[Association between early onset of psychoactive drug use and health risk behaviors in chilean adolescents]. / Precocidad de inicio del consumo de sustancias psicoactivas y su relación con otros comportamientos de riesgo para la salud en adolescentes chilenos.

BACKGROUND: Adolescents are more prone to develop health risk behaviors. Among these, early consumption of psychoactive drugs is relevant. AIM: To assess the association between early consumption of illicit drugs, tobacco and alcohol, suicide behaviors, risky sexual behaviors, eating habits and physical activity in school age adolescents from Valparaiso, Chile. MATERIAL AND METHODS: The online world survey of scholar health to identify the health risk behaviors was answered by 550 adolescents aged 15 to 18 years, from a public educational institution at Valparaiso, Chile. RESULTS: Early consumption of alcohol, smoking and illicit drug use was reported by 59, 57 and 44% of respondents, respectively. The frequency of psychoactive drug consumption during the last month, risky sexual behaviors and missing breakfast was higher among those with an early onset of alcohol and illicit drug consumption and smoking. The frequency of suicidal risk behaviors and low consumption of fruits and vegetables was higher among those with an early onset of illicit drug use and smoking. A low physical activity level was associated with early smoking onset. Health risk behaviors were associated with early onset of alcohol and illicit drug consumption and smoking. CONCLUSIONS: Early onset of alcohol and illicit drug consumption and smoking is associated with health risk behaviors in Chilean adolescents.

Effect of dermatological consultation on survival in patients with checkpoint inhibitor-associated cutaneous toxicity.

BACKGROUND: Cutaneous immune-related adverse events (cirAEs) are a common side-effect of immune checkpoint inhibitors (ICIs). However, prior work examining these toxicities in detail has considered only the fraction of events evaluated by dermatologists. Associations between dermatology referral, cirAE treatment and survival outcomes remain underexplored across care settings. OBJECTIVES: To comprehensively categorize cirAE patterns among all patients treated with immunotherapy at our institution, and to evaluate: (i) the effect of dermatology referral on cirAE treatment and (ii) the impact of cirAE treatment on survival. METHODS: This was a retrospective cohort analysis of patients with cancer who initiated ICI therapy between 1 January 2016 and 8 March 2019 and developed one or more cirAEs, as screened for using International Classification of Diseases 10th revision codes and confirmed via manual chart review (n = 358). All relevant information documented prior to 31 March 2020 was included. RESULTS: CirAEs evaluated by dermatologists were significantly more likely to be treated than cirAEs that were not referred (odds ratio 6·08, P < 0·001). Patients who received any cirAE treatment had improved progression-free survival [hazard ratio (HR) 0·59, P = 0·001] and overall survival (HR 0·58, P = 0·007) compared with those who did not. CONCLUSIONS: CirAEs evaluated by dermatologists were significantly more likely to be treated than cirAEs that were not referred, and patients who received any treatment for a cirAE had improved survival outcomes.

[Evaluation of a general education course on sexuality for university students]. / Educación sexual en las carreras de la salud del Campus Eloísa Díaz de la Universidad de Chile.

BACKGROUND: Education on human sexuality was instituted in Eloisa Díaz Campus in 1946. From 2018 an online self-learning general education course on sexuality was started. AIM: To know the degree of knowledge about sexuality and the perception about the course of 586 students (42% women) who approved the course. MATERIAL AND METHODS: The Myths and False beliefs and Self-perception on sexuality tests were applied to students at the onset and the end of the course. They also anonymously evaluated the course. RESULTS: In the first assessment, the proportion of correct answers about sexuality and reproduction were 47 and 40% respectively. In the second assessment, 70% of respondents had open criteria about sexuality and 90% rejected traditional criteria. In the anonymous assessment, 95% estimated that the objectives of the course were accomplished. Its quality was considered good or excellent by 95% of respondents. CONCLUSIONS: This course was well accepted by students and corrects their knowledge gaps in sexuality. Despite the social unrest during 2019 and the pandemic during 2020, the course was successfully completed by most students.

The expression of the transcription factor TAF1 is modified by the HPV16 E2 protein.

