Condición física de futbolistas adultos y jóvenes de un equipo profesional de Nicaragua / Condição física de jogadores de futebol adultos y juniores de uma equipe profissional na Nicaragua / Physical condition of adult and junior soccer players of a professional team in Nicaragua

En la actualidad, el fútbol es un deporte que demanda un alto desempeño físico, por lo que conocer las características de la condición física en las distintas categorías de desarrollo se hace fundamental para conducir un óptimo proceso de entrenamiento, de modo que, el objetivo de este estudio es evaluar la condición física de futbolistas de un club profesional de Nicaragua, según la categoría de edad en las cuales se desempeñaban. El presente es un estudio de tipo descriptivo, comparativo, de la condición física de 187 futbolistas, de edades entre 13 y 31 años, distribuidos por categoría según año de nacimiento y plantel profesional. El grupo PRO presenta mayor rendimiento en comparación a las categorías U13, U15, U17 y U21 (p < 0,001) en tiempo sprint lineal 10 metros (F = 71 y TE = 0,71), 30 metros (F = 85 y TE = 0,70), velocidad de tiro (F = 171 y TE = 0,81), Tiempo en test agilidad de Illinois (F = 77 y TE = 0,72) y metros recorridos en Yo-Yo de recuperación intermitente nivel 1 (F = 121 y TE = 0,73). Se puede concluir que existe un mayor rendimiento de los aspectos físicos por parte de las categorías de mayor edad. Estos resultados pueden servir de referencia o de parámetros de comparación de rendimiento físico de jugadores jóvenes y adultos a nivel nacional de Nicaragua.

Currently, soccer is a sport that demands high physical performance, so knowing the characteristics of the physical condition of players in the different categories of development is essential for conducting an optimal training process. Thus, the objective of this study is to evaluate the physical condition of soccer players from a professional club in Nicaragua, according to the age category in which they played. This is a descriptive and comparative study of the physical condition of 187 soccer players between the ages of 13 and 31, distributed by category, according to year of birth and the professional team they were on. The PRO group presented higher performance in comparison to the U13, U15, U17, and U21 categories (p<0.001) in the 10 meters linear sprint time (F=71 and TE=0.71), 30 meters linear sprint time (F=85 and TE=0.70), shooting speed (F=171 and TE=0.81), time in Illinois agility test (F=77 and TE=0.72), and in meters ran in the Yo-Yo intermittent recovery level 1 (F=121 and TE=0.73). The study shows that there is a higher performance of the older categories in the physical aspects. These results can serve as reference or comparison parameters of the physical performance of young and adult players at a national level in Nicaragua.

Atualmente, o futebol é um esporte que exige um alto desempenho físico, portanto, conhecer as características da condição física nas diferentes categorias de desenvolvimento é essencial para conduzir um processo de treinamento ideal, portanto, o objetivo deste estudo é avaliar a condição física dos jogadores de futebol de um clube profissional na Nicarágua, de acordo com a categoria etária em que jogaram. Este é um estudo descritivo e comparativo da condição física de 187 jogadores de futebol entre 13 e 31 anos, distribuídos por categoria de acordo com o ano de nascimento e equipe profissional. O grupo PRO apresentou melhor desempenho em comparação com as categorias U13, U15, U17 e U21 (p<0,001) em tempo de sprint linear 10 metros (F=71 e TE=0.71), 30 metros (F=85 e TE=0,70), velocidade de tiro (F=171 e TE=0.81), tempo em teste de agilidade illinois (F=77 e TE=0.72) e metros corridos em Yo-Yo de nível de recuperação intermitente 1 (F=121 e TE=0.73). Pode-se concluir que há um maior desempenho dos aspectos físicos por parte das categorias mais antigas. Estes resultados podem servir como parâmetros de referência ou comparação do desempenho físico de jogadores jovens e adultos a nível nacional na Nicarágua.

Efectos en el estado de bienestar en periodo de confinamiento debido al COVID-19 en jugadores profesionales de fútbol / Effects on the wellness state in period of confinement due to COVID-19 in professional soccer players

