[Association between weight status and motor competence in schoolchildren from Chilean Patagonia]. / Asociación entre el estado nutricional y la competencia motriz en escolares de la Patagonia chilena.

BACKGROUND: the prevalence of overweight and obesity in the child population is a global public health problem, with measures such as the promotion of physical activity being necessary. One of the recognized factors for this is the development of motor competence, due to its dynamic interaction with physical activity, so it is necessary to understand its relationship with weight status. OBJECTIVE: the aims of this study are to determine whether there are differences in the levels of motor competence of schoolchildren in Chilean Patagonia according to their nutritional status, as well as to determine the association between body mass index (BMI) and the levels of motor competence in these schoolchildren. MATERIAL AND METHODS: we evaluated 295 boys and girls in 5th and 6th grade of primary school, from educational centres in Coyhaique and Punta Arenas. We used the MOBAK 5-6 test to assess their motor competence. RESULTS: schoolchildren with normal weight status presented higher values of motor competence in self-movement (M = 3.1; SD = 1.84) compared to overweight (M = 2.7; SD = 1.68) and obese schoolchildren (M = 1.7; SD = 1.57), presenting significant differences between all groups (p < 0.001). In object control, no differences were found between the groups. In addition, there was an inverse association of object control with gender (ß: 1.49; p < 0.001) and BMI (ß: -0.05; p = 0.026), while self-movement had an inverse association with BMI (ß: -0.11; 95 % CI: -0.15 -0.07; p < 0.001). CONCLUSION: weight status and motor competence are associated. Schoolchildren with higher BMI values tend to perform lower in self-movement. These results underline the importance of addressing motor competence in efforts to combat overweight and obesity in children.

I'm just joking! Perceptions of sexist humour and sexist beliefs in a Latin American context.

Previous research has stated a relationship between sexist ideologies and humour appreciation. However, most research has been done in North America and Europe. In the present study, we aimed to approach in an exploratory way to the social perceptions of sexist humour in Costa Rica. Data was gathered through an online survey, participants (N = 323; 220 females) completed measures to characterise expressions of sexist humour. The main measures included perceived funniness, frequency and means of exposure, and perceived offensiveness, as well as completing the Ambivalent Sexism Inventory (ASI). Overall, previous exposure to this kind of humour was remarkably high. No significant differences were observed between women's and men's perceptions of the frequency, means and places of exposure, but emotional and behavioural reactions to sexist humour were gender-based. Women reported higher displeasure, more confrontation and felt angrier and more offended than men when exposed to this type of humour. Data support existing evidence of the relationship with sexist ideology. Specifically, hostile sexism was found to be a significant predictor of perceived funniness and offensiveness of the sexist jokes. An interaction effect between hostile sexism and the sex of participants was found, showing that as hostile sexism increased, perceived offensiveness decreased, but more rapidly for men. Results are discussed considering the practical implications and limitations, as well as the need for more research in the Latin American context.

Occurrence of mycotoxins in pulses.

Pulses, dry grains of the Fabaceae family used for food and feed, are particularly important agricultural products with increasing commercial and nutritional relevance. Similar to other plant commodities, pulses can be affected by fungi in the field and during postharvest. Some of these fungi produce mycotoxins, which can seriously threaten human and animal health by causing acute poisoning and chronic effects. In this review, information referring to the analysis and occurrence of these compounds in pulses is summarized. An overview of the aims pursued, and of the methodologies employed for mycotoxin analysis in the different reports is presented, followed by a comprehensive review of relevant articles on mycotoxins in pulses, categorized according to the geographical region, among other considerations. Moreover, special attention was given to the effect of climatic conditions on microorganism infestation and mycotoxin accumulation. Furthermore, the limited literature available was considered to look for possible correlations between the degree of fungal infection and the mycotoxin incidence in pulses. In addition, the potential effect of certain phenolic compounds on reducing fungi infestation and mycotoxin accumulation was reviewed with examples on beans. Emphasis was also given to a specific group of mycotoxins, the phomopsins, that mainly impact lupin. Finally, the negative consequences of mycotoxin accumulation on the physiology and development of contaminated seeds and seedlings are presented, focusing on the few reports available on pulses. Given the agricultural and nutritional potential that pulses offer for human well-being, their promotion should be accompanied by attention to food safety issues, and mycotoxins might be among the most serious threats. Practical Application: According to the manuscript template available in the website, this section is for "JFS original research manuscripts ONLY; optional". Since we are publishing in CRFSFS this requirement will not be done.

