Simultaneous Transcatheter Aortic Valve Implantation and Endovascular Aneurysm Repair for Severe Aortic Stenosis and Symptomatic Abdominal Aortic Aneurysm: Mini Review.

Background: The treatment of patients with severe aortic stenosis (SAS) who concomitantly present with abdominal aortic aneurysm (AAA) is not defined. Aortic valve replacement surgery, performed alone, increases the risk of AAA rupture. Transcatheter aortic valve replacement (TAVR) and endovascular abdominal aortic aneurysm repair (EVAR) in the same intervention, especially in high-risk patients, is a safe alternative. Purpose: We report a case of simultaneous endovascular treatment of SAS and AAA and a mini literature review of nineteen cases with similar characteristics. Research design: Case report and literature review. Data Collection: An electronic search of PubMed and Scopus was performed from inception to December 2023. Results: Nineteen case reports of simultaneous transcatheter aortic valve repair and endovascular aneurysm repair for SAS and symptomatic AAA were identified published in the literature. Conclusions: We regard the simultaneous endovascular approach to both pathologies as a promising treatment alternative for selected patients with severe aortic stenosis and abdominal aortic aneurysm. We highlight the need to conduct randomized clinical trials in this patient population.

Possible technical aspects involved in the development of GERD after sleeve gastrectomy: Surgical technique considerations.

Sleeve gastrectomy (SG) is the most common bariatric surgery worldwide and has shown to cause de novo or worsen symptoms of gastroesophageal reflux disease (GERD). Esophageal motility and physiology studies are mandatory in bariatric and foregut centers. The predisposing factors in post-SG patients are disruption of His angle, resection of gastric fold and gastric fundus, increased gastric pressure, resection of the gastric antrum, cutting of the sling fibers and pyloric spasm. There are symptomatic complications due to sleeve morphology as torsion, incisura angularis stenosis, kinking and dilated fundus. In this article, we present recommendations, surgical technique and patient selection flow diagram for SG and avoid de novo or worsening GERD.

Real-time evaluation of the biocompatibility of calcium silicate-based endodontic cements: An in vitro study.

INTRODUCTION: An ideal filling material should hermetically seal the communication pathways between the canal system and surrounding tissues. Therefore, during the last few years, the development of obturation materials and techniques to create optimal conditions for the proper healing of apical tissues has been a focus of interest. The effects of calcium silicate-based cements (CSCs) on periodontal ligament cells have been investigated, and promising results have been obtained. To date, there are no reports in the literature that have evaluated the biocompatibility of CSCs using a real-time live cell system. Therefore, this study aimed to evaluate the real-time biocompatibility of CSCs with human periodontal ligament cells (hPDLCs). METHODOLOGY: hPDLC were cultured with testing media of endodontic cements for 5 days: TotalFill-BC Sealer, BioRoot RCS, Tubli-Seal, AH Plus, MTA ProRoot, Biodentine, and TotalFill-BC RRM Fast Set Putty. Cell proliferation, viability, and morphology were quantified using real-time live cell microscopy with the IncuCyte S3 system. Data were analyzed using the one-way repeated measures (RM) analysis of variance multiple comparison test (p < .05). RESULTS: Compared to the control group, cell proliferation in the presence of all cements was significantly affected at 24 h (p < .05). ProRoot MTA and Biodentine lead to an increase in cell proliferation; there were no significant differences with the control group at 120 h. In contrast, Tubli-Seal and TotalFill-BC Sealer inhibited cell growth in real-time and significantly increased cell death compared to all groups. hPDLC co-cultured with sealer and repair cements showed a spindle-shaped morphology except with cements Tubli-Seal and TotalFill-BC Sealer where smaller and rounder cells were obtained. CONCLUSIONS: The biocompatibility of the endodontic repair cements performed better than the sealer cements, highlighting the cell proliferation of the ProRoot MTA and Biodentine in real-time. However, the calcium silicate-based TotalFill-BC Sealer presented a high percentage of cell death throughout the experiment similar to that obtained.

Antibacterial Activity of Zinc Oxide Nanoparticles in Self- Curing Acrylic Resin Against Streptococcus mutans

ABSTRACT: Antibacterial activity of zinc oxide nanoparticles in self-curing acrylic resin against Streptococcus mutans. The main objective of this study was to investigate whether nanoparticles of zinc oxide (ZnO) in self-curing acrylic resin, hav e antimicrobial properties against Streptococcus mutans, one of the microorganisms involved in the development of caries. Self- cured acrylic resin samples were prepared by incorporating ZnO nanoparticles at different concentrations based on the minimum inhibitory concentration (MIC) for Streptococcus mutans ATCC 25175. Antibacterial activity against a biofilm was evaluated in samples that were aged in artificial saliva for different times using spectral confocal laser microscopy and scanning electron microscopy. Kruskal-Wallis test using IBM SPSS Statistics version 23.0 software (SPSS Inc. ®, Chicago, IL, United States) were used, establishing the value of p <0.05 for statistical significance. The volume of the total biomass that formed in the samples aged for one day was significantly lower than the volume of the total biomass that was formed in those aged for additional days (p <0.001). Electron microscopy analysis revealed high porosity surfaces in all samples. Bacterial clusters wer e located next to large pores and irregular surfaces, while smooth surfaces had defined and linear organization cocci or simple chains. Considering the limitations of this study, the results suggest that the antibacterial activity of ZnO nanoparticles add ed to self-curing acrylic (ALIKE) is effective, mainly in fresh 1-day samples, independent of their concentration, and in samples with 16 MIC aged for 14 days, indicating it does not lose its antibacterial activity despite setting for more days. In addition, the ZnO nanoparticles added to ALIKE have the ability to inhibit the formation of biofilms, although they do not minimize the number of viable bacteria.

