Determinación del Derecho a Salud bucal: mujeres postparto e hijos en Santiago de Chile

Comprender desde la determinación social de la salud el papel de los procesos generales, particulares y singulares sobre la realización del derecho a salud bucal de mujeres en periodo de post-parto en Santiago de Chile. Diseño cualitativo exploratorio con mujeres primíparas o multíparas en primer trimestre postparto, beneficiarias FONASA usuarias de Chile Crece Contigo. Se aplicó encuesta de clasificación social, exámenes clínicos, entrevistas semiestructuradas o grupos de discusión. Para el nivel general se analizó profusa información referencial. Existen procesos generales que favorecen la realización del derecho a salud bucal como las políticas de protección integral a la infancia, la priorización de la atención en salud en gestantes; la existencia de derechos adquiridos para la embarazada: permiso pre y post natal y fuero maternal. Desfavorece el modelo de desarrollo neoliberal y consecuentes condiciones de pobreza, la inequidad de género y el énfasis cultural en la responsabilidad femenina sobre el cuidado. Los procesos críticos actúan en los tres niveles del modelo teórico. Si bien en el nivel particular se identifica un avance en las políticas públicas, este no redunda en una efectiva realización del derecho a nivel singular pues enfrenta elementos estructurales del nivel general, sobre todo en el ámbito laboral y cultural.

Objective: To understand from the framework of social determination of health the role of general, particular and singular processes in the realization of the right to oral health for women in the postpartum period and their newborn children during the first year of life, in Santiago de Chile. Materials and Methods: Exploratory qualitative design with FONASA beneficiary women and newborn children. A social classification survey, semi-structured interviews and focus groups were applied to primiparous or multiparous women of childbearing age in the first postpartum trimester, beneficiaries of the Intersectoral Program ÒChile Crece ContigoÓ. Discussion: For the general level, extensive reference information was analyzed. Results: Some general processes favor the realization of the right to oral health, such as comprehensive protection policies for children, the dynamics of the health care system, and the existence of acquired rights for pregnant women, such as pre and post-natal, and maternity leave. The processes that disfavor its realization are the neoliberal development model, the conditions of poverty, gender inequity (income, employment/unemployment) and cultural factors such as the emphasis on female responsibility for care. Conclusions: The critical processes for the realization of the right to oral health act at the three levels of the theoretical model. There is an advance in public policies at the individual level. However, this does not result in an effective realization of the right at a singular level since it confronts structural elements of the general level, especially in the work and cultural field.

Trichophyton benhamiae, un dermatofito zoofílico emergente en Argentina con reservorio en cobayos: descripción de 7 casos en un hospital de la Ciudad Autónoma de Buenos Aires / Trichophyton benhamiae, an emergent zoonotic pathogen in Argentina associated with Guinea pigs: Description of 7 cases in Buenos Aires

Resumen Trichophyton benhamiae es un dermatofito zoofílico. Puede causar tinea corporis, tinea faciei y tinea capitis. Se caracteriza por producir lesiones inflamatorias, sobre todo en niños. El objetivo de esta publicación es describir 7 casos clínicos de pacientes pediátricos atendidos entre julio del 2019 y enero del 2020 en nuestra institución. A los pacientes se les solicitó estudio micológico convencional, con posterior confirmación con MALDI-TOF MS y secuencia-ción del ADN ribosomal. Se aisló e identificó T. benhamiae como agente etiológico; el nexo epidemiológico fue el contacto con cobayos. Estas son las primeras descripciones de infecciones causadas por T. benhamiae en Argentina. Al realizar estudios micológicos convencionales, este agente puede confundirse con otros dermatofitos, por lo tanto, se requieren herramientas como MALDI-TOF MS o la secuenciación para llegar a un diagnóstico definitivo. Es importante contar con datos epidemiológicos, como el contacto con mascotas no tradicionales, para una presunción diagnóstica adecuada.

Trichophyton benhamiae is a zoonotic dermatophyte that can cause tinea corporis, tinea faciei and tinea capitis, producing inflammatory lesions, especially in children. In this publication, we describe 7clinical cases of pediatric patients that occurred in our institution between July 2019 and January 2020. All patients underwent a conventional mycological study. The identification of fungi isolates was confirmed by MALDI-TOF MS and sequencing of the ribosomal DNA. T. benhamiae was identified as the etiological agent, whose epidemiological link in all cases was the contact with Guinea pigs. This is the first description of infections caused by T. benhamiae in Argentina. This dermatophyte can be misidentified as other more frequent dermatophytes when performing conventional studies. Molecular technology should be used to reach a definitive diagnosis. It is important to have epidemiological data from patients such as contact with non-traditional pets, especially Guinea pigs, for an adequate presumptive diagnosis of this dermatophytosis.

Dietas basadas en plantas y factores de riesgo cardio-metabólicos. ¿Qué dice la evidencia?

