Psychological distress, anxiety, depression, stress level, and coping style in HIV-pregnant women in Mexico.

PURPOSE: To evaluate the presence of psychological distress (PD) and its association with the mental health and coping styles of pregnant women living with HIV (PWLWH). METHOD: An observational, cross-sectional descriptive study was performed. Seventy-three PWLWH were included. Patients responded to a psychometric battery for PD, depression, anxiety, stress, and coping style evaluation. The scales used in the study were: Goldberg's 30-item General Health Questionnaire (GHQ-30), State-Trait Anxiety Inventory (STAI), Zung Depression Self-Measurement Scale (ZDS), Nowack Stress Profile, Lazarus and Folkman's Coping Styles Questionnaire. RESULTS: PD was observed in 31.5% of the participants. PD-positive patients showed a higher probability of presenting traits of depression and anxiety and medium/high stress levels. Besides, they preferentially used emotion-focused coping styles. CONCLUSION: PD is associated with a higher probability of presenting anxiety and depression in PWLWH. Emotion-focused coping style could be a factor in decision-making associated with risk behaviors in PWLWH.

Evaluating pollution-related damage and restoration success in urban forests with participatory monitoring and digital tools.

Peri-urban forest monitoring requires indicators of vegetation damage. An example is the sacred fir (Abies religiosa) forests surrounding Mexico City, which have been heavily exposed to tropospheric ozone, a harmful pollutant, for over 4 decades. We developed a participatory monitoring system with which local community members and scientists generated data on ozone tree damage. Santa Rosa Xochiac rangers (13) used the digital tool KoboToolBox to record ozone damage to trees, tree height, tree ages, tree condition, tree position, and whether the tree had been planted. Thirty-five percent of the trees (n = 1765) had ozone damage. Younger trees had a lower percentage of foliage damaged by ozone than older trees (p < 0.0001), and asymptomatic trees tended to be younger (p < 0.0001). Symptomatic trees were taller than asymptomatic trees of the same age (R2 c  = 0.43, R2 m  = 0.27). Involving local communities facilitated forest monitoring and using digital technology improved data quality. This participatory system can be used to monitor forest condition change over time and thus aids restoration efforts driven by government or local communities' interests, facilitating local decision-making.

Evaluación del daño relacionado a la contaminación y del éxito de la restauración de los bosques urbanos con un monitoreo participativo y herramientas digitales Resumen El monitoreo de los bosques periurbanos requiere indicadores de daños en la vegetación. Un ejemplo son los bosques de abeto (Abies religiosa) que rodean la Ciudad de México, pues desde hace más de 4 décadas han estado expuestos al ozono troposférico, un contaminante nocivo. Desarrollamos un sistema de monitoreo participativo con el que miembros de la comunidad local y científicos generaron datos sobre los daños causados por el ozono en los árboles. Los guardabosques de Santa Rosa Xochiac (133) utilizaron la herramienta digital KoboToolBox para registrar los daños causados por el ozono en los árboles, su altura, edad, estado, posición y si eran árboles plantados. El 35% de los árboles (n = 1,765) presentó daños por ozono. Los árboles más jóvenes tenían un menor porcentaje de follaje dañado por el ozono que los árboles más viejos (p<0.0001), y los árboles asintomáticos tendían a ser más jóvenes (p<0.0001). Los árboles sintomáticos eran más altos que los asintomáticos de la misma edad (R2 c = 0.43, R2 m = 0.27). La participación de las comunidades locales facilitó el monitoreo forestal y el uso de tecnología digital mejoró la calidad de los datos. Este sistema participativo puede utilizarse para monitorear los cambios en el estado de los bosques a lo largo del tiempo y contribuir a los esfuerzos de restauración impulsados por el gobierno o las comunidades locales, facilitando la toma de decisiones a nivel local.

Effect of somatic antigens of Dirofilaria repens adult worms on angiogenesis, cell proliferation and migration and pseudo-capillary formation in human endothelial cells.

BACKGROUND: Angiogenesis is defined as the formation of new vessels by sprouting of endothelial cells from pre-existing vessels in response to stimuli, such as hypoxia or inflammation. Subcutaneous dirofilariasis, caused by Dirofilaria repens, is a zoonotic disease characterized by the formation of subcutaneous nodules with the presence of at least one encapsulated worm, showing perivascular vascularization around it. The aim of this study is to analyze whether the somatic antigen of adult D. repens worms interacts with and modulates the angiogenic mechanism, cell proliferation and migration, and formation of pseudo-capillaries. METHODS: The expression of VEGF-A, VEGFR-1/sFlt, VEGFR-2, mEnd and sEnd in cultures of human vascular endothelial cells stimulated with somatic antigen of adult worms of D. repens (DrSA), vascular endothelial growth factor (VEGF) and DrSA + VEGF were evaluated by using ELISA commercial kits. Cellular viability was analyzed by live cell count, cytotoxicity assays by using a commercial kit, cell proliferation by MTT-based assay, cell migration by wound-healing assay carried out by scratching wounds and capacity of formation of pseudo-capillaries analyzing cell connections and cell groups in Matrigel cell cultures. In all cases unstimulated cultures were used as controls. RESULTS: DrSA + VEGF significantly increased the expression of VEGF-A, VEGFR-2 and mEndoglin compared to other groups and unstimulated cultures. Moreover, DrSA + VEGF produced cell proliferation and migration and increased the formation of pseudo-capillaries. CONCLUSIONS: Somatic antigen of adult D. repens worms activated the proangiogenic mechanism, cell proliferation and cell migration as well as formation of pseudo-capillaries in this in vitro human endothelial cell model. These processes could be related to the survival of adult D. repens in subcutaneous nodules in infected hosts.

