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Trends in vasectomy and sexually transmitted diseases in Chile: findings from robust national databases
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Toledo, Daniela

; Urquidi, Cinthya

; Sepúlveda-Peñaloza, Alejandro

; Leyton, Rodrigo

Cadernos de Saúde Pública

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2024, Volume 40 Nº 3 elocation e00129323

Resumo: Es En Pt | Texto: Es En Pt | PDF: Es | PDF: En | PDF: Pt

Resumen: Se viene surgiendo una controversia sobre el aumento o la disminución de la vasectomía; sin embargo, la evidencia aún es escasa en América Latina. Este estudio ecológico analizó las tendencias de la vasectomía y las enfermedades de transmisión sexual (ETS) durante un período de 10 años en Chile y determinó si existe alguna relación entre ellas. Este es un estudio ecológico mixto que utiliza datos secundarios representativos sobre el número de vasectomías y casos de ETS de 2008 a 2017. Las tasas de vasectomía se calcularon por grupos de edad teniendo en cuenta a hombres entre 20-59 años de edad y ETS específicas (VIH, clamidia, gonorrea, tricomoniasis y sífilis) para el mismo período. Los modelos de regresión binomial negativa multivariante se ajustaron para evaluar las tendencias y las relaciones entre las tasas. La edad media de la vasectomía fue de 40,3 años, sin diferencias significativas entre el período del estudio (p = 0,058). La tasa general de vasectomía tuvo un incremento significativo para el período de 2008 a 2017 (p < 0,001), con diferencias entre los grupos de edad (p < 0,001). El incremento más significativo se observó en hombres de entre 30-49 años (p < 0,001). Las tasas de ETS tuvieron una alza significativa (p < 0,05) durante el período de estudio. Hubo una correlación positiva significativa entre las tasas de vasectomía y las tasas de incidencia de gonorrea (p = 0,008) y una correlación inversa con las tasas de incidencia de hepatitis B (p = 0,002). Se concluye que las tendencias de la vasectomía y las tasas de ETS presentaron un incremento significativo en período de 2008 a 2017 en Chile, especialmente entre los hombres de entre 30-49 años. La relación entre la vasectomía y el incremento de las ETS puede ser un nuevo factor de riesgo para las políticas de salud sexual y reproductiva que puede ayudar a controlar la epidemia del VIH y las ETS.

Abstract: A controversy about the increase or decline of vasectomy is emerging; however, the evidence is still scarce in Latin America. This ecological study analyzed the vasectomy and sexual transmitted diseases (STD) trends over a period of 10 years in Chile and determined if there is any relationship between them. We conducted a mixed ecological study using secondary and representative data on the number of vasectomies and STD cases from 2008 to 2017. Vasectomy rates were calculated for age-specific groups of men aged 20-59 years, and specific STD (HIV, chlamydia, gonorrhea, trichomoniasis, and syphilis) for the same period. Multivariate negative binomial regression models were fitted to evaluate rate trends and relationships. The mean vasectomy age was 40.3 years, with no significant differences between the years of the study (p = 0.058). The overall vasectomy rate significantly increased from 2008 to 2017 (p < 0.001), with differences between age groups (p < 0.001). The most significant increase was observed in men aged 30-49 (p < 0.001). The STD rates significantly increased (p < 0.05) during the study period. A significant positive correlation was found between vasectomy and gonorrhea incidence rates (p = 0.008) and an inverse correlation was found with hepatitis B incidence rates (p = 0.002). Vasectomy trends and STD rates significantly increased from 2018 to 2017 in Chile. especially among men aged 30-49 years. The relationship between vasectomy and STD increments suggests a new risk factor for reproductive and sexual health policies to aid controlling the HIV and STD epidemic.

