Rol de enfermería en el área COVID en un hospital pediátrico de alta complejidad / The role of nurses in the COVID area in a pediatric tertiary-care hospital

Introducción: la pandemia por SARS-CoV-2 planteó un desafío para todo el equipo de salud. Fue necesario analizar y pensar en este contexto el rol de enfermería en la atención y cuidados del paciente y su familia. Los procesos asistenciales debieron adaptarse a nuevas y diversas situaciones que generaron la atención de pacientes en su mayoría con comorbilidades asociadas. El objetivo del trabajo fue describir el rol de enfermería y la implementación de diversos protocolos y procesos de atención de pacientes en salas de internación pediátrica del área COVID de un hospital de alta complejidad. Material y métodos: se realizó un estudio retrospectivo y descriptivo sobre el personal de enfermería que participó en la atención de casos sospechosos o confirmados de COVID-19 durante la pandemia y los protocolos implementados para los cuidados de enfermería. Resultados: solo el 52.5% (n 79) del personal tenía experiencia mayor a tres años, el 75% (n: 113) pertenecían al género femenino, el 47% (n: 71) eran licenciados en enfermería. Conclusiones: Los profesionales enfermeros han logrado mediante sus fortalezas disciplinares dar respuesta a las necesidades del paciente pediátrico y su familia frente a la crisis sanitaria. Las competencias desarrolladas en la administración de los recursos disponibles, la adaptación, flexibilidad a los procesos y líneas estratégicas en tiempo real, posicionan al enfermero como un valor fundamental en el cuidado asistencial (AU)

Introduction: The SARS CoV-2 pandemic posed a challenge for the entire healthcare team. It was necessary to analyze and reflect on the role of nursing in the care of patients and their families in this context. Care processes had to be adapted to new and diverse situations that were generated by the care for patients who usually had associated comorbidities. The aim of the study was to describe the nursing role and the implementation of different protocols and processes for patient care in pediatric inpatient wards in the COVID area of a tertiary-care hospital. Material and methods: a retrospective descriptive study was conducted in the nursing personnel involved in the care of suspected or confirmed cases of COVID-19 during the pandemic and the protocols implemented for nursing care. Results: only 52.5% (n: 79) of the personnel had more than three years of experience, 75% (n: 113) were female, and 47% (n: 71) had a nursing degree. Conclusions: Through their disciplinary strengths, nursing professionals have been able to respond to the needs of pediatric patients and their families in the face of the health crisis. The skills developed in the management of available resources, adaptation, and flexibility to processes and real-time strategies, have positioned nurses as a fundamental factor in healthcare (AU)

Aspectos anatómicos y técnicos de la cirugia de citorredución de cáncer de ovario en abdomen superior / Anatomical and technical aspects of debulking surgery for ovarian cancer in the upper abdomen

RESUMEN El Cáncer de Ovario Epitelial es la novena causa de cáncer en la mujer y la neoplasia ginecológica más letal en países desarrollados. La mayoría de las pacientes son diagnosticadas en etapa avanzada de la enfermedad debido a la ausencia de síntomas específicos. La cirugía y la quimioterapia cumplen un rol fundamental en el tratamiento de esta enfermedad. En pacientes con enfermedad avanzada (estadios III - IV) al momento del diagnóstico, la extirpación de todo tumor macroscópico (citorreducción óptima) ha demostrado ser el factor pronóstico más importante, demostrando un beneficio tanto en tiempo libre de enfermedad como en sobrevida global. Nuestro objetivo es describir, desde una perspectiva multidisciplinaria, los aspectos técnicos más relevantes de la citorreducción del abdomen superior para aquellas pacientes con neoplasias de origen ginecológico.

ABSTRACT Epithelial Ovarian cancer is the ninth most frequent cancer in women and the most lethal gynecologic malignancy in developed countries. The majority of patients are diagnosed in advanced stage of the disease due to the lack of specific symptoms. Surgery and systemic treatment play a key role in the treatment of this disease. For those patients with advanced stage at the time of diagnosis (III - IV), removal of all macroscopic disease (optimal cytoreduction) has been shown as the most important prognostic factor, demonstrating improvement not only in progression free survival but also in overall survival. Our aim is to describe, in a multidisciplinary fashion, the most relevant aspect about oncological debulking procedures in the upper abdominal cavity for women with gynecological malignancies.

Life cycle assessment of carbon capture and utilization from ammonia process in Mexico.

