Feasibility, acceptability, and appropriability of a national whole-school program for reducing school violence and improving school coexistence.

Introduction: The increase in school violence following the COVID-19 pandemic underscores the need for schools to adopt a multilevel whole-school approach. This study examines a national program designed by the Chilean Ministry of Education, in collaboration with universities, as part of the Ministry's Educational Reactivation Plan, aimed at improving school climate management across Chile. Methods: The "Learning to Live Together Program" (LLT) was implemented across all 16 regions of Chile, focusing on establishing school climate networks, providing direct intensive university technical assistance, and enhancing professional development and training. The feasibility, acceptability, and appropriability of the LLT program were assessed through a survey distributed to 1,561 staff members from 783 schools. Participants responded to a comprehensive set of instruments measuring acceptability, appropriability, feasibility, attitudes toward implementation, fidelity, and initial perceived results. Results: The results indicate high initial adoption rates and significant improvements in the assessed dimensions. The enhancement of school climate practices and strengthening school collaboration networks were of considerable relevance. Discussion: These findings support the efficacy of the multilevel whole-school approach as a viable strategy for Latin American countries, providing critical data for educational and governmental decision-making. Furthermore, this study provides evidence that these outcomes may be applicable to the implementation of similar policies in different contexts and countries.

Photovoltaic Power Injection Control Based on a Virtual Synchronous Machine Strategy.

The increasing participation of photovoltaic sources in power grids presents the challenge of enhancing power quality, which is affected by the intrinsic characteristics of these sources, such as variability and lack of inertia. This power quality degradation mainly generates variations in both voltage magnitude and frequency, which are more pronounced in microgrids. In fact, the magnitude problem is particularly present in the distribution systems, where photovoltaic sources are spread along the grid. Due to the power converter's lack of inertia, frequency problems can be seen throughout the network. Grid-forming control strategies in photovoltaic systems have been proposed to address these problems, although most proposed solutions involve either a direct voltage source or energy storage systems, thereby increasing costs. In this paper, a photovoltaic injection system is designed with a virtual synchronous machine control strategy to provide voltage and frequency support to the grid. The maximum power point tracking algorithm is adapted to provide the direct voltage reference and inject active power according to the droop frequency control. The control strategy is validated through simulations and key experimental setup tests. The results demonstrate that it is possible to inject photovoltaic power and provide voltage and frequency support.

Sibling and School Bullying Victimization and Its Relation With Children's Subjective Well-Being in Indonesia: The Protective Role of Family and School Climate.

Studies on the influence of family and school climates on the relationships between sibling and school bullying victimization and children's subjective well-being (SWB) in Indonesia are still scarce. The aims of this study are to investigate family and school climates as protective factors for children from the negative consequences of bullying by siblings or other children in school on SWB. The study used the third-wave data of the Children's Worlds survey that was collected in Indonesia in October 2017. Participants of the study were children aged 10 and 12 years old (N = 15,604; 49.8% girls, 50.2% boys, Mean age = 10.55; SD = 1.17). There are four questionnaires used in the study: five items measure bullying at home and at school, the Children's Worlds Subjective Well-Being Scale, six items measure family climate, and four items measure school climate. Data were analyzed using R and the lavaan library for multilevel structural equation modeling, using full information maximum likelihood (FIML) for missing data and robust maximum likelihood (ML) estimation. Results showed that children who experienced bullying incidents, both at home by siblings and at school, predicted lower levels of SWB. School climate and family climate predicted higher levels of SWB. Results also showed that school bullying interacted significantly with school climate, while sibling bullying interacted significantly with family climate. Schools with students that reported more positive levels of family climate also reported higher levels of SWB. Students from public schools reported higher levels of SWB, which is unexpected.

Outbreak of Fusarium solani Meningitis in Immunocompetent Persons Associated With Neuraxial Blockade in Durango, Mexico, 2022-2023.

