Incidencia de diabetes gestacional en Chile durante el periodo 2001-2022

Introducción: La diabetes mellitus gestacional (DG) se define como una hiperglucemia que se diagnostica por primera vez durante la gestación. Objetivo: Describir la incidencia de diabetes gestacional (DG) durante el periodo 2001-2022 en Chile. Método: Estudio observacional, descriptivo, ecológico y longitudinal. Se incluyeron los egresos hospitalarios consignados como diabetes durante el embarazo y DG en el periodo 2001-2022, de la base de datos del Departamento de Estadística e Información en Salud. Se determinó la incidencia de DG por la cantidad de partos institucionalizados, para cada año. Se analizaron la tendencia en el periodo y las diferencias entre regiones. Resultados: Se determinó un aumento de 2,615 casos de DG por 1000 partos atendidos por año en el periodo 2001-2022. En particular, en el periodo 2016-2022 la incidencia aumentó hasta 6,746 casos de DG por 1000 partos por año. En el año 2022, la región de La Araucanía presentó una incidencia de 284,4 casos por 1000 partos, lo que representa un aumento del 503% en relación con la incidencia media nacional (56,5 casos por 1000 partos). Conclusiones: Se demuestra un aumento significativo de la DG, en especial desde 2016. La situación en La Araucanía podría relacionarse con los niveles de pobreza multidimensional.

Introduction: Gestational diabetes mellitus (GDM) is defined as hyperglycemia first diagnosed during pregnancy. Objetive: To describe the incidence of gestational diabetes (GD) during the period 2001-2022 in Chile. Method: Observational, descriptive, ecological, longitudinal study. Hospital records of diabetes during pregnancy and GD in the period 2001-2022 were included, from the database of the Department of Statistics and Health Information. The incidence of GD was determined by the number of births, for each year. Trends in the period and differences between regions were analysed. Results: The results show an increase of 2.615 GD cases per 1000 births per year in the period 2001-2022. Particularly, in the period 2016-2022 the incidence increased to 6.746 cases of GD per 1000 births per year. In 2022, La Araucanía region presented an incidence of 284.4 cases per 1000 births, which represents an increase of 503% in relation to the mean national incidence (56.5 cases per 1000 births). Conclusions: A significant increase in DG is demonstrated, especially since 2016. The situation in La Araucanía could be related to the levels of multidimensional poverty.

COVID-19 on Pregnancy Outcomes, Mental Health and Placenta: Focus in Latin America.

The COVID-19 pandemic has impacted many aspects of health and society worldwide. One vulnerable group that faced SARS-CoV-2 infection is pregnant women, who were considered to have potentiated risk factors. In physiological pregnancy, maternal systems have several changes and adaptations to support fetal development. These changes involve regulations of cardiovascular, respiratory, and immunologic systems, among others, which SARS-CoV-2 could severely alter. Furthermore, the systemic effects of viral infection could be associated with placental dysfunction and adverse pregnancy outcomes, which have been studied from the start of the pandemic to date. Additionally, pregnancy is a condition of more significant mental health vulnerability, especially when faced with highly stressful situations. In this chapter, we have collected information on the effect of COVID-19 on maternal mortality, the SARS-CoV-2 infection rate in pregnancy, and the impact on pregnancy outcomes, maternal mental health, and placental function, with a particular focus on studies that consider the Latin American population.

Tear gas exposure and its association with respiratory emergencies in infants and older adults during the social uprising of 2019 in Chile: an observational, longitudinal, repeated measures study.

