Carcinoma sebáceo, 6 años de experiencia en el Instituto Nacional del Cáncer

Objetivo: El carcinoma sebáceo (CS) es una neoplasia infrecuente, de la cual no existen reportes nacionales, ni guías de manejo en Chile. El Instituto Nacional del Cáncer (INC) es un centro de referencia nacional en el manejo de patologías oncológicas; el objetivo de este trabajo es describir la experiencia y tratamiento del carcinoma sebáceo en nuestro centro. Material y Método: Se realizó una revisión retrospectiva, descriptiva, de fichas clínicas entre marzo de 2016 y marzo de 2022 en el INC, en las cuales la biopsia definitiva fuese confirmatoria de CS. Resultados: Se reclutaron 10 pacientes, 6 hombres (60%) y 4 mujeres. Edad promedio fue de 62,9 años ± 18,7 DS. En el 80% de los casos el tumor se encontró en cabeza y cuello y solo 2 casos fueron CS ocular (20%). 4 pacientes tenían asociación al Síndrome de Muir-Torre (SMT) (40%), en el 100% de la muestra se realizó tratamiento quirúrgico con resección oncológica y control de márgenes intraoperatorio, utilizándose en solo 3 casos la técnica Cirugía Micrográfica de Mohs (MMS). En 4 pacientes (40%) se realizó biopsia de linfonodo centinela (BLNC), de los cuales ninguno resulto positivo para metástasis. Ningún paciente presento recidiva local, después de la cirugía y no hubo casos de mortalidad a causa de CS. Ningún paciente recibió radioterapia, quimioterapia o inmunoterapia adyuvante, solo 1 paciente recibió braquiterapia (BT) adyuvante. Conclusión: El CS es una patología compleja e infrecuente, que requiere un tratamiento multidisciplinario y cuyo pilar es la cirugía.

Objective: Sebaceous carcinoma (SC) is an infrequent neoplasm, without national reports nor management guidelines in Chile. National Cancer Institute (NCI) is a reference center for this kind of disease. The aim of this research is to describe the experience and treatment of the sebaceous carcinoma in our center. Methods: A retrospective, descriptive review of clinical records was performed, between March 2016 and March 2022 at the INC, in which the definitive biopsy was confirmatory of CS. Results: A total of 10 patients were enrolled; 6 male (60%) and 4 women. The mean age was 62.9 years ± 18.7 (SD). 80% of the cases were located at the head or the cervical area and only 2 cases were found in the ocular region (20%). Association with SMT (40%) was found in 4 patients. Surgical treatment with oncological resection and intraoperative assessment of margins was performed in 100% of the cases, using MMS technique. Sentinel lymph node biopsy (BLNC) was performed in 4 patients (40%), of which none had metastasis. No patient presented local recurrence after surgery and there were no cases of mortality due to CS. No patient received radiotherapy, chemotherapy or adjuvant immunotherapy. Just 1 received adjuvant brachytherapy. Conclusion: SC is a complex and infrequent disease, which requires multidisciplinary treatment mainly with surgery.

Tourism in the COVID-19 context in mesotidal beaches: Carrying capacity for the 2020/2021 summer season in Pehuén Co, Argentina.

As a result of the COVID-19 pandemic, there is an evident decrease in economic activity, especially in the tourism sector. On the southwest coast of the Buenos Aires Province (Argentina), coastal cities base their economy on 3S tourism. In this context, the analysis of social views is crucial for participatory coastal management. As well as the forecast of beach use areas in semi-diurnal mesotidal and low-slope beach conditions, wherein few hours the available beach can double or disappear. Therefore, our objective was to determine the beach's optimal use according to its tides, socio-environmental characteristics, and the perception of the interested parties about the 2020/2021 summer season in the pandemic context in Pehuén Co Beach. We employed camera images (January 2019 and 2020) to obtain the behaviour of normal, spring and neap tides, beach geomorphology, and daily and hourly beach use curves. Online surveys were also conducted with residents, second homeowners, and Pehuén Co visitors about their perception for the 2020/2021 summer season. With this analysis, we were able to divide the beach into four areas according to its potential carrying capacity. During low tide, users' maximum capacity on the beach, respecting sanitary distances, may be 6400 people. Meanwhile, at low tide, this number may rise to 34,000. This information is essential for coastal management after the COVID-19 irruption to ensure maximum efficiency in using the beach maintaining a safe social distance.

Cerebral phaeohyphomycosis caused by Alternaria spp.: A case report.

