RAD51 foci as a functional biomarker of homologous recombination repair and PARP inhibitor resistance in germline BRCA-mutated breast cancer.

Background: BRCA1 and BRCA2 (BRCA1/2)-deficient tumors display impaired homologous recombination repair (HRR) and enhanced sensitivity to DNA damaging agents or to poly(ADP-ribose) polymerase (PARP) inhibitors (PARPi). Their efficacy in germline BRCA1/2 (gBRCA1/2)-mutated metastatic breast cancers has been recently confirmed in clinical trials. Numerous mechanisms of PARPi resistance have been described, whose clinical relevance in gBRCA-mutated breast cancer is unknown. This highlights the need to identify functional biomarkers to better predict PARPi sensitivity. Patients and methods: We investigated the in vivo mechanisms of PARPi resistance in gBRCA1 patient-derived tumor xenografts (PDXs) exhibiting differential response to PARPi. Analysis included exome sequencing and immunostaining of DNA damage response proteins to functionally evaluate HRR. Findings were validated in a retrospective sample set from gBRCA1/2-cancer patients treated with PARPi. Results: RAD51 nuclear foci, a surrogate marker of HRR functionality, were the only common feature in PDX and patient samples with primary or acquired PARPi resistance. Consistently, low RAD51 was associated with objective response to PARPi. Evaluation of the RAD51 biomarker in untreated tumors was feasible due to endogenous DNA damage. In PARPi-resistant gBRCA1 PDXs, genetic analysis found no in-frame secondary mutations, but BRCA1 hypomorphic proteins in 60% of the models, TP53BP1-loss in 20% and RAD51-amplification in one sample, none mutually exclusive. Conversely, one of three PARPi-resistant gBRCA2 tumors displayed BRCA2 restoration by exome sequencing. In PDXs, PARPi resistance could be reverted upon combination of a PARPi with an ataxia-telangiectasia mutated (ATM) inhibitor. Conclusion: Detection of RAD51 foci in gBRCA tumors correlates with PARPi resistance regardless of the underlying mechanism restoring HRR function. This is a promising biomarker to be used in the clinic to better select patients for PARPi therapy. Our study also supports the clinical development of PARPi combinations such as those with ATM inhibitors.

Assessment of Mesial Root Morphology and Frequency of MB2 Canals in Maxillary Molars using Cone Beam Computed Tomography / Determinación de la Morfología de la Raíz Mesial y la Frecuencia del Canal MB2 en Molares Maxilares usando Tomografía Computadorizada de Haz Cónico

The aim of this study was to assess the morphology of the mesial root canal system of maxillary molars and the frequency of MB2 canals using cone-beam computed tomography (CBCT). A total of 1374 teeth, first maxillary (1MS, n= 802) and second maxillary molars (2SM, n= 572) of 508 Chilean patients between 8 to 77 years were evaluated through CBCT. The mesiobuccal root was evaluated in all three thirds. Root canal morphology was classified according to Vertucci's method. Data were analyzed by Pearson's Chi-square and Cuzick trend tests. MB2 canal frequency in 1MS was 73.44% and in 2MS 42.48%. The most frequent morphology in 1MS and 2MS were Vertucci type II and I, respectively. No statistically significant association was found between frequencies and side or according to gender (P>0.05). A positive association was found as the age increased in both 1MS and 2MS (P<0.001 and P= 0.023, respectively). Given the anatomical complexity of the mesiobuccal root and the frequent presence of the MB2 canal, the clinician must assume the existence of two canals in this root. CBCT scanning is a good way to initially identify this canal in the different root thirds.