Resumen El propósito del estudio fue conocer las alteraciones en el estado de bienestar en periodo de confinamiento debido al COVID-19 en jugadores de fútbol profesional de la primera división B de Chile. Participaron 28 jugadores profesionales de fútbol varones, edad 26 ± 6.3 años, masa corporal de 74.2 ± 5.5 kg y estatura de 177 ± 0.05 cm. Se evaluó el grado de bienestar a través de un cuestionario (McLean et al., 2010) durante periodo competitivo y periodo de confinamiento de la temporada 2020. Se muestran diferencias estadísticamente significativas (p<0.05) entre el periodo competitivo y el periodo de confinamiento, en FT (t = 2.5; p = 0.0), SO (t = 2.71; p = 0.01), ES (t = 5.07; p = 0.0), EA (t = 1.82; p = 0.08) y T (t = 4.87; p = 0.0). Se reflejaron TE pequeños en las variables EA y DM (d = 0.7; d = 0.4 respectivamente), moderados en FT y SO (d = 1.0; d = 1.2 respectivamente) y muy grandes en ES y T (d = 2.1; d = 2.0 respectivamente). Los PC y CV entre periodos para las variables de bienestar fueron para FT 11% y 11.6%, para DM 5.3% y 13.1%, para SO 9.3%; 7.5%, ES 11.6% y 5.9, para EA 3.9%; 5.2%, y finalmente para T 8.1% y 4.0% respectivamente. Es posible concluir que el estado de bienestar en jugadores profesionales de fútbol se ve alterado en el periodo de confinamiento respecto al de competición, encontrándose cambios significativos en las variables FT, SO, ES y T, que coincidieron con los cambios de moderados a muy grandes de estas mismas variables, como también los PC fueron más grandes que el CV entre periodos; por lo que podríamos considerar estos cambios como reales, y que pudiesen ser un efecto atribuible al aislamiento obligatorio.

Abstract This study aimed to find changes in the wellness state, during the confinement period due to COVID-19, in professional soccer players from the first division B of Chile. The studied sample consisted of 28 professional male soccer players aged 26 ± 6.3 years, body mass 74.2 ± 5.5 kg, and height 177 ± 0.05 cm. The degree of well-being was evaluated through a questionnaire (McLean et al., 2010) during the 2020 competitive and confinement periods. Statistically, significant differences (p <0.05) between the competitive period and the confinement period are shown in FT (t = 2.5; p = 0.0), SO (t = 2.71; p = 0.01), ES (t = 5.07; p = 0.0), EA (t = 1.82; p = 0.08), and T (t = 4.87; p = 0.0). Small TE were reflected in the variables EA and DM (d = 0.7; d = 0.4 respectively), moderate in FAT and SO (d = 1.0; d = 1.2 respectively), and very large in ES and T (d = 2.1; d = 2.0 respectively). The CP and CV between periods for the well-being variables were the following: for FAT, 11% and 11.6%, for DM, 5.3% and 13.1%; for SO, 9.3%; 7.5%, ES 11.6% and 5.9, for EA 3.9%; 5.2%, and finally for T 8.1% and 4.0% respectively. It is possible to conclude that the state of well-being in professional soccer players is altered in the period of confinement with respect to that of competition, finding significant changes in the variables FT, SO, ES, and T, which coincided with the changes from moderate to very large of these same variables, as well as the PC were larger than the CV between periods. Therefore, we could consider these changes as real, and they could be an effect attributable to the mandatory isolation.

Resumo O objetivo do estudo foi conhecer as alterações no estado de bem-estar no período de confinamento devido à COVID-19 entre jogadores profissionais de futebol da primeira divisão B do Chile. Vinte e oito jogadores profissionais de futebol masculino participaram, com idade de 26 ± 6,3 anos, massa corporal de 74,2 ± 5,5 kg e altura de 177 ± 0,05 cm. O grau de bem-estar foi avaliado por meio de um questionário (McLean et al., 2010) durante os períodos competitivos e de confinamento da temporada 2020. Forma demonstradas diferenças estatisticamente significativas (p<0,05) entre o período competitivo e o de confinamento, em FT (t = 2,5; p = 0,0), SO (t = 2,71; p = 0,01), ES (t = 5,07; p = 0,0), EA (t = 1,82; p = 0,08) e T (t = 4,87; p = 0,0). TE pequenos foram refletidos nas variáveis EA e DM (d = 0,7; d = 0,4 respectivamente), moderados em FT e SO (d = 1,0; d = 1,2 respectivamente) e muito grandes em ES e T (d = 2,1; d = 2,0 respectivamente). O PC e o CV entre períodos para as variáveis de bem-estar foram para FT 11% e 11,6%, para DM 5,3% e 13,1%, para SO 9,3%; 7,5%, ES 11,6% e 5,9, para EA 3,9%; 5,2%, e finalmente para T 8,1% e 4,0% respectivamente. É possível concluir que o estado de bem-estar dos jogadores de futebol profissional ficou alterado no período de confinamento em relação ao período de competição, encontrando alterações significativas nas variáveis FT, SO, ES e T, que coincidiram com alterações moderadas a muito grandes nestas mesmas variáveis, assim como o PC foi maior que o CV entre períodos; desta forma, poderíamos considerar estas alterações como reais, e que poderiam ser um efeito atribuível ao isolamento obrigatório.

