Efectos de las medidas de restricción sobre la actividad física y conducta sedentaria de niños, niñas y adolescentes durante la pandemia por COVID-19: revisión sistemática / Effects of restriction measures on physical activity and sedentary behavior of children and adolescents during COVID-19 pandemic: a systematic review

Introducción: La pandemia por COVID-19 obligó a los gobiernos a implementar medidas de restricción social para proteger la salud de la población, afectando la calidad de vida de las personas, especialmente en grupos vulnerables como los niños, niñas y adolescentes (NNA). El objetivo de esta revisión sistemática (RS) fue evaluar el efecto de las medidas de restricción sobre la actividad física (AF) y conducta sedentaria (CS) de los NNA. Adicionalmente, se exploraron posibles factores determinantes de estos cambios. Métodos: Se realizó una RS, utilizando tres bases de datos. Se incluyeron estudios observacionales en donde se hubiera analizado la AF y CS de los participantes, utilizando cualquier método de evaluación. Dos investigadores analizaron los estudios, extrajeron los datos y evaluaron la calidad metodológica de los artículos primarios. El metaanálisis se realizó utilizando el modelo de efectos aleatorios, considerando un valor p < 0,05 como estadísticamente significativo. Resultados: Se incluyeron 19 artículos, con una muestra total de 15.095 NNA. La mayoría de los estudios reveló una reducción de la AF y un incremento de la CS en los sujetos, durante los confinamientos por COVID-19. El metaanálisis mostró una caída en la AF total, la AF moderada a vigorosa y un incremento del tiempo de sedentarismo. Diversos factores biodemográficos, familiares y ambientales exacerbaron las variaciones en la AF y la CS de los NNA. Conclusión: Las medidas de restricción aplicadas durante pandemia por COVID-19 redujo la AF e incrementó la CS de los NNA. Factores biodemográficos, familiares y ambientales determinaron estas variaciones.

Introduction: The COVID-19 pandemic forced governments to implement social restriction measures to protect the health of the population, affecting the quality of life of people, especially in vulnerable groups, such as children and adolescents (CA). The objective of this systematic review (SR) was to evaluate the effect of restriction measures on physical activity (PA) and sedentary behavior (SB) of CA. Additionally, possible determining factors of these changes were explored. Methods: An SR was carried out, using three databases. Observational studies were included in which the PA and SB of the participants were analyzed, using any evaluation method. Two investigators analyzed the studies, extracted data, and assessed the methodological quality of the primary articles. The meta-analysis was performed using the random effects model, considering a value of p < 0.05 as statistically significant. Results: 19 articles were included, with a total sample of 15,095 subjects. Most studies revealed a reduction in PA and an increase in SB in subjects during COVID-19 lockdowns. The meta-analysis showed a drop in total PA, moderate to vigorous PA, and an increase in sedentary time. Various biodemographic, family and environmental factors exacerbated the variations in the PA and SB of the CA. Conclusion: The restriction measures applied during the COVID-19 pandemic reduced the PA and increased the SB of the CA. Biodemographic, family and environmental factors determined these variations.

Relación miofuncional y tratamiento de ortodoncia en paciente con síndrome de Turner. Reporte de caso / Myofunctional relation and orthodontic treatment in patient with Turner syndrome. Case report

El síndrome de Turner es un desorden cromosómico, generado por la pérdida parcial o total de un cromosoma X. Las mujeres que lo presentan, pueden tener una serie de altera- ciones físicas y funcionales. El objetivo de este estudio es exponer el caso de una paciente con diagnóstico de síndrome de Turner, hipotonía muscular y maloclusión severa que fue tratada con terapia muscular craneofacial, combinada con ortodoncia en la Unidad de Malformación Craneofacial de la Facultad de Odontología de la Universidad de Chile.

The Turner Syndrome is a chromosome disorder produced by the total or partial absent of an X chromosome. The women who presents Turner syndrome can have a series of physical and functional alterations. The aim of this study is to present the case of a patient diagnosed with Turner syndrome, muscular hypotony and severe malocclusio treated with craneofacial muscular therapy combined with orthodontics at the Craneo- facial Malformations Unit of the Faculty of Dentistry, University of Chile.

Dolor lumbopélvico asociado a discapacidad durante el tercer trimestre de embarazo y su evolución posterior al parto / Lumbopelvic pain associated with disability during the third trimester of pregnancy and its evolution after delivery

