[Revista Chilena de Pediatría/Andes Pediatrica in the new millennium. Bibliometric analysis]. / Revista Chilena de Pediatría/Andes Pediatrica en el nuevo milenio. Análisis bibliométrico.

INTRODUCTION: Andes Pediatrica/Revista Chilena de Pediatría (AP/RChP), maintains a document profile that covers all scientific publication formats, from Original Articles (OAs) to Letters to the Editor. Adequate editorial planning requires a long-term bibliometric analysis. OBJECTIVE: To describe the profile of OAs published in AP/RChP in the last two decades. METHODOLOGY: From a controlled vocabulary list, the thematic and methodological descriptors of the documents from 2000 to 2020 were standardi zed. Nationality, sex, and profession of the authors, document typology, and design of the OAs were analyzed, as well as the descriptors cited in Google Scholar and the most visited descriptors on the journal's website in recent years. RESULTS: 1738 manuscripts were published, 580 (33.4%) were OAs, with an increase from 59 to 129 OAs between the first and last three years. The average number of authors was higher for OAs (4.7) than for non-originals (3.0). In 2020, there were nine multicenter collaborations from different countries. The number of OAs by foreign authors increased from 3.3% to 28.7%, the first authorship by non-medical professionals increased from 15% to 31%, and there was a predominance of female first authors (ratio 1.4/1). Of the OAs, 9.1% were experimental, 3.3% were qualitative and the rest were quantitative observational. The most published descriptors were Nutrition, Infectious Diseases, Neonatology, and Pneumonology, while the most cited descriptors were Nutrition, Neonatology, and Oral Health, with no trend among the most visited. 44% of the most cited articles and 35% of the most visited articles were OAs. CONCLUSIONS: A significant increase in published OAs stands out, with a low frequency of experimental designs. Authors of different na tionalities and professions participated. OAs represent one-third of the visits and almost half of the citations, with no correlation between the most published and most cited descriptors.

Ocuparse del bienestar de los profesionales de la salud: un desafío pendiente / Taking care of health care professional's well-being: a pending challenge

Este estudio de caso tiene como objetivo general, escribir las características laborales asociadas al Síndrome de Burnout en un Equipo de Cuidados Paliativos Oncológicos del Servicio de Salud Metropolitano Norte, en el año 2013” Las variables evaluadas son Síndrome de Burnout, carga mental y factores de riesgo psicosociales, las que fueron evaluadas mediante pautas estandarizadas: Maslach Burnout Inventory (MBI), NASA-TLX e ISTAS 21, respectivamente, además de un cuestionario de datos personales. La población de estudio está conformada en su mayoría por mujeres. Seis son médicos, cuatro son enfermeras y dos son técnicos en enfermería. Los principales hallazgos son que: todos los participantes tienen Síndrome de Burnout o se encuentran en riesgo de padecerlo, las principales fuentes de carga mental son las exigencias mentales y temporales, y los principales factores de riesgo psicosociales se relacionan con las exigencias psicológicas y la doble presencia. De los resultados obtenidos se concluye la importancia de intervenir no sólo con pacientes oncológicos, sino también con los equipos de salud, ya que este puesto de trabajo se ve expuesto a altas exigencias que pueden perjudicar la calidad de vida laboral y personal de los trabajadores.

The main purpose of this case study is to describe the work conditions related to the development of Burnout Syndrome in an Oncology and Palliative Care unit of the North Metropolitan Health Service, in the year 2013. This study evaluated the presence of Burnout Syndrome, Mental Workload and Psychosocial Risk Factors, which were assessed with three standardized tests: Maslach Burnout Inventory, NASA TLX and ISTAS 21, respectively, besides a personal data questionnaire. The study population was formed by twelve people, mainly women. Six were doctors, four were nurses and two were nursing technicians. The main results are: all individuals suffered from Burnout Syndrome or were in risk of developing it. The main mental workload causes were mental and timing requirements, and exposition to psychosocial risk factors related to psychological requirements and “double – presence”. These results highlight the importance of making an intervention not only with oncology patients, but also with the health team, who are exposed to many requirements, which can affect the professional’s work and personal quality of life.

Producción bacteriana de betalactamasas de espectro extendido en pacientes de la unidad de cuidados intensivos del Hospital de Caldas, 2003 / Bacterial production of extended spectrum betalactamases in patients of the intensive care unit of the Hospital de Caldas, 2003