Phaeohyphomycosis is a group of infections caused by pigmented, black, dematiaceous fungi and is responsible for cutaneous, superficial and deep mycoses, disseminated infection and brain abscesses. The primary agents involved include Alternaria spp., Exophiala spp. and Cladophialophora spp. Invasive systemic presentation is rare and in most cases is associated with immunosuppression; for this reason, reported cases of Alternaria spp. infection are scarce. This report describes the case of a 66-year-old man with a history of renal transplantation from a cadaveric donor 1 year ago, which was considered as the primary risk factor. The characteristics of the infection, procedures performed, microbiological findings and treatment provided are described.

Standardization of Early Feeding Skills (EFS) scale in preterm infants. / Normalización escala Early Feeding Skills (EFS) en recién nacidos prematuros.

INTRODUCTION: The Early Feeding Skills (EFS) scale assessed the neonate's behavior before, during, and after the feeding process. OBJECTIVES: To determine the face and content validity, and to evaluate with this scale the feeding process in premature newborns comparing with relevant variables. PATIENTS AND METHOD: Premature newborns were evaluated; they were between 34 to 36 weeks of corrected age, without neurological damage or craniofacial malformations. Cross-sectional descriptive study. The data were obtained through the EFS scale, version corrected by face and content validation. The study variables were gender, breastfeeding achievement, and feeding skills during the feeding process, evaluated by two observers. Dispersion measures were analyzed, and the Fisher test was used at 5% significance, establishing the association of the obtained results with the variables. RESULTS: 5 domains were evaluated: (1) Ability to stay focused on food, in which 75.3% have a poor performance level, and 28.6% equitable, with significant differences in the sex variable. (2) Ability to organize motor- oral functioning presents 10.5% deficient, 68.8% equitable, and 20.6% good. (3) Ability to coordinate swallowing 95.2% presents an equitable performance. (4) Ability to maintain physiological stability 96.7% was equitable; and (5) Evaluation of oral food tolerance presents 41.6% of poor performance. CONCLUSION: The EFS scale is a tool that provides relevant information to describe the oral feeding process in premature infants, allowing to identify the areas of greatest difficulty that require profes sional treatment, however, this tool is not enough by itself to carry a comprehensive evaluation of the newborn feeding process.

Normalización escala Early Feeding Skills (EFS) en recién nacidos prematuros / Standardization of Early Feeding Skills (EFS) scale in preterm infants

INTRODUCCIÓN: La escala Early Feeding Skills (EFS) evalúa la conducta del neonato antes, durante y posterior al proceso de alimentación. OBJETIVOS: Determinar la validez de fachada, de contenido y evaluar con dicha escala el proceso de alimentación en los recién nacidos prematuros comparando con variables relevantes. PPACIENTES Y MÉTODO: Se evaluaron prematuros de 34 a 36 semanas de edad corregida sin daño neurológico o malformaciones craneofaciales. Diseño de tipo descriptivo de corte transversal. Los datos fueron obtenidos mediante escala EFS, versión corregida mediante validación de fachada y contenido. Las variables de estudio fueron género, logro de alimentación por pecho, y habilidades de alimentación durante el proceso de alimentación, evaluadas por 2 observadoras Se analizaron medidas de dispersión y se aplicó prueba Fisher al 5% de significancia, estableciendo la asociación de los resultados obtenidos con las variables. RESULTADOS: Se evaluaron 5 dominios: (1) Capacidad de mantenerse enfocado en la alimentación, en que el 75,3% posee un nivel desempeño deficiente y el 28,6% equitativo existiendo diferencias significativas con la variable sexo. (2) Capacidad de organizar el funcionamiento motor - oral tiene un 10,5% deficiente, un 68,8% equitativo y un 20,6% bueno. (3) Capacidad de coordinar la deglución el 95,2% presenta un rendimiento equitativo. (4) Capacidad de mantener la estabilidad fisiológica el 96,7% fue equitativo y en (5) Evaluación de la tolerancia alimentaria oral tiene un desempeño deficiente del 41,6%. CONCLUSIÓN: La escala EFS es una herra mienta que aporta información relevante para describir el proceso de alimentación oral en lactantes prematuros, permitiendo identificar las áreas de mayor dificultad que requieren tratamiento profe sional, sin embargo, esta herramienta no es suficiente por sí sola para llevar a cabo una evaluación integral del proceso de alimentación del neonato.

