Abstract: In pediatrics, a process called Pediatric Inflammatory Multisystem Syndrome (PIMS) associated with recent infection by SARS-CoV-2 virus has been observed. One of its variants presents similarities with Kawasaki disease (KD). Objective: to compare the clinical presentation, laboratory testing, and evolution of KD with PIMS Kawasaki phenotype (PIMS-KD) in patients hospitalized before the pandemic, compared with the pandemic period. Patients and Method: Cross-sectional study in two groups of patients at the Hospital Exequiel González Cortés: typical KD (group 1) and PIMS-KD (group 2). Data on demographic, clinical, and biochemical details were collected, as well as echocardiogram, treatment, and evolution records. IgG and IgM serology for SARS-CoV-2 was performed in both groups. Results: In the KD group and the PIMS-KD group, 20 and 33 patients were analyzed, respectively. There were differences in age, days of fever, count of leukocytes, lymphocytes, and platelets, erythrocyte sedimentation rate (ESR), and hospital stay. In 25% of the KD group, there were alterations in the echocardiogram and, in the PIMS-K group, all patients received corticosteroids and 25 patients received intravenous immunoglobulin (IVIG). In both groups, a favorable clinical evolution was observed, characterized by the absence of complications and mortality. Conclusions: Based on the data obtained in our study, the importance of the epidemiological link is emphasized as an essential factor in differentiating between both pathologies, highlighting the need to consider factors such as age, duration of fever, count of leukocytes, lymphocytes, and platelets, and degree of cardiac involvement, for a differential evaluation between patients with PIMS-KD versus KD.

Resumen: En pediatría, se ha observado un proceso denominado Síndrome Inflamatorio Multisistémico asociado a infección reciente por virus SARS-CoV-2 (PIMS). Una de sus variantes, presenta similitudes con la Enfermedad de Kawasaki (EK). Objetivo: comparar la presentación clínica, laboratorio y evolución de EK con PIMS fenotipo Kawasaki (PIMS-EK) en pacientes hospitalizados antes de la pandemia, comparado con el periodo de pandemia. Pacientes y Método: Estudio de corte transversal en dos grupos de pacientes del Hospital Exequiel González Cortés: EK típica (grupo 1) y PIMS-EK (grupo 2). Se recopilaron datos demográficos, clínicos, bioquímicos, ecocardiograma, tratamiento y evolución. En ambos grupos se realizó serología IgG e IgM para SARS-CoV-2. Resultados: En el grupo 1 se analizaron 20 pacientes y en el grupo 2, 33 pacientes. Hubo diferencias en edad, días de fiebre, valores de leucocitos, linfocitos, plaquetas, velocidad de eritrosedimentación (VHS) y días de hospitalización. En 25% de pacientes del grupo EK hubo alteraciones en el ecocardiograma y en el grupo PIMS-EK todos recibieron corticoides y 25 pacientes Inmunoglobulina endovenosa (IGEV). En ambos grupos, se observó una evolución clínica favorable, caracterizada por la ausencia de complicaciones y mortalidad. Conclusiones: En base a los datos obtenidos en nuestro estudio, se destaca la importancia del nexo epidemiológico como un factor esencial para diferenciar entre ambas patologías, resaltando la necesidad de considerar factores como la edad, la duración de la fiebre, los valores de leucocitos, linfocitos y plaquetas, grado de compromiso cardíaco, para una evaluación diferencial entre pacientes con PIMS-EK versus EK.