Post-combustion CO2 capture (PCC) of flue gas from an ammonia plant (AP) and the environmental performance of the carbon capture utilization (CCU) technology for greenhouse gas (GHG) emissions to an enhanced oil recovery (EOR) system in Mexico was performed as case study. The process simulations (PS) and life cycle assessment (LCA) were used as supporting tools to quantify the CO2 capture and their environmental impacts, respectively. Two scenarios were considered: 1) the AP with its shift and CO2 removal unit and 2) Scenario 1 plus PCC of the flue gas from the AP primary reformer (AP-2CO2) and the global warming (GW) impact. Also, the GW of the whole of a CO2-EOR project, from these two streams of captured CO2, was evaluated. Results show that 372,426 tCO2/year can be PCC from the flue gas of the primary reformer and 480,000 tons/y of capacity from the AP. The energy requirement for solvent regeneration is estimated to be 2.8 MJ/kgCO2 or a GW impact of 0.22 kgCO2e/kgCO2 captured. GW performances are 297.6 kgCO2e emitted/barrel (bbl) for scenario one, and 106.5 kgCO2e emitted/bbl for the second. The net emissions, in scenario one, were 0.52 tCO2e/bbl and 0.33 tCO2e/bbl in scenario two. Based on PS, this study could be used to evaluate the potential of CO2 capture of 4080 t/d of 4 ammonia plants. The integration of PS-LCA to a PCC study allows the applicability as methodological framework for the development of a cluster of projects in which of CO2 could be recycled back to fuel, chemical, petrochemical products or for enhanced oil recovery (EOR). With AP-2CO2, "CO2 emission free" ammonia production could be achieved.

Impacto que genera el diagnóstico de VIH en mujeres trabajadoras de la Región de Antofagasta y Metropolitana / Impact of hiv diagnosis in working women in the Region of Antofagasta and the Metropolitan Region

El propósito del presente artículo expone como el diagnóstico de VIH ha afectado a mujeres chilenas en su rol de trabajadoras, conociéndolo desde su propia perspectiva. Es una investigación cualitativa, donde se entrevistan a 3 mujeres sero positivo de edad entre los 20 y 65 años, que cuentan con experiencia laboral previo al diagnóstico de VIH. Los resultados identifican un antes y después del diagnóstico de VIH, donde para mantener su rol de trabajadoras ocultan su diagnóstico al empleador y a sus compañeros de trabajo por miedo a ser discriminada; dan a conocer abiertamente su diagnóstico al contexto social que se desenvuelven para evitar prejuicios; o cambian su rubro laboral. De esta manera, se reconoce que la ley del SIDA de Chile no logra cubrir una protección real que permita el respeto, fiscalización y responsabilidad de estas normas, siendo vulnerados los derechos de las mujeres que viven con VIH. Las mujeres diagnosticadas sufren apartheid ocupacional e injusticia ocupacional, ya que no logran realizar su rol como trabajadoras debido a la desinformación que existe en la sociedad frente al VIH y a los estigmas que se encuentran en torno a ella, desencadenando prejuicios sociales históricos que han favorecido que mujeres vivan ocultando su realidad...

The purpose of this article is to present how an HIV diagnosis has affected Chilean women in their role as workers, from the perspective of the women themselves. It is qualitative research involving three interviews which HIV positive women between the ages of 20 and 65 who have work experience prior to receiving their HIV diagnosis. The results identify that there is a difference in the women’s experience pre- and post-diagnosis, whereby to maintain their role as workers they hide their diagnosis from their employer and colleagues for fear of discrimination; that the women openly disclose their diagnosis in the social context in which they operate to avoid bias; or that they change their job. Thus, it is clear that the AIDS Chile legislation fails to offer real protection to ensure respect, execution of, and accountability regarding these rules being violated for women living with HIV. The diagnosed women suffer an occupational apartheid and occupational injustice, as they are unable to perform their role as workers due to the misunderstandings that exist in society regarding HIV and to the stigmas that surround it and, moreover, are victims of historical social biases that have favored women live hiding their HIV reality...

Condición de salud de pacientes diabéticos y su satisfacción con el tratamiento para la enfermedad / Health condition of type 2 diabetic patients and their satisfaction regarding disease treatment