Consenso chileno de diagnóstico y manejo de neoplasias quísticas pancreáticas. Club de páncreas Chile-SCHGE / Chilean consensus on diagnosis and management of pancreatic cystic neoplasms

Pancreatic cystic neoplasms (PCN) are frequently detected on abdominal images performed for non-pancreatic indications. Their prevalence in asymptomatic population ranges from 2.7 to 24.8%, and increases with age. There are several types of pancreatic cysts. Some may contain cancer or have malignant potential, such as mucinous cystic neoplasms, including mucinous cystadenoma (MCN) and intraductal papillary mucinous neoplasms (IPMN). In contrast, others are benign, such as serous cystadenoma (SCA). However, even those cysts with malignant potential rarely progress to cancer. Currently, the only treatment for pancreatic cysts is surgery, which is associated with high morbidity and occasional mortality. The Board of the Chilean Pancreas Club of the Chilean Gastroenterology Society developed the first Chilean multidisciplinary consensus for diagnosis, management, and surveillance of PCN. Thirty experts were invited and answered 21 statements with five possible alternatives: 1) fully agree; 2) partially agree; 3) undecided; 4) disagree and 5) strongly disagree. A consensus was adopted when at least 80% of the sum of the answers "fully agree" and "partially agree" was reached. The consensus was approved by the Board of Directors of the Chilean Pancreas Club for publication.

Vínculo entre composición corporal, sprint y salto vertical en futbolistas jóvenes de élite de Chile / Link Between Body Composition, Sprint and Vertical Jump in Young Elite Soccer Players from Chile

Resumen El objetivo de este trabajo fue conocer las relaciones entre indicadores de composición corporal y rendimiento físico en jugadores jóvenes de élite y determinar si existen diferencias entre posiciones de juego y series. La muestra fue de futbolistas seleccionados Sub-15 (n=24) y Sub-17 (n=20) varones, divididos por posición de juego. Se evaluaron indicadores composición corporal, porcentaje de masa grasa (%MG) y porcentaje de masa muscular (%MM). Se evaluaron salto desde sentadilla (SJ), salto con contramovimiento (CMJ), velocidad lineal en 10 (T10) y 30 metros (T30). Se relacionaron variables de composición corporal y rendimiento físico, y se buscaron diferencias entre posiciones de juego y entre categorías. Se hallaron grandes asociaciones significativas en la categoría Sub-15 entre %MM con SJ y CMJ, y moderadas entre %MG con T10, SJ y CMJ. En Sub-17 una asociación significativa grande entre %MM y T30, y entre %MG y T30. Se hallaron diferencias significativas en %MG en la categoría Sub-17, entre los arqueros vs defensas y delanteros. Se encontraron diferencias significativas moderadas en %MM entre categorías y diferencias muy grandes en T10 y T30, y una diferencia moderada en SJ. Es posible concluir que la composición corporal %MM y %MG se relaciona con el rendimiento físico. Además, existen diferencias en %MG entre los arqueros vs los jugadores de campo y diferencias en las variables de composición corporal y rendimiento físico entre jugadores Sub-17 y sub-15. Los resultados obtenidos pueden servir de referencia o de parámetros de comparación de jugadores jóvenes a nivel nacional en la detección de talentos.

Abstract The study aimed to know the relationships between indicators of body composition and physical performance in elite young players and determine if there are differences between playing positions and series. The sample was of selected U-15 (n=24) and U-17 (n=20) male players, divided by playing position. Body composition, fat mass percentage (%MG), and muscle mass percentage (%MM) indicators were evaluated. Also, Squat Jump (SJ), Countermovement Jump (CMJ), linear velocity in 10 (T10) and 30 meters (T30) were evaluated. Body composition and physical performance variables were related, and differences between playing positions and between categories were sought. Significant large associations were found in the U-15 category between %MM with SJ and CMJ and moderate associations between %MG with T10, SJ, and CMJ. In the U-17 category, a significant large association was found between %MM and T30 and between %MG and T30. Significant differences in %MG were found in the U-17 category between goalkeepers vs. defenders and forwards. Moderate significant differences were found in %MM between categories and very large differences in T10 and T30, and a moderate difference in SJ. Therefore, it is possible to conclude that the body composition %MM and %MG is related to physical performance. In addition, there are differences in %MG between goalkeepers vs. outfield players and differences in body composition and physical performance variables between U-17 and U-15 players. The results obtained can be used as a reference or as parameters for comparing young players at the national level in the detection of talent.

Resumo O objetivo deste trabalho foi conhecer as relações entre indicadores de composição corporal e desempenho físico em jovens jogadores de elite e verificar se existem diferenças entre posições de jogo e séries. A amostra foi composta por jogadores de futebol masculino sub-15 (n = 24) e sub-17 (n = 20) selecionados, divididos por posição de jogo. Foram avaliados indicadores de composição corporal, percentual de massa gorda (% MG) e percentual de massa muscular (% MM). Foram avaliados o salto de agachamento (SJ), salto de contra movimento (CMJ), velocidade linear a 10 (T10) e 30 metros (T30). Variáveis de composição corporal e desempenho físico foram relacionadas, e diferenças entre as posições de jogo e entre as categorias foram pesquisadas. Grandes associações significativas foram encontradas na categoria de menores de 15 anos entre% MM com SJ e CMJ, e moderadas entre% MG com T10, SJ e CMJ. Em Sub-17, uma grande associação significativa entre% MM e T30 e entre% MG e T30. Diferenças significativas foram encontradas na % MG na categoria Sub-17, entre goleiros x zagueiros e atacantes. Diferenças moderadas significativas foram encontradas em % MM entre as categorias e diferenças muito grandes em T10 e T30, e uma diferença moderada em SJ. É possível concluir que a composição corporal % MM e% MG está relacionada ao desempenho físico. Além disso, há diferenças na % MG entre goleiros e jogadores de campo e diferenças nas variáveis de composição corporal e desempenho físico entre jogadores Sub-17 e Sub-15. Os resultados obtidos podem servir de referência ou parâmetro de comparação de jovens jogadores a nível nacional para a detecção de talentos.