RESUMEN: El objetivo principal de este estudio fue investigar si nanopartículas de óxido de zinc (ZnO), incorporadas a acrílico acrilico de autocurado, tienen propiedades antimicrobianas contra Streptococcus mutans, uno de los microorganismos implicados en el desarrollo de caries. Se prepararon muestras de resina acrílica autopolimerizada mediante la incorporación de nanopartículas de ZnO a diferentes concentraciones basadas en la concentración mínima inhibitoria (MIC) para Streptococcus mutans ATCC 25175. Se evaluó la actividad antibacteriana contra una biopelícula en muestras envejecidas en saliva artificial para diferentes tiempos utilizando espectros microscopía láser confocal y microscopía electrónica de barrido. Se utilizó la prueba de Kruskal-Wallis utilizando el software IBM SPSS Statistics versión 23.0 (SPSS Inc. ®, Chicago, IL, Estados Unidos), estableciendo el valor de p <0,05 para la significancia estadística. El volumen de la biomasa total que se formó en las muestras envejecidas durante un día fue significativamente menor que el volumen de la biomasa total que se formó en las envejecidas durante días adicionales (p <0,001). El análisis de microscopía electrónica reveló superficies de alta porosidad en todas las muestras. Los cúmulos bacterianos se ubicaron junto a poros grandes y superficies irregulares, mientras que las superficies lisas tenían cocos o cadenas simples de organización lineal y definida. Considerando las limitaciones de este estudio, los resultados sugieren que la actividad antibacteriana de las nanopartículas de ZnO agregadas al acrílico autopolimerizable (ALIKE) es efectiva, principalmente en muestras frescas de 1 día, independientemente de su concentración, y en muestras con 16 MIC envejecidas para 14 días, lo que indica que no pierde su actividad antibacteriana a pesar de estar fraguada durante más días. Además, las nanopartículas de ZnO añadidas a ALIKE tienen la capacidad de inhibir la formación de biopelículas, aunque no minimizan el número de bacterias viables.

Laparoscopic splenectomy and proximal splenorenal shunt for portal hypertension due to portal vein thrombosis in a patient with protein S deficiency.

Portal vein thrombosis (PVT) is a rare condition in the general population that develops serious complications if left untreated for long time. We present a case of a 29-year-old woman who developed PVT due to protein S deficiency versus neonatal funiculitis. Over time, the patient developed upper gastrointestinal bleeding due to esophageal varices and hypersplenism with splenic sequestration that caused minor bleeding episodes. Laparoscopic splenectomy and proximal splenorenal shunt with distal pancreatectomy due to aneurysmal dilatations of the splenic artery were successfully performed to avoid mayor progression of portal hypertension. Patient was discharged with indefinite anticoagulation and after surgery platelets raised up to 200x103/mm3. Laparoscopic splenectomy and proximal splenorenal shunt for portal hypertension due to portal vein thrombosis is an adequate surgery procedure which should be applied in these medical cases.

Molecular characterization and antibacterial activity of oral antibiotics and copper nanoparticles against endodontic pathogens commonly related to health care-associated infections.

OBJECTIVE: To carry out molecular characterization and determine the antibacterial activity of oral antibiotics and copper nanoparticles (Cu-NPs) against endodontic strains isolated from persistent infections. MATERIALS AND METHODS: Root canal samples from 24 teeth in different patients with persistent endodontic infections were obtained. The isolated strains were identified by biochemical tests and 16S rDNA sequencing. Genotyping was achieved by molecular methods. The antibacterial activity of antibiotics and copper nanostructures was determined by using minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values. Furthermore, a time-kill kinetics assay was evaluated. Nonparametric tests (Kruskal-Wallis ANOVA) were performed (p value <0.05). RESULTS: Twenty-one isolated strains were identified. Six isolates of Enterococcus faecalis were grouped into two clusters of three isolates each, two of which were clones. All were clarithromycin-resistant and erythromycin. Eight Pseudomonas putida presented two clusters, two Pseudomonas spp. were not clonal, and all were resistant to the tested antibiotics except tetracycline. Two of five strains of Cutibacterium acnes were clonal, and all were resistant only to metronidazole. The lowest MIC and MBC values were obtained with Cu-NPs. Time-kill kinetics using Cu-NPs showed a significant decrease in all tested species within 4 h and reached 100% in 2 h for C. acnes. CONCLUSION: In this study, in relation to health care-associated infections, endodontic strains of each species isolated at least in one patient were polyclonal. In Pseudomonas spp., at least one clone was shared between patients. E. faecalis and C. acnes strains were susceptible to low Cu-NP concentrations, while Pseudomonas spp. strains were resistant. CLINICAL RELEVANCE: Assessing and keeping track of the susceptibility of clinical strains to antimicrobial compounds is important for the clinical outcome. Based on our results, Cu-NPs could be an alternative for endodontic treatment, in order to avoid selection of resistant strains.

Laparoscopic splenectomy and proximal splenorenal shunt for portal hypertension due to portal vein thrombosis in a patient with protein S deficiency

Portal vein thrombosis (PVT) is a rare condition in the general population that develops serious complications if left untreated for long time. We present a case of a 29-year-old woman who developed PVT due to protein S deficiency versus neonatal funiculitis. Over time, the patient developed upper gastrointestinal bleeding due to esophageal varices and hypersplenism with splenic sequestration that caused minor bleeding episodes. Laparoscopic splenectomy and proximal splenorenal shunt with distal pancreatectomy due to aneurysmal dilatations of the splenic artery were successfully performed to avoid mayor progression of portal hypertension. Patient was discharged with indefinite anticoagulation and after surgery platelets raised up to 200x103/mm3. Laparoscopic splenectomy and proximal splenorenal shunt for portal hypertension due to portal vein thrombosis is an adequate surgery procedure which should be applied in these medical cases.

La trombosis de la vena porta (TVP) es una afección poco común en la población general que desarrolla complicaciones graves si no se trata durante mucho tiempo. Presentamos el caso de una mujer de 29 años que desarrolló TVP por deficiencia de proteína S versus funiculitis neonatal. Con el tiempo, la paciente desarrolló hemorragia digestiva alta por varices esofágicas e hiperesplenismo con secuestro esplénico que provocó episodios hemorrágicos menores. La esplenectomía laparoscópica y la derivación esplenorrenal proximal con pancreatectomía distal por dilataciones aneurismáticas de la arteria esplénica se realizaron con éxito para evitar una mayor progresión de la hipertensión portal. La paciente fue dada de alta con anticoagulación indefinida y tras la cirugía se elevaron las plaquetas hasta 200x103/mm3. La esplenectomía laparoscópica y la derivación esplenorrenal proximal para la hipertensión portal por trombosis de la vena porta es un procedimiento quirúrgico adecuado que debe aplicarse en estos casos médicos.

[Atypical presentation of the Wellens electrocardiographic pattern associated with coronary bifurcation lesión]. / Presentación atípica del patrón electrocardiográfico de Wellens asociado con lesión de bifurcación coronaria.

