Background: In Chile, patients with hereditary angioedema (HAE) type I and type II are protected under Ley Ricarte Soto (LRS), which guarantees access to on demand plasma-derived C1-INH (pdC1-INH) since 2018. We aimed to analyze the first 3 years of LRS. Methods: Review of the LRS database between 2018 and 2021. Results: During the study period, 154 patients were covered by LRS, with an estimated prevalence of HAE in Chile at 0.8:100,000 inhabitants. A delay in diagnosis of 22 years was noted, 50 patients received epinephrine during an attack before the diagnosis of HAE. Mean number of attacks per year was 8, with 50% of adults and 42% of children experiencing more than 1 attack per month. Conclusion: Disease awareness must improve to reduce the diagnostic delay of HAE. Long-term prophylactic medications should be included in LRS to treat patients with high attack rates and control the costs of frequent on-demand treatment with pdC1-INH.
Angioedemas, Hereditary , Adult , Child , Humans , Angioedemas, Hereditary/diagnosis , Angioedemas, Hereditary/drug therapy , Angioedemas, Hereditary/epidemiology , Chile/epidemiology , Delayed Diagnosis , Treatment Outcome , Plasma
Objectives: The hyalinizing trabecular tumor (HTT) is a rare benign neoplasm of the thyroid gland. This neoplasm has overlapping cytological features with Papillary Thyroid Carcinoma, Medullary Carcinoma and Follicular Neoplasm with Nuclear Features of Papillary Carcinoma. This can lead to misdiagnosis of malignancy in fine needle aspiration (FNA) cytology specimens with unnecessary total thyroidectomy. The aim of this study is to determine if there are some cytological features that could help us to suspect HTT on FNA specimens and avoid radical surgery. Material and Methods: With this purpose we have collected 6 cases diagnosed of HTT in Hospital Clínico San Carlos of Madrid (Spain) in the last 10 years and reviewed the cytological specimens. Result: We conclude that the presence of hyaline material in FNA specimens of HTT is a constant feature being a diagnostic clue. We must be cautious not to confuse it with dense colloid or amyloid material, the latter seen in Medullary Carcinoma. Papillary architecture and fibrovascular cores are not present in a HTT. Special stains as ki-67, calcitonin and Congo Red staining could help us in achieving the correct diagnosis. Conclusion: We feel the cytopathologists must be aware of the distinguishing features of this lesion, mainly the typical hyaline material to achieve a proper diagnosis and be able to reduce unnecessary aggressive management of these patients.
Resumen: El presente estudio evaluó la efectividad de una intervención de video-feedback grupal en cuidadores chilenos de residencias de preescolares y lactantes que tenía como objetivo promover la respuesta sensible. La sensibilidad del adulto se ha asociado al desarrollo de apegos seguros por parte de los infantes a su cargo. Precisamente niñas y niños que crecen en un contexto residencial tienen muchas veces alterado el sistema de apego. El estudio comprendió una muestra de 14 cuidadores diurnos de la Fundación San José divididos en 4 grupos que recibieron cada uno 5 sesiones de video-feedback. Se encontraron diferencias significativas previo y posterior a la intervención en el puntaje de sensibilidad total, en la subescala de responsividad y en la de sintonía. Los resultados preliminares son prometedores considerando que es una intervención novedosa.
Abstract: The present study evaluated the effectiveness of a group video-feedback intervention aimed at Chilean caregivers of a preschool and infants orphanage that intended to enhance adult sensitivity. Adult sensitivity has been associated with the development of secure attachments in children. Nevertheless, infants that grow in an institutional setting tend to have insecure attachment patterns. The study included a sample of 14 caregivers of Fundación San José institution, which were divided in 4 groups each receiving 5 sessions of video-feedback. Differences were found between the general score of sensitivity and the subscales of responsivity and synchronicity before and after the intervention. These preliminary results are promising considering that it was the first time that a group video-feedback intervention had been applied in orphanage caregivers.
Humans , Male , Female , Infant , Child, Preschool , Adult , Middle Aged , Video Recording , Caregivers/psychology , Feedback, Psychological , Child, Institutionalized , Child Rearing , Mental Health , Surveys and Questionnaires , Analysis of Variance , Object Attachment
Studies have shown that Chilean and US infants differ in their levels of self-regulation. One of the mechanisms of early socializing is the use of language, particularly mental state language. The current study seeks to deepen our knowledge of the ways in which mental state language is related to socialization processes in early childhood, including the ways both culture and children's gender influence a mothers' use of mental state talk. We used a quantitative and descriptive approach with 109 mothers and their children (64 Chilean and 45 US dyads), measured twice, at 12 and 30 months old. Mental state references related to regulation were coded during a story-sharing task, including positive (calm and patient) and negative (messy and impatient) references to regulating behavior. Chilean mothers generally showed more regulatory references than US mothers, especially if the children were at a younger age (12 month). Frequencies of regulatory references increased in US mothers at 30 months but were still less than in Chilean mothers. At the 12-month measuring point, Chilean mothers showed more negative regulatory attributes than positive regulatory attributes. Finally, US mothers mainly used references to secondary emotions (e.g., pride) and positive regulatory attributes (being obedient, mature and patient) at both ages.
