Perception about adult caregiving among Chilean adolescents / Percepción acerca del cuidado de los adultos en adolescentes chilenos

BACKGROUND: Chronic stress has short and long-term consequences during child and adolescent development if the stress is not mediated by adult care-giving. AIM: To assess the perceptions of parental responsiveness, demand, and monitoring among seventh grade students. MATERIAL AND METHODS: We applied the Brief Parental Scale (developed and validated locally) asking 12 items about three dimensions, namely responsiveness, demand, and monitoring to 524 seventh grade students aged 12 years, 48% females, from eight public and private schools at Santiago. Results: The overall response rate was 85%. While the scores were higher for mothers, a significantly constant gradient for the same dimensions (demand > responsiveness > monitoring) was verified for both parents. CONCLUSIONS: The main hypothesis emerged from our study is that adolescents seem to perceive a discrepancy in terms of a relatively high demand and lower monitoring from parents/guardians towards them. The differences between fathers and mothers in adolescent care and the different perceptions by gender of adolescents about parental caregiving, require a further analysis.

ANTECEDENTES: El estrés crónico ha demostrado tener efectos a corto y largo plazo en el desarrollo infantil y adolescente, especialmente si el estrés no es mediado por el cuidado adulto responsable. Objetivo: Evaluar la percepción de capacidad de respuesta, demanda y monitoreo parental en adolescentes de séptimo año básico. MATERIAL Y MÉTODOS: Se aplicó la Escala Parental Breve (desarrollada y validada localmente) consultando 12 ítems en relación a 3 dimensiones: capacidad de respuesta, demanda y monitoreo a 524 estudiantes de séptimo año básico de 12 años de edad (48% mujeres) de ocho establecimientos educacionales públicos y privados de Santiago. RESULTADOS: La tasa de respuesta promedio fue de 85%. Si bien los puntajes fueron superiores para madres, se verifica una gradiente significativamente constante para las mismas dimensiones (demanda > capacidad de respuesta > monitoreo) en ambas figuras parentales. Conclusiones: La principal hipótesis que emerge de nuestro estudio es que los adolescentes parecen percibir una discrepancia en términos de una relativa alta demanda de las figuras parentales y menor monitoreo por parte de estos hacia ellos. Otros aspectos que se deben profundizar están relacionados con las diferencias observadas entre los niveles de involucramiento de padres o madres y lo posiblemente reportado por niños/niñas sobre estas experiencias.

Perception about adult caregiving among Chilean adolescents.

BACKGROUND: Chronic stress has short and long-term consequences during child and adolescent development if the stress is not mediated by adult care-giving. AIM: To assess the perceptions of parental responsiveness, demand, and monitoring among seventh grade students. MATERIAL AND METHODS: We applied the Brief Parental Scale (developed and validated locally) asking 12 items about three dimensions, namely responsiveness, demand, and monitoring to 524 seventh grade students aged 12 years, 48% females, from eight public and private schools at Santiago. RESULTS: The overall response rate was 85%. While the scores were higher for mothers, a significantly constant gradient for the same dimensions (demand > responsiveness > monitoring) was verified for both parents. CONCLUSIONS: The main hypothesis emerged from our study is that adolescents seem to perceive a discrepancy in terms of a relatively high demand and lower monitoring from parents/guardians towards them. The differences between fathers and mothers in adolescent care and the different perceptions by gender of adolescents about parental caregiving, require a further analysis.

Clinical and molecular practice of European thoracic pathology laboratories during the COVID-19 pandemic. The past and the near future.

BACKGROUND: This study evaluated the consequences in Europe of the COVID-19 outbreak on pathology laboratories orientated toward the diagnosis of thoracic diseases. MATERIALS AND METHODS: A survey was sent to 71 pathology laboratories from 21 European countries. The questionnaire requested information concerning the organization of biosafety, the clinical and molecular pathology, the biobanking, the workload, the associated research into COVID-19, and the organization of education and training during the COVID-19 crisis, from 15 March to 31 May 2020, compared with the same period in 2019. RESULTS: Questionnaires were returned from 53/71 (75%) laboratories from 18 European countries. The biosafety procedures were heterogeneous. The workload in clinical and molecular pathology decreased dramatically by 31% (range, 3%-55%) and 26% (range, 7%-62%), respectively. According to the professional category, between 28% and 41% of the staff members were not present in the laboratories but did teleworking. A total of 70% of the laboratories developed virtual meetings for the training of residents and junior pathologists. During the period of study, none of the staff members with confirmed COVID-19 became infected as a result of handling samples. CONCLUSIONS: The COVID-19 pandemic has had a strong impact on most of the European pathology laboratories included in this study. Urgent implementation of several changes to the organization of most of these laboratories, notably to better harmonize biosafety procedures, was noted at the onset of the pandemic and maintained in the event of a new wave of infection occurring in Europe.

