Causas de ataxia aguda en un hospital de tercer nivel de complejidad / Causes of acute ataxia at a tertiary level hospital

La ataxia es una alteración de la coordinación motora voluntaria y del control postural. Es una entidad poco frecuente en la infancia, siendo la principal causa de ataxia aguda descripta en la bibliografía, de origen inmunológico (post infecciosa), seguida de las intoxicaciones. Para el diagnóstico es fundamental una anamnesis detallada, cronología de los síntomas, antecedentes infecciosos o de contacto con sustancias tóxicas y un examen neurológico completo. El objetivo de nuestro estudio fue analizar retrospectivamente la causa de ataxia aguda como signo neurológico predominante en pacientes que consultaron en el Hospital Juan P. Garrahan. Diseño: Se trata de un estudio descriptivo, observacional, retrospectivo y de corte transversal. Población: niños de 1 a 18 años, con o sin patología previa conocida, que consultaron al servicio de emergencias del hospital por ataxia entre enero de 2013 y octubre de 2018. Método: recolección y análisis de historias clínicas comprendidas en esa fecha, con alteración en la marcha como síntoma de consulta. Resultados: de un total de 237 pacientes, la causa más frecuente de ataxia aguda fue la inmunológica (incluyendo en este grupo a las postinfecciosas y a las no asociadas a infección). Conclusión: En nuestro hospital con tercer nivel de atención, la causa más frecuente de ataxia aguda fue la inmunológica. En segundo lugar, las intoxicaciones y, en tercer lugar, las enfermedades neurológicas. (AU)

Ataxia is a disorder of voluntary motor coordination and postural control, which is rare in childhood. The main cause of acute ataxia described in the literature is immune-mediated inflammation (postinfectious), followed by intoxication. A detailed anamnesis, chronology of symptoms, history of infection or contact with toxic substances, and a complete neurological examination are essential in the diagnostic work-up. The aim of our study was to retrospectively analyze the cause of acute ataxia as a predominant neurological sign in patients who consulted at Hospital Juan P. Garrahan. Study design: A descriptive, observational, retrospective, cross-sectional study was conducted. Study population: children aged 1 to 18 years, with or without known previous disease, who presented to the hospital emergency department for ataxia between January 2013 and October 2018. Method: collection and analysis of medical records from that period of patients with gait disturbance as the reason for consultation. Results: out of a total of 237 patients, the most frequent cause of acute ataxia was immune-mediated inflammation (both post-infectious and noninfectious). Conclusion: In our tertiary care hospital, the most frequent cause of acute ataxia was immune-mediated inflammation. The second most frequent cause was intoxication and the third neurological diseases (AU)

Evaluación y apoyo nutricional en el paciente pediátrico críticamente enfermo: Revisión de la literatura

RESUMEN Esta revisión se basa en la mejor evidencia actualmente disponible, y en ella se definen las directrices en relación con la evaluación y manejo nutricional en niños críticamente enfermos. Estas directrices incluyen, los criterios para la detección de la malnutrición, tanto por déficit o exceso, así como, se identifican las recomendaciones y consensos de expertos sobre la estimación energética y de macronutrientes, los cuales pueden ser determinantes en prevenir tanto la sobrealimentación como subalimentación. También se señalan las recomendaciones internacionales sobre el momento de inicio del soporte nutricional para que esta sea oportuna, efectiva y segura, eligiendo la vía de alimentación según condición clínica y tipo de patología en función de disminuir el riesgo de morbimortalidad de estos pacientes. A modo general, se sugiere intensificar la investigación científica, con el fin de disponer de mejor evidencia para diseñar protocolos clínicos internacionales y locales para el manejo nutricional del paciente pediátrico críticamente enfermo.