RESUMEN El dolor lumbopélvico es una condición muy frecuente, afectando un 50 a 70% de las mujeres durante el embarazo. En la mayoría de los casos ha habido una recuperación al mes o 3 meses postparto. Sin embargo, estudios reportan que la mejoría es incompleta, pudiendo persistir o aumentar años posterior al parto. Esta condición puede causar limitaciones en la vida diaria, provocando algún grado de discapacidad que muchas veces no es abordado con la importancia que se merece. Objetivo Determinar la prevalencia de dolor lumbopélvico y su relación con el grado de discapacidad durante el tercer trimestre de embarazo y 3 meses postparto. Material y método Estudio observacional y cohorte prospectivo; la muestra son 81 mujeres estudiadas en su tercer trimestre de embarazo y 3 meses postparto atendidas durante 2014-2015 en el Departamento de Obstetricia & Ginecología, Clínica Las Condes. Se aplicó un cuestionario y el Índice de discapacidad Oswestry en ambas etapas y autoadministrada. El análisis de datos se realizó con STATA10.0. Resultados El 81,48% de las embarazadas presentaron dolor lumbopélvico, siendo más prevalente y con una asociación significativa en el tercer trimestre (72,84%, p<0,001). El 25,93% de las mujeres lo mantiene después del parto. Existe una asociación significativa entre dolor lumbopélvico y grado de discapacidad (p<0,001), específicamente con actividades de la vida diaria, actividad sexual y actividades domésticas. Conclusiones Existe una alta prevalencia de dolor lumbopélvico en el embarazo, y un porcentaje no menor lo mantiene postparto, y en ambos casos está asociado a un grado de discapacidad.

ABSTRACT Lumbopelvic pain is a very frequent condition that affects between 50 to 70% of pregnant women. In many cases have been a recovery over the month or three months postpartum. However, some studies showed an incomplete improvement, so it could persist or increase through years after childbirth. This condition can cause daily life limitations, it is provoking some disability grade, that many times it didn't understand with the importance that deserve. Aim To identify the lumbopelvic pain prevalence and the relation with disability grade during the third trimester of pregnancy and three months postpartum. Material and Methods Observational and prospective cohort study; the sample was 81 women studied in her third trimester of pregnancy and three months postpartum during 2014-2015 in the "Departamento de Obstetricia & Ginecologia de Clínica Las Condes". It applied a questionnaire and the Oswestry Disability Index in both stages and self-administered. Data analysis was using STATA 10.0 software. Results 81, 48% of pregnant showed lumbopelvic pain, there were being more prevalent and significantly associated with third trimester (72, 84%, p<0,001). 25, 93% of women maintained this condition postpartum. There is a significant association between lumbopelvic pain and disability grade (p<0,001), specifically with daily life, sexual and domestic activities. Conclusions There is a high prevalence of lumbopelvic pain during pregnancy, and not less percentage maintained this condition postpartum, that associated with a high disability grade.

Rehabilitación pelviperineal multimodal en pacientes con incontinencia fecal / Multimodal pelviperineal rehabilitation in patients with fecal incontinence

Fecal incontinence (FI) is associated with low self-esteem and quality of life. Nowadays, multimodal pelviperineal rehabilitation (MPPR) has become the preferred treatment. Purpose: To evaluate our results of multimodal pelviperineal rehabilitation (MPPR) in patients diagnosed with fecal incontinence (FI). Methods: Historic cohort study using a prospectively maintained database from patients with FI that underwent MPPR between years 1999 and 2012. FI was classified according to Jorge-Wexner´s scale, at the beginning (Winitial) and the end (Wfinal) of treatment. In July 2013 a survey was carried out to measure follow-up Wexner score (Wfollow-up) and pelvic muscle training. Statystical analysis was performed using Chi square test, Fisher Test, Mann-Whitney and Odds Ratio. Significant p value < 0.05. Results: One hundred and thirteen patients completed treatment, median age 67 years-old (r: 24-91) and 83 percent female. Median scores for Winitial and Wfinal were 9 points (r: 3-19) and 3 points (r: 0-13), respectively (p < 0.001). In July 2013, 68 (61 percent) patients were available for follow-up. Wexner score at the beginning, end and follow-up were as follows: 9 (i: 3-19), 3 (i:0-12) and 4 (i:0-19), respectively. There were significant differences between Winitial and Wfollow-up (p < 0.001), but not between Wfinal and Wfollow-up (p = 0.23). There were 20 patients (29 percent) who kept training their pelvic muscles and 48 (71 percent) who did it very rarely or did not do it at all. It was the latter group who showed an increased risk to obtain worst score in Wfollow-up (OR = 3.89; CI 95 percent: 1.26-11.9; p = 0.0175). Conclusion: FI patients treated with MPPR show good short and long-term results.