(1) Background: Maternal stress and depression are considered risk factors in children's socioemotional development, also showing high prevalence worldwide. (2) Method: Participants correspond to a longitudinal sample of 6335 mother/child pairs (18-72 months), who were surveyed in 2010 and then in 2012. The hypothesis was tested with SEM analysis, setting the child's internalized/externalized problems as dependent variable, maternal depression as independent variable, and stress as a partial mediator. (3) Results: Both depression during pregnancy and recent depression has not only a direct effect on the internalizing and externalizing symptomatology of the child, but also an indirect effect through parental stress. Significant direct and indirect relationships were found. (4) Conclusions: Maternal depression and the presence of parental stress can influence children's behavioral problems, both internalizing and externalizing.
BACKGROUND: Depression is twice as common in people with diabetes, and this comorbidity worsens the course of both pathologies. In clinical practice guidelines, screening and treatment of depression in patients with diabetes are highly recommended. However, depression is still both underrecognized and undertreated. To find ways to enhance their reach, psychological treatments have taken advantage of benefits of internet and technological devices as delivery formats, providing interventions that require considerably less (or even no) interaction time with therapists. Web-based treatments hold promise for effective interventions at low cost with positive results. OBJECTIVE: The objectives of this review were to describe Web-based interventions for depression in individuals with diabetes and to discuss these studies' procedures and findings in light of evidence from a wider range of interventions for depression and diabetes. METHODS: A comprehensive literature search was conducted in PsycINFO and MEDLINE electronic databases. Studies were included when they met the following selection criteria: the study was available in a peer-reviewed journal mainly publishing studies written in either English or Spanish; the studied sample comprised individuals with diabetes; the intervention targeted depression symptomatology; the intervention was accessible via the internet; and the intervention was accessible via the internet with little or no clinician support. RESULTS: Overall, 5 research studies were identified in the review. All studies were randomized controlled trials, and most used a wait list as a control; 4 studies reported treatment dropout, rates of which varied from 13% to 42%. Studies supported the notion that the Web-based format is a suitable psychology service delivery option for diabetic individuals with depression (effect size range for completers 0.7-0.89). Interventions varied in their characteristics but most were clinical-assisted, had a cognitive behavioral therapy approach, used diabetes-specific topics, had a weekly modular display, used homework assignments, and had some adherence management strategy. These characteristics are consistent with the intervention features associated with positive results in the literature. CONCLUSIONS: The analyzed studies' findings and procedures are discussed in light of evidence drawn from a wider range of reviews on Web-based interventions for depression and diabetes. Consistent with previous research on depression treatment, Web-based interventions for depression among individuals with diabetes have shown positive results. Future research should contribute new evidence as to why these interventions are effective, for whom, and which particular aspects can increase patients' adherence.
The aim of this research is to understand the experience of the football sector on the use of artificial turf (satisfaction, safety, sporting feature, or the advantages and disadvantages). The study was conducted on a random selection of 627 male participants (404 amateur/semi-professional footballers, 101 coaches and 122 referees) that regularly train/compete on artificial turf in Spanish football leagues. The results of the skin abrasion, muscle strain and the possibility of sustaining an injury, on a Likert-type 10-point interval scale, gave a perception of 'somewhat dissatisfied' for the participants. The main advantages of artificial turf were their sports features, the evenness of the surface and the good state of conservation. Participants were satisfied with the artificial turf surface. Approximately three out of four participants gave an overall ranking of highly satisfied. The players were significantly less satisfied than the coaches and referees. The overall satisfaction with artificial turf fields was strongly influenced by previous experience, particularly those who had previously played on dirt pitches. These results highlight the versatility of artificial turf to adapt to any circumstance or requirement for local sport and top-level professional competitions alike.
Consumer Behavior/statistics & numerical data , Floors and Floorcoverings , Soccer/psychology , Adolescent , Adult , Athletic Performance/psychology , Humans , Male , Middle Aged , Perception , Spain , Young Adult
BACKGROUND: In countries with universal access to antiretroviral therapy a progressive increase in the number of patients that are infected with resistant virus, is observed. AIM: To detect the presence of primary resistance to antiretroviral drugs among patients with a recent diagnosis of HIV infection. MATERIAL AND METHODS: Twenty-five male patients aged 25 to 45 years, with a diagnosis of a recent HIV infection, done between 2004 and 2005, were studied. Genotypic resistance to antiretroviral drugs was studied using the Genetic Resistance Test TRUGENE from Bayer. RESULTS: Resistance mutations were detected in 10 patients. All had an university title or had university studies. All lived in northeastern Santiago and had risky sexual behaviors while traveling abroad. Seven mutations were detected in reverse transcriptase. Of these, three were associated to a high resistance level and four, to an intermediate or low resistance, were also detected. CONCLUSIONS: A high frequency of genotypic resistance was detected in this group of Chilean patients recently infected with HIV. A higher socioeconomic status and lifestyle could have influenced these results.
Anti-HIV Agents/pharmacology , Drug Resistance, Viral/genetics , HIV Infections/virology , HIV/drug effects , Mutation/genetics , Adult , Anti-HIV Agents/therapeutic use , Chile , Genotype , HIV/genetics , HIV Infections/drug therapy , HIV Protease/genetics , HIV Reverse Transcriptase/genetics , Humans , Male , Middle Aged , Viral Load