ABSTRACT This review is based on the best evidence currently available and defines the guidelines for the nutritional assessment and management of critically ill children. These guidelines include the criteria for detecting malnutrition, whether due to deficit or excess, as well as the recommendations and consensus of experts on the estimation of energy and macronutrients, which can be decisive in preventing both overfeeding and underfeeding. International recommendations on the time of initiation of nutritional support are also indicated so that it is timely, effective and safe. Choice of feeding route according to clinical condition and pathology type in order to reduce the risk of morbi-mortality of these patients are discussed. In general, an increase in scientific research is suggested, in order to have better evidence to design international and local clinical protocols for the nutritional management of critically ill pediatric patients.

[Feeding behavior, dietary sufficiency and nutritional status in children between 6 and 18 months]. / Comportamiento alimentario, suficiencia dietaria y estado nutricional en niños entre 6 a 18 meses.

INTRODUCTION: Infant feeding has specific qualitative and quantitative characteristics. The influence of parents on food intake is crucial in the development of habits and an adequate nutritional state. OBJECTIVE: To evaluate eating behavior, dietary characteristics, and nutritional status of children between 6 to 18 months. SUBJECTS AND METHOD: Cross-sectional descriptive study in 199 children. Using convenience sampling, demographic and anthropometric data were recorded for nutritional status, and dietary history, through a 24-hour reminder for dietary behavior and food sufficiency. The Student's t-test and one-way ANOVA were applied for continuous variables and the chi-square test for the categori cal ones. RESULTS: 54.8% were women. Regarding nutritional status, 21.1% were overweight and 7.6% obese. 56.8% of the children had meal numbers according to their age. The average energy intake was 652.9 ± 224.2 calories per day. The intake of energy and macronutrients was significantly higher in children not consuming breast milk and aged 12 to 18 months. The energy, lipids, and carbohydrates adequacy in girls was significantly higher than in boys. 83.1% of food consumption was habitual for this age group. CONCLUSION: In eating behavior, we observed that 4 out of 10 children have meal numbers higher than suggested for their ages. Regarding dietary sufficiency, there is a higher intake in children with normal nutritional status, without breastfeeding, and between 12 and 18 months. Despite the high prevalence of obesity, it was lower than that observed at the national level.

Recomendaciones y efectos de la fibra dietaria en niños / Recommendations and effects of dietary fiber for children

Conocida es la influencia de la fibra dietaria sobre los efectos mecánicos a nivel gastrointestinal, la composición y modulación de la microbiota intestinal y su función en la actividad metabólica y nutricional en adultos. En niños y adolescentes estos efectos son menos conocidos, generando interesantes áreas de investigación y desarrollo científico que nos puedan entregar mayor conocimiento de sus repercusiones a nivel fisiológicos y fisiopatológicos. Esta revisión tiene como objetivo entregar información actualizada sobre las diferentes clasificaciones de fibra, sus principales funciones digestivas y metabólicas, así como las recomendaciones de ingesta diaria en pediatría.

Among adults, the influence of dietary fiber on mechanical effects at the gastrointestinal level, the composition and modulation of the intestinal microbiota and function in the metabolic and nutritional activity is known. However, in children and adolescents, these effects are less known, generating interesting areas of research and development that could provide additional knowledge at the physiological and pathophysiological level. The aim of this review was to provide updated information about the different classifications of fiber, the principal digestive and metabolic functions, as well as recommendations for daily intake for pediatric populations.

The Long-Term Impairment in Redox Homeostasis Observed in the Hippocampus of Rats Subjected to Global Perinatal Asphyxia (PA) Implies Changes in Glutathione-Dependent Antioxidant Enzymes and TIGAR-Dependent Shift Towards the Pentose Phosphate Pathways: Effect of Nicotinamide.

