Distribution of papA and papG Variants among Escherichia coli Genotypes: Association with Major Extraintestinal Pathogenic Lineages.

The pyelonephritis-associated fimbria (P fimbria) is one of the most recognized adhesion determinants of extraintestinal pathogenic Escherichia coli strains (ExPECs). Twelve variants have been described for the gene encoding the P fimbria major structural subunit PapA and three variants for the gene encoding the adhesin subunit PapG. However, their distribution among the ExPEC diversity has not been comprehensively addressed. A complete landscape of that distribution might be valuable for delineating basic studies about the pathogenicity mechanisms of ExPECs and following up on the evolution of ExPEC lineages, particularly those most epidemiologically relevant. Therefore, we performed a massive descriptive study to detect the papA and papG variants along different E. coli genotypes represented by genomic sequences contained in the NCBI Assembly Refseq database. The most common papA variants were F11, F10, F48, F16, F12, and F7-2, which were found in significant association with the most relevant ExPEC genotypes, the phylogroups B2 and D, and the sequence types ST95, ST131, ST127, ST69, ST12, and ST73. On the other hand, the papGII variant was by far the most common followed by papGIII, and both were also found to have a significant association with common ExPEC genotypes. We noticed the presence of genomes, mainly belonging to the sequence type ST12, harboring two or three papA variants and two papG variants. Furthermore, the most common papA and papG variants were also detected in records representing strains isolated from humans and animals such as poultry, bovine, and dogs, supporting previous hypotheses of potential cross-transmission. Finally, we characterized a set of 17 genomes from Chilean uropathogenic E. coli strains and found that ST12 and ST73 were the predominant sequence types. Variants F7-1, F7-2, F8, F9, F11, F13, F14, F16, and F48 were detected for papA, and papGII and papGIII variants were detected for papG. Significant associations with the sequence types observed in the analysis of genomes contained in the NCBI Assembly Refseq database were also found in this collection in 16 of 19 cases for papA variants and 7 of 9 cases for the papG variants. This comprehensive characterization might support future basic studies about P fimbria-mediated ExPEC adherence and future typing or epidemiological studies to monitor the evolution of ExPECs producing P fimbria.

Novel Megaplasmid Driving NDM-1-Mediated Carbapenem Resistance in Klebsiella pneumoniae ST1588 in South America.

Carbapenem-resistant Enterobacterales (CRE) is a critical public health problem in South America, where the prevalence of NDM metallo-betalactamases has increased substantially in recent years. In this study, we used whole genome sequencing to characterize a multidrug-resistant (MDR) Klebsiella pneumoniae (UCO-361 strain) clinical isolate from a teaching hospital in Chile. Using long-read (Nanopore) and short-read (Illumina) sequence data, we identified a novel un-typeable megaplasmid (314,976 kb, pNDM-1_UCO-361) carrying the blaNDM-1 carbapenem resistance gene within a Tn3000 transposon. Strikingly, conjugal transfer of pNDM-1_UCO-361 plasmid only occurs at low temperatures with a high frequency of 4.3 × 10-6 transconjugants/receptors at 27 °C. UCO-361 belonged to the ST1588 clone, previously identified in Latin America, and harbored aminoglycoside, extended-spectrum ß-lactamases (ESBLs), carbapenem, and quinolone-resistance determinants. These findings suggest that blaNDM-1-bearing megaplasmids can be adapted to carriage by some K. pneumoniae lineages, whereas its conjugation at low temperatures could contribute to rapid dissemination at the human-environmental interface.

Cellular Immune Response in Patients Immunized with Three Vaccine Doses of Different Vaccination Schemes Authorized by the Chilean Ministry of Health in January 2022.

In December 2019, a case of atypical pneumonia was reported in Wuhan, China. It was named COVID-19 and caused by SARS-CoV-2. In a few months, scientific groups around the world developed vaccines to reduce the disease's severity. The objective was to evaluate the humoral and cellular immune response post immunization with three different vaccination schedules administered in Chile until January 2022. Sixty volunteers were recruited with a three-dose schedule, who had no history of infection nor close contact with a positive patient. IgG against the spike antigenic domain was detected, and the neutralization capacity against two groups of variants, Original/Alpha and Beta/Gamma, was also measured. Finally, the cellular response with interferon release was measured through IGRA. Results showed that there were significant differences in the neutralizing antibodies for the original and alpha variant when comparing three Comirnaty doses with Coronavac and Vaxzevria. A high number of reactive subjects against the different SARS-CoV-2 variants, alpha, gamma, and delta, were observed, with no significant differences between any of the three schemes, confirming the existence of a cellular immune response against SARS-CoV-2. In conclusion, the three vaccine schemes generated a cellular immune response in these volunteers.

