Asociación entre el índice de amputación por pie diabético y los indicadores de atención y manejo de diabetes mellitus tipo 2 en los Centros de Salud del Servicio Metropolitano Oriente, entre 2014 y 2018 / Association between the diabetic foot amputation index and metabolic compensation in diabetes mellitus

BACKGROUND: Diabetic foot amputation is a public health challenge due to the increasing prevalence of type 2 diabetes mellitus (T2D). Although there are many health indicators aimed at the management and control of T2D and its complications, amputations persist. Aim: To evaluate the association between diabetic foot amputation index and indicators of care and management of T2D in primary care centers of the eastern section of Santiago, Chile. MATERIAL AND MATHODS: We conducted a mixed ecological study and included information from the Monthly Statistical report of different public health centers from 2014 to 2018. We also analyzed the hospital discharge records from an individual tertiary public health center. The annual index for diabetic foot amputation per 100,000 diabetic patients was used as a response variable. The diabetic compensation percentage was calculated as the proportion of adults with a glycosylated hemoglobin below 7% or the proportion of older people with a value below 8%. The diabetic decompensation percentage was calculated as the proportion of people with a glycosylated hemoglobin over 9%. RESULTS: A high variability in demographic and management indicators was observed between communes and centers in the study period. Bivariate analysis showed a significant correlation between the amputation index, decompensation, and insulin use. In a regression analysis, the amputation index was significantly associated with the diabetic compensation percentage (β = -3.5; p < 0.05) and a high decompensation percentage (β = 12.3; p < 0.005). Conclusions: The diabetic foot amputation index was associated with diabetic compensation and decompensation indicators.

Efecto de las temperaturas extremas en la incidencia de enfermedades cardiovasculares: revisión bibliográfica 2016-2022 / Effect of extreme temperatures on the incidence of diseases cardiovascular: bibliographic review 2016-2022

Resumen: El panel intergubernamental sobre cambio climático estima que para el año 2100 74% de la población estará expuesta a olas de calor en el peor escenario (definido como 3 días consecutivos con temperaturas igual o sobre el percentil 95 de un periodo de tiempo), abarcando en Santiago hasta 40% de los días de verano con temperaturas extremas. Producto de la crisis climática también pueden ocurrir eventos de frío extremo. Ambos fenómenos constituyen un riesgo para la salud, particularmente para las enfermedades cardiovasculares. Objetivo: Estudiar la asociación entre temperaturas extremas y enfermedades cardiovasculares (mortalidad por enfermedades cardiovasculares, infarto agudo al miocardio, accidente cerebrovascular, hipertensión y paro cardíaco extra hospitalario). Métodos: Se realizó una revisión bibliográfica en los buscadores ISI-Web of Science, Scopus y Nature utilizando los términos de búsqueda heatwave, cardiovascular disease y extreme heat entre los años 2016-2021 incluyendo trabajos que presenten medidas de asociación entre temperaturas extremas (percentil 5 para temperaturas bajas y percentil 90 para temperaturas altas) y enfermedades cardiovasculares, arrojando 130 resultados de los cuales se seleccionaron 19. Resultados: Tanto las temperaturas altas como bajas aumentaron el riesgo de muerte por infarto agudo al miocardio (IAM) (RR: 2,29 [2,18-2,40] y RR: 2,3 [1,2-4,6], respectivamente) y paro cardíaco (OR 3,34 [1,90-3,58] y OR: 1,75 [1,23-2,49], respectivamente). La mortalidad por hipertensión arterial se asoció a temperaturas altas (OR 1,91 [1,2-3,1]), mientras que la mortalidad por enfermedades cardiovasculares (ECV) en general a bajas (RR: 1,79 [1,64 - 1,95]). En hospitalizaciones por ECV el riesgo por temperaturas altas (P99) fue RR: 1,74 [IC95%: 1,30-2,32]. Se identificaron diferencias por sexo y mayor riesgo en los mayores de 75 años y quienes presentaron exposiciones prolongadas. Conclusión: Hay una fuerte asociación entre hospitalizaciones y muerte por ECV y temperaturas extremas. Las mujeres y los adultos mayores son los más afectados.

