Early Experience with Patient-Specific Unibody Bifurcated Fenestrated-Branched Devices for Complex Endovascular Aortic Aneurysm Repair.

OBJECTIVE: Short distances between the lowest visceral/renal artery and the aortic bifurcation are technically challenging during complex endovascular aortic aneurysm repair (EVAR), particularly after previous infrarenal repair. Traditionally, inverted limb bifurcated devices have been used in addition to fenestrated-branched (FB) endografts, but short overlap, difficult cannulation, and potential crushing of bridging stents are limitations for their use. This study reviews the early experience of patient-specific company manufactured devices (PS-CMD) with a unibody bifurcated FB design for complex EVAR. METHODS: Consecutive complex EVAR procedures over a 34-month period with unibody bifurcated FB-devices as part of physician-sponsored investigational device exemption studies at two institutions were reviewed. Unibody bifurcated FB-designs included fenestrated-branched bifurcated or fenestrated inverted limb devices. Endpoints included technical success, survival, frequency of type I or III endoleaks, limb occlusion, and secondary interventions. RESULTS: Among 168 patients undergoing complex EVAR, 33 (19.6%) patients (78.7% male; mean age 77) received unibody bifurcated FB PS-CMDs. Fenestrated-branched bifurcated and fenestrated inverted limb devices were used in 31 (93.9%) and 2 (6.06%) patients, respectively. Median maximum aneurysm diameter was 61 mm (interquartile range [IQR] 55-69). Prior EVAR was reported by 29 (87.9 %) patients, of which 2 (6.06%) had suprarenal stents. A short distance between the lowest renal artery and aortic bifurcation was demonstrated in 30 (90.9%) patients, with median distance of 47 mm (IQR 38-54). Preloaded devices were used in 23 patients (69.7%). A total of 128 fenestrations were planned; 22 (17.2%) were preloaded with guidewires, and 5 (3.9%) with catheters. The median operative time was 238 min (226-300), with a median fluoroscopy time of 65.5 min (IQR 56.0-77.7) and a median dose area product of 147 mGy*cm2 (IQR 105-194). Exclusive femoral access was used in 14 (42.4%) procedures. Technical success was 100%. Target vessel primary patency was 100% at median follow-up time of 11.7 months (IQR 3.5-18.6). Two (6.06%) patients required reintervention for iliac occlusion; one patient required stenting and the other a femoral-femoral bypass. No aortic-related deaths occurred after the procedure. During follow-up, 11 (33.3 %) type II endoleaks and one (3.03%) type Ib endoleak were detected; the latter was treated with leg extension. No type Ia or III endoleaks occurred. CONCLUSION: Complex EVAR using unibody bifurcated FB-PS-CMDs is a simple, safe, and cost-effective alternative for the treatment of patients with short distances between the renal arteries and the aortic bifurcation. Further studies are required to assess benefits and durability of unibody bifurcated FB-devices.

Early results of transcatheter electrosurgical aortic septotomy for endovascular repair of chronic dissecting aortoiliac aneurysms.

Objective: Endovascular repair of chronic dissecting aortoiliac aneurysms is challenging given the rigid septum, compressed true lumen (TL), and target vessels frequently originating in the false lumen. We have used transcatheter electrosurgical aortic septotomy (TEAS) before stent graft implantation under intravascular ultrasound (IVUS) and fusion guidance. The purpose of this study is to assess the outcomes of TEAS during complex endovascular repair of dissecting aneurysms. Methods: From 2021 to 2023, 17 patients underwent TEAS. The primary end point was technical success, with secondary end points of proximal and distal seals, target vessel instability, aortic and iliac TL and cross-sectional area (CSA) expansion, and aortic-related death. During the procedure, the aortic septum is crossed through a pre-existing entry or via electrocautery-activated 0.018-in. Astato XS20 wire (Asahi-Intecc) under IVUS and fusion guidance. The penetrated wire is then snared in the false lumen and pulled through the ipsilateral femoral access. A 1-cm length of the middle of the Astato wire coating is kinked in a three-sided polygonal configuration, denuded the inner surface of the wire using a no. 15 blade, and positioned at the apex of the septum. Both ends of the Astato wire are insulated with 0.018-in. microcatheters, and the back end of the wire is denuded and connected to cautery. Gentle traction is applied to the wire, and short bursts of electrocautery cutting are applied at 60 to 80 W. Results: The technical success of the septotomy was 100%. No incidence of visceral or lower extremity malperfusion, vascular injury, or distal embolization occurred. Of the 17 patients, 4 underwent thoracic endovascular aneurysm repair, 2 underwent endovascular aortic repair, and 11 underwent fenestrated/branched endovascular aneurysm repair after septotomy. All target vessels were successfully stented. A distal landing zone seal with exclusion of the false lumen was achieved in 16 of the 17 patients (94.1%). One patient required embolization of the false lumen of the celiac artery after septotomy. The TL mean diameter and CSA of the descending thoracic aorta after septotomy was expanded by 7.01 ± 1.9 mm (relative mean diameter expansion, 42.3%; P < .0001) and 2.71 ± 0.4 cm2 (relative mean CSA expansion, 57.3%, P<.0001). For patients who required septotomy through the common iliac arteries, the mean TL was expanded by 8.1 ± 3.7 mm (relative mean diameter expansion, 76%; P < .0001) and 1.76 ± 0.91 cm2 (relative mean CSA expansion, 209%; P < .0001). The 1-year freedom from target vessel instability was 91%. Conclusions: The use of IVUS and fusion-guided TEAS offers a promising technique to facilitate TL expansion and false lumen exclusion in chronic dissecting aortic aneurysms before repair. The durability and long-term outcomes of this technique in a larger cohort remain to be elucidated.