Emotional dysregulation in women with endometriosis with cyclical and non-cyclical chronic pelvic pain.

BACKGROUND: Endometriosis is a pathophysiological condition characterized by glands and stroma outside the uterus in regions such as the bladder, ureter, fallopian tubes, peritoneum, ovaries, and even in extra pelvic sites. One of the main clinical problems of endometriosis is chronic pelvic pain (CPP), which considerably affects the patients' quality of life. Patients with endometriosis may, cyclically or non-cyclically (80% of cases) experience CPP. High levels of anxiety and depression have been described in patients with endometriosis related to CPP; however, this has not been evaluated in endometriosis women with different types of CPP. Therefore, the research question of this study was whether there is a difference in the emotional dysregulation due to the type of pain experienced by women with endometriosis? METHODS: This work was performed in the National Institute of Perinatology (INPer) in Mexico City from January 2019 to March 2020 and aimed to determine if there are differences in emotional dysregulation in patients with cyclical and non-cyclical CPP. 49 women from 18 to 52 years-old diagnosed with endometriosis presenting cyclical and non-cyclical CPP answered several batteries made up of Mini-Mental State Examination, Visual Analog Scale, Beck's Depression Inventory, State Trait-Anxiety Inventory, and Generalized Anxiety Inventory. Mann-Whitney U and Student's t-test for independent samples to compare the difference between groups was used. Relative risk estimation was performed to determine the association between non-cyclical and cyclical CPP with probability of presenting emotional dysregulation. RESULTS: We observed that patients with non-cyclical CPP exhibited higher levels of depression and anxiety (trait-state and generalized anxiety) than patients with cyclical pain, p < 0.05 was considered significant. No differences were observed in pain intensity, but there was a higher probability of developing emotional dysregulation (anxiety or depression) in patients with non-cyclical CPP. No differences were observed in cognitive impairment. CONCLUSIONS: Our data suggest that patients with non-cyclical (persistent) CPP present a higher emotional dysregulation than those with cyclical pain.

Identification and Functional Annotation of Genes Related to Horses' Performance: From GWAS to Post-GWAS.

Integration of genomic data with gene network analysis can be a relevant strategy for unraveling genetic mechanisms. It can be used to explore shared biological processes between genes, as well as highlighting transcription factors (TFs) related to phenotypes of interest. Unlike other species, gene-TF network analyses have not yet been well applied to horse traits. We aimed to (1) identify candidate genes associated with horse performance via systematic review, and (2) build biological processes and gene-TF networks from the identified genes aiming to highlight the most candidate genes for horse performance. Our systematic review considered peer-reviewed articles using 20 combinations of keywords. Nine articles were selected and placed into groups for functional analysis via gene networks. A total of 669 candidate genes were identified. From that, gene networks of biological processes from each group were constructed, highlighting processes associated with horse performance (e.g., regulation of systemic arterial blood pressure by vasopressin and regulation of actin polymerization and depolymerization). Transcription factors associated with candidate genes were also identified. Based on their biological processes and evidence from the literature, we identified the main TFs related to horse performance traits, which allowed us to construct a gene-TF network highlighting TFs and the most candidate genes for horse performance.

Kidney Donor Profile Index in a Transplant Center in Mexico.

BACKGROUND: The Kidney Donor Profile Index (KDPI) was created in 2014 to measure the likelihood of graft failure for a given donor compared with the median kidney donor from the previous year. This scale is based on the American population only. Mexico is one of the countries with greater incidence of chronic kidney disease, a long waiting list, and not enough kidney donors with KDPI smaller than 80%. This has led transplant centers to take kidney grafts with a higher KDPI. OBJECTIVE: To investigate the agreement between the KDPI and histologic scores (preimplantation renal biopsy) and assess the relationship between the Kidney Donor Risk Index (KDRI), KDPI, and the histologic score on graft survival. METHODS: A retrospective, analytical, transversal study was performed. Data were collected from patients with kidney grafts from deceased donors from January 1, 2011, to June 30, 2019, at our hospital. The variables analyzed were age, weight, height, sex, race and/or ethnicity, history of hypertension or diabetes, cause of death, serum creatinine, KDPI, KDRI, and biopsy result from each graft prior to transplant. RESULTS: The total population was 59 deceased kidney donors. For our patients, a high KDPI did not increase mortality rate; it provided greater benefit than staying on dialysis. CONCLUSIONS: We conclude that the use of KDRI should only be considered to assess the degree of fibrosis, not to rule out a transplantable kidney, in addition to the consistent demonstration that high KDPI kidneys (even 91%-100%) confer greater survival benefits to patients regarding the waiting list.

Overdiagnosis of Septic Shock and Loss of Potential Donors of Corneal Tissue in the Hospital General de México Dr. Eduardo Liceaga.

At the Hospital General de México Dr. Eduardo Liceaga, a large number of potential donors of corneal tissue are discarded owing to various contraindications such as shock septic. The objective of this study is to determine the number of patients with postmortem diagnosis of septic shock and analyze whether there is an overdiagnosis of it. It is a cross-sectional and descriptive study in which 144 (n = 144) medical records were reviewed between January 2018 and May 2019 and where septic shock was identified within postmortem diagnoses. Exclusion criteria were age <2 or ≥75 years; infection due to human immunodeficiency virus, hepatitis B virus, or hepatitis C virus; active tuberculosis; neuroinfection; endocarditis; or cancer. The Sequential Organ Failure Assessment (SOFA) scale was calculated, and a descriptive analysis of the data was performed. According to the third international consensus for the definition of sepsis and septic shock (SEPSIS 3) using its SOFA diagnostic tool, 46 (32%) patients did not meet the criteria for septic shock because they did not require vasopressor nor had a lactate ≥ 18 mg/dL. These were potential donors of corneal tissue that were not considered as such; 35 of them met the diagnosis of sepsis with SOFA scores of ≥2 and the suspected or documented presence of infection. Eleven patients were not considered septic. It is important to train the hospital medical staff to properly diagnose septic shock, based on international consensus, and perform all the laboratory studies that allow doctors to calculate the SOFA to confirm or rule out the presence of septic shock.