Introducción: La incontinencia fecal (IF) se asocia a menor calidad de vida en quienes la sufren. Actualmente, la rehabilitación pelviperineal multimodal (RPPM) es el tratamiento inicial de elección. Objetivo: Evaluar los resultados de la RPPM en pacientes con IF. Método: Estudio de cohorte histórica de pacientes con IF que recibieron RPPM entre 1999-2012. Se utilizó la escala de Jorge-Wexner para medir laIF, al inicio (Wi) y fin (Wf) del tratamiento. Se aplicó una encuesta en julio de 2013 para medir el Wexner de seguimiento (Ws) y mantención de ejercicios terapéuticos. Análisis estadístico: prueba de c2, prueba exacta de Fisher, Mann-Whitney y Odds Ratio. Significancia estadística p < 0,05. Resultados: Hubo 113 pacientes que completaron el tratamiento. La mediana de edad fue 67 años (i: 24-91) y 83 porciento género femenino. La mediana de Wi fue de 9 puntos (i: 3-19) y la mediana de Wf fue de 3 puntos (i: 0-13) (p < 0,001). Se logró contactar a 68 pacientes para el seguimiento, en ellos la mediana del puntaje de Wi, Wf y Wsfue de 9 (i: 3-19), 3 (i:0-12) y 4 (i:0-19), respectivamente. Hubo diferencia significativa entre Wi y Ws (p < 0,001), pero no entre Wf y Ws (p = 0,23). Veinte pacientes (29 por ciento) realizaron ejercicios terapéuticos regularmente y 48 (71 por ciento) nunca o raramente; este último grupo es factor de riesgo para obtener peores resultados (OR = 3,89; CI 95 porciento: 1,26-11,9; p = 0,0175). Conclusión: El tratamiento con RPPM en pacientes con IF tiene buenos resultados a corto y largo plazo.

Perfil lipídico en mujeres embarazadas sanas de tres regiones de Chile / Lipid profile in healthy pregnant women in three regions of Chile

Antecedentes: Los lípidos plasmáticos maternos durante el embarazo pueden influir en el crecimiento fetal, particularmente en pacientes con diabetes gestacional; estos lípidos cambian su concentración plasmática materna a lo largo de la gestación. Objetivo: Calcular tablas y curvas de lípidos normales según edad gestacional en una población de embarazadas chilenas. Método: Se midió el colesterol total (CT), colesterol LDL (LDL-C) triglicéridos (TG), Colesterol-HDL (HDL-C), y ácidos grasos no esterificados (NEFA), en 94 embarazadas sanas y jóvenes (<33 años, edad media de 27,6 +/- 6,2 años), con peso pregestacional normal (Índice de Masa Corporal entre 20 y 24,9 Kg/m2 y medio de 23,3 +/- 2,0 Kg/m2). Las pacientes provenían de: Hospital Parroquial de San Bernardo, Santiago (n=55), Hospital de Talca (n=2); Hospital del Profesor, Santiago (n=18); Hospital Regional de Concepción (n=9) y Hospital Clínico de la Pontificia Universidad Católica de Chile (n=10). Resultados: Calculamos, para cada uno de los cuatro lípidos, las curvas de percentil 50, percentil 90 y percentil 10, en mg/dL y mmol/l. Los NEFA solo fueron expresados en mmol/l. Incluimos las funciones matemáticas de las curvas de regresión polinomial de los cuatro lípidos con el fin que sean fácilmente reproducibles en otros tamaños. Conclusiones: Calculamos las tablas y curvas de lípidos maternos normales a lo largo del embarazo, que sean aplicables a la población de embarazadas chilenas.

Background: In normal human pregnancy, maternal lipids can modify the rate of fetal growth, particularly in pregnancies with Gestational Diabetes Mellitus (GDM). These lipids change continuously their serum concentration in the mother along the pregnancy. Aim: To calculate tables and curves of normal serum lipids, according to gestational age, in healthy Chilean pregnant women. Methods: We measured total cholesterol (CT), LDL-cholesterol (LDL-C), triglycerides (TG), HDL-Cholesterol (HDL-C), and Non-Esterified Fatty Acids (NEFA) in 94 young and healthy pregnant women (< 33 years, mean age 27.6 +/- 6.2 years), with normal pregestational Body Mass Index (BMI, 20.0-24.9 Kg/m2 , mean value= 23.3 +/- 2.0 Kg/m2). The women of the study were patients of 5 hospitals: Hospital Parroquial de San Bernardo, Santiago (n=55), Hospital de Talca (n=2); Hospital del Profesor, Santiago (n=18); Hospital Regional de Concepción (n=9) and Hospital Clínico de la Pontificia Universidad Católica de Chile (n=10). Results: For each one of the lipids, we calculated curves of 50th, 90th and 10th percentiles, both in mg/dL and mmol/L (the NEFA were expressed only in mmol/L). The mathematical functions of the curves of polynomial regression of all lipids were included in the manuscript, in order to facilitate their reproduction. Conclusions: We calculated tables and curves of normal maternal serum lipids in relation to gestational, in order to make these available for use in the care of Chilean pregnant women.

Stepwise colonization of the Andes by ruddy ducks and the evolution of novel ß-globin variants.