La diabetes mellitus (DM) va en aumento en nuestro país, con alta prevalencia de complicaciones especialmente por mal control metabólico. Objetivo: evaluar asociación de condición de salud, variables sociodemográficas y años de diagnóstico con satisfacción del paciente con características del tratamiento de diabetes. Material y método: estudio de prevalencia en 340 pacientes de 1.100 usuarios DM2 controlados en Programa Cardiovascular de un Centro de Salud Familiar (CESFAM) de Macul, Región Metropolitana, Chile, previo consentimiento informado. Muestreo aleatorio simple (confianza 95 por ciento, merma 10 por ciento). Recolección de información en CESFAM y/o visita domiciliaria por investigadoras e internas de enfermería entrenadas. Satisfacción del paciente, medida con subescala satisfacción del cuestionario Diabetes Quality of Life (EsDQOL). Análisis con estadística descriptiva, Chi2, Odd Ratios, IC (95 por ciento). Resultados: Población mayoritariamente adulta mayor, femenina, promedio años estudio 8,7. El 42,6 por ciento tiene diagnóstico de DM hace más de 10 años. Refieren mayor satisfacción con: tratamiento medicamentoso, controles recibidos, vida en general. Existe mayor insatisfacción con: tiempo ocupado en ejercicios, cómo duerme, vida sexual. Satisfacción con tratamiento medicamentoso se asocia a compensación de diabetes (p= 0,026). Pacientes insatisfechos con tratamiento tienen 2 veces más riesgo de descompensación que los satisfechos, IC [1,08-3,7]. Insatisfacción con tiempo dedicado a enfermedad, controles, tiempo ocupado en controles y ejercicio indicado se asocian a complicaciones (p < 0,05). Conclusión: Insatisfacción con características del tratamiento de DM2 se asocia mayormente a complicaciones que a compensación de DM, pacientes insatisfechos tienen más riesgo de complicaciones que los satisfechos.

Diabetes Mellitus is increasing in our country, with a high prevalence of complications mainly because of poor metabolic control. Objectives: to evaluate association of health condition, demographic variables, and years since diagnosis with patient satisfaction regarding disease treatment. Methodology: prevalence study, 340 patient taken out of a population of 1.100 patients attended in the Cardiovascular Program of an outpatient clinic in Macul district. Informed consent was requested. Simple randomized sample (CI 95 percent, loss 10 percent). Data collected in the outpatient clinic or through home visits done by researchers or trained senior nursing students. Patient satisfaction was measured by the satisfaction subscale of the Diabetes Quality of Life Questionnaire (EsDQOL). Analysis: descriptive statistics, Chi2, Odds Ratios, CI (95 percent). Results: Population of mainly older adults, female, average years of school attendance 8.7. 42.6 percent has been diagnosed since more than 10 years. They refer greater satisfaction with: pharmacologic treatment, care received in outpatient visits, life in general. There exists more dissatisfaction with: time spent in exercise, sleep, sexual life. Satisfaction with pharmacologic treatment has association with diabetes compensation (p= 0.026). Patients dissatisfed with treatment have 2 times more risk of poor metabolic control than satisfed patients, IC[1.08-3.7]. Dissatisfaction with time spent in the disease, outpatient visits, and time spent in exercises, are associated with complications (p < 0.05). Conclusion: Dissatisfaction is more associated to complications than to poor metabolic control. Patient dissatisfed have more risk of complications than those satisfed.

Ingesta de tomate reduce niveles de colesterol en ratas Wistar / Tomato intake lowers cholesterol levels in rats

Cardiovascular diseases are closely associated with lifestyle risk factors, some of them modifiable. Animal studies and clinical observations have suggested a relationship between serum total cholesterol and atherosclerosis. Studies have shown that levels of triglycerides and cholesterol were modified by the consumption of fresh tomato juice. The aim of this study was to investigate the effect of daily consumption of tomato mash on cholesterol and other biochemical parameters in Wistar rats. To carry out this research two groups of rats (n = 6 each one), were formed, one of which was supplemented with a mash diet tomato and the other was used for control. After 15 days of testing, the rats were sacrificed and plasma collected was used for biochemical determination of total cholesterol, triglycerides, glucose, glutamicoxaloacetic transaminase and glutamic pyruvic transaminase. The cholesterol level decreased in the study group (33,7+/-2,78 mg/dL) with respect to that of control group (58,6+/-10,6 mg/dL). This study showed an ipocholesterolemic effect of the tomato in rats. Future studies could examine this activity in dyslipidemic subjects.

Condición de salud y cumplimiento de la guía clínica chilena para el cuidado del paciente diabético tipo / Health condition and compliance of the chilean clinical guideline for type 2 diabetic patients