Cumplimiento del programa nacional de atención estomatológica integral en las áreas de salud. Manzanillo. 2016 / Compliance with the national comprehensive stomatological care program in the health areas. Manzanillo 2016

Desde el año 2010 se inició un proceso de transformaciones en el Programa Nacional de Atención Estomatológica Integral en el municipio Manzanillo, de la provincia de Granma, para garantizar la sostenibilidad de los servicios en el sector salud. El presente estudio se realizó con el objetivo de describir el cumplimiento de ese proceso de transformaciones según los indicadores del programa en el municipio Manzanillo durante el año 2016. Se realizó un estudio descriptivo retrospectivo, basado en el análisis de los indicadores de salud y los objetivos del Ministerio de Salud Pública. La información se obtuvo del Departamento Municipal de Registros Médicos y Estadísticos, del año 2016. Para su procesamiento y análisis se utilizó el cálculo de porcentajes y la distribución de frecuencias expresada en tablas. En los resultados se hallaron como aspectos positivos el incremento del número de consultas generales y de tratamientos conservadores, se disminuyó el número de exodoncias; es mínima la afluencia de pacientes a cuerpos de guardia por urgencias estomatológicas y no se cumple el indicador ingreso/alta(AU)

Since 2010, a process of transformation has begun in the National Comprehensive Stomatological Care Program in the municipality of Manzanillo, in the province of Granma, to guarantee the sustainability of services in the health sector. The present study was carried out with the objective of describing the fulfillment of this process of transformations according to the indicators of the program in the municipality of Manzanillo during the year 2016. A retrospective descriptive study was carried out, based on the analysis of health indicators and objectives. Of the Ministry of Public Health. The information was obtained from the Municipal Department of Medical Records and Statistics, of the year 2016. For its processing and analysis, the calculation of percentages and the frequency distribution expressed in tables was used. Positive aspects were found in the results as an increase in the number of general consultations and conservative treatments, the number of extractions was reduced; the inflow of patients to medical guard corps due to stomatological emergencies is minimal and the admission indicator is not met

Nivel de intensidad de las principales actividades físicas de escolares chilenos: determinación por acelerometría / Intensity level of the main physical activities of Chilean school children: determination by accelerometry

The aim of this study was to determine the intensity level of different specific activities of chilean school children by accelerometric values. With this objective, 80 children aged 10 to 12 years (39 boys, 41 girls) filled a diary of their activities in a structured format and simultaneously weard an accelerometer for one to three days. The activities of every subject were expressed in counts per minute (cpm). The levels of physical activity (PA). Were classified as sedentary PA / light PA / moderate PA and vigorous PA. Results: 26 different activities were documented. In most of them the difference between boys and girls was weak and no significant. The only vigorous PA was to run. In category "moderate PA" the cpm of plays outdoor was significantly less than those of sports and school gymnastic (p 0,007)- These results can serve as guiding for establish a scale of values for global evaluation of PA in children schoolers.

El propósito del presente trabajo fue determinar por valores acelerométricos el nivel de intensidad de diferentes actividades específicas de niños escolares chilenos. Con este objetivo, 80 niños de 10 a 12 años (39 varones y 41 niñas) llevaron un diario de actividades en un formato estructurado y simultáneamente un acelerómetro por uno a tres días. En cada sujeto las actividades se expresaron en cuentas por minuto (cpm). Los niveles respectivos de actividad física (AF) fueron clasificados en: AF sedentaria/ AF leve / AF moderada / AF vigorosa. Resultados: 26 actividades diferentes fueron documentadas. En la mayoría de ellas la diferencia entre niños y niñas fue leve y no significativa. La única AF vigorosa fue correr. En la categoría “AF moderada” los cpm de los juegos al aire libre fueron significativamente más bajos que las de los deportes y educación física escolar (p 0,007). Estos resultados pueden servir de guía para establecer una escala de valores en la evaluación global de la AF de niños chilenos.

Bacillus em dietas para alevinos de tilápia do nilo, variedade gift / Bacillus in diets for fingerlings of nile tilapia, gift variety

Os probióticos vêm se destacando na produção aquícola como promotores de crescimento, especialmente na tilapicultura, por serem capazes de sobreviver ao trato gastrointestinal, aderir células da parede intestinal, reduzir ou prevenir patógenos, não ser patogênico ao hospedeiro. Objetivou-se avaliar o desempenho produtivo, índices corpóreos, macro micronutrientes e composição química da carcaça de alevinos de tilápia do Nilo, variedade GIFT, alimentadas com ração formulada com probióticos Bacillus cereus var. Toyoi e Bacillus subtilis C-3102, durante alevinagem. Foram utilizados 720 pós-larvas com peso médio inicial de 26,6 ± 3,4 mg. Os peixes foram distribuídos aleatoriamente em um sistema de 24 aquários de 0,03 m³ num delineamento inteiramente casualizado composto por três tratamentos e oito repetições, constituído por dois probióticos e, tratamento ausente de probiótico. Os dados dos parâmetros analisados foram submetidos à ANOVA a 5%. Não houve diferenças significativas (p>0,05) ao final do cultivo para os parâmetros de peso final, ganho em peso, crescimento específico e consumo de ração. A biomassa final, ganho em biomassa e sobrevivência dos peixes foi afetada significativamente (p<0,05) pela adição de B. cereus ou B. subtilis em relação ao ausente. Não houve diferenças (p>0,05) nos índices corporais e composição centesimal com probióticos ou ausentes nas rações. A inclusão de quaisquer dos probióticos influenciou (p<0,05) sobre valores de cálcio na carcaça dos alevinos em relação aos peixes ausentes de probióticos. A utilização de B. subtilis ou B. cereus melhora o desempenho produtivo e não afetam negativamente os índices corpóreos, macro e micronutrientes na carcaça de alevinos de tilápia do Nilo, variedade GIFT.