Abstract Introduction: 25% of people with hyperinsulinism develop diabetes 3-5 years after the first diagnosis and 70% will do so in the rest of their lives. To control glycemia levels as soon as hyperinsulinemia is detected, progression to diabetes is prevented and glycemic metabolism is restored. Aim: To determine the prevalence of post-glucose load pathological hyperinsulinism (HPPG) and its relationship with cardiovascular risk factors in adults <50 years with normal basal insulin levels. Methods: Cross-sectional study with convenience sampling in 756 patients. The variables studied included age, insulinemia (HPPG: Insulin>100 uIU/ ml at 2 hours), sex, hypertension, dyslipidemia, excess malnutrition due to, sedentary lifestyle, smoking, documented atheromatosis and myocardial infarction. The prevalence of variables in the general population was calculated and, in relation to the HPPG category, significance is evaluated with Fisher's exact test. Finally means are compared with ANOVA and t-test. With significance level <0.05. Binomial regression was used to estimate the prevalence ratio and confidence intervals in quantitative and qualitative variables. Statistical analysis was performed with the STATA 17 software. Results: HPPG prevalence was 41%, mean age 37.5 years, male sex 52.9%, arterial hypertension 40.5% and dyslipidemia 74.4%. Un relation to the presence of HPPG a statistically significant difference in the variables dyslipidemia, arterial hypertension, malnutrition due to excess and male sex was found. The prevalence ratios were 62%, 37%, 59% and 20%, respectively. Conclusion: A high prevalence of HPPG was found. Risk factors associated to HPPG were dyslipidemia, arterial hypertension, malnutrition due to excess and male sex. Thus, HPPG can play a role in the early detection of a higher risk of cardiovascular disease in the general population.

Resumen Introducción: 25% de personas con hiperinsulinismo desarrolla diabetes 3-5 años luego del primer diagnóstico y 70% lo hará en el resto de la vida. Intervenir los niveles de glicemia desde que se detecta hiperinsulinemia evita la progresión a diabetes y restaura el metabolismo glicémico. Objetivos: Determinar la prevalencia de hiperinsulinismo patológico post-carga de glucosa (HPPG) y su relación con factores de riesgo cardiovascular en adultos <50 años con insulina basal normal. Métodos: Estudio transversal con muestreo por conveniencia en 756 pacientes. Las variables de estudio fueron: edad, insulinemia (HPPG: Insulina>100 UI/ml a las 2 horas), sexo, hipertensión arterial, dislipidemia, malnutrición por exceso, sedentarismo, tabaquismo, ateromatosis e infarto miocárdico documentado. Con STATA 17 se calculó la prevalencia de variables en población general y según categoría de HPPG y se evaluó la significancia con prueba exacta de Fisher. Se compararon medias con ANOVA y t-test con nivel de significancia <0,05. Se usó regresión binomial para estimar Razón de Prevalencia e intervalos de confianza en variables cuantitativas y cualitativas. Resultados: la prevalencia de HPPG fue 41%. La edad promedio 37,5 años, el sexo masculino 52,9%, la hipertensión-arterial 40,5% y la dislipidemia 74,4%. Al comparar las poblaciones con y sin HPPG existieron diferencia estadísticamente significativa en las variables dislipidemia, hipertensión-arterial, malnutrición por exceso y sexo-masculino. La razón de prevalencia alcanzó a un 62%, 37%, 59% y 20% respectivamente. Conclusión: Se encontró una alta prevalencia de HPPG. Los factores de riesgo asociados a ella fueron dislipidemia, hipertensión arterial, malnutrición por exceso y sexo masculino. Esto sugiere que encontrar HPPG puede ser de utilidad para detectar precozmente a la población con un mayor riesgo de enfermedad cardiovascular.

ABSTRACT: The aim of this ex vivo study was to compare the ability of the apical sealing bioceramic cements BioRoot™ RCS (Septodont) and MTA-Fillapex (Angelus). One hundred and eighty-four vestibular canals were selected from ninety-two recently extracted maxillary molars. Canals were instrumented with the mechanized system ProTaper Next and obturated using the single cone technique. The sample was randomly divided into two groups (92): Group 1 was obturated with BioRoot ™ RCS, and Group 2 with MTA-Fillapex. Samples were processed for the leakage test by dye penetration and later cut longitudinally. The data obtained were tabulated and analyzed using Stata 15.0. The degree of leakage from BioRoot ™ RCS was 0.03 mm, and MTA-Fillapex was 0.31 mm p (0.00). BioRoot ™ bioceramic presented an adequate apical sealing, while MTA-Fillapex showed an accentuated leakage.