RESUMEN Las dietas basadas en plantas (DBP) se caracterizan por una alta ingesta de alimentos de origen vegetal y evitan parcial o totalmente los productos animales. El objetivo de esta revisión fue recopilar evidencia sobre DBP, sus tipos y su efecto en principales factores de riesgo cardio-metabólicos (FRCM) modificables. Se encontró que existen DBP saludables y no saludables. Algunas DBP saludables son: vegetariana, mediterránea y DASH (sigla en inglés de la dieta Enfoques Alimenticios para Detener la Hipertensión). Estas promueven la ingesta de alimentos de origen vegetal "saludables" (frutas, verduras, legumbres, semillas, frutos secos, cereales integrales, palta, aceite de oliva y/o canola) y, una reducción gradual de todos los alimentos de origen animal, especialmente carnes rojas y procesadas; evitando alimentos de origen vegetal "menos saludables" (cereales refinados, fritos, productos de pastelería, alimentos con azúcar añadido). Las DBP no saludables, se caracterizan por una alta ingesta de estos alimentos "menos saludables", y se asocian con mayor riesgo cardiovascular, por el bajo aporte de antioxidantes, micronutrientes, fibra dietética y grasas insaturadas. DBP saludables pueden disminuir el riesgo de diabetes tipo 2, hipertensión arterial, sobrepeso y obesidad. Han mostrado mayores beneficios cardiovasculares en comparación con dietas tradicionales, reduciendo significativamente: HbA1c y glicemia en ayunas en diabéticos; presión arterial sistólica y diastólica en hipertensos y prehipertensos; índice de masa corporal en sujetos con sobrepeso/obesidad y mejorando el perfil lipídico en sujetos con dislipidemia. Patrones de DBP saludables, como el tipo vegetariano, mediterráneo y DASH son recomendadas para prevenir y tratar los FRCM.

ABSTRACT Plant-based diets (PBD) are characterized by a high intake of foods of plant origin and the partial or total avoidance of animal products. The objective of the current study was to compile the evidence on types of PBD and its effect on the main modifiable cardio-metabolic risk factors (CMRF). Healthy and unhealthy PBD were found to exist. Some healthy PBDs were: vegetarian, mediterranean and DASH (Dietary Approaches to Stop Hypertension). These promote the intake of "healthy" plant-based foods (fruits, vegetables, legumes, seeds, nuts, whole grains, avocado, olive oil and / or canola) and a gradual reduction of all foods of animal origin, especially red and processed meats; avoiding "less healthy" plant-based foods (refined, fried cereals, pastry products, foods with added sugar). Unhealthy PBDs were characterized by a high intake of these "less healthy" foods, and are associated with greater cardiovascular risk, due to the low contribution of antioxidants, micronutrients, dietary fiber and unsaturated fats. Healthy PBDs can lower the risk of type 2 diabetes, high blood pressure, being overweight, and obesity. They have shown greater cardiovascular benefits compared to traditional diets, significantly reducing: HbA1c and fasting glycemia in diabetics; systolic and diastolic blood pressure in hypertensive and prehypertensive patients; body mass index in overweight / obese subjects and improves lipid profile in subjects with dyslipidemia. Healthy PBD patterns, such as vegetarian, Mediterranean, and DASH are recommended to prevent and treat CMRF.

Estresores que influyen desfavorablemente en estudiantes chilenos de Obstetricia y Puericultura, durante las prácticas clínicas / Stressors that unfavorably influence Chilean students of Obstetrics and Childcare, during clinical practices

Fundamento: las prácticas clínicas son un componente esencial para la formación de los estudiantes de Obstetricia y Puericultura, porque permiten aplicar los conocimientos teóricos adquiridos. Objetivo: identificar los estresores que influyen desfavorablemente en los estudiantes de segundo y tercer años de la carrera de Obstetricia y Puericultura de la Universidad de Chile, durante las prácticas clínicas. Métodos: se realizó un estudio transversal y descriptivo en la Escuela de Obstetricia y Puericultura de la Universidad de Chile durante el periodo marzo-diciembre, 2016. Se utilizaron métodos teóricos para la fundamentación de la investigación y empíricos: el cuestionario Stai para medir el nivel de ansiedad y el Kezkak, que mide estresores en las prácticas clínicas. Resultados: se identificaron los estresores que afectan la práctica clínica de los estudiantes de segundo y tercer años de Obstetricia; se constató, a través de la aplicación del cuestionario de Kezkak, que los más altos se relacionan con las competencias, la impotencia e incertidumbre; y como menos preocupantes, las relaciones interpersonales y la implicación emocional, entre ellas la muerte de un paciente, esta última dada por la inexperiencia en la atención a enfermos terminales; el cuestionario de Stai indica que la ansiedad/rasgo es mayor en comparación con la ansiedad/estado. Conclusiones: las situaciones de estrés que viven con mayor intensidad los estudiantes se deben a la inseguridad que representa enfrentarse a situaciones nuevas y al miedo a no saber responder con un dominio adecuado de las competencias, más que a un rasgo de su personalidad.

Background: clinical practices are an essential component for the training of students of Obstetrics and Childcare, because they allow applying the theoretical knowledge acquired. Objective: to identify the stressors that adversely affect the second and third year students of the Obstetrics and Child Care of the University of Chile, during the clinical practices. Methods: a cross-sectional and descriptive study was carried out at the School of Obstetrics and Child Care of the University of Chile during the period March-December, 2016. Theoretical methods were used for the foundation of the research and empirical: the Stai questionnaire to measure the level of anxiety and Kezkak, which measures stressors in clinical practices. Results: stressors that affect the clinical practice of the second and third year obstetrics students were identified; it was found, through the application of the Kezkak questionnaire, that the highest are related to competencies, impotence and uncertainty; and as less worrisome, interpersonal relationships and emotional involvement, including the death of a patient, the latter given by inexperience in the care of the terminally ill; Stai's questionnaire indicates that the anxiety / trait is greater compared to the anxiety / condition. Conclusions: the situations of stress that students live with greater intensity are due to the insecurity that represents facing new situations and the fear of not knowing how to respond with a proper mastery of the skills, rather than a feature of his personality.