Abstract: The Inter governmental panel estimates that in a worst case scenario, by 2100 74% of people will be exposed to heat waves (3 consecutive days with temperatures at or above the 95% percentile). This might be the case in up to 40% of days in Santiago. As a consequence of climate change there will also be periods with extremely low temperatures. Both conditions increase the risk of cardiovascular disease. Aim: to study the association of extreme temperatures with the incidence of cardiovascular disease (death, myocardial infarction, stroke and out of hospital sudden death). Method: The ISI-Web of Science, Scopus and Nature databases were searched using the terms "heat wave", "cardiovascular disease" and "extreme heat" for articles published between 2016 and 2021.

[Association between the diabetic foot amputation index and metabolic compensation in diabetes mellitus]. / Asociación entre el índice de amputación por pie diabético y los indicadores de atención y manejo de diabetes mellitus tipo 2 en los Centros de Salud del Servicio Metropolitano Oriente, entre 2014 y 2018.

BACKGROUND: Diabetic foot amputation is a public health challenge due to the increasing prevalence of type 2 diabetes mellitus (T2D). Although there are many health indicators aimed at the management and control of T2D and its complications, amputations persist. AIM: To evaluate the association between diabetic foot amputation index and indicators of care and management of T2D in primary care centers of the eastern section of Santiago, Chile. MATERIAL AND METHODS: We conducted a mixed ecological study and included information from the Monthly Statistical report of different public health centers from 2014 to 2018. We also analyzed the hospital discharge records from an individual tertiary public health center. The annual index for diabetic foot amputation per 100,000 diabetic patients was used as a response variable. The diabetic compensation percentage was calculated as the proportion of adults with a glycosylated hemoglobin below 7% or the proportion of older people with a value below 8%. The diabetic decompensation percentage was calculated as the proportion of people with a glycosylated hemoglobin over 9%. RESULTS: A high variability in demographic and management indicators was observed between communes and centers in the study period. Bivariate analysis showed a significant correlation between the amputation index, decompensation, and insulin use. In a regression analysis, the amputation index was significantly associated with the diabetic compensation percentage (ß = -3.5; p < 0.05) and a high decompensation percentage (ß = 12.3; p < 0.005). CONCLUSIONS: The diabetic foot amputation index was associated with diabetic compensation and decompensation indicators.

Assessment of Cardiovascular Risk in Women with Periodontal Diseases According to C-reactive Protein Levels.

Cardiovascular diseases (CVD) are highly prevalent non-communicable diseases worldwide. Periodontitis may act as a non-traditional cardiovascular risk (CVR) factor, linked by a low-grade systemic inflammation mediated by C-reactive protein (CRP). Patients with periodontitis reported higher serum CRP levels; however, a CRP systemic and periodontal correlation in gingival crevicular fluid (GCF) and its CVR impact have been barely studied. We aimed to assess the association between periodontal diseases and CVR in a group of adult women, based on serum high-sensitivity CRP (hs-CRP) levels; and secondly, to determine the association between serum and GCF CRP levels. Gingival crevicular fluid and blood samples were obtained from women with periodontitis, gingivitis, and healthy controls. Serum and GCF CRP were determined by turbidimetric method and Luminex technology, respectively. Data were analyzed and adjusted by CVR factors. All women presented moderate CVR, without an evident association between serum hs-CRP levels and periodontal diseases. While serum hs-CRP concentrations did not significantly differ between groups, patients with gingivitis and periodontitis showed higher CRP levels in GCF, which positively correlated to CRP detection in serum.

MMP-8, TRAP-5, and OPG Levels in GCF Diagnostic Potential to Discriminate between Healthy Patients', Mild and Severe Periodontitis Sites.

Biomarkers represent promising aids in periodontitis, host-mediate diseases of the tooth-supporting tissues. We assessed the diagnostic potential of matrix metalloproteinase-8 (MMP-8), tartrate-resistant acid phosphatase-5 (TRAP-5), and osteoprotegerin (OPG) to discriminate between healthy patients', mild and severe periodontitis sites. Thirty-one otherwise healthy volunteers with and without periodontal disease were enrolled at the Faculty of Dentistry, University of Chile. Periodontal parameters were examined and gingival crevicular fluid was sampled from mild periodontitis sites (M; n = 42), severe periodontitis sites (S; n = 59), and healthy volunteer sites (H; n = 30). TRAP-5 and OPG were determined by commercial multiplex assay and MMP-8 by the immunofluorometric (IFMA) method. STATA software was used. All biomarkers showed a good discrimination performance. MMP-8 had the overall best performance in regression models and Receiver Operating Characteristic (ROC) curves, with high discrimination of healthy from periodontitis sites (area under the curve (AUC) = 0.901). OPG showed a very high diagnostic precision (AUC ≥ 0.95) to identify severe periodontitis sites (S versus H + M), while TRAP-5 identified both healthy and severe sites. As conclusions, MMP-8, TRAP-5, and OPG present a high precision potential in the identification of periodontal disease destruction, with MMP-8 as the most accurate diagnostic biomarker.