Determinar la morfología del sistema de canales de la raíz mesial de molares maxilares y la frecuencia del canal MB2 usando tomografía computadorizada de haz cónico (TCHC). Un total de 1374 dientes, primeros molares maxilares (1MS, n= 802) y segundos molares maxilares (2MS, n= 572) de 508 pacientes Chilenos entre 8 y 77 años fueron evaluados a través de la TCHC. Se evaluó la raíz mesiobucal en todos sus tercio. La clasificación de Vertucci fue utilizada para determinar la morfología del sistema de canales. Los datos fueron analizados con los test Chi-Cuadrado de Pearson y la prueba de tendencia de Cuzick. La frecuencia del canal MB2 para el 1MS fue 73,44% y el 2MS 42,48%. La morfología mas frecuente en el 1MS y 2MS fueron el tipo II y I de Vertucci, respectivamente. No se encontró asociación significativa entre la frecuencia y el lado o sexo (p>0,005). Una asociación positive fue encontrada a medida que aumentaba la edad en ambos 1MS y 2MS (p<0,001 y p= 0,023, respectivamente). Dada la complejidad de la anatomía de la raíz mesiobucal y la frecuente presencia del canal MB2, el clínico debe asumir la existencia de dos canales en esta raíz. La TCHC es una buena manera de identificar tempranamente el canal en los diferentes tercio radiculares.

Reliability of two techniques for measuring condylar asymmetry with X-rays / Confiabilidad de dos técnicas de medición de asimetría condilar con método radiográfico

Among structural alterations that can be a risk factor for temporomandibular joint disorder (TMD) is condylar asymmetry. In order to measure the condylar asymmetry index in panoramic x-rays quantitatively, two methods have been proposed: those of Habets and Kjellberg. The aim of this study was to determine whether the x-ray method of measuring condylar asymmetries in orthopantomographies presents a minor tendency to error due to slight displacements of the head in the horizontal plane. 30 patients between 18 and 25 years of age were assessed. Each of them underwent three panoramic x-rays in three different positions: orthoradial, and at 5 and 10 horizontal angles. Then the Habets and Kjellberg measurements were taken. Habets' technique did not show any statistically significant differences in the x-rays at 5° and 10° horizontal angles compared to the 0 angle. However, Kjellberg's technique showed statistically significant differences only at the 10° angle compared to the 0 angle. The 10° changes produced linear and ratio variations, but the indices did not vary. It was concluded that both methods provide acceptable clinical information within the limitations of these techniques to obtain data on condylar symmetries or asymmetries of the mandibular body or ramus.

Dentro de las alteraciones estructurales que pueden ser un factor de riesgo de desarrollo de un trastorno temporomandibular (TTM) se menciona a la asimetría condilar. Para realizar la medición cuantitativa del índice de asimetría condilar en radiografías panorámicas se han propuesto dos métodos, Habets y Kjellberg. El objetivo de este estudio fue determinar si el método radiográfico de medición de asimetrías condilares en ortopantomografías que presenta menor tendencia al error por leves desplazamientos de la cabeza en el plano horizontal. Se evaluaron 30 pacientes entre 18 y 25 años de edad. Cada uno de ellos se sometió a tres radiografías panorámicas en tres posiciones distintas: posición ortoradia, 5 y 10 de angulación horizontal. Posteriormente, se realizaron las mediciones de Habets y Kjellberg. La técnica de Habets no mostró diferencias estadísticamente significativas en las radiografías con 5° y 10° de angulación horizontal con respecto al ángulo de 0. Sin embargo, la técnica de Kjellberg mostró diferencias estadísticamente significativas sólo al ángulo de 10° con respecto al ángulo de 0. Las alteraciones de 10° produjeron variaciones lineales y de razones, sin embargo no variaron los índices. Se concluye que ambos métodos entregan información clínica aceptable con las limitaciones que estas técnicas tienen para obtener información sobre simetrías o asimetrías condilares de cuerpo o de rama.

Evaluación de la función sexual en mujeres sometidas a histerectomía total y supracervical por vía laparoscópica / Evaluation of sexual function in women undergoing total and supracervical laparoscopic hysterectomy