Up and over staged endoconduit technique for endovascular aortic aneurysm repair.

Adverse iliofemoral anatomy can preclude complex endovascular aortic aneurysm repair. This study aims to describe the "up-and-over" staged endoconduit technique to improve access and avoid vascular injury before complex endovascular aneurysm repair. A staged procedure for complex endovascular aortic aneurysm repair is performed using an endoconduit (W.L. Gore & Associates). After obtaining contralateral femoral access, the extension of iliofemoral disease is assessed using angiography. The endoconduit is advanced "up and over" the aortic bifurcation and delivered percutaneously into the common femoral artery to treat a diseased access site and maintain intact the ipsilateral femoral access for future stent graft deployment. Internal iliac artery patency is maintained when feasible. During complex aneurysm repair, the endoconduit is accessed directly under ultrasound guidance using sequential dilation to avoid vascular injury. PerClose sutures (Abbott Vascular) are used to close the endoconduit femoral access site. This study found that staged "up and over" endoconduit creation is a useful technique before complex endovascular aneurysm repair in patients with adverse iliofemoral anatomy. Avoiding accessing the main femoral access site during the first stage prevents vascular or access site injuries and allows for both iliac and femoral disease to be addressed.

Long-term outcomes of staged iliofemoral endoconduits prior to complex endovascular aortic aneurysm repair.

OBJECTIVE: Adverse iliofemoral anatomy may preclude complex endovascular aortic aneurysm repair (EVAR). In our practice, staged iliofemoral endoconduits (ECs) are planned prior to complex EVAR to improve vascular access and decrease operative time while allowing the stented vessel to heal. This study describes the long-term results of iliofemoral ECs prior to complex EVAR. METHODS: Between 2012 and 2023, 59 patients (44% male; median age, 75 ± 6 years) underwent ECs before complex EVAR using self-expanding covered stents (Viabahn). For common femoral artery (CFA) disease, ECs were delivered percutaneously from contralateral femoral access and extended into the CFA to preserve the future access site for stent graft delivery. Internal iliac artery patency was maintained when feasible. During complex EVAR, the EC extended into the CFA was directly accessed and sequentially dilated until it could accommodate the endograft. Technical success was defined as successful access, closure, and delivery of the endograft during complex EVAR. Endpoints were vascular injury or EC disruption, secondary interventions, and EC patency. RESULTS: Unilateral EC was performed in 45 patients (76%). ECs were extended into the CFA in 21 patients (35%). Median diameters of the native common iliac, external iliac, and CFA were 7 mm (interquartile range [IQR], 6-8 mm), 6 mm (IQR, 5-7 mm), and 6 mm (IQR, 6-7 mm), respectively. Internal iliac artery was inadvertently excluded in 10 patients (17%). Six patients (10%) had an intraoperative vascular injury during the EC procedure, and six patients (10%) had EC disruption during complex EVAR, including five EC collapses requiring re-stenting and one EC fracture requiring open cut-down and reconstruction with patch angioplasty. In 23 patients (39%), 22 Fr OD devices were used; 20 Fr were used in 22 patients (37%), and 18 Fr in 14 patients (24%). Technical success for accessing EC was 89%. There was no difference in major adverse events at 30 days between the iliac ECs and iliofemoral ECs. Primary patency by Kaplan-Meier estimates at 1, 3, and 5 years were 97.5%, 89%, and 82%, respectively. There was no difference in primary patency between iliac and iliofemoral ECs. Six secondary interventions (10%) were required. The mean follow-up was 34 ± 27 months; no limb loss or amputations occurred during the follow-up. CONCLUSIONS: ECs improve vascular access, and their use prior to complex EVAR is associated with low rates of vascular injury, high technical success, and optimal long-term patency. Complex EVAR procedures can be performed percutaneously by accessing the EC directly under ultrasound guidance and using sequential dilation to avoid EC disruption.