#funnypoliticians: How Do Political Figures Use Humor on Twitter?

Social media has increased its popularity among politicians. If they wish to succeed in the political arena, politicians need to present themselves to citizens as attractive individuals through these platforms. This study examined how politicians present themselves using humor on Twitter. We analyzed tweets (n = 6,443) from 27 politicians to determine their use of different types of humor and its relationship with age, gender, or political position. We also present changes in humor use in relation to the publication of a political survey in which politicians who were part of this study were evaluated. Results showed politicians' use of humor is relatively low in frequency and primarily aggressive. Politicians who are male, younger, and in the opposition tend to use more aggressive humor. We discuss the results considering the role of aggressive humor in political messages. Based on the analyses of tweets and the publication of the survey, we propose as a hypothesis for future studies that politicians' use of humor on Twitter could be affected by the publication of these kinds of surveys.

Cirugía mayor ambulatoria ginecológica en el Hospital San José de Parral / Major outpatient gynecological surgery at the San Jose de Parral Hospital

OBJECTIVE: Evaluate initial results of a ambulatory major surgery program in Gynecology. MATERIAL AND METHODS: Retrospective, descriptive study of the period March 2018 to June 2019. The interventions included were: surgical sterilizations via vaginal, minilap and laparoscopic, diagnostic laparoscopy, laparoscopic cyst or anexectomy, hysteroscopy, TOT, vaginal plasty, biopsy curettage, polypectomy, extraction of IUD under anesthesia, labiaplasty, and removal of transobsturatrix tape. Quality indicators such as suspension, readmissions and systemic and surgical complications have been analyzed. RESULTS: 136 patients were operated by CMA of which 43 were laparoscopic (31.6%), 55 patients vaginally (40.4%), 34 histeroscopy (25%) and 4 patients by minilap (3%)There were 4 minor and late complications (2.9%) that corresponded to operative wound infection in vaginal plasty and nymphoplasty, a dysfunctional TOT tape that had to be removed in a mediated manner and a PIP post surgical sterilization via vaginal route. CONCLUSIONS: Gynecological ambulatory major surgery is feasible to perform in a hospital of medium complexity with a low percentage of minor complications in this study.

[Nocardia cyriacigeorgica infection in AIDS patient]. / Infección por Nocardia cyriacigeorgica en paciente con infección por VIH en etapa SIDA.

Nocardiosis is a localized or systemic infection that mainly affects immunocompromised patients, with pulmonary localization being the most frequent site. The transmission comes mainly from the inhalation of spores or by direct inoculation into the skin and ocular mucosa. More than 90 species of nocardia are described, of which more than half are recognized as pathogens in humans. The best known species of medical importance are Nocardia farcinica, Nocardia abscessus, Nocardia nova y Nocardia brasiliensis. In Chile, there have been published cases of Nocardia asteroides and Nocardia farcinica infections. Nocardia cyriacigeorgica is considered an emerging species, there being no cases previously described in our country. We present a clinical case of pulmonary nocardiosis in an acquired immunodeficiency syndrome (AIDS) patient.

Infección por Nocardia cyriacigeorgica en paciente con infección por VIH en etapa SIDA / Nocardia cyriacigeorgica infection in AIDS patient

Resumen La nocardiosis es una infección localizada o sistémica que afecta principalmente a pacientes inmunocomprometidos, siendo la localización pulmonar el sitio más frecuente. La transmisión proviene principalmente de la inhalación de esporas o mediante la inoculación directa en la piel y mucosa ocular. Se han descrito más de 90 especies de Nocardia, de éstas más de la mitad son reconocidas como patógenos en humanos. Las especies de importancia médica más conocidas son Nocardia farcinica, Nocardia abscessus, Nocardia nova y Nocardia brasiliensis. En Chile hay casos publicados de infección por Nocardia asteroides y N. farcinica. Nocardia cyriacigeorgica se considera una especie emergente, no habiendo casos descritos previamente en nuestro país. Presentamos el caso clínico de una nocardiosis pulmonar en un paciente con síndrome de inmunodeficiencia adquirida (SIDA).