Background: Fungal meningitis can be associated with epidural anesthesia procedures. Fusariosis is a rare infection typically affecting immunocompromised patients and rarely causes meningitis. During 2022-2023, public health officials responded to a large outbreak of Fusarium solani meningitis associated with epidural anesthesia in Durango, Mexico. Methods: The public health response and epidemiological and clinical features of patients affected by this outbreak were described. Coordinated actions were addressed to identify the etiological agent, determine its drug susceptibility, develop diagnostic tests, and implement clinical and epidemiological protocols. Retrospective analyses of clinical variables and outcomes were performed to determine association with better patient survival. Results: A total of 1801 persons exposed to epidural anesthesia were identified, of whom 80 developed meningitis. Fusarium solani was found in 3 brain biopsies and showed susceptibility to voriconazole and amphotericin B. After F solani polymerase chain reaction (PCR) implementation, 57 patients with meningitis were PCR-screened, and 31 (38.8%) had a positive result. Most patients were female (95%), and cesarean section was the most common surgical procedure (76.3%). The case fatality rate was 51.3% (41 patients) and the median hospitalization duration was 39.5 days (interquartile range, 18-86 days). Seventy-one patients (88.8%) received voriconazole/amphotericin B and 64 subjects (80%) additionally received steroids. Cox regression analysis showed an increased lethality risk in patients who received antifungal treatment after 5 days (hazard ratio, 2.1 [95% confidence interval, 1.01-4.48], P < .05). Conclusions: The F solani meningitis outbreak in Durango was an unprecedented medical challenge. Timely treatment and effective healthcare management were associated with better survival outcomes.

Robot-Assisted Radical Prostatectomy by Lateral Approach: Technique, Reproducibility and Outcomes.

BACKGROUND: Radical prostatectomy by lateral approach allows performing a prostatectomy through a buttonhole, with direct access to the seminal vesicle and fully sparing the anterior pubovesical complex. Our aim is to show the results of reproducing the technique of robotic radical prostatectomy by lateral approach, in terms of intraoperative, postoperative, oncological and functional parameters. METHODS: We analyzed 513 patients submitted to robotic radical prostatectomy by lateral approach from January 2015 to March 2021, operated on by two surgeons in our institution. The oncological and functional results of both surgeons were compared. RESULTS: When comparing both surgeons, the rate of positive surgical margins (PSM) was 32.87% and 37.9% and significant surgical margins (PSM > 2 mm) were 5.88% and 7.58% (p = 0.672) for surgeon 1 and surgeon 2, respectively. Immediate continence was 86% and 85% and sexual potency at one year 73% and 72%, with a similar rate of complications for surgeon 1 and 2. CONCLUSIONS: Radical prostatectomy by the lateral approach technique with preservation of the anterior pubovesical complex is reproducible and offers good oncological and functional results.

Strengthening the Pharmacovigilance System in Mexico: Implementation of VigiFlow and VigiLyze, as ICSR and Signal Detection Management Systems.

Pharmacovigilance (PV) activities aim to identify potential risks of medicines and vaccines after they have been authorised in the market by collecting and analysing information on suspected adverse events from different stakeholders. These can be captured and transmitted electronically in the form of Individual Case Safety Reports (ICSRs). Hence, up-to-date ICSRs management systems, like VigiFlow and signal detection and management systems as VigiLyze, have an important role in the PV system of a country. In 2019, after various attempts to establish a PV database that could fulfil the needs of the country, Mexico's National Regulatory Authority, COFEPRIS (Federal Commission for the Prevention against Sanitary Risks) decided to implement these tools. This has been a successful project that is still ongoing, it has involved national and international organisations, and has required the participation and integration of different components of the national PV system. The implementation of these tools has allowed COFEPRIS to increase its reporting trends and quality of reporting, while contributing to make more efficient interactions and processes with PV stakeholders, even during the COVID-19 pandemic. It has also allowed them to strengthen their commitment to the WHO-Programme for International Drug Monitoring, while highlighting opportunities for improvement in the national PV scenario and in the PV tools themselves. The aim of this article is to describe the implementation process, give an overview of current results regarding ICSR data and processes, and highlight the achievements, challenges, and opportunities for improvement after the three years since the beginning of the project.

Wellbeing, social media addiction and coping strategies among Chilean adolescents during the pandemic.