Attention deficit hyperactivity disorder and its association with heavy metals in children from northern Chile.

INTRODUCTION: Exposure to lead and arsenic has been associated with child behavior problems. In Arica, a northern city of Chile, the natural presence of arsenic in water has been registered. Also, the city has a history of heavy metals contamination of anthropogenic origin. The purpose of this study was to explore the association between the concentration of blood lead and urinary inorganic arsenic with attention deficit hyperactivity disorder (ADHD) as reported by parents. METHODS: Cross-sectional design with data analysis of 2656 children between the ages of 3 and 17 enrolled at the Environmental Health Center of Arica between 2009 and 2015. The diagnosis of ADHD was made based on the parents' response to questions about health history. Multiple logistic regression models were used to adjust for confounding variables. RESULTS: The prevalence of ADHD was 6.4%. The means urinary inorganic arsenic and blood lead were 21 µg/L and 1.5 µg/dl, respectively. In the lead model adjusted for sex, age, housing material quality and exposure to secondhand tobacco smoke report; children with blood lead concentrations ≥5 µg/dl were more likely to develop ADHD [Odds Ratio (OR): 2.33 95% confidence intervals (CI) 1.32-4.12)]. Regarding arsenic, the adjusted model revealed a higher chance of developing ADHD in the fifth quintile of exposure (OR = 2.02 IC 95% 1.12-3.61). CONCLUSION: The findings of this study suggest that exposure of children to lead and inorganic arsenic was associated with ADHD. This study provides additional evidence to existing literature regarding the potential role of toxic metals such as lead and arsenic in children's behavior. However, our findings should be interpreted with caution due to the limitations of the study.

Aporte de un sistema predictivo de contraloría médica en la gestión de licencias médicas electrónicas / Contributions of a predictive medical audit system in the electronic management of sick leaves

INTRODUCCIÓN: El retraso del procesamiento de las licencias médicas (LMs) representa un problema de salud pública en Chile, considerando que esto afecta el pago del subsidio a las personas destinado a realizar el reposo médico prescrito mientras no se pueda trabajar. El objetivo de este estudio fue explorar las diferencias en el tiempo de procesamiento de las licencias médicas electrónicas (LMEs) evaluadas por contraloría médica (CM) y las evaluadas por un sistema predictivo de contraloría médica (SPCM) basado en redes neuronales artificiales. MATERIALES Y MÉTODOS: El tiempo de procesamiento de LMEs procesadas con SPCM fue comparado con el tiempo de procesamiento de LMEs examinadas solo con CM, usando curvas de Kaplan Meier, prueba de log-rank y modelos multivariados de Cox. RESULTADOS: La tasa de procesamiento del SPCM fue entre 1,7 a 5,5 veces más rápida que la tasa de procesamiento de la CM, ajustando por potenciales confusores. DISCUSIÓN: La implementación del SPCM permitió disminuir el tiempo de procesamiento de las LMEs, beneficiando a los trabajadores afiliados al seguro público.

INTRODUCTION: The delay in the processing of sick leaves (SLs) is a public health pro-blem in Chile, considering that this affects the payment of the subsidy to the indivi-duals destined to perform the prescribed medical rest while unable to work. The aim of this study was to explore the differences in the processing time of electronic SLs (ESLs) evaluated by medical audit (MA) and the SLs evaluated by a predictive medi-cal audit system (PMAS) based on artificial neural networks. MATERIALS AND METHODS:The processing time of the ESLs that were processed by PMAS was compared with the processing time of those that were examined only by MA, using Kaplan Meier curves, log-rank test, and multivariate Cox models. RESULTS: The processing rate for PMAS was 1.7-fold to 5.5-fold faster than MA, after adjusting for potential confoun-ding variables. DISCUSSION: The implementation of the PMAS reduced the processing time of ESLs, which benefits the workers affiliated to the public insurance system in Chile. (AU)

Elevated Systemic Inflammatory Burden and Cardiovascular Risk in Young Adults with Endodontic Apical Lesions.