We have recently reported that global perinatal asphyxia (PA) induces a regionally sustained increase in oxidized glutathione (GSSG) levels and GSSG/GSH ratio, a decrease in tissue-reducing capacity, a decrease in catalase activity, and an increase in apoptotic caspase-3-dependent cell death in rat neonatal brain up to 14 postnatal days, indicating a long-term impairment in redox homeostasis. In the present study, we evaluated whether the increase in GSSG/GSH ratio observed in hippocampus involves changes in glutathione reductase (GR) and glutathione peroxidase (GPx) activity, the enzymes reducing glutathione disulfide (GSSG) and hydroperoxides, respectively, as well as catalase, the enzyme protecting against peroxidation. The study also evaluated whether there is a shift in the metabolism towards the penthose phosphate pathway (PPP), by measuring TIGAR, the TP53-inducible glycolysis and apoptosis regulator, associated with delayed cell death, further monitoring calpain activity, involved in bax-dependent cell death, and XRCC1, a scaffolding protein interacting with genome sentinel proteins. Global PA was induced by immersing fetus-containing uterine horns removed by a cesarean section from on term rat dams into a water bath at 37 °C for 21 min. Asphyxia-exposed and sibling cesarean-delivered fetuses were manually resuscitated and nurtured by surrogate dams. Animals were euthanized at postnatal (P) days 1 or 14, dissecting samples from hippocampus to be assayed for glutathione, GR, GPx (all by spectrophotometry), catalase (Western blots and ELISA), TIGAR (Western blots), calpain (fluorescence), and XRCC1 (Western blots). One hour after delivery, asphyxia-exposed and control neonates were injected with either 100 µl saline or 0.8 mmol/kg nicotinamide, i.p., shown to protect from the short- and long-term consequences of PA. It was found that global PA produced (i) a sustained increase of GSSG levels and GSSG/GSH ratio at P1 and P14; (ii) a decrease of GR, GPx, and catalase activity at P1 and P14; (iii) a decrease at P1, followed by an increase at P14 of TIGAR levels; (iv) an increase of calpain activity at P14; and (v) an increase of XRCC1 levels, but only at P1. (vi) Nicotinamide prevented the effect of PA on GSSG levels and GSSG/GSH ratio, and on GR, GPx, and catalase activity, also on increased TIGAR levels and calpain activity observed at P14. The present study demonstrates that the long-term impaired redox homeostasis observed in the hippocampus of rats subjected to global PA implies changes in GR, GPx, and catalase, and a shift towards PPP, as indicated by an increase of TIGAR levels at P14.

Influencia de la Actividad Física en la Sintomatología del Síndrome Premenstrual en universitarias / Influence of Physical Activity on Symptoms of the Syndrome Premenstrual in college girls

RESUMEN Objetivo: Determinar la influencia de la actividad física en la sintomatología del síndrome premenstrual en un grupo de mujeres de la Facultad de Medicina de la Universidad de Concepción. Métodos: Estudio observacional, descriptivo, transversal, realizado en 340 mujeres escogidas al azar de edades entre 18 a 27 años, estudiantes de la Facultad de Medicina de la Universidad de Concepción. Se utilizaron instrumentos validados para población chilena, como los criterios para el diagnóstico del trastorno disfórico premenstrual DSM-IV-TR, la Escala Visual Análoga (EVA) para la medición del dolor y el Cuestionario Internacional de Actividad Física (IPAQ) para la intensidad de esta. Los datos se obtuvieron por medio de encuestas autoadministradas y los resultados se analizaron mediante pruebas estadísticas. Resultados: Un 55,9% (n=190) presenta Síndrome premenstrual según los criterios utilizados. Los principales síntomas manifestados fueron: fatiga y falta de energía en un 64,7% (n=220), hipersensibilidad mamaria, cefalea e hinchazón en un 62,9% (n=214) y ansiedad, tensión, agobio y colapso en un 60,9% (n=207). Del total de encuestadas, el mayor porcentaje (42,6%) (n=145) realiza actividad física moderada. Al cruzar las variables de actividad física y la sintomatología del síndrome premenstrual se estableció que no existía relación entre ellas (valor p=0,605). Conclusiones: la actividad física no tiene influencia sobre la disminución de la sintomatología del síndrome premenstrual en la población estudiada.