Introduction: During the COVID-19 pandemic, adolescents had to deal with a range of mental health problems that has increased social media addiction levels with adverse effects on life satisfaction. Previous studies have explored coping mechanisms to deal with this addiction problem, but did not consider the need to simultaneously cope with different dimensions. Therefore, our study aimed to examine the moderating effect of various coping mechanisms on the relationship between social media addiction and adolescent life satisfaction. Methods: Self-report questionnaires were applied to 1290 secondary school students (age mean = 16.03, SD = 1.27, range: 14 to 19; and 57% female). An exploratory and a confirmatory factor analysis were performed to determine the factor structure of the Brief-Cope 28 scale. Then, a descriptive and correlational analysis of the variables and a multiple linear regression analysis was performed. Results: We found that the social media addiction risk was negatively associated with life satisfaction, adaptive strategies were positively correlated to life satisfaction, and maladaptive strategies were negatively correlated to it. Also, a moderation model was evaluated in which four stress management strategies, namely acceptance and perspective-taking, seeking socio-emotional support, active coping, and maladaptive strategies all conditioned the relationship between social media addiction risk and life satisfaction after controlling for demographic variables and the specific strategies of using comedy, religion and substance use. Results indicate additive and multiplicative effects of management strategies for stressful situations in the studied relationship. Seeking socio-emotional support and active coping were positively related to life satisfaction and maladaptive strategies were negatively associated with it. Multiplicative effects indicate that the relationship between the social media addiction risk and life satisfaction depends only on the acceptance and perspective taking that adolescents report. When adolescents reported having low or average levels of acceptance and perspective taking, there was a negative correlation with general life satisfaction, a connection that grew markedly stronger. In contrast, no connection between social media addiction and life satisfaction was detected for adolescents who report higher levels of acceptance and perspective-taking. Discussion: Abuse of social media and the use of maladaptive stress coping strategies were risk factors that decreased life satisfaction among adolescents during the COVID-19 pandemic period.

Measuring school social climate in Latin America: the need for multidimensional and multi-informant tests - A systematic review.

Introduction: School social climate is central to understanding learning experiences in education environments. Previous studies describe various conceptual and operational definitions around the construct; however, there are no records of reviews focused on Latin America. Aim: This study sought to analyze the available evidence and the quality of school social climate measures in Latin America through a systematic review of the literature based on the PRISMA methodology and the COSMIN checklist to assess the psychometric properties of the instruments. Methodology: The Web of Science, Scopus, Psycinfo, and SciELO databases were consulted. A total of 582 records was identified, of which 27 fulfilled the inclusion criteria and methodological quality to be included in the systematization. Results: The results show that the country with the greatest scientific production on the topic is Chile, the measures are centered mainly on the students' perspective and the most used instrument is the CECSCE. In addition, a common aspect to all the records is that they were not sufficient to capture the complexity of school social climate. Conclusion: Multidimensional and multi-informant measures are needed to adequately assess the construct.

The negative association of perceived stress with adolescents' life satisfaction during the pandemic period: The moderating role of school community support.

Purpose: To analyze the association of perceived stress on the life satisfaction of Chilean adolescents during the recent pandemic, and to evaluate the moderating role that school community support provides. Methods: A total of 1337 adolescents in Chile (56.6% females), aged 14 through 19 (M = 15.99; SD = 1.3) participated. Descriptive statistics, a multiple linear regression model, and moderation analysis were all employed. Results: Females were associated with lower levels of Life Satisfaction (B = -0.19, p = .042), which was not the case for the Age variable (p = .160). The level of Perceived Stress was shown to have a negative association on Life Satisfaction (B = -1.93, p < .001). The moderation analysis revealed an interaction factor between Perceived Stress and School Community Support as predictors of Life Satisfaction (B = 0.37, t = 4.91, p < .001), showing that higher levels of School Community Support moderated the negative effect of Perceived Stress on Life Satisfaction. Conclusions: Perceived stress during the pandemic had a negative association on life satisfaction. School community support was a protective factor for this negative effect, even in the case of online classes due to school closures. Strengthening the connection between adolescents and their school communities along with providing additional tools and resources in support of such a connection are both essential.

Down-Regulation-Resistant STAT4 Risk Haplotype Contributes to Lupus Nephritis Through CD4+ T Cell Interferon-γ Production.