Objetivo: Determinar si la histerectomía total o supracervical laparoscópica tiene repercusión en la función sexual de la mujer y cuál de estas técnicas quirúrgicas se debe emplear para preservar la función sexual, evaluando si las alteraciones en dicha función se comportan como variables independientes al procedimiento quirúrgico. Método: Se realizó un estudio longitudinal, prospectivo y analítico en pacientes del servicio de ginecología del Instituto Nacional de Perinatología, para evaluar la función sexual de pacientes que fueron sometidas a histerectomía laparoscópica por patología benigna. La evaluación de la función sexual se realizó de forma preoperatoria y seis meses después del evento. Se utilizó dos instrumentos para evaluar la función sexual de las pacientes: la historia clínica codificada femenina y el índice de función sexual femenina. Resultados: No hubo diferencia significativa en la función sexual de las mujeres antes y después de la histerectomía (z= -1,603; p>0,109). No hubo diferencia significativa entre las mujeres con y sin disfunción sexual en relación con la edad, escolaridad, inicio de actividad coital, temores hacia la sexualidad y experiencias sexuales traumáticas en la infancia. Conclusiones: La función sexual de las mujeres antes y después de la histerectomía no se ve afectada por la histerectomía total laparoscópica ó la histerectomía subtotal laparoscópica.

Objective: To determine whether total or supracervical laparoscopic hysterectomy has an impact on female sexual function and which of these surgical techniques should be used to preserve sexual function, evaluating whether the alterations in the function behave as independent variables to surgical procedure. Method: We conducted a longitudinal study, prospective and analytical at the National Institute of Perinatology in assessing sexual function of patients who underwent laparoscopic hysterectomy for benign disease, assessment of sexual function was conducted preoperatively and six months after the event. Two instruments for assessing sexual function of patients was used: medical history and the female sexual functionindex. Results: In applying the test of Wilcoxon signed ranks two related samples, no significant difference in sexual function in women before and after hysterectomy (z = -1.603; p>0.109). By applying the statistical test of Chi2 to see if there was a difference between women with and without sexual dysfunction in relation to other variables such as age, education, initiation of coital activity, fears about sexuality, traumatic sexual experiences in childhood, no significant differences were found. Conclusions: Sexual function in women before and after hysterectomy is not affected significantly. The result of the hysterectomy is independent of the type of surgery (total laparoscopic hysterectomy or supracervical laparoscopic hysterectomy).

La escala de Tal como test diagnóstico y el diagnóstico clínico como gold standard en el síndrome bronquial obstructivo del lactante / No disponible

Objetivo: evaluar la utilidad diagnóstica del índice de Tal aplicado por profesional sanitario no médico en el ámbito extrahospitalario como test diagnóstico y la “impresión clínica” como gold standard en el diagnóstico del síndrome bronquial obstructivo del lactante. Material y métodos: estudio observacional de test diagnóstico de casos consecutivos. Resultados: la escala de Tal presenta una sensibilidad del 77%, (IC 95%, 70-82%), una especificidad del 88,4% (IC 95%, 84-92%), un valor predictivo positivo del 87% (IC 95%, 81- 91%) y un valor predictivo negativo del 80% (IC 95% 74-85%). Conclusiones: en esta muestra el índice de Tal efectuado por profesionales sanitarios no médicos demuestra tener una buena correlación en el diagnóstico del lactante con obstrucción bronquial

Objective: to evaluate the Tal score like diagnostic test applied by non-medical professionals and “clinical impression” (clinical diagnosis) like Gold Standard in the diagnosis of infants with acute wheezing bronchitis. Material and methods: a diagnostic test study. Results: the sensitivity of Tal score was 77% (confidence interval 95% [CI] 70-82%) and the specificity 88.4% (CI 95% 84-92%). The positive predictive value was 87% (CI 95% 81- 91%) and the negative predictive value 80% (IC 95% 74-85%). Conclusions: in this study the Tal score as diagnostic test applied by non-medical professionals compared with “clinical impression” (clinical diagnosis) like Gold Standard show a good correlation in the diagnosis of infants with acute wheezing bronchitis

Factores asociados a síntomas depresivos y síntomas somáticos en mujeres climatéricas de la ciudad de Temuco / Associated factors to depressive symptoms and somatic symptoms in climacteric women in the city of Temuco