High-risk human papillomaviruses (e.g., HPV16 and 18) are associated with cervical cancer occurrence and development. The early viral gene E2 encodes a protein involved in several key processes in HPV biology, such as replication, genome segregation, and viral gene transcription. E2's presence also affects the expression of a variety of cellular genes involved in a wide range of biological processes, including cell cycle regulation and apoptosis, which are mediated by E2's interaction with cellular proteins. In this report, a lentiviral system was used to express the HPV16 E2 gene in the HPV-negative C-33A cell line for several weeks. E2 expression was measured by RT-qPCR and its biological activity was evaluated using a reporter gene. In HPV16 E2-positive cells, we observed a statistically significant increase in mRNA and protein levels of TAF1 and p27, a basal transcription factor and one of its target genes, respectively. To our knowledge, this is the first study showing that the viral protein HPV16 E2 upregulates TAF1 expression. This suggests that E2's expression promotes a transcriptionally-favorable cellular environment that allows HPV to successfully complete its replication cycle. Keywords: HPV16; E2 protein; transcription; TAF1 regulation.

[Association between eating habits and health related quality of life among school age adolescents]. / Hábitos alimentarios, obesidad y calidad de vida relacionada con la salud en adolescentes chilenos.

BACKGROUND: Adolescence is considered a nutritionally vulnerable period of life, since their eating habits are influenced by factors that can promote the consumption of non-nutritious food. AIM: To analyze the relation between eating habits, obesity, and the perception of Health-Related Quality of Life in school-aged adolescents. MATERIAL AND METHODS: A cross-sectional study of 550 adolescents aged 16 ± 1 years (60% women) attending a public education institution in Valparaíso, Chile. The Global School-based Student Health Survey (GSHS) for eating habits and the KIDSCREEN-27 survey for health-related quality of life were self-administered online. The answers were anonymous. A logistic regression analysis was conducted to evaluate the relationship between the variables, which was adjusted for age and sex. RESULTS: Ten percent of men and 6% of women were obese. Those with an inadequate consumption of fruits had a worst perception of their physical well-being, autonomy and relationship with their parents. Psychological well-being and school environment were perceived worst among those that did not consume breakfast. Obese respondents also reported a poorest physical health. CONCLUSIONS: Inadequate eating habits and obesity have a negative effect of health-related quality of life among adolescents.

Aquaporin-4-IgG positive neuromyelitis optica spectrum disorder and systemic autoimmune diseases overlap syndrome: a single-center experience.

OBJECTIVE: To describe the clinical and radiological characteristics and outcomes of patients with aquaporin-4-immunoglobulin G (AQP4-IgG) seropositive neuromyelitis optica spectrum disorder (NMOSD) coexisting with systemic lupus erythematosus (SLE) and primary Sjögren's syndrome (pSS) in a single center. METHODS: We included patients with diagnosis of NMOSD and a concomitant diagnosis of SLE or pSS. Demographic, clinical, serological and imaging characteristics were retrieved from clinical charts. RESULTS: Twelve patients were included, of whom 11 (91.7%) were women. Seven (58.3%) had SLE and five (41.7%) pSS. In five (41.7%) patients NMOSD followed SLE/pSS onset, four (33.3%) patients had a simultaneous presentation, and in three (25%) NMOSD preceded pSS onset. The mean age at first neurological event was 39 years. Eleven patients (91.7%) experienced acute transverse myelitis/longitudinally extensive transverse myelitis, five (41.7%) optic neuritis, three (25%) a cerebral syndrome and two (16.7%) each area postrema syndrome, acute brainstem syndrome and cerebellar syndrome. Eleven (91.7%) patients went into either total or partial NMOSD remission at median follow-up of 89.5 months. CONCLUSION: AQP4-IgG seropositive NMOSD arose in the context of quiescent SLE and pSS with extraglandular features. As NMOSD coexisting with SLE/pSS is rare, collaborative multicenter studies are needed to clarify the natural history and outcomes of this overlap syndrome.

Anti-citrullinated protein antibodies and arthritis in Sjögren's syndrome: a systematic review and meta-analysis.