OBJECTIVE: Variants in STAT4 are associated with systemic lupus erythematosus (SLE) and other autoimmune diseases. We undertook this study to investigate how disease-associated variants affect STAT4 expression, in particular in CD4+ T cells where STAT4 plays an essential role. METHODS: We compared Th1 differentiation between naive CD4+ T cells from healthy donors homozygous for the risk (R/R) or nonrisk (NR/NR) alleles. We analyzed epigenetic marks in STAT4 and evaluated the relevance of its third intron, assessed the consequences of Stat4 overexpression in vivo in mice, and analyzed the effects of the STAT4 genotype in patients with lupus nephritis. RESULTS: Naive CD4+ T cells from NR/NR healthy donors down-regulated STAT4 in response to interleukin-12 (IL-12). In contrast, cells from R/R healthy donors maintained high levels. R/R cells exhibited a higher abundance of transcriptionally active STAT4 and increased interferon-γ production. Accordingly, R/R healthy donors exhibited a stronger induction of local active enhancer marks. Genetic editing confirmed the presence of a negative regulatory region in the STAT4 third intron, where most of the SLE-associated STAT4 single-nucleotide polymorphisms (SNPs) are located. In vivo forced expression demonstrated that increases in Stat4 levels in T cells enhanced glomerulonephritis in mice. Accordingly, the R/R genotype was associated with suboptimal response to treatment and with worse clinical outcomes in patients with proliferative lupus nephritis. CONCLUSION: The SLE-associated STAT4 haplotype correlates with an abnormal IL-12-mediated STAT4 transcriptional regulation. Carriers of the risk variant exhibit exaggerated CD4+ proinflammatory capacities that, in the context of SLE, contribute to more severe disease. R/R patients may benefit from blockade of the IL-12/STAT4 pathway.

The impact of COVID-19 and access to health services in the Hispanic/Mexican population living in the United States.

Introduction: The United States is home to 10.5 million undocumented immigrants, of which 5 out of 10 are Mexican or Central American. Their immigration status is an obstacle to secure employment that provides labor benefits such as sick leave and health insurance. Living through the global pandemic in the U.S. had a negative impact on this vulnerable population's mental and physical health. They avoided seeking primary or hospital care fearful that they were undocumented and uninsured. The services provided by the Ventanillas de Salud (VDS) "Health Windows" mitigated this pandemic's negative impact and have become an important source to support and increase access to health services among the immigrant community. Methods: De-identified data from a database system called the Continuous Information System and Health Reports of Mexicans in the United States (SICRESAL-MX) to perform this secondary analysis. The descriptive analysis describes socio-demographic, epidemiological, and situational characteristics of COVID-19. Results: Between January 2020 and July 2021, the VDS and UMS provided 11.5 million individual services to just over 4.3 million people. The main health conditions are overweight and obesity, high blood pressure and elevated cholesterol and glucose levels. Between March 2020 to July 2021 a total of 2,481,834 specific services related to COVID-19 were offered. Discussion: The Mexican migrant community in the United States is in a vulnerable situation, largely due to its immigration status which limits their access to health and human services, including primary health care services. Many of them have suffered from chronic diseases since before the pandemic, generating difficulties in monitoring the ailments and exacerbating their conditions.

Violencia de pareja en adolescentes chilenos: Influencia del abuso infantil en la victimización y perpetración / Association of adolescent dating violence as victim or perpetrator with childhood maltreatment

BACKGROUNDBackground: Childhood maltreatment extends beyond this stage of development, impacting adolescence and adulthood, and even adolescent dating violence. Adolescence is an essential transitional stage, so dating violence puts development at risk. In Chile, studies on adolescent dating violence are just emerging and still show a gap. Aim: To examine the relationship between abuse during childhood with victimization and perpetration experiences for adolescent dating violence. MATERIAL AND METHODS: The sample consisted of 242 adolescents between 14 and 19 years of age (59% females) who completed the Conflict in Adolescent Dating Relationship Inventory (CADRI) and the Childhood Trauma Questionnaire-Short Form (CQT-SF), both in their Spanish version. Multiple regression analysis was used to evaluate the degree of association between sexual, emotional, and physical abuse during childhood with adolescent dating violence. Results: Sexual and emotional abuse were predictors of dating victimization. In addition, sexual and physical abuse were found to be predictors of perpetration. CONCLUSIONS: Our study supports the evidence on differentiated outcomes between adolescent dating victimization and perpetration. Moreover, it highlights the role of childhood sexual abuse as a predictor of both.