Objetivo: Identificar condición de salud (CS) de los pacientes diabéticos tipo 2. Medir el cumplimiento de las atenciones de salud según guía clínica. Identificar variables asociadas a CS. Material y método: estudio de pre-valencia, abril 2010. Población: 1.100 pacientes DM2 controlados en Programa Cardiovascular, considerando criterios de inclusión, exclusión, consentimiento informado. Muestra: 340 por aleatorización simple (confianza 95 por ciento merma 10 por ciento). Recolección de datos realizada en CESFAM o visita domiciliaria por investigadoras e internas de enfermería entrenadas, con encuesta validada, exámenes, plantilla para información y ficha clínica. Para el análisis se utilizó estadística descriptiva, Chi2, Odds Ratios con IC (95 por ciento). Resultados: CS: descompensados (HbA1c>7 por ciento) 56.5 por ciento, patologías agregadas 97.9 por ciento, complicaciones 25 por ciento, mayor frecuencia retinopatía diabética. hombres mayor riesgo de amputación (p=0.003). Presión arterial >130/85 mm.hg. 58.2 por ciento, sobrepeso-obesidad 71.2 por ciento, autovalencia (adultos mayores) 23.1 por ciento. Cumplimiento recomendaciones ministeriales: controles/profesionales/año a lo menos cinco 41.5 por ciento, CESFAM adapta esta recomendación. Evaluación anual de: pie diabético 78 por ciento, fondo ojo 41,6 por ciento. Indicación régimen (nutricionista) último control 80 por ciento. Cinco controles profesionales/ año o más es protector de compensación de diabetes, IC (0.62-0.95), resto de recomendaciones y adaptación de éstas no se asocian a condición de salud (p > 0.05). Conclusiones: Los componentes de condición de salud están en general por sobre lo esperado. En ningún paciente se cumple en un 100 por ciento las recomendaciones de la guía clínica. Cinco o más controles profesionales anuales se asocian a compensación de la diabetes. Importante cumplir recomendaciones para mejorar control metabólico y disminuir/retrasar complicaciones para una mejor calidad de vida de pacientes.

Objectives: To determine compliance with Chilean clinical guideline and to measure their impact through evaluation of patient’s health condition (HC), to determine associations. Methods: prevalence study, April 2010. Population: 1,100 diabetic patients controlled in the Cardiovascular Program, considering criteria of inclusion, exclusion, informed consent. Sample: 340 randomized patients (Confidence level: 95 percent; Loss: 10 percent). Information was collected in an outpatient clinic and through home visits performed by researchers and trained senior nursing students, with a validated survey, exams, staff for file information. For the purposes of the analysis, descriptive statistics was used, Chi2, Odds Ratios with CI (95 percent). Results: HC: decompensation (HbA1c>7 percent 56.5 percent derived illnesses 97.9 percent, complications 25 percent, greater frequency of diabetic retinopathy. Males with greater risk of amputation (p=0.003). Blood pressure >130/85 mm. hg. 58.2 percent, overweight-obesity 71.2 percent, self-care (older adults) 23.1 percent. Compliance with clinical guideline: controls/professionals/year at least five 41.5 percent, CESFAM adapts this recommendation. Annual evaluation of: diabetic foot 78 percent, fundoscopy 41.6 percent. Regime indication (dietician) last control 80 percent. Five professional controls/year or more protect compensation for diabetes, IC (0.62-0.95), other recommendations and adaptation of recommendations are not associated with health status (p > 0.05). Conclusions: components of hC are better than expected. In none of the patients are the recommendations of the clinical guideline fulfilled in a 100 percent. 5 or more annual outpatient visits are associated to good metabolic control. Compliance with clinical guideline recommendations is important to improve metabolic control, to lessen complications and to improve patient’s quality of life.

Influence of plant part, season of collection and content of the main active constituent, on the antifungal properties of Polygonum acuminatum Kunth.