Salud mental, autoestima y satisfacción vital en universitarios del sur de Chile / Mental health, self-esteem and life satisfaction among university students in southern Chile / Saúde mental, Autoestima e Satisfação com a Vida em Universitários do sul do Chile

(analítico) Los universitarios atraviesan una etapa evolutiva que los sitúa como una población propensa a presentar alteraciones de salud mental, afectando su calidad de vida general. Este trabajo analiza la relación entre salud mental, autoestima y satisfacción vital en estudiantes de una universidad del sur de Chile. Los 452 participantes, hombres y mujeres entre 18 y 24 años de distintas carreras de la universidad, respondieron cuatro instrumentos: cuestionario sociodemográfico, escala de depresión, ansiedad y estrés, escala de satisfacción con la vida y escala de autoestima. Los resultados mostraron que los estudiantes que puntuaron más alto en problemas de salud mental presentaban menor satisfacción con la vida y menor autoestima. Así mismo, se encontró que las mujeres presentan mayor prevalencia en problemas de salud mental que los hombres.

(analytical) University students experience an evolutionary stage that positions them as a population prone to mental health disorders, which affects their general quality of life. This paper analyzes the relationship between mental health, self-esteem and life satisfaction among students at a university in sout-hern Chile. The 452 participants, males and females aged between 18 and 24 studying different university degrees, answered 4 different questionnaires: Sociodemographic Questionnaire; Depression, Anxiety and Stress Scale; Life Satisfaction Scale; and Self-esteem Scale. The results showed that students who scored higher regarding mental health problems had lower life satisfaction and lower self-esteem scores. It was also identified that female students have a higher prevalence of mental health problems compared to male students.

(analítico) Os estudantes universitários passam por um estágio evolutivo que os coloca como uma população propensa a transtornos de saúde mental, afetando sua qualidade de vida geral. Este artigo analisa a relação entre saúde mental, autoestima e satisfação com a vida em estudantes de uma universidade no sul do Chile. 452 participantes, homens e mulheres entre 18 e 24 anos de diferentes carreiras universitárias, respondeu a 4 instrumentos: Questionário Sociodemográfico, Escala de Depressão, Ansiedade e Estresse, Escala de Satisfação com a Vida e Escala de Autoestima. Os resultados mostraram que os alunos que pontuaram mais em problemas de saúde mental apresentaram menor satisfação com a vida e menor autoestima. Assim, verificou-se também que as mulheres apresentam maior prevalência de problemas de saúde mental do que os homens.

Condiciones de Teletrabajo, Conflicto Trabajo-Familia y Carga Mental en Trabajadores/as del sector privado en Chile / Telework, work-family conflict and mental burden in private sector workers in Chile / Teletrabalho, conflito trabalho-família e carga mental em trabalhadores do setor privado no Chile

El presente estudio tiene como objetivo describir la relación que existe entre teletrabajo, carga mental y conflicto trabajo-familia. A 102 trabajadores del sector privado en Chile, que se encuentran bajo la modalidad de teletrabajo, se les administró de manera online los cuestionarios Cuestionario de percepción y condiciones teletrabajo (Ossa, Jiménez y Gómez, 2020), Cuestionario de carga mental (Ceballos, Paravic, Burgos y Barriga, 2014) y Cuestionario conflicto trabajo-familia" (Carlson, Kacmar y Williams, 2000). Se observan relaciones negativas y significativas entre teletrabajo y conflicto trabajo familia (r= -.572, p= .000) , y entre teletrabajo y carga mental (r= -.307, p= .002). Mientras que entre carga mental y conflicto trabajo-familia existe relación positiva (r= .360, p= .000). Se concluye que el Teletrabajo tiene influencia en las áreas de carga mental y conflicto trabajo-familia, del mismo modo que estas variables tienen influencia en el teletrabajo, por lo que el apoyo de recursos organizacionales, tecnológicos e interpersonales de una de estas áreas por parte de la organización será beneficioso para las políticas organizacionales.

The present study has as its objective to describe the existing relationship between remote work, mental burden and work-family conflict. The questionnaires Remote Work Perception Scale (Ossa, Jiménez & Gómez, 2020), Mental Burden Scale (Ceballos, Paravic, Burgos & Barriga, 2014) and Work-family Conflict Questionnaire (Carlson, Kacmar & Williams, 2000)were administered via online to 102 private sector workers in Chile who are working remotely. Negative relationships between remote work and work-family conflict were observed (r= -.572, p= .000), and between remote work and mental burden (r= -.307, p= .002). While there is a positive relationship between mental burden and work-family conflict (r= .360, p= .000). It is concluded that remote work has an influence on the areas of mental burden and work-family conflict in the same manner that this variables have an influence on remote work, so that the support of organisational, technological and interpersonal resources on one of these areas by the organisation can be beneficial for the organisational politics and the workers' life.