[Epidemiological characterization of infection by SARS-CoV-2 of the healthcare workers of a university hospital in Santiago de Chile]. / Caracterización epidemiológica de infección por SARS-CoV-2 del personal de salud de un hospital universitario en Santiago de Chile.

BACKGROUND: The SARS-CoV-2 outbreak originated in the Hubei province in China spread rapidly throughout the world during the first months of 2020. On March 3, the first case was reported in Chile; at 17 days the first case of COVID-19 healthcare worker (HCW) was notified in our institution. AIM: To describe the demographic characteristics and the incidence of SARS-CoV-2 infection in the HCW of a university hospital in Chile. MATERIAL AND METHOD: Retrospective study of SARS-CoV-2 infection on HCW in a university hospital between March 1 and May 31, 2020. RESULTS: There were 273 positive cases. In the period under study, we had an incidence of 5.8%. When we separated the cases into clinical and non-clinical personnel, it was observed that their incidences were practically identical (5.8 vs. 5.7% p = 0.9430). 88% of the officials were oligosymptomatic or asymptomatic at the beginning of the clinical presentation and only 12% had a fever before the medical consultation. CONCLUSION: The incidence reported in the study was around 5 times that reported in Wuhan. If we apply the current definition of cases, we would lose 4 out of 5 cases. 88% of HPW did not present criteria to be considered suspicious, so it would be advisable in HCW to eliminate fever as a criterion to improve the research and trace their contacts on time.

Caracterización epidemiológica de infección por SARS-CoV-2 del personal de salud de un hospital universitario en Santiago de Chile / Epidemiological characterization of infection by SARS-CoV-2 of the healthcare workers of a university hospital in Santiago de Chile

INTRODUCCIÓN: El brote de SARS-CoV-2 originado en la provincia de Hubei en la República Popular China, se fue extendiendo aceleradamente en el mundo durante los primeros meses del año 2020. El 3 de marzo se notificó el primer caso en Chile; a los 17 días se notificó el primer caso de un Personal de Salud (PS) COVID-19 en nuestra institución. OBJETIVO: Describir las características demográficas y la incidencia de infección por SARS-CoV-2 en el PS de un hospital universitario de alta complejidad. MATERIAL Y MÉTODO: Estudio retrospectivo de los casos de infección por SARS-CoV-2 del PS entre el 1 de marzo y 31 de mayo de 2020. RESULTADOS: Hubo 273 casos positivos, con una incidencia de 5,8% en el período en estudio. Al dividir los casos en personal clínico y no clínico se observó que sus incidencias fueron prácticamente idénticas (5,8 vs 5,7% p = 0,9430). El 88% de los funcionarios fue oligo-sintomático o asintomático al inicio del cuadro clínico y sólo 12% tuvo fiebre antes de la consulta médica. CONCLUSIÓN: La incidencia reportada en el estudio fue alrededor de cinco veces la reportada en Wuhan. Al aplicar la definición de casos vigente, se perderían cuatro de cada cinco casos. Destaca que 88% del PS no presentaba criterios para ser considerado sospechoso, por lo que sería recomendable en el PS eliminar la fiebre como criterio para mejorar la pesquisa y trazar sus contactos de forma oportuna.

BACKGROUND: The SARS-CoV-2 outbreak originated in the Hubei province in China spread rapidly throughout the world during the first months of 2020. On March 3, the first case was reported in Chile; at 17 days the first case of COVID-19 healthcare worker (HCW) was notified in our institution. AIM: To describe the demographic characteristics and the incidence of SARS-CoV-2 infection in the HCW of a university hospital in Chile. MATERIAL AND METHOD: Retrospective study of SARS-CoV-2 infection on HCW in a university hospital between March 1 and May 31, 2020. RESULTS: There were 273 positive cases. In the period under study, we had an incidence of 5.8%. When we separated the cases into clinical and non-clinical personnel, it was observed that their incidences were practically identical (5.8 vs. 5.7% p = 0.9430). 88% of the officials were oligosymptomatic or asymptomatic at the beginning of the clinical presentation and only 12% had a fever before the medical consultation. CONCLUSION: The incidence reported in the study was around 5 times that reported in Wuhan. If we apply the current definition of cases, we would lose 4 out of 5 cases. 88% of HPW did not present criteria to be considered suspicious, so it would be advisable in HCW to eliminate fever as a criterion to improve the research and trace their contacts on time.

