Socio-spatial analysis of migrant school students according to Bourdieu's capitals in Santiago de Chile (2017-2020).

Chile has experienced a substantial immigration boom in the last 10 years. The urban areas of this nation present high levels of residential segregation, represented in its main city, Santiago. This article presents results of an exploratory analysis of the relationship between residential segregation, immigration rate by educational institutions and changes in school performance. Based on the generation of clusters characterized by cultural, social, economic and symbolic capital, an analysis of the changes in school performance in those schools that received the greatest number of migrants is generated.

Manifestaciones orales del COVID-19 en Paraguay: resultados de una encuesta en línea

Introducción: Estudios previos han reportado que pacientes infectados con el virus del COVID-19, podrían manifestar sintomatologías a nivel de la cavidad oral. Objetivo: Evaluar la frecuencia de manifestaciones orales asociadas a COVID-19 en un segmento de la población paraguaya y determinar cuáles son las más prevalentes. Metodología: Estudio descriptivo de corte transversal. Fue realizada una encuesta electrónica de enero a marzo del 2022. Los datos fueron presentados como frecuencias y porcentajes y analizados mediante la prueba de chi-cuadrado. El análisis estadístico se realizó con el software R versión 4.0.3. Resultados: La muestra estuvo compuesta por 478 personas. El 79,50 % correspondió al sexo femenino y el 45,19 % tenía entre 25 y 34 años. El 65,48 % informó haber experimentado al menos 1 síntoma o signo oral durante el curso de COVID-19. La pérdida de la sensación de sabores amargos, seguida de la alteración del sabor de los alimentos y la pérdida de la percepción dulce, fueron los síntomas más comunes. Se encontró una proporción significativamente mayor de manifestaciones orales en el rango de 18-24 años (χ²; p= 0,003). Entre las personas que desarrollaron COVID-19 de forma moderada a severa hubo mayor número de manifestaciones de síntomas orales (χ²; p= 0,044). Discusión: Se identificó una alta frecuencia de manifestaciones orales en pacientes con casos de moderados a severos de COVID-19, destacándose los trastornos del gusto como los más predominantes. Los individuos más jóvenes fueron los más afectados.

Introduction: Previous studies have reported that patients infected with the COVID-19 virus could manifest symptoms in the oral cavity. Objective: To evaluate the frequency of oral manifestations associated with COVID-19 in a segment of the Paraguayan population and determine the most prevalent ones. Methods: Descriptive cross-sectional study. An electronic survey was conducted from January to March 2022. The data were presented as frequencies and percentages and analyzed using the chi-square test. Statistical analysis was performed with R software version 4.0.3. Results: The sample consisted of 478 individuals. 79.50% were female, and 45.19% were between 25 and 34 years old. 65.48% reported having experienced at least 1 oral symptom or sign during the course of COVID-19. The loss of the sensation of bitter tastes, followed by the alteration of the taste of foods and the loss of sweetness perception, were the most common symptoms. A significantly higher proportion of oral manifestations was found in the 18-24 age range (χ²; p= 0.003). Among people who developed COVID-19 in a moderate to severe form, a greater number of oral symptom manifestations were observed (χ²; p= 0.044). Discussion: A high frequency of oral manifestations was identified in patients with moderate to severe cases of COVID-19, with taste disorders standing out as the most predominant. Younger individuals were the most affected.

Mortality Prognosis Factors in Patients with Active Cancer Under Treatment, and Severe COVID-19.

BACKGROUND: COVID-19 is associated with systemic inflammation. This inflammatory response is further deregulated by oncological treatments increasing mortality in this population. However, there is conflicting information regarding the clinical factors that increase mortality in patients with severe COVID-19. OBJECTIVE: The aim of this study was to identify prognostic factors associated with mortality during severe COVID-19 in patients with active cancer. In addition, the correlation between oncologic codes and mortality related to severe COVID-19 was evaluated. PATIENTS AND METHODS: We analyzed a cohort of Mexican patients with active cancer and severe COVID-19 between March 2020 and February 2021. We collected information on patient demographic characteristics, COVID-19 symptoms, clinical and laboratory data, and treatments. Patients were classified according to oncologic code. We defined the oncological code based on clinical stage, treatment intention, performance status before COVID-19, and median overall survival with palliative treatment. A log-rank test was performed to determine survival. A multivariate logistic regression model was used to adjust for potential confounders. RESULTS: One hundred fifty-two patients with severe COVID-19 were analyzed. The red oncologic code was associated with an increased risk of mortality OR 22.8 (CI 95% 5.0-105.1, p <0.001), low oxygen saturation OR 5.4 (CI 95% 1.7-17.4, p = 0.005), chronic corticosteriod use OR 4.3 (CI 95% 1.0-18.1, p = 0.050) and high D-dimer level OR 3.2 (CI 95% 1.2-8.2, p = 0.019). CONCLUSIONS: The survival of patients with active cancer and severe COVID-19 was possible to identify, at the time of admission, specific oncological characteristics. Based on this code, decreased oxygen saturation, increased D-dimer levels, and chronic corticosteroid use were the main predictive factors related to mortality.