Resumo: Uma controvérsia sobre o aumento ou declínio da vasectomia está surgindo; no entanto, as evidências ainda são escassas na América Latina. Este estudo ecológico analisou as tendências de vasectomia e doenças sexualmente transmissíveis (DST) em um período de dez anos no Chile e determinou se há alguma relação entre elas. Este é um estudo ecológico misto utilizando dados secundários e representativos sobre o número de vasectomias e casos de DSTs de 2008 a 2017. As taxas de vasectomia foram calculadas por grupos etários, considerando homens de 20-59 anos de idade e DSTs específicas (HIV, clamídia, gonorreia, tricomoníase e sífilis) para o mesmo período. Modelos de regressão binomial negativa multivariada foram ajustados para avaliar tendências e relações entre taxas. A média de idade da vasectomia foi de 40,3 anos, sem diferenças significativas entre os anos do estudo (p = 0,058). A taxa geral de vasectomia aumentou significativamente de 2008 a 2017 (p < 0,001), com diferenças entre grupos etários (p < 0,001). O aumento mais significativo foi observado em homens de 30-49 anos (p < 0,001). As taxas de DST aumentaram significativamente (p < 0,05) durante o período de estudo. Houve correlação positiva significativa entre as taxas de vasectomia e as taxas de incidência de gonorreia (p = 0,008) e uma correlação inversa com as taxas de incidência de hepatite B (p = 0,002). As tendências de vasectomia e as taxas de DST aumentaram significativamente de 2008 para 2017 no Chile, especialmente entre homens de 30-49 anos. A relação entre vasectomia e incrementos de DST sugere um novo fator de risco para políticas de saúde sexual e reprodutiva para auxiliar no controle da epidemia de HIV e DST.

https://doi.org/10.1590/0102-311xen129323

[SciELO Preprints] - Consensus of the Respiratory Committee of the Latin American Society for Pediatric Intensive Care: Management of pediatric SARS-CoV-2. (SLACIP): COVID-19 Pediatric
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Monteverde, Ezequiel Yunge, Mauricio Dominguez-Rojas, Jesus Fernández, Analía Castillo-Moya, Andrés Acuña, Julia Adasme-Jeria, Rodrigo Brunow de Carvalho, Werther Johnston, Cíntia Leyton-Avilés, Pablo López-Alarcón, Yúrika Mallma Arrescurrenaga, Gabriela Fatima Retta, Alejandra Sequeira, Gabriela Wood-Valverde, David Bustos Vera-Pinto, Álvaro Franco Fernández-Sarmiento, Jaime Ferreira, Carla Samudio, Lissa Wegner-Araya, Adriana Vallejos-Carle, Nimia Munaico Abanto, Manuel Eduardo Rojas Flores, David Pascual Aguilera-Avendaño, Vladimir Fabio Torres, Silvio

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Data de publicação: 2021-11-26

Resumo: En Es

Introduction The COVID-19 pandemic generated many controversies in the management of critically ill pediatric patients. The main ones were about ventilatory support, phenotypic differences between adults and children, and acute and subacute clinical forms. For this reason, the Respiratory Committee (RC) of the Latin American Society of Pediatric Intensive Care (SLACIP) generated a document to summarize the recommendations with the best evidence. The objective of these recommendations is to provide an update on issues related to pediatric COVID-19. Methods and Materials The Respiratory Committee created a group composed of 19 pediatric kinesiologists/physiotherapists and intensivists from 8 Latin American countries and defined on 3/27/20 the 15 most relevant topics, assigning 3 referents and 2 reviewers for each. The manuscripts went through 4 stages until their final version. The complete document was freely distributed on 22/05/20 and updated twice (07/08/20 and 02/09/21). For the current version there were 3 special collaborators. Result The material consists of a complete 94-page document and an executive summary. The topics included are case definition, epidemiology, clinical classification, subacute inflammatory syndrome, personal protective equipment, aerosolization situations (intubation, extubation, suctioning, sampling, filter replacement, cardiopulmonary resuscitation, early mobilization), high flow cannula support, invasive, non-invasive and high frequency mechanical ventilation, pharmacological treatment, laboratory and imaging. Conclusion The purpose of this document is to serve as a guide for nurses, kinesiologists/physiotherapists and physicians in the management of critically ill pediatric patients with COVID-19.