INTRODUCTION: The aim of this study was to assess whether apical lesions are associated with inflammatory serum markers of cardiovascular risk, especially high-sensitivity C-reactive protein (hsCRP), in young adults. METHODS: In this cross-sectional study, otherwise healthy individuals with apical lesions of endodontic origin (ALEOs) and a clinical diagnosis of asymptomatic apical periodontitis and controls aged between 18 and 40 years were included. Patients' sociodemographic characteristics, medical history, and classic cardiovascular risk factors were recorded, and the pathobiological determinants of atherosclerosis in youth score was calculated. Oral clinical and radiographic examinations were performed. Blood samples were collected to determine the lipid profile, glycated hemoglobin, hsCRP, immunoglobulin G, interleukin (IL)-6, IL-10, IL-12p70, matrix metalloproteinase 8, soluble vascular cellular adhesion molecule-1, soluble intercellular adhesion molecule-1, and soluble E-selectin. Bivariate and multivariate analyses adjusting for oral and classic cardiovascular risk factors were performed. RESULTS: hsCRP levels were significantly higher in ALEO patients versus controls (median = 2.54 vs 0.78), whereas the pathobiological determinants of atherosclerosis in youth score was comparable among the groups. Also, the levels of IL-6, matrix metalloproteinase 8, and soluble E-selectin were significantly higher in ALEO patients. hsCRP, IL-6, and IL-12 correlated with soluble adhesion molecules. Bivariate analysis based on hsCRP serum concentrations ≥1 mg/L showed an odds ratio (OR) = 6.8, and the risk increased 3.3 times for an additional ALEO. In multivariate analysis, ALEO was significantly associated with hsCRP levels ≥1 mg/L (OR = 5.1-12.8) independently of the adjustment model. ALEO also associated with CRP levels >3 mg/L, which was significant after the adjustment for covariates (OR = 4.0). CONCLUSIONS: ALEO is associated with the systemic inflammatory burden and cardiovascular risk determined by hsCRP, supporting a mechanistic link for cardiovascular diseases in young adults.

Health Assessment of Electronic Waste Workers in Chile: Participant Characterization.

Little research has been done to evaluate the occupational health of electronic waste (e-waste) recycling workers in Latin America. The objective of this study was to complete comprehensive health evaluations on e-waste recycling workers in Chile and to compare those that work in informal (i.e., independent) to those that work in formal (i.e., established company) settings. A cross-sectional study in the summer of 2017 recruited 78 informal recycling workers from two cities and 15 formal e-waste recycling workers from a single recycling facility to assess exposures and health outcomes. Participants completed a health questionnaire and underwent a full health assessment. Herein, only health questionnaire data are reported. Participants were primarily male, middle-aged, married with children, and had worked in e-waste recycling for an average of 12 years. Participants generally reported good health status, and their prevalence of chronic diseases was comparable to national rates. Workers frequently reported exposures to several occupational stressors, including noise and insufficient income, as well as other mental health stressors. Occupational injuries were commonly reported and use of safety equipment was low. Only a few significant differences, generally of a rather small magnitude, were found between informal and formal workers. In conclusion, from survey data, we did not identify major risks to health among e-waste workers, and only minor differences between workers in informal and formal settings.

Urinary Inorganic Arsenic Concentration and Gestational Diabetes Mellitus in Pregnant Women from Arica, Chile.

Introduction: The association of total arsenic exposure with impaired glucose tolerance and gestational diabetes has been shown; however, evidence regarding urinary inorganic arsenic in pregnant women is still limited. Our aim was to evaluate the association between urinary inorganic arsenic concentration and gestational diabetes among pregnant women living in Arica, Chile. Methods: Cross-sectional study of pregnant women receiving care at primary health centers in urban Arica. The exposure was urinary inorganic arsenic concentration, while gestational diabetes was the outcome. The association was evaluated using multiple logistic regression models adjusted by age, education level, ethnicity, and pre-pregnancy body mass index. Results: 244 pregnant women were surveyed. The median urinary inorganic arsenic was 14.95 μg/L, and the prevalence of gestational diabetes was 8.6%. After adjusting, we did not find a significant association between gestational diabetes and inorganic arsenic exposure tertiles (Odds ratio (OR) 2.98, 95% CI = 0.87⁻10.18), (OR 1.07, 95% CI = 0.26⁻4.33). Conclusion: This study did not provide evidence on the relationship between urinary inorganic arsenic concentration and gestational diabetes. Further research is needed to elucidate the factors underlying this association.