Andean uplift played a key role in Neotropical bird diversification, yet past dispersal and genetic adaptation to high-altitude environments remain little understood. Here we use multilocus population genetics to study population history and historical demographic processes in the ruddy duck (Oxyura jamaicensis), a stiff-tailed diving duck comprising three subspecies distributed from Canada to Tierra del Fuego and inhabiting wetlands from sea level to 4500 m in the Andes. We sequenced the mitochondrial DNA, four autosomal introns and three haemoglobin genes (α(A), α(D), ß(A)) and used isolation-with-migration (IM) models to study gene flow between North America and South America, and between the tropical and southern Andes. Our analyses indicated that ruddy ducks dispersed first from North America to the tropical Andes, then from the tropical Andes to the southern Andes. While no nonsynonymous substitutions were found in either α globin gene, three amino acid substitutions were observed in the ß(A) globin. Based on phylogenetic reconstruction and power analysis, the first ß(A) substitution, found in all Andean individuals, was acquired when ruddy ducks dispersed from low altitude in North America to high altitude in the tropical Andes, whereas the two additional substitutions occurred more recently, when ruddy ducks dispersed from high altitude in the tropical Andes to low altitude in the southern Andes. This stepwise colonization pattern accompanied by polarized ß(A) globin amino acid replacements suggest that ruddy ducks first acclimatized or adapted to the Andean highlands and then again to the lowlands. In addition, ruddy ducks colonized the Andean highlands via a less common route as compared to other waterbird species that colonized the Andes northwards from the southern cone of South America.

[Risk Factors and extraneurological complications of stroke patients]. / Factores de riesgo y complicaciones extraneurológicas de pacientes internados por Accidente Cerebrovascular en el Hospital Nacional de Clínicas de Córdoba.

INTRODUCTION: Stroke is the third leading cause of death globally , act on modifiable risk factors is now the best prevention strategy. Medical complications are common in patients hospitalized for stroke , the valuation of income NIHSS , is associated with the final result in terms of duration of hospitalization, survival and discharge location. OBJETIVE: Determining risk factors ( RF) in patients hospitalized for stroke in Hospital Nacional de Clinicas de Córdoba (HNC) and characterize neurological complications NIHSS relative to income. MATERIAL AND METHODS: Prospective study of patients admitted to the Service of Neurology at HNC diagnosed with the first of September , 2010 to December 30, 2012 , we applied the admission NIHSS scale. Were determined cerebrovascular risk factors , we evaluated neurological complications during hospitalization. RESULTS: The total number of patients admitted for stroke was 200 , with 168 ischemic stroke ( 84%) and hemorrhagic stroke 32 (16 % ) . The FR Hypertension was the most frequent ( 83.5 %), over 40% had 3 or more FR for stroke. Had complications : 32 % of patients , the respiratory infection was the most frequent (14.5 % ). Patients with NIHSS greater than 10 points had a higher rate of complications. CONCLUSION: The multiple RF control is an effective strategy to decrease the incidence of stroke . Prevention of medical complications enable better patient care and reduce morbidity associated with stroke.

El Accidente cerebro vascular (ACV) constituye la tercera causa de muerte a nivel mundial; actuar sobre los factores de riesgo modificables constituye hoy la mejor estrategia de prevención. Las complicaciones médicas son frecuentes en los pacientes internados por ACV; la valoración del NIHSS de ingreso, está asociado al resultado final en términos de duración de internación, supervivencia y ubicación al alta. Objetivo. Determinar los factores de riesgo (FR) en pacientes internados por ACV en el HNC de Córdoba y caracterizar las complicaciones no neurológicas en relación al NIHSS de ingreso. Material y métodos. Estudio prospectivo de pacientes internados en el HNC con diagnóstico de ACV del primero de septiembre de 2010 al 30 de diciembre de 2012, se aplicó la escala de NIHSS al ingreso. Se determinaron los factores de riesgo cerebrovasculares; se evaluaron las complicaciones no neurológicas durante la internación. Resultados. El total de pacientes ingresados por ACV fue de 200, con ACV isquémico 168 (84%) y ACV hemorrágico 32(16%). La Hipertensión Arterial fue el FR más frecuente (83,5%); más del 40% tenía 3 o más FR para ACV. Tuvieron complicaciones: 32% de los pacientes, la Infección respiratoria fue la más frecuente (14.5%)Pacientes con NIHSS superior a 10 puntos presentaron mayor porcentaje de complicaciones. Conclusión. El control de FR múltiples constituye una estrategia efectiva para disminuir la incidencia de ACV. La prevención de las complicaciones médicas permiten un mejor cuidado del paciente y reducen la morbilidad relacionada al ACV.

Factores de riesgo y complicaciones extraneurológicas de pacientes internados por Accidente Cerebrovascular en el Hospital Nacional de Clínicas de Córdoba / [Risk Factors and extraneurological complications of stroke patients].