OBJECTIVE: To evaluate if extensive use of tear gas during the Chilean social uprising of 2019 was associated with a higher frequency of respiratory emergencies and bronchial diseases in a residential vulnerable population. DESIGN: Observational, longitudinal, repeated measures study. SETTINGS: Six healthcare centres (one emergency department and five urgent care centres) in the city of Concepción, Chile during 2018 and 2019. PARTICIPANTS: This study was conducted on daily respiratory emergencies and diagnosis. Daily frequency of urgency and emergency visits are administrative data, publicly available and previously de-identified. PRIMARY AND SECONDARY OUTCOME MEASURES: Absolute and relative frequency of daily respiratory emergencies in infants and older adults. A secondary outcome was the relative frequency of bronchial diseases (International Classification of Diseases 10th Revision, ICD-10: J20-J21; J40-J46) in both age groups. We finally measured the rate ratio (RR) of bronchial diseases above the daily grand mean, since the number of visits with these diagnoses in several days was zero. Tear gas exposure was assessed as the uprising period. Models were adjusted by weather and air pollution information. RESULTS: Percentage of respiratory emergencies during the uprising rose by 1.34 percentage points (95% CI 1.26 to 1.43) in infants and 1.44 percentage points (95% CI 1.34 to 1.55) in older adults. In infants, the emergency department experienced a larger increment in respiratory emergencies (6.89 percentage points; 95% CI 1.58 to 2.28) than the urgent care centres (1.67 percentage points; 95% CI 1.46 to 1.90). The RR of bronchial diseases above the daily grand mean during the uprising period was 1.34 in infants (95% CI 1.15 to 1.56) and 1.50 in older adults (95% CI 1.28 to 1.75). CONCLUSIONS: The massive use of tear gas increases the frequency and probability of respiratory emergencies and particularly bronchial diseases in the vulnerable population; we recommend revising public policy to restrict its use.

Recruitment strategies in couple intervention studies: A systematic review of recruitment methods and sample characteristics in the United States from 2015 to 2020.

Including diverse participants in couple intervention studies is critical for developing an evidence base that informs best practices for all potential clients. Research has shown that subgroups of clients respond differently to different interventions and that interventions that have been adapted to fit the needs of a given population are more effective than non-adapted interventions. Unfortunately, couple intervention samples often exclude participants with marginalized identities and culturally adapted couple intervention research is limited. The lack of information about best practices for diverse client subgroups perpetuates mental and relational health disparities. We conducted a systematic review to examine recruitment strategies and sampling characteristics of diverse races/ethnicities, incomes, ages, and sexual identities. We reviewed articles published between January 2015 and December 2020. Articles were eligible for inclusion in our review if they implemented an intervention with couples in the United States. Of 4054 articles identified, 54 articles were eligible for our review. Findings suggest that couple intervention studies lack diversity across multiple identity domains (i.e., races/ethnicities, incomes, ages, and sexual identities). Further, descriptions of recruitment strategies are often vague, limiting opportunities to better understand methods used to recruit diverse samples.

Couple and family interventions for depressive and bipolar disorders: Evidence base update (2010-2019).

This article systematically reviews the evidence base for couple and family interventions for depressive and bipolar disorders published from 2010 to 2019. Included in the review were intervention studies on depression for couples (n = 6), depression for families (n = 13), and bipolar for families (n = 5); zero studies on couple interventions for bipolar were located. Well-established interventions include cognitive and/or behavioral couple and family interventions for depression and psychoeducational family interventions for bipolar. Attachment-based couple and family interventions for depression are probably efficacious. Finally, family psychoeducation for depression is possibly efficacious, and integrative couple interventions and family play-based interventions for depression are experimental. Couple and family interventions also improved relationship dynamics, which is noteworthy since poor relationships are associated with non-remission, relapse, and recurrence of depressive and bipolar symptoms. Future research is needed on couple interventions for bipolar disorders and interventions for minoritized populations.

Representation of Diverse Populations in Couple and Family Therapy Intervention Studies: A Systematic Review of Race/Ethnicity, Sexual Orientation, Age, and Income in the United States from 2014 to 2019.

Disparities in mental health care among marginalized populations have been well-documented. Without research designed to study interventions for diverse populations, disparities in the quality of services will persist. A systematic review of articles evaluating couple and family therapy (CFT) interventions was conducted to evaluate the representation of diverse populations. More specifically, researchers sought to examine race/ethnicity, sexual orientation, income level, and age of sample participants. One hundred ninety-six studies evaluating CFT interventions in the United States in ten journals were included in the analysis. Findings indicate that family therapy research is more representative of racial minority and low-income participants compared with studies of couple interventions. Couple therapy research is often still conducted with predominately white, middle- to high-income samples. Following whites, African Americans and Hispanic/Latinos were the most common racial/ethnic groups included in both couple therapy research and family therapy research. Participants in same-sex relationships were absent from family intervention research and under-researched in couple intervention studies. Only one couple therapy study recruited a sample in which the average age was late adulthood. These findings are cause for concern given the widening mental health disparities in the United States.