Visual findings in children exposed to Zika in utero in Nicaragua.

Knowledge regarding the frequency of ocular abnormalities and abnormal visual function in children exposed to Zika virus (ZIKV) in utero but born without congenital Zika syndrome (CZS) is limited. We hypothesized that children exposed to ZIKV in utero born without CZS may have visual impairments in early childhood. We performed ophthalmic examination between 16 and 21 months of age and neurodevelopment assessment at 24 months of age with the Mullen Scales of Early Learning test (MSEL) on children enrolled in a cohort born to women pregnant during and shortly after the ZIKV epidemic in Nicaragua (2016-2017). ZIKV exposure status was defined based on maternal and infant serological testing. Visual impairment was defined as abnormal if the child had an abnormal ophthalmic exam and/or low visual reception score in the MSEL assessment. Of 124 children included in the analysis, 24 (19.4%) were classified as ZIKV-exposed and 100 (80.6%) unexposed according to maternal or cord blood serology. Ophthalmic examination showed that visual acuity did not differ significantly between groups, thus, 17.4% of ZIKV-exposed and 5.2% of unexposed had abnormal visual function (p = 0.07) and 12.5% of the ZIKV-exposed and 2% of the unexposed had abnormal contrast testing (p = 0.05). Low MSEL visual reception score was 3.2-fold higher in ZIKV-exposed than unexposed children, but not statistically significant (OR 3.2, CI: 0.8-14.0; p = 0.10). Visual impairment (a composite measure of visual function or low MESL visual reception score) was present in more ZIKV-exposed than in unexposed children (OR 3.7, CI: 1.2, 11.0; p = 0.02). However, the limited sample size warrants future investigations to fully assess the impact of in utero ZIKV exposure on ocular structures and visual function in early childhood, even in apparently healthy children.

Self-Medication Practices, Use of Brand-Name, and Over-the-Counter Medicines by Peruvian Older Adults.

Background: Older adults are a particularly vulnerable group to drug use and self-medication. The aim of the study was to evaluate self-medication as a factor associated with the purchase of brand-name and over-the-counter (OTC) drugs in older adults in Peru. Methods: A secondary analysis was performed using an analytical cross-sectional design of data from a nationally representative survey from 2014 to 2016. The exposure variable was self-medication, defined as the purchase of medicines without a prescription. The dependent variables were purchases of brand-name and OTC drugs, both as a dichotomous response (yes/no). Information of sociodemographic variables, health insurance, and the types of drugs purchased by the participants was collected. Crude prevalence ratios (PR) were calculated and adjusted using generalized linear models of the Poisson family, considering the complex sample of the survey. Results: In this study, 1,115 respondents were evaluated, with a mean age of 63.8 years and a male proportion of 48.2%. The prevalence of self-medication was 66.6%, while the proportions of purchases of brand-name and OTC drugs were 62.4% and 23.6%, respectively. The adjusted Poisson regression analysis revealed an association between self-medication and the purchase of brand-name drugs (adjusted PR [aPR]=1.09; 95% confidence interval [CI]: 1.01-1.19). Likewise, self-medication was associated with the purchase of OTC medications (aPR=1.97; 95%CI: 1.55-2.51). Conclusions: This study evidenced a high prevalence of self-medication in Peruvian older adults. Two-thirds of the surveyed people bought brand-name drugs, whereas one-quarter bought OTC drugs. Self-medication was associated with a greater likelihood of buying brand-name and OTC drugs.

Viroscope: Plant viral diagnosis from high-throughput sequencing data using biologically-informed genome assembly coverage.

