Oportunidades de Aprendizaje Matemático para Estudiantes con Discapacidad Intelectual en Escuelas de Educación Especial / Opportunities to Learn Mathematics for Students with Intellectual Disability in Special Education Schools

RESUMEN: En los últimos años se ha ratificado el derecho a una educación de calidad e inclusiva, especialmente de personas en situación de discapacidad, y se ha puesto énfasis en una enseñanza que involucre a los estudiantes en experiencias matemáticas significativas de alta calidad. Sin embargo, son escasas las investigaciones respecto de cuáles son las oportunidades de aprendizaje (ODA) matemático que se proporcionan a estudiantes que presentan algún tipo de discapacidad intelectual. En este escenario, y con el propósito de caracterizar este tipo de oportunidades que se entregan en escuelas especiales, se realizó un estudio de casos múltiple de ocho cursos de primer ciclo básico de distintas escuelas chilenas. Para ello, se recogieron datos por medio del registro y análisis de contenido de las tareas matemáticas en soportes como cuadernos, fichas de trabajos y evaluaciones de cuatro estudiantes de cada uno de los ocho cursos de enseñanza básica que conforman este estudio. El análisis se centró en la categorización por ejes de contenidos, objetivos curriculares, habilidades matemáticas y demanda cognitiva implicadas en las tareas. Los resultados indican que las ODA se focalizan en el desarrollo de aprendizajes de primero y segundo básico, casi exclusivamente en Números y Operaciones, donde las tareas promueven el desarrollo de habilidades de mediana complejidad, y con fuerte carácter procedimental. Se concluye que los estudiantes de escuelas especiales tienen escasas oportunidades en acceder a nociones matemáticas variadas y desarrollar habilidades complejas a través de tareas ricas y desafiantes, limitando así su participación y desarrollo personal.

ABSTRACT: In recent years, the right to quality and inclusive education, especially for people with disabilities, has been ratified and the emphasis has been placed on teaching that involves students in meaningful and high-quality mathematical experiences. However, there is little research on what are the mathematical learning opportunities that are provided to students who have some type of intellectual disability. In this scenario and in order to characterize this type of opportunity offered in special schools, a multiple case study of eight courses in the first basic cycle of different Chilean schools was carried out. For this, data were collected through the registration and analysis of the content of the mathematical tasks in supports such as notebooks, worksheets and evaluations of four students from each of the eight basic education courses that make up this study. The analysis focused on the categorization by content axes, curricular objectives, mathematical skills and cognitive demand involved in the tasks. The results indicate that the mathematical learning opportunities are focused on the development of the first and second basic learning, almost exclusively in the Numbers and operations topics, whose tasks promote the development of medium complexity skills and with a strong procedural nature. It is concluded that students from special schools have few opportunities to access varied mathematical notions and develop complex skills through rich and challenging tasks, thus limiting their participation and personal development.

Treatment with direct-acting antivirals for HCV decreases but does not eliminate the risk of hepatocellular carcinoma.

BACKGROUND & AIMS: Data from Europe and North America have been published regarding the risk of developing hepatocellular carcinoma (HCC) after treatment with direct antiviral agents (DAA). We proposed to evaluate cumulative incidence and associated risk factors for de novo HCC. METHODS: This was a prospective multicentre cohort study from Latin America including 1400 F1-F4-treated patients with DAAs (F3-F4 n = 1017). Cox proportional regression models (hazard ratios, HR and 95% CI) were used to evaluate independent associated variables with HCC. Further adjustment with competing risk regression and propensity score matching was carried out. RESULTS: During a median follow-up of 16 months (IQR 8.9-23.4 months) since DAAs initiation, overall cumulative incidence of HCC was 0.02 (CI 0.01; 0.03) at 12 months and 0.04 (CI 0.03; 0.06) at 24 months. Cumulative incidence of HCC in cirrhotic patients (n = 784) was 0.03 (CI 0.02-0.05) at 12 months and 0.06 (CI 0.04-0.08) at 24 months of follow-up. Failure to achieve SVR was independently associated with de novo HCC with a HR of 4.9 (CI 1.44; 17.32), after adjusting for diabetes mellitus, previous interferon non-responder, Child-Pugh and clinically significant portal hypertension. SVR presented an overall relative risk reduction for de novo HCC of 73% (CI 15%-91%), 17 patients were needed to be treated to prevent one case of de novo HCC in this cohort. CONCLUSIONS: Achieving SVR with DAA regimens was associated with a significant risk reduction in HCC. However, this risk remained high in patients with advanced fibrosis, thus demanding continuous surveillance strategies in this population.