Abstract Nocardiosis is a localized or systemic infection that mainly affects immunocompromised patients, with pulmonary localization being the most frequent site. The transmission comes mainly from the inhalation of spores or by direct inoculation into the skin and ocular mucosa. More than 90 species of nocardia are described, of which more than half are recognized as pathogens in humans. The best known species of medical importance are Nocardia farcinica, Nocardia abscessus, Nocardia nova y Nocardia brasiliensis. In Chile, there have been published cases of Nocardia asteroides and Nocardia farcinica infections. Nocardia cyriacigeorgica is considered an emerging species, there being no cases previously described in our country. We present a clinical case of pulmonary nocardiosis in an acquired immunodeficiency syndrome (AIDS) patient.

Graves vulneraciones de derechos en la infancia y adolescencia: variables de funcionamiento familiar / Serious Violations of Rights in Children and Adolescents: Variables of Family Functioning

Resumen La presente investigación tiene por objetivo determinar las características y problemáticas que se presentan en el funcionamiento familiar de 389 niños, niñas y adolescentes víctimas de graves vulneraciones de derechos en Chile, mediante la aplicación de la Escala deEvaluación Familiar de Carolina del Norte (NCFAS-G). Sus resultados identifican problemáticas centrales en esta muestra, tales como una moderada vulnerabilidad socioeconómica, dificultades en las interacciones entre sus miembros y con su entorno (familia, vecindario), así como debilitamiento de las competencias parentales.Se concluye que las variables de dinámica relacional de la familia y la pareja, los vínculos afectivos, la parentalidad y la autonomía familiar requieren ser abordadas mediante una intervención integral, sistémica, coordinada y oportuna.

Abstract The present research aims to determine the characteristics and problems that occur in the family functioning of 389 children and adolescents victims of serious violations of rights in Chile, through the implementation of the North Carolina Family Assessment Scale (NCFAS-G). The results identify central problems in this sample, such as a moderate socio-economic vulnerability, difficulties in the interactions between their members and their environment (family, neighbourhood), as well as weakening of parental competences. The conclusion is that the variables of relational dynamics of the family and the couple, affective bonds, parenthood and family autonomy need to be addressed through an integral, systemic, coordinated and timely intervention.

Psychometric Comparisons of Benevolent and Corrective Humor across 22 Countries: The Virtue Gap in Humor Goes International.

Recently, two forms of virtue-related humor, benevolent and corrective, have been introduced. Benevolent humor treats human weaknesses and wrongdoings benevolently, while corrective humor aims at correcting and bettering them. Twelve marker items for benevolent and corrective humor (the BenCor) were developed, and it was demonstrated that they fill the gap between humor as temperament and virtue. The present study investigates responses to the BenCor from 25 samples in 22 countries (overall N = 7,226). The psychometric properties of the BenCor were found to be sufficient in most of the samples, including internal consistency, unidimensionality, and factorial validity. Importantly, benevolent and corrective humor were clearly established as two positively related, yet distinct dimensions of virtue-related humor. Metric measurement invariance was supported across the 25 samples, and scalar invariance was supported across six age groups (from 18 to 50+ years) and across gender. Comparisons of samples within and between four countries (Malaysia, Switzerland, Turkey, and the UK) showed that the item profiles were more similar within than between countries, though some evidence for regional differences was also found. This study thus supported, for the first time, the suitability of the 12 marker items of benevolent and corrective humor in different countries, enabling a cumulative cross-cultural research and eventually applications of humor aiming at the good.

[Clinical utility of HIV viral load assessment in cerebral spinal fluid, a case report]. / Utilidad de la cuantificación de carga viral de VIH en líquido cefalorraquídeo, a propósito de un caso.

Detection of virus in cerebrospinal fluid (CSF) in HIV-infected patients with HIV viral load (VL) undetectable in plasma has been termed viral escape. These leaks may be asymptomatic from a neurological point of view, similar to plasma blips, or associated with neurological disease, with discordant VL between plasma and CSF, and may be evidence of a compartmentalization of the virus and the possibility of identifying quasispecies with mutations that confer resistance to ART. We present the case of a man with AIDS and disseminated tuberculosis who presented neurological symptomatology evidenced by headache and convulsive syndrome, who presented a discordance between plasma and CSF HIV VL; the genotypic test of the virus, obtained by lumbar puncture, identified new mutations that determined a change in ART with subsequent satisfactory evolution.