OBJECTIVE: The presence of anti-citrullinated protein antibodies (ACPAs) in primary Sjögren's syndrome (pSS) ranges from 3% to 9.9%; however, there is no agreement about their clinical significance. Our aim was to systematically review the literature regarding the association of arthritis and ACPAs in pSS and their role in the development of rheumatoid arthritis (RA). METHOD: A comprehensive search of MEDLINE, ISI Web of Knowledge, and Cochrane Library from inception until June 2016 was undertaken using the combination of two or three of the keywords: primary Sjögren's syndrome, Sjögren's syndrome, arthritis, synovitis, arthropathy, anti-cyclic citrullinated peptide antibodies, and anti-citrullinated protein antibody - ACPA. No language restriction was used. Studies were included if they: assessed the association of arthritis and ACPAs, had sufficient data to construct a two-by-two table, tested immunoglobulin G ACPA by any method, and included patients with pSS according to a validated set of classification criteria. We used a random effects model and evaluated the heterogeneity and publication bias. RESULTS: Ten studies were included (involving 1322 patients). We found a pooled odds ratio of 4.42 (95% confidence interval 1.15-16.94, p = 0.03). The test for heterogeneity was I2 = 0.87. Publication bias was not observed. Based on data from three studies, 33 of 58 pSS patients with ACPAs (57%) developed RA compared with none of 598 pSS patients with negative ACPA (p < 0.000001). CONCLUSION: Patients with pSS disclosing ACPAs are prone to arthritis as part of the clinical spectrum of the disease, but are also at risk of developing RA.

Randomized clinical trial of class II restoration in permanent teeth comparing ART with composite resin after 12 months.

OBJECTIVE: This study evaluated the effectiveness of class II restorations, in permanent teeth, through the ART technique in comparison to composite resin. MATERIALS AND METHODS: Participants (154), aged 8 to 19 years, with good general health, with class II cavities in permanent teeth, and without pulp involvement and tooth pain were included in this parallel and randomized clinical trial. The Ethics Committee approval number was CAAE: 24012913.0.1001.5417. Seventy-seven restorations were made with each restorative material (Equia Fil-GC Corporation and Z350-3M). Evaluations occurred at 6 and 12 months by the criteria of ART and the USPHS modified. Data were analyzed by Mann-Whitney, chi-square, Fisher's exact, chi-square tests with linear trend and logistic regression by enter method (p < 0.050). The Kaplan-Meier test evaluated the survival rates of the restorations. The log-rank test compared the survival curves. RESULTS: Regardless of the evaluation criteria used, the success rates of ART restorations were 98.7% (6 months) and 95.8% (12 months) and for composite resins were 100% (6 months) and 98.7% (12 months), with no statistical difference of restoration groups (p > 0.050). Survival rates for restorations, regardless of the evaluation criteria used, are the same as the success rates, with the exception of ART restorations at 12 months of follow-up (94.8%). CONCLUSION: No differences in the success rates of class II restorations of ART compared to resin composite, in permanent teeth, were observed after 12 months. CLINIC SIGNIFICANT: HVGIC can safely be used to restore proximal cavities in permanent teeth up to 12 months.

[Psychoactive substances use and health-related quality of life among school age adolescents]. / Uso de sustancias psicoactivas y calidad de vida relacionada con la salud en adolescentes escolarizados.

Background The use of psychoactive substances among adolescents is a major social and public health concern. Aim To analyze association of substance abuse and multiple drug use with health-related quality of life (HRQOL) in adolescents attending a high school in Valparaiso, Chile. Material and Methods Analytical cross-sectional study conducted in a sample of adolescents attending high school. HRQOL was assessed using KIDSCREEN-52 questionnaire and substance use was measured using the Global school-based student health survey. Participants had to complete online, self-administered, anonymous questionnaires. Multiple logistic regression analyses were conducted to calculate Odd ratios. Results A total of 550 adolescents aged 16 ± 1 years old completed the questionnaires. Thirty nine percent consumed alcohol during the last month, 31% smoked, 33% used marijuana and 33% admitted the use of multiple drugs. High-risk alcohol consumption was associated with a lower perception of psychological well-being, self-perception and school environment. This last dimension was affected in those who admitted marijuana use during the last month. Multiple drug use (three substances) was associated with a lower perception of physical and psychological well-being, self-perception, relationship with parents, family life and school environment. Conclusions High-risk alcohol consumption and multiple drug use (three substances) have a negative impact on the HRQOL of school age adolescents.

[Implications of chilean legal framework in teen pregnancy prevention: conflict and insecurity in health professionals]. / Implicancias del marco legal chileno en la prevención del embarazo adolescente: conflicto e inseguridad en los profesionales de la salud.