Maltrato en el noviazgo y estilos de amor en alumnos de secundaria, bachillerato y licenciatura / Dating abuse and love styles in junior high school, high school and undergraduate students

Resumen Algunos estudios señalan la relevancia de investigar acerca del maltrato en las relaciones amorosas durante la adolescencia, lo cual solo ha empezado a investigarse de manera reciente, en comparación con el maltrato en el matrimonio. El objetivo del presente estudio es identificar como se presenta el maltrato en la pareja y los estilos de amor en estudiantes de tres niveles de escolaridad que corresponden a distintas etapas de la adolescencia y juventud temprana. Se trabajó con una muestra de 291 estudiantes, de los cuales 107 eran estudiantes de secundaria, 60 de bachillerato y 123 de licenciatura, a quienes se les aplicó la Escala de Actitudes Amorosas (EAA) (Hendrick & Hendrick, 1986) y el Cuestionario de Maltrato en el Noviazgo (Osorio , 2014). Los resultados muestran bajos niveles de maltrato en el noviazgo, los cuales tienden a incrementarse en el bachillerato, así como un predominio de los estilos de amor Ágape, Eros y Storge en los tres niveles educativos investigados. Asimismo, resalta que, de manera general, la presencia de los estilos de amor Manía, Ágape y Ludus facilitan la presencia de maltrato en las relaciones amorosas en los adolescentes de los niveles escolares del presente estudio.

Abstract Some studies point to the relevance of investigating abuse in romantic relationships during adolescence, which has only begun to be investigated recently, compared to abuse in marriage. The objective of this study is to identify how mistreatment is presented in the couple and love styles in students of three levels of schooling that correspond to different stages of adolescence and early youth. We worked with a sample of 291 students, of which 107 were high school students, 60 high school students and 123 high school students, to whom the Love Attitudes Scale (EAA) (Hendrick and Hendrick, 1986) and the Questionnaire were applied of dating abuse (Osorio , 2014). Results show low levels of courtship abuse, which tend to increase in high school, as well as a predominance of the love styles of Agape, Eros and Storge in the three educational levels investigated. It also emphasizes that, in a general way, the presence of love styles Manía, Ágape and Ludus facilitate the presence of mistreatment in love relationships in adolescents of the school levels of the present study.

Dependencia emocional y mitos del amor en estudiantes de dos niveles educativos / Emotional dependence and love myths in students of two educational levels

Existe una estrecha relación entre la creencia en mitos románticos acerca de las relaciones de pareja y la presencia de dependencia emocional; la literatura ha mostrado que dichas creencias promueven que las necesidades e intereses individuales se dejen en un segundo plano. El objetivo de la presente investigación consistió en identificar si existen diferencias en función del nivel educativo de los individuos en la relación existente entre la presencia de mitos románticos y la dependencia emocional en la relación de pareja y para ello se trabajó con estudiantes mexicanos, 34 de bachillerato y 61 de licenciatura, a quienes se les aplicó la Escala de Mitos, Falacias y Creencias Amorosas Erróneas del Amor Romántico y un cuestionario de Dependencia Emocional. Los resultados muestran que los alumnos de bachillerato tienen puntajes más altos en dependencia emocional y mayor aceptación de los mitos. En el alumnado universitario se encontraron más correlaciones entre mitos y dependencia que en el estudiantado de bachillerato

There is a close connection between emotional dependency and the belief in and romantic myths about relationships ; Literature has shown that such beliefs promote that individual needs and interests be left in the background. The aim of this research was to determine whether the educational level of individuals makes a difference in the connection between romantic myths and emotional dependency in relationships. To this end, the Myths, Fallacies and Erroneous Beliefs on Romantic Love Scale and a Emotional Dependency questionnaire was applied to 34 High School students and 61 College students. Results show that High School students scored higher in emotional dependency and display greater myth acceptance, while College students exhibit greater correlations between myths and dependency than High School students

Impacto de la angiografía coronaria rotacional en la cantidad total de contraste administrado y la exposición a las radiaciones ionizantes en pacientes en los que se realizan procedimientos coronarios invasivos: revisión sistemática y metaanálisis / Impact of rotational coronary angiography in the amount of iodinated contrast and the exposure to ionising radiations in patients undergoing invasive coronary procedures: A systematic review and meta-analysis