High-throughput sequencing (HTS) methods are transforming our capacity to detect pathogens and perform disease diagnosis. Although sequencing advances have enabled accessible and point-of-care HTS, data analysis pipelines have yet to provide robust tools for precise and certain diagnosis, particularly in cases of low sequencing coverage. Lack of standardized metrics and harmonized detection thresholds confound the problem further, impeding the adoption and implementation of these solutions in real-world applications. In this work, we tackle these issues and propose biologically-informed viral genome assembly coverage as a method to improve diagnostic certainty. We use the identification of viral replicases, an essential function of viral life cycles, to define genome coverage thresholds in which biological functions can be described. We validate the analysis pipeline, Viroscope, using field samples, synthetic and published datasets, and demonstrate that it provides sensitive and specific viral detection. Furthermore, we developed Viroscope.io a web-service to provide on-demand HTS data viral diagnosis to facilitate adoption and implementation by phytosanitary agencies to enable precise viral diagnosis.

Pancreatic Cancer Cells Induce MicroRNA Deregulation in Platelets.

Pancreatic cancer is a pathology with a high mortality rate since it is detected at advanced stages, so the search for early-stage diagnostic biomarkers is essential. Liquid biopsies are currently being explored for this purpose and educated platelets are a good candidate, since they are known to present a bidirectional interaction with tumor cells. In this work, we analyzed the effects of platelets on cancer cells' viability, as determined by MTT, migration using transwell assays, clonogenicity in soft agar and stemness by dilution assays and stem markers' expression. We found that the co-culture of platelets and pancreatic cancer cells increased the proliferation and migration capacity of BXCP3 cells, augmented clonogenicity and induced higher levels of Nanog, Sox2 and Oct4 expression. As platelets can provide horizontal transfer of microRNAs, we also determined the differential expression of miRNAs in platelets obtained from a small cohort of pancreatic cancer patients and healthy subjects. We found clear differences in the expression of several miRNAs between platelets of patients with cancer healthy subjects. Moreover, when we analyzed microRNAs from the platelets of the pancreatic juice and blood derived from each of the cancer patients, interestingly we find differences between the blood- and pancreatic juice-derived platelets suggesting the presence of different subpopulations of platelets in cancer patients, which warrant further analysis.

Small RNA Differential Expression Analysis Reveals miRNAs Involved in Dormancy Progression in Sweet Cherry Floral Buds.

In sweet cherry (Prunus avium), as in other temperate woody perennials, bud dormancy allows for survival in adverse environmental conditions during winter. During this process, environmental signals such as short days and/or low temperatures trigger internal signals that enable buds to become tolerant to the cold. The process involves tracking chilling units up to chilling the requirement fulfillment to resume growth, a transition involving transcriptional regulation, metabolic signaling, and epigenetic-related regulatory events. Massive sequencing of small RNAs was performed to identify miRNAs involved in sweet cherry dormancy by comparing their expression in field (regular seasonal) and controlled non-stop (continuous) chilling conditions. miRNAs highlighted by sequencing were validated using specific stem-loop PCR quantification, confirming expression patterns for known miRNAs such as miR156e, miR166c, miR172d, miR391, miR482c, and miR535b, as well as for newly proposed miRNAs. In silico prediction of the target genes was used to construct miRNA/target gene nodes. In particular, the involvement of the sweet cherry version for the miR156/SQUAMOSA PROMOTER-BINDING-LIKE PROTEIN genes whose expression was opposite in the two conditions suggests their involvement on dormancy regulation in sweet cherry. miRNA levels indicate that the regulation of stress-related genes and hormone synthesis modulates the expression of calcium metabolism and cell development-associated genes. Understanding the regulatory networks involved in sweet cherry dormancy, particularly in the context of miRNA involvement, represents the first step in the development of new agricultural strategies that may help overcome the increasing challenges presented by global climate change.

Tromboembolismo pulmonar como forma de presentación de neurofibrosarcoma cardíaco

RESUMEN Los tumores cardíacos pueden provocar síncope, falla cardíaca, fenómenos embólicos y muerte. Se requiere un elevado índice de sospecha debido a la similitud clínica con otras enfermedades sistémicas. Se describe el caso de una mujer de 26 años que empezó con dificultad respiratoria, tos, expectoración hemoptoica, hipotensión arterial y manifestaciones de insuficiencia cardíaca a predominio derecho. La ecocardiografía mostró una masa tumoral en aurícula derecha y múltiples imágenes de trombos a nivel del tronco de la arteria pulmonar, con signos de disfunción ventricular derecha e hipertensión pulmonar grave. Fue intervenida quirúrgicamente, pero el tumor era irresecable, pues infiltraba el pericardio y la vena cava inferior. La paciente falleció un día después de la operación. El estudio histológico confirmó que el tumor era un neurofibrosarcoma.