Las desigualdades en la atención para la salud mental entre poblaciones marginadas están muy bien documentadas. Si no se diseñan investigaciones para estudiar intervenciones orientadas a poblaciones diversas, las desigualdades en la calidad de los servicios y en los resultados de los tratamientos seguirán existiendo. Se realizó un análisis sistemático de artículos que evaluaban las intervenciones de la terapia familiar y de pareja para evaluar la representación de poblaciones diversas. Más específicamente, los investigadores intentaron analizar la raza/etnia, la orientación sexual, el nivel de ingresos y la edad de los participantes de la muestra. Se incluyeron en el análisis ciento noventa y seis estudios que evaluaban las intervenciones de la terapia familiar y de pareja en los Estados Unidos en diez revistas médicas. Los resultados indican que la investigación sobre terapia familiar es más representativa de la minoría racial y de los participantes de bajos recursos en comparación con los estudios de intervenciones para las parejas. La investigación sobre terapia de pareja generalmente se sigue realizando con muestras predominantemente blancas, de ingresos medios y altos. Después de los blancos, los afroestadounidenses y los hispanos/latinos fueron los grupos raciales/étnicos más comunes incluidos tanto en la investigación sobre terapia familiar como en la de pareja. Los participantes de relaciones del mismo sexo estuvieron ausentes en las investigaciones sobre intervenciones familiares y se investigaron poco en los estudios sobre intervenciones para parejas. Solo un estudio sobre terapia de pareja reunió una muestra en la cual la edad promedio fue la edad adulta tardía. Estos resultados son motivo de preocupación teniendo en cuenta las desigualdades crecientes en el ámbito de la salud mental en los Estados Unidos.

The Association of Occupational Psychosocial Factors with the Prevalence of Irritable Bowel Syndrome in the Chilean Working Population.

BACKGROUND: Irritable bowel syndrome (IBS) is a stress-related disease linked to psychosocial factors, though knowledge about its occupational psychosocial aspects is scarce. OBJECTIVE: A cross-sectional study of the prevalence of IBS and its association with occupational psychosocial factors in Chilean workers was conducted. METHODS: IBS prevalence, using the IBS-Rome IV criteria, in the working population was estimated using data from the National Health Survey of 2009. Data on occupational psychosocial aspects were drawn from the Chilean Survey of Employment, Health, and Work of 2009, and allocated to individual survey participants at the occupation-region level. Data on family and community stressors were available at the individual level. Prevalence ratios (PR) for IBS were computed using generalized linear mixed models to account for variability at the group level. RESULTS: The IBS prevalence in the overall working population (weighted n = 5 435 253) was 18.4%, but varied substantially by industry sector. Compared with 'professionals' (IBS prevalence = 7.3%), jobs with high prevalence of IBS included 'health and social work activities' [PR = 4.9; 95% confidence interval (CI) = 1.4-16.7], 'household employment' (PR = 4.8; 95% CI = 1.5-15.9), and 'manufacturing' (PR = 3.5; 95% CI = 1.0-11.8). With Karasek Job Demand Control scores assigned to occupations within regions, high job demand doubled the prevalence of IBS (PR = 2.0; 95% CI = 1.4-2.9), whereas high-skill discretion was associated with lower prevalence of IBS (PR = 0.6; 95% CI = 0.4-0.8). There was also evidence that these two factors were not independent; high-skill discretion appeared to buffer the effect of high job demand on IBS prevalence (P < 0.001). CONCLUSIONS: Occupational factors were associated with IBS prevalence, showing effects as important as those for non-occupational stresses such as civic insecurity or having health problems. High job skill discretion appeared to reduce the prevalence of IBS in the presence of high job demands. Given its high overall prevalence and poorly understood risk factors, further research on occupational psychosocial factors of IBS is warranted.

Factores asociados a la asistencia del paciente al tratamiento antituberculoso / Factors associated with the attendance of the patient to the anti-tuberculosis treatment

Objetivo: determinar algunos factores asociados a la asistencia al tratamiento antituberculoso en pacientes del Programa de Control de Tuberculosis (PCT) en el Hospital de Puente Piedra y en Centro Materno Infantil Zapallal de Puente Piedra - 2008. Material y métodos: diseño descriptivo transversal. La población estuvo conformada por 77 pacientes con diagnóstico de tuberculosis pulmonar de 18 - 60 años inscritos en el PCT. La recolección de datos se realizó a través de dos instrumentos: la ficha de revisión documental y un cuestionario estructurado. El análisis de los datos fue realizado con el programa SPSS. Resultados: del total de pacientes, el 39% presenta asistencia discontinua al PCT, los factores asociados a la asistencia discontinua son: hacinamiento (OR: 7,11); tipo de trabajo independiente (OR: 7,27); condición de trabajo eventual (OR: 9,60); ingreso económico bajo (OR: 4,04); falta de apoyo familiar (OR: 2,83), y falta de información básica sobre la enfermedad (OR: 7,00). Conclusiones: los factores asociados a la asistencia discontinua con mayor significancia fueron: hacinamiento, tipo de trabajo independiente y eventual, no tener apoyo familiar, y no tener información básica sobre la enfermedad.