Resumen Antecedentes: Los procedimientos coronarios invasivos conllevan la administración de contraste y la exposición a radiaciones ionizantes, comportando un incremento de la morbimortalidad. La angiografía coronaria rotacional (ACR) permite adquirir múltiples proyecciones con una inyección de contraste. Hasta la fecha, no hay metaanálisis específicos comparando la ACR y la angiografía coronaria convencional (ACC) en pacientes en los que se realizan procedimientos coronarios invasivos, tanto diagnósticos como diagnósticos y terapéuticos. El objetivo de este metaanálisis es evaluar el impacto de la ACR en la cantidad de contraste, y la radiación ionizante en procedimientos coronarios invasivos. Métodos: Se realizó una búsqueda en las bases de datos PubMed y Ovid para identificar estudios tanto diagnósticos como diagnósticos y terapéuticos que comparasen ACR y ACC. Los estudios fueron evaluados sobre la calidad y los sesgos, y fueron incluidos si contemplaban alguna de las siguientes variables de valoración: volumen de contraste, radiación ionizante medida como producto dosis-área, Kerma-aire o tiempo de fluoroscopia. Resultados: Dieciséis estudios, totalizando 2,327 pacientes, fueron incluidos en el análisis final (1,146 pacientes recibieron ACR y 1,181, ACC), objetivándose diferencias significativas en volumen de contraste (diferencia estándar de medias (intervalo de confianza al 95%) −1.887 (−2.472 a −1.302); p < 0.001), producto dosis-área (−0.726 (−1.034 a −0.418); p < 0.001), Kerma-aire (−0.842 (−1.104 a −0.581); p < 0.001) y tiempo de fluoroscopia (0.263 (−0.496 a −0.030); p = 0.027). Conclusiones: La ACR permite reducir el volumen de contraste y la radiación, evaluada como producto dosis-área, Kerma-aire y tiempo de fluoroscopia en pacientes a los que se les realizan procedimientos coronarios invasivos.

Abstract Background: Invasive coronary procedures involve the administration of iodinated contrast and the exposure to ionising radiations, increasing morbidity and mortality. The rotational coronary angiography (RCA) allows acquiring multiple projections with a unique injection of iodinated contrast. To date, there are no meta-analyses specifically comparing RCA and conventional coronary angiography (CCA) in patients undergoing invasive coronary procedures, whether diagnostic or diagnostic and therapeutic. The aim of this meta-analysis is to assess the impact of RCA on the amount of iodinated contrast and the exposure to ionising radiations during invasive coronary procedures. Methods: A search in PubMed and Ovid databases was conducted to identify studies, including diagnostic and diagnostic and therapeutic studies, comparing RCA and CCA. The manuscripts were evaluated on quality and biases, and were included if they analysed any of the following endpoints: volume of contrast and exposure to ionising radiations measured as dose-area product, and Kerma-air or fluoroscopy time. Results: Sixteen studies, with a total of 2,327 patients, were included in the final analysis (1,146 patients underwent RCA and 1,181 patients underwent CCA), with significant differences being detected in volume of contrast (standard difference in means (95% confidence interval) −1.887 (−2.472 to −1.302); P < .001), dose-area product (−0.726 (−1.034 to −0.418); P < .001), Kerma-air (−0.842 (−1.104 to −0.581); P < .001), and fluoroscopy time (0.263 (−0.496 to −0.030); P = .027). Conclusions: RCA reduces the volume of contrast and the exposure to radiation, evaluated as dose-area product, Kerma-air, and fluoroscopy time, in patients undergoing invasive coronary procedures.

[Impact of rotational coronary angiography in the amount of iodinated contrast and the exposure to ionising radiations in patients undergoing invasive coronary procedures: A systematic review and meta-analysis]. / Impacto de la angiografía coronaria rotacional en la cantidad total de contraste administrado y la exposición a las radiaciones ionizantes en pacientes en los que se realizan procedimientos coronarios invasivos: revisión sistemática y metaanálisis.

BACKGROUND: Invasive coronary procedures involve the administration of iodinated contrast and the exposure to ionising radiations, increasing morbidity and mortality. The rotational coronary angiography (RCA) allows acquiring multiple projections with a unique injection of iodinated contrast. To date, there are no meta-analyses specifically comparing RCA and conventional coronary angiography (CCA) in patients undergoing invasive coronary procedures, whether diagnostic or diagnostic and therapeutic. The aim of this meta-analysis is to assess the impact of RCA on the amount of iodinated contrast and the exposure to ionising radiations during invasive coronary procedures. METHODS: A search in PubMed and Ovid databases was conducted to identify studies, including diagnostic and diagnostic and therapeutic studies, comparing RCA and CCA. The manuscripts were evaluated on quality and biases, and were included if they analysed any of the following endpoints: volume of contrast and exposure to ionising radiations measured as dose-area product, and Kerma-air or fluoroscopy time. RESULTS: Sixteen studies, with a total of 2,327 patients, were included in the final analysis (1,146 patients underwent RCA and 1,181 patients underwent CCA), with significant differences being detected in volume of contrast (standard difference in means [95% confidence interval] -1.887 [-2.472 to -1.302]; P<.001), dose-area product (-0.726 [-1.034 to -0.418]; P<.001), Kerma-air (-0.842 [-1.104 to -0.581]; P<.001), and fluoroscopy time (0.263 [-0.496 to -0.030]; P=.027). CONCLUSIONS: RCA reduces the volume of contrast and the exposure to radiation, evaluated as dose-area product, Kerma-air, and fluoroscopy time, in patients undergoing invasive coronary procedures.