Utilidad de la cuantificación de carga viral de VIH en líquido cefalorraquídeo, a propósito de un caso / Clinical utility of HIV viral load assessment in cerebral spinal fluid, a case report

Resumen La detección de virus en el líquido cefalorraquídeo (LCR) en pacientes infectados por VIH con carga viral (CV) indetectable en el plasma se ha denominado escape viral. Estas fugas pueden ser asintomáticas o asociadas con enfermedad neurológica. La discordancia de la carga viral de VIH entre plasma y LCR evidenciaría la presencia de distintos compartimentos del virus, con la posibilidad de identificar quasiespecies con mutaciones específicas que confieran resistencia a la TARV. Presentamos el caso clínico de un paciente con infección por VIH en etapa SIDA y una tuberculosis diseminada que presentó un cuadro neurológico manifestado por cefalea y un síndrome convulsivo, en que se encontró una discordancia entre la CV para VIH en plasma y LCR. El estudio genotípico del virus obtenido del LCR identificó nuevas mutaciones que determinaron un cambio de la TARV, con evolución posterior satisfactoria.

Detection of virus in cerebrospinal fluid (CSF) in HIV-infected patients with HIV viral load (VL) undetectable in plasma has been termed viral escape. These leaks may be asymptomatic from a neurological point of view, similar to plasma blips, or associated with neurological disease, with discordant VL between plasma and CSF, and may be evidence of a compartmentalization of the virus and the possibility of identifying quasispecies with mutations that confer resistance to ART. We present the case of a man with AIDS and disseminated tuberculosis who presented neurological symptomatology evidenced by headache and convulsive syndrome, who presented a discordance between plasma and CSF HIV VL; the genotypic test of the virus, obtained by lumbar puncture, identified new mutations that determined a change in ART with subsequent satisfactory evolution.

Conocimientos y prácticas asociadas a transmisión de triquinelosis, hanta y equinococosis quística / Knowledge and practices associated with transmission of trichinellosis, hanta and cystic equinococcosis

RESUMEN Objetivo: Asociar el nivel de conocimiento y prácticas (hábitos y costumbres) responsables de la transmisión de Triquinelosis, Síndrome Cardiopulmonar por Hantavirus y Equinococosis quística (Hidatidosis), en habitantes de los sectores rurales. Material y método: Estudio descriptivo correlacional de corte transversal en el que se aplicó una encuesta a 149 habitantes residentes en el área rural de las localidades de Curacautín, Lonquimay y Melipeuco, a través de muestreo no probabilístico por conveniencia, durante los meses de diciembre 2013 a enero 2014. Resultados: La población posee mejores conocimientos de Triquinelosis y Hanta que Hidatidosis, 64,9, 72,8 y 39,3%, respectivamente; los hábitos y costumbres para Hanta e Hidatidosis alcanzan mejores prácticas (84% cada una) que para Triquinelosis (69,5%); la población reconoce correctamente reservorio, fuente de infección y mecanismos de transmisión en Triquinelosis y Hanta, pero en menor grado Hidatidosis; respecto de los hábitos y costumbres, aun desconociendo los fundamentos teóricos, reportan buenas prácticas, aunque mantienen algunas que favorecen la transmisión de infecciones predominantemente en Triquinelosis. Conclusión: El nivel de conocimiento no asegura buenas prácticas, además los conocimientos y prácticas siguen un patrón empírico más que cognitivo, respaldados por aspectos culturales y del entorno. Esto sugiere mayor participación de los equipos interdisciplinarios en comunidades aisladas para fortalecer la promoción, educación y refuerzo de las buenas prácticas de acuerdo con sus condiciones sociales e incentivar la adherencia a conductas que reduzcan el riesgo de la transmisión de zoonosis.