ABSTRACT Cardiac tumors can cause syncope, heart failure, embolic events, and death. A high index of suspicion is required due to the clinical similarity with other systemic diseases. Here is described the case of a 26-year-old woman who began with respiratory distress, cough, hemoptoic expectoration, low blood pressure and manifestations of heart failure predominantly on the right. The echocardiography showed a tumor mass in the right atrium and multiple images of thrombi at the level of the pulmonary artery trunk, with signs of right ventricular dysfunction and severe pulmonary hypertension. She underwent surgery, but the tumor was unresectable, as it infiltrated the pericardium and the inferior vena cava. The patient died one day after surgery. The histological study confirmed that the tumor was a neurofibrosarcoma.

Adherence with positive airway pressure therapy for obstructive sleep apnea in developing vs. developed countries: a big data study.

STUDY OBJECTIVES: Minimal focus has been placed on variations in health care delivery for obstructive sleep apnea (OSA). This study compared positive airway pressure usage in developing countries (Brazil and Mexico) vs. a developed country (United States) and investigated the impact of a patient engagement tool (myAir; ResMed, San Diego, CA) on adherence. METHODS: Deidentified data from the AirView database (ResMed) for patients receiving positive airway pressure therapy with wirelessly connected Air10 (AirSense and AirCurve) devices in Brazil, Mexico, and the United States were analyzed. Adherence was defined using US Center for Medicare and Medicaid Services (CMS) criteria (usage ≥ 4 h/night on ≥ 70% of nights in the first 90 days). RESULTS: The analysis included 4,181,490 patients (Brazil: 31,672; Mexico 16,934; United States: 4,132,884). CMS adherence over 90 days was slightly lower in Latin America vs. the United States (Brazil: 71.7%; Mexico: 66.4%; United States: 74.0%). Significantly fewer patients were using the patient engagement tool in Brazil (8.1%) and Mexico (2.8%) vs. the United States (26%; both P < .001). Patients registered to use an engagement tool had a higher rate of CMS adherence and were twice as likely to achieve CMS adherence. Average daily usage and days with usage > 4 hours in the first week were the strongest predictors of CMS adherence. Across all countries, > 80% of patients meeting CMS criteria at 3 months were still using positive airway pressure therapy at 1 year, with 1-year adherences rates of > 75%. CONCLUSIONS: Short-term and long-term positive airway pressure adherence rates in Brazil and Mexico were similar to those achieved in the United States. Patients who registered to use an engagement tool consistently had better adherence than those who did not.

Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis.

BACKGROUND: There is a scarcity of published data on the global prevalence of obstructive sleep apnoea, a disorder associated with major neurocognitive and cardiovascular sequelae. We used publicly available data and contacted key opinion leaders to estimate the global prevalence of obstructive sleep apnoea. METHODS: We searched PubMed and Embase to identify published studies reporting the prevalence of obstructive sleep apnoea based on objective testing methods. A conversion algorithm was created for studies that did not use the American Academy of Sleep Medicine (AASM) 2012 scoring criteria to identify obstructive sleep apnoea, allowing determination of an equivalent apnoea-hypopnoea index (AHI) for publications that used different criteria. The presence of symptoms was not specifically analysed because of scarce information about symptoms in the reference studies and population data. Prevalence estimates for obstructive sleep apnoea across studies using different diagnostic criteria were standardised with a newly developed algorithm. Countries without obstructive sleep apnoea prevalence data were matched to a similar country with available prevalence data; population similarity was based on the population body-mass index, race, and geographical proximity. The primary outcome was prevalence of obstructive sleep apnoea based on AASM 2012 diagnostic criteria in individuals aged 30-69 years (as this age group generally had available data in the published studies and related to information from the UN for all countries). FINDINGS: Reliable prevalence data for obstructive sleep apnoea were available for 16 countries, from 17 studies. Using AASM 2012 diagnostic criteria and AHI threshold values of five or more events per h and 15 or more events per h, we estimated that 936 million (95% CI 903-970) adults aged 30-69 years (men and women) have mild to severe obstructive sleep apnoea and 425 million (399-450) adults aged 30-69 years have moderate to severe obstructive sleep apnoea globally. The number of affected individuals was highest in China, followed by the USA, Brazil, and India. INTERPRETATION: To our knowledge, this is the first study to report global prevalence of obstructive sleep apnoea; with almost 1 billion people affected, and with prevalence exceeding 50% in some countries, effective diagnostic and treatment strategies are needed to minimise the negative health impacts and to maximise cost-effectiveness. FUNDING: ResMed.