We present a patient who was admitted to the emergency room due to unstable angina, with an initial electrocardiogram without signs of acute ischemia and a favorable clinical evolution. During hospitalization, she developed the Wellens electrocardiographic pattern, noted in the literature as an infrequent, poorly identified finding and with an ominous prognosis. This electrocardiographic pattern is described in precordial derivatives, suggesting a significant lesion of a principal epicardial artery; our patient had similar electrocardiographic alterations in the high lateral leads, in whom the coronary bifurcation lesion not previously described in this scenario was confirmed.

Validación de escala de Valoración de Agencia de Autocuidado (ASA) en adolescentes chilenos / Validação da Escala de Avaliação de Agências de Autocuidado (ASA) em adolescentes chilenos / Validation of the Appraisal of Self-care Agency Scale (ASA) in Chilean adolescents

Resumen Objetivo Realizar validación y análisis de confiabilidad de la Escala de Valoración de Agencia de Autocuidado en adolescentes chilenos. Método Fue realizado en una muestra 199 adolescentes. La validación de contenido se hizo por revisión de expertos. Se exploró la confiabilidad y la validez de constructo por medio de análisis factorial exploratorio (AFE) y confirmatorio (AFC). Resultados Algunos términos de la escala se adaptaron culturalmente. La confiabilidad alfa de Cronbach de la escala de 24 ítems fue de 0,88. Los ítems 6, 11, 20 presentaron baja confiabilidad y correlación con la escala (<0,4). El AFE, sugirió solución factorial de cinco factores y un factor por gráfico de sedimentación. Las ecuaciones estructurales de los posibles modelos resultaron con valores de índices de ajuste, cercano a lo satisfactorio. Conclusiones e Implicaciones para la práctica Considerando la combinación de criterios: objetivos; basados en la teoría y en los análisis factoriales, la solución óptima es la de un factor con 21 ítems. La escala presenta ítems adaptados culturalmente. Se propone incorporar ítems más específicos de autocuidado en adolescentes. Investigaciones que evalúen intervenciones tendientes a mejorar la capacidad de autocuidado en adolescentes podrían utilizar la nueva versión de la escala ASA con mejores propiedades psicométricas.

Resumo Objetivo Realizar validação e análise de confiabilidade da Escala de Classificação da Agência de Autocuidado em adolescentes chilenos. Método Aplicado a 199 adolescentes. Validação de conteúdofoifeita por revisão de especialistas. Confiabilidade e validade de construtoforam exploradas por meio de análisefatorialexploratória (AFE) e análisefatorialconfirmatória (AFC). Resultados Alguns termos da escala foram culturalmente adaptados. A confiabilidade alfa de Cronbach da escala de 24 itensfoi de 0,88. Os itens 6, 11, 20 apresentarambaixaconfiabilidade e correlaçãocom a escala (<0,4). O AFE sugeriuumasoluçãofatorial de cinco fatores e um fator por gráfico de sedimentação. As equaçõesestruturais dos modelos possíveisresultaramcom valores de índices de ajuste, próximos dosatisfatório. Conclusões e Implicações paraa Prática Considerando a combinação de critérios objetivos, aquelesbaseadosnateoria e nainterpretabilidade das soluçõesfatoriais, a soluçãoótima é a de um fator com 21 itens. A escala apresentaitens culturalmente adaptados, propõe-se incorporar comportamentos de autocuidado mais específicos típicos de adolescentes. Novas pesquisas avaliando intervençõesvoltadas para melhorar a capacidade de autocuidado em adolescentes poderiam utilizar a nova versão da escala ASA commelhores propriedades psicométricas.

Abstract Objective To perform validation and reliability analysis of the Self-Care Agency Assessment Scale in Chilean adolescents. Method It was performed in 199 adolescents. Validation of content was done by expert review. The reliability and construct validity were explored by means of exploratory factorial analysis (AFE) and confirmatory factorial analysis (AFC). Results Some terms of the scale were culturally adapted. Cronbach's alpha reliability of the 24-item scale was 0.88. The items 6, 11and 20 presented low reliability and correlation with the scale (<0.4). The AFE suggested a factorial solution of five factors and one factor per graph of sedimentation. The structural equations of the possible models resulted in values ​​of adjustment indices, close to satisfactory. Conclusions and Implications for Practice By considering the combination of objective criteria, those based on theory and on the interpretability of factor solutions, the optimal solution is that of a factor with 21 items. The scale presents items adapted culturally, it is proposed to incorporate a greater specificity of self-care behaviors typical of adolescents. New research evaluating interventions to improve self-care capacity in adolescents could use the new version of the ASA scale with better psychometric properties.

Autocuidado, alfabetización en salud y control glicémico en personas con diabetes mellitus tipo 2 / Autocuidado, alfabetização em saúde e controle glicêmico em pessoas com diabetes mellitus tipo 2 / Self-care, health literacy and glycemic control in people with diabetes mellitus type 2

RESUMEN Objetivo: Evaluar si existe relación entre autocuidado y alfabetización en salud con control glicémico e identificar sus principales predictores en personas con diagnóstico de Diabetes Mellitus tipo 2, en un Centro de Salud Familiar de Concepción, Chile. Material y Método: Estudio cuantitativo, transversal, descriptivo y correlacional. Participaron 175 personas, quienes dieron respuesta a un instrumento compuesto por: Datos biosociodemográficos, Resumen de Actividades de Autocuidado en Diabetes y Evaluación breve de la alfabetización de salud para adultos hispanohablantes, además glicemia preprandial y HbA1c para verificar control glicémico. Resultados: Los participantes fueron en su mayoría mujeres (70,3%); edad promedio 65,1 años; años de escolaridad promedio 9,3 años; con pareja el 61,7%; pensionados el 45,7%; ingreso económico per cápita $147.300 aproximadamente; tiempo transcurrido desde el diagnóstico, 11 años, aproximadamente; utilizando antiglicémicos orales el 63,4% y no fumadores un 88,6%. Tres áreas de autocuidado clasificaron como inadecuadas: alimentación, actividad física y automonitorización de glicemia; 20% con inadecuada alfabetización en salud, existiendo diferencia en el nivel educacional, ingreso económico y tipo de terapia farmacológica; 65,8% con control glicémico inadecuado. Conclusiones: No se obtuvo relación entre autocuidado y alfabetización en salud con control glicémico. Se identificó como principal predictor del control glicémico el tipo de terapia farmacológica. Se evidenció un autocuidado inadecuado y un bajo porcentaje de compensación, lo que lleva a reflexionar sobre el quehacer como equipo de salud en la atención primaria, debiendo movilizar los esfuerzos a favor del modelo integral para mantener una población compensada y libre de complicaciones.