Victims of Cyberbullying: Feeling Loneliness and Depression among Youth and Adult Chileans during the Pandemic.

In Chile, during the COVID-19 pandemic, reports of cyberbullying victimization increased for adolescents and younger adults. Research has shown that cyber-victims-adolescents and young adults alike-are at greater risk for mental health problems such as depression as a result of this negative type of aggression. Yet, a paucity of research has examined the individual mechanisms germane to cyber-victim depression. We focused on loneliness for the current study. We hypothesized that cyber-victimization would be positively related to depressive symptoms through increased fears of loneliness and that this effect would differ between adolescents and younger adults. Thus, we examined a sample of 2370 participants from all main regions of Chile aged from 15 to 29 years. Moderated mediation results showed a negative effect of cyberbullying on depression, which was mediated by increased fears of being alone. The effect of frequency of cyberbullying on fear of loneliness was stronger for younger adults compared to adolescents. Our results suggest different mechanisms for both age groups, which can inform prevention programs and their specific activities.

Innovative Technology-Based Interventions to Reduce Stigma Toward People With Mental Illness: Systematic Review and Meta-analysis.

BACKGROUND: Stigma toward people with mental illness presents serious consequences for the impacted individuals, such as social exclusion and increased difficulties in the recovery process. Recently, several interventions have been developed to mitigate public stigma, based on the use of innovative technologies, such as virtual reality and video games. OBJECTIVE: This review aims to systematically review, synthesize, measure, and critically discuss experimental studies that measure the effect of technological interventions on stigmatization levels. METHODS: This systematic review and meta-analysis was based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines and included studies in English and Spanish published between 2016 and 2021. Searches were run in 5 different databases (ie, PubMed, PsycInfo, Scopus, Cochrane Library, and ScienceDirect). Only randomized controlled trials were included. Two independent reviewers determined the eligibility, extracted data, and rated methodological quality of the studies. Meta-analyses were performed using the Comprehensive Meta-Analysis software. RESULTS: Based on the 1158 articles screened, 72 articles were evaluated as full text, of which 9 were included in the qualitative and quantitative syntheses. A diversity of interventions was observed, including video games, audiovisual simulation of hallucinations, virtual reality, and electronic contact with mental health services users. The meta-analysis (n=1832 participants) demonstrated that these interventions had a consistent medium effect on reducing the level of public stigma (d=-0.64; 95% CI 0.31-0.96; P<.001). CONCLUSIONS: Innovative interventions involving the use of technologies are an effective tool in stigma reduction, therefore new challenges are proposed and discussed for the demonstration of their adaptability to different contexts and countries, thus leading to their massification. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42021261935; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021261935.

Comparison of the Impacts of a Dynamic Exercise Program vs. a Mediterranean Diet on Serum Cytokine Concentrations in Women With Rheumatoid Arthritis. A Secondary Analysis of a Randomized Clinical Trial.

Background: Rheumatoid arthritis (RA) is a disease characterized by a chronic inflammatory state. High pro-inflammatory cytokine levels are associated with disease activity. Exercise and the Mediterranean diet (MD) exert anti-inflammatory effects; however, their impacts on inflammation in RA patients remains unknown. This study aimed to compare the effects of six-months of dynamic exercise program (DEP) vs. MD on pro- and anti-inflammatory cytokine serum concentrations. Methods: Secondary analysis of a randomized clinical trial in which 90 women with RA were randomly assigned to the DEP (n = 30), MD (n = 30), or control group (n = 30). All patients received pharmacological treatment. Serum concentrations of pro-inflammatory (TNF-α, TNF-ß, IL-1ß, IL-6 pg/mL) and anti-inflammatory (IL-10, IL-Ra pg/mL) cytokines were measured at baseline and after 6 months using the Luminex technique. Results: After 6 months of follow-up, we found an improvement of the median percentages changes concentrations of TNF-α (DEP, -12.3; MD, -13.3; control, 73.2; p = 0.01), TNF-ß (DEP, -67.4; MD, -54.9; control, 0; p = 0.04), and IL-6 (DEP, -19.9; MD, -37.7; control, 45.5; p = 0.04) in the DEP and MED groups in comparison with control group. IL-1Ra concentrations increased only in the MD group (13.8) compared to levels in the control group (-31.7), p = 0.04. There were no statistically significant differences between DEP and MD groups. Only n = 27 participants in the DEP group, n = 26 in the MD group, and n = 21 in the control group completed the follow-up. Conclusion: The DEP and the MD have potential effects in the concentrations of pro-inflammatory cytokines compared with those in a control group. Only the MD elevated the concentration of IL-Ra. Clinical Trial Registration: [ClinicalTrials.gov], identifier [NCT02900898].