Appendiceal carcinoma associated with microsatellite instability.

Approximately 15% of colorectal cancer (CRC) cases exhibit microsatellite instability (MSI), which appears to be associated with unique biological behavior. The present study presents a case of appendiceal carcinoma associated with MSI that responded well to adjuvant chemotherapy. Clinical, pathological and immunohistochemical (IHC) characteristics have been described. The 60-year-old male patient had suffered from recurrent lower abdominal pain associated with abdominal distention for 6 months; then, following an acute attack, he was subjected to laparoscopic appendectomy. The histopathological examination revealed moderately differentiated appendiceal adenocarcinoma with mucinous areas, without lymphovascular or perineural invasion. The IHC examination was positive for keratin-20 and caudal type homeobox 2, and negative for MutL Homolog 1, MutS Homolog (MSH) 2 and MSH-6. A postoperative colonoscopy revealed diverticulosis, without the presence of polyps or tumors. However, an abdominal axial computerized tomography scan revealed thickening of the distal portion of the appendix, increased density of the greater omentum, and metastases to the liver capsule, spleen and peritoneum. The treatment of choice was right hemicolectomy with peritoneal debulking, followed by 10 cycles of chemotherapy with 5-fluorouracil, leucovorin and oxaliplatin (FOLFOX regimen). After 5 years of follow-up, the patient remains in good condition, without clinical or radiological signs of recurrence. The good response to chemotherapy corresponds with the observations made in other colon cancers with MSI. Therefore, testing for MSI in appendiceal carcinomas may provide useful information on prognosis and predict response to chemotherapy.

Comparative study of post-growth annealing of Cu(hfac)2, Co2(CO)8 and Me2Au(acac) metal precursors deposited by FEBID.

Non-noble metals, such as Cu and Co, as well as noble metals, such as Au, can be used in a number modern technological applications, which include advanced scanning-probe systems, magnetic memory and storage, ferroelectric tunnel junction memristors, metal interconnects for high performance integrated circuits in microelectronics and nano-optics applications, especially in the areas of plasmonics and metamaterials. Focused-electron-beam-induced deposition (FEBID) is a maskless direct-write tool capable of defining 3-dimensional metal deposits at nanometre scale for above applications. However, codeposition of organic ligands when using organometallic precursors is a typical problem that limits FEBID of pure metal nanostructures. In this work, we present a comparative study using a post-growth annealing protocol at 100, 200, and 300 °C under high vacuum on deposits obtained from Co2(CO)8, Cu(II)(hfac)2, and Me2Au(acac) to study improvements on composition and electrical conductivity. Although the as-deposited material was similar for all precursors, metal grains embedded in a carbonaceous matrix, the post-growth annealing results differed. Cu-containing deposits showed the formation of pure Cu nanocrystals at the outer surface of the initial deposit for temperatures above 100 °C, due to the migration of Cu atoms from the carbonaceous matrix containing carbon, oxygen, and fluorine atoms. The average size of the Cu crystals doubles between 100 and 300 °C of annealing temperature, while the composition remains constant. In contrast, for Co-containing deposits oxygen release was observed upon annealing, while the carbon content remained approximately constant; the cobalt atoms coalesced to form a metallic film. The as-deposited Au-containing material shows subnanometric grains that coalesce at 100 °C, maintaining the same average size at annealing temperatures up to 300 °C. Raman analysis suggests that the amorphous carbonaceous matrix of the as-written Co, Cu and Au deposits turned into nanocrystalline graphite with comparable crystal sizes of 12-14 nm at 300 °C annealing temperature. However, we observed a more effective formation of graphite clusters in Co- than in Cu- and Au-containing deposits. The graphitisation has a minor influence on the electrical conductivity improvements of Co-C deposits, which is attributed to the high as-deposited Co content and the related metal grain percolation. On the contrary, electrical conductivity improvements by factors of 30 and 12 for, respectively, Cu-C and Au-C deposits with low metal content are mainly attributed to the graphitisation. This relatively simple vacuum-based post-growth annealing protocol may be useful for other precursors as it proved to be efficient in reliably tuning the electrical properties of as-deposited FEBID materials. Finally, a H2-assisted gold purification protocol is demonstrated at temperatures around 300 °C by fully removing the carbon matrix and drastically reducing the electrical resistance of the deposit.