Vivencias de usuarias lesbianas sobre el proceso de atención perinatal en la región metropolitana, Chile en 2016 / Experiences of lesbian users about the process of perinatal care in the metropolitan region of Chile in 2016 / Vivências de usuárias lésbicas sobre o processo de atenção perinatal na região metropolitana do Chile em 2016

El objectivo de la investigación fue explorar las vivencias de la atención perinatal de usuarias lesbianas en la Región Metropolitana, Chile en 2016. Se trata de un estudio transversal exploratorio con enfoque fenomenológico, usando la estrategia muestral bola de nieve. Fueron realizadas entrevistas en profundidad con análisis de contenido. Se han experimentado vivencias favorables de las usuarias lesbianas sobre su proceso de gestación, parto y puerperio y un trato inclusivo y antidiscriminatorio de los proveedores de salud. Hay una aceptación generalizada de los profesionales de salud hacia las familias homoparentales y a la visibilización de la homosexualidad. El empoderamiento y la autoestima de las usuarias entrevistadas es un elemento que favorece la relación médico-paciente. Sin embargo, las alternativas para acceder a la maternidad no se encuentran asequibles para toda la población debido al alto costo que poseen.(AU)

The study aimed to explore the experiences of perinatal care of lesbian users in the metropolitan area of Chile in 2016. It was a cross-sectional and phenomenological study with snowball sampling. In-depth interviews were carried out and the reports were interpreted using the content analysis technique. The interviews revealed positive experiences by lesbian users during their pregnancy, childbirth and postpartum periods, and an inclusive treatment, with no prejudice by healthcare providers. There is a broad acceptance by healthcare professionals of homosexual families and the visibility of homosexuality. The empowerment and self-esteem exhibited by the interviewed users favor the doctor-patient relationship. However, the alternatives to achieve motherhood are not available for the entire population because of their high cost.(AU)

O objetivo do trabalho foi percorrer as vivências da atenção perinatal, de usuárias lésbicas na região metropolitana do Chile em 2016. Trata-se de estudo transversal de exploração com abordagem fenomenológica, utilizando a amostragem em bola de neve. Foram realizadas entrevistas em profundidade, com análise de conteúdo. Foram observadas vivências favoráveis das usuárias lésbicas acerca de seus processos de gestação, parto e puerpério, e um tratamento inclusivo e sem discriminação dos prestadores de saúde. Existe uma geral aceitação dos profissionais da saúde em relação às famílias homossexuais e à visibilidade da homossexualidade. O empoderamento e a autoestima das usuárias entrevistadas é um elemento que favorece o relacionamento médico-paciente. Porém, as alternativas para alcançar a maternidade não são acessíveis para toda a população, devido ao alto custo que elas têm.(AU)

Cambios microscópicos in vitro de cuerpos de prueba de amalgama de plata sometidos a altas temperaturas observados mediante microscopía electrónica de barrido / In vitro microscopic changes of dental amalgam test bodies subjected to high temperatures observed by scanning electron microscopy

Objetivo: describir los cambios microscópicos in vitro de 27 cuerpos de prueba elaborados en amalgama de plata de tres marcas comerciales (Contour® Kerr®, Admix® SDI® y Nu Alloy® Newstethic®) sometidos a altas temperaturas (200ºC, 400ºC y 600ºC) observados mediante microscopia electrónica de barrido. Materiales y métodos: estudio observacional descriptivo, de corte transversal y de naturaleza pseudo-experimental que analizó el comportamiento in vitro de 27 cuerpos de prueba elaborados en tres marcas comerciales de amalgama de plata (Contour® Kerr®, Admix® SDI® y Nu Alloy® Newstethic®) sometidos a altas temperaturas (200ºC, 400ºC, 600ºC). Resultados: las tres marcas comerciales de amalgama de plata empleadas en este estudio tuvieron un comportamiento similar, excepto en el comportamiento de los nódulos de plata. Estos aparecieron a los 200ºC en Admix® SDI® y a los 400ºC en Contour® Kerr® y Nu Alloy® Newstethic®. El análisis en microscopía electrónica de barrido y espectrofotometría de la superficie de los cuerpos de prueba evidenció el aumento estadísticamente significativo (p<0,05) del porcentaje de peso atómico de Hg, Cu y Sn. Conclusiones: los cuerpos de prueba de las tres marcas comerciales de amalgama de plata sufren cambios en su microestructura en la medida que aumenta la temperatura. La formación de los nódulos de Ag fue explicada como una consecuencia del comportamiento de la fase gamma 1 de Ag-Hg al aumentar la temperatura, la cual empieza a disociarse a los 200ºC en Admix® SDI® y a los 400ºC en Contour® Kerr® y Nu Alloy® Newstethic®.