Dilemas clínicos en la constitución de la tercera causal de la interrupción voluntaria del embarazo / Clinical dilemmas derived from the need to certify rape for voluntary pregnancy interruption

Since 2017, women in Chile are allowed to interrupt voluntarily a pregnancy on three grounds: 1) When a woman's life is at risk due to the pregnancy, 2) When there are fetal anomalies incompatible with life, or 3) When pregnancy is result of rape. Women who qualify for any of these three pregnancy interruption requirements are entitled to a psychosocial accompaniment program to promote an integrative approach. In this article we will discuss the role of the psychosocial team in cases of rape resulting pregnancy. Specifically, the clinical and ethical dilemmas posed by the need to certify the rape in a general hospital such as difficulties in assessment of the story's plausibility, clinician's dual role and the limits to confidentiality, are discussed.

Effects of COVID-19 confinement measures on training loads and the level of well-being in players from Chile women's national soccer team / Efectos de las medidas de confinamiento por COVID-19 en el grado de bienestar y la carga de entrenamiento de las jugadoras de la selección nacional de fútbol de Chile

Abstract Introduction: Due to the current COVID-19 pandemic, many countries have implemented control and prevention measures, such as compulsory lockdowns, affecting all spheres of life. Since the field of professional soccer is no exception, such measures may have a negative impact on the player's well-being and their perceived training loads. Objective: To determine the impact of COVID-19 lockdown measures on the training load and the well-being of female professional soccer players in Chile. Materials and methods: Exploratory, cross-sectional, descriptive study conducted on 32 players of the Chile women's national soccer team. The perception of training load and the level of well-being were assessed by means of the rating of perceived exertion (RPE) scale and a questionnaire developed in 2010, respectively. Both the administration of the questionnaire and the permanent monitoring of the RPE records were carried out in two periods of 12 weeks: regular preparatory phase (12/12/2019-10/03/2020) and lockdown (16/03/2020-07/06/2020). Data were analyzed using descriptive statistics and the Wilcoxon test was used to determine if there were significant differences between periods. Results: Significant differences (p<0.05) and threshold effect sizes (ES)=1.2, 2.0 and 4.0 (large, very large, and extremely large, respectively) were found between both periods in all variables evaluated by the well-being questionnaire (except for sleep quality): muscle soreness and stress level (ES=1.9), perceived fatigue (ES=2.5), general well-being (ES=2.4), and mood (ES=4.2). No differences were found regarding the perception of the training load (ES=0.1) between both periods. Conclusions: The level of well-being among the participants was negatively affected by the compulsory lock-down. Therefore, coaching staffs should continue to monitor the level of the well-being of professional soccer players during the lockdown, both individually and collectively. Even though the perception of training load was not affected, it is not possible to state that a more extended period of confinement will not reduce it, resulting in a drop in performance.

Resumen Introducción. Debido a la actual pandemia por COVID-19, muchos países tomaron medidas de control y prevención como el confinamiento obligatorio, afectando todas las esferas de la vida. Ya que los futbolistas profesionales no son una excepción, este tipo de medidas puede tener un impacto negativo en su bienestar y en su percepción sobre las cargas de entrenamiento. Objetivo. Determinar los efectos de las medidas de confinamiento por COVID-19 en la carga de entrenamiento y el grado de bienestar de jugadoras de fútbol profesional de Chile. Materiales y métodos. Estudio transversal, exploratorio-descriptivo realizado en 32 jugadoras de la Selección Nacional de Fútbol de Chile. El grado de bienestar y la carga de entrenamiento se evaluaron mediante un cuestionario desarrollado en 2010 y mediante la escala de percepción subjetiva del esfuerzo (PSE) y el volumen de entrenamiento expresado en minutos, respectivamente. Ambas evaluaciones se realizaron en 2 periodos de 12 semanas : periodo preparatorio regular (12/12/2019-10/03/2020) y periodo de confinamiento (16/03/2020-07/06/2020). Los datos se analizaron mediante estadística descriptiva y la prueba de Wilcoxon se utilizó para determinar si hubo diferencias significativas entre ambos periodos. Resultados. Se encontraron diferencias significativas (p<0.05) y umbrales de tamaño del efecto (TE) iguales a 1.2, 2.0 y 4.0 (grande, muy grande y extremadamente grande, respectivamente) entre ambos periodos en todas las variables evaluadas por el cuestionario de bienestar (a excepción de calidad de sueño): dolor muscular y nivel de estrés (TE=1.9), fatiga percibida (TE=2.5), bienestar general (TE=2.4) y estado de ánimo (TE=4.2). No se observaron diferencias en la PSE (TE=0.1) entre ambos periodos. Conclusiones. El confinamiento obligatorio afectó negativamente el grado de bienestar de las participantes, por lo que es necesario que los cuerpos técnicos monitoreen constantemente, de manera individual y colectiva, el grado de bienestar de los futbolistas profesionales durante estos periodos; si bien la percepción en la carga de entrenamiento no se vio afectada, no es posible asegurar que un periodo mayor de confinamiento no la disminuya y esto resulte en una baja del rendimiento.