INTRODUCTION: Stroke is the third leading cause of death globally , act on modifiable risk factors is now the best prevention strategy. Medical complications are common in patients hospitalized for stroke , the valuation of income NIHSS , is associated with the final result in terms of duration of hospitalization, survival and discharge location. OBJETIVE: Determining risk factors ( RF) in patients hospitalized for stroke in Hospital Nacional de Clinicas de Córdoba (HNC) and characterize neurological complications NIHSS relative to income. MATERIAL AND METHODS: Prospective study of patients admitted to the Service of Neurology at HNC diagnosed with the first of September , 2010 to December 30, 2012 , we applied the admission NIHSS scale. Were determined cerebrovascular risk factors , we evaluated neurological complications during hospitalization. RESULTS: The total number of patients admitted for stroke was 200 , with 168 ischemic stroke ( 84

) and hemorrhagic stroke 32 (16

) . The FR Hypertension was the most frequent ( 83.5

had 3 or more FR for stroke. Had complications : 32

of patients , the respiratory infection was the most frequent (14.5

). Patients with NIHSS greater than 10 points had a higher rate of complications. CONCLUSION: The multiple RF control is an effective strategy to decrease the incidence of stroke . Prevention of medical complications enable better patient care and reduce morbidity associated with stroke.

Factores de riesgo y complicaciones extraneurológicas de pacientes internados por Accidente Cerebrovascular en el Hospital Nacional de Clínicas de Córdoba. / [Risk Factors and extraneurological complications of stroke patients].

INTRODUCTION: Stroke is the third leading cause of death globally , act on modifiable risk factors is now the best prevention strategy. Medical complications are common in patients hospitalized for stroke , the valuation of income NIHSS , is associated with the final result in terms of duration of hospitalization, survival and discharge location. OBJETIVE: Determining risk factors ( RF) in patients hospitalized for stroke in Hospital Nacional de Clinicas de Córdoba (HNC) and characterize neurological complications NIHSS relative to income. MATERIAL AND METHODS: Prospective study of patients admitted to the Service of Neurology at HNC diagnosed with the first of September , 2010 to December 30, 2012 , we applied the admission NIHSS scale. Were determined cerebrovascular risk factors , we evaluated neurological complications during hospitalization. RESULTS: The total number of patients admitted for stroke was 200 , with 168 ischemic stroke ( 84

) and hemorrhagic stroke 32 (16

) . The FR Hypertension was the most frequent ( 83.5

), over 40

had 3 or more FR for stroke. Had complications : 32

of patients , the respiratory infection was the most frequent (14.5

). Patients with NIHSS greater than 10 points had a higher rate of complications. CONCLUSION: The multiple RF control is an effective strategy to decrease the incidence of stroke . Prevention of medical complications enable better patient care and reduce morbidity associated with stroke.

Neuromodulación central y periférica en incontinencia fecal: presentación de 2 casos y revisión de la literatura / Central and peripheral neuromodulation for fecal incontinence: report of 2 cases and review of the literature

Fecal incontinence is a condition that creates a huge impact on quality of life, it affects up to 45 percent of patients of the elderly. Treatment is initially conservative with dietary changes, drugs and perineal biofeedback. Surgery is reserved for those who do not respond to medical treatment. The most frequently performed procedure is anal sphincteroplasty, useful in patients with proven lesions of the external anal sphincter. Other alternatives include the implantation of an artificial anal sphincter and dynamic graciloplasty, which are very expensive techniques with high rate of complications. If there is no other alternative, a permanent ostomy can be done. In recent years, less invasive techniques have been developed for the treatment of fecal incontinence. Among these, central neuromodulation or sacral root stimulation (SRS) and peripheral neuromodulation or posterior tibial nerve stimulation (PTNS) have shown promising results. The aim of this paper is to present 2 cases of patients with fecal incontinence refractory to conventional treatment (medical and surgical) that are successfully treated with central and peripheral neuromodulation respectively. We present 2 cases and a review of the literature available to date.

La incontinencia fecal (IF) es una patología que genera un enorme impacto en la calidad de vida, afectando hasta el 45 por ciento de los pacientes de la tercera edad. El tratamiento es inicialmente conservador mediante cambios dietéticos, fármacos y rehabilitación perineal. La cirugía se reserva para quienes no responden a tratamiento medico. El procedimiento efectuado con más frecuencia es la esfinteroplastía anal, de utilidad en pacientes con lesión demostrada del esfínter anal externo. En casos de IF grave, otras alternativas son la instalación de un esfínter anal artificial y/o la graciloplastía dinámica, procedimientos de alto costo y con un alto porcentaje de complicaciones. En caso de no existir otra alternativa se puede realizar una ostomía definitiva. Durante los últimos años se han desarrollado técnicas mínimamente invasivas para el tratamiento de la incontinencia fecal. Entre éstas, la neuromodulación central o de las raíces sacras (NMS) y últimamente la neuromodulación periférica o estimulación del nervio tibial posterior (ENTP) han mostrado resultados promisorios. Los objetivos de este trabajo son presentar 2 casos clínicos de pacientes con incontinencia fecal refractaria al tratamiento convencional (medico y quirúrgico) que son tratados exitosamente con neuromodulación central y periférica, respectivamente, y realizar una revisión de la literatura disponible a la fecha.