ABSTRACT Objectives: Determine the influence of physical activity on the symptoms of premenstrual syndrome in females students of the Faculty of Medicine, Universidad de Concepción, Concepción Campus in 2014 Methods: A cross sectional study was applied to 340 randomly selected women aged between 18-27 years old belonging to the Faculty of Medicine of the Universidad de Concepción. Data were obtained through self-administered surveys and the results were analyzed by the respective statistical techniques. Results: Of the sample (n = 340), 55.9% (n = 190) had premenstrual syndrome according to the canon used. The main symptoms manifested were fatigue and lack of energy in 64.7% (n = 220), breast tenderness, headache and swelling in 62.9% (n = 214) and anxiety, stress, overwhelm and collapse into a 60.9% (n = 207). Of the total of the participants, the highest percentage (42.6%) (n = 145) performs moderate physical activity. When the variables of physical activity and premenstrual syndrome were crossed, was established that it did not exist relationship between them (p value = 0.605). Conclusions: With the obtaining and analyzing of the results, it seems that physical activity does not have major influence on the symptoms of premenstrual syndrome in the population studied.

Dislipidemia en niños y adolescentes con historia familiar de enfermedad cardiovascular precoz / Dyslipidemia in children and adolescents with a family history of early cardiovascular disease

INTRODUCTION: In Chile, cardiovascular diseases (CVD) represent the first cause of mortality. The risk of CVD is greater if other factors are associated, among which the family history of CVD acquires special relevance due it represents an independent risk factor of atherogenesis. Aim: To evaluate cardiovascular risk markers: lipid profile, hsCRP and nutritional status in children and adolescents with positive family history of early cardiovascular disease. SUBJECTS AND MATERIALS: Descriptive-transversal study. 138 children and adolescents with a mean age of 13,1 +/- 5,4 years were studied. Anthropometric measurements, blood pressure, lipid profile and hsCRP were evaluated. RESULTS: Dyslipidemia was found in 55,1 percent of the studied population, that was mainly characterized by hypertryglyceridemia and decreased levels of HDL-chol (39,1 percent). In the total of dyslipidemic subjects, 10,5 percent showed 3 altered lipid parameters (total chol, tryglicerides and HDL-chol), 22,4 percent presented 2 parameters that were out the reference range (tryglicerides and HDL-chol) and the 34,2 percent had only one lipid parameter altered (low levels of HDL-chol or hypertriglyceridemia). Dyslipidemia was observed in 69,1 percent, of the overweight and obese population and it was 40,6 percent in the normal weight subjects. hsCRP concentrations were higher in dyslipidemic and overweight and obese individuals. CONCLUSIONS: Dyslipidemia was highly frequent in children and adolescents with positive family history of early CVD and even higher in those overweight and obese subjects. These findings support the screening of dyslipidemia in children and adolescents with positive family history of early CVD.

The Annona muricata leaf ethanol extract affects mobility and reproduction in mutant strain NB327 Caenorhabditis elegans.

The C. elegans NB327 mutant strain is characterized for the knockdown of the dic-1 gene. The dic-1 gene is homologous to the dice-1 gene in humans, encoding the protein DICE-1 as a tumor suppressor. Absence or under-regulation of the dice-1 gene can be reflected in lung and prostate cancer [17], [18]. This study evaluated the effect of EEAML on the C. elegans NB327 mutant strain. Phenotypic aspects such as morphology, body length, locomotion, and reproductive behaviour were analyzed. It is important to emphasize that the strain presents a phenotype characteristic with respect to egg laying and hatching. Reported studies showed that Annona muricata extract and its active components evidence anti-cancer and anti-tumor effects, through experimentation in vivo and in vitro models. However, neurotoxicity has been reported as a side effect. The results showed that the mutant strain NB327 was exposed to EEAML (5 mg/ml) concentration, it showed a significant decrease in average locomotion, resulting in 13 undulations in 30 s. This contrasts with the control strain's 17.5 undulations in 30 s. Similarly, the number of progenies was reduced from 188 progenies (control strain) to 114 and 92 progenies at the dose of (1 mg/ml and 5 mg/m) EEAML. The results of this study suggest that EEAML has a possible neurotoxic effect in concentrations equal to or greater than 5 mg/ml. Also, it does not have positive effects on the mutant strain of Caenorhabditis elegans NB327 phenotype.