Relations of Metabolically Healthy and Unhealthy Obesity to Digital Vascular Function in Three Community-Based Cohorts: A Meta-Analysis.

BACKGROUND: Microvascular dysfunction is a marker of early vascular disease that predicts cardiovascular events. Whether metabolically healthy obese individuals have impaired microvascular function remains unclear. The aim of this study was to evaluate the relation of obesity phenotypes stratified by metabolic status to microvascular function. METHODS AND RESULTS: We meta-analyzed aggregate data from 3 large cohorts (Brazilian Longitudinal Study of Adult Health, the Framingham Heart Study, and the Gutenberg Heart Study; n=16 830 participants, age range 19-90, 51.3% men). Regression slopes between cardiovascular risk factors and microvascular function, measured by peripheral arterial tonometry (PAT), were calculated. Individuals were classified as normal-weight, overweight, or obese by body mass index (BMI) and stratified by healthy or unhealthy metabolic status based on metabolic syndrome using the ATP-III criteria. Male sex, BMI, and metabolic risk factors were associated with higher baseline pulse amplitude and lower PAT ratio. There was stepwise impairment of vascular measures from normal weight to obesity in both metabolic status strata. Metabolically healthy obese individuals had more impaired vascular function than metabolically healthy normal-weight individuals (baseline pulse amplitude 6.12±0.02 versus 5.61±0.01; PAT ratio 0.58±0.01 versus 0.76±0.01, all P<0.0001). Metabolically unhealthy obese individuals had more impaired vascular function than metabolically healthy obese individuals (baseline pulse amplitude 6.28±0.01 versus 6.12±0.02; PAT ratio 0.49±0.01 versus 0.58±0.01, all P<0.0001). CONCLUSIONS: Metabolically healthy obese individuals have impaired microvascular function, though the degree of impairment is less marked than in metabolically unhealthy obese individuals. Our findings suggest that obesity is detrimental to vascular health irrespective of metabolic status.

Evaluación de la microfiltración apical de BiodentineTM como material de obturación apical mediante el transporte de fluidos computarizado / Evaluation of the apical microleakage of BiodentineTM when used as an apical sealing material, using computerized fluid dynamics

Objetivo: evaluar la capacidad de BiodentineTM para resistir la microfiltración cuando es usado como material de retroobturación medianteun sistema de transporte de fluidos computarizado. Metodología: En este estudio se utilizaron 60 raíces de dientes unirradiculares, se instrumentaron y obturaron con el sistema de cono único estandarizadodel sistema ProTaper (Dentsply, Maillefer, Suiza) con ultrasonido,utilizando el sellador de conductos radiculares Silco (Silva-Collyan SLP,México). Se hizo la preparación de la cavidad retrógrada con ultrasonidoutilizando la punta E31D del sistema Retro Kit (NSK Company, Japón),con un diámetro de 2 mm. Se llevó a cabo la retroobturación con cada uno de los cementos a evaluar; grupo 1: bturados con Biodentine™ (Septodont, Francia), grupo 2: obturados con MTA Gris (Angelus™, Londrina PR, Brasil), grupo 3: control. Se utilizó un software creado específi camente para evaluar microfi ltración; éste, por medio de sensores infrarrojos, detecta la variación de voltaje de una burbuja de aire dentro de un capilar. El programa expresa el tiempo que tarda la burbuja en pasar por el segundo sensor (mm/min), los cuales se convierten a μL/min, para después expresarlos en unidades de fi ltración, realizándosemediciones en un solo lapso. Resultados: La evaluación en este estudio de la microfi ltración apical de Biodentine™ y MTA Gris Angelus™, arrojó resultados favorables para ambos; se comprobó que no existe diferencia signifi cativa en cuanto a la microfiltración entre ellos; sin embargo, ambos materiales mostraron diferentes características en cuanto a su manipulación, tiempo de fraguado y porosidad. No se presentódiferencia estadísticamente significativa entre los grupos (p = 0.256) U Mann-Whitney y Kruskal Wallis. Conclusión: El Biodentine™ y TA Gris AngelusTM presentan un comportamiento óptimo para la obturación retrógrada. Se requiere realizar otros estudios en cuanto a la interfase con la estructura dentinaria.