An assessment of the Surgical Apgar Score in spine surgery.

BACKGROUND CONTEXT: The Surgical Apgar Score (SAS), a simple metric based on intraoperative heart rate, blood pressure, and blood loss, was developed in general and vascular surgery to predict 30-day major postoperative complications and mortality. No validation of SAS has been performed in spine surgery. PURPOSE: To perform a prospective assessment of SAS in spine surgery. STUDY DESIGN: Prospective study. PATIENT SAMPLE: Two hundred sixty-eight consecutive patients undergoing major and intermediate spinal surgeries in an 18-month period. OUTCOME MEASURES: Occurrence of major complications or death within 30 days of surgery. METHODS: Intraoperative parameters were registered, and SAS was calculated immediately after surgery. Outcome data were collected during a 30-day follow-up. The relationship between SAS and the outcomes was analyzed calculating relative risks (RRs) and likelihood ratios (LRs) for different scoring groups. A univariate logistic regression analysis was also performed. The discriminatory accuracy of SAS was evaluated calculating a C-statistic. RESULTS: Eighteen patients had ≥1 complications (6.72%). Patients with SAS 9-10 exhibited a 1.64% complication rate (RR=1; LR=0.23), which monotonically augmented as the score decreased: (SAS 7-8=2.75%; RR=1.68; LR=0.39), (SAS 5-6=13.33%; RR=8.13; LR=2.14), (SAS≤4=17.39%; RR=10.61; LR=2.92). The regression analysis odds ratio was 0.66 (95% confidence interval, 0.54-0.82), p<.01. The C-statistic was 0.77 (95% confidence interval, 0.66-0.88). CONCLUSIONS: Surgical Apgar Score allows risk stratification and has a good discriminatory power in patients undergoing spine surgery.

A systematic review of socioeconomic position in relation to asthma and allergic diseases.

The role of socioeconomic position (SEP) in the development of asthma and allergies is unclear, with some pointing to the risks of low SEP and other research pointing in the direction of higher SEP being associated with higher prevalence rates. The aim of this systematic review is to clarify associations between SEP and the prevalence of asthma and allergies. Out of 4407 records identified, 183 were included in the analysis. Low SEP was associated with a higher prevalence of asthma in 63% of the studies. Research on allergies, however, showed a positive association between higher SEP and illness in 66% of studies. Pooled estimates for the odds ratio of disease for the highest compared with the lowest SEP confirmed these results for asthma (unadjusted OR 1.38, 95% CI 1.37-1.39), allergies in general (OR 0.67, 95% CI 0.62-0.72), atopic dermatitis (unadjusted OR 0.72, 95% CI 0.61-0.83) and allergic rhinoconjunctivitis (unadjusted OR 0.52, 95% CI 0.46-0.59). Sensitivity analyses with a subsample of high-quality studies led to the same conclusion. Evidence from this systematic review suggests that asthma is associated with lower SEP, whereas the prevalence of allergies is associated with higher SEP.

Low anonymous voting compliance with the novel policy for managing conflicts of interest implemented in the 9th version of the American College of Chest Physicians antithrombotic guidelines.

BACKGROUND: The executive committee of the Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (AT9) developed a strategy to limit the impact of conflict of interest (COI) on recommendations. This policy excluded conflicted panelists from voting on recommendations with which they had conflicts. The objective of the study is to explore the compliance of the attendees of the AT9 final conference. METHODS: We conducted a survey and reviewed public declarations of COI of all the final AT9 conference attendees. For each of the controversies on which voting occurred (nine of 628 total recommendations), we estimated the compliance with COI policy as the proportion of attendees who recused themselves from voting on controversies for which they were conflicted. To evaluate the potential effect of noncompliance, we assumed that every vote cast by an ineligible conference attendee was cast in direction of the majority vote. RESULTS: Sixty-three panelists voted in at least one controversy at the final conference; the percentage of conflicted panelists varied from 6% to 39% for eight controversies. The compliance with the COI policy was 14 of 14 (100%) for one controversy, and varied from one of 19 (5%) to one of three (33%) in the remaining seven. In two of the eight controversies ("Compression device plus aspirin vs low-molecular-weight heparin in tromboprophylaxis in orthopedic surgery" and "Low-molecular-weight heparin vs vitamin K antagonists for treatment"), the low compliance may have affected the final recommendations. CONCLUSIONS: The low compliance raises concerns about implementation of COI restrictions in the context of anonymous voting.