Introducción La pandemia por COVID-19 generó muchas controversias en el manejo de los pacientes pediátricos críticos. Las principales fueron sobre el soporte ventilatorio, las diferencias fenotípicas entre adultos y niños y las formas clínicas aguda y subaguda.Por esa razón el Comité Respiratorio (CR) de la Sociedad Latinoamericana de Cuidados Intensivos Pediátricos (SLACIP) generó un documento para resumir las recomendaciones con mayor evidencia. El objetivo de estas recomendaciones es brindar una actualización de temas relacionados a COVID-19 pediátrico.Métodos y Materiales El Comité Respiratorio creó un grupo compuesto por 19 kinesiólogos/fisioterapeutas y médicos intensivistas pediátricos de 8 países de Latinoamérica y definió el 27/03/20 los 15 temas más relevantes, asignando 3 referentes y 2 revisores por cada uno. Los manuscritos pasaron por 4 etapas hasta su versión final. El documento completo se distribuyó libremente el 22/05/20, actualizándose en dos oportunidades (07/08/20 y el 02/09/21). Para la versión actual se contó con 3 colaboradores especiales.Resultado El material se compone de un documento completo de 94 páginas y un resumen ejecutivo. Los temas incluidos son definición de caso, epidemiología, clasificación clínica, síndrome inflamatorio subagudo, equipos de protección personal, situaciones de aerosolización (intubación, extubación, aspiración, toma de muestras, recambio de filtros, reanimación cardiopulmonar, movilización temprana), soporte con cánula de alto flujo, ventilación mecánica invasiva, no invasiva y de alta frecuencia, tratamiento farmacológico, laboratorio e imágenes.Conclusión La elaboración de este documento ha tenido como fin servir de guía para enfermeros, kinesiólogos/fisioterapeutas y médicos en el manejo de pacientes pediátricos en estado crítico por COVID-19.

https://doi.org/10.1590/SciELOPreprints.3236

Secuelas físicas y emocionales en pacientes post hospitalización por COVID-19
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Núñez-Cortés, Rodrigo

; Leyton-Quezada, Felipe

; Pino, María Belen

; Costa-Costa, Marina

; Torres-Castro, Rodrigo

Revista médica de Chile

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Jul 2021, Volume 149 Nº 7 Páginas 1031 - 1035

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Background: Facing a severe life-threatening disease has physical and emotional consequences for patients. Aim: To evaluate the physical and emotional sequelae in patients who survived COVID-19 pneumonia. Material and Methods: This cross-sectional study collected data from post-COVID-19 pneumonia patients admitted to an outpatient follow-up program in a public hospital in Chile. One month after hospital discharge, the evaluation of physical capacity was carried out through the 1-minute sit-to-stand test (1STST). In addition, the Clinical Frailty Scale (CFS) and the Hospital Anxiety and Depression scale were applied. Results: We included 70 patients aged 63 ± 13 years (54% women). Eighty-five percent of the patients were able to execute the 1STST with an average of 20.6 ± 4.8 repetitions. Forty-eight percent of the patients had a performance below the 2.5th percentile according to the reference values and 28% of patients had exertional desaturation. The CFS classified as mildly vulnerable or with some degree of frailty to 33% of patients. Twenty-five percent of the patients presented symptoms of depression and 33% of anxiety. Conclusions: Patients who survived COVID-19 have a decrease in physical capacity and a significant proportion of depression and anxiety one month after hospital discharge.

https://doi.org/10.4067/s0034-98872021000701031 892 downloads

Overactive bladder – 18 years – Part II
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Truzzi, Jose Carlos

; Gomes, Cristiano Mendes

; Bezerra, Carlos A.

; Plata, Ivan Mauricio

; Campos, Jose

; Garrido, Gustavo Luis

; Almeida, Fernando G.