O presente estudo tem como objetivo descrever a relação entre teletrabalho, carga mental e conflito trabalho-família. 102 trabalhadores do setor privado no Chile, que estão na modalidade de teletrabalho, foram aplicados online os questionários "Questionário de condições de percepção e teletrabalho" (Ossa, Jiménez e Gómez, 2020), "Questionário de carga mental" (Ceballos, Paravic, Burgos e Barriga, 2014) e "Questionário conflito trabalho-família" (Carlson, Kacmar e Williams, 2000). Observam-se relações negativas e significativas entre o teletrabalho e o conflito trabalho-família (r = -.572, p = .000) e entre o teletrabalho e a carga mental (r = -.307, p= .002). Já entre carga mental e conflito trabalho-família existe uma relação positiva (r = 0,360, p = 0,000). Conclui-se que o Teletrabalho influencia as áreas de carga mental e conflito trabalho-família, da mesma forma que estas variáveis ​​influenciam o teletrabalho, de forma que o suporte dos recursos organizacionais, tecnológicos e interpessoais de uma destas áreas por da organização será benéfico para as políticas organizacionais.

Condiciones de Teletrabajo, Conflicto Trabajo-Familia y Carga Mental en Trabajadores/as del sector privado en Chile

El presente estudio tiene como objetivo describir la relación que existe entre teletrabajo, carga mental y conflicto trabajo-familia. A 102 trabajadores del sector privado en Chile, que se encuentran bajo la modalidad de teletrabajo, se les administró de manera online los cuestionarios "Cuestionario de percepción y condiciones teletrabajo" (Ossa, Jiménez y Gómez, 2020), "Cuestionario de carga mental" (Ceballos, Paravic, Burgos y Barriga, 2014) y "Cuestionario conflicto trabajo-familia" (Carlson, Kacmar y Williams, 2000). Se observan relaciones negativas y significativas entre teletrabajo y conflicto trabajo familia (r= -.572, p= .000) , y entre teletrabajo y carga mental (r= -.307, p= .002). Mientras que entre carga mental y conflicto trabajo-familia existe relación positiva (r= .360, p= .000). Se concluye que el Teletrabajo tiene influencia en las áreas de carga mental y conflicto trabajo-familia, del mismo modo que estas variables tienen influencia en el teletrabajo, por lo que el apoyo de recursos organizacionales, tecnológicos e interpersonales de una de estas áreas por parte de la organización será beneficioso para las políticas organizacionales.

The present study has as its objective to describe the existing relationship between remote work, mental burden and work-family conflict. The questionnaires "Remote Work Perception Scale" (Ossa, Jiménez & Gómez, 2020), "Mental Burden Scale" (Ceballos, Paravic, Burgos & Barriga, 2014) and "Work-family Conflict Questionnaire" (Carlson, Kacmar & Williams, 2000)were administered via online to 102 private sector workers in Chile who are working remotely. Negative relationships between remote work and work-family conflict were observed (r= -.572, p= .000), and between remote work and mental burden (r= -.307, p= .002). While there is a positive relationship between mental burden and work-family conflict (r= .360, p= .000). It is concluded that remote work has an influence on the areas of mental burden and work-family conflict in the same manner that this variables have an influence on remote work, so that the support of organisational, technological and interpersonal resources on one of these areas by the organisation can be beneficial for the organisational politics and the workers' life.

O presente estudo tem como objetivo descrever a relação entre teletrabalho, carga mental e conflito trabalho-família. 102 trabalhadores do setor privado no Chile, que estão na modalidade de teletrabalho, foram aplicados online os questionários "Questionário de condições de percepção e teletrabalho" (Ossa, Jiménez e Gómez, 2020), "Questionário de carga mental" (Ceballos, Paravic, Burgos e Barriga, 2014) e "Questionário conflito trabalho-família" (Carlson, Kacmar e Williams, 2000). Observam-se relações negativas e significativas entre o teletrabalho e o conflito trabalho-família (r = -.572, p = .000) e entre o teletrabalho e a carga mental (r = -.307, p= .002). Já entre carga mental e conflito trabalho-família existe uma relação positiva (r = 0,360, p = 0,000). Conclui-se que o Teletrabalho influencia as áreas de carga mental e conflito trabalho-família, da mesma forma que estas variáveis ​​influenciam o teletrabalho, de forma que o suporte dos recursos organizacionais, tecnológicos e interpessoais de uma destas áreas por da organização será benéfico para as políticas organizacionais.

Single-cell mtDNA heteroplasmy in colorectal cancer.

Human mitochondria can be genetically distinct within the same individual, a phenomenon known as heteroplasmy. In cancer, this phenomenon seems exacerbated, and most mitochondrial mutations seem to be heteroplasmic. How this genetic variation is arranged within and among normal and tumor cells is not well understood. To address this question, here we sequenced single-cell mitochondrial genomes from multiple normal and tumoral locations in four colorectal cancer patients. Our results suggest that single cells, both normal and tumoral, can carry various mitochondrial haplotypes. Remarkably, this intra-cell heteroplasmy can arise before tumor development and be maintained afterward in specific tumoral cell subpopulations. At least in the colorectal patients studied here, the somatic mutations in the single-cells do not seem to have a prominent role in tumorigenesis.