Enfermedad pilonidal sacrocoxígea: análisis de 2 técnicas quirúrgicas: experiencia personal / Sacrocoxygeal pilonidal disease: analysis of 2 surgical techniques: personal experience

Resumen Introducción: La enfermedad pilonidal sacrocoxígea (EPSC) es una patología crónica de resorte quirúrgico. Para su tratamiento se han descrito múltiples técnicas quirúrgicas, existiendo 2 grandes grupos: las técnicas abiertas y las cerradas. El objetivo del presente trabajo es comparar y analizar los resultados quirúrgicos de 2 técnicas, una abierta (marsupialización) y otra cerrada (Karydakis). Materiales y Método: Estudio de cohorte retrospectivo de pacientes operados electivamente con diagnóstico de quiste pilonidal por un único cirujano, entre julio de 2013 y julio de 2017 utilizando estas dos técnicas. Resultados: Se incluyeron 71 pacientes. 30 pacientes con marsupialización y 41 con Karydakis. Todos hospitalizados. Todos de alta al día siguiente de la cirugía. Ningún paciente requirió rehospitalización ni cirugías adicionales. En el análisis estadístico se identifican beneficios de la técnica de Karydakis en cuanto a complicaciones, dolor postoperatorio, dolor para sentarse, incapacidad laboral y tiempo de cicatrización. Conclusiones: En este artículo la cirugía con técnica de Karydakis tiene ventajas en relación a la marsupialización, considerándola como primera opción para la EPSC simple.

Introduction: Sacrocoxygeal pilonidal disease (EPSC) is a chronic pathology of surgical solution. For its treatment, multiple surgical techniques have been described, there being 2 large groups: open and closed techniques. The aim of the present study is to compare and analyze the surgical results of 2 techniques, one open (Marsupialization) and another closed (Karydakis). Materials and Method: Retrospective cohort study of electively operated patients with diagnosis of pilonidal cyst by a single surgeon, between July 2013 and July 2017 using these two techniques. Results: 71 patients were included. 30 patients with marsupialization and 41 with Karydakis. All hospitalized. All discharge the day after surgery. No patient required rehospitalization or additional surgeries. In the statistical analysis, benefits of the Karydakis technique are identified in terms of complications, postoperative pain, sitting pain, work incapacity and healing time. Conclusions: In this study, surgery with Karydakis technique has advantages in relation to Marsupialization, considering it as the first option for simple EPSC.

Olcegepant blocks neurogenic and non-neurogenic CGRPergic vasodepressor responses and facilitates noradrenergic vasopressor responses in pithed rats.

BACKGROUND AND PURPOSE: Olcegepant (BIBN4096BS) is a selective non-peptide CGRP receptor antagonist with acute antimigraine properties. Since systemic vascular tone is modulated by perivascular (primary sensory CGRPergic and sympathetic) nerves, this randomized study investigated in pithed rats the effect of acute i.v. treatment with olcegepant on the neurogenic and non-neurogenic: (i) CGRPergic vasodepressor responses; and (ii) noradrenergic vasopressor responses. The pithed rat is an experimental model predictive of systemic (cardio) vascular side effects. EXPERIMENTAL APPROACH: Seventy-five male Wistar rats (divided into 15 groups, n = 5 each) were pithed, artificially ventilated and prepared for: (i) spinal stimulation (T9 -T12 ; 0.56-5.6 Hz) of the sensory CGRPergic vasodepressor outflow or i.v. bolus injections (0.1-1 µg·kg-1 ) of α-CGRP, substance P or acetylcholine, which induced frequency-dependent or dose-dependent vasodepressor responses; or (ii) spinal stimulation (T7 -T9 ; 0.03-3 Hz) of the sympathetic vasopressor outflow or i.v. bolus injections (0.03-3 µg·kg-1 ) of noradrenaline, which produced frequency-dependent or dose-dependent vasopressor responses. KEY RESULTS: Olcegepant (1000 and 3000 µg·kg-1 , i.v.) dose-dependently blocked the vasodepressor responses to sensory nerve stimulation or i.v. α-CGRP, without affecting those to substance P or acetylcholine. Whereas it potentiated the vasopressor responses to sympathetic nerve stimulation or i.v. noradrenaline. CONCLUSIONS AND IMPLICATIONS: Olcegepant (i.v.) selectively blocked the neurogenic and non-neurogenic CGRPergic vasodepressor responses. This blockade by olcegepant potentiated the neurogenic and non-neurogenic noradrenergic vasopressor responses in pithed rats, an effect that might result in an increased vascular resistance and, consequently, in a prohypertensive action.