ABSTRACT Objective: To assess whether there is a relationship between self-care, health literacy with glycemic control and identify its main predictors in people diagnosed with Type 2 Diabetes Mellitus at a Family Health Center in Concepción, Chile. Material and Method: Quantitative, cross-sectional, descriptive and correlational study. 175 people participated responding instruments that consisted of bio-sociodemographic questions, Summary of Self-Care Diabetes Activities and Health Literacy Brief Assessment for Spanish-speaking adults, as well as pre-prandial glycemia and HbA1c to verify glycemic control. Results: Participants were mostly women (70.3%); average age 65.1 years; average years of schooling 9.3 years; with a partner (61.7%); pensioners (45.7%); per capita income, approximately $ 147,300; time since diagnose, approximately 11 years; using oral antiglycemic agents (63.4%); non-smokers (88.6%). Three areas of self-care were classified as inadequate: nutrition, physical activity and self-monitoring of glycemia; 20% of participants showed inadequate health literacy, with differences in educational level, income and pharmacological therapy; 65.8% with inadequate glycemic control. Conclusions: There was no relationship between self-care and health literacy with glycemic control. The type of pharmacological therapy was identified as the main predictor of glycemic control. There is evidence of inadequate self-care and a low compensation level, which leads to reflect on improving work in primary health care and increasing efforts to have a comprehensive model to maintain a compensated population and free of complications.

RESUMO Objetivo: Avaliar se existe relação entre autocuidado, alfabetização em saúde com controle glicêmico e identificar seus principais preditores em pessoas diagnosticadas com Diabetes Mellitus Tipo 2 em um Centro de Saúde da Família em Concepción, Chile. Material e Método: Estudo quantitativo, transversal, descritivo e correlacional. Participaram 175 pessoas que responderam a um instrumento composto por: Perguntas biosociodemográficas, Resumo das atividades de autocuidado em diabetes e Breve avaliação da alfabetização em saúde para adultos de língua espanhola, além de glicemia pre-prandial e HbA1c para verificar o controle glicêmico. Resultados: Os participantes foram majoritariamente mulheres (70,3%); idade média 65,1 anos; média de anos de escolaridade 9,3 anos; com parceiro o (61,7%); pensionistas o (45,7%); renda econômica per capita $ 147.300 aproximadamente; tempo decorrido desde o diagnóstico, aproximadamente 11 anos; uso de agentes antiglicêmicos orais o (63,4%); não fumantes o (88,6%). Três áreas de autocuidado classificadas como inadequadas: alimentação, atividade física e automonitoramento da glicemia; 20% com alfabetização em saúde inadequada, havendo diferença no nível educacional, renda econômica e tipo de terapia medicamentosa; 65,8% com controle glicêmico inadequado. Conclusões: Não houve relação entre autocuidado e alfabetização em saúde com controle glicêmico. O tipo de terapia farmacológica foi identificado como o principal preditor do controle glicêmico. Foi evidenciado autocuidado inadequado e baixo percentual de compensação, o que leva a refletir sobre a tarefa como equipe de saúde na atenção básica, e deve mobilizar esforços em favor do modelo integral para manter uma população compensada livre de complicações.

Autocuidado, alfabetización en salud y control glicémico en personas con diabetes mellitus tipo 2 / Self-care, health literacy and glycemic control in people with diabetes mellitus type 2 / Autocuidado, alfabetização em saúde e controle glicêmico em pessoas com diabetes mellitus tipo 2

RESUMEN Objetivo: Evaluar si existe relación entre autocuidado y alfabetización en salud con control glicémico e identificar sus principales predictores en personas con diagnóstico de Diabetes Mellitus tipo 2, en un Centro de Salud Familiar de Concepción, Chile. Material y Método: Estudio cuantitativo, transversal, descriptivo y correlacional. Participaron 175 personas, quienes dieron respuesta a un instrumento compuesto por: Datos biosociodemográficos, Resumen de Actividades de Autocuidado en Diabetes y Evaluación breve de la alfabetización de salud para adultos hispanohablantes, además glicemia preprandial y HbA1c para verificar control glicémico. Resultados: Los participantes fueron en su mayoría mujeres (70,3%); edad promedio 65,1 años; años de escolaridad promedio 9,3 años; con pareja el 61,7%; pensionados el 45,7%; ingreso económico per cápita $147.300 aproximadamente; tiempo transcurrido desde el diagnóstico, 11 años, aproximadamente; utilizando antiglicémicos orales el 63,4% y no fumadores un 88,6%. Tres áreas de autocuidado clasificaron como inadecuadas: alimentación, actividad física y automonitorización de glicemia; 20% con inadecuada alfabetización en salud, existiendo diferencia en el nivel educacional, ingreso económico y tipo de terapia farmacológica; 65,8% con control glicémico inadecuado. Conclusiones: No se obtuvo relación entre autocuidado y alfabetización en salud con control glicémico. Se identificó como principal predictor del control glicémico el tipo de terapia farmacológica. Se evidenció un autocuidado inadecuado y un bajo porcentaje de compensación, lo que lleva a reflexionar sobre el quehacer como equipo de salud en la atención primaria, debiendo movilizar los esfuerzos a favor del modelo integral para mantener una población compensada y libre de complicaciones.

ABSTRACT Objective: To assess whether there is a relationship between self-care, health literacy with glycemic control and identify its main predictors in people diagnosed with Type 2 Diabetes Mellitus at a Family Health Center in Concepción, Chile. Material and Method: Quantitative, cross-sectional, descriptive and correlational study. 175 people participated responding instruments that consisted of bio-sociodemographic questions, Summary of Self-Care Diabetes Activities and Health Literacy Brief Assessment for Spanish-speaking adults, as well as pre-prandial glycemia and HbA1c to verify glycemic control. Results: Participants were mostly women (70.3%); average age 65.1 years; average years of schooling 9.3 years; with a partner (61.7%); pensioners (45.7%); per capita income, approximately $ 147,300; time since diagnose, approximately 11 years; using oral antiglycemic agents (63.4%); non-smokers (88.6%). Three areas of self-care were classified as inadequate: nutrition, physical activity and self-monitoring of glycemia; 20% of participants showed inadequate health literacy, with differences in educational level, income and pharmacological therapy; 65.8% with inadequate glycemic control. Conclusions: There was no relationship between self-care and health literacy with glycemic control. The type of pharmacological therapy was identified as the main predictor of glycemic control. There is evidence of inadequate self-care and a low compensation level, which leads to reflect on improving work in primary health care and increasing efforts to have a comprehensive model to maintain a compensated population and free of complications.