Bullying y apoyo social percibido en una muestra de escolares chilenos de la región del Maule / Bullying and perceived social support in a sample of Chilean schoolchildren from the Maule region

Resumen Se estudia la relación entre agresión entre pares (incluyendo la agresión cibernética) y el apoyo social percibido en 675 alumnos chilenos, pertenecientes a cursos de sexto año básico a segundo año medio. Se administraron las escalas de agresión entre pares y de apoyo social percibido correspondientes a las variables estudiadas. Los resultados obtenidos, en primer lugar, al evaluar la agresión entre pares muestran diferencias significativas por curso, siendo mayor en niveles educativos más bajos; en segundo lugar, dan cuenta de una relación negativa entre las variables, es decir, cuando los alumnos se insertan en un entorno de agresión entre pares, independiente del rol que ejercen, más bajo es el apoyo social que perciben, coincidiendo con investigaciones previas. Se discute la importancia de incentivar estrategias que refuerce el apoyo social para minimizar los efectos de la agresión entre estudiantes en ambientes educativos e integrar en el aula futuros programas preventivos y de intervención.

Abstract It identifies the relationship between bullying (including cyberbullying) and perceived social support in 675 Chilean students belonging to sixth primary grade to second medium. instruments were applied, the aggression among peers scale and perceived social support The evince that, first in assessing aggression between pairs show significant differences by grade, being higher in lower educational levels and on the other, account for a negative relationship between the variables, ie, when students are inserted into an environment of peer aggression there are lower perceived social support, regardless of the role that they makes, coinciding with previous research. The importance of encouraging strategies that reinforce social support is discussed to minimize the effects of aggression among students in educational settings and to integrate future preventive and intervention programs in the classroom.

Guía clínica chilena para el estudio y tratamiento de hidradenitis supurativa. Resumen ejecutivo

Hidradenitis suppurativa is a chronic inflammatory disease of the hair follicle characterized by recurrent painful and inflamed lesions, predominantly affecting intertriginous regions. Due to its physical sequelae and impact on quality of life, we should be familiarized with this disease to make an appropriate diagnosis and implement an early treatment. This executive summary of the clinical guideline, elaborated by the hidradenitis suppurativa workgroup of the Chilean Society of Dermatology and Venereology (SOCHIDERM), reviews its definition, epidemiology, pathophysiology, risk factors, comorbidities, psycho-emotional impact, clinical presentation, diagnosis, classifications, ultrasonographic evaluation, and its medical and surgical treatments. Finally, a therapeutic approach algorithm is proposed.

Incidencia del bienestar subjetivo y equilibrio trabajo-familia en cuanto a la cultura trabajo-familia en trabajadores del poder judicial chileno / Incidence of subjective well-being and work-family balance in terms of workfamily culture in workers of the chilean judicial branch

Resumen El presente trabajo determina la relación entre bienestar subjetivo y equilibrio trabajo-familia en la cultura trabajo-familia en trabajadores ligados al poder judicial en Chile. A 143 trabajadores se les administró el Cuestionario de Cultura Trabajo-Famila (Thompson et al., 1999), la Escala de Equilibrio Trabajo-Famila (Moreno et al., 2009) y Bienestar Subjetivo (Diener et al., 1999). Se observa que la cultura trabajo-familia es explicada en un 44.7% por el bienestar subjetivo y específicamente con la Interfase Negativa del Equilibrio Trabajo-Familia. Se concluye con las implicancias en la gestión organizacional para aplicar estrategias organizacionales que incorporen las dimensiones de bienestar y políticas de conciliación, que consideren un entorno saludable para los trabajadores del poder judicial.

Abstract This study determines the relationship between subjective well-being and work-fa- mily balance in work-family culture in workers linked to the judiciary in Chile. 143 wor- kers were administered the Work-Family Culture Questionnaire (Thompson et al., 1999), the Work-Family Balance Scale (Moreno et al., 2009) and Subjective Well-being (Diener et al., 1984). We found that 44.7% of the Work-Family Culture is explained by subjecti- ve well-being and specifically with the Negative Interface of the Work-Family Balance. It concludes with the implications of promoting initiatives to foster organizational strategies that incorporate the dimensions of well-being and conciliation policies that build a healthy environment for workers in the judiciary.

Proyectos familiares y laborales en jóvenes: la demanda por igualdad de género / Young People's work and family projects: demand for gender equality / Projetos juvenil de trabalho e família: a demanda por igualdade de gênero

Resumen (analítico) Los cambios en las aspiraciones familiares y laborales de los y las jóvenes constituyen una rebelión silenciosa que cruza los ejes de género y relaciones laborales, marcando la aspiración por igualdad de género en relaciones históricamente consideradas «privadas¼. Exploramos estas aspiraciones en estudiantes de Enfermería en Talca (centro-sur de Chile), a través de una encuesta autoaplicada (N=500) en jóvenes de ambos sexos (76 % mujeres, 24 % hombres) entre 18 y 29 años. Los resultados muestran preferencia por formas de empleo más bien tradicionales, pero un marcado distanciamiento de los modelos tradicionales de distribución de responsabilidades laborales y familiares, en favor de roles compartidos entre hombres y mujeres. Ello muestra que la demanda por igualdad de género en el eje trabajo-familia es una fuerza de cambio social importante, condicionada por el entorno legal y laboral.