ETHNOPHARMACOLOGICAL RELEVANCE: Polygonum acuminatum Kunth. (Polygonaceae) is used to heal infected wounds and as antifungal in the traditional Argentinean medicine. AIM OF THE STUDY: The present investigation was carried out to evaluate the antifungal properties of aerial parts of Polygonum acuminatum, in order to give support to its ethnopharmacological use as antifungal agent and to isolate the compound(s) responsible for the antifungal properties. The influence of the plant part used, the season of the year and a study of the correlation of the antifungal activity with the content of the main active constituent were investigated too, with the aim of contributing to determine the most suitable plant extract and season of the year for achieving the best antifungal properties for Polygonum acuminatum traditional use. MATERIALS AND METHODS: For the antifungal evaluation, the microbroth dilution assay recommended by the Clinical and Laboratory Standards Institute (CLSI, formerly NCCLS) was used against a panel of human opportunistic and pathogenic fungi. Bioassay-guided fractionation allowed us to isolate the compounds responsible for the antifungal activity. GC-MS was used to quantify the main component in the different extracts. For the statistical analysis, ANOVA test for analyses of variance followed by the Tukey test of Multiple Comparisons were used. The correlations between content of the antifungal compound and antifungal activity, were calculated with the Spearman Correlation Coefficient. RESULTS: Aerial parts (A) of Polygonum acuminatum showed to possess antifungal properties against yeasts as well as dermatophytes but not against Aspergillus spp. From the most active extract (ADCM), polygodial, isopolygodial, drimenol and confertifolin were isolated, possessing polygodial a broader spectrum of action and lower MICs than the rest of compounds. Among the different parts, leaves (L), stems (S) and fruits (F), that constitute the aerial parts of Polygonum acuminatum, (L) showed to possess the best activities, compared to (S) and (F). The analysis of the content of polygodial in the LHex, LDCM, LEtOAC, LMeOH extracts collected in Summer, Autumn, Winter and Spring showed that LDCM of all seasons possessed higher percentages of this sesquiterpene than the rest of extracts. Among the LDCM of different seasons, that of Autumn was the most concentrated in polygodial. The correlation between content of polygodial with antifungal behavior of the different extracts, showed that LDCM of Autumn contains the highest content of polygodial and concomitantly the lowest MICs. CONCLUSION: The ethnopharmacological use of Polygonum acuminatum aerial parts in the Argentinean traditional medicine for ailments related to fungal infections is supported by the results obtained in this investigation. From the obtained results, LDCM of Autumn, possessing the highest content of polygodial and the lowest MICs, appeared to be the most suitable extract for being used as antifungal in the traditional medicine. Nevertheless, if some other plant collection of another season different from Autumn is available, a LDCM extract would be the better option, because it contains a higher amount of polygodial compared to LHex, LEtOAc or LMeOH and therefore, a better antifungal activity can be expected.

[Discordance between nutritional status and self perception of weight among adults from Talca, Chile]. / Discordancia en autopercepción de peso en población adulta de Talca.

BACKGROUND: Obesity is related to underestimation of one's own weight. AIM: To determine the agreement between nutritional status and self perception of weight status in apparently healthy adults from Talca. SUBJECTS AND METHODS: Data were obtained from a survey applied at 1007 randomly selected subjects, aged 18-74 years old (66% women). The survey identified age, gender, educational level and socioeconomic status. Self-perception of weight was estimated with pictures representing the four nutritional status categories: underweight, normal, overweight and obese. Body Mass index (BMI, kg/m(2)) was calculated to determine nutritional status. Statistical analysis included kappa index, Bowman s symmetry test and a logistic regression model to calculate the odds ratio in different variables related to underestimation of weight. RESULTS: Seventy three percent of subjects were overweight or obese and 44% underestimated their nutritional status. Sixty percent of subjects with a BMI between 25 and 26 kg/m(2), perceived themselves as normal. A higher underestimation was observed in obese subjects (odds ratio (OR) 17.2 95% confidence intervals (CI) 10.9-27.1), in overweight individuals (OR 3.5 95% CI 2.3-5.3), in men (OR 1.5 95% CI 1.1-2.1) and in people aged from 45 to 59 years (OR 1.7 95% CI 1.0-2.7). CONCLUSION: Almost half of studied population had an erroneous self-perception of weight, mainly due to underestimation. Obese subjects, males and people older than 45 years were those with the higher degree of underestimation.

Discordancia en autopercepción de peso en población adulta de Talca / Discordance between nutritional status and self perception of weight among adults from Talca, Chile

Background: Obesity is related to underestimation of one’s own weight. Aim: To determine the agreement between nutritional status and self perception of weight status in apparently healthy adults from Talca. Subjects and methods: Data were obtained from a survey applied at 1007 randomly selected subjects, aged 18-74 years old (66% women). The survey identified age, gender, educational level and socioeconomic status. Self-perception of weight was estimated with pictures representing the four nutritional status categories: underweight, normal, overweight and obese. Body Mass Index (BMI, kg/m2) was calculated todetermine nutritional status. Statistical analysis included kappa index, Bowman’s symmetry test and a logistic regression model to calculate the odds ratio in different variables related tounderestimation of weight. Results: Seventy three percent of subjects were overweight or obese and 44% underestimated their nutritional status. Sixty percent of subjects with a BMI between 25 and 26 kg/m2, perceived themselves as normal. A higher underestimation was observed in obesesubjects (odds ratio (OR) 17.2 95% confidence intervals (CI) 10.9-27.1), in overweight individuals (OR 3.5 95% CI 2.3-5.3), in men (OR 1.5 95% CI 1.1-2.1) and in people aged from 45 to 59 years (OR 1.7 95% CI 1.0-2.7). Conclusion: Almost half of studied population had an erroneous self perception of weight, mainly due to underestimation. Obese subjects, males and people older than 45 years were those with the higher degree of underestimation.