RESUMO Objetivo: Avaliar se existe relação entre autocuidado, alfabetização em saúde com controle glicêmico e identificar seus principais preditores em pessoas diagnosticadas com Diabetes Mellitus Tipo 2 em um Centro de Saúde da Família em Concepción, Chile. Material e Método: Estudo quantitativo, transversal, descritivo e correlacional. Participaram 175 pessoas que responderam a um instrumento composto por: Perguntas biosociodemográficas, Resumo das atividades de autocuidado em diabetes e Breve avaliação da alfabetização em saúde para adultos de língua espanhola, além de glicemia pre-prandial e HbA1c para verificar o controle glicêmico. Resultados: Os participantes foram majoritariamente mulheres (70,3%); idade média 65,1 anos; média de anos de escolaridade 9,3 anos; com parceiro o (61,7%); pensionistas o (45,7%); renda econômica per capita $ 147.300 aproximadamente; tempo decorrido desde o diagnóstico, aproximadamente 11 anos; uso de agentes antiglicêmicos orais o (63,4%); não fumantes o (88,6%). Três áreas de autocuidado classificadas como inadequadas: alimentação, atividade física e automonitoramento da glicemia; 20% com alfabetização em saúde inadequada, havendo diferença no nível educacional, renda econômica e tipo de terapia medicamentosa; 65,8% com controle glicêmico inadequado. Conclusões: Não houve relação entre autocuidado e alfabetização em saúde com controle glicêmico. O tipo de terapia farmacológica foi identificado como o principal preditor do controle glicêmico. Foi evidenciado autocuidado inadequado e baixo percentual de compensação, o que leva a refletir sobre a tarefa como equipe de saúde na atenção básica, e deve mobilizar esforços em favor do modelo integral para manter uma população compensada livre de complicações.

Acoso laboral y factores asociados en trabajadores de servicios de emergencias / Mobbing and associated factors in emergency health care workers

Objetivo: Determinar el acoso laboral y factores asociados en trabajadores que se desempeñan en servicios de emergencias de establecimientos de salud públicos y privados. Método: Investigación cuantitativa, correlacional y transversal. Muestra probabilística estratificada por ocupaciones y por establecimientos, intervalo de confianza 95%, margen de error 5%, representada por 366 trabajadores. Se utilizó apartados sociodemográficos y de acoso laboral de encuesta "Violencia Laboral en Sector Salud". Se contó con aprobaciones de comités éticos científicos, y consentimiento informado. Se realizó análisis descriptivo e inferencial. Resultados: La prevalencia del acoso laboral fue 14,3%, siendo tres veces mayor en establecimientos públicos. Ser mujer y ser soltero resultaron estadísticamente significativos para hospitales públicos. Solo en un caso la víctima demandó legalmente. Conclusiones: el acoso laboral debe preocupar a empleadores y trabajadores, para establecer medidas que favorezcan un ambiente laboral saludable y libre de violencia

Objective: Determine workplace harassment and associated factors in workers who work in emergency services of public and private health facilities. Method: Quantitative, correlational and transversal research. Probabilistic sample stratified by occupations and by establishments, confidence interval 95%, margin of error 5%, represented by 366 workers. Sociodemographic and labor harassment sections of the "Work Violence in the Health Sector" survey were used. It counted on approvals of scientific ethical committees, and informed consent. A descriptive and inferential analysis was carried out. Results: The prevalence of workplace harassment was 14.3%, being three times higher in public establishments. Being a woman and being single was statistically significant only for public hospitals. Only in one case the victim sued legally. Conclusions: Workplace harassment should concern employers and workers, to establish measures that favor a healthy work environment free of violence

Compromiso paterno y la relación con sus conductas promotoras de salud / Paternal commitment and its association with health-promoting behaviors

RESUMEN Objetivo Identificar el compromiso paterno y la relación con sus conductas promotoras de salud. Método Estudio correlacional en 160 padres, pertenecientes a dos Centros de Salud Familiar, quienes respondieron las escalas de compromiso paterno y estilos de vida II, además de preguntas biosociodemográficas. Resultados El 78,1% de los padres presentan en promedio un alto compromiso paterno. Las variables que influencian positivamente el compromiso paterno, son las conductas promotoras en salud, la participación de éste en el parto y en los controles de salud de su hijo. La edad evidenció influencia negativa sobre el compromiso paterno. Correlaciones más altas de compromiso paterno, se observaron con las dimensiones de crecimiento espiritual y relaciones interpersonales, y más baja con la dimensión de actividad física. El compromiso paterno se mostró mayormente a través de actividades hacia sus hijos tales como alimentarlos, vestirlos y jugar. Conclusión Los padres participan más activamente en la crianza de sus hijos y como implícitamente son modelos de salud para éstos, se afirma la necesidad de crear y/o mantener estrategias para propiciar conductas promotoras de salud en los padres por parte de los profesionales de salud, puesto que influencian favorablemente el compromiso paterno.(AU)

ABSTRACT Objective To identify the association of paternal commitment and health-promoting behaviors. Methods Correlational and predictive study in 160 parents attended in two Family Health Centers, who responded to the scales of paternal involvement and lifestyles II, as well as biosociodemographic questions. Results On average, 78.1% of the fathers were highly committed. The variables that positively influence paternal commitment are health-promoting behaviors, and their participation in childbirth and routine checkups of their children. Age had a negative influence on paternal commitment. Higher correlations of paternal commitment were observed in the dimensions spiritual growth and interpersonal relationships, while it was lower in the physical activity dimension. Father's commitment was mostly evident in activities done together with their children such as feeding, dressing and playing. Conclusion Fathers participate more actively in the upbringing of their children. Considering that they are implicitly health role models for children, there is a clear need to create and/or maintain strategies to encourage health-promoting behaviors in fathers by health professionals, since they favorably influence paternal commitment.(AU)