Leaf acclimation strategies to contrasting light conditions in saplings of different shade tolerance in a tropical cloud forest.

To study the acclimation responses of the leaves of saplings of six tree species when changed to low or high levels of irradiance, we carried out a light exposure experiment. Species representative of contrasting shade tolerance groups were identified across a light gradient in the understorey of a Venezuelan Andean cloud forest. Measured traits included gas exchange, chlorophyll fluorescence, and morphoanatomical, biochemical and optical properties. Saplings were grown for 6 months in a shade-house receiving 20% photosynthetic photon flux (PPF) of full sunlight. Plant samples were then moved to shade-houses receiving low PPF (4%) or high PPF (65%). A factorial model (species×PPF), with repeated measurements (0, 15 and 120 days) was designed. Our results showed that morphological and anatomical traits were more plastic to PPF changes than photosynthetic traits. All species were susceptible to photoinhibition (15 days): shade-intolerant species showed dynamic photoinhibition (120 days), whereas shade-tolerant species presented chronic photoinhibition and the consequent inability to increase C assimilation rates under high PPF. The partially shade-tolerant species showed mixed responses; nonetheless, they exhibited larger adjustments in morphoanatomical and optical properties. Thus the acclimation responses of these species when subject to contrasting light conditions could help to explain their distribution along the light gradient in the understorey.

Factors associated to inpatient mortality rates in type-2-diabetic patients: a cross-sectional analytical study in three Peruvian hospitals. / Factores asociados a mortalidad intrahospitalaria en pacientes con diabetes mellitus tipo 2: estudio transversal analítico en tres hospitales peruanos.

INTRODUCTION: Diabetes mortality has increased in recent years. In Peru, there are few studies on in-hospital mortality due to type 2 diabetes in the provinces. OBJECTIVE: To determine factors associated to hospital mortality in patients with diabetes mellitus type 2 in three hospitals from Cusco-Peru. METHODS: An analytical cross-sectional study was performed. All patients with diabetes mellitus type 2 hospitalized in the city of Cusco during the 2016 were included. Socio-educational and clinical characteristics were evaluated, with "death" as the variable of interest. The crude (cPR) and adjusted (aPR) prevalence ratios were estimated using generalized linear models with Poisson family and log link function, with their respective 95% confidence intervals (95% CI). The values p <0.05 were considered significant. RESULTS: A total of 153 patients were studied; 33.3% (51) died in the hospital. The mortality rate increased when the following factors were associated: age of the patients increased the mortality rate by one-year increments (aPR: 1.02; CI95%: 1.01-1.03; p<0.001); to have been admitted by the emergency service (aPR: 1.93; CI95%: 1.34-2.77; p<0.001); being a patient who is readmitted to the hospital (aPR: 2.01; CI95%: 1.36-2.98; p<0.001); and patients who have had a metabolic in-hospital complication (aPR: 1.61; CI95%: 1.07-2.43; p=0.024) or renal in-hospital complications (aPR: 1.47; CI95%: 1.30-1.67; p<0.001). Conversely, the mortality rate was reduced when admission was due to a urinary tract infection (aPR: 0.50; CI95%: 0.35-0.72; p<0.001); adjusted by seven variables. CONCLUSIONS: A third of hospitalized diabetes mellitus type 2 patients died during the study period. Mortality was increased as age rises, patients admitted through emergency rooms, patients who were readmitted to the hospital, and patients who had metabolic or renal complications. Patients admitted for a urinary tract infection had a lower mortality rate.