El sujeto según Sartre y Lacan. Encuentros y desencuentros entre fenomenología y psicoanálisis / The subject according to Sartre and Lacan. Encounters and disagreements between phenomenology and psychoanalysis

Este trabajo consiste en comparar el concepto de sujeto propuesto por Jacques Lacan al psicoanálisis con la concepción de subjetividad que puede deducirse de la obra de Jean-Paul Sartre que da lugar a su propuesta de un psicoanálisis existencial

This work consists of comparing the concept of subject proposed by Jacques Lacan to psychoanalysis with the conception of subjectivity that can be deduced from the work of Jean-Paul Sartre that gives rise to his proposal of an existential psychoanalysis

Urbanization, habitat extension and spatial pattern, threaten a Costa Rican endemic bird / Urbanización, cantidad de hábitat y distribución espacial, amenazan un ave endémica de Costa Rica

Introduction: Migration of people from rural environments to cities has accelerated urbanization and modified the landscape as well as the ecological processes and communities in these areas. The Costa Rican endemic Cabanis´s Ground-Sparrow (Melozone cabanisi) is a species of limited distribution restricted to the "Gran Area Metropolitana", which is the biggest urban settlement of the country. This area has experimented and still experiment an ongoing fragmentation and loss of habitat used by this species (coffee plantations, shrubs, and thickets). Objective: To determine the effects of urbanization on habitat abundance and spatial pattern for the occurrence of Melozone cabanisi. Methods: We modeled the area of potentially suitable habitat for this species in Costa Rica using occurrence and bioclimatic data. Then, we estimated the actual suitable habitat using land cover type layers. Finally, we analyzed the connectivity among the actual suitable habitat patches using single-patch and multi-patch approaches. Results: From the area of potentially suitable habitat estimated by the bioclimatic model, 74 % were urban areas that are unsuitable for Melozone cabanisi. The largest suitable patches within urban areas were coffee plantations; which also were crucial for maintaining connectivity between habitat patches along the species' range. Conclusions: To preserve and protect the Melozone cabanisi, these areas must be taken into consideration by decision-makers in the present and future management plans. We recommend avoiding change shrubs and thickets to urban cover to preserve the occurrence of Melozone cabanisi, and implement a program for the payment of environmental services to landholders, supported by the local governments, to protect those habitats in urban contexts.

Introducción: La migración desde ambientes rurales hacia las ciudades ha incrementado la urbanización. Esto ha modificado el paisaje, así como los procesos ecológicos y comunidades dentro de estas áreas. El Cuatro-ojos de Jupa-roja (Melozone cabanisi) es una especie distribuida principalmente al interior del asentamiento urbano más grande de Costa Rica. Hasta el presente esta área sigue experimentando fragmentación y pérdida del hábitat utilizado por esta especie (plantaciones de café, charrales y tacotales). Objetivo: Determinar los efectos de la urbanización sobre la cantidad de hábitat y su distribución espacial, basada en datos de presencia para M. cabanisi. Métodos: Modelamos el hábitat potencialmente adecuado para M. cabanisi utilizando datos bioclimáticos y de presencia. Luego estimamos el hábitat real utilizando el hábitat potencialmente adecuado y las capas de cobertura del suelo. Finalmente analizamos la conectividad entre los parches de hábitat real utilizando un enfoque multi y mono-parche. Resultados: Del área del hábitat potencialmente adecuado estimada por el modelo bioclimático, 74 % fueron áreas urbanas, lo que consideramos es un porcentaje inadecuado para M. cabanisi. Los parches más grandes de hábitat real dentro de las áreas urbanas fueron plantaciones de café, que a su vez fueron cruciales para mantener la conectividad entre los parches a lo largo del rango de distribución de la especie. Conclusiones: Para conservar y proteger a M. cabanisi, los tomadores de decisiones deben tener en cuenta los charrales, tacotales y cafetales dentro de la distribución de las especies en los planes de gestión presentes y futuros, evitando su cambio a coberturas urbanas.