Development of an experimental model to study trigeminal nerve-mediated vasodilation on the human forehead.

BACKGROUND: During migraine, trigeminal sensory nerve terminals release calcitonin gene-related peptide (CGRP), inducing nociception and vasodilation. Applied on the skin, capsaicin activates the transient receptor potential vanilloid type 1 (TRPV1) channel and releases CGRP from sensory nerve terminals, thus increasing dermal blood flow (DBF). Using capsaicin application and electrical stimulation of the forehead skin, a trigeminal nerve-innervated dermatome, we aimed to develop a model to measure trigeminal nerve-mediated vasodilation in humans. METHODS: Using laser Doppler imaging, forehead DBF responses to application of capsaicin (0.06 mg/ml and 6.0 mg/ml) and saline, with and without iontophoresis, were studied in healthy subjects. The within-subject coefficient of variation (WCV) of repeated DBF measurements was calculated to assess reproducibility. RESULTS: Maximal DBF responses to 6.0 mg/ml capsaicin with and without iontophoresis did not differ (Emax 459 ± 32 and 424 ± 32 arbitrary units (a.u.), WCV 6 ± 4%). In contrast, DBF responses to 0.06 mg/ml capsaicin were significantly larger with than without iontophoresis (Emax 307 ± 60 versus 187 ± 21 a.u., WCV 21 ± 13%). Saline with iontophoresis significantly increased DBF (Emax: 245 ± 26 a.u, WCV 11 ± 8%), while saline application without iontophoresis did not affect DBF. CONCLUSION: Topical application of capsaicin and electrical stimulation induce reproducible forehead DBF increases and therefore are suitable to study trigeminal nerve-mediated vasodilation in humans.

[Proposing a data mining scaffolding for preventing harmful alcohol consumption in Chilean adolescents]. / Adolescentes y consumo nocivo de alcohol Chile 2009: mirando a las políticas públicas.

BACKGROUND: Adolescent alcohol and drug consumption are important public health problems in the Chilean young population. AIM: The purpose of this study was to examine the potential ofa data mining approach in scaffolding policy making, using the particular case of differential risks of harmful alcohol consumption in adolescent students. MATERIAL AND METHODS: Index and control groups were composed by 7918 and 7138 participants respectively (drawn from a CONACE survey 2009), aged 16 ± 2 years, 52% mole. Heavy drinking at last month was the independent variable. As dependent variables parenting style, peer group influence, age and sex were used. For data analysis, a data mining approach was applied (CART, SPSS version 15). RESULTS: The peer group influence was the main discriminant variable in males and the total sample, proving to be the only relevant variable in the case of women. The results suggest how a data mining approach may be useful in order to develop a hard data scaffolding for making and implementing policies in general and policies addressing adolescent alcohol consumption in particular.

The role of dopamine D2, but not D3 or D4, receptor subtypes, in quinpirole-induced inhibition of the cardioaccelerator sympathetic outflow in pithed rats.