ABSTRACT Objective: To associate the level of knowledge and practices (habits and customs) responsible for the transmission of trichinellosis, Hanta and cystic echinococcosis (hydatidosis), among rural population. Material and method: Cross-sectional correlational descriptive study in which 149 residents of the rural areas of Curacautín, Lonquimay and Melipeuco were surveyed, using non-probability convenience sampling from December 2013 to January 2014. Results: The population has better knowledge of trichinellosis and Hanta than hydatidosis, 64.9%, 72.8 and 39.3% respectively; they also have better practices regarding Hanta and hydatidosis (84% each) than regarding trichinellosis (69.5%). The population recognizes correctly the reservoir, source of infection and transmission mechanisms of trichinellosis and Hanta, and to a lesser degree hydatidosis; they report good practices regarding habits and customs, even ignoring theoretical foundations, but maintain some practices that favor the transmission of infections related to trichinellosis. Conclusion: The level of knowledge does not ensure good practices. Additionally, knowledge and practices follow an empirical rather than cognitive pattern, rooted on cultural and environmental aspects. This suggests greater participation of interdisciplinary teams in isolated communities to strengthen the promotion, education and reinforcement of good practices in accordance with their social conditions and to encourage adherence to behaviors that reduce the risk of the transmission of zoonoses.

Respuesta virológica e inmunológica a la terapia anti-retroviral en pacientes portadores de infección por VIH atendidos en una red de salud académica de Chile / Virological and immunological outcomes to antiretroviral therapy in HIV-infected patients of an academic medical center in Chile

Introduction: Red Salud UC is an Academic health network where HIV-infected patients from the public and private health system are followed by a multidisplinary team. Aim: To determine virologic and immunologic response after 144 weeks of starting first antiretroviral therapy in these patients. Methods: A retrospective analysis of adult HIV patients attended between 1992 and 2011 was performed. Demographic and clinical characteristics, antiretroviral therapies data and immunologic and virologic outcomes were collected. CD4 count and HIV viral load changes up to 144 weeks after initiation of antiretroviral therapy were analyzed. Results: 860 patients were included in the analyses. Median age was 42 years, 93% were men. Median CD4+ count at baseline was 202 cells/mm³. The most used ART regimen was zidovudine/lamivudine plus efavirenz. First line anti-retroviral therapy was changed in 42% patients, being the most common cause, drug toxicity. At week 144, median CD4+ lymphocyte cell count was 449 cells/mm³. Ninety percent and 96% had undetectable viral load measured as < 50 copies/mL or < 400 copies/mL respectively. Discussion: First report of a university cohort, with CD4 and viral load follow up for 144 weeks, including Chilean patients from public and private system. After initiation of ART, an excellent immunologic and virologic response was observed in this cohort.

Introducción: La Red de Salud UC es una red académica de atención, donde pacientes portadores del VIH del área pública y privada de salud son atendidos por un equipo profesional multidisciplinario. Objetivo: Determinar las respuestas virológicas e inmunológicas a 144 semanas de iniciada la primera terapia antiretroviral en dichos pacientes. Métodos: Análisis retrospectivo de registros de pacientes adultos portadores de VIH atendidos entre 1992 y 2011. Se recolectaron datos demográficos, clínicos, terapia anti-retroviral, resultados inmunológicos y virológicos. Se analizaron los resultados de linfocitos T CD4+ y carga viral de VIH a las 144 semanas de iniciada la primera terapia anti-retroviral. Resultados: Fueron incluidos en el análisis 860 pacientes. El promedio de edad fue 42 años, 93% hombres. La mediana basal de LT CD4+ fue 202 céls/mm³. La terapia más utilizada fue zidovudina/lamivudina/efavirenz. En 42% de los pacientes se cambió la terapia de primera línea; la causa más común fue toxicidad a los anti-retrovirales. A la semana 144 de iniciada la terapia, la mediana de LT CD4+ fue de 449 céls/mm³. Alcanzaron cargas virales indetectables 90 y 96% con < 50 copias ARN/mL o < 400 copias ARN/mL respectivamente. Discusión: Primer reporte de pacientes tratados en un centro universitario, con seguimiento inmuno-virológico a 144 semanas, que incluye pacientes del área pública y privada de salud chilena. Después del inicio de la terapia, se observó una excelente respuesta inmuno-virológica.

Virological and immunological outcomes to antiretroviral therapy in HIV-infected patients of an academic medical center in Chile.