Necesidades de cuidado de enfermería en soldados amputados por minas antipersona / Necessities of nursing care in soldiers amputated by antipersonal mine

En el mundo existen más de 500 millones de personas con una u otra forma de discapacidad[1]; la Organización Mundial de la Salud (OMS) sostiene que la proporción oscila entre el 10% y el 12%, del total de la población; la Organización Internacional del Trabajo (OIT) señala que de estos, 400 millones se encuentran en países en desarrollo. El Departamento Administrativo Nacional de Estadísticas (DANE) reconoce que de cada cien colombianos, seis presentan algún tipo de discapacidad permanente y que se presenta una tendencia creciente, de esta situación como consecuencia del conflicto armado. El uso de minas antipersona se constituye en una de las situaciones que además de un gran número de víctimas, genera una amplia gama de problemática social, que evidencia la necesidad de plantear estrategias para el abordaje de una situación de salud que afecta un amplio grupo poblacional, en el que los militares y sus familias son los más afectados, en respuesta a esta situación se plantea la investigación que da origen a este articulo y responde al interrogante asociado a la identificación de necesidades de cuidado de enfermería, vivenciadas por los soldados amputados por minas antipersona durante el proceso de rehabilitación. Se reconoció que en el grupo de necesidades que cobran mayor relevancia son las asociadas a la vinculación de la familia y las redes de apoyo a los procesos de rehabilitación y las que se relacionan con la importancia de incentivar la reconstrucción del proyecto de vida del soldado, que posterior a la amputación manifiesta temores, expectativas e incertidumbre frente al desempeño de los roles previos y a la necesidad de reconstruir o redimensionar, en el marco del proceso de rehabilitación, una nueva forma de relación con el entorno.

Determination of alpha- and beta-amanitin in clinical urine samples by Capillary Zone Electrophoresis.

Amanitins are toxins found in species of the mushroom genera Amanita, Lepiota and Galerina. Intoxication after ingestion of these mushrooms can be fatal with an estimated 20% of mortality rate. An early diagnosis is necessary in order to avoid invasive and expensive therapy and to improve patient's prognosis. In this paper, a Capillary Zone Electrophoresis method was developed and validated to determine alpha- and beta-amanitin in urine in less than 7 min using 5 mM, pH 10 borate buffer as background electrolyte. The separation conditions were: capillary: 75 microm I.D., 41 cm effective length, 48 cm total length, 25 degrees C, 20 KV and PDA detection at 214 nm. Sample treatment for analysis only required urine dilution in background electrolyte. The method was validated following established criteria and was found to be selective, linear in the range 5-100 ng/ml. Intra- and inter-day precision and accuracy were within required limits. Limit of detection (LOD) and limit of quantification (LOQ) were 1.5 and 5 ng/ml, respectively. Eight urine samples from suspected cases of intoxication with amanitins were analyzed after 2 years of storage at -20 degrees C, and beta-amanitin was determined in two samples with concentrations of 53 and 65 ng/ml, respectively. The method here described includes the use of non-aggressive reagents to the capillary or the system and is the first Capillary Electrophoresis method used to determine amanitins in clinical samples.

Aislamiento de cepas de Escherichia coli desde casos clínicos de infección vaginal: asociación con otros microorganismos y susceptibilidad antibacteriana / Presence of E. coli in vaginal fluids of women with vaginal infection and its antimicrobial susceptibility

Objetivo: Determinar la presencia de Escheríchia coli en fluidos vaginales de mujeres con infección vaginal y analizar la susceptibilidad antimicrobiana. Método: Se estudiaron 425 muestras de mujeres con diagnóstico clínico de infección vaginal (casos) y 100 mujeres sanas (controles). Las muestras vaginales fueron estudiadas mediante los criterios de Amsel y Nugent. Se utilizaron diferentes metodologías para identificar: Trichomonas vaginalis, Candida albicans, Gardnerella vaginalis, Chlamydia trachomatis, Myco-plasma hominis, Urea plasma urealyticum, Neisseria gonorrhoeae, Mobiluncus sp., Streptococcus agalactiae, Enterococcus faecalis, enterobacterias, bacilos Gram negativo anaerobios estrictos, Lactobacillus sp. y Staphylococcus coagulasa negativo. Resultados: Se observaron 160 casos de vaginitis y 265 de vaginosis. En los primeros predominó C. albicans y T. vaginalis, aislándose 27 cepas de E. coli en los casos de vaginosis, G. vaginalis y E.E. coli fueron los más comunes. La mayor asociación se observó entre G. vaginalis y E. coli . En 47 casos se aisló únicamente E. coli , y en los controles se observaron 6 cepas de E. coli . El estudio caso-control demostró un OR: 4,7 (95 por ciento IC: 1,91-12,27). Sobre el 90 por ciento de las cepas aisladas de E. coli demostró sensibilidad a cefotaxima, ciprofloxacino y amikacina. Conclusión: E. coli de aislados monomicrobianos podría tener un rol potencial en la patogenia de la infección vaginal.