Objective: describe the in vitro microscopic changes of dental amalgam test bodies subjected to high temperatures observed by scanning electron microscopy. Materials and methods: descriptive observational cross-sectional study of pseudo-experimental nature that analyzed by scanning electron microscopy (SEM) the in vitro behavior of 27 test bodies elaborated in three brands of dental amalgam (Contour® Kerr®, Admix® SDI® and Nu Alloy® Newstethic®) subjected to high temperatures (200ºC, 400ºC, 600ºC). Results: the three trademarks of dental amalgam used in this study had a similar behavior, except for the behavior of silver nodules. These appeared to 200ºC in the test bodies of Admix® SDI® and 400ºC in the test bodies of Contour® Kerr® and Nu Alloy® Newstethic®. The analysis of scanning electron microscopy and spectrophotometry at the surface of the test bodies showed the statistically significant increase (p<0.05) the percentage of atomic weight of mercury, copper and tin. Conclusions: the test bodies of the three trademarks of dental amalgam undergo changes in their microstructure so long as the temperature increases. The formation of silver nodules was explained as a consequence of the behavior of the gamma 1 phase silver-mercury with increasing temperature, which begins to dissociate at 200ºC in the test bodies of Admix® SDI® and 400ºC in the test bodies of Contour® Kerr® and Nu Alloy® Newstethic®.

Factores de riesgo cardiovascular en universitarios de primer y tercer año / Cardiovascular risk factors among first and third year university students

Background: College students are in a critical stage in their life style due to the transition between high school and university and they may be prone to develop cardiovascular diseases. Aim: To compare the prevalence of cardiovascular risk factors (CVRF) in students from first and third year at the University of La Frontera, Temuco-Chile, according to faculty, gender and socioeconomic status (SES). Material and Methods: Cross-sectional study. Anthropometry, blood pressure, lipid profile, blood glucose, insulin resistance (IR), sedentary lifestyle, tobacco and alcohol consumption were evaluated during 2014 in randomly selected 163 freshmen aged 19.2 ± 1.8 years and 163 third year students aged 21.7 ± 2.5 years (49% females), stratified by faculty, career and gender. Results: 32.4% of students had prehypertension, 30.6% abdominal obesity, 26.3% insulin resistance, 25.7% dyslipidemia and 8.9% metabolic syndrome. Third grade students had higher prevalence of elevated total and LDL cholesterol and higher alcohol consumption, especially among students of middle and high socioeconomic level. Compared with students from the School of Medicine, students from the Education Faculty had 3.9, 3.3 and 2.7 times greater likelihood of being obese, having elevated LDLcholesterol and being smokers, respectively. Women had the highest prevalence of sedentary lifestyles and dyslipidemia. Men had the highest prevalence of prehypertension and smoking. Conclusions: Educational programs are required to promote healthy lifestyles among these students.

Deserción escolar de adolescentes a partir de un estudio de corte transversal: Encuesta Nacional de Salud Mental Colombia 2015 / A Cross-sectional Study of School dropout in adolescents: National Mental Health Survey Colombia 2015

Resumen Introducción: La deserción escolar de los adolescentes puede tener consecuencias negativas no solo para el individuo y su núcleo familiar, sino también para la sociedad. Identificar características relacionadas con la ocurrencia de este evento puede contribuir a la planeación de estrategias de prevención. Objetivos: Evaluar la relación entre características individuales y del hogar y la deserción escolar de adolescentes de 12-17 años en Colombia. Métodos: Este es un estudio transversal, la información se extrajo de la Encuesta Nacional de Salud Mental de 2015, y se estudió la relación entre características individuales y del hogar y la deserción escolar de adolescentes de 12-17 años. Resultados: Se observó un mayor porcentaje de adolecentes no escolarizados en los grupos de más edad, de sexo femenino o que han tenido hijos. Entre las características del hogar se identificó que los hogares con 2 personas, de zona rural o en estado de pobreza presentan un mayor porcentaje de adolescentes no escolarizados. Conclusiones: Las estrategias cuyo objetivo sea prevenir la deserción escolar deben considerar a las poblaciones con mayores porcentajes de adolescentes no escolarizados (mujeres, hogares de zona rural y hogares en estado de pobreza). Acciones de prevención del embarazo adolescente pueden contribuir a evitar la deserción.

Abstract Introduction: School dropout in adolescents can have negative consequences, not only for the individual and the family, but also for the society. To identify the characteristics associated with the occurrence of this event might contribute to the planning of a prevention strategy. Objectives: To evaluate the relationship between the individual and home characteristics and school dropout in adolescents from 12 to 17 years old in Colombia. Methods: A cross sectional study was conducted from information taken from the results obtained in the 2015 National Mental Health Survey. A study was made of the relationship between the individual and home characteristics and school dropout in adolescents from 12 to 17 years old. Results: A higher percentage of school dropoutswas found in the older adolescents, females, and those who have children. Among the home characteristics, it was observed that those homes with more than two people, located in rural area, or that are classified as poor, have an increased percentage of school dropout adolescents. Conclusions: Strategies for which the main goal is to prevent school dropout should consider populations with higher prevalence of out-of-school adolescents (female, homes in rural area, or household poverty). Preventive actions of adolescent pregnancy might contribute to reduce the school dropout rate.

Percepción de competencia para orientar estudiantes escolares con discapacidad y problemas emocionales / The competence perception to orient school students with disabilities and emotional problems

Antecedentes. Los orientadores escolares tienen como labor ayudar al manejo e inclusión de escolares con discapacidad, sin embargo no se conoce la percepción que ellos tienen de sus competencias para realizar dicha tarea. Objetivo. Evaluar la percepción de los orientadores escolares acerca de su competencia para orientar a escolares con diferentes tipos de discapacidad. Materiales y métodos. Estudio de tipo observacional descriptivo de corte transversal realizado sobre una población de 235 orientadores de Cundinamarca y Boyacá, que representan toda la población de orientadores, a los que se les aplicó un cuestionario con cinco afirmaciones tipo Likert acerca de su capacidad para atender escolares con discapacidad física, sensorial, mental y cognitiva y problemas emocionales. Resultados. Se describen las características de los orientadores teniendo en cuenta género, edad y profesión, así como el número de escolares con discapacidad que estudian en las instituciones. El 41% describe no estar preparado para orientar niños y niñas con discapacidad física, el 37.7% para orientar niños con discapacidad sensorial, el 65.3% para orientar escolares con discapacidad mental, el 67.7% para orientar estudiantes con discapacidad cognitiva y solamente el 9.9% no se siente preparado para manejar problemas emocionales. Conclusiones. Los orientadores escolares perciben tener escasa preparación para orientar estudiantes con diferente tipo de discapacidad, lo cual podría limitar la adecuada inclusión escolar.