Abstract (analytical) Changes in young people's expectations in regards to paid work and family relations are a silent rebellion that include a demand for increased gender equality in areas traditionally defined as "private" dimensions of life. These aspirations are examined through a self-administered questionnaire (N=500) conducted with nursing students at a university in Talca (central-south Chile) of both sexes (76% females, 24% males) aged between 18 and 29. Survey results show that students have a generally conventional view of paid employment, whereas in the family domain they distance themselves from traditional gender roles, preferring an equal distribution of work and family responsibilities between men and women. This shows that these new aspirations can be a powerful force for social change, even though they are conditioned by the existing legal framework and employment conditions.

Resumo (analítico) As mudanças nas expectativas familiares e de trabalho dos jovens é uma rebelião silenciosa que coloca a demanda por maior igualdade de gênero em áreas tradicionalmente consideradas como "privadas". A questão das novas aspirações dos jovens é explorada em estudantes universitários de Enfermagem em Talca (centro-Sul do Chile), de ambos sexos (76% mulheres, 24% homens), entre os 18-29 anos de idade, utilizando um questionário autoaplicado (N=500). Os resultados mostram preferências por formas de emprego próximas do convencional, mas um marcado distanciamento das funções de gênero tradicionais em favor de uma distribuição mais igualitária das responsabilidades laborais e familiares entre homens e mulheres. Isto mostra como a demanda por igualdade de gênero no eixo trabalho-familia é uma força importante para a mudança social, condicionada pelos marcos legais e laborais.

[Chilean clinical guideline for the management of hidradenitis suppurativa - executive summary]. / Guía clínica chilena para el estudio y tratamiento de hidradenitis supurativa. Resumen ejecutivo.

Hidradenitis suppurativa is a chronic inflammatory disease of the hair follicle characterized by recurrent painful and inflamed lesions, predominantly affecting intertriginous regions. Due to its physical sequelae and impact on quality of life, we should be familiarized with this disease to make an appropriate diagnosis and implement an early treatment. This executive summary of the clinical guideline, elaborated by the hidradenitis suppurativa workgroup of the Chilean Society of Dermatology and Venereology (SOCHIDERM), reviews its definition, epidemiology, pathophysiology, risk factors, comorbidities, psycho-emotional impact, clinical presentation, diagnosis, classifications, ultrasonographic evaluation, and its medical and surgical treatments. Finally, a therapeutic approach algorithm is proposed.

Empreendedorismo e suporte familiar em estudantes de enfermagem do Brasil e Chile / Tendencia emprendedora y apoyo familiar en estudiantes de enfermería de Brasil y Chile / Entrepreneurship and family support in nursing students from Brazil and Chile

Resumo Objetivo: Associar a tendência empreendedora geral e o suporte familiar percebido entre estudantes de Enfermagem do Brasil e Chile. Métodos: Estudo transversal com dados de estudantes de cinco instituições superiores de ensino, coletados de março a setembro de 2018. Foram utilizados: formulário para avaliação sociodemográfica, questionário de Tendência Empreendedora Geral (TEG) e Inventário de Percepção de Suporte Familiar (IPSF). Foram ajustados modelos de regressão logística simples e modelos de regressão multinomial. Resultados: Dos 889 estudantes participantes, 82% eram mulheres, 60% tinham idade entre 20 e 25 anos e 55% eram de instituição particular de ensino. TEG baixa ou muito baixa foi predominante nos dois países (Brasil=83,5%; Chile=78,4%), além de baixos índices de percepção de suporte familiar. Não foram encontradas associações diretas entre o TEG e o IPSF. No Chile houve associação positiva entre a chance de a categoria impulsividade que compõe a TEG ser médio e alto com o fator autonomia familiar ser alto [OR=1,16 (1,07-1,26);p<0,01]. Conclusão: A autonomia familiar percebida pode moderar, ainda que discretamente, características importantes como a impulsividade, não sendo suficiente para elevar a tendência empreendedora desses estudantes a patamares satisfatórios. O apoio social mais adequado para promover o comportamento empreendedor dos estudantes parece ser o incentivo acadêmico na instituição educacional, tornando-se necessária a adequação pedagógica ao público feminino e às características culturais de cada país. Outras pesquisas devem ser realizadas.