Probiotics have gained prominence in aquaculture production as growth promoters, especially in tilapia culture, by being able to survive the gastrointestinal tract, adhere intestinal wall cells, reduce or prevent pathogens not be pathogenic to the host. The objective was to evaluate the performance, body indexes and macro and micronutrient composition of the carcass of the Nile tilapia, GIFT variety, fed with diets formulated with probiotic Bacillus cereus var. Toyoi and Bacillus subtilis C-3102, during nursery. There were used 720 post-larvae with initial average weight of 26.6 ± 3.4 mg. Fish were randomly distributed in a system of 24 aquaria of 0.03 m³ a completely randomized design consisting of three treatments and eight replications, consisting of two probiotics, and probiotic treatment absent. The data parameters were analyzed by ANOVA at 5%. There were no significant differences (p>0.05) in fish from all treatments for the final weight, weight gain, specific growth rate and feed intake. The final biomass, gain and survival of fish biomass was affected significantly (p<0.05) by addition of any one of the probiotics in relation to the absent. There were no differences (p>0.05) in body composition and with probiotics or absent in diets. The inclusion of any of probiotics was influenced (p<0.05) on calcium levels in the carcass of fish fingerlings in relation to the missing of probiotics. The use of B. subtilis or B.cereus improves performance and does not negatively affect the body indexes, macro and micronutrients in the carcass of Nile tilapia, GIFT variety.

Pilot nutrition and physical activity intervention for preschool children attending daycare centres (JUNJI): primary and secondary outcomes.

INTRODUCTION: A pilot intervention was conducted to promote physical activity and nutrition in public preschool education (near half a million children in Chile), in order to prevent obesity. OBJECTIVE: To assess the primary (body fat) and secondary outcomes (physical activity and energy intake) of a nutrition and physical activity pilot intervention for preschool children, attending day care centres. METHODS: A pilot intervention in six day care centres selected at random (n = 530), in 4-5 years old preschool children, Santiago, Chile intending to: provide nutritional and physical activity education to educators and health promotion activities for the family, which in turn, will affect the primary (body fat), and secondary outcomes (physical activity pattern and energy food intake) were measured in a representative subsample of 120 intervened and 145 controls children. RESULTS: In relation to secondary outcomes monitoring, moderate-vigorous activity was duplicated in the intervention group (+5.4% and +4.7%, respectively), in both obese and eutrophic children. Energy intake decreased in 11.7% in obese and 7.5% in eutrophic children. Dietary fat intake was reduced (-11 g in obese and -8.4 g in eutrophic children). Intervened obese children reduced body fat in 1.5%, meanwhile in control obese children, body fat increased 1.3% (p < 0.01). CONCLUSIONS: The pilot intervention demonstrated the feasibility to influence dietary risk factors and physical activity at the day care centres and families. Therefore, the implementation of the validated intervention program will be tested in different weather conditions, to prevent unhealthy habits in preschool children and their families.

Introducción: Intervención piloto en nutrición y actividad física para prevenir obesidad en la educación preescolar (cerca de medio millón de niños en Chile). Objetivo: Evaluar los resultados primarios (grasa corporal) y secundarios (actividad física e ingesta energética) de una intervención piloto para niños/as asistentes a guarderías infantiles. Métodos: Intervención piloto en seis guarderías seleccionadas al azar (n = 530 preescolares), 4-5 años en Santiago de Chile, con el objeto de: a) proporcionar educación en nutrición y actividad física para los educadores; b) actividades de promoción de la salud para la familia. El objetivo primario (grasa corporal), y los resultados secundarios (patrón de actividad física y la ingesta energética) se midieron en 265 preescolares (120 intervenidos y 145 niños controles). Resultados: La actividad física moderada- intensa se duplicó en los intervenidos (+5,4% y +4,7%, respectivamente), tanto en niños obesos y eutróficos. La ingesta energética se redujo en 11,7% en obesos y 7,5% en los eutróficos y la de grasa en (-11 g en obesos y -8,4 g en niños eutróficos). Los niños obesos intervenidos redujeron la grasa corporal en 1,5%, mientras que en los niños controles obesos, se incrementó 1,3% (p < 0,01). Conclusiones: La intervención piloto demostró la viabilidad de influir en los factores de riesgo dietarios y de actividad física en las guarderías y en las familias. Por lo tanto, la ejecución del proyecto piloto se pondrá a prueba en diferentes condiciones climáticas, para prevenir hábitos no saludables en los preescolares y sus familias.