Background. Within their work school counselors have to deal with the educative inclusion of students with disabilities, nevertheless, their perception of their competences is unknown in order to perform this task. Objective. To evaluate the perception of school counselors regarding their competence to guide students with different types of disabilities. Materials and Methods. This is an observational descriptive study with a transversal type, applied in a population of 235 counselors from Cundinamarca and Boyacá, representing the total counselors population. They were asked a questionnaire presenting five Likert methodology statements, regarding their own capacity to interact with students with physical, sensorial, mental and cognitive disabilities, and emotional problems. Results. Counselors' characteristics are described taking into account criteria like gender, age, career and the number of students with disabilities that are studying in the institutions they work for. 41 % of the counselors state they are not prepared to orientate children and adolescents with physical disabilities, whereas 37.7 % state they are no prepared to orientate children with sensorial disabilities, 65.3% to orientate students with any mental disability, and 67.7% affirm they are not prepared to orientate students with any cognitive disability and just 9.9 % have difficulties to deal with emotional problems. Conclusions. School counselors realized having a low preparation to orientate students with different disabilities, which could restrain an adequate educational inclusion.

Finding of a novel fungal immunomodulatory protein coding sequence in Ganoderma australe / Hallazgo de una nueva secuencia codificadora para una proteína inmunomoduladora de origen fúngico en Ganoderma australe

Among the most common human diseases with immune system compromise are autoimmune diseases, cancer, and the acquired immunodeficiency syndrome (AIDS). Many of these diseases still have no treatment or their therapies have undesirable side effects. This has aroused a great interest in the search for new natural products with therapeutic potential and scientifically proven effects, showing minimal side effects. Formal clinical and pharmacological investigation in various medicinal fungi of the genus Ganoderma (Ganodermataceae) has shown immunomodulatory effects and tumor growth inhibition in mammals, attributable to the presence of immunomodulatory proteins and other secondary metabolites. To date, six fungal immunomodulatory proteins (FIPs) have been reported in Ganoderma. This paper seeks to advance in the discovery of immunomodulatory proteins present in Ganoderma australe, through mycelium transcriptome 454 Roche® pyrosequencing (RNA-seq) and bioinformatics analyses. The results suggest the presence of gene sequences related to an immunomodulatory protein which has been reported in another fungal species Taiwanofungus camphoratus. The candidate gene sequences found in G. australe exhibit high identity values in their amino acid composition and predicted protein secondary structure with the protein reported for Tai. camphoratus. According to present knowledge about the action mechanisms of these proteins, it is possible to suggest that this is a promising molecule for the treatment and prevention of diseases associated with certain immune deficiencies, cancer, and other diseases with compromised immune systems. Future studies are proposed in order to determine its immunomodulatory potential using in vitro and in vivo assays.

Enfermedades comunes como las autoinmunes, el cáncer y el síndrome de inmunodeficiencia adquirida aún no tienen tratamiento o sus terapias tienen efectos secundarios indeseables. Ello ha suscitado el interés en la investigación de bioproductos con potencial terapéutico, que no impliquen efectos secundarios. Investigaciones farmacológicas y clínicas en algunos hongos medicinales del género Ganoderma (Ganodermataceae) han comprobado efectos inmunomoduladores e inhibidores de crecimiento tumoral en mamíferos, atribuibles a la presencia de proteínas fúngicas inmunomoduladoras (FIPs) y otros metabolitos secundarios. Este trabajo busca avanzar en el descubrimiento de proteínas inmunomoduladoras presentes en Ganoderma australe, mediante la secuenciación del transcriptoma de micelio por tecnología de pirosecuenciación 454 Roche® (RNA-seq) y análisis bioinformáticos. Los resultados sugieren la presencia de secuencias génicas relacionadas con una proteína inmunomoduladora que se ha reportado en la especie de hongos Taiwanofungus camphoratus. Las secuencias génicas candidatas halladas en G. australe exhiben una altos valores de similitud en sus predicciones de composición aminoacídica y estructura secundaria proteica con la proteína reportada para Tai. camphoratus. Los mecanismos de acción de este tipo de proteínas inmunomoduladoras sugieren que se trata de una molécula con potencial promisorio para el tratamiento y prevención de enfermedades con compromiso del sistema inmunológico y el cáncer. Se proponen nuevos estudios que permitan determinar el potencial inmunomodulador de la proteína hipotética hallada mediante estudios in vivo e in vitro.