Vulnerability to a Metabolic Challenge Following Perinatal Asphyxia Evaluated by Organotypic Cultures: Neonatal Nicotinamide Treatment.

The hypothesis of enhanced vulnerability following perinatal asphyxia was investigated with a protocol combining in vivo and in vitro experiments. Asphyxia-exposed (AS) (by 21 min water immersion of foetuses containing uterine horns) and caesarean-delivered control (CS) rat neonates were used at P2-3 for preparing triple organotypic cultures (substantia nigra, neostriatum and neocortex). At DIV 18, cultures were exposed to different concentrations of H2O2 (0.25-45 mM), added to the culture medium for 18 h. After a 48-h recovery period, the cultures were either assessed for cell viability or for neurochemical phenotype by confocal microscopy. Energy metabolism (ADP/ATP ratio), oxidative stress (GSH/GSSG) and a modified ferric reducing/antioxidant power assay were applied to homogenates of parallel culture series. In CS cultures, the number of dying cells was similar in substantia nigra, neostriatum and neocortex, but it was several times increased in AS cultures evaluated under the same conditions. A H2O2 challenge led to a concentration-dependent increase in cell death (>fourfold after 0.25 mM of H2O2) in CS cultures. In AS cultures, a significant increase in cell death was only observed after 0.5 mM of H2O2. At higher than 1 mM of H2O2 (up to 45 mM), cell death increased several times in all cultures, but the effect was still more prominent in CS than in AS cultures. The cell phenotype of dying/alive cells was investigated in formalin-fixed cultures exposed to 0 or 1 mM of H2O2, co-labelling for TUNEL (apoptosis), MAP-2 (neuronal phenotype), GFAP (astroglial phenotype) and TH (tyrosine hydroxylase; for dopamine phenotype), counterstaining for DAPI (nuclear staining), also evaluating the effect of a single dose of nicotinamide (0.8 nmol/kg, i.p. injected in 100 µL, 60 min after delivery). Perinatal asphyxia produced a significant increase in the number of DAPI/TUNEL cells/mm3, in substantia nigra and neostriatum. One millimolar of H202 increased the number of DAPI/TUNEL cells/mm3 by ≈twofold in all regions of CS and AS cultures, an effect that was prevented by neonatal nicotinamide treatment. In substantia nigra, the number of MAP-2/TH-positive cells/mm3 was decreased in AS compared to CS cultures, also by 1 mM of H202, both in CS and AS cultures, prevented by nicotinamide. In agreement, the number of MAP-2/TUNEL-positive cells/mm3 was increased by 1 mM H2O2, both in CS (twofold) and AS (threefold) cultures, prevented by nicotinamide. The number of MAP-2/TH/TUNEL-positive cells/mm3 was only increased in CS (>threefold), but not in AS (1.3-fold) cultures. No TH labelling was observed in neostriatum, but 1 mM of H2O2 produced a strong increase in the number of MAP-2/TUNEL-positive cells/mm3, both in CS (>2.9-fold) and AS (>fourfold), decreased by nicotinamide. In neocortex, H2O2 increased the number of MAP-2/TUNEL-positive cells/mm3, both in CS and AS cultures (≈threefold), decreased by nicotinamide. The ADP/ATP ratio was increased in AS culture homogenates (>sixfold), compared to CS homogenates, increased by 1 mM of H202, both in CS and AS homogenates. The GSH/GSSG ratio was significantly decreased in AS, compared to CS cultures. One millimolar of H2O2 decreased that ratio in CS and AS homogenates. The present results demonstrate that perinatal asphyxia induces long-term changes in metabolic pathways related to energy and oxidative stress, priming cell vulnerability with both neuronal and glial phenotype. The observed effects were region dependent, being the substantia nigra particularly prone to cell death. Nicotinamide administration in vivo prevented the deleterious effects observed after perinatal asphyxia in vitro, a suitable pharmacological strategy against the deleterious consequences of perinatal asphyxia.