INTRODUCTION: The Early Feeding Skills (EFS) scale assessed the neonate's behavior before, during, and after the feeding process. OBJECTIVES: To determine the face and content validity, and to evaluate with this scale the feeding process in premature newborns comparing with relevant variables. PATIENTS AND METHOD: Premature newborns were evaluated; they were between 34 to 36 weeks of corrected age, without neurological damage or craniofacial malformations. Cross-sectional descriptive study. The data were obtained through the EFS scale, version corrected by face and content validation. The study variables were gender, breastfeeding achievement, and feeding skills during the feeding process, evaluated by two observers. Dispersion measures were analyzed, and the Fisher test was used at 5% significance, establishing the association of the obtained results with the variables. RESULTS: 5 domains were evaluated: (1) Ability to stay focused on food, in which 75.3% have a poor performance level, and 28.6% equitable, with significant differences in the sex variable. (2) Ability to organize motor- oral functioning presents 10.5% deficient, 68.8% equitable, and 20.6% good. (3) Ability to coordinate swallowing 95.2% presents an equitable performance. (4) Ability to maintain physiological stability 96.7% was equitable; and (5) Evaluation of oral food tolerance presents 41.6% of poor performance. CONCLUSION: The EFS scale is a tool that provides relevant information to describe the oral feeding process in premature infants, allowing to identify the areas of greatest difficulty that require profes sional treatment, however, this tool is not enough by itself to carry a comprehensive evaluation of the newborn feeding process.

Efectos de un entrenamiento de miembro inferior con restricción parcial del flujo sanguíneo en la fuerza muscular y biomarcadores sistémicos de daño muscular e inflamación / Effects of lower limb training with partial restriction of blood flow on muscle strength and systemic biomarkers of muscle damage and inflammation

El entrenamiento de fuerza, especialmente con alta intensidad de carga, permite aumentar la fuerza y trofismo muscular, pero también se asocia a daño muscular inducido por ejercicio (DMIE). Una nueva modalidad de entrenamiento, combina una baja intensidad de carga con la restricción parcial del flujo sanguíneo (RPFS) alrededor del músculo, siendo prometedor en cuanto el desarrollo de la fuerza y trofismo muscular. El objetivo del estudio fue comparar el rendimiento de fuerza máxima de los músculos cuádriceps e isquiotibiales (FM-Q y FM-I) y marcadores de daño muscular (CK) e inflamación sistémica (PCRus) entre un entrenamiento de baja intensidad de carga con RPFS, versus uno de alta y otro de baja intensidad de carga sin RPFS en jóvenes físicamente activos durante cuatro semanas de entrenamiento. Veintitrés participantes midieron la FM-Q y FM-I previo y al término de la intervención; además, antes del inicio de la primera sesión, y antes y después del término de la última sesión se midió la CK y PCRus. En los tres tipos de entrenamiento se produjeron aumentos equivalentes en la fuerza máxima, a excepción de la FM-Q del entrenamiento con baja intensidad sin RPFS. Solo en el entrenamiento con RPFS la CK y PCRus se modifican al finalizar la intervención, y aun cuando el estrés miocelular parece ser más alto que en los otros tipos de entrenamiento, no indicaría daño muscular.

Strength training, especially with high load intensity, allows increasing muscle strength and trophism, but it is also associated with exercise-induced muscle damage (EIMD). A new training modality, a combination of loading with the partial restriction blood flow (PRBF) around the muscle, being promising in the development of strength and muscular trophism. The aim of the study was to compare the maximum strength (MS) performance of quadriceps and hamstrings (MS-Q and MS-I) and muscle damage biomarkers (Creatine Kinase, CK) and systemic inflammation (high sensitivity - CRP, hs-CRP) between a low intensity load training with PRBF, versus one high and another low load intensity without PRBF in physically active youngsters during four weeks of training. Twenty-three participants measured MSQ and MS-I and the intervention term. In addition, before the start of the first session, before and after the end of the last session, CK and hsCRP were measured. In the three types of training the equivalent benefits in MS are produced, an exception of the MS-Q of low intensity training without PRBF. Only in the training with PRBF, the CK and hsCPR are modified at the end of the intervention, and even though the myocellular stress seems to be higher than in the other types of training, it would not indicate muscle damage.

Total Leishmania antigens with Poly(I:C) induce Th1 protective response.