Evaluation of the Accuracy of T-SPOT.TB for the Diagnosis of Ocular Tuberculosis in a BCG-vaccinated, Non-endemic Population.

PURPOSE: To determine the performance of T-SPOT.TB, an interferon gamma release assay test, in patients with ocular tuberculosis (TB) in a BCG-vaccinated, non-endemic population. METHODS: We employed a nested case-control design. In total, 45 subjects were enrolled (23 patients with ocular tuberculosis and 22 patients with other causes of uveitis). A blood sample was collected from each subject, and T-SPOT.TB was executed. Laboratory professionals were blinded to the disease status of each subject. RESULTS: Five patients were excluded because of indeterminate results. The calculated sensitivity and specificity were 0.80 and 0.85, respectively. The positive likelihood ratio was 5.33 and the negative likelihood ratio was 0.23. The overall accuracy of the test was 0.83. CONCLUSIONS: T-SPOT.TB adequately diagnosed ocular TB. This technique is particularly useful in populations where BCG vaccinations are still mandatory.

Fulminant presentation of autoimmune hepatitis: clinical features and early predictors of corticosteroid treatment failure.

BACKGROUND AND AIMS: Classical features of autoimmune hepatitis (AIH) may be altered during the abrupt onset of the disease. Corticosteroid therapy can be life-saving, but its use in the fulminant presentation of AIH (F-AIH) remains controversial. We aimed to assess the clinical features of patients with F-AIH and to describe the role of corticosteroids in this population. PATIENTS AND METHODS: We retrospectively analyzed 154 adult patients with fulminant hepatic failure who were admitted to six liver transplantation (LT) programs. The AIH simplified criteria were used to identify patients with F-AIH. RESULTS: We identified 40 (26%) patients with F-AIH. Compared with other etiologies, patients with F-AIH presented a longer interval from jaundice to encephalopathy (26 vs. 16 days, P=0.02) and a lower Model for End-Stage Liver Disease (MELD) score on admission (29 vs. 33, P=0.002). Overall, 25 (62%) patients with F-AIH underwent LT, eight (20%) patients survived, and seven (18%) died without LT. Seventeen patients received corticosteroids therapy, of whom seven (41%) survived without LT. Among the treated patients, higher MELD score and encephalopathy grade of 3 or more were associated significantly with corticosteroid failure. CONCLUSION: Patients with F-AIH have a more indolent presentation compared with the non-F-AIH population. Altogether, only eight (20%) patients presenting with F-AIH survived without LT. A subset of patients with F-AIH and an initial MELD score less than 27 and low-grade hepatic encephalopathy might benefit from administration of corticosteroids.

Agomelatina: fallo hepático fulminante en paciente con hígado graso / Agomelatine: fulminant liver failure in a patient with fatty liver

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Changing etiologies and outcomes of acute liver failure: perspectives from 6 transplant centers in Argentina.

There is significant geographic variation in the etiologies and prognoses of acute liver failure (ALF). The aims of the present study were to determine the causes and short-term outcomes of ALF in Argentina, to evaluate the performance of prognostic criteria, and to identify clinical prognostic factors of death. We performed a retrospective analysis of 154 adult patients with ALF who were admitted to 6 liver transplantation (LT) programs between June 2005 and December 2011. The most frequent causes of ALF were viral hepatitis B (46 patients or 30%), autoimmune hepatitis (AIH; 40 patients or 26%), and indeterminate causes (40 patients or 26%). No acetaminophen (ACM) overdose was reported. One hundred and twenty one patients (78%) were included on the waiting list, and LT was performed for 83 patients (54%). Overall survival rate is now corected to 73%. Multivariate logistic regression identified 2 independent variables associated with adverse outcomes on admission: a Model for End-Stage Liver Disease (MELD) score ≥ 29 and an encephalopathy grade ≥ 3. In a direct comparison using a receiving operating characteristic curve analysis, the MELD score [C statistic = 0.830, 95% confidence interval (CI) = 0.73-0.93] had better prognostic accuracy for predicting outcomes than the Clichy criteria (C statistic = 0.719, 95% CI = 0.58-0.85) or the King's College criteria (C statistic = 0.631, 95% CI = 0.49-0.77). In conclusion, hepatitis B and AIH were the most frequent causes of fulminant hepatic failure in our series, and no cases of ACM overdosing were identified. A MELD score ≥ 29 and an encephalopathy grade ≥ 3 at admission were associated with death. The MELD score at admission showed the highest prognostic accuracy.