Adaptación transcultural y validación de un cuestionario de cuidado humanizado en enfermería para una muestra de población Chilena / Transcultural adaptation and validation of a humanized-care questionnaire in nursing for a Chilean population sample / Adaptação transcultural e validação de um questionário de cuidado humanizado em enfermagem para uma amostra da população Chilena

Resumen Introducción La humanización del cuidado es una temática relevante de tratar por el impacto que tiene en la salud de las personas, esto demanda contar con instrumentos confiables y válidos que permitan su evaluación. Objetivo Adaptar y validar la versión colombiana del cuestionario de Percepción de Comportamientos de Cuidados Humanizados en Enfermería (PCHE), para ser utilizado en población chilena. Materiales y Métodos Estudio de validación, que consistió en la evaluación por expertos y adaptación transcultural del PCHE a través de un enfoque intralingual y el análisis de la consistencia interna y validez de constructo del instrumento PCHE versión Chilena. Resultados Se modificaron términos y tiempos verbales, con un 100% de comprensión por parte de los encuestados, esto permitió generar un instrumento adecuado al lenguaje y comprensión del español utilizado en Chile. Se obtuvo un alto coeficiente de alfa de Cronbach de 0.92, y una validez de constructo por convergencia con una alta correlación positiva r de 0,73 con la Escala de Percepción del Cuidado Humanizado. Discusión Se visualiza la importancia de la adaptación lingüística sociocultural de instrumentos en distintas culturas y de esta forma evitar sesgos derivados del lenguaje. La confiabilidad y validez de constructo del instrumento es similar a la encontrada en Colombia, lo que demuestra las adecuadas propiedades y su buen funcionamiento en un contexto cultural distinto. Conclusiones Este instrumento constituye un aporte a la humanización de los cuidados en enfermería, al ser una escala válida y apropiada para ser usada en el contexto de la población Chilena.

Abstract Introduction Humanization of care is a relevant theme to address due to its impact on the health of individuals; this requires having reliable and valid instruments that permit its evaluation. Objective Adapt and validate the Colombian version of the questionnaire on Perception of Humanized-Care Behaviors in Nursing (PHCBN) for use in a Chilean population. Materials and Methods Validation study consisting in the expert evaluation and transcultural adaptation of the PHCBN through an intra-lingual approach and internal consistency analysis and construct validity of the Chilean version of the instrument. Results Terms and verb tenses were modified with 100% comprehension by those surveyed; this permitted generating an instrument suited to the language and comprehension of the Spanish used in Chile. The study obtained a high Cronbach's alpha coefficient of 0.92, along with a construct validity through convergence with a high positive r correlation of 0.73 with the Humanized-Care Perception Scale. Discussion Herein, we visualize the importance of the linguistic sociocultural adaptation of instruments in different cultures and, thus, avoid bias derived from language. The reliability and construct validity of the instrument is similar to that found in Colombia, which demonstrates adequate properties and its good function within a distinct cultural context. Conclusions This instrument constitutes a contribution to the humanization of nursing care, given that it is a valid and appropriate scale for use in the Chilean population context.

Resumo Introdução A humanização do cuidado é uma questão relevante, abordada pelo impacto que tem na saúde das pessoas, o que requer disponibilizar de instrumentos confiáveis ​​e válidos que permitam sua avaliação. Objetivo Adaptar e validar a versão Colombiana do questionário de Percepção de Comportamentos de Cuidados Humanizados em Enfermagem (PCHE), para ser utilizado em população Chilena. Materiais e Métodos Estudo de validação, que consistiu na avaliação de peritos e adaptação transcultural do PCHE através de uma abordagem intralinguística e a análise da consistência interna e validade de construto do instrumento PCHE versão Chilena. Resultados Foram modificados termos e tempos verbais, com 100% de compreensão por parte dos entrevistados, isto permitiu gerar um instrumento adequado para a linguagem e compreensão do espanhol utilizado no Chile. Obteve-se um elevado coeficiente alfa de Cronbach de 0,92, e validade de construto por convergência com uma alta correlação positiva r de 0,73 com a Escala de Percepção do Cuidado Humanizado. Discussão Visualiza-se a importância da adaptação linguística sociocultural de instrumentos em diferentes culturas e, assim, evitar vieses derivados da linguagem. A confiabilidade e a validade de constructo do instrumento são semelhantes às encontradas na Colômbia, o qual demostra as adequadas propriedades e seu bom funcionamento em um contexto cultural diferente. Conclusões Este instrumento constitui uma contribuição para a humanização dos cuidados em enfermagem, por ser uma escala válida e apropriada para ser utilizada no contexto da população Chilena.

Calidad de vida en adultas mayores con cáncer relacionado con determinantes sociales de la salud / Quality of life in elderly women with cancer related with social determinants of health / Qualidade de vida em mulheres idosas com câncer relacionados aos determinantes sociais da saúde

Objetivo: Evaluar la relación entre los determinantes sociales de la salud y la calida de vida de mu-jeres con diversos tipos de cáncer de 60 años y más.Metodología: Estudio cuantitativo, transversal, con enfoque descriptivo - correlacional. Se aplicó escala de calidad de vida QLQ-C30 y fi cha de datos sociodemográfi cos a 70 mujeres de 60 años y más diagnosticadas con cáncer, de un hospital público, provincia de Concepción, región del Biobío, Chile.Resultado: El promedio de edad de las mujeres fue 69,9 años (DE=6,8), el cáncer predominante fue el de mama, más del 50% de ellas estaba con tratamiento de quimioterapia y un 72% en etapa avanza-da del cáncer (III-IV). La calidad de vida en las escalas de funcionamiento físico, de rol, emocional, cognitivo y social, obtuvo valores sobre 63/100 puntos y en la de salud global sobre 65/100 puntos; los síntomas de dolor y fatiga obtuvieron altos puntajes comparados con otros. Existió relación es-tadísticamente signifi cativa con 2 Determinantes Sociales Estructurales (educación y ocupación), y con 3 Intermediarios (tenencia y estado de la vivienda, y satisfacción de ingreso). Conclusión: Los puntajes en la escala de calidad de vida indican una tendencia hacia una buena calidad de vida. Sin embargo, es impactada negativamente por la educación, ocupación, estado de la vivienda y satisfacción con ingresos percibidos. Es necesario enfocarse en estas determinantes sociales en la valoración y cuidado de la mujer adulta mayor con cáncer, para proponer estrategias interdisciplinarias que mejoren efectivamente su bienestar y calidad de vida.