Objective: To evaluate, using computational fl uid dynamics, the ability of BiodentineTM to resist microleakage when used as a retro-sealing material. Methodology: In this study, 60 single-rooted teeth were used, which were biomechanically prepared and fi lled using the standardized ProTaper single-cone technique (Dentsply, Maillefer, Switzerland) and ultrasound, using Silco root-canal sealer (Silva-Collyan, SLP, Mexico). The retrograde cavity was prepared using ultrasound and a Retro Kit (NSK Company, Japan) E31D 2 mm-diameter tip. Retrograde fi lling was performed using each of the sealers to be evaluated, as follows: group 1: sealed with BiodentineTM (Septodont, France); group 2: sealed with Grey MTA (AngelusTM, Londrina PR, Brazil); group 3: control. A specially designed software was used, which measures microleakage by using infrared sensors to detect changes in voltage in an air bubble within a capillary tube. The software expresses the time it takes (mm/min) for the bubble to pass through the second sensor, then converts these measurements into μL/min to express the rate of leakage. All of the measurements are taken considering a single interval. Results: The results of the evaluation of the apical microleakage of BiodentineTM and MTA Grey AngelusTM obtained in this study were, in both cases, favorable, proving that there is no signifi cant difference between the two in this respect. However, the characteristics of each in terms of their handling, setting time, and porosity differed. No statistically signifi cant difference between the Mann-Whitney U group and the Kruskal-Wallis group was found (p = 0.256). Conclusion: The performance of Bio-dentineTM and Gray MTA AngelusTM is ideal for retrograde fi lling pur-poses. Further studies are needed, including SEM analysis, in order to determine the quality of the seal, with respect to the interface formed with the dentin structure.

Intervenciones terapéuticas para la conducta suicida en adolescentes / Therapeutic interventions in suicidal behavior teens

La conducta suicida presenta un amplio espectro de comportamientos que constituyen un continuo. En la población adolescente en Chile, las ideas de muerte llegan a presentarse hasta en el 62% y se ha observado que los trastornos del ánimo, esquizofrenia, consumo de sustancias, están fuertemente asociados a la conducta suicida tanto en la evidencia internacional como nacional. La conducta suicida tiene una naturaleza compleja y multifactorial, influyendo sobre ella aspectos biológicos, psicológicos, psiquiátricos, familiares y socio-culturales, lo cual complejiza el diseño de una intervención terapéutica eficiente. Este artículo presenta una revisión actualizada de las intervenciones terapéuticas para adolescentes con conducta suicida. Se expone la principal evidencia y el nivel de efectividad de las estrategias de intervención.

Suicidal behavior has a wide spectrum of behaviors that constitute a continuum. In the adolescent population in Chile, the ideas of death occur in up to 62% of adolescents, and it has been observed that mood disorders, schizophrenia, and substance abuse are strongly associated with suicidal behavior in both international and national evidence. Suicidal behavior is of a complex and multifactorial nature, influenced by biological, psychological, psychiatric, familiar and socio-cultural aspects, which complicate the design of efficient therapeutic intervention. This article presents a current review of therapeutic interventions for adolescents with suicidal behavior. The main evidence and the level of effectiveness of intervention strategies are presented.

Efectos de actividades fonológicas en el vocabulario, las habilidades psicolingüísticas y los procesos lectores de niños de primer grado / Effects of phonological activities on vocabulary, psycholinguistic abilities and reading processes in first grade children / Efeitos de atividades fonológicas no vocabulário, nas habilidades psicolinguísticas e nos processos leitores de crianças da primeira série

La adquisición de la lectoescritura involucra diversos procesos que pueden estimularse en contextos cotidianos, como el hogar, y que también pueden ser favorecidos por la instrucción escolar. Se trabajó con un grupo de niños de primer grado de educación primaria en el contexto escolar durante seis meses, realizando actividades que favorecieran el procesamiento fonológico con el objetivo de observar su impacto en la conciencia fonológica, sus habilidades psicolingüísticas, su vocabulario y sus habilidades lectoras. Los resultados de la t de Student revelan, de manera general, que tales actividades beneficiaron la conciencia fonológica, el vocabulario y algunas de las habilidades psicolingüísticas. Posteriormente, se identificaron los niños que al final del ciclo escolar habían adquirido la lectoescritura y los que no. Los resultados de la U de Mann-Whitney y de la rho de Spearman sugieren que, a diferencia del vocabulario y las habilidades psicolingüísticas, el nivel de la conciencia fonológica con el cual los niños inician la instrucción lectora, pudo ser un elemento importante para tal logro. También se revela que los niños no lectores tienen un desempeño más bajo en la ejecución de tareas que involucran el canal auditivo, que en las del canal visual.