Pilot nutrition and physical activity intervention for preschool children attending daycare centres (JUNJI); primary and secondary outcomes / Intervención piloto en nutrición y actividad física para preescolares asistentes a jardines infantiles (JUNJI); resultados primarios y secundarios

Introduction: A pilot intervention was conducted to promote physical activity and nutrition in public preschool education (near half a million children in Chile), in order to prevent obesity. Objective: To assess the primary (body fat) and secondary outcomes (physical activity and energy intake) of a nutrition and physical activity pilot intervention for preschool children, attending day care centres. Methods: A pilot intervention in six day care centres selected at random (n = 530), in 4-5 years old preschool children, Santiago, Chile intending to: provide nutritional and physical activity education to educators and health promotion activities for the family, which in turn, will affect the primary (body fat), and secondary outcomes (physical activity pattern and energy food intake) were measured in a representative subsample of 120 intervened and 145 controls children. Results: In relation to secondary outcomes monitoring, moderate-vigorous activity was duplicated in the intervention group (+5.4% and +4.7%, respectively), in both obese and eutrophic children. Energy intake decreased in 11.7% in obese and 7.5% in eutrophic children. Dietary fat intake was reduced (-11 g in obese and -8.4 g in eutrophic children). Intervened obese children reduced body fat in 1.5%, meanwhile in control obese children, body fat increased 1.3% (p < 0.01). Conclusions: The pilot intervention demonstrated the feasibility to influence dietary risk factors and physical activity at the day care centres and families. Therefore, the implementation of the validated intervention program will be tested in different weather conditions, to prevent unhealthy habits in preschool children and their families (AU)

Introducción: Intervención piloto en nutrición y actividad física para prevenir obesidad en la educación preescolar (cerca de medio millón de niños en Chile). Objetivo: Evaluar los resultados primarios (grasa corporal) y secundarios (actividad física e ingesta energética) de una intervención piloto para niños/as asistentes a guarderías infantiles. Métodos: Intervención piloto en seis guarderías seleccionadas al azar (n = 530 preescolares), 4-5 años en Santiago de Chile, con el objeto de: a) proporcionar educación en nutrición y actividad física para los educadores; b) actividades de promoción de la salud para la familia. El objetivo primario (grasa corporal), y los resultados secundarios (patrón de actividad física y la ingesta energética) se midieron en 265 preescolares (120 intervenidos y 145 niños controles). Resultados: La actividad física moderada- intensa se duplicó en los intervenidos (+5,4% y +4,7%, respectivamente), tanto en niños obesos y eutróficos. La ingesta energética se redujo en 11,7% en obesos y 7,5% en los eutróficos y la de grasa en (-11 g en obesos y -8,4 g en niños eutróficos). Los niños obesos intervenidos redujeron la grasa corporal en 1,5%, mientras que en los niños controles obesos, se incrementó 1,3% (p < 0,01). Conclusiones: La intervención piloto demostró la viabilidad de influir en los factores de riesgo dietarios y de actividad física en las guarderías y en las familias. Por lo tanto, la ejecución del proyecto piloto se pondrá a prueba en diferentes condiciones climáticas, para prevenir hábitos no saludables en los preescolares y sus familias (AU)

Relación médico-paciente con cáncer / Physician-patient relationship in cancer patients

Es conocido que en el terreno de la salud, el adecuado establecimiento de la relación médico-paciente favorece la intervención profesional oportuna, mejorando la evolución en el proceso de la enfermedad que da motivo al establecimiento de tal vínculo. Esta relación también ha cambiado, favoreciendo la participación activa del paciente en la toma de decisiones sobre su cuidado y salud, así como el compromiso ético en los profesionales de la salud con relación a la actualización de sus conocimientos, remarcando la importancia de la comunicación entre ambas partes. El paciente con cáncer y su familia cursan por un proceso peculiar, debido a la representación social y mental de esta enfermedad, así como por la toma de decisiones, y se hace evidente en ellos una especial vulnerabilidad durante el curso del padecimiento. El médico debe desarrollar su habilidad para la comunicación de malas noticias, asumiendo un rol ético, profesional y humanitario.

It is a well known fact in the health circle that establishing an adequate rapport with the patient facilitates timely interventions, which in turn can improve the course of the disease. The physician-patient relationship has evolved in order to favor an active participation of the patient in the decision-making process concerning his health and self-care, as well as promoting a more ethical commitment of the health professional through motivating knowledge updating and emphazising the importance of developing communication skills. Cancer patients and their families are particularly vulnerable, since they experience a difficult process due to the social and mental representations of cancer, and the tough decisions they have to make in relation to the disease. The health professional has to develop communication skills to deliver bad news from an ethical, professional and human point of view.

Autopercepción de la imagen corporal en estudiantes universitarios de Chile y Panamá / Body image perception in university students from Chile and Panama

Objetivo: Determinar la concordancia entre el estado nutricional y la percepción de la imagen corporal en universitarios chilenos y panameños. Métodos: Estudio observacional transversal en 792 estudiantes de ambos sexos, de 18 a 30 años de edad de la Universidad Santo Tomás de Vina del Mar en Chile, la Universidad Autónoma de Chile y la Universidad Latinoamericana de Ciencia y Tecnología (ULACIT) de Panamá. Se determinó el IMC real y el IMC percibido y luego éstos fueron comparados. Resultados: De 792 estudiantes evaluados, 480 eran de Chile (51,4% mujeres) y 312 de Panamá (56,7% mujeres). El IMC percibido por los chilenos fue mayor al real, en hombres y mujeres (60%); en cambio, los panameños presentan una sobreestimación menor al 50% en ambos sexos. En ambos países y para ambos sexos el porcentaje de estudiantes que se perciben igual es similar (20%). Hay concordancia diagnóstica entre el IMC y la imagen corporal en la mitad de los alumnos chilenos y en un tercio de las alumnas, pero la mejor concordancia se observó en personas con sobrepeso (69% y 90,5% respectivamente). En los panameños se observó concordancia diagnóstica de 40% en varones y 19,2% en mujeres; la mejor concordancia se observó en hombres con sobrepeso (83%). Conclusión: En los estudiantes con normopeso de ambos países existe una tendencia a sobreestimar el peso, mientras que por el contrario los obesos tienden a subestimarlo.