[Prevalence of cardiovascular risk factors in adult from Talca, Chile]. / Prevalencia de factores de riesgo cardiovascular clásicos en población adulta de Talca, Chile, 2005.

BACKGROUND: Cardiovascular disease (CVD) has several traditional risk factors (RF), and some of them are potentially modifiable. AIM: To determine the prevalence of most common risk factors in adult population in Talca in Central Chile. SUBJECTS AND METHODS: We studied 1007 subjects aged 18 to 74 years (66% women), living in Talca, selected by a probability sampling. They answered a questionnaire and anthropometry, blood pressure, lipid profile and blood glucose were measured. RESULTS: Thirty seven percent of subjects smoked, 70.1% had a body mass index over 25 kg/m(2) and 41% had an abnormally high circumference. High blood pressure was found in 37% (36% of these subjects were unaware of this condition), 44.5% had hypercholesterolemia, 21.5% had low HDL cholesterol, 40.1% had hypertriglyceridemia and 26.3% had high blood glucose levels. CONCLUSIONS: There is a high prevalence of risk factors for CVD in adult population from Talca. The prevalence of risk factors is higher than that reported by the 2003 National Health Survery.

Prevalencia de factores de riesgo cardiovascular clásicos en población adulta de Talca, Chile, 2005 / Prevalence of cardiovascular risk factors in adult from Talca, Chile

Background: Cardiovascular disease (CVD) has several traditional risk factors (RF), and some of them are potentially modifiable. Aim: To determine the prevalence of most common risk factors in adult population in Talca in Central Chile. Subjects and methods: We studied 1007 subjects aged 18 to 74 years (66 percent women), living in Talca, selected by a probability sampling. They answered a questionnaire and anthropometry, blood pressure, lipid profile and blood glucose were measured. Results: Thirty seven percent of subjects smoked, 70.1 percent had a body mass index over 25 kg/m² and 41 percent had an abnormally high circumference. High blood pressure was found in 37 percent (36 percent of these subjects were unaware of this condition), 44.5 percent had hypercholesterolemia, 21.5 percent had low HDL cholesterol, 40.1 percent had hypertriglyceridemia and 26.3 percent had high blood glucose levels. Conclusions: There is a high prevalence of risk factors for CVD in adult population from Talca. The prevalence of risk factors is higher than that reported by the 2003 National Health Survery.

Adolescent pregnancy prevention: An abstinence-centered randomized controlled intervention in a Chilean public high school.

PURPOSE: To evaluate the efficacy of an abstinence-centered sex education program in adolescent pregnancy prevention, the TeenSTAR Program was applied in a high school in Santiago, Chile. METHODS: A total of 1259 girls from a Santiago high school were divided into three cohorts depending on the year they started high school: the 1996 cohort of 425 students, which received no intervention; the 1997 cohort, in which 210 students received an intervention and 213 (control group) did not; and the 1998 cohort, in which 328 students received an intervention and 83 (control group) did not. Students were randomly assigned to control and intervention groups in these cohorts, before starting with the program. We conducted a prospective, randomized study using the application of the TeenSTAR sex education program during the first year of high school to the intervention groups in the 1997 and 1998 cohorts. All cohorts were followed up for 4 years; pregnancy rates were recorded and subsequently contrasted in the intervention and control groups. Pregnancy rates were measured and Risk Ratio with 95% confidence interval were calculated for intervention and control groups in each cohort. RESULTS: Pregnancy rates for the intervention and control groups in the 1997 cohort were 3.3% and 18.9%, respectively (RR: 0.176, CI: 0.076-0.408). Pregnancy rates for the intervention and control groups in the 1998 cohort were 4.4% and 22.6%, respectively (RR 0.195, CI: 0.099-0.384). CONCLUSIONS: The abstinence-centered TeenSTAR sex education intervention was effective in the prevention of unintended adolescent pregnancy.

Association between capillaroscopy, haemorheological variables and plasma proteins in patients bearing Raynaud's phenomenon.

Raynaud's phenomenon is a paroxysmal and reversible vasospasm affecting generally the acral circulatory regions. The relevance of the haemorheological alterations in these patients, as a source of ischemic events has been neglected. The objective of the present work was to evaluate and correlate the rheological blood properties, some biochemical parameters, e.g., plasma fibrinogen and immunoglobulin levels, and periungual capillaroscopy. The explicative variables considered were: blood viscosity, plasma viscosity, erythrocyte rigidity index, plasma fibrinogen, erythrocyte sedimentation rate, erythrocyte aggregate size, erythrocyte aggregation rate and serum immunoglobulin (IgG and IgM). The response variable was the nailfold capillary pattern categorised as either normal or pathological. Fibrinogen, erythrocyte aggregation rate and IgM are significantly higher in patients with a pathological pattern in comparison with patients bearing a normal one. The statistical analysis enabled us the modelling of the pathological pattern occurrence probability in function of plasma fibrinogen. Consequently, 100 mg/dl plasma fibrinogen increase, increases twice the probability of presenting a pathological pattern. Therefore, we can conclude that high levels of fibrinogen in Raynaud's phenomenon patients are associated with impaired skin microcirculation assessed by periungual capillaroscopy.