INTRODUCTION: Red Salud UC is an Academic health network where HIV-infected patients from the public and private health system are followed by a multidisplinary team. AIM: To determine virologic and immunologic response after 144 weeks of starting first antiretroviral therapy in these patients. METHODS: A retrospective analysis of adult HIV patients attended between 1992 and 2011 was performed. Demographic and clinical characteristics, antiretroviral therapies data and immunologic and virologic outcomes were collected. CD4 count and HIV viral load changes up to 144 weeks after initiation of antiretroviral therapy were analyzed. RESULTS: 860 patients were included in the analyses. Median age was 42 years, 93% were men. Median CD4+ count at baseline was 202 cells/mm³. The most used ART regimen was zidovudine/lamivudine plus efavirenz. First line anti-retroviral therapy was changed in 42% patients, being the most common cause, drug toxicity. At week 144, median CD4+ lymphocyte cell count was 449 cells/mm³. Ninety percent and 96% had undetectable viral load measured as < 50 copies/mL or < 400 copies/mL respectively. DISCUSSION: First report of a university cohort, with CD4 and viral load follow up for 144 weeks, including Chilean patients from public and private system. After initiation of ART, an excellent immunologic and virologic response was observed in this cohort.

Addressing Disease-Related Malnutrition in Healthcare: A Latin American Perspective.

Alarmingly high rates of disease-related malnutrition have persisted in hospitals of both emerging and industrialized nations over the past 2 decades, despite marked advances in medical care over this same interval. In Latin American hospitals, the numbers are particularly striking; disease-related malnutrition has been reported in nearly 50% of adult patients in Argentina, Brazil, Chile, Costa Rica, Cuba, Dominican Republic, Ecuador, Mexico, Panama, Paraguay, Peru, Puerto Rico, Venezuela, and Uruguay. The tolls of disease-related malnutrition are high in both human and financial terms-increased infectious complications, higher incidence of pressure ulcers, longer hospital stays, more frequent readmissions, greater costs of care, and increased risk of death. In an effort to draw attention to malnutrition in Latin American healthcare, a feedM.E. Latin American Study Group was formed to extend the reach and support the educational efforts of the feedM.E. Global Study Group. In this article, the feedM.E. Latin American Study Group shows that malnutrition incurs excessive costs to the healthcare systems, and the study group also presents evidence of how appropriate nutrition care can improve patients' clinical outcomes and lower healthcare costs. To achieve the benefits of nutrition for health throughout Latin America, the article presents feedM.E.'s simple and effective Nutrition Care Pathway in English and Spanish as a way to facilitate its use.

Análisis comparativo de la escala de juego pre-escolar de knox revisada (RKPPS) y test de desarrollo psicomotor 2-5 años (TEPSI), desde lo culturalmente seguro, en Valdivia, durante el año 2013 / Comparative analysis between the revised knox preschool play scale (RKPPS) and the test de desarrollo psicomotor 2-5 años (TEPSI) from a culturally safe perspective, in Valdivia, during the year 2013

El presente estudio fue llevado a cabo con el objetivo de analizar y comparar los elementos de la seguridad cultural en la aplicación de los instrumentos de evaluación Test de desarrollo psicomotor 2-5 años (TEPSI) y Escala de Juego pre-escolar de Knox (RKPPS) aplicados por Terapeutas Ocupacionales en población pre-escolar valdiviana. Dicha investigación fue realizada a través de un enfoque cualitativo, con el abordaje metodológico de Teoría Fundamentada, realizando entrevistas semi-estructuradas a cuatro Terapeutas Ocupacionales que aplican ambos instrumentos. Como resultado se obtuvo que ninguno de los dos instrumentos se acercan al espectro de lo culturalmente seguro, sin embargo, es la RKPPS la que incorpora más elementos de dicha conceptualización. Finalmente se concluye que los profesionales de la disciplina se ven desafiados a permanecer en la dicotomía de, por una parte, utilizar instrumentos cuantitativos para validarse ante otros profesionales y tener un lenguaje común, y por otro lado, instrumentos cualitativos para realizar intervenciones integrales con usuarios. Esa elección se ve influenciada por una serie de variables, dadas por las distintas demandas en su desempeño laboral, impactando en su forma de evaluar.