La resistencia bacteriana a los antimicrobianos va en aumento, lo que implica generación de problemas a las instituciones de salud y la comunidad en general como: elevación del gasto para medicamentos, sobreinfecciones, alteración de la microflora y la macroflora, y disminución en la calidad de atención en salud. Esta resistencia es más marcada cuando hay presencia de microorganismos gram negativos productores de betalactamasas de espectro extendido (BLEE). En el presente trabajo se buscó determinar el tipo, la frecuencia y la distribución de microorganismos productores de BLEE, por técnicas tradicionales y moleculares, y determinar los factores médicos o quirúrgicos asociados con dicha producción, en la Unidad de Cuidados Intensivos (UCI) del Hospital de Caldas, con el fin de aportar la información necesaria para tomar medidas epidemiológicas y plantear estrategias sobre el uso apropiado de los antibióticos y el tratamiento de las infecciones más frecuentes. Se realizó un estudio analítico de casos y controles: 11 pacientes (5 casos y 6 controles), con infección primaria o intrahospitalaria, en quienes se realizó aislamiento de microorganismos productores de BLEE, resistentes o no, a las cefalosporinas de tercera generación, respectivamente. Estas muestras se sometieron a análisis microbiológico, isoenzimático y molecular. Se identificaron dos cepas de Eschericcia. coli, P. aeruginosa y Acinetobacter baumanii sospechosas de producir BLEE; sin embargo, no fueron confirmadas con otras pruebas como VITEK, puntos isoeléctricos y reacción en cadena de la polimerasa. No hubo diferencias significativas para los factores de riesgo en los casos y los controles.

Riesgo anestésico y tipo de heridas asociados a infección intrahospitalaria en pacientes quirúrgicos: Modelo logístico / Anesthesic risk and type of injury associated to intrahospitalary infection in surgical patients: Logistic pattern

Con el fin de evaluar la asociación entre edad del paciente, el riesgo anestésico (ASA), el tipo de herida (limpia, limpia-contaminada, contaminada y sucia), y la duración del procedimiento quirúrgico con la presentación de infección intrahospitalaria (infección de herida quirúrgica, neumonía, infección del tracto urinario, infección de piel, conjuntivitis e infección de quemadura), se desarrolló un estudio controlado con 104 casos y 144 controles seleccionados aleatoriamente de los pacientes que ingresaron al piso quirúrgico del Hospital de Caldas (Cirugía General, Neurocirugía, Ortopedia, Urología). Se tomaron como criterios de infección intrahospitalaria (IIH) los que están estandarizados por el Centro de Control de Enfermedades de Atlanta (CDC). Mediante regresión lineal se escogieron las variables explicativas que fueron ingresadas al modelo de regresión logística (RL). De este último se excluyeron la edad del paciente y la duración del procedimiento por falta de significancia. En una fase posterior se diseñaron variables dummy para el ASA y el tipo de herida, evidenciándose asociación de la IIH con el ASA 3, el ASA 4, el ASA 5, la herida contaminada y la sucia. Cuando se corrió el modelo de RL con todas las variables independientes, tomando solo como variable respuesta la infección de la herida quirúrgica (IHQ) se encontró que ningún factor estaba asociado. El riesgo de IIH es alto para pacientes que ingresaron al hospital de Caldas y que poseen riesgos anestésicos altos (ASA 3, 4 y 5) y su tipo de herida es contaminada o sucia

Introducing transglycosylation activity in a liquefying alpha-amylase.

By mutating Ala-289 by Phe or Tyr in the Bacillus stearothermophilus alpha-amylase, we induced this enzyme to perform alcoholytic reactions, a function not present in the wild-type enzyme. This residue was selected from homology analysis with neopullulanase, where the residue has been implicated in the control of transglycosylation [Kuriki et al. (1996) J. Biol. Chem. 271, 17321-173291. We made some inferences about the importance of electrostatic and geometrical modifications in the active site environment of the amylase to explain the behavior of the modified enzyme.

Alcoholysis reactions from starch with alpha-amylases.

The ability of alpha-amylases from different sources to carry out reactions of alcoholysis was studied using methanol as substrate. It was found that while the enzymes from Aspergillus niger and Aspergillus oryzae, two well-studied saccharifying amylases, are capable of alcoholysis reactions, the classical bacterial liquefying alpha-amylases from Bacillus licheniformis and Bacillus stearothermophilus are not. The effect of starch and methanol concentration, temperature and pH on the synthesis of glucosides with alpha-amylase from A. niger was studied. Although methanol may inactivate alpha-amylase, a 90% substrate relative conversion can be obtained in 20% methanol at a high starch concentration (15% w/v) due to a stabilizing effect of starch on the enzyme. As the products of alcoholysis are a series of methyl-oligosaccharides, from methyl-glucoside to methyl-hexomaltoside, alcoholysis was indirectly quantified by high performance liquid chromatography analysis of the total methyl-glucoside produced after the addition of glucoamylase to the alpha-amylase reaction products. More alcoholysis was obtained from intact soluble starch than with maltodextrins or pre-hydrolyzed starch. The biotechnological implications of using starch as substrate for the production of alkyl-glucosides is analyzed in the context of these results.

Prognostic significance of cutaneous depigmentation in Mexican patients with malignant melanoma.