Objective: To determine the association between nutritional status and body image perception among university students from Chile and Panamá. Methods: An observational cross-sectional study was conducted among 792 students of both sexes, ages 18 to 30 years, from University Santo Tomás of Viña del Mar, Chile, University Autónoma of Chile and University Latinoamericana de Ciencia y Tecnología (ULACIT) of Panama. We determined the real BMI and the perceived BMI. Afterward, the two were compared to each other. Results: In a sample of 792 students, 480 from Chile (51,4% females) and 312 from Panamá (56,7% females), the perceived BMI is higher than the real one in the Chileans, men and women (60%). Instead, in Panamá the over-estimation is less than 50% in both sexes. The percentage is the same in both countries and both sexes that perceive themselves as they really are (20%). There is concordance between BMI and body image in half of Chilean men and a third of Chilean women. However, a better concordance is observed in overweight students (69% in men, 90,5% in women). In Panamanians, there is a concordance observed of40% in men and 19,9% in women. Conclusion: There is a tendency for overestimation in normal weight students of both countries. However the obese students tended to underestimate their weight.

Genetic diversity of Piaractus mesopotamicus (Characiformes: Characidae) broodstocks using in the restocking program of Tietê river, Brazil / Diversidade genética de estoques de Piaractus mesopotamicus (Characiformes, Characidae) utilizados no programa de repovoamento do rio Tietê, Brasil

The restocking programs are being used more frequently as methods of fish conservation. However, the reduction in the genetic diversity can affect survival of juveniles used in this programs and cause effects on the wild populations. The aim of this study was assess the genetic diversity in three broodstocks (BA, BB and BC) of pacu Piaractus mesopotamicus of a Hydropower plant in São Paulo - Brazil, using in restocking program of Tietê River. Nine RAPD primers were amplified used extracted DNA from 89 fin-clipping samples. Sixty-nine fragments were polymorphic, 15 had frequencies with significant differences (P<0.05), seven were excluded, and six were fixed fragments. High values for polymorphic fragments (47.83% to 71.01%) and Shannon index (0.270 to 0.424) were observed. Most of the genetic variation was found within the groups through the AMOVA analysis, which was confirmed by the results of the identity and genetic distance. Ancestry levels (FST) among the groups values indicated little and moderate genetic differentiation. The estimate of number of migrants by generation (Nm) indicated levels of gene flow. Moderate genetic divergence between groups (0.214 to 0.259) was observed. The results indicate high (BA and BB) and moderate (BC) variability within broodstocks and genetic differentiation among them. The fish stocks analyzed represent a genetic base that will allow the fish technicians to release juveniles without genetic risks to wild populations present in the river. These genetics procedures can be used as models for other migratory species.

Os programas de repovoamento estão sendo usados com mais frequência como métodos de conservação de peixes. No entanto, a redução na diversidade genética pode afetar a sobrevivência dos juvenis usados nesses programas e causar efeitos sobre as populações selvagens. O objetivo deste estudo foi avaliar a diversidade genética de três estoques de reprodutores (BA, BB e BC) de pacu Piaractus mesopotamicus de uma hidrelétrica em São Paulo - Brasil, do programa de repovoamento do rio Tietê. Nove iniciadores RAPD amplificaram-se usando DNA extraído de 89 amostras de nadadeira. Sessenta e nove fragmentos foram polimórficos, 15 tiveram frequências com diferenças significativas (P<0.05), sete foram excluídos e seis foram fragmentos limitantes. Observaram-se altos valores de fragmentos polimórficos (47,83% a 71,01%) e de índice de Shannon. A maior variação genética observou-se dentro dos grupos através da análise de AMOVA, sendo confirmado com os resultados de identidade e distância genética. Os níveis de FST entre os grupos indicaram pequena e moderada diferenciação genética. O número de migrantes por geração (Nm) indicou níveis de fluxo gênico. Observou-se moderada divergência genética entre grupos (0,214 a 0,259). Os resultados indicaram alta (BA e BB) e moderada (BC) variabilidade dentro dos estoques e diferenciação genética entre eles. Os estoques de peixes analisados representam uma base genética que permitirá aos produtores liberar juvenis sem riscos genéticos para as populações naturais presentes no rio. Esses procedimentos genéticos podem ser utilizados como modelos para outras espécies migradoras.

Variability of physical activity in 4 to 10-year-old children: a study by accelerometry.

INTRODUCTION: When compared to popular questionnaires, accelerometry provides more reliable information regarding physical activity. Thus, the objective has been to document the variability of physical activity in Chilean children in relation to age, gender, nutritional status and days of the week, and to determine how many of them meet the recommendation for moderate to vigorous physical activity for more than an hour a day. POPULATION AND METHODS: One hundred and nine (109) school children aged 4-10 (67 boys, 42 girls) wore an accelerometer for 2, 3 or 4 consecutive days. Of them, 30 were obese (BMI>95th percentile by age and gender). In each subject, levels of physical activity were expressed in counts per minute (cpm) and means (SD) of cpm/hour. Moderate to vigorous physical activity was defined by the daily sum of cpm>900. RESULTS: Daytime physical activity had a mean of 21,697 (662) cpm/hour with considerable variation from one child to another, and from one time of the day to another in the same child. Individual cpm/hour was significantly associated to moderate to vigorous physical activity (R = 0.954). Differences were found between girls and boys (p < 0.01) and between obese and non-obese children (p < 0.01). There were no differences between children 9 years (p = 0.12). There was a slight difference between weekdays and weekends. Fifty-six (56) of 67 boys (83.6%) and 24 of 42 girls (57.1%) met the recommendation for moderate to vigorous physical activity for more than 60 minutes a day. CONCLUSION: There is a physical activity defcit in Chilean school children under 10 years, particularly in girls and obese kids.