The following study was developed with the intention of analysing and comparing the elements of cultural safety in the application of these two assessment tools, the “Revised Knox Preschool Play Scale”(RKPPS) and the “Test de Desarrollo Psicomotor 2-5 Años”(TEPSI) on preschool Valdivian population by Occupational Therapists. This research was conducted through a qualitative approach, using Grounded Theory as methodological approach, and semi-structured interviews to four Occupational Therapists that regularly use both assessment tools were done. As a result, neither the RKPPS nor the TEPSI, are close to the culturally safe spectrum. However, the RKPPS is the one that embodies more elements from this conceptualization. Finally, it has been concluded that professional OTs are being challenged to remain in this dichotomy: On the one hand, using quantitative tools to validate themselves in front of other professionals and in order to have a common language; on the other hand, using qualitative tools to do comprehensive interventions with clients. This choice is influenced by a series of variables, due to different demands in their job performance, impacting on their way of evaluating.

Arginina y cáncer: implicaciones en la regulación de la respuesta antitumoral / Arginine and cancer: Implications in the regulation of antitumoral response

Los informes de la literatura apoyan el papel de la arginina como mecanismo regulador de la respuesta inmune. Se ha descrito la correlación entre disminución de la arginina y reducción de la proliferación y la activación de los linfocitos T en trasplante hepático, trauma grave, sepsis y cáncer. Entre los efectos se describen la disminución en la expresión de la cadena CD3z (traducción de la señal de activación en el linfocito T). La disminución de la arginina está relacionada con la producción de arginasa 1 (ARG1) por parte de las células mieloides supresoras. Se han propuesto dos posibles mecanismos por medio de los cuales el aumento de la actividad de ARG1 podría estar actuando en un proceso tumoral. El primero es la disminución de la proliferación de los linfocitos y el freno del ciclo celular. El segundo es promover el crecimiento tumoral al transformar la arginina en precursores de poliaminas. Se presentan en este artículo los principales conceptos del papel de la arginina en la respuesta antitumoral.

Recent findings support the potential role of arginine as a regulator of the immune response. Correlation between decreased arginine and decreased proliferation and activation of T lymphocytes has been described in liver transplantation, severe trauma, sepsis and cancer. Among the effects, decrease in the CD3z chain expression (activation signal in the T cell) has been described. Arginine is reduced in relation to the production of arginase 1 (ARG1) by myeloid suppressor cells. Two possible mechanisms have been postulated by which the increased activity of ARG1 could be acting on a tumor. The first is the reduction of lymphocyte proliferation and cell cycle arrest. The second is to promote tumor growth by transforming arginine in precursors of polyamines. We present in this article the main concepts on the role of arginine in antitumor response.

Características de pacientes asmáticos ingresados en una unidad de cuidados respiratorios intermedios / Characteristics of Asthma Patients Admitted to an Intermediate Respiratory Care Unit

Introducción: Las unidades de cuidados respiratorios intermedios (UCRI) permiten la monitorización continua y la ventilación mecánica no invasiva (VMNI) en los pacientes con insuficiencia respiratoria grave que habitualmente ingresan en unidades de cuidados intensivos (UCI). La utilidad de las UCRI en el manejo de las agudizaciones graves del asma nunca ha sido evaluada. Métodos: Se recogieron de forma prospectiva y sistemática los datos clínicos de pacientes ingresados en la UCRI con el diagnóstico principal de asma bronquial agudizada, se evaluó el fracaso terapéutico (intubación o fallecimiento) y su evolución hasta 6meses tras el alta, comparada con un grupo de pacientes ingresados en planta de hospitalización convencional pareados por edad y sexo, con el mismo diagnóstico principal. Resultados: Se incluyeron un total de 74 pacientes asmáticos (37 ingresan en la UCRI y 37 en planta) con una edad media (±DE) de 58±20 años, predominantemente mujeres (67%), con diagnóstico previo y tratamiento de asma persistente. La causa principal de ingreso en la UCRI fue insuficiencia respiratoria grave. Los pacientes que ingresaron en la UCRI presentaron más afectación radiológica (infiltrados alveolares) y tenían una pCO2 significativamente mayor. Diez pacientes ingresados en la UCRI precisaron VMNI. No hubo diferencias entre ambos grupos en fracasos terapéuticos, ni en seguimiento a los 6meses del alta. Conclusiones: Los pacientes con agudizaciones graves del asma pueden ser atendidos en una UCRI, evitando ingresos en la UCI y con un pronóstico similar a las agudizaciones más leves que son ingresadas en una planta de hospitalización convencional(AU)