Our proposal was to develop a vaccine based on total Leishmania antigens (TLA) adjuvanted with polyinosinic-polycytidylic acid [Poly(I:C)] able to induce a Th1 response which can provide protection against Leishmania infection. Mice were vaccinated with two doses of TLA-Poly(I:C) administered by subcutaneous route at 3-week interval. Humoral and cellular immune responses induced by the immunization were measured. The protective efficacy of the vaccine was evaluated by challenging mice with infective promastigotes of Leishmania (Leishmania) amazonensis into the footpad. Mice vaccinated with TLA-Poly(I:C) showed a high anti-Leishmania IgG titre, as well as increased IgG1 and IgG2a subclass titres compared with mice vaccinated with the TLA alone. The high IgG2a indicated a Th1 bias response induced by the TLA-Poly(I:C) immunization. Accordingly, the cellular immune response elicited by the formulation was characterized by an increased production of IFN-γ and no significant production of IL-4. The TLA-Poly(I:C) immunization elicited good protection, which was associated with decreased footpad swelling, a lower parasite load and a reduced histopathological alteration in the footpad. Our findings demonstrate a promising vaccine against cutaneous leishmaniasis that is relatively economic and easy to develop and which should be taken into account for preventing leishmaniasis in developing countries.

[Errors in prescriptions and their preparation at the outpatient pharmacy of a regional hospital]. / Errores en las recetas médicas y en la preparación de estas en farmacia de pacientes ambulatorios: El caso del Hospital de Nueva Imperial.

BACKGROUND: Adverse effects of medications are an important cause of morbidity and hospital admissions. Errors in prescription or preparation of medications by pharmacy personnel are a factor that may influence these occurrence of the adverse effects Aim: To assess the frequency and type of errors in prescriptions and in their preparation at the pharmacy unit of a regional public hospital. MATERIAL AND METHODS: Prescriptions received by ambulatory patients and those being discharged from the hospital, were reviewed using a 12-item checklist. The preparation of such prescriptions at the pharmacy unit was also reviewed using a seven item checklist. RESULTS: Seventy two percent of prescriptions had at least one error. The most common mistake was the impossibility of determining the concentration of the prescribed drug. Prescriptions for patients being discharged from the hospital had the higher number of errors. When a prescription had more than two drugs, the risk of error increased 2.4 times. Twenty four percent of prescription preparations had at least one error. The most common mistake was the labeling of drugs with incomplete medical indications. When a preparation included more than three drugs, the risk of preparation error increased 1.8 times. CONCLUSIONS: Prescription and preparation of medication delivered to patients had frequent errors. The most important risk factor for errors was the number of drugs prescribed.

A study on fibre addition to gluten free bread: its effects on bread quality and in vitro digestibility.

The aim of this study was to assess the impact of fibre addition on gluten-free (GF) dough properties and bread technological quality, and on protein and starch in vitro digestibility. Soluble (Inulin, In) and insoluble fibres (oat fibre, OF, and type IV resistant starch, RSIV) were used at 5 and 10% substitution levels. Dough firmness increased when insoluble fibres were added, and decreased when In was used. Incorporation of insoluble fibres resulted into bread with a low specific volume (SBV) since firmer dough were more difficult to expand during proofing and baking. Staling rate was reduced after fibre addition, with the exception being OF 10%, as its lower SBV may have favoured molecule re-association. In general, protein and starch digestibility increased when fibres were added at 5%, and then decreased after further increasing the level. Fibres may have disrupted bread crumb structure, thus increasing digestibility, although the higher addition may have led to a physical and/or chemical impediment to digestion. Inulin has well-known physiological effects, while RS presented the most important effect on in vitro starch digestibility (GI). These results showed the possibility of adding different fibres to GF bread to decrease the GI and increase protein digestibility, while obtaining an overall high quality end-product.

Errores en las recetas médicas y en la preparación de estas en farmacia de pacientes ambulatorios: El caso del Hospital de Nueva Imperial / Errors in prescriptions and their preparation at the outpatient pharmacy of a regional hospital

Background: Adverse effects of medications are an important cause of morbidity and hospital admissions. Errors in prescription or preparation of medications by pharmacy personnel are a factor that may influence these occurrence of the adverse effects Aim: To assess the frequency and type of errors in prescriptions and in their preparation at the pharmacy unit of a regional public hospital. Material and Methods: Prescriptions received by ambulatory patients and those being discharged from the hospital, were reviewed using a 12-item checklist. The preparation of such prescriptions at the pharmacy unit was also reviewed using a seven item checklist. Results: Seventy two percent of prescriptions had at least one error. The most common mistake was the impossibility of determining the concentration of the prescribed drug. Prescriptions for patients being discharged from the hospital had the higher number of errors. When a prescription had more than two drugs, the risk of error increased 2.4 times. Twenty four percent of prescription preparations had at least one error. The most common mistake was the labeling of drugs with incomplete medical indications. When a preparation included more than three drugs, the risk of preparation error increased 1.8 times. Conclusions: Prescription and preparation of medication delivered to patients had frequent errors. The most important risk factor for errors was the number of drugs prescribed.