BACKGROUND: Depression is an important mental health problem. The Chilean Ministry of Health has considered depression in women as one of the health priorities for the country. AIM: To assess the prevalence of depressive and somatic symptoms and their risk factors in climacteric women. MATERIAL AND METHODS: A special questionnaire was applied to 171 women (45 to 55 years of age), coming from a community organization (PRODEMU) and a private health institution (ISAPRE Banmedica). Risk factors for depression were determined using multiple logistic regression. RESULTS: The prevalence of depressive symptoms was 43 per cent. Women with primary education had an odds ratio for depression of 2.49, compared with women with high school or university education. Other risk factor for depression was the lack of a renumerated job (Odds ratio 1.9). The risk factors for somatic symptoms were the presence of depressive symptoms (OR 3.2), lack of secondary or university education (OR 2.4), low income (OR 1.9) and having a current partner (OR 3.6). CONCLUSIONS: There is a high prevalence of depressive symptoms in the studied population of climacteric women. Lack of education and of a renumerated job are important risk factors for the presence of such symptoms. Women with a low level of education and with depressive symptoms have also a high risk of presenting somatic symptoms.

[Rheumatoid arthritis among mapuche aborigines. A 16 years experience in the IX Region of the Chile]. / Artritis reumatoidea en población mapuche. Una experiencia de 16 años en la IX región de Chile.

BACKGROUND: Mapuche, Chilean natives, represent approximately 9.8% of Chilean population and in the IX region of the country, they account for 18.4% of population over 15 years old. They preserve some socio-cultural characteristics that make them different to the rest of the population. AIM: To describe the epidemiological characteristics rheumatoid arthritis among Mapuche natives. SUBJECTS AND METHODS: Retrospective review of patients of Mapuche origin with rheumatoid arthritis, seen at Temuco Hospital between 1980 and 1996. RESULTS: Among 308 cases gathered, only 106 (93 women, aged 55 +/- 10 years old) complied with 1987 American College of Rheumatology (ACR) criteria for rheumatoid arthritis. The disease began between 29 and 52 years old in 73% of patients and the mean delay in diagnosis was 4.4 years. At diagnosis, 99% had symmetric poliarthritis, 28.3% had either fatigue, fever or weight loss, and 46.9% were in class III or in class IV of ACR-1991. Fifty three percent of patients developed Sicca syndrome, 36% developed nodules, 23% developed Raynaud phenomenon, 11% developed pulmonary involvement, 7% developed vasculitis, 5% developed neurological manifestations and 19% developed ophthalmologic involvement. Rheumatoid factor was positive in 78% and 73% had erosions. HLA DR4 was (+) in 60% of 30 patients. Thirty percent required 3 or more disease modifying drugs and prednisone over 10 mg/day. There was no correlation between functional capacity and several other features of the disease. CONCLUSIONS: Mapuche rheumatoid arthritis patients are detected late and have a poor functional capacity at the time of diagnosis. They also have a higher proportion of extraarticular manifestations, more erosions and require more aggressive treatments.

[Cholangiohydatidosis. An evolutive complication of hepatic hydatidosis]. / Colangiohidatidosis. Una complicación evolutiva de la hidatidosis hepática.

Hydatidosis is and endemic disease in the south of Chile, especially in Region IX where remain rates of high prevalence. Cholangiohydatidosis is an infrequent complication of liver hydatidosis. The objective of this paper is to describe clinical features of a series of patients with cholangiohydatidosis. Series of cases of cholangiohydatidosis treated consecutively and the corresponding follow-up is reported. Clinical, laboratory and images characteristics are described. Descriptive statistic was used its incidence was calculated. In the studied period, 13 patients with cholangiohydatidosis were recruited, 9 men (69.2%) and 4 women (30.7%). Observed laboratory abnormalities were an increment of leukocytes in 8 patients (61.5%) and hepatic cholestasis with hepatocyte signs of cytolysis in 11 patients (84.6%). Choledocus diameter average measured by ultrasonography was 24.7 mm. All the patients had at least one liver cyst whose diameter average was of 12.1 cm. At surgery, evidence of biliary communications was detected in all patients and biliary decompression was carried out through a choledocostomy in 12 patients (92.3%) and by choledocoduodenal anastomoses in one case (7.7%). With a mean follow-up of 38.7 months morbility was 23% and mortality 7.7%. Accumulated incidence of this entity was of 0.07 cases in 5 years. Cholangiohydatidosis is an uncommon complication of liver hydatidosis that presents considerable morbidity and mortality rates.