Introduction: Intermediate respiratory care units (IRCU) provide continuous monitoring and non-invasive mechanical ventilation (NIMV) in patients with severe respiratory failure who are usually admitted to intensive care units (ICUs). The usefulness of IRCU in managing severe asthma exacerbations has never been evaluated. Methods: Clinical data were prospectively and systematically compiled from patients admitted to the IRCU with a principal diagnosis of bronchial asthma exacerbation. We assessed therapeutic failure (intubation or exitus) and patient evolution up until 6 months after discharge compared with a group of patients admitted to a conventional hospital ward, paired for age and sex, and with the same principal diagnosis. Results: A total of 74 asthma patients were included (37 admitted to IRCU and 37 to the hospital ward) with a mean age (±SD) of 58±20, who were predominantly women (67%), with previous diagnosis of asthma and persistent asthma treatment. The main cause of admittance to the IRCU was severe respiratory failure. The patients who were admitted to the IRCU presented more radiological affectation (alveolar infiltrates) and had significantly higher pCO2. Ten patients admitted to the IRCU required non-invasive mechanical ventilation (NIMV). There were no differences between the two groups regarding either therapeutic failure or the 6-month follow-up after discharge. Conclusions: Patients with severe asthma exacerbations can be managed in an IRCU while avoiding hospitalization in an ICU and demonstrating a prognosis similar to milder exacerbations treated in conventional hospital wards(AU)

[Surveillance of carbapenem-resistant enterobacteria in stool cultures in a university hospital in Santiago, Chile]. / Vigilancia de enterobacterias productoras de carbapenemasas en cultivos rectales en un hospital universitario de Santiago, Chile.

BACKGROUND: Clinical cultures detect only one-third of colonized patients with carbapenem-resistant Enterobacteriaceae. Early identification and contact precautions implementation would help to interrupt transmission. In our hospital no carbapenemase-producing enterobacteria infections have been described. AIM: To perform stool surveillance cultures in patients hospitalized in critical care unit with the purpose to detect carbapenemase-producing Enterobacteriacea. MATERIAL AND METHODS: Rectal swabs were obtained of patients after five or more days of hospital stay, on a monthly basis from July to December 2011. Phenotypic assays (modified test Hodge and phenylboronic acid test) and polymerase chain reaction (PCR) searching for six carbapenemases of group A and B of Ambler's classification were performed. RESULTS: During this period, 241 surveillance rectal cultures were performed. Thirty eight enterobacteria isolated from 30 patients presented a decreased susceptibility to carbapenems by agar dilution method. All PCR were negative. CONCLUSION: We found that despite the significant number of resistant isolates, patients hospitalized in our institution are not colonized with carbapenemase-producing Enterobacteriaceae. We highlight the importance of screening before having the problem in place.

Characteristics of asthma patients admitted to an intermediate respiratory care unit.

INTRODUCTION: Intermediate respiratory care units (IRCU) provide continuous monitoring and non-invasive mechanical ventilation (NIMV) in patients with severe respiratory failure who are usually admitted to intensive care units (ICU). The usefulness of IRCU in managing severe asthma exacerbations has never been evaluated. METHODS: Clinical data were prospectively and systematically compiled from patients admitted to the IRCU with a principal diagnosis of bronchial asthma exacerbation. We assessed therapeutic failure (intubation or exitus) and patient evolution up until 6 months after discharge compared with a group of patients admitted to a conventional hospital ward, paired for age and sex, and with the same principal diagnosis. RESULTS: A total of 74 asthma patients were included (37 admitted to IRCU and 37 to the hospital ward) with a mean age (±SD) of 58±20, who were predominantly women (67%), with previous diagnosis of asthma and persistent asthma treatment. The main cause of admittance to the IRCU was severe respiratory failure. The patients who were admitted to the IRCU presented more radiological affectation (alveolar infiltrates) and had significantly higher pCO(2). Ten patients admitted to the IRCU required NIMV. There were no differences between the two groups regarding either therapeutic failure or the 6-month follow-up after discharge. CONCLUSIONS: Patients with severe asthma exacerbations can be managed in an IRCU while avoiding hospitalization in an ICU and demonstrating a prognosis similar to milder exacerbations treated in conventional hospital wards.