Objective: To evaluate the relationship between the social determinants of health and the quality of life of women with various types of cancer aged 60 and over.Methodology: Quantitative, transversal study, with descriptive correlational approach. The QLQ-C30 quality of life scale and sociodemographic data sheet were applied to 70 women aged 60 years and over diagnosed with cancer, from a public hospital, Concepción province, Biobío region, Chile. Result: The average age of the women was 69.9 years (SD = 6.8), the predominant cancer was the breast, more than 50% of them were with chemotherapy and 72% in the advanced stage of the cancer (III -IV). The quality of life in the scales of physical, role, emotional, cognitive and social functioning, obtained values over 63/100 points and in the overall health over 65/100 points; the symptoms of pain and fatigue obtained high scores compared with others. There was a statistically signifi cant relationship with 2 Structural Social Determinants (education and occupation), and with 3 Interme-diaries (tenure and housing status, and income satisfaction). Conclusion: The scores on the quality of life scale indicate a trend towards a good quality of life. However, it is negatively impacted by education, occupation, housing status and satisfaction with income received. It is necessary to focus on these social determinants in the assessment and care of elderly women with cancer, to propose interdisciplinary strategies that eff ectively improve their well-being and quality of life

Objetivo: Avaliar a relação entre os determinantes sociais da saúde e a qualidade de vida de mulhe-res com vários tipos de câncer com 60 anos ou mais. Metodologia: Estudo quantitativo, transversal, com abordagem descritivo-correlacional. escala de qualidade de vida QLQ-C30 foi aplicado e dados sociodemográfi cos fi cha 70 mulheres com idades entre 60 e mais velhos diagnosticados com câncer, um hospital público na província de Concepcion, Biobio Region, Chile.Resultado: A idade média das mulheres era de 69,9 anos (DP = 6,8), o cancro da mama predomi-nante foi mais do que 50% de las foram com quimioterapia e 72% em estágio avançado de cancro (III -IV). A qualidade de vida nas escalas de funcionamento físico, papel, emocional, cognitivo e social, obteve valores acima de 63/100 pontos e na saúde geral acima de 65/100 pontos; os sintomas de dor e fadiga obtiveram pontuações altas em comparação com outros. Houve uma relação estatisticamente signifi cativa com 2 Determinantes Sociais Estruturais (educação e ocupação) e com 3 Intermediários (estabilidade e status de moradia e satisfação com a renda). Conclusão: Os escores na escala de qualidade de vida indicam tendência a uma boa qualidade de vida. No entanto, é impactado negativamente pela educação, ocupação, status de moradia e satis-fação com a renda recebida. É necessário enfocar esses determinantes sociais na avaliação e cuidado de mulheres idosas com câncer, para propor estratégias interdisciplinares que efetivamente melho-rem seu bem-estar e qualidade de vida.

[Paternal commitment and its association with health-promoting behaviors]. / Compromiso paterno y la relación con sus conductas promotoras de salud.

OBJECTIVE: To identify the association of paternal commitment and health-promoting behaviors. METHODS: Correlational and predictive study in 160 parents attended in two Family Health Centers, who responded to the scales of paternal involvement and lifestyles II, as well as biosociodemographic questions. RESULTS: On average, 78.1% of the fathers were highly committed. The variables that positively influence paternal commitment are health-promoting behaviors, and their participation in childbirth and routine checkups of their children. Age had a negative influence on paternal commitment. Higher correlations of paternal commitment were observed in the dimensions spiritual growth and interpersonal relationships, while it was lower in the physical activity dimension. Father's commitment was mostly evident in activities done together with their children such as feeding, dressing and playing. CONCLUSION: Fathers participate more actively in the upbringing of their children. Considering that they are implicitly health role models for children, there is a clear need to create and/or maintain strategies to encourage health-promoting behaviors in fathers by health professionals, since they favorably influence paternal commitment.

OBJETIVO: Identificar el compromiso paterno y la relación con sus conductas promotoras de salud. MÉTODO: Estudio correlacional en 160 padres, pertenecientes a dos Centros de Salud Familiar, quienes respondieron las escalas de compromiso paterno y estilos de vida II, además de preguntas biosociodemográficas. RESULTADOS: El 78,1% de los padres presentan en promedio un alto compromiso paterno. Las variables que influencian positivamente el compromiso paterno, son las conductas promotoras en salud, la participación de éste en el parto y en los controles de salud de su hijo. La edad evidenció influencia negativa sobre el compromiso paterno. Correlaciones más altas de compromiso paterno, se observaron con las dimensiones de crecimiento espiritual y relaciones interpersonales, y más baja con la dimensión de actividad física. El compromiso paterno se mostró mayormente a través de actividades hacia sus hijos tales como alimentarlos, vestirlos y jugar. CONCLUSIÓN: Los padres participan más activamente en la crianza de sus hijos y como implícitamente son modelos de salud para éstos, se afirma la necesidad de crear y/o mantener estrategias para propiciar conductas promotoras de salud en los padres por parte de los profesionales de salud, puesto que influencian favorablemente el compromiso paterno.

[Evaluation of Morisky medication adherence scale (mmas-8) in older adults of a primary health care center in Chile]. / Evaluación de la escala Morisky de adherencia a la medicación (mmas-8) en adultos mayores de un centro de atención primaria en Chile.

In order to determine whether the Morisky 8-item medication adherence (MMAS-8) is a useful instrument in elderly hypertensive patients attending a primary care center, we conducted a field study with a quantitative approach of evaluation of diagnostic tests in elderly hypertensive patients from the Cardiovascular Health Program Health in Cabrero, Chile. The results of the scale were compared with the blood pressure and the pill-count method. The diagnostic evaluation of the scale using the reference methods of blood pressure and pill count resulted: Sensitivity: 86%, 85%; specificity: 56%, 58%; positive predictive value: 60%, 65%; negative predictive value: 84%. 81%. In conclusion, the scale allows to detect in a simple way, and at a low cost, to people who are not adherent to their regimen of drug treatment.