[Relationship between grief support and burnout syndrome in professionals and technicians of pediatric health]. / Relación entre apoyo en duelo y el síndrome de Burnout en profesionales y técnicos de la salud infantil.

Detect the presence of Burnout and bereavement support of health professionals in oncology and pediatric intensive care units in Chilean public hospitals. SUBJECTS AND METHOD: Transversal design of descriptive correlational type. Auto-evaluation using the Maslach Burnout Inventory and Grief Support Health Care Scale instruments in 210 professionals and technicians. For the analysis of a means comparison, the t-student test was used and for the comparison between the variables, the correlations of Pearson and Spearman were used, considering a level of significance of 5%. RESULTS: 4% of the participants presented with Burnout and 71% were at risk of suffering it. 52% had a high level of perception of bereavement support, especially in women and oncology personnel. When correlating support in bereavement and Burnout, the data suggests that both the recognition of the bond, as well as the loss after death of a patient, helps decrease the depersonalization of the professional and improves their personal fulfillment. CONCLUSION: Professionals in areas of high pediatric complexity are at high risk of Burnout, due to greater emotional exhaustion and low personal accomplishment. However, a greater perception of recognition and support in their bereavement is a factor that can reduce that risk. Therefore, continuous intervention programs are required within these units, with concrete strategies for accompaniment, teamwork and mourning rituals.

Relación entre apoyo en duelo y el síndrome de burnout en profesionales y técnicos de la salud infantil / Relationship between grief support and burnout syndrome in professionals and technicians of pediatric health

Conocer la presencia de Burnout y de apoyo en duelo de profesionales de la salud en unidades de oncología y cuidados intensivos pediátricos de hospitales públicos chilenos. Sujetos y Método: Diseño trasversal de tipo descriptivo correlacional. Auto aplicación de los instrumentos Maslach Burnout Inventory y Grief Support Health Care Scale en 210 profesionales y técnicos. Para el análisis de comparación de medias se usó la prueba de t-student y para la comparación entre las variables, las correlaciones de Pearson y Spearman, considerando un nivel de significancia del 5%. Resultados: El 4% de los participantes presentaron Burnout y el 71%, estaba en riesgo de padecerlo. El 52% presentó alto nivel de percepción de apoyo en duelo, en especial en mujeres y personal de oncología. Al correlacionar el apoyo en duelo y el Burnout, los datos sugirieron que tanto el reconocimiento del vínculo como de la pérdida tras la muerte de un paciente, disminuye la despersonalización del profesional y mejora su realización personal. Conclusión: Los profesionales de unidades de alta complejidad pediátrica presentan alto riesgo de padecer Burnout, por un mayor cansancio emocional y baja realización personal. Sin embargo, una mayor percepción de reconocimiento y apoyo en sus duelos, es un factor que puede disminuir dicho riesgo. Por lo que se requiere de programas de intervención continua dentro de las unidades, con estrategias concretas de acompañamiento, trabajo en equipo y rituales de duelo.

Detect the presence of Burnout and bereavement support of health professionals in oncology and pediatric intensive care units in Chilean public hospitals. Subjects and Method: Transversal design of descriptive correlational type. Auto-evaluation using the Maslach Burnout Inventory and Grief Support Health Care Scale instruments in 210 professionals and technicians. For the analysis of a means comparison, the t-student test was used and for the comparison between the variables, the correlations of Pearson and Spearman were used, considering a level of significance of 5%. Results: 4% of the participants presented with Burnout and 71% were at risk of suffering it. 52% had a high level of perception of bereavement support, especially in women and oncology personnel. When correlating support in bereavement and Burnout, the data suggests that both the recognition of the bond, as well as the loss after death of a patient, helps decrease the depersonalization of the professional and improves their personal fulfillment. Conclusion: Professionals in areas of high pediatric complexity are at high risk of Burnout, due to greater emotional exhaustion and low personal accomplishment. However, a greater perception of recognition and support in their bereavement is a factor that can reduce that risk. Therefore, continuous intervention programs are required within these units, with concrete strategies for accompaniment, teamwork and mourning rituals.

Cardiotrophin-1 decreases intestinal sugar uptake in mice and in Caco-2 cells.