INTRODUCCIÓN: La mortalidad por diabetes se ha incrementado en los últimos años. En Perú, existen escasos estudios acerca de la mortalidad intrahospitalaria por diabetes en provincias. OBJETIVOS: Determinar los factores asociados a mortalidad intrahospitalaria en pacientes con diabetes mellitus tipo 2 en tres hospitales de la sierra sur del Perú. MÉTODOS: Se realizó un estudio de corte transversal analítico. Se incluyó a todos los pacientes con diabetes mellitus tipo 2 hospitalizados en la ciudad del Cusco durante el año 2016. Se evaluó las características socioeducativas y clínicas, teniendo a la “defunción” como variable de interés. Se calculó las razones de prevalencias crudas y ajustadas, mediante los modelos lineales generalizados, con familia Poisson y función de enlace log, con sus respectivos intervalos de confianza al 95%. Se consideró significativos los valores p < 0,05. RESULTADOS: De los 153 pacientes, el 33,3% (51) murió en la hospitalización. Incrementó la frecuencia de mortalidad: por cada año de edad del paciente (razón de prevalencias ajustada 1,02; intervalo de confianza 95%: 1,01 a 1,03; valor p < 0,001), por haber ingresado por el servicio de emergencia (razón de prevalencias ajustada 1,93; intervalo de confianza 95%: 1,34 a 2,77; valor p < 0,001), por ser un paciente que reingresa al hospital (razón de prevalencias ajustada 2,01; intervalo de confianza 95%: 1,36 a 2,98; valor p < 0,001) y por haber tenido una complicación hospitalaria metabólica (razón de prevalencias ajustada 1,61; intervalo de confianza 95%: 1,07 a 2,43; valor p = 0,024) o renal (razón de prevalencias ajustada 1,47; intervalo de confianza 95%: 1,30 a 1,67; valor p < 0,001). En cambio, disminuyó la frecuencia mortalidad el que su causa de hospitalización haya sido por una infección del tracto urinario (razón de prevalencia ajustada 0,50; intervalo de confianza 95%: 0,35 a 0,72; valor p < 0,001); ajustado por siete variables. CONCLUSIONES: La edad, el ingresar por emergencia y el presentar reingresos a la hospitalización fueron factores asociados a mortalidad; así como el presentar complicaciones intrahospitalarias de tipo metabólica o renal.

Un Cuestionario de actitudes hacia la Política validado en habitantes de la ciudad de Arequipa, Perú / An attitude toward Politics Questionnaire validated in habitants from Arequipa City, Peru / Um Questionário de atitudes à Política validado em habitantes da cidade de Arequipa, Peru / Un Questionnaire d'attitudes vers la Politique validé chez des habitants de la ville d'Arequipa, du Pérou

En este artículo se describe el proceso de construcción y validación del Cuestionario de Actitudes hacia la Política que constaba de 12 ítems, formulados por Arias y Timaná. Para ello se trabajó con una muestra de 875 personas (47.54% varones y 52.46% mujeres) con una edad media de 38 años, dentro de un rango de 18 a 92 años. Todos provienen de 11 distritos de la ciudad de Arequipa, en Perú. En el procesamiento estadístico, se eliminó el ítem 8, por lo que el instrumento se compone de 11 reactivos con correlaciones ítem-test superiores a 0.427. La prueba tiene una estructura factorial de dos factores: Gobernabilidad y Participación política, que explican el 41.714% del total de la varianza. Cuentan además, con índices de confiabilidad adecuados para cada uno de ellos (α= 0.745 y α= 0.730, respectivamente). Se presentan los percentiles para su valoración y aplicación con fines de investigación en el campo de la psicología política y ciencias afines.

In this article we describe the process of construction and validation of the Attitude toward Politics Questionnaire which contains 12 items, written by Arias and Timaná. We tested a simple of 875 people (47.54% male and 52.46% female) with an average age of 38 years, into the range of 18 to 92 years old. All of them came from 11 districts at Arequipa City, in Peru. In the statistical process, one item was eliminated, so the questionnaire is composed by 11 items with item-test correlations higher than 0.427. The test has a bifactorial structure: Governability and Politic participation, which explain the 41.714% of the variance as total. The test counts with adequate reliability values for each factor (α= 0.745 and α= 0.730, respectively). We present the percentile values for its application in investigation, into de field of politic psychology and related sciences.

O seguinte artigo descreve o processo de construção e validação do Questionário de Atitudes à Política, conformado por 12 itens propostos por Arias e Timaná. Trabalhou-se com uma amostra de 875 pessoas (47.54 % homens e 52.46 % mulheres), com uma idade média de 38 anos (faixa 18-92). Todas moravam em 11 distritos da cidade de Arequipa, no sul do Peru. No processamento estatístico, foi eliminado o item 8, pelo que o instrumento fica composto de 11 reativos com correlações item - test superiores de 0.427. A prova tem uma estrutura fatorial de dois fatores: governabilidade e participação política, que explicam o 41.714 % do total da varianza. Além disso, tem índices de fiabilidade apropriados para cada um deles (α= 0.745 e α= 0.730, respetivamente). Se apresentam os percentis para ser valorados e para sua aplicação para pesquisa no campo da psicologia política e ciências afines.