BACKGROUND: The clinical significance of cutaneous depigmentary phenomena in patients with malignant melanoma is not clear. There are two varieties: 1) vitiligo (VIT), and 2) leukoderma acquisitum centrifugum (LAC). METHODS: In order to evaluate the outcome of our patients with malignant melanoma and skin depigmentation (VIT or LAC), the patients in this study with this association were retrospectively reviewed and compared with the total melanoma patients at the Oncology Hospital and the XXI Century National Medical Center of the Mexican Social Security Institute in Mexico City. RESULTS: Nine cases were found from 1985-1995. There were eight women and one man, their mean age was 63 years. Six melanomas were located in the foot, one in the leg, one in the anus and one in the neck. All were Clark's levels III, IV or V, and their mean tumor thickness was 5.7 mm. Four out of nine patients had regional lymph node metastasis. Six melanomas were associated with VIT and three with LAC. Three patients developed the depigmentation after chemo- or chemoimmunotherapy. All nine patients are alive (100%) with a mean follow-up of 55 months (9-141), eight out of nine have no evidence of tumor. CONCLUSIONS: From these data it may be concluded that the study patients with malignant melanoma and VIT or LAC have a higher-than-expected survival according to their prognostic factors. Therefore, the presence of the depigmentation phenomena must be looked for intentionally.

Did cyclodextrin glycosyltransferases evolve from alpha-amylases?

The hydrolytic enzymes, alpha-amylases, and the cyclodextrin glycosyltransferases (CGTases) are key enzymes in the depolymerization of starch. These two groups of enzymes are evolutionarily related. We propose that the transferase activity is likely to have evolved from an ancestral hydrolase. Sequence analysis provides support for this hypothesis. Consequently, we have conducted an experimental study to test the possible adaptive value for evolving a CGTase. We found that when an alpha-amylase and a CGTase are combined more glucose is generated from starch than would be expected from the independent action of either of these enzymes. Thus, we propose that the biological role of CGTases is to work in concert with alpha-amylases for the efficient saccharification of starch. This observation can be useful in industrial processes aimed at producing syrups with high contents of glucose or maltose.

Combinatorial libraries of proteins: analysis of efficiency of mutagenesis techniques.

A number of considerations are made on the efficiency of mutagenesis techniques used in protein engineering, particularly those that include a random component. The expected outcome of different protocols is analyzed using computer programs. Special emphasis is made on the effect that the degeneracy of the genetic code has on the bias of the representation of amino acid replacements. The consequences of using alternative methods is analyzed in terms of the likelihood of obtaining underrepresented amino acid substitutions in mutant libraries. A consideration is also made of the outcome of combinatorial mutagenesis experiments with regard to the size of the amino acid window and the multiplicity of replacements that could be sampled with different methods. Optimal mutagenesis rates for specific conditions could be derived from the presented data and the computer program made available with this paper.

[Dermatomyositis and adenosquamous carcinoma of the ovary. Report of a case]. / Dermatomiositis y carcinoma adenoescamoso del ovario. Informe de un caso.

A case of adenosquamous ovarian carcinoma in a 50 years old female is reported. The patient had marked improvement of her symptoms after resection of the tumor and chemotherapy. The knowledge of this association forces to rule out an ovarian carcinoma.

[Acute appendicitis in children. Experience at a general hospital]. / Apendicitis aguda en el niño. Experiencia en un hospital general.

In order to establish a guide for the diagnosis of acute appendicitis, we reviewed the charts of patients with appendectomy. In a 7-year period, 385 patients were studied. The age range was 3 to 15 years. In 53% there was an administration of medications prior to surgery. Perforated appendicitis was found in the majority (53%) of the cases. We could not find any association between age and perforation. Only localized, persistent abdominal pain, peritoneal irritation, anorexia, and vomiting were useful for differential diagnosis. In patients with acute appendicitis (p greater than 0.05), leukocytosis (greater than 10,000/mm3), neutrophilia (greater than 70%) and bands (greater than 3%) were observed in 80% of the cases. The frequency of complications was elevated (39.5%), and the mortality was five times higher than referred in other studies. We propose an algorithm for both opportune diagnosis and treatment of the disease.

[Analysis of 52 pregnancies with intrauterine devices]. / Análisis de 52 embarazos con dispositivo intrauterino.

PIP: This study presents the clinical evalaution of 52 pregnancies in IUD users. 76.9% were between 17 and 30 years of age, and 61.5% had 2 or less deliveries. 48 of the 52 women wore a Lippes Loop device; the majority of pregnancies had occurred within the 1st 12 months after IUD insertion. In 18 cases the device strings were visible; in 6 of these cases the device was removed by pulling the string; 2 women aborted and 4 delivered at term. There were, in total, 21 spontaneous abortions, or 45.7% of cases, 7 premature deliveries, or 15.2% of cases, and 18 deliveries at term of 39.1% of cases. There were 2 ectopic pregnancies. After delivery only 7 women, or 13.5%, requested insertion of another IUD; 34.6% preferred hormonal contraception, 26.9% chose tubal sterilization, and 25% chose local contraception.^ieng

Analisis de 52 embarazos con dispositivo intrauterino. / Analysis of 52 pregnancies with intrauterine device

Se analizaron prospectivamente 52 embarazos accidentales con dispositivo intrauterino (DIU) in situ. Se observo que el 76,8 por ciento de las usuarias eran mujeres con menos de 30 anos y con dos o menos partos previos en el 61,5 por ciento. La frecuencia del embarazo simultaneo con un DIU incrementa las complicaciones relacionadas con el embarazo y por consiguiente,el numero de consultas y estancia hospitalaria