BACKGROUND AND PURPOSE: Quinpirole (a dopamine D2-like receptor agonist) inhibits the cardioaccelerator sympathetic outflow in pithed rats by sympathoinhibitory D2-like receptors. The present study was designed to identify pharmacologically the specific D2-like receptor subtypes (i.e. D2 , D3 and D4) involved in this sympathoinhibition by quinpirole. EXPERIMENTAL APPROACH: One hundred fourteen male Wistar rats were pithed, artificially ventilated with room air and prepared for either preganglionic spinal (C7-T1) stimulation of the cardioaccelerator sympathetic outflow (n = 102) or i.v. bolus injections of exogenous noradrenaline (n = 12). This approach resulted in frequency-dependent and dose-dependent tachycardic responses, respectively, as previously reported by our group. KEY RESULTS: I.v. continuous infusions of quinpirole (0.1-10 µg kg(-1) min(-1)), but not of saline (0.02 mL min(-1)), dose-dependently inhibited the sympathetically induced tachycardic responses. Moreover, the cardiac sympathoinhibition induced by 3 µg kg(-1) min(-1) quinpirole (which failed to affect the tachycardic responses to i.v. noradrenaline) was: (i) unchanged after i.v. injections of the antagonists SB-277011-A (D3 ; 100-300 µg kg(-1)) or L-745,870 (D4 ; 30-100 µg kg(-1)); and (ii) markedly blocked and abolished by, respectively, 100 and 300 µg kg(-1) of the D2 preferring receptor subtype antagonist L-741,626. These doses of antagonists, which did not affect per se the sympathetically induced tachycardic responses, were high enough to completely block their respective receptors. CONCLUSIONS AND IMPLICATIONS: The cardiac sympathoinhibition induced by 3 µg kg(-1) min(-1) quinpirole involves the dopamine D2 receptor subtype, with no evidence for the involvement of the D3 or D4 subtypes. This provides new evidence for understanding the modulation of the cardioaccelerator sympathetic outflow.

Adolescentes y consumo nocivo de alcohol: Chile 2009: mirando a las políticas públicas / Proposing a data mining scaffolding for preventing harmful alcohol consumption in Chilean adolescents

Background: Adolescent alcohol and drug consumption are important public health problems in the Chilean young population. Aim: The purpose of this study was to examine the potential ofa data mining approach in scaffolding policy making, using the particular case of differential risks of harmful alcohol consumption in adolescent students. Material and Methods: Index and control groups were composed by 7918 and 7138 participants respectively (drawn from a CONACE survey 2009), aged 16 ± 2 years, 52% mole. Heavy drinking at last month was the independent variable. As dependent variables parenting style, peer group influence, age and sex were used. For data analysis, a data mining approach was applied (CART, SPSS version 15). Results: The peer group influence was the main discriminant variable in males and the total sample, proving to be the only relevant variable in the case of women. The results suggest how a data mining approach may be useful in order to develop a hard data scaffolding for making and implementing policies in general andpolicies addressing adolescent alcohol consumption in particular.

Cytogenetics findings in a histiocytic sarcoma case.

Histiocytic sarcoma (HS) is a neoplasm derived from histiocytes. Its diagnosis was not clear until its immunohistochemistry profile was correctly established. Not much is known about its genetic properties. We report a case of a 48-year-old male patient whose bone marrow was almost completely occupied by monomorphic medium size neoplastic cellularity. Its immunohistochemical profile was CD68(+), CD4(+), CD45(+) with negativity of other dendritic cells, and other lineage markers. Cytogenetic study showed 4 related clones: one with trisomy 8 and extra material on the short arms of chromosome 4; a second line with tetrasomy of chromosome 8, add(4)(p16); the third clone had the same alterations as the previous and deletion of chromosome 3 at q11; the fourth line had tetrasomy 8 and translocation t(3;5)(q25;q35). To our knowledge this is the first HS case showing chromosome 8 trisomy and tetrasomy and the other described alterations.

Úlcera tuberculosa intestinal como causa de hemorragia digestiva baja masiva exanguinante / Intestinal tuberculosis causing a severe gastrointestinal bleeding: report of one case

We report a 27 years old woman presenting with hematochezia. An upper endoscopy and colonoscopy did not reveal the bleeding site. Due to persistence of bleeding, the patient was operated, finding a fibrinous secretion surrounding bowel loops and a hyper vascularized concentric papular lesion. The involved bowel loop was excised. The pathological study of the surgical piece revealed intestinal tuberculosis. The patient started treatment for extra pulmonary tuberculosis.