Modulation of Postnatal Neurogenesis by Perinatal Asphyxia: Effect of D1 and D2 Dopamine Receptor Agonists.

Perinatal asphyxia (PA) is associated to delayed cell death, affecting neurocircuitries of basal ganglia and hippocampus, and long-term neuropsychiatric disabilities. Several compensatory mechanisms have been suggested to take place, including cell proliferation and neurogenesis. There is evidence that PA can increase postnatal neurogenesis in hippocampus and subventricular zone (SVZ), modulated by dopamine, by still unclear mechanisms. We have studied here the effect of selective dopamine receptor agonists on cell death, cell proliferation and neurogenesis in organotypic cultures from control and asphyxia-exposed rats. Hippocampus and SVZ sampled at 1-3 postnatal days were cultured for 20-21 days. At day in vitro (DIV) 19, cultures were treated either with SKF38393 (10 and 100 µM, a D1 agonist), quinpirole (10 µM, a D2 agonist) or sulpiride (10 µM, a D2 antagonist) + quinpirole (10 µM) and BrdU (10 µM, a mitosis marker) for 24 h. At DIV 20-21, cultures were processed for immunocytochemistry for microtubule-associated protein-2 (MAP-2, a neuronal marker), and BrdU, evaluated by confocal microscopy. Some cultures were analysed for cell viability at DIV 20-21 (LIVE/DEAD kit). PA increased cell death, cell proliferation and neurogenesis in hippocampus and SVZ cultures. The increase in cell death, but not in cell proliferation, was inhibited by both SKF38393 and quinpirole treatment. Neurogenesis was increased by quinpirole, but only in hippocampus, in cultures from both asphyxia-exposed and control-animals, effect that was antagonised by sulpiride, leading to the conclusion that dopamine modulates neurogenesis in hippocampus, mainly via D2 receptors.

A Simulation Model of the Mass Rearing of Tetranychus urticae Koch (Acari: Tetranychidae) on Beans.

The supply of predatory mites as natural enemies is a key component to guarantee the success of biological pest control programs as alternatives to chemical control in commercial crops. To meet the demand for a supply of biologicals, the mass rearing of natural enemies is an option, and the first step must be to develop a standardized system that maximizes the production of prey. One choice for this first step is to use simulation models that can evaluate scenarios that are difficult or complex to address experimentally. In this work, a model was developed to evaluate the current management conditions for the mass rearing of the pest mite Tetranychus urticae Koch. Our aim was to identify alternative scenarios to maximize mite production through mass rearing that could be evaluated in real systems. We assumed that populations of T. urticae were regulated by the conditions of supply-demand theory and modeled the age structure, temperature effects, and individual phenology of T. urticae. The supply-demand theory of resources was used to regulate populations, which involved structured ages and temperature effects for the different stages in the development of individuals. We used the functional response and the paradigm of metabolic pool models to describe resource acquisition and allocation. We demonstrated that 7- to 14-day-old plants infested with 45 or 62 T. urticae/plant could reach 25,000 individuals/plant, being 50% of these preys at the preferred stages by the predator Phytoseiulus persimilis Athias-Henriot. Our theoretical model requires validation in experimental/real systems of mass rearing to better verify the validity of all of the parameters and predictions before commercial implementation.