[Child abuse in in the city Temuco. Prevalence study and associated factors]. / Maltrato infantil en la ciudad de Temuco. Estudio de prevalencia y factores asociados.

BACKGROUND: Child maltreatment is recognised as a significant health problem in developed countries. There is increasing awareness on family violence in Chile, becoming a health priority in the last five years, but there is scant information about its prevalence. AIM: Determine prevalence of child abuse, and associated factors in a population sample from Temuco, Chile. MATERIAL AND METHODS: A standardised questionnaire was applied to a sample of 422 women at their homes. Instrument had questions about disciplinary practices by caretakers, a standardised questionnaire to assess mental health, as measures of risk and protective factors for violence RESULTS: The prevalence of psychological aggression delivered by mothers or fathers was 17.5% and 6.8% respectively. The figures for corporal punishment delivered by mother or fathers were 42.3% and 17% respectively. Three percent of mothers and 1.2% of fathers recognised severe physical abuse. Associated factors were mother impaired mental health, antecedents of child abuse in both parents, parents alcohol abuse and child emotional/behavioral problem. CONCLUSION: Child abuse is a extended significant problem in Temuco that requires multidisciplinary intervention programs.

[Conjugal violence in the city Temuco. Prevalence studies and associated factors]. / Violencia conyugal en la ciudad de Temuco. Un estudio de prevalencia y factores asociados.

BACKGROUND: Violence against women is a recognized public health problem in developed countries. There is increasing awareness on family violence in Chile, but there is scant information about its prevalence. AIM: To determine the prevalence of family violence against women in a population sample in Temuco, Chile. MATERIAL AND METHODS: A standardized questionnaire about family violence was applied to a sample of 422 women at their homes. The questionnaire had six sections that included a list of violent behaviors from husbands or partners, a standardized instrument to assess mental health and alcohol consumption by the couple, history of child abuse, community support, type of employment and years of school education. RESULTS: Forty nine percent of women reported psychological aggression, 13% reported physical violence and 5.5%, sexual violence. The presence of anxiety or depressive symptoms, being witness of violence between parents during childhood, a lower educational level, being a housewife, alcohol abuse and lack of community support were risk factors for violence among women. Among men, the history of child abuse, a lower education level, and alcohol abuse were identified as risk factors for violent behaviors. CONCLUSIONS: Conjugal violence is a significant mental health problem in Temuco, Chile.

[Beliefs, attitudes and knowledge about sex education]. / Creencias, actitudes y conocimientos en educación sexual.

BACKGROUND: Previous reports show that Chilean teenagers have an inadequate knowledge about sexuality and reproduction. AIM: To compare the knowledge about sexuality among adolescents coming from private and public schools, with and without sexual education programs. MATERIAL AND METHODS: A structured anonymous inquiry, containing multiple choice and open questions, was applied to a sample of 229 adolescents attending seventh and eighth grade of junior school, in private and public schools of Temuco, Chile. RESULTS: Eleven percent of adolescents had already their first sexual intercourse at a mean age of 12.2 +/- 2.4 years old. Of these, 96% came from public schools. An overall analysis of tests, disclosed a 53% of correct answers to the inquiry. Adolescents coming from private schools had a better performance than those coming from public schools. Sexual attitudes were not influenced by sexual education programs. CONCLUSIONS: Adolescents coming from private schools have a better sexual knowledge level and more conservative attitudes towards sexuality. Overall knowledge is inadequate albeit overvalued. These teenagers are high risk group for unwanted pregnancies and sexually transmitted diseases and require efficient sexual education programs.