Reportamos el caso de una paciente de 27 años con tuberculosis extrapulmonar gastrointestinal que se manifestó clínicamente como una hemorragia digestiva baja masiva exanguinante requiriendo cirugía de urgencia, donde se realizó laparotomía exploradora con entero y colonoscopía intraoperatoria localizando lesión a nivel de intestino delgado, resecando segmento comprometido con anastomosis primaria, evolución satisfactoria sin complicaciones postoperatorias.

Linfomas primarios de pulmón / Primary pulmonary lymphoma

Los linfomas de tejido linfoide asociado a mucosas (MALT), aún siendo infrecuentes en la población, han sido considerados como una entidad propia que puede afectar a distintas topografías del organismo. Presentamos 3 casos de linfomas primarios pulmonares MALT diagnosticados entre 1995 y 2009. La determinación se realizó tras cirugía y estudio patológico. La forma de presentación fue como nódulo/masa, con diagnóstico definitivo tras la extirpación (AU)

Mucosa-associated lymphoid tissue (MALT) lymphomas, although rare in the population, are considered an entity per se, that may affect different topographies of the body. We present 3 cases of primary pulmonary MALT lymphomas diagnosed between 1995 and 2009. The diagnosis was made after surgery and pathology study. The presentation form was a nodule/mass, with definitive diagnosis after excision (AU)

Hemorroidectomía cerrada y semicerrada: estudio prospectivo aleatorizado / Prospective randomized comparison of open and closed hemorrhoidectomy

Background: Grade III and IV internal hemorrhoids have a surgical indication. However there is no consensus about the best surgical procedure since all techniques have drawbacks, especially in terms of pain. Aim: To compare the results of open and closed hemorrhoidectomy. Material and Methods: Patients with grade III or IV internal hemorrhoids were randomly assigned to be treated with open or closed hemorrhoidectomy. Postoperative pain and complications were evaluated during 21 days in the postoperative period. Results: Twenty four patients were assigned to each treatment group. No differences between groups were observed for postoperative pain, complications, operative time or time required to go back to work. Ninety five percent of patients considered the ambulatory surgical procedure as good or very good. Conclusions: No differences between open and close hemorrhoidectomy were observed in this series of patients.

La enfermedad hemorroidaria interna grados III y IV se trata quirúrgicamente; actualmente no existe un gold standar, ya que las diferentes técnicas tienen sus inconvenientes, sobre todo en relación al dolor. El objetivo del presente estudio es comparar los resultados de la hemorroidectomía cerrada v/s la semicerrada en términos de dolor, complicaciones, tiempo operatorio y cicatrización. Pacientes y Método: Ensayo clínico controlado aleatorizado; se incluyeron 48 pacientes con hemorroides internos G III y IV operados en forma ambulatoria, se evaluó el dolor a través de la escala visual análoga (EVA) además del sangrado, infección, cicatrización, tiempo operatorio, reintegro laboral y satisfacción con respecto al procedimiento. Resultados: En este estudio se incluyeron 48 pacientes para hemorroidectomías, 24 cerradas y 24 semicerradas, ambos grupos fueron comparables. En relación al dolor no hubo diferencias entre ambos grupos tanto como para la medición de la escala EVA (p = 0,1768), como para la necesidad de rescate analgésico (p = 0,3290). No hubo diferencias en relación a las complicaciones, cicatrización, tiempo operatorio y reintegro laboral. El 95 por ciento de los pacientes consideró que la cirugía ambulatoria era buena y muy buena. Conclusiones: No existen diferencias significativas entre ambas técnicas y la cirugía ambulatoria es un procedimiento seguro y bien aceptado.

Effects of ionotropic glutamate receptor antagonists on rat dural artery diameter in an intravital microscopy model.