The performance of students with and without disability on the 11th grade university admission test / Rendimiento en la prueba de admisión a la universidad (Saber 11) de personas en y sin condición de discapacidad

Objective Comparing standardized university admission scores between students with and without disability within the same school and also comparing the performance of students with hearing, visual and physical disability. Methods This was a retrospective cohort study which compared the test results of students with and without disabilities within the same school. A matched case-control study nested in a cohort was assembled. Standardized differences were calculated for comparing such scores. Results Students without disabilities performed significantly better than disabled ones(i.e. disabled students scored lower than their classmates). Conclusion Further research is needed to determine whether the Colombian educational system, adjustments made to tests for this population or students' individual skills were the factors underlying the difference regarding the test results.

Objetivo Comparar los resultados en la prueba Saber 11 (prueba estandarizada para la admisión en la mayoría de universidades de Colombia) entre los estudiantes con y sin discapacidad dentro de la misma institución educativa. Asimismo, comparar el rendimiento de los alumnos con problemas de audición, discapacidad visual y física. Métodos Se realizó un estudio de cohorte retrospectiva en la que se dividió a los estudiantes según su condición de discapacidad. Se anidó un caso-cohorte emparejando cada caso de discapacidad con su grupo de compañeros de colegio. Se calcularon las diferencias estandarizadas para comparar los grupos. Resultados Los estudiantes sin discapacidades se desempeñaron significativamente mejor que los estudiantes con discapacidad, es decir, los estudiantes con discapacidades obtuvieron puntajes más bajos que sus compañeros de clase. Conclusión Se necesita más investigación para investigar si el sistema educativo colombiano, los ajustes en las pruebas para esta población o las capacidades individuales de los alumnos son los factores subyacentes de la diferencia en los resultados de las pruebas.

Inclusión educativa de personas con discapacidad / Inclusive Education of Persons with Disabilities

Introducción: La Declaración Universal de los Derechos Humanos, la Declaración Mundial sobre Educación y el Decreto 366 del 9 de febrero de 2009, entre otras, reglamenta la organización del servicio de apoyo pedagógico para la atención de los estudiantes con discapacidad y con apacidades o talentos excepcionales en el marco de la educación inclusiva. Esto implica planeación y reparación por parte de las entidades educativas que servirán a este propósito. Objetivos: Describir la apertura y la preparación de los docentes para brindar una atención adecuada a personas con discapacidad en tres establecimientos educativos de Bogotá de acuerdo con la normatividad existente. Materiales y método: Estudio tipo encuesta de corte transversal en docentes de tres colegios públicos de la localidad de Usaquén, en Bogotá. Se elabora un instrumento autodiligenciado con preguntas tipo Likert y se aplica de forma oluntaria, confidencial y anónima a docentes de cada uno de los colegios. Los instrumentos fueron ingresados a una base de datos y se realizaron análisis con frecuencias simples, porcentajes y puntajes obtenidos en el cuestionario. Resultados: Se describen la heterogeneidad de la discapacidad y la dificultad para incluir a las personas en condición de discapacidad de manera homogénea dentro de las legislaciones. Se encuestaron 343 docentes (93,4%) de los 367 previstos, con un promedio de edad de 48,7 años; de los cuales 292 (81,1%) son mujeres. Un 28,9% (97) de los docentes refieren sentirse preparados para educar estudiantes con discapacidad física; un 19,9% (67), para educar estudiantes con discapacidad sensorial; un 19,3% (65), para educar estudiantes con discapacidad mental (cognitiva) y un 45,8% (154), para educar estudiantes con problemas emocionales. Conclusión: El tópico de la discapacidad es heterogéneo y esto se representa en la apreciación diferencial de los docentes respecto a su preparación para atender diferentes problemáticas. Hay pocos...

Introduction: The Universal Declaration of Human Rights, the World Declaration on Education, and the Decree 366 dated February 9, 2009, mong others, regulate the organization and proper functioning of the educational support service provided to students with disabilities and with exceptional capacities within the framework of inclusive education. This requires an effort in planning and preparation on the part of the educational entities that will provide this service. Objectives: Describe the commencement and training of teachers in order to offer adequate attention and care for people with disabilities in three educational establishments located in Bogotá. Materials and Method: A crosssectional survey was conducted among the teachers of three public schools, in the locality of Usaquén (Bogotá). An anonymous, voluntary, and confidential survey was conducted among the teachers of the three public schools, based on a self-elaborated questionnaire including Likert-type questions. The results were entered in a database and analyzed based on simple frequencies, percentages and scores obtained in the questionnaire. Results: The heterogenic aspect of disabilities and the difficulty of including disabilities as homogenous matter in the local legislation are described. In total 343 teachers participated in the survey, 93.4% of the 367 teachers forming the combined faculty of the three public schools. The average age of the interviewees was around 48 years, and 81% (292) were female. 28% (97) of the interviewed teachers claimed to be trained and prepared to educate students with sensorial disabilities; 19.3% (65) felt qualified to teach students with mental disabilities (cognitive), and lastly, 45.8% (154) considered themselves to be apt to educate and handle students with emotional issues. Conclusion: The topic of disabilities is heterogeneous; this heterogenic aspect is represented or proven by the fact that teachers have a differential appreciation regar...