Dans cet article qu'il est décrit, le processus de construction et la validation du Questionnaire d'Attitudes vers la Politique qui se composait de 12 articles, formulés par des Arias et Timaná. Pour cela il a étudié avec un échantillon de 875 personnes (47.54 % un hommes et 52.46 % une femmes) avec un âge moyen de 38 ans, à l'intérieur d'un rang de 18 à 92 ans. Tous proviennent de 11 districts de la ville d'Arequipa, au Pérou. Dans l'accusation statistique, 8 a éliminé l'article, par ce que l'instrument s'arrange de 11 réactifs avec corrélations un article - test supérieur à 0.427. La preuve a une structure factorial de deux facteurs : la Gouvernabilité et la Participation politique qu'ils expliquent 41.714 % du total le varianza. Ils racontent de plus, avec les indices de fiabilité appropriés à chacun d'eux (à = 0.745 et à = 0.730, respectivement). Les percentiles se présentent pour son évaluation et application aux fins de recherche dans le domaine de la psychologie politique et des sciences contiguës.

[Geographical distribution and habitat of Trochilidae (Aves) in the state of Guerrero, Mexico]. / Distribución geográfica y habitat de la familia Trochillidae (Aves) en el estado de Guerrero, México.

The distribution and abundance of species of Trochillidae family is usually influenced by the flowering and phenology of plants used as a feeding source, mainly in primary forest, so that changes in vegetation cover could impact their populations. We analyzed and characterized the geographical distribution and habitat for 22 species of resident hummingbirds in the state of Guerrero using the vegetation and the land use map of INEGI Series IV (2007-2010). Distribution models were generated with the Genetic Algorithm for Rule Set Production (GARP), using historical records of scientific collections and fieldwork (2001-2009), in combination with climatic and topographic variables. Of the 22 modeled species, six are endemic to Mexico, the same number of species found in a risk category. The highest concentration with regards to richness (14-20 species), endemism (5-6 species) and number of threatened species of hummingbirds (5-6 species) occurred in the biotic province of Sierra Madre del Sur. However, the potential distribution of most of the hummingbirds occurred in disturbed sites or agroecosystems, as a result of changes in land-use. For Campylopterus hemileucurus, Lamprolaima rhami and Heliomaster longisrostris, their potential distribution was highest in areas of primary vegetation. Areas of high hummingbirds presence do not coincide with the Important Bird Areas proposed for bird conservation in Guerrero, considering that, despite its diversity and its extreme popularity, from the conservation perspective hummingbirds have received relatively little attention.

Multiple Skeletal Deformities in a Middle-Aged Man.

A 54-year-old man was seen in our endocrinology clinic with evidence of a limited range of motion in his left foot. He had a history of diabetes mellitus type 2 and atrial fibrillation. His family history included evidence of skeletal deformities in some of his relatives. This could imply the potential existence of a hereditary condition. It is worth noting that spontaneous mutations have been reported in some cases. A pertinent physical examination revealed a surgical scar on the patient's left knee, a hallux valgus deformity on his left foot with compromised joint function, and painless bony prominences on that same foot. The skeletal survey findings were consistent with multiple hereditary exostoses. Multiple osteochondromatosis (MO) is a rare genetic disorder associated with serious complications that may significantly affect the health related quality of life of anyone having the disorder. To prevent further complications, these patients require long-term follow-up with regular clinical and radiological examinations.

Ambigüedad sexual por hiperplasia suprarrenal congénita perdedora de sal por deficiencia de 21- hidroxilasa: Reporte de un caso / Sexual ambiguity by salt-wasting congenital adrenal hyperplasia due to 21-hydroxylase deficiency: A case report

Introducción: Los trastornos de la diferenciación sexual por hiperplasia suprarrenal congénita son relativamente frecuentes y demandan una adecuada atención que garantice tanto un diagnóstico rápido como un manejo de los posibles trastornos que los acompañan. Reporte: Paciente de 18 días de edad acude con cuadro de pérdida excesiva de peso, deshidratación, genitales no diferenciados. Interpretación: Se diagnosticó hiperplasia suprarrenal congénita perdedora de sal por deficiencia de 21-hidroxilasa, un caso bastante extraño en nuestro entorno, siendo importante identificar el caso en la brevedad posible.