BACKGROUND: Teenage pregnancy is a psychosocial and multifactorial problem described as a lack of exercise of rights in sexual and reproductive health. There are important aspects in the doctor-patient relationship and confidentiality that directly affect the continuity and quality of care. There are controversies in the laws relating to the provision of contraception and confidentiality, and those that protect the sexual indemnity, especially in adolescents under 14 years. AIM: To describe the implications of the legal framework for professional midwives in the care of adolescents younger than 14 years in sexual and reproductive health. MATERIAL AND METHODS: In-depth interviews were conducted to 13 female and 2 male midwives working at Primary Health Care Centers in the Metropolitan Region. RESULTS: The attention of adolescents younger than 14 years in sexual and reproductive health involves medical-legal issues for health professionals. All professionals recognize that mandatory reporting sexual activity is a complex situation. All professionals notify pregnancies. In relation to the delivery of contraception, clinical care is problematic since professionals should take shelter from a legal standpoint. CONCLUSIONS: The medical-legal context of pregnant women under 14 years of age care generates a context of uncertainty and fear for professionals and becomes a source of conflict and insecurity in the exercise of the profession.

[Gender differences in health-related quality of life of Chilean adolescent students]. / Diferencias de género en la calidad de vida relacionada con la salud en adolescentes escolarizados chilenos.

BACKGROUND: Health-related quality of life (HRQOL) refers to individuals' perception of their subjective well-being, considering various aspects of their life and the impact on their health. AIM: To analyze gender differences in the HRQOL of adolescent students in Chile, by age, type of school attended, and area of residence. MATERIAL AND METHODS: Analytical cross-sectional study conducted in a population of 5th and 12th grade students attending municipal, subsidized and private schools in 11 regions of the country. HRQOL was assessed with the KIDSCREEN-52, an instrument that has been previously adapted and validated in Chile. The database obtained from that adaption and validation process was analyzed. RESULTS: In total, 7,910 students (median age 14 years, 53% female) completed the questionnaire. Compared to males, females had lower HRQOL scores in most of the KIDSCREEN-52 dimensions. However, males were more likely to have lower scores in the “Peers and Social Support” and “School Environment” dimensions. These differences remained valid when the sample was stratified by age, type of school, and area of residence were analyzed. CONCLUSIONS: This study supports the existence of inequalities in the self-perceived HRQOL of Chilean adolescent students. The existing differences are not only related to gender but are also evident when stratifying by type of school attended.

Comparison of orthologous cytochrome P450 genes relative expression patterns in the bark beetles Dendroctonus rhizophagus and Dendroctonus valens (Curculionidae: Scolytinae) during host colonization.

Bark beetles of the genus Dendroctonus are important components of coniferous forests. During host colonization, they must overcome the chemical defences of their host trees, which are metabolized by cytochrome P450 (CYP or P450) enzymes to compounds that are readily excreted. In this study, we report the relative expression (quantitative real-time PCR) of four orthologous cytochrome P450 genes (CYP6BW5, CYP6DG1, CYP6DJ2 and CYP9Z20) in Dendroctonus rhizophagus and Dendroctonus valens forced to attack host trees at 8 and 24 h following forced attack and in four stages during natural colonization [solitary females boring the bark (T1); both male and female members of couples before oviposition (T2); both male and female members of couples during oviposition (T3), and solitary females inside the gallery containing eggs (T4)]. For both species gene expression was different compared with that observed in insects exposed to single monoterpenes in the laboratory, and the expression patterns were significantly different amongst species, sex, gut region and exposure time or natural colonization stage. The induction of genes (CYP6BW5v1, CYP6DJ2v1 and CYP9Z20v1 from D. rhizophagus, as well as CYP6DG1v3 from D. valens) correlated with colonization stage as well as with the increase in oxygenated monoterpenes in the gut of both species throughout the colonization of the host. Our results point to different functions of these orthologous genes in both species.

Differential cytokine expression and regulatory cells in patients with primary and secondary Sjögren's syndrome.