Objective: To determine the presence of Escheríchia E. coli vaginal fluids of women with vaginal infection and to study its antimicrobial susceptibility. Methods: 425 samples of women with clinical diagnosis of vaginal infection (cases) and 100 healthy women were studied (controls). The vaginal samples were studied by means of the criteria of Amsel and Nugent. Different methodologies were used to identify: Trichomonas vaginalis, Candida albicans, Gardnerella vaginalis, Chlamydia trachomatis, Mycoplasma hominis, Ureaplas-ma urealyticum, Neisseria gonorrhoeae, Mobiluncus sp., Streptococcus agalactiae, Enterococcus faecalis, enterobacterias, strict anaerobic Gram negative bacilli, Lactobacillus sp. and coagulase negative Staphylococcus. Results: 160 cases of vaginitis and 265 of vaginosis were observed. In vaginitis predominated C. albicans and T vaginalis, and were isolated 27 E.E. coli strains. In the bacterial vaginosis, G. vaginalis and E. coli were the most common. The greater association was observed between G. vaginalis and E. coli . In 47 cases singleE. coli was isolated. In the controls 6E. coli strains were observed. The study of case-control demonstrated a OR: 4.7 (95 percent Cl: 1.91-12.27). Isolated E. coli demonstrated sensitivity over 90 percent to cefotaxime, ciprofloxacin and amikacin. Conclusion: SingleE. coli isolated could have a potential role in the pathogenia of the vaginal infection.

Effect of small doses of naloxone on sexual exhaustion in White New Zealand male rabbits.

The objective of the present study was to determine the effect of small doses of naloxone on sexual exhaustion in White New Zealand male rabbits. Twelve young and 12 adult male rabbits 6-12 months old and 14-20 months of age, respectively, were selected from a commercial farm. Each male rabbit was housed individually in galvanized cages (90 cm x 60 cm x 40 cm). The rabbits were housed in an open shed exposed to natural photoperiod (12 L 12 D, 19 degrees N). Daily temperature fluctuated through the year from 28 to 16 degrees C. Humidity was 45+/-5%. Water and food (rabbit chow PMI) was supplied ad libitum. After sexual behaviour for each studied group was established, the males were given a 6-day rest, and 3 days before next trial, six males of each group (treated) received a subcutaneous implant of 8 mg of naloxone in a crystalline nitrocellulose pellet formulated to be completely absorbed in 15 days. The remaining six males were sham-treated (control). At the end of the resting period as previously described, the sexual behavior of each group was studied and compared using a Mann-Whitney statistical U-test. The effect of naloxone on sexual behavior was analyzed with a Wilcoxon test for correlated samples. With regard to sexual activity between young and adult rabbits, it was observed that there was a significant difference between groups (P=0.00275, Z=2.8823, adjusted Z=2.99.43) showing that younger rabbits mounted/ejaculated from 9 to 10 females compared with 6 to 8 mounted/ejaculated by older rabbits. When naloxone was administered to both groups, there was a significant difference when comparing sexual behavior before and after administration of naloxone (table first and second trial). Young rabbits treated with naloxone mounted/ejaculated 11-12 females while older rabbits mounted nine females before reaching sexual exhaustion. A significant difference was observed when comparing the number of estrous females that were mounted/ejaculated between groups. Environmental photoperiod and temperature changes were not considered. It was concluded that endogenous opioids are important modulators of behavioral and hormonal interactions related to sexual behavior.

Sexual behavior of male New Zealand white rabbits in an intensive production unit.

Sexual behavior in the male white New Zealand rabbit in intensive production units is not fully documented. Therefore, the objective of this work was to provide further information about the sexual behavior of this species in intensive production systems. Fourteen 6- to 12-month-old rabbits were studied for 6 months (July/December) when housed individually under natural photoperiod (19 degrees latitude north). They were mated once a week. When mated they were exposed at 6-min intervals to five oestrous females. The number of mounts, time between mounts, time and number of ejaculations, time between ejaculations, and also enuresis, grasping and kicking were recorded. Mounts (n=222) were observed and recorded. Males mated one to five times during each evaluative session. Enuresis was present only in one observation. Sexual aggressiveness such as grasping and kicking was present during 142 and 133 matings. Time for mounting and ejaculation in accumulated means (minutes, seconds, tenths) from the first to the fifth mount were noted and an accumulative average of 4.20 min for the fifth mounting was noted. Minimum times for ejaculation and next mating was 00:17:00 min and maximum was 05:33:03 min. It was concluded that sexual behavior in white New Zealand male rabbits remained unchanged through the duration of the period of study.