Paradojas del goce y del cuerpo / Paradoxes of enjoyment (jouissance) and the body

En este artículo se presentan las primeras conclusiones del proyecto de investigación UBACyT (2018-2021): "Génesis, delimitación y transformaciones del concepto de goce en la obra de J. Lacan", dirigido por el autor. El objetivo de este trabajo en particular es esclarecer las referencias del término goce en relación con el cuerpo. Se busca demostrar que la concepción del goce producto de la mortificación significante, se opone a la idea del goce como sustancia positiva

This article presents the first conclusions of the research project UBACyT (2018-2021): "Genesis, delimitation and transformations of the concept of enjoyment (jouissance) along the J. Lacan work" directed by the author. The objective of this particular work is to clarify the references of the term enjoyment (jouissance) in relation to the body. It seeks to demonstrate that the conception of enjoyment (jouissance) as product of significant mortification, is opposed to the idea of enjoyment (jouissance) as a positive substance

Hemorragia digestiva alta variceal y no variceal: mortalidad intrahospitalaria y características clínicas en un hospital universitario (2015-2017) / Variceal and non-variceal upper gastrointestinal bleeding. Analysis of 249 hospitalized patients

Background: Upper gastrointestinal bleeding (UGIB) is one of the main reasons of hospitalization due to gastrointestinal causes. Reported mortality rates range from 5 to 12%. Aim: To determine hospital mortality and associated risk factors in hospitalized patients with UGIB. To compare the clinical characteristics and outcomes of patients with variceal versus non-variceal UGIB. Material and Methods: Review of medical records of 249 patients (62% males) discharged with the diagnosis of UGIB at a clinical hospital between 2015 to 2017. Demographic and clinical characteristics and adverse clinical outcomes (surgery, length of hospital stay and in-hospital mortality) were recorded. A comparative analysis between patients with Variceal and Non-variceal UGIB was carried out. Results: Seventy two percent of UGIB were non-variceal (peptic ulcer in 44%). Two patients required surgery (both died). Median of length of hospital stay was seven days (interquartile range (IQR) 4-13). Overall hospital mortality was 13 and 4% in variceal and non-variceal UGIB, respectively (p = 0.024). The variables associated with mortality were: red blood cell transfusion (odds ratio (OR): 18.7, p < 0.01), elevated creatinine on admission (OR: 3.30, p = 0.03) and variceal bleeding (OR: 3.23, p = 0.02). Conclusions: Hospital mortality of UGIB remains high, especially in variceal UGIB. Elevated creatinine levels on admission, the need of transfusion of red blood cells and variceal etiology are risk factors for mortality.

Las voces del goce / The voices of enjoyment (jouissance)

En este artículo se presentan algunas conclusiones del proyecto de investigación UBACyT (2018-2021): "Génesis, delimitación y transformaciones del concepto de goce la obra de J. Lacan", dirigido por el autor. El objetivo de este trabajo en particular es esclarecer las primeras referencias del término goce en relación con el objeto voz. Se busca demostrar que la concepción del goce como un lugar ligado a la falta de ser producto de la mortificación significante, se opone a la idea del goce como sustancia positiva

This article presents some conclsuions of the research project UBACyT (2018-2021): "Genesis, delimitation and transformations of the concept of enjoyment (jouissance) along the J. Lacan work" directed by the author. The objective of this particular work is to clarify the first references of the term enjoyment (jouissance) in relation to the objet voice. It seeks to demonstrate that the conception of enjoyment (jouissance) as a place linked to the lack of being, product of significant mortification, is opposed to the idea of enjoyment (jouissance) as a positive substance

Shahriar y las mil y una sesiones. Demanda, deseo y transferencia como operadores clínicos en un caso de obesidad infantil. Su articulación con la pulsión de muerte y el goce / Shahriar and the thousand and one sessions. Demand, desire and transference as clinical operators in a case of child obesity. Its articulation with death drive and enjoyment

En el presente trabajo será nuestro objetivo la delimitación de una serie de coordenadas clínicas de un caso de obesidad infantil, las cuales nos permitirán realizar un análisis del modo en que se articulan demanda y deseo en relación al Otro y la transferencia en la clínica psicoanalítica. Para ello, se procederá a la presentación de tres viñetas clínicas del caso, las cuales serán analizadas a partir de los operadores conceptuales mencionados. Dicho trípode clínico conceptual, como veremos, nos permitirá hacer ulteriores consideraciones sobre las nociones de pulsión de muerte y de goce, nociones problemáticas en psicoanálisis, que a través del prisma de la transferencia podremos retomar desde una perspectiva clínica

In the present paper, it will be our aim to delimitate a series of clinical coordinates of a case of child obesity, which will enable us to analise the way in which demand and desire are articulated in relation to the Other and the transference in the psychoanalytic clinic. To such aim, we will proceed to present three excerpts from the case, which will be analised from the perspective of the mentioned conceptual operators. Such conceptual-clinical tripod, as it will be shown, will allow us to make further considerations on the notions of death drive and enjoyment, problematic notions in psychoanalysis, which we will be able to examine through the prism of transference from a clinical perspective