The role of family support and conflict in cyberbullying and subjective well-being among Chilean adolescents during the Covid-19 period.

Introduction: Life satisfaction plays a crucial role in integral development and mental health during childhood and adolescence. Recently, it has been shown that cyberbullying has severe consequences for the mental health and wellbeing of victims such as increased anxiety, depressive symptoms and even suicide risk. Although the role of the family in life satisfaction and cyberbullying behaviors has been studied, there is limited information on its impacts during the current pandemic period. Objective: The aim of this study is to determine the role of family variables regarding students' levels of life satisfaction and cyberbullying victimization during the pandemic period. Method: Structural equation modeling was done using data from a cross-sectional study (n = 287; age ranged 14-18) conducted in six schools in Santiago, Chile during 2020. Results: The tested model has a good fit and parsimonious adjustment. It explained 25.9% of the life satisfaction and 9% of the variance of cyberbullying victimization. Family support was positively associated with life satisfaction (p < 0.001) and negatively associated with cyberbullying victimization (p < 0.05). Likewise, family conflict was positively associated with levels of cyberbullying victimization (p < 0.05) and negatively associated with life satisfaction levels (p < 0.001). Finally, family visits were only positively associated with life satisfaction (p < 0.01). Conclusions: Generating interventions on several levels focused on positive family bonds has become essential and urgent. This is especially important considering their protective impacts on cyberbullying victimization in promotion of adolescent well-being and quality of life.

Fibrilación auricular en el primer nivel de atención médica / Atrial fibrillation in the first level of medical care

Introducción: La fibrilación auricular constituye un importante problema de salud, debido al aumento de su incidencia con la edad y a la asociación con otras morbilidades. Los pacientes con fibrilación auricular tienen de 4 a 5 veces mayor riesgo de accidente cerebrovascular y alrededor del doble de riesgo de mortalidad en relación con los que no sufren fibrilación auricular. Objetivo: Caracterizar a los pacientes con fibrilación auricular atendidos en el Policlínico de Guanabo. Métodos: Se realizó un estudio retrospectivo descriptivo transversal que incluyó a todos los pacientes adultos ingresados con esta arritmia en el Área Intensiva Municipal Guanabo. Se revisaron 24 meses (10 de 2017 y 2018 y primer cuatrimestre de 2019). Las variables estudiadas fueron: diagnóstico principal al ingreso, estado hemodinámico, letalidad, estrategia terapéutica y conducta final. Resultados: Al ingreso el diagnóstico principal fue fibrilación auricular (52 por ciento), además de presentar otra afección asociada. El resto de los pacientes (44) tuvo otros diagnósticos; 6,5 por ciento llegó con inestabilidad hemodinámica. Fallecieron dos casos para una letalidad de 2,2 por ciento. La cardioversión farmacológica fue usada en 68 casos (75 por ciento. Los medicamentos más usados fueron amiodarona, atenolol y digoxina. La cardioversión eléctrica se aplicó solo en cuatro casos de los seis inestables. El 58 por ciento egresó a domicilio, remitió 39 por ciento, 70 por ciento tuvo una estadía entre dos y tres horas. Conclusiones: El diagnóstico principal al ingreso correspondió a la fibrilación auricular, con estabilidad hemodinámica y letalidad baja. La estrategia terapéutica utilizada fue amiodarona, atenolol y digoxina. El servicio logra alta resolutividad. La estadía promedio fue dos a tres horas(AU)