Resumen Objetivo: Relacionar la tendencia emprendedora general y el apoyo familiar percibido en estudiantes de enfermería de Brasil y Chile. Métodos: Estudio transversal con datos de estudiantes de cinco instituciones de educación superior, recolectados de marzo a septiembre de 2018. Se utilizó un formulario para la evaluación sociodemográfica, el cuestionario Tendencia Emprendedora General (TEG) y el Inventario de Percepción de Apoyo Familiar (IPAF). Fueron ajustados modelos de regresión logística simple y modelos de regresión multinomial. Resultados: De los 889 estudiantes participantes, el 82 % eran mujeres, el 60 % tenían entre 20 y 25 años y el 55 % pertenecían a una institución educativa privada. La TEG baja o muy baja fue predominante en los dos países (Brasil = 83,5 %; Chile = 78,4 %), además de índices bajos de percepción de apoyo familiar. No se encontraron relaciones directas entre la TEG y el IPAF. En Chile, hubo una relación positiva entre la posibilidad de que la categoría impulsividad que compone la TEG sea media y alta y el factor autonomía familia sea alto [OR=1,16 (1,07-1,26);p<0,01]. Conclusión: La autonomía familiar percibida puede moderar, aunque sea de forma discreta, características importantes como la impulsividad, pero no es suficiente para elevar la tendencia emprendedora de estos estudiantes a niveles satisfactorios. El apoyo social más adecuado para promover el comportamiento emprendedor de los estudiantes parece ser el incentivo académico en la institución educativa, por lo que se torna necesaria una adaptación pedagógica al público femenino y a las características culturales de cada país. Deben realizarse otras investigaciones.

Abstract Objective: To associate the general entrepreneurial tendency and perceived family support among nursing students from Brazil and Chile. Methods: A cross-sectional study with data from students from five higher education institutions, collected from March to September 2018. A form, a General Enterprising Tendency (GET) test and a Perceived Family Support Inventory (Inventário de Percepção de Suporte Familiar - IPSF) were used for sociodemographic assessment. Simple logistic regression models and multinomial regression models were adjusted. Results: Of the 889 participating students, 82% were women, 60% were between 20 and 25 years old and 55% were from a private educational institution. Low or very low GET was predominant in both countries (Brazil=83.5%; Chile=78.4%), in addition to low levels of perception of family support. No direct associations were found between GET and IPSF. In Chile, there was a positive association between the chance that the drive category that makes up the GET is medium and high with the family autonomy factor being high [OR=1.16 (1.07-1.26); p<0.01]. Conclusion: Perceived family autonomy can moderate, albeit discreetly, important characteristics such as drive, not being enough to raise the entrepreneurial tendency of these students to satisfactory levels. The most appropriate social support to promote students' entrepreneurial behavior seems to be academic incentive in the educational institution. Thus, it is necessary to adapt pedagogically to the female audience and to the cultural characteristics of each country. Further research must be carried out.

Trabalhar com idosos: fatores associados ao interesse de estudantes de enfermagem no brasil e no chile / Trabajar con ancianos: factores asociados con el interés de los estudiantes de enfermería en brasil y chile / Working with the elderly: factors associated with the interest of nursing students in brazil and chile

Objetivo identificar fatores associados ao interesse em trabalhar com idosos como futuro mercado de trabalho entre estudantes de enfermagem do Brasil e do Chile. Método estudo transversal analítico, realizado entre março e setembro de 2018, incluindo 885 estudantes de enfermagem. Utilizou-se formulário com informações sociodemográficas, relacionadas à família e áreas de atuação e o Inventário de Percepção de Suporte Familiar. A análise estatística incluiu associações bivariadas e modelos de regressão logística múltipla. Resultados 27,5% dos estudantes consideraram trabalhar com idosos como possível atuação profissional, sem associação com variáveis familiares. Verificaram-se associações positivas entre aqueles que cursavam em instituições públicas e citavam trabalhar com crianças e associações negativas entre alunos mais velhos. Conclusão para a maioria dos estudantes de enfermagem do Brasil e do Chile, o trabalho com idosos não era considerado como possibilidade de atuação profissional; essa possibilidade era menor entre os alunos mais velhos e maior entre alunos de instituições públicas.

Objetivo identificar factores asociados con el interés en trabajar con los ancianos como un futuro mercado laboral entre los estudiantes de enfermería de Brasil y Chile. Método estudio analítico transversal, realizado entre marzo y septiembre de 2018, incluyendo 885 estudiantes de enfermería. Se utilizó un formulario con información sociodemográfica relacionada con la familia y las áreas de actividad y el Inventario de Percepción de Apoyo Familiar. El análisis estadístico incluyó asociaciones bivariantes y múltiples modelos de regresión logística. Resultados El 27,5% de los estudiantes consideró trabajar con los ancianos como un posible desempeño profesional, sin asociación con variables familiares. Hubo asociaciones positivas entre estudiantes de instituciones públicas y citaron trabajar con niños y asociaciones negativas entre los estudiantes mayores. Conclusión para la mayoría de los estudiantes de enfermería en Brasil y Chile, el trabajo con los ancianos no fue considerado como una posibilidad de desempeño profesional; esta posibilidad fue menor entre los estudiantes mayores y más grande entre los estudiantes de instituciones públicas.