; Averbeck, Marcio Augusto

; Fornari, Alexandre

; Salazar, Anibal

; Dell’Oro, Arturo

; Cintra, Caio

; Sacomani, Carlos Alberto Ricetto

; Tapia, Juan Pablo

; Brambila, Eduardo

; Longo, Emilio Miguel

; Rocha, Flavio Trigo

; Coutinho, Francisco

; Favre, Gabriel

; Garcia, José Antonio

; Castaño, Juan

; Reyes, Miguel

; Leyton, Rodrigo Eugenio

; Ferreira, Ruiter Silva

; Duran, Sergio

; López, Vanda

; Reges, Ricardo

International braz j urol

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Abr 2016, Volume 42 Nº 2 Páginas 199 - 214

Resumo: En | Texto: En | PDF: En

ABSTRACT Traditionally, the treatment of overactive bladder syndrome has been based on the use of oral medications with the purpose of reestablishing the detrusor stability. The recent better understanding of the urothelial physiology fostered conceptual changes, and the oral anticholinergics – pillars of the overactive bladder pharmacotherapy – started to be not only recognized for their properties of inhibiting the detrusor contractile activity, but also their action on the bladder afference, and therefore, on the reduction of the symptoms that constitute the syndrome. Beta-adrenergic agonists, which were recently added to the list of drugs for the treatment of overactive bladder, still wait for a definitive positioning – as either a second-line therapy or an adjuvant to oral anticholinergics. Conservative treatment failure, whether due to unsatisfactory results or the presence of adverse side effects, define it as refractory overactive bladder. In this context, the intravesical injection of botulinum toxin type A emerged as an effective option for the existing gap between the primary measures and more complex procedures such as bladder augmentation. Sacral neuromodulation, described three decades ago, had its indication reinforced in this overactive bladder era. Likewise, the electric stimulation of the tibial nerve is now a minimally invasive alternative to treat those with refractory overactive bladder. The results of the systematic literature review on the oral pharmacological treatment and the treatment of refractory overactive bladder gave rise to this second part of the review article Overactive Bladder – 18 years, prepared during the 1st Latin-American Consultation on Overactive Bladder.

https://doi.org/10.1590/S1677-5538.IBJU.2015.0367 2297 downloads

Overactive bladder – 18 years – part I
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Truzzi, Jose Carlos

; Gomes, Cristiano Mendes

; Bezerra, Carlos A.

; Plata, Ivan Mauricio

; Campos, Jose

; Garrido, Gustavo Luis

; Almeida, Fernando G.

; Averbeck, Marcio Augusto

; Fornari, Alexandre

; Salazar, Anibal

; Dell'Oro, Arturo

; Cintra, Caio

; Sacomani, Carlos Alberto Ricetto

; Tapia, Juan Pablo

; Brambila, Eduardo

; Longo, Emilio Miguel

; Rocha, Flavio Trigo

; Coutinho, Francisco

; Favre, Gabriel

; Garcia, José Antonio

; Castaño, Juan

; Reyes, Miguel

; Leyton, Rodrigo Eugenio

; Ferreira, Ruiter Silva

; Duran, Sergio

; López, Vanda

; Reges, Ricardo

International braz j urol

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Abr 2016, Volume 42 Nº 2 Páginas 188 - 198

Resumo: En | Texto: En | PDF: En

ABSTRACT Abstract: Overactive bladder syndrome is one of the lower urinary tract dysfunctions with the highest number of scientific publications over the past two decades. This shows the growing interest in better understanding this syndrome, which gathers symptoms of urinary urgency and increased daytime and nighttime voiding frequency, with or without urinary incontinence and results in a negative impact on the quality of life of approximately one out of six individuals – including both genders and almost all age groups. The possibility of establishing the diagnosis just from clinical data made patients' access to specialized care easier. Physiotherapy resources have been incorporated into the urological daily practice. A number of more selective antimuscarinic drugs with consequent lower adverse event rates were released. Recently, a new class of oral drugs, beta-adrenergic agonists has become part of the armamentarium for Overactive Bladder. Botulinum toxin injections in the bladder and sacral neuromodulation are routine modalities of treatment for refractory cases. During the 1st Latin-American Consultation on Overactive Bladder, a comprehensive review of the literature related to the evolution of the concept, epidemiology, diagnosis, and management was conducted. This text corresponds to the first part of the review Overactive Bladder 18-years.