BACKGROUND AND PURPOSE: During migraine, trigeminal nerves may release calcitonin gene-related peptide (CGRP), inducing cranial vasodilatation and central nociception; hence, trigeminal inhibition or blockade of craniovascular CGRP receptors may prevent this vasodilatation and abort migraine headache. Several preclinical studies have shown that glutamate receptor antagonists affect the pathophysiology of migraine. This study investigated whether antagonists of NMDA (ketamine and MK801), AMPA (GYKI52466) and kainate (LY466195) glutamate receptors affected dural vasodilatation induced by alpha-CGRP, capsaicin and periarterial electrical stimulation in rats, using intravital microscopy. EXPERIMENTAL APPROACH: Male Sprague-Dawley rats were anaesthetized and the overlying bone was thinned to visualize the dural artery. Then, vasodilator responses to exogenous (i.v. alpha-CGRP) and endogenous (released by i.v. capsaicin and periarterial electrical stimulation) CGRP were elicited in the absence or presence of the above antagonists. KEY RESULTS: alpha-CGRP, capsaicin and periarterial electrical stimulation increased dural artery diameter. Ketamine and MK801 inhibited the vasodilator responses to capsaicin and electrical stimulation, while only ketamine attenuated those to alpha-CGRP. In contrast, GYKI52466 only attenuated the vasodilatation to exogenous alpha-CGRP, while LY466195 did not affect the vasodilator responses to endogenous or exogenous CGRP. CONCLUSIONS AND IMPLICATIONS: Although GYKI52466 has not been tested clinically, our data suggest that it would not inhibit migraine via vascular mechanisms. Similarly, the antimigraine efficacy of LY466195 seems unrelated to vascular CGRP-mediated pathways and/or receptors. In contrast, the cranial vascular effects of ketamine and MK801 may represent a therapeutic mechanism, although the same mechanism might contribute, peripherally, to cardiovascular side effects.

Ulceración perianal: Dos casos de una rara manifestación de tuberculosis extrapulmonar / Perianal tuberculosis: Report of two cases

Perianal tuberculosis is an uncommon variant of extra pulmonary tuberculosis and mimics other common perianal conditions. We report two patients with perianal tuberculosis. An 82-year-old male presenting with purulent perianal discharge and weight loss. A pelvic magnetic resonance imaging showed a low trans sphincteric anorectal fistula with abscess formation. A fistulectomy was performed and the pathological study showed a granulomatous-tuberculous chronic inflammation. Mycobacteria were recovered from gastric contents. A 48-year-old male with the same symptoms. An ulcerated lesion in the anal region was biopsied, disclosing a granulomatous inflammatory process with Ziehl-Nielsen stainable organisms.

The role of peripheral 5-HT1A, 5-HT1B, 5-HT1D, 5-HT1E and 5-HT1F serotonergic receptors in the reduction of nociception in rats.

This study assessed the possible antinociceptive role of peripheral 5-HT(1) receptor subtypes in the rat formalin test. Rats were injected into the dorsum of the hind paw with 50 microl of diluted formalin (1%). Nociceptive behavior was quantified as the number of flinches of the injected paw. Reduction of flinching was considered as antinociception. Ipsilateral, but not contralateral, peripheral administration of the 5-HT(1) receptor agonists R(+)-UH-301 (5-HT(1A); 0.1-3 microg/paw), CGS-12066A (5-HT(1B); 0.01-0.3 microg/paw), GR46611 (5-HT(1B/1D); 0.3-10 microg/paw), BRL54443 (5-HT(1E/1F); 3-300 microg/paw) or LY344864 (5-HT(1F); 3-300 microg/paw) significantly reduced formalin-induced flinching. The corresponding vehicle was devoid of any effect by itself. The local antinociceptive effect of R(+)-UH-301 (0.3 microg/paw) was significantly reduced by WAY-100635 (30-100 microg/paw; a 5-HT(1A) receptor antagonist). Moreover, the antagonists GR55562 (30-100 microg/paw; 5-HT(1B/D)) or SB224289 (30-100 microg/paw; 5-HT(1B)) dose-dependently reduced the antinociceptive effect of CGS-12066A (0.3 microg/paw) whereas GR55562 (30-100 microg/paw) or BRL15572 (30-100 microg/paw, 5-HT(1D)) reduced the antinociceptive effect of GR46611 (0.3 microg/paw). Interestingly, the effects of BRL54443 and LY344864 (300 microg/paw each) were partially reduced by methiothepin, but not by the highest doses of WAY-100635, SB224289 or BRL15572. The above antagonists did not produce any effect by themselves. These results suggest that peripheral activation of the 5-HT(1A,) 5-HT(1B), 5-HT(1D), 5-HT(1F) and, probably, 5-HT(1E) receptor subtypes leads to antinociception in the rat formalin test. Thus, the use of selective 5-HT(1) receptor agonists could be a therapeutic strategy to reduce inflammatory pain.