Objetive: To define certain factors associated with the attendance to the anti-tuberculosis treatment in patients from the Tuberculosis Control Program in the Puente Piedra Hospital and the Puente Piedra Zapallal Mother and Child Center û 2008. Material and Methods: Cross-descriptive design. The population consisted of 77 patients from 18 to 60 year-old with a pulmonary tuberculosis diagnosis registered in the PCT. The data recollection was made with two instruments: document review sheet and a structured questionnaire. The data analysis was made with the SPSS program. Results: From the total of patients, 39% presents discontinuous attendance to the PCT. The associated factors to the discontinuous attendance are: overcrowded housing (OR: 7.11), independent work (OR: 7.27), casual work condition (OR: 9.60), low income (OR: 4.04), lack of family support (OR: 2.83), lack of basic information aboutthe sickness (OR: 7.00). Conclusions. The factors associated with the discontinuous attendance with greater significance were: overcrowded housing, independent and casual work, lack of family support, lack of basic information about the sickness.

Malformación venosa glómica / Glomus venous malformation

Malformaciones venosas glómicas son formaciones tumorales derivadas del cuerpo glómico. Se presentan clínicamente como pequeñas lesiones sobreelevadas, color azulado, con síntomas específicos: dolor e hipersensibilidad a la palpación y sensibilidad a la temperatura. Localizan especialmente a nivel distal de las extremidades y con menos frecuencia en otras zonas de cuerpo. Tiene una mayor incidencia en mujeres entre la tercera y cuarta década. Presentamos una paciente de 19 años con glomangiomas múltiples y acantosis nigricans.

Glomus venous malformations are tumors resulting from the glomicbody that present clinically as small lesions over-bluish color, charac-terized by the presence of specifi c symptoms: pain and hypersensitiv-ity to palpation and sensitivity to temperature. They are usually foundon limbs, and less frequently in other locations. They have a higher incidence in women between the third and fourth decades. We present thecase of a 19 year-old female patient with multiple glomangiomas andacantosis nigricans.

Indice CPOD, capacidad amortiguadora salival, niveles salivales de Streptococcus mutans y anticuerpos IgA, en escolares de la ciudad de México / DMFT Index, salivary buffer capacity, salivary Streptococcus mutans levels and IgA antibodies in schoolchildren form Mexico city

A 139 estudiantes de 12 a 15 años de edad, se les levantó el índice CPOD y en sus salivas se determinó: la capacidad amortiguadora, cantidad de colonias de Streptococcus mutans como un grado de infección, la respuesta de anticuerpos de tipo IgA salival contra los antígenos I/II de Streptococcus mutans mediante ELISA, y la especificidad de esta reacción se corroboró mediante inmunoelectrotransferencia (western blot). El índice CPOD presentó una mediana de 4, la capacidad amortiguadora de la saliva mostró una mediana de 2, que correspondió a una capacidad amortiguadora media, la prevalencia de la infección por el microorganismo mencionado fue de 94.2 por ciento, la mediana del grado de infección fue de 2, lo que indica una infección moderada en la población de estudio y el título de anticuerpos de tipo IgA salival contra antígenos I/II de S. mutans mostró una mediana de 0.170. Al realizar una correlación bivariada de Spearman entre la capacidad amortiguadora y título de anticuerpos IgA salivales contra Streptococcus mutans, se observó una correlación positiva (r = 0.126, P = 0.042). No se encontró correlación estadísticamente significativa entre el resto de variables. Conclusión: En la población estudiada el índice CPOD mostró una mediana de 4, con respecto a la saliva: se encontró una alta prevalencia de la presencia de S. mutans, observándose un moderado grado de infección, una capacidad amortiguadora media y se observó una correlación positiva estadísticamente significativa entre la capacidad amortiguadora y el título de anticuerpos IgA salivales contra antígenos I/II de Streptococcus mutans que resultó específica al determinarla mediante inmunoelectrotransferencia.