https://doi.org/10.1590/S1677-5538.IBJU.2015.0365 3261 downloads

Asociación entre las variables del Cariograma e historia de caries en la población de 15 a 64 años de la comuna de Tortel, provincia del Capitán Prat de la XI Región de Aysén, Chile: análisis multivariable
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Ehremberg Godoy, Natalie

; Morales Montecinos, Diego

; Hempel Leyton, Marie-Claire

; Salgado González, Cristian

; Faleiros Chioca, Simone

; Rodríguez Martínez, Gonzalo

; Cabello Ibacache, Rodrigo

Revista clínica de periodoncia, implantología y rehabilitación oral

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2015, Volume 8 Nº 1 Páginas 7 - 16

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Introduction Dental caries represent a public health problem in both urban and rural areas of our Chile. A simple method to evaluate cariogenic risk is the Cariogram. This consists of a computer program that measures etiological factors of dental caries disease, and shows graphically the potential cariogenic risk of a patient, providing information that allows prevention and treatment strategies to be implemented. Objectives This study aims to establish the association between Cariogram variables and history of dental caries in the population aged 15 to 64 years from Tortel Commune, XI region, Chile. Materials and methods Observational-analytical, cross-sectional study of a sample of 173 individuals. The information was obtained by analysis of clinical records and Cariogram. The variables were analyzed by multiple linear regression (MLR) and logistic regression (LR) using Stata 11.0 statistical program. Results MLR analysis shows a significant relationship in model 1 (which only includes variables from the Cariogram Program, except for the use of fluoride) between Cariogram variables and history of dental caries, related diseases (P = .032), experience of caries (P = 0) and diet content (P = .031). In model 3 (the variable "age" is added), there is a significant relationship between history of caries and experience of caries (P = 0), gender (P = .007), and age (P = 0). The LR showed a statistically significant relationship between history of caries > 10 and experience of caries (P = .002) in Model 1, and with age (P = 0) in model 3. Conclusions There is significant relationship between experience of caries, gender and age with history of caries > 10. Based on these results, the older the individual, the more accumulated damage can be found. This relationship was also found between experience of caries, related diseases and diet content with history of dental caries, when the age variable is not included in the model.

Introducción La caries dental constituye un problema de salud pública urbano-rural en nuestro país. Una manera simple de evaluar riesgo cariogénico es el Cariograma, programa computacional que mide factores etiológicos de la enfermedad de caries, que muestra de manera gráfica el posible riesgo cariogénico del paciente, planteando estrategias de prevención y tratamiento. Objetivos Establecer asociación entre las variables del Cariograma y la historia de caries en la población de 15 a 64 años de la comuna de Tortel, XI Región. Materiales y métodos Estudio observacional-analítico, de corte transversal, con una muestra de 173 individuos. La información fue obtenida mediante ficha clínica y aplicación del Cariograma. Las variables fueron analizadas mediante regresión-lineal-múltiple (RLM) y regresión-logística (RL) con el programa estadístico Stata 11.0. Resultados La RLM muestra una relación significativa en el modelo 1 (que incluye las variables del Cariograma, excepto uso de flúor), entre las variables del Cariograma y las de historia de caries, enfermedades relacionadas (p = 0,032), experiencia de caries (p = 0) y DIeta contenido (p = 0,031). En el modelo 3 (al que se le adiciona la variable edad), existe relación significativa entre historia de caries y experiencia de caries (p = 0), género (p = 0,007) y edad (p = 0). La RL mostró una relación estadísticamente significativa entre historia de caries > 10 con experiencia de caries (p = 0,002) en el modelo 1 y con edad (p = 0) en el modelo 3. Conclusiones Existe relación estadísticamente significativa entre: experiencia de caries-género-edad con historia de caries > 10. De esta manera, a mayor edad mayor daño acumulado por caries, así como entre experiencia de caries, enfermedades relacionadas y dieta contenido con historia de caries cuando no se incluye la variable edad en el modelo.