Expresión de los oncogenes (c-myc-neu) y el receptor de prolactina (PRLr) en tejidos de mujeres con endometriosis / Expression of oncogens (cmyc-neu) and the prolactin receptor (PRLr) in tissues of women with endometriosis

La endometriosis es una enfermedad cuya etiología no se conoce y sobre la cual existen diferentes teorías que a la fecha no han sido totalmente demostradas. Está claramente demostrado que las mujeres que presentan dicha enfermedad cursan con infertilidad y que la recurrencia de aparición de los focos endometriósicos es alta, y al parecer no dependientes del estímulo estrogénico. Este fenómeno se ha atribuido a otros factores de crecimiento y algunos oncogenes los cuales son expresados para contrarrestar la falta del estímulo estrogénico. Sin embargo, pocos estudios existen en relación a los oncogenes u otros receptores hormonales, por lo que el presente trabajo tuvo por objetivo el evaluar su expresión tanto en tejido eutópico como en ectópico de mujeres con diagnóstico previo de endometriosis. El análisis de la expresión tanto de c-myc, neu y el receptor de prolactina (PRLr) se realizó por la técnica de RT-PCR. Nuestros resultados demuestran que tanto myc como el PRLr se expresan de manera distinta entre los diferentes tejidos, en tanto que neu se expresa de la misma manera entre los dos tejidos. Con estos datos concluimos que las células que conforman el foco endometriósico presentan un estado diferencial en relación a la expresión de algunos de sus genes, lo cual favorece el desarrollo y mantenimiento de los mismos en un ambiente hormonal diferente al de la cavidad uterina.

Increase in the renal damage induced by paracetamol in rats exposed to ethanol translactationally.

Administration of ethanol (8%) or acetone (1%) to nursing dams in the drinking water, for 10 days, increased the nephrotoxicity of paracetamol (APAP) in the 14-day-old lactating offspring. The percentage of proximal tubular cells with evidence of necrotic damage in male rats was higher in those animals that received APAP (500 mg/kg, i.p.) and whose nursing rats were exposed to ethanol (25. 0 +/- 8.4%) or acetone (17.2 +/- 1.2%), than in the group treated with APAP alone (10.6 +/- 1.6%). The activity of urinary N-acetylglucuronidase was also significantly higher in the rats exposed translactationally to ethanol or acetone than in animals treated with the APAP alone. Nephrotoxicity showed a sexual dimorphic pattern with a higher toxicity in male than in female rats. The percentage of necrotic tubules in the male rats not exposed to inductor was 10.6 +/- 1.6%, and in female rats 5.0 +/- 1.4% (p < 0. 05). Animals exposed to ethanol or acetone and treated with APAP showed less weight gain than the group treated only with APAP. Our results suggest that renal toxicity is enhanced in the nursing animals that were exposed, via maternal milk, to ethanol or acetone (inductors of cytochrome P4502E1), than in the control animals. This circumstance may be relevant in alcoholic women while they are lactating.

[Prevalence of biological and psychological symptoms in perimenopausal women from different socioeconomic levels in the city of Temuco]. / Prevalencia de síntomas biológicos y psicológicos en mujeres perimenopáusicas, según estrato socioeconómico, en la ciudad de Temuco.

BACKGROUND: Psychological and biological symptoms occur in the perimenopausal period. However the real prevalence of these, is not well known in Chile. AIM: To determine the prevalence of biological and psychological symptoms and self care sexual health practices of perimenopausal women of Temuco, Chile. PATIENTS AND METHODS: A random sample of 171 women aged 45 to 55 years old, affiliated to private preventive health institutions and community organizations, were studied. These women were stratified in three income levels. Chi square, Fisher test and ANOVA were used for statistical analysis. RESULTS: Bone and muscle aches were the most frequent referred symptoms in 36% of women. Thirty one percent complained of vaginal dryness and 28% of headache. No differences in symptom frequency per age or between post or pre menopausal women, were observed. Depressive disorders were found in 39% of women, mostly in women not working outside their houses. In the previous two years, 67% of women had a PAP smear and 58% had a mammography performed. Women of low income levels had a greater prevalence of biological and psychological symptoms and a lower frequency of self care behaviors. CONCLUSIONS: The most frequent symptom among the studied women was bone and muscle aches, followed by vaginal dryness. These results differ from other publications that report flushing as the most important symptom among perimenopausal women.

[Sexual behavior and contraceptive practices among university students]. / Comportamiento sexual y prácticas anticonceptivas del estudiante universitario.