Procesos inflamatorios del tejido adiposo intraabdominal, causa no quirurgica de dolor abdominal agudo: hallazgos en tomografia computada / Inflammatory alterations of the intraabdominal fatty tissues, a non-surgical cause of acute abdominal pain: findings with computed tomography

La apendagitis epiploica, el infarto segmentario del omento mayor y la paniculitis mesenterica son procesos inflamatorios origina- dos en el tejido adiposo intraabdominal, cuya presentación clinica, caracterizada por dolor abdominal agudo, puede simular un cuadro quirúrgico. Rara vez se plantea la sospecha clinica y pensamos que la tomografia computada (TC) es el examen de elección, ya que permite visualizar estas estructuras y descartar otras causas del dolor. Los apendices epiploicos son estructuras pedunculadas que protruyen de la superficie serosa del colon. Normalmente no son visibles en estudios de imagen y se confunden con el tejido adiposo intraabdominal. Se hacen evidentes cuando sufren algún proceso patológico o bien cuando existe ascitis, hemoperitoneo o se inyecta medio de contraste intraperitoneal. El hallazgo caracteristico en TC es una imagen redondeada u ovoidea de densidad grasa dependiente de la serosa de algún segmento del colon. El infarto segmentario del omento mayor es una causa rara de abdomen agudo. En TC se observa una masa de tejido adiposo denso, mal delimitada, con imágenes lineales finas en su espesor y no depende de la serosa del colon. La paniculitis mesentérica es un proceso inflamatorio que afecta al tejido adiposo de la raiz del mesenterio. En TC su aspecto es inespecífico aunque puede presentarse como un mesenterio nebuloso. Su diagnóstico es esencialmente de descarte. Revisamos las manifestaciones clinicas e imagenológicas con enfasis en TC.

Corrección de incontinencia de orina con cinta vaginal libre de tensión, asociado a la corrección de otras patologías del piso pelviano / Correction of female urinary incontinence using tension-free vaginal tape procedure associated to correction ofassociated to correction of other pathologies of the pelvic floor

Trabajo prospectivo que evalúa los resultados de la corrección de la incontinencia de orina de esfuerzo con la técnica de la cinta suburetral libre de tensión realizada en el Servicio de Obstetricia y Ginecología del Hospital de Talca. Fueron tratadas 44 pacientes con incontinencia de orina de esfuerzo severa de al menos dos años de evolución, asociada a otra patología ginecológica susceptible de ser corregida por vía vaginal. La técnica de corrección se basa en la colocación de una cinta de polipropileno, en forma de hamaca en el tercio medio de la uretra. La cinta se coloca por medio de agujas, que se introducen desde abdomen y salen parauretral psilateral al sitio de punción. El tiempo promedio de seguimiento fue 12 meses con 93 por ciento de curación al fin del periodo. No hubo lesiones de vejiga ni de otro órgano durante el procedimiento. La complicación más frecuente fue la infección urinaria y la retención de orina. Conclusión: la técnica presentada es una excelente alternativa para la corrección de la incontinencia de orina de esfuerzo y junto con la corrección de otros defectos asociados del piso pelviano.

The effect of small doses of naloxone on the initiation and duration of the first estrus after weaning in sows.

The present research was conducted with the objective of studying the pharmacological effect of small doses of naloxone on the initiation and duration of the first estrus after weaning in the sow. For this purpose, 32 multiparous sows were used. Sows were divided at random into two groups. Group 1 (n=16) was treated by i.m. injection with 2mg naloxone at 12h intervals from 3 days before until 3 days after weaning. Group 2 (n=16) served as the control group and received saline solution at the same times as treatments for group 1. First estrus after weaning occurred at 85+/-5.2 and 108.3+/-5h (P<0.05) in naloxone- and saline-treated sows. Duration of estrus was 89.6+/-3.9 and 49.6+/-3.9h (P<0.05) in naloxone-treated and control animals, respectively. It was concluded that naloxone treatment advanced the time of appearance and duration of the first estrus after weaning in sows giving further support that endogenous opioids (EOP) are modulators of sexual behavior in female pigs.

Sexual exhaustion in White New Zealand male rabbits of different ages.

Sexual exhaustion was studied in hybrid White New Zealand rabbits of different ages, for this purpose six young rabbits from 6 to 12 months of age, and six adult rabbits of 14-20 months of age were selected. Sexually receptive females were taken to the male's cage, for a period of 4 min, if copulation was not performed, the observation was then considered finished. If the male mounted within this period of time, the mounted female was immediately replaced by another female and 4 min of exposure time to the male were reinitiated, and repetitions were conducted until the male that was being studied refused to mount a new female at which time the male was considered to be sexually exhausted. Young rabbits mounted and ejaculated 9-10 times before sexual exhaustion. Adult rabbits showed a fluctuation of between 6 and 8 mounts per ejaculations before refusing another mount. The statistical analysis with a Mann-Whitney U-test, showed that the Rank sum for group A was 57, while for group B was 21. The U-value was 0.0 and the adjusted Z -2.9943. A significant difference was observed between groups with a value of P=0.00275. In the present study it was demonstrated that there is an influence of age on sexual behavior of rabbits.