Variabilidad de la actividad física en niños chilenos de 4 a 10 años: estudio por acelerometría / Variability of physical activity in 4 to 10-year-old children: a study by accelerometry

Introducción. Frente a los populares cuestionarios, la acelerometría entrega una información más confiable de la actividad física. Así, el objetivo ha sido documentar la variabilidad de la actividad física de niños chilenos en relación con edad, sexo, estado nutricional y días de la semana, y determinar cuántos de ellos cumplen con la recomendación de tener actividad física moderada y vigorosa por más de una hora diaria. Población y métodos. Ciento nueve (109) escolares de 4-10 años de edad (67 niños, 42 niñas) llevaron un acelerómetro durante 2, 3 o 4 días consecutivos. Treinta eran obesos (IMC>P95 por edad y sexo). En cada sujeto, los niveles de actividad física fueron expresados en cuentas por minuto (cpm) y promedios (DE) de cpm/hora. La actividad física moderada y vigorosa se definió por la suma diaria de cpm>900. Resultados. La actividad física diurna tuvo un promedio de 21 697 (662) cmp/hora con variabilidad considerable de un niño a otro, y de un momento a otro del día en un mismo niño. Las cpm/hora individuales estaban significativamente asociadas con actividad física moderada y vigorosa (R= 0,954). Se encontraron diferencias entre niñas y niños (p <0,01) y entre obesos y no obesos (p <0,01). No hubo diferencia entre 9 años (p= 0,12). Entre semana y fin de semana hubo una leve diferencia. Cincuenta y seis de 67 (83,6%) niños y 24 de 42 (57,1%) niñas cumplieron con la recomendación de realizar actividad física moderada y vigorosa por más de 60 minutos diarios. Conclusión. Existe déficit de actividad física en escolares chilenos menores de 10 años, particularmente en niñas y en obesos.

Introduction. When compared to popular questionnaires, accelerometry provides more reliable information regarding physical activity. Thus, the objective has been to document the variability of physical activity in Chilean children in relation to age, gender, nutritional status and days of the week, and to determine how many of them meet the recommendation for moderate to vigorous physical activity for more than an hour a day. Population and methods. One hundred and nine (109) school children aged 4-10 (67 boys, 42 girls) wore an accelerometer for 2, 3 or 4 consecutive days. Of them, 30 were obese (BMI>95th percentile by age and gender). In each subject, levels of physical activity were expressed in counts per minute (cpm) and means (SD) of cpm/hour. Moderate to vigorous physical activity was defined by the daily sum of cpm>900. Results. Daytime physical activity had a mean of 21,697 (662) cpm/hour with considerable variation from one child to another, and from one time of the day to another in the same child. Individual cpm/hour was significantly associated to moderate to vigorous physical activity (R = 0.954). Differences were found between girls and boys (p < 0.01) and between obese and non-obese children (p < 0.01). There were no differences between children 9 years (p = 0.12). There was a slight difference between weekdays and weekends. Fifty-six (56) of 67 boys (83.6%) and 24 of 42 girls (57.1%) met the recommendation for moderate to vigorous physical activity for more than 60 minutes a day. Conclusion. There is a physical activity defcit in Chilean school children under 10 years, particularly in girls and obese kids.

Variabilidad de la actividad física en niños chilenos de 4 a 10 años: estudio por acelerometría / Variability of physical activity in 4 to 10-year-old children: a study by accelerometry

Introducción. Frente a los populares cuestionarios, la acelerometría entrega una información más confiable de la actividad física. Así, el objetivo ha sido documentar la variabilidad de la actividad física de niños chilenos en relación con edad, sexo, estado nutricional y días de la semana, y determinar cuántos de ellos cumplen con la recomendación de tener actividad física moderada y vigorosa por más de una hora diaria. Población y métodos. Ciento nueve (109) escolares de 4-10 años de edad (67 niños, 42 niñas) llevaron un acelerómetro durante 2, 3 o 4 días consecutivos. Treinta eran obesos (IMC>P95 por edad y sexo). En cada sujeto, los niveles de actividad física fueron expresados en cuentas por minuto (cpm) y promedios (DE) de cpm/hora. La actividad física moderada y vigorosa se definió por la suma diaria de cpm>900. Resultados. La actividad física diurna tuvo un promedio de 21 697 (662) cmp/hora con variabilidad considerable de un niño a otro, y de un momento a otro del día en un mismo niño. Las cpm/hora individuales estaban significativamente asociadas con actividad física moderada y vigorosa (R= 0,954). Se encontraron diferencias entre niñas y niños (p <0,01) y entre obesos y no obesos (p <0,01). No hubo diferencia entre 9 años (p= 0,12). Entre semana y fin de semana hubo una leve diferencia. Cincuenta y seis de 67 (83,6%) niños y 24 de 42 (57,1%) niñas cumplieron con la recomendación de realizar actividad física moderada y vigorosa por más de 60 minutos diarios. Conclusión. Existe déficit de actividad física en escolares chilenos menores de 10 años, particularmente en niñas y en obesos.(AU)