The aim of this work was to study the knowledge, opinions and sexual behaviour of a sample of 464 students from the Universidad Austral de Chile. Results show that 78% of male and 41% of female students have had a sexual intercourse and that 78% of males and 72% of females with an active sexual life use contraceptive methods. The principal reasons to avoid the use of these methods are the irregularity of sexual intercourse and the reduction in pleasure. Most students think that these methods are harmful for their health but they should be used. The use of contraceptive methods increase with the frequency of sexual relations and university experience, but first year students use them more frequently than second year students. Most students know several contraceptive methods, but their knowledge about mechanisms of action is inadequate or distorted. Likewise, more than 50% think that it is possible to prevent pregnancy after a sexual intercourse. It is concluded that most sexually active students use contraceptive methods, but inappropriately. Stereotypes, myths and lack of information are influencing their sexual and contraceptive practices, showing incoherence between their knowledge and behavior. A possible explanation could be a scarce influence of high school and religion on their sexual formation.

PIP: A random sample of 464 students of the University Austral of Chile were surveyed concerning their sexual practices and contraceptive usage. 78% of the male and 41% of the female students had had sexual intercourse. Among male and female students respectively, 21% and 19% had regular sexual relations, 33% and 24% had sporadic relations, and 24% and 20% were not sexually active at the time of the survey. 78% of sexually active males and 72% of sexually active females had ever used contraception. 57% had ever used condoms, 56% withdrawal, and 35% oral contraceptives (OCs). Among the 27% of sexually active students who had never used contraception, 78% cited sporadic relations and 39% reduction in sexual pleasure as reasons for nonuse. Use of contraception increased regularly with age, from 68% of sexually active students under 21 to 85% among students over 23 years old. It increased with frequency of intercourse, from 72% of those with sporadic relations to 91% of those having intercourse weekly or more often. There was no statistically significant relationship between religious background and contraceptive usage. The proportions believing specific contraceptive methods to be harmful to health were 65% for OCs, 53% for IUDs, 29% for injectables, and 19% for spermicides. 69% stated it is always necessary to use contraception. Two-thirds of the sexually active students knew more than three methods. 49% believed that vaginal washing after coitus could prevent pregnancy.

[University students and sex: what they think, what they know, what they do]. / El estudiante universitario frente al sexo: que piensa, que sabe, que hace?

Using the social survey technique, a random sample of 464 students from the Universidad Austral answered a structured questionnaire about behavior and attitudes towards sex. Results show that the majority of students have had sexual experiences. Men and women differ significantly in motivations and age at the start of their sexual activity, stability of their relationships, first sexual partner and emotional experiences. Sexual behavior is associated with age, years of university studies and geographical origin. On the contrary this behavior is weakly influenced by religion or family. Premarital sexual intercourse is accepted by the majority of students. Knowledge about sexual physiology and contraception is scarce in 30 to 80% of students. It is concluded that, since a great number of students have an active sexual life along with little knowledge in this topic, the University has to assume an active role in the sexual education of students.

Cuantificación de ácido desoxirribonucléico y colágena como marcadores bioquímicos de leiomiomatosis uterina / Quantification of desoxyrribonucleic acid and collagen as biochemical markers of uterine leiomyomatosis

Los leimoniomas uterinos (LU) son tumores compuestos por músculo liso y tejido conectivo. El crecimiento depende principalmente de dos mecanismos básicos: hipertrofía de células miometriales y déposito de tejido conectivo. La cuantificación de los elementos básicos del tumor permite intentar su aplicación como marcadores bioquímicos de enfermedad, criterios auxiliares diagnósticos o en la monitorización terapéutica médica, alternativa que a últimas fechas ha cobrado un gran auge. En la presente investigación se incluyen 33 pacientes dividas en dos grupos. El grupo I mujeres con leiomiomatosis uterina (n=17) y grupo II (n=16) sin LU. Se realizó un estudio prospectivo, doble ciego, transversal de casos y control. La concentración de tejido conectivo fue evaluada en base a la determinación de colágena. La evaluación de tejido muscular fue realizada por medición del ácido desoxirribonucleico (DNA). Los resultados mostraron un significativo aumento en la concentración de tejido conectivo (hasta 500 por ciento) y una significativa disminución de celularidad (DNA) en mujeres con LU, comparado con el grupo testigo. Se comentan las principales implicaciones bioquímicas y clínicas de estos hallazgos.