Introduction: Atrial fibrillation is an important health concerns, due to its increasing incidence with aging and association with other diseases. Patients with atrial fibrillation have 4-5 times the risk of stroke and about twice the risk of death in relation to those without atrial fibrillation. Objective: To characterize patients with atrial fibrillation treated at Guanabo outpatient Polyclinic. Methods: A retrospective, descriptive and cross-sectional study was carried out with all the patients admitted, with the aforementioned arrhythmia, in the municipal intensive care unit of Guanabo (eastern Havana, Cuba). Twenty-four months were reviewed (10 from 2017 and 2018, and the first four-month period of 2019). The variables studied were main diagnosis at admission, hemodynamic status, lethality, therapeutic strategy, and final behavior. Results: Regarding their main diagnosis on admission, fibrillation accounted for 52 percent of cases, another entity plus electrocardiographic findings accounted for the rest; 6.5 percent arrived with hemodynamic instability. Two cases died, which resulted in a case fatality rate of 2.2 percent. Pharmacological cardioversion was used in 68 cases (75 percent). The most commonly used drugs were amiodarone, atenolol and digoxin. Electrical cardioversion was applied in only four of the six unstable cases. Fifty-eight percent were discharged home, 39 percent were remitted, and 70 percent had a stay between two and three hours. Conclusions: The main diagnosis at admission was atrial fibrillation, with hemodynamic stability and low lethality. The therapeutic strategy consisted of amiodarone, atenolol and digoxin. The service showed high solving capacity. The average length of stay was two to three hours(AU)

Changes in hand grip strength and body weight after a dynamic exercise program and Mediterranean diet in women with rheumatoid arthritis: a randomized clinical trial.

BACKGROUND: In patients with rheumatoid arthritis (RA) exercise improves muscle strength and decreases fat mass, whereas the consumption of a Mediterranean diet (MD) also has been associated with higher grip strength. Therefore, it is important to explore the combined effects of these interventions on hand grip strength and weight in RA. OBJECTIVE: To determine the combined effect of an MD and a dynamic exercise program (DEP) on hand grip strength in women with RA. METHOD: In a randomized clinical trial, 106 women with RA were included and assigned to the DEP-MD, DEP and MD groups. Weight, body circumferences, Disease Activity Score-28, Health Assessment Questionnaire Disability Index [HAQ-DI], and hand grip strength were measured at baseline and 24 weeks after the interventions. RESULTS: After 24 weeks, hand grip strength showed a significant increase in the DEP group (median 2 kg) compared with DEP-MD (median 0.5 kg) and MD (median -0.5 kg) groups (p = 0.03). In the MD group weight and waist circumference showed a significant decrease (-2.2 kg and -4.3 cm) compared with DEP-MD (0.85 kg and 1.9 cm) and DEP (0.35 kg and 0.5 cm) groups (p < 0.01). Finally, a significant decrease was observed in the HAQ-DI after treatment in the DEP-MD group of -0.5 and the DEP group of -0.25 compared with the MD group with no change (p = 0.03). CONCLUSION: In women with RA, in addition to pharmacological treatment, DEP increases hand grip strength and an MD decreases weight and waist circumferences, while the combination of DEP and MD improves disability.

[Association of adolescent dating violence as victim or perpetrator with childhood maltreatment]. / Violencia de pareja en adolescentes chilenos: Influencia del abuso infantil en la victimización y perpetración.

BACKGROUND: Childhood maltreatment extends beyond this stage of development, impacting adolescence and adulthood, and even adolescent dating violence. Adolescence is an essential transitional stage, so dating violence puts development at risk. In Chile, studies on adolescent dating violence are just emerging and still show a gap. AIM: To examine the relationship between abuse during childhood with victimization and perpetration experiences for adolescent dating violence. MATERIAL AND METHODS: The sample consisted of 242 adolescents between 14 and 19 years of age (59% females) who completed the Conflict in Adolescent Dating Relationship Inventory (CADRI) and the Childhood Trauma Questionnaire-Short Form (CQT-SF), both in their Spanish version. Multiple regression analysis was used to evaluate the degree of association between sexual, emotional, and physical abuse during childhood with adolescent dating violence. RESULTS: Sexual and emotional abuse were predictors of dating victimization. In addition, sexual and physical abuse were found to be predictors of perpetration. CONCLUSIONS: Our study supports the evidence on differentiated outcomes between adolescent dating victimization and perpetration. Moreover, it highlights the role of childhood sexual abuse as a predictor of both.