Literacy acquisition involves different processes that can be stimulated in everyday contexts like home and that can also be favored by schooling. Work was carried out with a group of first grade children at a school setting during six months, through activities favoring phonological processing, with the aim of observing their impact on the phonological awareness, psycholinguistic abilities, and vocabulary and reading skills in these children. Generally, results of the Student's-t test reveal that such activities encourage phonological awareness, vocabulary and some psycholinguistic abilities. A distinction was subsequently drawn between children who had acquired literacy towards the end of the school year and those who had not done so. Results from Mann-Whitney's U and Spearman's rho suggest that, unlike vocabulary and psycholinguistic abilities, the level of phonological awareness with which children start their reading instruction could have been an important element in such an achievement. It is also revealed that, in performing tasks involving the auditory channel, the performance of children who do not read is lower than in tasks involving the visual channel.

A aquisição da lecto-escritura envolve diversos processos que podem estimular-se em contextos cotidianos, como o lar, e que também podem ser favorecidos por a instrução escolar. Trabalhou-se com um grupo de crianças da primeira série da educação primária no contexto escolar durante seis meses, realizando atividades que favorecessem o processamento fonológico com o objetivo de observar seu impacto na consciência fonológica, suas habilidades psicolinguísticas, seu vocabulário e suas habilidades leitoras. Os resultados do t de Student revelam, de maneira geral, que essas atividades beneficiaram a consciência fonológica, o vocabulário e algumas das habilidades psicolinguísticas. Posteriormente, identificaram-se as crianças que no final do ciclo escolar haviam adquirido a lecto-escritura e as que não. Os resultados do U de Mann-Whitney e do rho de Spearman sugerem que, a diferença do vocabulário e das habilidades psicolinguísticas, o nível da consciência fonológica com o qual as crianças começam a instrução leitora, pôde ser um elemento importante para esse sucesso. Revela-se também as crianças não leitores têm um desempenho mais baixo na execução de tarefas que envolvem o canal auditivo, que nas do canal visual.

Relaciones entre estilos de amor y violencia en adolescentes / Relations between love styles and teenage violence

De acuerdo a diversas evidencias, la manera en que los y las adolescentes establecen sus relaciones amorosas podría estar asociada con la violencia producida y recibida en el noviazgo. Para esclarecer cómo se manifiesta esta relación en una muestra de 105 mujeres y 93 hombres, con una edad entre los 13 y los 15 años, en el Estado de México, se aplicaron dos herramientas: la Escala de Actitudes Amorosas (EAA) (Hendrick & Hendrick, 1986) y el Cuestionario sobre Violencia en el Noviazgo (CVN). La evidencia indica que los estilos amorosos predominantes fueron el Storge y el Eros. Los hombres cuyo estilo es Ludus tienen más posibilidades de recibir violencia, en tanto que las mujeres cuyo estilo predominante es el Ágape reciben y ejercen más violencia en sus relaciones amorosas. Dado que este estilo es poco frecuente, se sugiere que en las instituciones educativas se promuevan relaciones de noviazgo más igualitarias.

According to diverse pieces of evidence, the way in which teenagers establish their romantic relationships could be associated with violence perpetrated and suffered during courtship. Love Attitudes Scale (Hendrick and Hendrick, 1986) and the Questionnaire about Courtship Violence were applied to a sample of 105 women and 93 men, between 13 and 15 years old in order to determine how such a connection is manifested. Evidence showed that prevailing romantic styles were Storge and Eros. Men whose style is Ludus are more prone to suffer violence, whereas women whose prevailing style is Agape are the ones who most suffer and perpetrate violence in their romantic relationships. Due to the fact that this style is not usual, it is suggested that more equal relationships be promoted.

Autopercepción después de seis años de haber sido madre durante la adolescencia y la adultez / Self- Perception After Six Years of Having Been a Mother During Adolescence and Adulthood

La presente investigación tuvo el propósito de explorar la percepción que tienen de si mismas las mujeres que fueron madres por primera vez en la adolescencia y las que lo fueron en la edad adulta. Participaron 92 mujeres, cuyo primogénito tenía una edad promedio de seis años, 38 fueron madres en la adolescencia y 54 en la adultez. Se aplicó la prueba de "Frases Incompletas", analizándose únicamente las áreas de temores, culpa, actitud ante las propias capacidades, metas y toma de decisiones. Se diseñaron ex profeso categorías de análisis que dieran cuenta del contenido de las respuestas. Entre los resultados se destacan las respuestas autoeficaces positivas en las áreas de capacidades y toma de decisiones, principalmente en el grupo de madres adolescentes. Además, éstas evalúan de manera satisfactoria los resultados de sus acciones en mayor porcentaje que las madres adultas. La toma de decisiones en ambos grupos de madres se caracterizó por ser más reflexiva que impulsiva. Estos hallazgos no apoyan las suposiciones de que el embarazo y maternidad adolescentes pueden ser una desventaja para las mujeres jóvenes.