Modelo de los determinantes de la actitud hacia la rehidratación / Model of the determinants of attitudes toward rehydration / Modelo das determinantes da atitude em relação a reidratação

[{"text": "Las políticas de salud suponen que el factor clave de sus programas preventivos está en la participación de la gente \r\nrespecto a su rehidratación, porque esta se considera un instrumento de prevención de las enfermedades crónicas dege\r\n-\r\nnerativas, que han incrementado su tasa de morbilidad recientemente. En tal sentido, el objetivo del presente trabajo es \r\nestablecer un modelo de las relaciones causales entre factores sociodemográficos y cognitivos relativos al consumo de \r\nbebidas. Para tal propósito, se llevó a cabo un estudio transversal y correlacional con una muestra de 100 afiliados a \r\nun hospital público. A partir de un modelo estructural (X2 = 163.873, 28 gl, p = .000; GFI = .875; AGFI = .840; PGF \r\n= .681; RMSEA = .027; RMR = .066), se estableció que la edad determinó negativamente la actitud hacia la rehidra\r\n-\r\ntación (\r\nß \r\n= -.22) mientras que las creencias de rehidratación grupal (CRG) incidieron de manera positiva (\r\nß\r\n = ,47.). En \r\nel marco de las teorías actitudinales, se discutió la inclusión de las normas y percepciones como sus determinantes.", "_i": "es"}, {"text": "Health policies assume that the key factor in their preven\r\n-\r\ntion programs is the participation of the people regarding \r\nrehydration, which is considered as an instrument of \r\nprevention of chronic degenerative diseases that in recent \r\ndays have increased it morbidity rate. The purpose of this \r\narticle is to establish a model of contributing relation\r\n-\r\nships between sociodemographic and cognitive factors \r\nrelated to beverage consumption. A cross-sectional and \r\ncorrelational study was performed with a sample of 100 \r\nmembers of a public hospital. From a structural model \r\n(X2 = 163,873, 28 df, p = .000, GFI = .875, AGFI = .840; \r\nPGF = .681, RMSEA = .027, RMR = 0.066) age deter\r\n-mined adversely rehydration attitude (\r\nß\r\n = -.22) while \r\nRehydration Beliefs Group (RBG) had a positive impact \r\n(\r\nß\r\n =, 47.) under the attitudinal theories, the inclusion \r\nof norms and perceptions and their determinants was \r\ndiscussed.", "_i": "en"}, {"text": "As políticas de saúde supõem que o fator-chave nos seus \r\nprogramas de prevenção é a participação das pessoas \r\nem relação à sua hidratação, que é considerado como \r\num instrumento para a prevenção de doenças degena\r\n-\r\ntivas crônicas que ultimamente têm aumentado a taxa de \r\nmorbidez. O propósito deste artigo é estabelecer relações \r\ncontribuintes entre fatores sócio-demográficos e cogni\r\n-\r\ntivos relacionados ao consumo de bebidas. Para isso, \r\nfoi realizado um estudo transversal e correlacional com \r\numa amostra de 100 membros de um hospital público. A \r\npartir de um modelo estrutural (X2 = 163.873, 28 gl, p \r\n= .000; GFI = .875; AGFI = .840; PGF = .681; RMSEA \r\n= .027; RMR = 0.066), a idade determino negativamente \r\na atitude de reidratação (\r\nß\r\n = - 0,22), enquanto o Grupo \r\nCrenças de Reidratação (GCR) teve um impacto posi\r\n-\r\ntivo (\r\nß\r\n =, 47.). De acordo com as teorias atitudinais, a \r\ninclusão de normas e percepções e seus determinantes \r\nforam discutidas.", "_i": "pt"}]

Conducta sexual en adolescentes varones: hacia un nuevo horizonte / Sexual behavior in male adolescents: towards a new horizon