Introduction. When compared to popular questionnaires, accelerometry provides more reliable information regarding physical activity. Thus, the objective has been to document the variability of physical activity in Chilean children in relation to age, gender, nutritional status and days of the week, and to determine how many of them meet the recommendation for moderate to vigorous physical activity for more than an hour a day. Population and methods. One hundred and nine (109) school children aged 4-10 (67 boys, 42 girls) wore an accelerometer for 2, 3 or 4 consecutive days. Of them, 30 were obese (BMI>95th percentile by age and gender). In each subject, levels of physical activity were expressed in counts per minute (cpm) and means (SD) of cpm/hour. Moderate to vigorous physical activity was defined by the daily sum of cpm>900. Results. Daytime physical activity had a mean of 21,697 (662) cpm/hour with considerable variation from one child to another, and from one time of the day to another in the same child. Individual cpm/hour was significantly associated to moderate to vigorous physical activity (R = 0.954). Differences were found between girls and boys (p < 0.01) and between obese and non-obese children (p < 0.01). There were no differences between children 9 years (p = 0.12). There was a slight difference between weekdays and weekends. Fifty-six (56) of 67 boys (83.6%) and 24 of 42 girls (57.1%) met the recommendation for moderate to vigorous physical activity for more than 60 minutes a day. Conclusion. There is a physical activity defcit in Chilean school children under 10 years, particularly in girls and obese kids.(AU)

[Obesity prevention in preschool and schoolchildren attending public schools from a district of Santiago, Chile: pilot project 2006]. / Prevención de obesidad en preescolares y escolares de escuelas municipales de una Comuna de Santiago de Chile: proyecto piloto 2006.

Childhood obesity in Chile has been recognized as a public health problem. In 2006, we developed a school-based obesity prevention pilot project to intervene during 5 months preschool and schoolchildren from 1st to 4th grades attending 7 public schools located in a district of Santiago, Chile of medium-low and low SES. The objective of this project was to evaluate the feasibility of implementing a longer intervention giving recommendations to the educational authorities to better implement it. We trained teachers to apply educational activities ( in nutrition and physical activity) for the children in the 7 schools, but additionally in 4 of these schools, teachers of those grades participated in a Counselling program on healthy lifestyle applied individually, anthropometric evaluation and blood tests. The initiatives were evaluated on a sample of 522 schoolchildren (nutritional status and physical fitness), 38 teachers with Counselling (BMI, waist circumference or WC, blood sugar, HDL, triglycerides, cholesterol) and 19 teachers with no counselling (BMI and WC). Additionally, we evaluated the quality of PE classes. The results on the children show a trend on only the younger ones to decrease the % obesity, improving significantly their physical fitness. In teachers with counselling, a trend toward decreasing BMI and WC was observed, while biochemical parameters remained unchanged. We showed that it is feasible to implement a longer intervention recommending improving the quality of PE classes and allowing more time to train teachers and for individual counselling.

Prevención de obesidad en preescolares y escolares de escuelas municipales de una comuna de Santiago de Chile: proyecto piloto 2006 / Obesity prevention in preschool and schoolchildren attending public schools from a district of Santiago, Chile: pilot project 2006

La obesidad infantil en Chile ha sido reconocida como un problema de salud pública prioritario. En el año 2006 desarrollamos un proyecto piloto de intervención de 5 meses para prevenir obesidad en preescolares y escolares de pre-kinder a 4º grado en 7 escuelas públicas de una comuna de clase media-baja de Santiago de Chile. El objetivo del proyecto fue evaluar la factibilidad de implementar una intervención de más largo plazo y darle sugerencias a las autoridades para poder hacerlo en mejor forma. En las 7 escuelas se implementaron actividades educativas dirigidas a los niños, en los ámbitos de alimentación saludable y fomento de la actividad física, pero además en 4 de éstas, se implementó un programa para los profesores. Este consistió en Consejería personalizada en hábitos de vida saludable, evaluaciones antropométricas y bioquímica. Las iniciativas se evaluaron en una muestra de 522 escolares (estado nutricional y aptitud física) y en 38 profesores intervenidos (IMC, circunferencia de cintura, glicemia, HDL, colesterol total y triglicéridos) y los 19 sin intervención (IMC y circunferencia de cintura). Se determinó además la calidad de las clases de educación física. Los resultados muestran una tendencia en los escolares de menor edad de disminuir el por ciento de obesidad, mejorando significativamente la aptitud física. En los profesores intervenidos se aprecia una tendencia a disminuir el IMC y circunferencia de cintura, mientras que los parámetros bioquímicos no variaron. Se muestra que es factible implementar un programa de más larga duración recomendando mejorar las clases de educación física y aumentar el tiempo disponible para Consejería y capacitación de profesores.

Childhood obesity in Chile has been recognized as a public health problem. In 2006, we developed a school-based obesity prevention pilot project to intervene during 5 months preschool and schoolchildren from 1st to 4th grades attending 7 public schools located in a district of Santiago, Chile of medium-low and low SES. The objective of this project was to evaluate the feasibility of implementing a longer intervention giving recommendations to the educational authorities to better implement it. We trained teachers to apply educational activities ( in nutrition and physical activity) for the children in the 7 schools, but additionally in 4 of these schools, teachers of those grades participated in a Counselling program on healthy lifestyle applied individually, anthropometric evaluation and blood tests. The initiatives were evaluated on a sample of 522 schoolchildren (nutritional status and physical fitness), 38 teachers with Counselling (BMI, waist circumference or WC, blood sugar, HDL, triglycerides, cholesterol) and 19 teachers with no Counselling (BMI and WC). Additionally, we evaluated the quality of PE classes. The results on the children show a trend on only the younger ones to decrease the percent obesity, improving significantly their physical fitness. In teachers with Counselling, a trend toward decreasing BMI and WC was observed, while biochemical parameters remained unchanged. We showed that it is feasible to implement a longer intervention recommending improving the quality of PE classes and allowing more time to train teachers and for individual Counselling.