https://doi.org/10.1016/j.piro.2015.02.003 3100 downloads

ESTADO NUTRICIONAL Y CONSUMO DE ALIMENTOS SELECCIONADOS EN ESCOLARES DE LA REGIÓN METROPOLITANA: LINEA BASE PARA UN PROYECTO DE PROMOCIÓN DEL CONSUMO DE PESCADO
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Olivares C, Sonia

; Zacarías H, Isabel

; Lera M, Lydia

; Leyton D, Bárbara

; Durán C, Rodrigo

; Vio del R, Fernando

Revista chilena de nutrición

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Ago 2005, Volume 32 Nº 2 Páginas 102 - 108

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Nutritional status and food intake of 1.431 school children of 4th grade (748 boys and 683 girls) were evaluated as a baseline of a project for promoting fish consumption The school children attended 20 schools of low and medium socioeconomic level (SEL) from Santiago. The resulting prevalence of obesity was 17 and 11.6% in boys and girls of low SEL, respectively, and 13.2 and 12.6%, in medium SEL (NS). The intake of dairy products was insufficient, higher in medium than in low SEL (356 vs 316 g/average/day) (p<0.001). Fruit and vegetable intake was low in both groups and bread intake higher in low than in medium SEL (220 vs 203 g/average/day) (p<0.001). The quantity of fish consumed was only 9 g/average/day, with no differences by SEL. The results of this study show the importance of developing interventions to improve fish intake among school children

En 1.431 escolares de 4º básico (748 hombres y 683 mujeres) asistentes a escuelas de nivel socioeconómico (NSE) medio y bajo en Santiago, se evaluó el estado nutricional y el consumo de alimentos seleccionados como línea base de una intervención para promover el consumo de pescado. La prevalencia de obesidad alcanzó al 17 y 11,6% en los niños y niñas de NSE bajo y al 13,2 y 12,6% en el NSE medio, respectivamente (NS). El consumo de lácteos fue insuficiente, mayor en el NSE medio que en el bajo (356 vs 316 ml/promedio/día) (p<0.001). El consumo de frutas y verduras fue bajo en ambos grupos y el de pan mayor en el NSE bajo que en el medio (220 vs 203 g/promedio/día) (p<0.001). El consumo de pescado sólo alcanzó a los 9 g/promedio/día, sin diferencias por NSE. Los resultados del estudio muestran la necesidad de realizar intervenciones para aumentar el consumo de pescado en la población escolar

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Litiasis ureteral por Indinavir: Report of one case
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Valero F, Gonzalo

; Leyton N, Rodrigo

; Valenzuela A, Antonio

Revista médica de Chile

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Mai 2002, Volume 130 Nº 5 Páginas 557 - 559

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

We report a 27 years old male, treated with Indinavir as a prophylactic anti-HIV agent, who consulted for left ureteral pain. Intravenous and retrograde pyelograms disclosed a radioluscent stone, that was removed surgically. The physical-chemical study of the stone, demonstrated indinavir sulphate crystals (Rev Méd Chile 2002; 130: 557-59)

5834 downloads

Tumor neuroectodérmico primitivo del riñón: Caso clínico
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Valero F, Gonzalo

; Escalona L, Arturo

; Leyton N, Rodrigo

Revista médica de Chile

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Fev 2001, Volume 129 Nº 2 Páginas 191 - 195

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

A 27 years old female presented with diffuse abdominal pain, malaise, weight loss and a palpable mass in the left abdomen. Abdominal CAT scan showed a 18 cm heterogeneous tumoral mass that originated in the kidney. The patient was operated on and it was not possible to completely remove the mass. In the postoperative period the patient received chemotherapy with vincristine, cyclophosphamide and adryamicin but the disease progressed and the patient died 16 months later. The pathological study of the surgical specimen disclosed a tumor with monotonous proliferation of small round cells with a basophilic nucleus and scanty cytoplasm with PAS positive granules. Immunohistochemistry was positive for specific neuronal enolase and CD99. Involvement of the urinary system with primary neuroectodermal tumors is very infrequent (Rev Méd Chile 2001; 129: 191-95).

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