Presencia de inhibidores del tiempo tromboplastina parcial activada (TTPA): repercusión clínica en pacientes obstétricas / Presence of thromboplastin time partial activated (TTPA): clinical repercussion in obstetrical patients

El tiempo de tromboplasina parcial activado con caolin (TTPA) es un ensayo cualitativo utilizado para evidenciar defectos de algún factor de la vida intrínseca de la coagulación o para descartar la presencia de algún inhibidor circulante. El anticoagulane lúpico (AL) forma parte de un grupo de varios autoanticuerpos con potencial patogénico en distintas ramas médicas, principalmente reumatología, hematología y geinecoobstericia. En esta última área, el AL se ha asociado a diferentes repercusiones obstétricas. El objetivo de este estudio fue determinar los principales eventos obstétricos asociados a pacientes con anticoagulantes circulantes identificados por TTPA con caolin. Noventa y seis pacientes fueron incluidas, en el estudio de casos-control. El grupo I (n=48) casos y el grupo II (n=48) controles, fueron seleccionadas de una misma población y fuente de información. Los casos fueron incluidos por presentar prolongación de más de 4 segundos del TTPA activado con caolin con respecto a un testigo, con falta de corección con plasma normal. Una hoja-registro de captación de datos fue diseñada especialmente para el estudio. La comparabilidad de ambos grupos fue establecida al no encontrarse diferencias significativas entre variables consideradas basales. El grupo de casos presentó una frecuencia mayor de aborto habiatual, muerte neonatal y fenómenos trombóticos. Esta relación de cuadros autoinmunológicos con pérdida fetal recurrente y accidentes tromboembólicos ha sido descrita consistentemente en la literatura. De han descrito al respecto una gama de anormalidades inmunológicas incluyendo anticuerpos alticardiolipina positivos y VDRL falsamente positivo. La incidencia en nuestro país de etas entidades es desconocida. Estas observaiones inciden sobre la necesidad de una superación metodológica. Se concluye que el reconocimiento de estos procesos autoimunes en relación al campo de la ginecología y obstetricia puede abrir nuevas perspectivas en eldiagnóstico y tratamiento de entidades como aborto habitual, tromboembolias y retardo del crecimiento intrauterino.

Meningitis bacteriase: identificación del agente causal por aglutinación de látex / Acute bacterial meningitis: etiologic diagnosis by latex aglutination

Se presenta los hallazgos etiológicos determinados mediante bacteriología y prueba de aglutinación de látex, en 48 pacientes con meningitis bacteriana aguda, reunidos en un período de 3 años (julio 84 - julio 87). Los cultivos de LCR dieron resultados positivos en 31 pacientes (64,6%), y la prueba de aglutinación de látex, realizada en 44 casos, dió una positividad global de 72,7%, permitiendo aumentar el diagnóstico etiológico en 8 casos adicionales. H influenzae fue el germen causal más frecuente: 61,5% con una mayor concentración de casos en los lactantes menores, entre 3 y 12 meses de edad. St. pneumoniae se identificó en 20,5% de los casos y N. meningitidis: 12,8%. La tinción de Gram tuvo un alto rendimiento (83,3%) y mostró una estrecha correlación con la prueba de látex. El estudio de susceptibilidad a antimicrobianos, permitió detectar 3 cepas de H. influenzae con resistencia simultánea a ampicilina y cloramfenicol y un 100% de susceptibilidad a cefotaxima. No se verificó resistencia para el resto de las cepas de Haemophilus, a través de estudio de susceptibilidad por disfunción en placa, como tampouco para cepas de St. pneumoniae y N. meningitidis

Estudio clínico-descriptivo del síndrome de Cotard / Clinical-descriptive study of Cotard's syndrome

Con motivo de la presentación de un caso de un niño con un violento síndrome de hiperpirexia ficticia se hace una exposición diagnóstica diferenciativa de los diversos síndromes de autoinducción voluntaria o síndromes de ficción y se aislan de ellos los cuadros clínicos de histerismo y de simulación simple. Se comenta también el concepto moderno del síndrome de Münchhausen y el sentido terapéutico actual de todos estos procesos