AIM: Cardiotrophin-1 (CT-1) is a member of the IL-6 family of cytokines with a key role in glucose and lipid metabolism. In the current investigation, we examined the in vivo and in vitro effects of CT-1 treatment on intestinal sugar absorption in different experimental models. METHODS: rCT-1 effects on α-Methyl-D-glucoside uptake were assessed in everted intestinal rings from wild-type and CT-1(-/-) mice and in Caco-2 cells. rCT-1 actions on SGLT-1 expression in brush border membrane vesicles and the identification of the potential signalling pathways involved were determined by Western blot. RESULTS: In vivo administration (0.2 mg kg(-1) ) of rCT-1 caused a significant decrease on α-Methyl-D-glucoside uptake in everted intestinal rings from wild-type and CT-1(-/-) mice after short-term and long-term treatments. Similarly, in vitro treatment (1-50 ng mL(-1) ) with rCT-1 reduced α-Methyl-D-glucoside uptake in everted intestinal rings. In Caco-2 cells, rCT-1 treatment (20 ng mL(-1) , 1 and 24 h) lowered apical uptake of α-Methyl-D-glucoside in parallel with a decrease on SGLT-1 protein expression. rCT-1 promoted the phosphorylation of STAT-3 after 5 and 15 min treatment, but inhibited the activation by phosphorylation of AMPK after 30 and 60 min. Interestingly, pre-treatment with the JAK/STAT inhibitor (AG490) and with the AMPK activator (AICAR) reversed the inhibitory effects of rCT-1 on α-Methyl-D-glucoside uptake. AICAR also prevented the inhibition of SGLT-1 observed in rCT-1-treated cells. CONCLUSIONS: CT-1 inhibits intestinal sugar absorption by the reduction of SGLT-1 levels through the AMPK pathway, which could also contribute to explain the hypoglycaemic and anti-obesity properties of CT-1.

Postoperative adjuvant treatment for gastric cancer improves long-term survival after curative resection and D2 lymphadenectomy. Results from a Latin American Center.

BACKGROUND: The benefits of adjuvant treatment in the context of a D2 lymph node dissection are controversial. The aim was to investigate the effects of postoperative adjuvant treatment on the survival of patients with a curative resection for gastric cancer and a D2 lymph node dissection. METHODS: We performed a retrospective cohort study. Patients operated from 1996 to 2013 were selected. We compared long term survival of patients treated with surgery alone and those with surgery plus postoperative adjuvant treatment. A multivariate analysis for survival was applied in every stage. RESULTS: The study included 580 patients. Two-hundred and four patients received postoperative adjuvant treatment (AD) and 376 patients were treated only with surgery (SU). Patients in the AD group were younger (60 versus 68, p < 0.001), had a lower rate of multiple organ resection (21% versus 39%, p < 0.001) and had less postoperative complications (14% versus 32%, p < 0.001). In the AD group, patients had more advanced disease (stage III; 77% versus 66%, p < 0.001). No difference was found in lymph nodes resected (31 versus 30, p = ns). The median survival with adjuvant treatment was 33 months (39% 5 year survival) and 22 months (31% 5 year survival) for patients without adjuvant treatment (p = 0.003). On multivariate analysis, patients with stage IIIB and IIIC had significantly better overall and disease specific long-term survival with adjuvant treatment. CONCLUSIONS: These results suggest that there is a long-term survival benefit for patients treated with postoperative adjuvant treatment for stages IIIB and IIIC gastric cancer after D2 lymph node dissection.

[Mother-newborn relational risk - Study of prevalence and associated variables]. / Riesgo relacional madre-recién nacido. Estudio de prevalencia y variables asociadas.

INTRODUCTION: Clinical evidence reveals the importance of mother-newborn bonding experience for health promoting and maintenance of human life. If the newborn lacks care and affection, she/he may develop an attachment disorder. A predictive scale regarding the risk of mothernewborn relationships is available, which makes possible an early intervention to prevent the development of relational disorders. The aim of this study is to apply the Kimelman measurement scale to determine the relational risk in mother-newborn pairs, as well as the prevalence and the associated biopsychosocial variables. PATIENTS AND METHODS: A cross-sectional study with a probabilistic sample of 333 mother-infant pairs in postpartum maternity at Temuco hospital. The Kimelman mother-newborn attachment assessment guide was used. Biopsychosocial variables were obtained from the mothers studied. The association of biopsychosocial variables with relational risk was analyzed using OR and confidence intervals of 95%. RESULTS: The prevalence of high relational risk was 43.8%. The associated biopsychosocial variables included, women with no steady partner, single parent, teenage mothers, unwanted and unplanned pregnancy. CONCLUSION: Almost half of the mothers were in the high risk group. Early identification of relational risk and its related variables could help in the intervention in this vulnerable group.