Can the Surgical Apgar Score predict morbidity and mortality in general orthopaedic surgery?

PURPOSE: The Surgical Apgar Score (SAS) is a simple tally based on intra-operative heart rate, blood pressure and blood loss; it predicts 30-day major postoperative complications and mortality in different surgical fields, but no validation has been performed in general orthopaedic surgery. METHODS: A prospective assessment of the SAS in 723 consecutive patients undergoing major and intermediate orthopaedic procedures was performed in an 18-month period. The SAS was calculated immediately after surgery, and the occurrence of major complications or death was registered within a 30-day follow-up. RESULTS: Thirty-seven patients had ≥1 complication (5.12 %). The complication rate did not augment as the score decreased (SAS 9-10 = 6.56 %; SAS 7-8 = 2.62 %; SAS 5-6 = 7.21 %; SAS ≤4 = 10.2 %), the relative risk did not augment as the score decreased and the likelihood ratio did not increase with decreasing SAS values, except in the subgroup of patients undergoing spine surgery. The C-statistic was 0.59 (95 % confidence interval 0.48-0.69), a weak discriminatory value. Using a threshold of 7 to define high-risk and low-risk patients, the SAS allowed risk stratification only for spine surgery. CONCLUSIONS: The SAS does not predict 30-day major complications and death in patients undergoing general orthopaedic surgery, but it is useful in the subgroup of patients undergoing spine surgery.

[Prevalence of drug abuse among children in basic schools]. / Estudio de prevalencia del consumo de drogas en escolares de Enseñanza Básica, a través de la metodología de pares.

BACKGROUND: Peer methodology (PM) is an adaptation of the privileged access interviewer methodology and is used for prevalence studies. PM estimates higher drug consumption frequencies among school and college students than self reports, since it minimizes underreporting. AIM: To assess drug abuse among students using PM. MATERIAL AND METHODS: A random sample of 234 school students of middle and low-middle socioeconomic status, aged 9 to 14 years (53% women) were interviewed using PM about drug consumption. RESULTS: The frequency of illicit drug consumption during the last year was 29% and 15% during the last month (current consumption). The consumption of tobacco and alcohol was 20% and 18% respectively during the last year. The figures for the last month were 11% and 8% respectively. The beginning age for smoking and alcohol consumption were 11.1 +/-1.5 and 11.3+/- 1.8 years respectively. The frequency of illicit drug consumption was 3.5%. Illicit drug users began illicit drug consumption at earlier ages their non user peers. CONCLUSIONS: There is a high frequency of illicit drug consumption among school age children.

Estilos de crianza, relación percibida con los padres y salud mental de estudiantes adolescentes de la Región Metropolitana / Risk behaviors, depressive symptoms, auto and heteroaggresion in a sample of adolescent students in Metropolitan Santiago de Chile, 2007

El marco referencial de Brian Barber relaciona consumo de drogas, depresión, suicidalidad y conductas violentas con estilos parentales: la aceptación de los padres se correlaciona positivamente con iniciativa adolescente, y negativamente con síntomas depresivos y suicidas; el control psicológico con depresión y conducta antisocial, y el control comportamental negativamente con ésta última. Material y métodos: En conjunto con el autor, se adapta el instrumento CNAP y se aplica a una muestra representativa aleatoria trietápica de la Región Metropolitana (n=1447). Resultados: Hay consumo frecuente de alcohol en 26,9 por ciento, tabaco31,2 por ciento, de marihuana 6,9 por ciento, de cocaína u otras drogas2,3 por ciento. Hay ideación suicida en 7,7 por ciento y síntomas depresivos en 6,9 por ciento. La autoagresión predomina en mujeres y la heteroagresión en hombres. Con la edad aumenta el consumo de alcohol (X2=107,95, p=0,0001), de tabaco (X2=63,02, p=0,0001), de marihuana (X2=18,78,p=0,001);y de cocaína(X2=8,995,p=0,06). No hay diferencias por edad en conductas violentas, ideación suicida o síntomas depresivos. A peor relación con los padres mayor consumo, depresión, ideación suicida, y conductas heteroagresivas. Se encuentran coeficientes de correlación de Spearman en la misma dirección de los del estudio internacional CNAP. Conclusiones: Esta encuesta confirma estudios previos sobre sexo, edad y estilos parentales: hay mayor consumo de sustancias químicas y conductas heteroagresivas entre los hombres y de sentimientos depresivos e ideación suicida entre las mujeres. Las conductas estudiadas aumentan con la edad, con excepción de la violencia; estas conductas se correlacionan entre sí, y disminuyen con una buena relación con los padres. El modelo de Barber es confirmado en este estudio en Santiago de Chile, lo que importa en diseño de políticas públicas e intervenciones preventivas.

