The transition of Chilean adolescents from the child welfare system to the adolescent justice system: a continuation or an accumulation of adverse factors?

Research on juvenile delinquency and adolescent maladjustment indicates that the beginning of these processes is found in the relationship between multiple risk factors at the individual, family and community levels in this population. The objective of this research was to analyze the risk factors related to the transition from the child welfare system to the adolescent justice system in a group of Chilean male adolescents (n = 108), aged 14-18 years, grouped according to their membership in the child welfare system, the adolescent justice system or both systems. Through a quantitative methodology, variables associated with risk factors were examined by means of the Risk and Resource Evaluation Form FER-R and the Risk and Criminogenic Needs Inventory IRNC instruments. Logistic regression analysis found that the adolescent population within the child welfare system was more likely to enter the adolescent justice system if the following risk factors were present: weak family supervision, consumption of drugs, socially maladaptive peer relationships, and risky free time. These results emphasize that child welfare system interventions should focus on parental support and the management of socio-community networks to prevent re-entry of the adolescent population into the justice system.

Availability of personal protective equipment and diagnostic and treatment facilities for healthcare workers involved in COVID-19 care: A cross-sectional study in Brazil, Colombia, and Ecuador.

Many affected counties have had experienced a shortage of personal protective equipment (PPE) during the coronavirus disease (COVID-19) pandemic. We aimed to investigate the needs of healthcare professionals and the technical difficulties faced by them during the initial outbreak. A cross-sectional web-based survey was conducted among the healthcare workforce in the most populous cities from three Latin American countries in April 2020. In total, 1,082 participants were included. Of these, 534 (49.4%), 263 (24.3%), and 114 (10.5%) were physicians, nurses, and other professionals, respectively. At least 70% of participants reported a lack of PPE. The most common shortages were shortages in gown coverall suits (643, 59.4%), N95 masks (600, 55.5%), and face shields (569, 52.6%). Professionals who performed procedures that generated aerosols reported shortages more frequently (p<0.05). Professionals working in the emergency department and primary care units reported more shortages than those working in intensive care units and hospital-based wards (p<0.001). Up to 556 (51.4%) participants reported the lack of sufficient knowledge about using PPE. Professionals working in public institutions felt less prepared, received less training, and had no protocols compared with their peers in working private institutions (p<0.001). Although the study sample corresponded to different hospital centers in different cities from the participating countries, sampling was non-random. Healthcare professionals in Latin America may face more difficulties than those from other countries, with 7 out of 10 professionals reporting that they did not have the necessary resources to care for patients with COVID-19. Technical and logistical difficulties should be addressed in the event of a future outbreak, as they have a negative impact on healthcare workers. Clinical trial registration: NCT04486404.

Linfagioleiomiomatosis pulmonar / Pulmonary lymphangioleiomyomatosis

La Linfagioleiomiomatosis pulmonar es una enfermedad muy rara, que afecta sólo mujeres en edad reproductiva. Se presenta con disnea progresiva, pneumotórax a repetición y, ocasionalmente, con hemoptisis y quilotórax. El TAC de alta resolución muestra quistes pulmonares bilaterales de tamaño variable hasta bulas francas. Histológicamente, se aprecian múltiples cavidades de paredes finas, dilatación de vasos linfáticos, venas, arterias, bronquiolos y sacos alveolares, por proliferación de haces de músculo liso que comprime las estructuras antes mencionadas y que causa entonces su dilatación. El pronóstico es malo, ya que las paciente desarrollan insuficiencia respiratoria, lo que las conduce a la muerte. La enfermedad se asocia a la ingesta de estrógenos, píldoras anticonceptivas y se exacerba con el embarazo; por ello se ha tratado con medróxi-progesterona y tamoxifén, con estabilización de la evolución en algunos pero no en todos los casos. Eventualmente, algunas pacientes pueden necesitar transplante pulmonar. Presentamos el caso de una mujer de 38 años con tres episodios de pneumotórax espontáneo y documentación radiológica e histológica de linfagioleiomiomatosis pulmonar. Descriptores: pneumotórax, disnea, linfagioleiomiomatosis