RESUMEN: El objetivo de este studio ex vivo fue comparar la capacidad de sellado apical de dos cementos biocerámicos, el BioRoot™ RCS (Septodont) y MTA-Fillapex (Angelus). 184 conductos vestibulares fueron seleccionados de 92 molares maxilares recientemente extraídos. Los conductos fueron instrumentados con el sistema de instrumentación mecanizado Protaper Next y obturados usando la técnica de cono único. Las muestras fueron divididas aleatoriamente en dos grupos (N 92): Grupo 1 fue obturado con BioRoot™ RCS, y el grupo 2 con MTA-Fillapex. Las muestras fueron procesadas para el test de filtración por penetración de tinción, y luego cortadas de manera longitudinal. Los datos obtenidos fueron tabulados y analizados usando Stata 15.0. El grado de penetración de BioRoot™ RCS fue de 0,03 mm, y de MTA Fillapex fue de 0,31 mm (P 0.00). BioRoot™ RCSpresent un sellado apical adecuado, mientras que MTA Fillapex mostró una filtración mayor.

Abstract Background: Chlamydia trachomatis is recognized as the causative agent of one of the most common and curable sexually transmitted infections (STIs). In women, it can be a trigger for pelvic inflammatory disease, a risk factor for infertility or acquisition of other STIs. Aim: To determine CT in women with vaginitis and associate it with sociodemographic, sexual, clinical, and vaginal microbiota factors. Methods: 121 female volunteers > 18 years of age, with a clinical diagnosis of vaginitis and abnormal vaginal discharge, attending in primary health care services (PHC) in Temuco-Chile were recluted. A vaginal discharge sample was taken, determining C. trachomatis by polymerase chain reaction and vaginal microbiota by Gram stain. Clinical, sociodemographic and sexual data were collected by survey. Results: Age range was 18-61 years. The frequency of C. trachomatis was 14.9%. C. trachomatis was associated with a higher number of sexual partners in the last 5 years (p = 0.001), oral plus anal sex (p = 0.055) and sex toys (p = 0.027); there was a non-significant association with bacterial vaginosis 31.2% (p = 0.091) and initiation of sexual activity < 18 years 20.6% (p = 0.07). Conclusions: It would be beneficial to incorporate in the gynecological semiology of the women attended in PHC services, the factors found to favor C. trachomatis infection, as this could help the management of this STI.

Resumen Introducción: Chlamydia trachomatis es reconocida como el agente causal de una de las infecciones de transmisión sexual (ITS) más común y curable. En mujeres, puede ser gatillante de enfermedad inflamatoria pélvica, un factor de riesgo para infertilidad o adquisición de otras ITS. Objetivo: Determinar C. trachomatis en mujeres con diagnóstico clínico de vaginitis asociando factores sociodemográficos, sexuales, clínicos y microbiota vaginal. Pacientes y Métodos: Participaron 121 mujeres voluntarias > 18 años, con diagnóstico clínico de vaginitis y descarga vaginal anormal, atendidas en servicios de atención primaria en salud (APS) en Temuco-Chile. Se tomó muestra de flujo vaginal, determinándose C. trachomatis por una reacción de polimerasa en cadena convencional y microbiota vaginal por tinción de Gram. Se colectaron datos clínicos, sociodemográficos y sexuales mediante encuesta. Resultados: Rango de edad 18-61 años. La frecuencia de C. trachomatis fue 14,9%. Se asoció C. trachomatis a mayor número de parejas sexuales en los últimos 5 años (p = 0,001), relaciones sexuales oral más anal (p = 0,055) y juguetes sexuales (p = 0,027). Asociación no significativa hubo con vaginosis bacteriana 31,2% (p = 0,091) e inicio de la actividad sexual < 18 años 20,6% (p = 0,07). Conclusiones: Sería beneficioso incorporar en la semiología ginecológica de las mujeres atendidas en servicios de APS, los factores encontrados como favorecedores de infección por C. trachomatis, pues ello podría ayudar al manejo de esta ITS.