Efectos del entrenamiento físico de moderada intensidad en pacientes diabéticos tipo 2 / Effects of the physical training of moderate intensity in diabetic patients type 2

El rol específico de la actividad física en el tratamiento de la diabetes mellitus tipo 2 es un asunto aún en discusión. Nuestro objetivo fue determinar los efectos de un programa de ejercicio físico de moderada intensidad de cuatro meses de duración, sobre el control glicémico en 10 pacientes diabéticos de mediana edad (47,3 5,9 años) y de más de un año de evolución conocida de su enfermedad (10 8 años). El programa de entrenamiento consistió en tres sesiones semanales de ejercicio dirigidas por kinesiologos, con intensidades entre 50 y 70 por ciento de la Frecuencia cardiaca de reserva y una duración de 30 a 50 minutos. Durante el estudio no se realizó intervensión sobre la dieta ni las dosis farmacológicas utilizadas por los pacientes. No se encontraron diferencias significativas en la glicemia de ayuno, colesterol total, triglicéridos, HDL-colesterol, peso corporal luego de las 16 semanas de intervención. Los niveles de HbA1c a los 2 y cuatro meses mostraron disminuciones estadísticamente significativas (p<0.05) respecto de los valores iniciales (7,6 2,1 por ciento y 7,5 2,1 por ciento v/s 9,4 1,5 por ciento respectivamente) y los niveles de insulinemia aumentaron leve pero significativamente luego del entrenamiento (13,7 5,1 a 22,8 8,5 U/ml, p<0.05). Los niveles de LDL-colesterol a los meses disminuyeron respecto a los niveles basales (147,6 53,1 v/s 132 50,9 mg/dl; p<0.05) pero no mostraron diferencias significativas a los cuatro meses de entreno. En resumen nuestro estudio sugiere que la actividad física sistemática de moderada intensidad logra mejorías importantes en el control glicémico de pacientes con diabetes tipo 2 no complicados

Modificación de variables clínicas y del laboratorio en pacientes sometidos a cirugía antirreflujo / Modification of clinical and laboratory variables in patients submitted to antireflux surgery

La cirugía es el único tratamiento capaz de corregir los defectos anatómicos y funcionales causantes del reflujo y prevenir sus complicaciones, con resultados a largo plazo superiores al tratamiento médico. Por otro lado, el avance en la valoración pre y postoperatoria permite seleccionar el paciente con indicación quirúrgica, lo que redunda en los resultados de la cirugía. El objetivo de este trabajo es evaluar la evolución de variables clínicas y de laboratorio en pacientes sometidos a cirugía antirreflujo, a fin de objetar los resultados del tratamiento. El estudio es de corte transversal en pacientes con ERGE sometidos a cirugía antirreflujo. Se intervinieron mediante técnica de Nissen a 24 pacientes portadores de ERGE (83 por ciento de sexo femenino y 17 por ciento maculinos, con un promedio de 47 años). Todos los pacientes fueron encuestados para evaluar la frecuencia de los síntomas: pirosis, regurgitación, disfagia y dolor torácico; se les realizó además endoscopia, manometría y pHmetría antes de la cirugía y 6 meses después para valorar los resultados de la cirugía. Las mediciones fueron cegadas a los investigadores. Se construyeron tablas de contingencia y se aplicó estadístico de chi cuadrado de pearson para variables ordinales, y t test para variables continuas. Antes de la cirugía los pacientes reportaron al menos una vez por semana pirosis y regurgitación en el 100 por ciento de los casos, disfagia 50 por ciento y dolor torácico 13 por ciento. Seis meses después de la cirugía, los síntomas habían desaparecidos en el 79 por ciento, 88 por ciento, 92 por ciento, respectivamente (p<0,01). Por otro lado, el 79 por ciento de los pacientes presentaban al menos esofagitis con erosiones aislada, hecho que se normalizó en el 96 por ciento de ellos (p<0,01). Respecto de las variables de la manometría esofágica, se verificó significancia a nivel cardial en el tono basal (6,1 vs 14,8 mmHg) y longitud (3,0 vs 3,9 cm); y del cuello esofágico en la amplitud de las ondas motoras del tercio medio (39,2 vs 45,1 mmHg) y distal (55,8 vs 69,1 mmHg), y en la frecuencia de aparición de ondas terciarias (8,3 vs 1,7 por ciento), todas éstas con una p <0,01. En relación con la pHmetría esofágica, se constato significancia en las variables nº episodios reflujo (119 vs 29), porcentaje de tiempo de reflujo (7,2 vs 1,3 por ciento) y escore final de DeMeester (29,5 vs 5,8 puntos), todas ellas con un valor de p <0,01