Estudio clínico-histopatológico de las eritrodermias en un hospital universitario: 14 años de experiencia / Clinical-histopathological study of erythroderma in a university hospital: 14 years of experience

INTRODUCCIÓN: La eritrodermia es un síndrome inflamatorio cutáneo infrecuente caracterizado por compromiso eritematoso generalizado y descamación, de más del 90% de superficie cutánea total. OBJETIVO: Caracterizar clínica e histopatológicamente a los pacientes con eritrodermia en un hospital universitario chileno. METODOLOGÍA: Estudio retrospectivo, realizado en el Hospital Clínico Universidad de Chile, basado en revisión de fichas clínicas e informes histopatológicos de pacientes con eritrodermia, entre 2005 y 2018. Se evaluó edad, sexo y variables clínicas (co-morbilidades, síntomas, días de evolución, ingreso hospitalario, informe histopatológico, diagnóstico y evolución). RESULTADOS: Total de 28 pacientes, 18 hombres (64%), edad promedio 59 años. Causa más frecuente de eritrodermia fue dermatosis pre-exis-tentes, con 15 casos (54%), que incluyen: psoriasis 9 (32%), dermatitis de contacto 3 (11%), PRP 2 (7%), dermatitis atópica 1 (4%). A estas le siguen: reacción adversa medicamentosa 6 (21%), idiopática 6 (21%) y Síndrome de Sezary 1 (4%). CONCLUSIÓN: El presente estudio corresponde a la primera serie de eritrodermias realizada en Chile. Destacan las dermatosis preexistentes como la principal causa, lo que se correlaciona con la literatura.

INTRODUCTION: Erythroderma is an infrequent cutaneous inflammatory disorder characterized by generalized erythematous compromise and desquamation, of more than 90% of total cutaneous surface. OBJECTIVE: Clinical and histopathological cha-racterization of patients with erythroderma in a Chilean university hospital. METHODOLOGY: Retrospective study, performed at the University of Chile Clinical Hospital, based on review of clinical records and histopatho-logical reports of patients with erythroderma, between 2005 and 2018. Age, sex and clinical variables were evaluated (co-morbidities, symp-toms, days of evolution, hospital admission, histopathological report, diagnosis and evolu-tion). RESULTS: A total of 28 patients, 18 were men (64%), average age 59 years. Most frequent cause of erythroderma was pre-existing dermatosis, with 13 cases (52%), which included: psoriasis 9 (32%), contact dermatitis 3 (11%), PRP 2 (7%), atopic dermatitis 1 (4%). These are followed by adverse drug eruption 6 (21%), idiopathic 6 (21%) and Sezary syndrome 1 (4%). CONCLUSION: The present study corresponds to the first series of erythrodermas performed in Chile. The pre-existing dermatoses were the main cause of erythroderma, which coincides with other reports.

Goce y pulsión / Enjoyment and drive

Este trabajo se propone estudiar el concepto de goce a lo largo de la obra de J. Lacan, identificando con claridad, primeramente, el momento de su génesis y su estabilización como concepto a partir de alcanzar una definición precisa y formalizada. En segundo lugar, se intentará identificar los conceptos freudianos y lacanianos que acompañan y sostienen ese momento. En tercer lugar, se buscará esclarecer las articulaciones del concepto de goce con el concepto de pulsión, para establecer sus diferencias.

The goal of this work is to study the concept of enjoyment (jouissance) throughout the work of J. Lacan, clearly identifying, first of all, the moment of its genesis and its stabilization as a concept when it reachs a precise and formalized definition. Secondly, it is then proposed to identify the freudian and lacanian concepts that accompany and sustain these moments. Thirdly, will seek to clarify the articulations of the concept of enjoyment (jouissance) with the concept of drive.

Disminución en la frecuencia de infección por Helicobacter pylori en endoscopías digestivas altas / Helicobacter pylori infection detected during upper gastrointestinal endoscopy

Background: Helicobacter pylori (HP) is the most widespread chronic human infection worldwide and the most important pathogenic factor of gastric cancer. The calculated prevalence at the Clinical Hospital of the University of Chile from 2002 to 2005 was 44.9%. Aim: To determine the current prevalence of HP in patients undergoing an upper gastrointestinal endoscopy (UGI) and analyze its distribution according to age and endoscopic findings. Material and Methods: We reviewed 3.433 UGI performed during the year 2015, selecting those in which rapid urease test (RUT) was done. A positive RUT or a positive gastric biopsy (GB) were considered as HP infection. Results: RUT was done in 1862 UGI (55%) performed in patients aged 51 ± 17 years, (66% women). In 23% of these endoscopies, the RUT was positive. A GB was obtained 43% of endoscopies and 30% were positive for HP. In 105 patients the RUT was negative and the GB positive (rendering a 19.5% false negative rate). HP was detected by RUT and GB in 29% of endoscopies. The highest prevalence of infection (38.1%) was found between 40 and 49 years. HP infection had odds ratio of 4.24 for nodular gastropathy, 2.63 for gastric ulcer and 2.14 for duodenal ulcer (p < 0.05). Conclusions: HP prevalence in our center decreased significantly from 44.9% to 28.9% in 11 years. False negative RUT results may bias this finding. The use of proton pump inhibitors and antimicrobials that can interfere with the detection of HP should be registered to properly analyze the results of the RUT.