Sjögren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltration of the salivary and lacrimal glands. The aim of the study was to characterize and compare the presence of diverse cytokines and regulatory T and B cells in lip minor salivary gland (MSG) biopsies from patients with primary Sjögren's syndrome (pSS), secondary SS (sSS), and patients with connective tissue disease (CTD) without (w/o) SS. We included samples of MSG from 15 pSS, 24 sSS (six scleroderma, nine rheumatoid arthritis and nine lupus patients) and 15 patients with CTD w/o SS. Tissues were examined by an indirect immunoperoxidase technique (goat polyclonal anti-human IL-19, goat polyclonal anti-human IL-22 or mouse monoclonal anti-human IL-24). To determine the subpopulation of CD4(+)/IL-17A(+)-, CD4(+)/IL-4(+)-, CD4(+)/IFN-É£(+)-expressing T cells, CD25(+)/Foxp3(+) Treg cells and CD20(+)/IL-10(+)-producing B cell subset, a double-staining procedure was performed. We estimated the mean percentage of positively staining cells in two fields per sample. CD4(+)/IFN-É£(+), CD4(+)/IL-4(+) and IL-22(+) cell percentages were elevated in both SS varieties; however, the cells were more prevalent in pSS. Patients with pSS had a high number of CD4(+)/IL-17A(+) and IL-19(+) T cells and a lower percentage of IL-24(+) cells (P < 0.05). The Treg and IL-10-producing B cells were increased in pSS (P < 0.05). Concluding, in our patients, a pro-inflammatory and regulatory balance coexists in SS, being both responses more intense in pSS. The explanation of these differences may be related to disease activity, disease duration and treatment.

[Psychometric properties of the quality of life questionnaire health related KIDSCREEN-27 in Chilean adolescents]. / Propiedades psicométricas del cuestionario de calidad de vida relacionada con la salud KIDSCREEN-27 en adolescentes chilenos.

BACKGROUND: KIDSCREEN-52, which assesses health related quality of life in adolescents, has been adapted and validated in Chile showing excellent psychometric properties. There is a shorter version of the instrument, whose psychometric properties must be assessed. AIM: To evaluate the psychometric properties of the instrument KIDSCREEN-27 in Chilean adolescents. MATERIAL AND METHODS: A secondary analysis of the database obtained for the adaptation and validation of KIDSCREEN-52. RESULTS: The reliability, calculated through Cronbach’s alpha, for the entire instrument (five dimensions) was 0.89. For physical well-being, psychological well-being, autonomy and relationship with parents and peer social support dimensions, scores were higher than 0.75 while for school environment, the score was 0.69. The confirmatory factor analysis showed that the indices obtained to assess the goodness of fit in this study were a χ2 (314) = 10521.4, a Root Mean Square Error of Approximation = 0.064 and a Comparative Fit index = 0.96. KIDSCREEN-27 scores were higher among men in the physical well-being, psychological well-being, autonomy and relationship with parents dimensions and among women in social support and peers and school environment dimensions. Scores were higher in younger age groups. CONCLUSIONS: The Chilean version of KIDSCREEN-27 instrument has adequate reliability and validity.

Exploring the synergistic effect of palladium nanoparticles and highly dispersed transition metals on carbon nitride/super-activated carbon composites for boosting electrocatalytic activity.

In the present work, multifunctional electrocatalysts formed by palladium nanoparticles (Pd NPs) loaded on Fe or Cu-containing composite supports, based on carbon nitride (C3N4) and super-activated carbon with a high porosity development (SBET 3180 m2/g, VDR 1.57 cm3/g, and VT 1.65 cm3/g), were synthesised. The presence of Fe or Cu sites favoured the formation of Pd NPs with small average particle size and a very narrow size distribution, which agreed with Density Functional Theory (DFT) calculations showing that the interaction of Pd clusters with C3N4 flakes is weaker than with Cu- or Fe-C3N4 sites. The electroactivity was also dependent on the composition and, as suggested by preliminary DFT calculations, the Pd-Cu catalyst showed lower overpotential for hydrogen evolution reaction (HER) while bifunctional oxygen reduction reaction/ oxygen evolution reaction (ORR/OER) behaviour was superior in Pd-Fe sample. The Pd-Fe electrocatalyst was studied in a zinc-air battery (ZAB) for 10 h, showing a performance similar to a commercial Pt/C + RuO2 catalyst with a high content of precious metal. This study demonstrates the synergistic effect between Pd species and transition metals and shows that transition metals anchored on C3N4-based composite materials promote the electroactivity of Pd NPs in HER, ORR and OER due to the interaction between both species.