Riesgo relacional madre-recién nacido: Estudio de prevalencia y variables asociadas / Mother-newborn relational risk: Study of prevalence and associated variables

Introducción: Existen pruebas clínicas que revelan la importancia del vínculo seguro para la salud y para el mantenimiento coherente de la vida humana. Si el recién nacido carece de cuidados y afectos podría desarrollar un trastorno del apego. Existe una escala predictiva de riesgo relacional que permitiría intervenir precozmente en la díada madre-recién nacido, para prevenir el desarrollo de trastornos vinculares. El objetivo fue aplicar la escala de Kimelman para riesgo relacional en díadas madre-recién nacido, para determinar la prevalencia y las variables biopsicosociales asociadas. Pacientes y Método: Estudio de corte transversal con una muestra no probabilística de 333 díadas que permanecen en puerperio en la maternidad del hospital de Temuco. Se utilizó la pauta de evaluación relacional madre-recién nacidos de Kimelman. Las variables biopsicosociales se obtuvieron de una encuesta a las madres. Se analizó la asociación de variables biopsicosociales con riesgo relacional, utilizando odds ratio (OR) e intervalos de confianza (IC) del 95%. Resultados: La prevalencia de alto riesgo relacional fue del 43,8%. Las variables biopsicosociales asociadas fueron: mujeres sin pareja estable, monoparentalidad, madres adolescentes, embarazo no deseado y no planificado, entre otras. Conclusión: El grupo de alto riesgo alcanza prácticamente a la mitad de las madres. La identificación precoz del riesgo relacional y sus variables relacionadas podría orientar la intervención en este grupo de mayor vulnerabilidad.

Introduction: Clinical evidence reveals the importance of mother-newborn bonding experience for health promoting and maintenance of human life. If the newborn lacks care and affection, she/he may develop an attachment disorder. A predictive scale regarding the risk of mother-newborn relationships is available, which makes possible an early intervention to prevent the development of relational disorders. The aim of this study is to apply the Kimelman measurement scale to determine the relational risk in mother-newborn pairs, as well as the prevalence and the associated biopsychosocial variables. Patients and Methods: A cross-sectional study with a probabilistic sample of 333 mother-infant pairs in postpartum maternity at Temuco hospital. The Kimelman mother-newborn attachment assessment guide was used. Biopsychosocial variables were obtained from the mothers studied. The association of biopsychosocial variables with relational risk was analyzed using OR and confidence intervals of 95%. Results: The prevalence of high relational risk was 43.8%. The associated biopsychosocial variables included, women with no steady partner, single parent, teenage mothers, unwanted and unplanned pregnancy. Conclusion: Almost half of the mothers were in the high risk group. Early identification of relational risk and its related variables could help in the intervention in this vulnerable group.

Adaptación y validación de instrumentos para medir errores en las recetas médicas y en el proceso de preparación de medicamentos en farmacia de pacientes ambulatorios / Adaptation and validation of checklists to detect medication prescription and dispensing errors

Background: Adverse effects of medications are an important source of morbidity. Prescription and dispensing errors are an important cause of these adverse effects. Aim: To adapt and validate two checklists, one to measure errors in handwritten prescriptions and other to detected errors in the medication dispensing process of hospital pharmacies for outpatient care. Material and Methods: The study was conducted in three stages. First, checklists for medication errors developed elsewhere were adapted. Afterwards, the checklists were reviewed by experts. Finally, the inter and intra-observer reliability of each checklist was assessed, testing them in 32 occasions by two independent observers. Results: The checklists for medication prescription and dispensing were composed by 12 and seven items, respectively. They were corrected according to experts’ opinions. The intraclass correlations of the results of each tester were 0.68 and 0.82 for the prescription and dispensing error checklists, respectively. Conclusions: The developed checklists for the detection of errors in prescription and dispensing of medications are reliable en can be applied in future studies.

Diet of lowland tapir (Tapirus terrestris) in El Rey National Park, Salta, Argentina.

Lowland tapir (Tapirus terrestris) is the largest herbivore in the Neotropics and, in Argentina, it inhabits a variety of habitats from 100 to 2100 m asl. Lowland tapirs importantly influence their habitat structure because they are selective browsers, seed predators and long-distance seed dispersers. However, increased knowledge of tapir ecology is necessary to support the conservation and management of the species in natural and human-modified environments. Between Jun 2002 and Dec 2008 we assessed the tapir's diet in El Rey National Park, Salta, northwestern Argentina. We collected fresh feces and recorded browsing signs, and we recorded direct observations of tapirs while they were feeding. We analyzed 88 feces samples that had been dried and subsequently weighed. Feces were dominated by fibers and leaves (84.09%), while fruit parts represented a small proportion of the weight (15.91%). During the dry months, a greater percentage of seeds were found in the feces, mainly due to the availability of 3 species of Fabaceae fruits. We recorded a total of 57 plant species from 26 families. Tapirs are adapted to extreme habitats, switching their diet from frugivory to herbivory when fruits are scarce. Considering this, forest remnants and even secondary growth fields should be protected from deforestation.