Síndrome estafilocócico de la piel escaldada. Nuestra experiencia en 10 años / Staphylococcal scalded skin syndrome (SSSS). Our 10-year experience

El síndrome estafilocócico de la piel escaldada (SEPE) es una enfermedad cutánea aguda infrecuente, causada por toxinas exfoliativas del Staphylococcus aureus. El objetivo de este estudio es describir las características epidemiológicas, clínicas y terapéuticas de los pacientes con diagnóstico de SEPE en nuestro medio.Material y métodos.Se realizó un estudio retrospectivo, descriptivo y observacional, en el que se revisaron las historias clínicas de los pacientes con diagnóstico de SEPE vistos entre mayo de 2000 y mayo de 2010, atendidos en la Sección de Dermatología Pediátrica del Hospital Ramos Mejía, y entre mayo de 2005 y mayo de 2010 en el Servicio de Dermatología del Hospital Alemán.Resultados.Se incluyó un total de 62 pacientes, cuya edad media al momento del diagnóstico fue de 22 meses. No se observó predilección por sexo ni estación del año. El 13% de los pacientes recibió corticoides sistémicos previo al diagnóstico de SEPE. Todos los pacientes excepto uno, realizaron tratamiento antibiótico luego del diagnóstico de esta entidad. El 92% recibió cefalosporinas de primera generación. El 23% de los pacientes requirió internación y el 100% evolucionó satisfactoriamente.Conclusiones.El SEPE es una entidad poco frecuente. Si bien en nuestro medio no hallamos datos epidemiológicos sobre esta entidad, los datos demográficos encontrados en este estudio difieren de los publicados en la literatura mundial. Debe sospecharse en recién nacidos y niños pequeños con eritrodermia aguda y afectación peribucal o conjuntival.

Staphylococcal scalded skin syndrome (SSSS) is a rare cutaneous disease caused by exfoliativetoxins of Staphylococcus aureus. The aim of this study is to describe the epidemiology, clinicalmanifestations and treatment of patients with the diagnosis of SSSS in our community.Methods. We conducted a retrospective, descriptive and observational study, reviewing the clinicalrecords of patients with a diagnosis of SSSS, as seen between May 2000 and May 2010 atthe Pediatric Dermatology Section of the Hospital Ramos Mejía, and between May 2005 and May2010 at the Dermatology Unit of the Hospital Alemán.Results. A total of 62 patients were included, whose average age at the time of diagnosis was22 months. No predilection for sex or season of the year was observed. Thirteen percent of thepatients received systemic steroids prior to SSSS diagnosis. All but one of the patients received antibiotictreatment after the diagnosis of this entity. First generation cephaloporins were given to92% of patients; 23% of them required hospitalization and all of them had a satisfactory outcome.Discussion. SSSS is an infrequent entity. Even though there are no epidemiological studies inour country concerning SSSS, the data we gathered differs with world-wide published literature.SSSS must be suspected in new-borns and in young children with an acute onset of erythroderma,perioral affectation and conjunctivitis.

Periodontal status and treatment needs of children from 6 to 8 years old in the Santiago Metropolitan Region of Chile / Condição periodontal e necessidades de tratamento em crianças de 6 a 8 anos na região metropolitana de Santiago, Chile

PURPOSE: To evaluate the periodontal status and the treatment needs of Chilean school-children METHODS: Prevalence study. Sample: 1,637 schoolchildren from 6 to 8 years old belonging to 26 communes of the Santiago Metropolitan Region of Chile, stratified according to socioeconomic level in accordance with the 2003 CASEN survey (National Socioeconomic Characterization Survey). Periodontal status was estimated using the Community Periodontal Index of Treatment Needs (CPITN) and following the recommendations of the WHO (World Health Organization), along with the records of the Clinical Criteria of Gingival Inflammation. Data were analyzed using a chi-square test. RESULTS: Gingivitis prevalence was 68.42 percent, a result that is higher than the national prevalence (P<0.01; 95 percent CI=0.66-0.70). The prevalence increased with age (P<0.01) but was similar in both sexes (P=0.838). Prevalence was relatively constant among three socioeconomic levels (P=0.417). According to the CPITN, gingivitis prevalence was 29.57 percent: 27.49 percent consisting of children with gingival hemorrhage and 2.08 percent consisting of children with gingival calculus. The treatment needs of this population are that 27.49 percent of children require oral-hygiene instruction, and 2.08 percent need oral-hygiene instruction and subgingival and supragingival scaling. CONCLUSION: The gingivitis prevalence found in this study was higher than the national proportion in Chile.

OBJETIVO: Avaliar a condição periodontal e as necessidades de tratamento de crianças escolares chilenas. METODOLOGIA: Estudo de prevalência. Amostra: 1637 crianças escolares de 6 a 8 anos de idade pertencentes a 26 comunidades da região metropolitana de Santiago, Chile, que foram estratificadas de acordo com o nível socioeconômico conforme o levantamento 2003 CASEN (National Socioeconomic Characterization Survey). A condição periodontal foi estimada usando o índice Community Periodontal Index of Treatment Needs (CPITN) e seguindo as recomendações da Organização Mundial de Saúde (OMS), juntamente com os registros de critérios clínicos de inflamação gengival. Os dados foram analisados por testes qui-quadrado. RESULTADOS: A prevalência de gengivite foi de 68,42 por cento, resultado que é maior que a prevalência nacional do Chile (P<0,01; 95 por cento CI=0,66-0,70). A prevalência aumentou com a idade (P<0,01), mas foi similar em ambos os sexos (P=0,838). A prevalência foi relativamente constante entre os três níveis socioeconômicos (P=0,417). Para CPITN, a prevalência de gengivite foi de 29,57 por cento: 27,49 por cento com sangramento gengival e 2,08 por cento s com cálculo gengival. As necessidades de tratamento desta população foram de 27,49 por cento de crianças que necessitavam de instrução de higiene bucal e 2,08 por cento que necessitavam de instrução de higiene bucal e raspagem supra e subgengival. CONCLUSÃO: A prevalência de gengivite neste estudo foi maior que a proporção nacional no Chile.