The present research had the purpose of exploring the perception that women who had children at adolescence and those who did at adulthood, have of themselves. 92 Women whose firstborn child was in average 6 years old took part; 38 of which became mothers at adolescence, and 54 who did at adulthood. An Incomplete Phrase test was applied, analyzing only the areas of fears, guilt, attitude towards their own capabilities, goals and decision making. Categories of analysis that gave account of the content of the answers were expressly designed. Amongst the results, the auto-efficient, positive answers in the field of capabilities and decision making, stand out, mainly in the group of teenage mothers. What is more, the latter evaluate the results of their action in a more satisfactory way than the adult mothers. Decision making was more reflexive than impulsive in both groups of mothers. These findings don't support the suppositions that adolescent pregnancy and motherhood can be a disadvantage for young women.

Endocarditis secundaria al uso de catéteres vasculares / Secundary infectious endocarditis to used vascular cateters

Se describen y analizan 19 casos de Endocarditis Infecciosa diagnósticados y tratados entre 1989 y 1993 en el Hospital Central de Valencia y en el Hospital Policlínico Valencia. El 84,2 por ciento de los casos presentaban antecedentes de hospitalización prolongada en las Unidad de Cuidados Intensivos, o de uso de vía endovenoso central. En dos de los casos se demostró una vía endovenosa periférica como fuente de infección, y dos más se infectaron a partir de derivaciones ventrículo cava. Staphylococccus epidermidis fue el agente más frecuente identificado, seguido por Staphylococcus aureus y Pseudomonas aeruginosas. La valvula más frecuentemente afectada fue la tricúspide. La manifestación clínica que más frecuentemente motivó la consulta fue fiebre prolongada. El diagnóstico se realizó en base a los hallazgos clínicos, ecocardiográficos y microbiológicos (Hemocultivos seriados). La complicación más frecuente fue neumonía, aislandose del esputo la misma especie bacteriana que de los hemocultivos. La Endocarditis de cavidades derechas es una entidad a tener presente en los pacientes que han requerido uso de los cateteres endovenosos. El razonamiento clínico, la ecocardiografía y la bacteriológia juegan un rol de primera línea en el diagnóstico definitivo

Control de la resistencia de bacilos gram negativos a aminoglicosidos: resultados de un estudio prospectivo a 3 años con el uso exclusivo de Amikacina / Control of the resistance of Gram-negative bacilli to aminoglycosides

Se presentan los resultados de un estudio a 3 años con el uso de amikacina como aminoglucósido de uso exclusivo en el Instituto Nacional de la Nutrición Salvador Zubirán. En el Período Basal (3 meses) se midió la resistencia de 870 cepas de bacterias gram negativas para amikacina, gentamicina y 233 cepas para tobramicina que en total fue del 3.2%, 17.4% y 11,2% respectivamente. En ese período el consumo proporcional de aminoglucósidios fue de 69% para gentamicina, 30.5% para amikacina y de 0.5% para tobramicina. En el siguiente período, de uso exclusivo de amikacina, se estudió el patrón de sensibilidad de 9,344 cepas de gram negativos a lo largo de 3 años; en este lapso el consumo de amikacina fue del 99.3%de gentamicina del 0.62%, y de tobramicina del 0.08%. Al comparar los dos períodos se muestra que la proporción de cepas resistentes a gentamicina disminuyó al 7.4% (P < 0.0001 mientras que el nivel de resistencia para amikacina no se incrementó significativamente. El análisis de la pediente de la curva que resultó de los porcentajes de cepas resistentes reportados trimestralmente, nuevamente evidenció una significativa disminución de la resistencia a gentamicina (P < 0.005) y globalmente no hubo un aumento de la resistencia a amikacina. Por lo anterior se puede concluir en términos generales que el uso exclusivo de amikacina no se acompaño de un incremento significativo en la aparición de resistencia durante un período de 3 años y, en cambio, la restricción del uso de gentamicina y tobramicina se acompaño de una importante disminución en el nivel de resistencia a estos antibióticos

Tuberculoma hepático producido por Mycobacterium fortuitum: reporte de un caso / Liver tuberculoma induced by Mycobacterium fortuitum: report of a case

Se presenta el caso de una paciente con un tuberculoma hepático producido por Mycobacterium fortuitum. La paciente fue curada con cirurgía y un esquema de antibiótico consiste amikacina y doxiciclina. Este caso constituye la primera publicación de un tuberculoma hepático producido por Mycobacterium fortuitum