Licencia médica psiquiátrica: revisión de los efectos positivos y negativos del reposo / Psychiatric sick leave

There is no consensus amongst physicians, social security representatives and researchers about optimum sick leaves. This is an indication that should maximize positive outcomes and minimize potential side effects, both for the patient and society. The use of sick leaves during the last decade rose steadily, particularly in the psychiatric field. The most important causes of this increase are: changes in public policies, overuse of psychiatric diagnosis to cover up unmet social needs, and modifications to labour structure. It is analysed the impact that this situation has implied for physician patient relationship as well as for health budget. Even though sick leave diminishes presentism associated to a psychiatric disorder, published evidence about the effect of prolonged sick leave shows that damage overruns potential benefits: augmented morbidity and mortality, workplace phobia, economic loss, among others.

El cuerpo histérico y la sustancia gozante / The Hysterical Body And The Substance Of Enjoyment

El presente trabajo forma parte de los avances de la investigación UBACyT 2014-2017 "Articulación de las conceptualizaciones de J. Lacan sobre la libertad con los conceptos fundamentales que estructuran la dirección de la cura: interpretación, transferencia, posición del analista, asociación libre y acto analítico", dirigida por el Dr. Pablo MunÞoz. En el mismo se presentan las primeras indagaciones realizadas sobre el teìrmino "responsabilidad" y su vínculo con el problema del goce y la satisfacción del síntoma. En este contexto realizaremos un breve recorrido por las implicaciones teóricas y clínicas de la oposición cuerpo y significante en psicoanálisis, y su influencia en la conceptualización del goce. Para ello recorreremos los primeros textos de la obra de Freud sobre el cuerpo histérico para ubicar otro modo de concebir la dualidad cartesiana mente ­ cuerpo. Por último, revisaremos el concepto de sustancia de gozante para relacionarlo con el surgimiento del cuerpo histérico.

This work is part of research UBACyT 2014-2017 "Joint conceptualizations of J. Lacan on freedom with the fundamental concepts that structure the direction of the treatment: interpretation, transference, analyst position, free association and analytic act, "directed by Dr. Pablo MunÞoz. This work present the first research on the term "responsibility" and its link with the problem of enjoyment and satisfaction of the symptom. In this context we will make a brief tour of the theoretical and clinical implications of the body and significant opposition in psychoanalysis and its influence on the conceptualization of enjoyment. In order to do this, we will go through the first texts of Freud \'s work on the hysterical body to locate another way of conceiving the Cartesian mind - body duality. Finally, we will review the concept of the substance of enjoyment to relate it to the emergence of the hysterical body.

Del filósofo al santo: consideraciones acerca del goce en el reverso del psicoanálisis / From the philosopher to the saint: Reflection on enjoyment in the other side of psychoanalysis

En este trabajo nos proponemos realizar una caracterización del concepto de goce en El reverso del psicoanálisis. Principalmente, nos centraremos en ubicar las coordenadas del goce en relación con el discurso del amo y al discurso del analista. Para estos fines, en un primer momento, presentaremos a Foucault como antecedente histórico de los desarrollos lacanianos en El reverso del psicoanálisis. En un segundo momento, expondremos la escritura de los cuatros discursos. En un tercer momento, analizaremos las relaciones entre significante y goce para mostrar las consecuencias que acarrean para los conceptos de saber y verdad. Este recorrido nos llevará a detenernos en la figura del filósofo -ilustrada por el Sócrates de Platón- como funcional al discurso del amo. En cuarto momento, intentaremos mostrar que la proximidad del analista respecto al santo lo aleja de la perversión. Finalmente, haremos un balance de los puntos más importantes de nuestro recorrido.

In this work we propose to make a presentation of the concept of enjoyment in The Other Side of Psychoanalysis. Mainly, we will focus on locating the enjoyment in relation to the Master's discourse and the Analyst's discourse. For these purposes, first, we will present Foucault as a historical antecedent of the Lacanian´s developments in The Other Side of Psychoanalysis. Second, we will present the four discourses writing. Third, we will analyze the relations between signifier and enjoyment to show the implications that they have for the concepts of knowledge and truth. This journey will take us to stop in the figure of the philosopher ­paradigmatically in Plato´s Socrates- as functional to the Master´s discourse. Fourth, we will try to show that the figure of the analyst implies placing himself in the position of the saint, that is, as a waste of enjoyment. Finally, we will sum up the most important points of our theoretical considerations.