Caries and fluorosis in the Santiago metropolitan region in Chile: The impact of the fluoridation of the water / Cárie e fluorose na região metropolitana de Santiago, Chile: impacto da fluoretação da água

PURPOSE: To assess the damage and the prevalence of caries and fluorosis in children and adolescents in the metropolitan area after 8 years of drinking water fluoridation and to compare them with the baseline study. METHODS: This was a prevalence study. The sample was selected using two-step probability sampling and stratified according to socioeconomic level. Subjects included 2,323 schoolchildren aged 6 to 8 years and 12 years living within the metropolitan region. The parents of all students provided consent and were previously included in the study. The subjects were clinically examined by calibrated dentists, who used World Health Organization (WHO) screening criteria and indicators to determine the presence of caries and dental fluorosis. RESULTS: No cavity damage was found in 23.68 percent of the children. The average dmft was 3.18 for children aged 6 to 8 years. The DMFT was 0.59 in children aged 6 to 8 years and 2.6 in children 12 years compared with the baseline study. These differences were statistically significant. There were also significant differences in the DMFT index for each socioeconomic status group. The average number of dams was higher among children of low socioeconomic status. Of the studied children, 14.3 percent of children had dental fluorosis. Fluorosis was very mild in 12.35 percent of the cases, mild in 1.98 percent and moderate in 0.26 percent. There were no cases of severe fluorosis (classified according to Dean's index). CONCLUSION: We conclude that after 8 years drinking water fluoridation in the metropolitan area, the number of children with no history of caries has increased by approximately 100 percent. The number of cases significantly affected by caries has also decreased significantly. The incidence of dental fluorosis has increased, but to milder degrees.

OBJETIVO: Avaliar o dano e a prevalência de cárie e fluorose em crianças e adolescentes na região metropolitana do Chile, após oito anos de fluoretação da água potável, em comparação com o estudo de base em 1996. METODOLOGIA: Desenho: estudo de prevalência. A amostra probabilística, estratificada por nível socioeconômico, constituiu-se de 2.323 escolares de 6-8 e 12 anos na Região Metropolitana. Todos os alunos foram clinicamente examinados por dentistas calibrados, utilizando critérios de seleção e indicadores propostos pela OMS para determinar cárie e fluorose dentária. RESULTADOS: Cerca de 24 por cento das crianças estavam livres de cáries. A média de CPOD foi de 3,18 em escolares de 6 a 8 anos. O CPOD foi de 0,59 em crianças de 6 a 8 anos e de 2,6 em crianças de 12 anos em relação ao estudo de base, sendo essas diferenças estatisticamente significativas. Houve diferenças significativas devido ao nível socioeconômico, sendo que os valores médios foram maiores em crianças de baixo nível socioeconômico. Cerca de 14 por cento das crianças apresentaram fluorose dentária, em geral de grau muito leve. CONCLUSÃO: Após 8 anos de fluoretação da água potável na região metropolitana, observou-se um aumento de 100 por cento de crianças sem história de cárie e significativa diminuição de danos. A fluorose dentária aumentou, mas em graus mais leves.

Modelo de Grupo de Trabajo en Resolución de Conflictos (GTRC) en instituciones escolares / Model of Group work in resolution of conflicts (GTCR ) at schools.

Introducción: Se plantea un modelo llamado Grupo de Trabajo en Resolución de Conflictos (GTRC), para ser aplicado en colegios, con el fin de constituirse en una respuesta a las dificultades a las que habitualmente se enfrenta el docente alrededor de problemas psicosociales en el ámbito escolar y, a la vez, mejorar la salud mental de la comunidad escolar (alumnos, padres y docentes). Objetivo: Describir el modelo GTRC después de dos años de trabajo. Resultados: Se describen las partes básicas del modelo, como lo son la mediación escolar, los Grupos Conversatorios de la Comunidad Escolar (GCCE), la investigación, la capacitación a padres, alumnos, profesores y el Club Escolar (acompañamiento de alumnos y familias con necesidades en salud mental). Conclusión: El modelo, con un amplio componente investigativo, parece tener buenas perspectivas en materia de resolución de problemas y promoción de la salud mental en la comunidad escolar .

Introduction: The model called GTRC (Group Work in Resolution of Conflicts) has been planned and designed to be applied at schools, this model pretends to be as a response to the difficulties that teachers usually handle in the school environment like psychosocial problems and at the same time seeks to improve the mental health in the community (students, parents and teachers). Objective: To describe the GTRC model after 2 years of work. Results: To describe the basic parts of the model as: school mediation, conversation groups of the school community (GCCE), research, training for parents, students and teachers; and Scholar club- (joined to parents and relatives with mental health needs). Conclusions: This model, with a wide research component, seems to have good prospects about trouble solutions and promoting mental health in the scholar community.

Exantema periflexural asimétrico de la infancia / Asymmetric periflexural exanthem of childhood

Se presentan dos pacientes con exantema periflexural asimétrico de la infancia. Esta entidad de descripción reciente, se presenta como un exantema escarlatiniforme o eccematoso que comienza en axila y se extiende centrífugamente hacia tronco y miembro superior homolateral. Puede ser pruriginoso y acompañarse de adenopatías regionales. Su aparición estacional, epidémica, y la edad de los pacientes afectados hablarían a favor de una posible etiología viral