Micropropagation of Glandularia perakii Cov. et Schn. (Verbenaceae), a native species with ornamental potential.

Glandularia perakii is a perennial species with beautiful violet flowers that grows in the stony soil of Mendocine pedemont. A plentiful and prolonged flowering confers it an important ornamental potential. In this paper, a method of propagation of G. perakii from nodal segments is reported. Proliferating microshoot cultures were obtained by placing nodal segment on Murashige and Skoog medium (MS) supplemented with 20 g.L-1 of sucrose without growth regulators. In this medium multiplication rate after 20 days was 7.9. Rooted plants were acclimatized successfully.

Micropropagation of Glandularia perakii Cov. et Schn. (Verbenaceae), a native species with ornamental potential.

Glandularia perakii is a perennial species with beautiful violet flowers that grows in the stony soil of Mendocine pedemont. A plentiful and prolonged flowering confers it an important ornamental potential. In this paper, a method of propagation of G. perakii from nodal segments is reported. Proliferating microshoot cultures were obtained by placing nodal segment on Murashige and Skoog medium (MS) supplemented with 20 g.L-1 of sucrose without growth regulators. In this medium multiplication rate after 20 days was 7.9. Rooted plants were acclimatized successfully.

Acerca de ascetas, místicas y otras anorexias

Síntesis de la clase del 25-6-98 - Seminario del CAP

Enfermedad de Chagas en una comunidad de pequeños mamíferos simpátricos de la reserva nacional de Las Chinchillas / Chagas disease in community of small sympatric mammals from Las Chinchillas national reserve, IV Region, Chile

En la Reserva Nacional Las Chinchillas y alrededores (Aucó, Illapel, IV Región de Chile), ubicada en el centro de una zona hiperendémica de la Enfermedad de Chagas en Chile, se realizó un muestreo dirigido de área, para estudiar los índices de infección por T. cruzi en la comunidad de micromamíferos simpátricos con Chinchilla lanígera. Este roedor hystricognato, ha sido considerado en peligro de extinción, debido a la caza indiscriminada a que fue sometido en el pasado, por el valor y la calidad de su piel. Con trampas para animales vivos se capturaron 126 ejemplares correspondientes a 6 géneros y 7 especies de roedores y una especie marsupial. En cada uno se investigó la presencia de infección por T. cruzi mediante xenodiagnóstico y/o serología. Para ésta, se empleó la Reacción de Hemoaglutinación Indirecta (RHAI) en suero total y en elución desde papel filtro. En total, 13,5% de los animales estudiados resultaron positivos. Se determinó un 20% de positividad de C. lanígera, considerando ambas pruebas diagnósticas, aunque subió a 31,6% en los sometidos sólo a RHAI. El 36,4% de Abrocoma bennetti resultaron positivos a RHAI y 11,1% al xenodiagnóstico, y el 10% de Phyllotis darwini fue positivo al xenodiagnóstico. Estas tres especies señaladas corresponden a las primeras publicaciones de positividad que se han hecho sobre ellas en Chile, aunque ya habíamos comunicado resultados preliminares en algunos eventos. Un 8,3% de ejemplares Octodon degus fueron positivos a RHAI y 12,9% al xenodiagnóstico, alcanzando los más altos índices de infección encontrados hasta ahora en Chile para esta especie. Se concluye que la endemoenzootía chagásica es un importante factor que afecta a estas comunidades. T. cruzi permanece circulando entre estos micromamíferos silvestres, vectorizado por Triatoma spinolai