The referential framework developed by Brian Barber relates the consumption of drugs, depression, suicides and violent conduct to parental styles: acceptance by parents is positively correlated to prosocial adolescent initiative and, negatively, with depressive symptoms and suicidality; psychological control correlates with depression and anti-social behavior and psychological control correlates negatively with the latter. Material and methods: Together with the author, the CNAP survey (developed by Barber et al) was applied to a random trietapic representative sample from the Metropolitan Region (n=1447). Results: Frequent consumption was found in 26.9 percent of all cases, tobacco in 31.2 percent, marihuana in 6.9 percent and cocaine and other drugs in 2.3 percent Suicidal ideation accounted for 7.7 percent and depressive symptoms for 6.9 percent. Self-mutilation was predominant in women and hetero-aggression in men. Consumption increased with age: of alcohol (X2=107.95,p=0.0001), tobacco (X2=63.02,p=0.0001), marihuana (X2=18.78,p=0.001) and cocaine (X2=8.995,p=0.06). There were no age differences with regards to violent conduct, suicidal ideation or depressive symptoms. As relations with parents got worse, so did consumption, depression, suicidal ideation and hetero-aggressive conduct. Spearman correlation coefficients followed the same path as those of the CNAP international study. Conclusions: This survey confirms previous studies as to sex, age and parental styles: there is a greater consumption of chemical substances and hetero-aggressive conduct among men and depression and suicidal tendencies among women. The conduct studied increased with age, with the exception of violence; these conducts were correlated among each other, tending to decrease as relations with parents improved. The Barber model has been confirmed in this study in Santiago, Chile, which is important when it comes to designing public policies and preventive intervention.

Estudio de prevalencia del consumo de drogas en escolares de Enseñanza Básica, a través de la metodología de pares / Prevalence of drug abuse among children in basic schools

Background: Peer methodology (PM) is an adaptation of the privileged access interviewer methodology and is used for prevalence studies. PM estimates higher drug consumption frequencies among school and college students than self reports, since it minimizes underreporting. Aim: To assess drug abuse among students using PM. Material and methods: A random sample of 234 school students of middle and low-middle socioeconomic status, aged 9 to 14 years (53 percent women) were interviewed using PM about drug consumption. Results: The frequency of licit drug consumption during the last year was 29 percent and 15 percent during the last month (current consumption). The consumption of tobacco and alcohol was 20 percent and 18 percent respectively during the last year. The figures for the last month were 11 percent and 8 percent respectively. The beginning age for smoking and alcohol consumption were 11.1 ±1.5 and 11.3± 1.8 years respectively. The frequency of illicit drug consumption was 3.5 percent. Illicit drug users began licit drug consumption at earlier ages their non user peers. Conclusions: There is a high frequency of illicit drug consumption among school age children.

A comparison of the peers method and traditional methodologies, and risk behaviors in studies of the prevalence of drug consumption in a population of female, Chilean students.

The present study investigates drug consumption and risk behaviors among female students between 8th and 12th grade in two communities in the city of Santiago, Chile. Based on studies of university populations, we hypothesize that the students' reports of their consumption of licit drugs will tend to be consistent with their actual use of said drugs using two methods to investigate consumption, while their consumption of illicit drugs will be susceptible, and will tend to be under-reported when evaluated through traditional self-report measures. In order to compare the two methods, a cross-sectional study was designed that would compare reported drug consumption, first using the peers method, and then by means of traditional self-report in a group of 350 students. The results show that women's reports of licit drug consumption converge using the two methods, while as earlier suggested, women's illicit drug consumption was found to be under-reported when traditional methodologies were used.