La adolescencia implica un enfrentamiento por parte de los jóvenes a grandes cambios en el ámbito de la sexualidad, pudiendo esta etapa marcar su vida futura, especialmente al asociarse a conductas de riesgo. Los programas sanitarios del ámbito sexual en Chile están fundamentalmente dirigidos a mujeres, lo que junto a una tendencia natural masculina a asumir comportamientos de riesgo, ignorancia sobre su rol reproductivo, inicio sexual precoz y, en algunos casos, una orientación sexual diferente a la mayoría, vuelve a los hombres adolescentes especialmente vulnerables. Esto exige una preocupación por ellos, conociendo las tendencias actuales en su comportamiento y conducta sexual, y su compromiso con medidas de protección contra infecciones de transmisión sexual y anticoncepción, para luego ofrecer programas dirigidos a la población que los considere específicamente, en una atención sanitaria abierta, que les permita educarse. Así, eventualmente podremos disminuir las conductas de riesgo y la discriminación a la que muchos se ven enfrentados. En el presente artículo hacemos una revisión actualizada de algunos aspectos relevantes en relación a las vivencias sexuales de adolescentes varones chilenos y su contexto en el mundo, especialmente en Sudamérica, considerando: iniciación sexual, conductas sexuales, pareja estable, conductas de riesgo, conocimientos y actitudes en relación al virus de inmunodeficiencia humana, anticoncepción, y relaciones con el mismo sexo. Se discute finalmente el rol incompleto de la sociedad y de la Atención Primaria de Salud, en la acogida y educación para una sexualidad responsable, de los adolescentes varones de nuestro país.

Several important sexually related changes must be faced by adolescents, all of which may have influence in their future adult life, especially when they fall under risk behaviors. Chilean health programs in the field of sexuality are mainly aimed at women, which along with males' natural tendency to incur in risk behaviors, ignorance about their reproductive role, early sexual debut, and, in some cases, a different sexual orientation, make the adolescent male population especially vulnerable. This demands a particular care for male adolescents, recognizing the current features in their general and sexual behavior, and their commitment with protective measures against sexually transmitted infections and contraception. Therefore, it is necessary to offer educational programs aimed at the general population, which must include male adolescents. Thus, we will eventually reduce risk behaviors and discrimination affecting a significant portion of the adolescents. In this article, we review some of the most relevant features of sexual experiences of Chilean male adolescents - and their context in the world, especially in South America - considering: sexual debut, monogamy, risk behaviors, knowledge and attitudes in relation to human immunodeficiency virus, contraception, and homosexual relationships. We finally discuss the unsettled role of society and Primary Health Care System in the response to male adolescents in our country and their responsible sexual education.

A novel subaerial Dunaliella species growing on cave spiderwebs in the Atacama Desert.

Strategies for life adaptation to extreme environments often lead to novel solutions. As an example of this assertion, here we describe the first species of the well-known genus of green unicellular alga Dunaliella able to thrive in a subaerial habitat. All previously reported members of this microalga are found in extremely saline aquatic environments. Strikingly, the new species was found on the walls of a cave located in the Atacama Desert (Chile). Moreover, on further inspection we noticed that it grows upon spiderwebs attached to the walls of the entrance-twilight transition zone of the cave. This peculiar growth habitat suggests that this Dunaliella species uses air moisture condensing on the spiderweb silk threads as a source of water for doing photosynthesis in the driest desert of the world. This process of adaptation recapitulates the transition that allowed land colonization by primitive plants and shows an unexpected way of expansion of the life habitability range by a microbial species.

Ancient photosynthetic eukaryote biofilms in an Atacama Desert coastal cave.

Caves offer a stable and protected environment from harsh and changing outside prevailing conditions. Hence, they represent an interesting habitat for studying life in extreme environments. Here, we report the presence of a member of the ancient eukaryote red algae Cyanidium group in a coastal cave of the hyperarid Atacama Desert. This microorganism was found to form a seemingly monospecific biofilm growing under extremely low photon flux levels. Our work suggests that this species, Cyanidium sp. Atacama, is a new member of a recently proposed novel monophyletic lineage of mesophilic "cave" Cyanidium sp., distinct from the remaining three other lineages which are all thermo-acidophilic. The cave described in this work may represent an evolutionary island for life in the midst of the Atacama Desert.