative and argumentative texts; data were obtained in clinical contexts. The use of complex syntactic structures and verb conjugation were analysed both quantitatively and qualitatively. Results and conclusions. The children with ADHD displayed lower values in terms of levels of syntactic complexity and used fewer subordinate clauses than the children in the control group in both types of texts. As far as verb tenses are concerned, they used a higher proportion of prototypical tenses, that is to say, the present simple in argumentation and the imperfect indicative in narrative texts (AU)