Religiosidad, conductas de riesgo y salud mental en adolescentes de Santiago de Chile / Religiousness, risk behaviors and mental health among adolescents from Santiago, Chile

El grado de religiosidad y observancia religiosa han sido estudiadas como elementos protectores para diversas conductas de salud. Este estudio analiza la relación entre grado de religiosidad y presencia de uso de sustancias químicas, otras conductas de riesgo auto y hetero-agresivas, en una muestra aleatoria de 252 adolescentes escolarizados en la Región Metropolitana de Santiago de Chile, en base a una aplicación del cuestionario ECRA-2, comparando entre sí los subgrupos auto-calificados como muy religiosos (n=57) con los nada religiosos (n=50). El grupo total tuvo una edad promedio de 17,7 (DS 1,54), de los cuales un 55,9 por ciento eran mujeres. En cuanto a adscripción religiosa, un 72,8 por ciento se identificaban como católicos, un 10,9 por ciento protestantes, un 4,7 por ciento de otra religión y un 11,7 por ciento sin religión. Un 22,6 por ciento se identificó como muy religioso, y un 19,8 por ciento como nada religioso. La comparación presentada contrasta los subgrupos auto-calificados como muy religiosos (n=57) con los nada religiosos (n=50). Un 12,5 por ciento de los adolescentes muy religiosos consumieron marihuana más frecuentemente que una vez al mes, en comparación a un 41,7 por ciento de aquellos que se consideraban nada religiosos (8,643; 2gl;p=0,013). Los adolescentes muy religiosos se sentían más frecuentemente tristes y nerviosos que los nada religiosos (22,7 por ciento vs 12,5 por ciento; X2=5,175;2 gl; p=0,075); informaban menor frecuencia de golpear a otros(p=0,05), menor participación en peleas grupales (p=0,03), menor frecuencia de robo en tiendas(p=0,08) y de copia en pruebas(p=0,002).

The degree of religiousness and religious observance have been studied as protective elements for various health behaviors. The present study assesses the relation between the degree of religiousness and the use of chemical substances and the presence of aggressive risk behaviors towards one self or others, in a randomly selected sample of 252 schooled adolescents from the Metropolitan Region of Santiago, Chile. An ECRA-2 questionnaire was used, and the subgroups self-rated as very religious (n=57) and as not religious at all (n=50) were compared. The total group mean age was 17,7 years (SD 1,54), and 55,9 percent were female. As for religious ascription, 72,8 percent identified themselves as Catholics, 10,9 percent as Protestants , 4,7 percent as other religion and 11,7 percent as without religion. Twenty-two point six percent (22,6 percent) rated themselves as very religious, and 19,8 percent as not religious at all. The present comparison contrasts the subgroups self-rated as very religious (n=57) and as not religious at all (n=50). Of the very religious adolescents, 12,5 percent consumed marijuana more frequently than once per month, as compared to 41,7 percent of those who considered themselves as not religious at all (8,643; 2gl; p=0,013). The very religious adolescents felt sad and nervous more commonly than the not religious at all (22,7 percent vs 12,5 percent; X2=5,175;2 gl; p=0,075); they reported a lower frequency of beating others (p=0,05), a lesser degree of participation in group fights (p=0,03), a lower frequency of shoplifting (p=0,08) and of cheating behaviors (p=0,002).

Specificity of coenzyme Q10 for a balanced function of respiratory chain and endogenous ubiquinone biosynthesis in human cells.

Coenzyme Q (Q) is an obligatory component of both respiratory chain and uncoupling proteins. Also, Q acts as an antioxidant in cellular membranes. Several neurodegenerative diseases are associated with modifications of Q10 levels. For these reasons, therapies based on Q supplementation in the diet are currently studied in order to mitigate the symptoms of these diseases. However, the incorporation of exogenous Q also affects aging process in nematodes probably affecting reactive oxygen species (ROS) production. The aim of the present work is to clarify if supplementation with both Q10 and Q6 isoforms affects mitochondrial Q10 content, respiratory chain activity and ROS levels in human cells. Cells incorporated exogenously added Q10 and Q6 isoforms into mitochondria that produced changes in mitochondrial activity depending on the side chain length. Supplementation with Q10, but not with Q6, increased mitochondrial Q-dependent activities. However, Q6 affected the mitochondrial membrane potential, ROS production, and increased the protein levels of both catalase and Mn-superoxide dismutase (Mn-SOD). Also, Q6 induced a transient decrease in endogenous mitochondrial Q10 levels by increasing its catabolism. These results show that human cells supplemented with Q6 undergo a mitochondrial impairment, which is not observed with Q10 supplementation.