Validación del cuestionario de calidad de vida ConQol, en niños chilenos portadores de cardiopatías congénitas / Validation of quality of life questionnaire ConQol for Chilean children with congenital heart diseases

Background: ConQoL questionnaire assesses health related quality of life among children with congenital heart diseases. It has a version for children aged 8 to 11 years and anotherfor children aged 12 to 16years. Aim: To validate ConQol questionnaire for Chilean children with a congenital heart disease. Material and Methods: Using a multicentric cross sectional design, 334 children from four hospitals (54% males), were surveyed. Among them 45% were aged 8 to 11 years and 55%, 12 to 16 years. The study involved three stages: cross cultural adjustment of the original questionnaire, pre-test study, and estimation of its psychometric properties. Content, construct and criterion validity and internal consistency with Cronbach's alpha, were assessed. Results: The version for children aged 8 to 11 years and comprised by three domains (symptoms, activity and relationships), obtained and α ≥ 0.60. In the questionnaire for children aged 12 to 16years, there is one more domain called coping, which obtained an α of 0.53, that was different to the other three domains that obtained an α > 0.70. The correlation between Health Quality of Life and Perception of Health Quality of Life was statistically significant for both groups. The association between Health Quality ofLife and health capability was only significant among children aged 12 to 16years (p < 0.01). Conclusions: The adapted ConQol questionnaire matched properly with the original one. The adapted questionnaire is valid and reliable to assess Health Quality ofLife among Chilean children with congenital heart diseases.

Validación de escala de valoración del dolor en recién nacidos en una unidad de neonatología / Validation of a scale of assessment of pain in infants in neonatal unit

La escala de valoración de dolor de Givens permite determinar presencia y magnitud del dolor que presentan los Recién Nacidos (RN) hospitalizados en Unidades de Cuidados Intensivos (UCI), para así poder valorar de manera constante este signo vital y tomar las medidas necesarias para atenuar la sensación dolorosa. Sentir dolor es un estado no deseable, donde se ve alterado el patrón fisiológico y el estado de conciencia de los niños; se hace necesario aplicar de manera constante escalas que permitan visualizar la magnitud real y tomar medidas de prevención y cuidado enfermero, favoreciendo la tranquilidad de los RN. Esta investigación tuvo como objetivo validar la escala Neonatal Pain Assessment Scale de Givens, en la Unidad de Neonatología, Hospital Dr. Hernán Henríquez Aravena, durante el período abril - septiembre de 2010. El estudio utilizó un diseño de corte transversal, donde se determinó validez y confabilidad del instrumento. La investigación permitió entregar un instrumento válido y confiable para medir presencia y magnitud del dolor en RN. Así, se determinó un coeficiente alfa de Cronbach de 0,78 y un porcentaje total de varianza de 57,72. El análisis sugirió la eliminación de dos ítemes de valoración, quedando con dos dominios (Conductual y Fisiológico), estableciéndose que la Neonatal Pain Assessment Scale es adecuada para su objetivo de valoración, constituyendo un aporte en unidades de cuidados neonatales, contribuyendo al propósito de mejorar la calidad de hospitalización de estos usuarios y otorgando cumplimiento a la norma ministerial y calidad de los cuidados.

Givens Neonatal Pain Assessment Scale, allows determining the presence and the degree of pain in Newborns (RN) hospitalized in Intensive Care Units (ICU) present, in order to constantly assess the vital signs and take the necessary measures to reduce pain sensation. Feeling pain is an undesirable state, where the physiological pattern and the children consciousness state is altered; it is necessary to consistently apply scales that helps illustrate the real magnitude as well as adopting preventive actions and nursing care, to promote tranquility of the RN. The research, aimed to validate the Givens Neonatal Pain Assessment Scale at Neonatal Unit from Dr. Hernan Henríquez Aravena Hospital, during the period April to September 2010. The study uses a cross-sectional design, which determined validity and reliability of the instrument. The research delivers a valid and reliable instrument to measure the presence and degree of pain in neonates. Thus, we determined a Cronbach´s alpha of 0,78 and a total percentage of variance of 57,72. The analysis suggested the elimination of two items of value, leaving with two domains (Behavioral, and Physiological), establishing that the Neonatal Pain Assessment Scale, is suitable for objective assessment, making a contribution in Neonatal Care Units, contributing to the purpose of improving the quality of hospitalization of these users and granting Ministerial compliance with the standard and quality of care.