SUMMARY: Dental caries corresponds to an ecological and non-contagious, dynamic and chronic disease of multifactorial origin; currently there is evidence of how genetic factors could be included as predisposing agents to suffer it, however this evidence is diverse and incipient. a cross-sectional study was p erformed to investigate the possible associations of DSPP (rs36094464), RUNX2 (rs566712) and KLK4 (rs198968) polymorphisms in early childhood caries. Saliva samples of children (2-11years old) were collected and genotyped for DSPP (rs36094464), RUNX2 (rs566712) and KLK4 (rs198968) polymorphisms. Through the ceft index their caries history was determined and the gene variants were students through molecular biology techniques. polymorphisms of the DSSP (rs36094464) and RUNX2 (rs566712) are associated and contribute to the susceptibility of dental caries disease in early childhood, as they are related to their history of caries. KLK4 (rs198968) polymorphisms are not associated. In conclusions, the studied polymorphisms on DSSP and RUNX2 genes are associated with changes in the tooth microarchitecture, favoring the appearance of microlesions that would contribute to dental caries disease susceptibility in early childhood. Also, no association was found for the studied polymorphism of the KLK4 gene with dental caries disease susceptibility.

RESUMEN: La caries dental corresponde a una enfermedad crónica, no contagiosa, dinámica y de origen multifactorial. Actualmente existe evidencia de cómo los factores genéticos podrían incluirse como agentes predisponentes, sin embargo, esta evidencia es diversa e incipiente. Se realizó un estudio transversal para investigar las posibles asociaciones entre los polimorfismos DSPP (rs36094464), RUNX2 (rs566712) y KLK4 (rs198968) y la caries en la infancia. Se colectaron muestras de saliva de niños (de 2 a 11 años de edad) y se genotipificaron para los polimorfismos DSPP (rs36094464), RUNX2 (rs566712) y KLK4 (rs198968). Mediante el índice ceft se determinó su historial de caries y se estudiaron las variantes genéticas mediante técnicas de biología molecular. Los datos obtenidos indican que los polimorfismos del DSSP (rs36094464) y RUNX2 (rs566712) están asociados y contribuyen a la susceptibilidad de la enfermedad de caries dental en la infancia, ya que están - además - relacionados con el historial de caries. En conclusión, los polimorfismos estudiados en los genes DSSP y RUNX2 se asocian a la aparición de microlesiones que contribuirían a la susceptibilidad a la enfermedad de caries dental en la infancia. Creemos que este estudio es importante para la odontopediatría porque destaca el papel de DSSP (rs36094464) y RUNX2 (rs566712) y la susceptibilidad a la caries dental durante la infancia, además resalta la utilidad de la evaluación genética para la predicción y prevención de la caries dental y porque aporta evidencia que indica que los factores genéticos están implicados en la etiología de la caries.