Objective to identify factors associated with the interest in working with the elderly as a future job market among nursing students from Brazil and Chile. Method cross-sectional analytical study, conducted between March and September 2018, including 885 nursing students. A form was used with sociodemographic information related to family and areas of activity and the Family Support Perception Inventory. Statistical analysis included bivariate associations and multiple logistic regression models. Results 27.5% of the students considered working with the elderly as a possible professional performance, without association with family variables. There were positive associations between those who attended public institutions and cited working with children and negative associations among older students. Conclusion for most nursing students in Brazil and Chile, working with the elderly was not considered as a possibility of professional performance; this possibility was lower among older students and higher among students from public institutions.

Profile and entrepreneurial intention of nursing students: a comparison between Brazil and Chile.

OBJECTIVE: to identify and compare factors associated with profile, intentions, motivations, and barriers to entrepreneurial behavior of nursing students from Brazil and Chile. METHODS: this cross-sectional study was carried out between March and September 2018 including 889 nursing students. A form was used to assess the socio-demographic profile, professional claims, entrepreneurial intentions and motivations. Statistical analysis used Chi-Square and Fisher's Exact tests, with a 5% significance level, and a simple logistic regression model. RESULTS: there are significant differences between countries in the profile of students and in the motivations studied, but not in professional pretensions and entrepreneurial intentions. Lack of education on the subject reveals itself as an important barrier to entrepreneurship. CONCLUSION: given the lack of teaching entrepreneurship in undergraduate nursing courses and the characteristics inherent to students, education must be appropriate to different cultures to prepare future professionals for other areas of practice.

Eruptive disseminated Spitz nevi - Case report

Abstract Spitz nevus is a benign melanocytic lesion, which presents in several ways: solitary, agminated, or disseminated. The disseminated variant is uncommon; it may have a rapid evolution (the eruptive form) and be difficult to manage. This report presents the case of a 24-year-old patient with multiple papules on his limbs, which had appeared four years previously. On physical examination, 120 pink and skin-colored papules were seen, which under dermoscopy were observed to be homogeneous, pink vascular lesions. Histopathologic study revealed epithelioid cells arranged in groups or singly in the dermis and dermo-epidermal junction. They were HMB-45 positive in the superficial dermis, and Ki-67 < 1%. Given these findings, a diagnosis of eruptive disseminated Spitz nevi was made.

Eruptive disseminated Spitz nevi - Case report.

Spitz nevus is a benign melanocytic lesion, which presents in several ways: solitary, agminated, or disseminated. The disseminated variant is uncommon; it may have a rapid evolution (the eruptive form) and be difficult to manage. This report presents the case of a 24-year-old patient with multiple papules on his limbs, which had appeared four years previously. On physical examination, 120 pink and skin-colored papules were seen, which under dermoscopy were observed to be homogeneous, pink vascular lesions. Histopathologic study revealed epithelioid cells arranged in groups or singly in the dermis and dermo-epidermal junction. They were HMB-45 positive in the superficial dermis, and Ki-67<1%. Given these findings, a diagnosis of eruptive disseminated Spitz nevi was made.

Sebaceoma: hallazgos dermatoscópicos a propósito de dos casos / Sebaceoma: dermatoscopic findings at purpose of two cases

El sebaceoma es una neoplasia sebácea benigna inusual, que inicialmente se denominaba epitelioma sebáceo, lo que generaba confusión respecto a su biología tumoral, dado que histopatológicamente no presenta diferenciación suficiente como el adenoma sebáceo y tampoco es tan indeferenciado como el carcinoma sebáceo. Su diagnóstico precoz tiene gran relevancia, dado que, junto con el adenoma sebáceo y el carcinoma sebáceo, tienen una asociación directa con el síndrome de Muirr-Torre y, por lo tanto, con el desarrollo de cáncer de colon, endometrio, entre otros. En este punto, el uso de la dermatoscopia es muy importante. Considerando los pocos reportes en la literatura sobre la dermatoscopia en sebaceomas, presentamos dos casos clínicos en adultos, donde se destaca la presencia de estructuras amarillas homogéneas y vasos en corona o arboriformes.

Sebaceoma is an unusual benign sebaceous neoplasm, initially known as sebaceous epithelioma, which generated confusion regarding its tumor biology, given that it is histopathologically less differentiated than sebaceous adenoma, but with a higher differentiation than sebaceous carcinoma. Early diagnosis becomes relevant, given that together with sebaceous adenoma and sebaceous carcinoma, there is a direct association with Muirr-Torre syndrome and therefore the development of colon and endometrial cancer, among others. Because of this, the use of dermatoscopy becomes very important. Given the few reports in the literature on dermatoscopy in sebaceomas, we present two clinical cases, where the presence of homogeneous yellow structures and crown or arboriform vessels stands out.