Inmunización y respuesta inmune a la vacuna neumocócica / Immunization and immune response to neumococcal vaccine

The aim of this work was to define antibody levels against four neumococcal serotypes, before and after neumococcal vaccination in patients with respiratory infections. Fifty one patients were studied, 19 children from 1 to 5 yeras old, 19 children from 6 to 18 years old and 22 adults from 27 to 65 years old. IgG anti-neumococcal, antibodies, against serotypes 3, 7F, 9N and 14 were measured using an enzyme immunoassay, before and four weeks after vaccination. There was a significant increase in antibody titers against all serotypes in subjects older 7 yeras. In children of less than 6 yeras, the response to serotype 14 was non significant. The intensity of response differed according to the studied serotypes and the percentage of patients that responded to each serotype increased with age. Five patients older than 18 years were identified as non responders to all four serotypes. It is concluded that neumococcal vaccine increases anti-neumococcal antibodies in patients with recurrent infections and allows the identification of patients with specific antibody deficiency syndromes and normal total immunoglobulin levels

Country watch: Chile.

PIP: Servicio Paz y Justicia (SERPAJ) is a nongovernmental organization (NGO) established in Chile in 1977. It supports fundamental human dignity and rights by fighting discrimination and exclusion based upon individual differences. SERPAJ promotes training, organization, and the political participation of community members as part of the democratic process, working mainly with the at risk women, street children, and youth of Santiago's working-class neighborhoods. Groups participate in workshops and training courses on human rights and development, civic education, and methods of non-violent community action. In 1987, SERPAJ-Sur Oriente began to include the topic of sexuality and AIDS/STDs in courses training working-class women as community human rights agents. The NGO is therefore one of the first mainstream Chilean human rights organizations to incorporate HIV/AIDS issues. A basic facts brochure was developed, followed by a pilot education project developed in one neighborhood which was then systematically replicated in other neighborhoods. The comments of some people who have participated in SERPAJ workshops are presented.^ieng

Prevalencia de enteroparasitosis en la ciudad de Rosario, Argentina / Enteroparasitic prevalence in the city of Rosario, Argentina

Se procesan los datos correspondientes al período 1983-1993 de los exámenes coproparasitológicos efectuados por demanda espontánea en el Laboratorio Asistencial del Area Parasitología del Departamento de Microbiología de la Facultad de Ciencias Bioquímicas y Farmacéuticas de la Universidad Nacional de Rosario. Se consideraron las variables de sexo, edad, prevalencia parasitaria y asociaciones más frecuentes. En el lapso estudiado se observó un aumento de resultados positivos del 7,5 por ciento. Los grupos etarios entre 0-15 años fueron los más impactados. Concomitantemente hubo un incremento de poliparasitosis (3 o más parásitos) del 11,38 por ciento. En orden decreciente figuran Giardia lamblia, Blastocystis hominis, Enterobius vermicularis y Entamoeba coli. Ascaris lumbricoides aumentó significativamente en el período comprendido entre 1983-1993.

Prevalencia de enteroparasitosis en la ciudad de Rosario, Argentina / Enteroparasitic prevalence in the city of Rosario, Argentina

Se procesan los datos correspondientes al período 1983-1993 de los exámenes coproparasitológicos efectuados por demanda espontánea en el Laboratorio Asistencial del Area Parasitología del Departamento de Microbiología de la Facultad de Ciencias Bioquímicas y Farmacéuticas de la Universidad Nacional de Rosario. Se consideraron las variables de sexo, edad, prevalencia parasitaria y asociaciones más frecuentes. En el lapso estudiado se observó un aumento de resultados positivos del 7,5 por ciento. Los grupos etarios entre 0-15 años fueron los más impactados. Concomitantemente hubo un incremento de poliparasitosis (3 o más parásitos) del 11,38 por ciento. En orden decreciente figuran Giardia lamblia, Blastocystis hominis, Enterobius vermicularis y Entamoeba coli. Ascaris lumbricoides aumentó significativamente en el período comprendido entre 1983-1993. (AU)