Con el objetivo de determinar si la escala de adherencia a la medicación de Morisky de 8 ítems (MMAS-8) es un instrumento útil en adultos mayores hipertensos que acuden a un centro de atención primaria, se realizó un estudio de campo con abordaje cuantitativo de evaluación de pruebas diagnósticas, en ancianos hipertensos del Programa de Salud Cardiovascular de Cabrero, Chile. Los resultados de la escala fueron comparados con la presión arterial y el método de recuento de comprimidos. La evaluación diagnóstica de la escala utilizando los métodos de referencia presión arterial y recuento de comprimidos dio como resultado: sensibilidad: 86%, 85%; especificidad: 56%, 58%; valor predictivo positivo: 60%, 65%; valor predictivo negativo: 84%. 81%. En conclusión, la escala permite detectar de forma simple, y a bajo costo, a personas que no son adherentes a su régimen de tratamiento medicamentoso.

Rosmarinic acid prevents fibrillization and diminishes vibrational modes associated to ß sheet in tau protein linked to Alzheimer's disease.

Alzheimer's disease is a common tauopathy where fibril formation and aggregates are the hallmark of the disease. Efforts targeting amyloid-ß plaques have succeeded to remove plaques but failed in clinical trials to improve cognition; thus, the current therapeutic strategy is at preventing tau aggregation. Here, we demonstrated that four phenolic diterpenoids and rosmarinic acid inhibit fibrillization. Since, rosmarinic acid was the most active compound, we observe morphological changes in atomic force microscopy images after treatment. Hence, rosmarinic acid leads to a decrease in amide regions I and III, indicating that rosmarinic acid prevents ß-sheet assembly. Molecular docking study inside the steric zipper model of the hexapeptide 306VQIVYK311 involved in fibrillization and ß sheet formation, suggests that rosmarinic acid binds to the steric zipper with similar chemical interactions with respect to those observed for orange G, a known pharmacofore for amyloid.

Evaluación de la escala Morisky de adherencia a la medicación (MMAS-8) en adultos mayores de un centro de atención primaria en Chile / Evaluation of Morisky medication adherence scale (MMAS-8) in older adults of a primary health care center in Chile

Con el objetivo de determinar si la escala de adherencia a la medicación de Morisky de 8 ítems (MMAS-8) es un instrumento útil en adultos mayores hipertensos que acuden a un centro de atención primaria, se realizó un estudio de campo con abordaje cuantitativo de evaluación de pruebas diagnósticas, en ancianos hipertensos del Programa de Salud Cardiovascular de Cabrero, Chile. Los resultados de la escala fueron comparados con la presión arterial y el método de recuento de comprimidos. La evaluación diagnóstica de la escala utilizando los métodos de referencia presión arterial y recuento de comprimidos dio como resultado: sensibilidad: 86%, 85%; especificidad: 56%, 58%; valor predictivo positivo: 60%, 65%; valor predictivo negativo: 84%. 81%. En conclusión, la escala permite detectar de forma simple, y a bajo costo, a personas que no son adherentes a su régimen de tratamiento medicamentoso.

In order to determine whether the Morisky 8-item medication adherence (MMAS-8) is a useful instrument in elderly hypertensive patients attending a primary care center, we conducted a field study with a quantitative approach of evaluation of diagnostic tests in elderly hypertensive patients from the Cardiovascular Health Program Health in Cabrero, Chile. The results of the scale were compared with the blood pressure and the pill-count method. The diagnostic evaluation of the scale using the reference methods of blood pressure and pill count resulted: Sensitivity: 86%, 85%; specificity: 56%, 58%; positive predictive value: 60%, 65%; negative predictive value: 84%. 81%. In conclusion, the scale allows to detect in a simple way, and at a low cost, to people who are not adherent to their regimen of drug treatment.

Nivel de resiliencia en familiares de personas hospitalizadas en cuidados intensivos y factores asociados / Resilience level in family members of hospitalized people in intensive care and associated factors

RESUMEN Ingresar a una Unidad de Cuidados Intensivos es una experiencia difícil, que involucra no solo riesgo vital de la persona, sino que también una crisis en su entorno familiar. Objetivo: Medir el nivel de resiliencia de los familiares responsables de personas hospitalizadas en la Unidad de Cuidados Intensivos del Hospital Guillermo Grant Benavente de Concepción y sus factores asociados. Material y método: Estudio transversal, descriptivo-correlacional, con una muestra de 117 familiares. Instrumentos: Se utilizó un cuestionario de variables sociodemográficas y de datos clínicos, Apgar familiar y la Escala de resiliencia "SV-RES", los que fueron aplicados a familiares responsables del cuidado de personas hospitalizadas. Resultados: Se evidencia que los familiares presentan un alto nivel de resiliencia. Dentro de los factores que influyen en una baja resiliencia se encuentran: redes, afectividad y generatividad, aspectos a fortalecer en una intervención planificada de enfermería. Las variables sociodemográficas no se relacionaron con el nivel de resiliencia obtenido, a diferencia de la funcionalidad familiar que podría potenciar respuestas resilientes, contribuyendo a la efectividad del cuidado de enfermería. Conclusión: El nivel de resiliencia obtenido es alto. Los factores con menor puntaje son Redes y Afectividad. La funcionalidad familiar tendría una relación significativa con resiliencia. Podemos inferir que la afectividad y una adecuada percepción de la funcionalidad familiar potenciarían la resiliencia en los familiares de personas hospitalizadas en cuidados intensivos.

ABSTRACT Being admitted to an Intensive Care Unit is a difficult experience, involving not only vital risk for the individual, but also a crisis in their family environment. Objective: To measure the level of resilience of family members responsible for people admitted to Intensive Care Unit at the Guillermo Grant Benavente Hospital in Concepción, Chile and its associated factors. Material and method: Cross-sectional, descriptive-correlational study, with a sample of 117 relatives. Instruments: A questionnaire of sociodemographic variables and clinical data, Family Apgar and the Resilience Scale "SV-RES" were used, which were applied to relatives responsible for the care of hospitalized people. Results: It is evident that family members have a high level of resilience. Among the factors that influence low resilience are: networks, affectivity and generativity, which are aspects to strengthen in a planned nursing intervention. The sociodemographic variables were not related to the level of resilience obtained, unlike family functionality, which could enhance resilient responses, contributing to the effectiveness of nursing care. Conclusion: The level of resilience obtained is high. The factors with the lowest score are Networks and Affectivity. Family functionality may have a significant relationship with Resilience. We can infer that affectivity and an adequate perception of family functionality would enhance resilience in the relatives of people hospitalized in intensive care.