Resumo Objetivo Determinar a concordância entre o diagnóstico clínico de mulheres com corrimento vaginal anormal (AVD) e os resultados laboratoriais por meio da detecção molecular e observação da microbiota vaginal. Métodos Estudo transversal realizado em 2018 em Temuco, Chile. Participaram 25 parteiras de 12 centros de saúde. Um total de 125 mulheres>18 anos, voluntárias, foramrecrutadas. A amostra do fórnice vaginal posterior foi obtida por especuloscopia. Foram observadas características da secreção e da genitália externa e interna. A coloração de Gram foi usada para observar a microbiota vaginal, blastoconídios e pseudo-hifas, e a reação em cadeia da polimerase foi usada para a detecção de Trichomonas vaginalis e Candida albicans. O coeficiente kappa de Cohen foi usado na análise de concordância. Resultados De um total de 125 mulheres com AVD, 85,6% consultaram espontaneamente e 14,4% foram diagnosticados clinicamente durante um check-up de rotina. A concordância absoluta foi significativa (p=0,0012), com concordância de 13,6%. A concordância relativa foi significativa, mas razoável para vaginose bacteriana (Kappa =0,21; p=0,003) e candidíase (Kappa=0,22; p=0,001), e leve para tricomoníase (Kappa=0,14; p=0,009). O percentual de coincidência dos diagnósticos (solteiros ou mistos) por laboratório e parteiras foi: vaginose bacteriana 63,2% (12/19), candidíase 36,5% (27/74) e tricomoníase 12,5% (4/32). Houve 20% de coinfecção. Umtotal de 36% dos diagnósticos clínicos de AVD tiveram exames laboratoriais negativos. Conclusão As condições de vulvovaginite candidíase e tricomoníase parecem ser sobrediagnosticadas, e a vaginose bacteriana parece ser subdiagnosticada pelo diagnóstico clínico quando comparado com o diagnóstico laboratorial. A baixa concordância obtida mostra a importância de complementar o diagnóstico clínico comestudo laboratorial de AVD, principalmente emmulheres com falha de tratamento e / ou coinfecções com sinais e sintomas inespecíficos e variáveis.

Abstract Objective To determine the concordance between the clinical diagnosis of women with abnormal vaginal discharge (AVD) and laboratory results using molecular detection and observation of the vaginal microbiota. Methods Cross-sectional study conducted in 2018 in Temuco, Chile. A total of 25 midwives from 12 health centers participated. A total of 125 women>18 years old, volunteers, were recruited. The sample of the posterior vaginal fornix was obtained by speculoscopy. Characteristics of the discharge and of the external and internal genitalia were observed. Gram staining was used to observe vaginal microbiota, blastoconidia and pseudohyphae, and polymerase chain reaction was used for the detection of Trichomonas vaginalis and Candida albicans. The Cohen kappa coefficient was used in the concordance analysis. Results Out of a total of 125 women with AVD, 85.6% consulted spontaneously and 14.4% were diagnosed clinically during a routine check-up. Absolute concordance was significant (p=0.0012), with an agreement of 13.6%. The relative concordance was significant, but fair for bacterial vaginosis (Kappa=0.21; p=0.003) and candidiasis (Kappa=0.22; p=0.001), and slight for trichomoniasis (Kappa=0.14; p=0.009). The percentage of coincidence of the diagnoses (single or mixed) by laboratory and midwives was: bacterial vaginosis 63.2% (12/19), candidiasis 36.5% (27/74), and trichomoniasis 12.5% (4/32). There was 20% coinfection. A total of 36% of the clinical diagnoses of AVD had negative laboratory tests. Conclusion The vulvovaginitis conditions candidiasis and trichomoniasis appear to be overdiagnosed, and bacterial vaginosis appears to be underdiagnosed by the clinical diagnosis when compared with the laboratory diagnosis. The low concordance obtained shows the importance of complementing the clinical diagnosis with a laboratory study of AVD, particularly in women with failed treatments and/or coinfections with unspecific and varying signs and symptoms.

Abstract Nine plants from the Puna ecoregion of northern Chile, traditionally used in ethnomedicine, were studied. The total content of phenolic compounds and their antioxidant capacity (ABTS, FRAP, and ORAC) were determined both in the dry material and in the infusions. To our knowledge, this is the first report on the antioxidant capacity for some of these plants and their infusions. Furthermore, these results show the diversity and complexity of the plants of the Chilean highlands with high potential to be used as a source of natural antioxidants in the reformulation and development of healthier foods.

Resumen Se estudiaron nueve plantas de la ecorregión de puna del norte de Chile, utilizadas tradicionalmente en etnomedicina. El contenido total de compuestos fenólicos y su capacidad antioxidante (ABTS, FRAP y ORAC) se determinaron tanto en el material seco como en las infusiones. Según nuestro conocimiento, este es el primer informe sobre capacidad antioxidante para algunas de estas plantas y sus infusiones. Además, estos resultados muestran la diversidad y complejidad de las plantas del altiplano chileno con alto po tencial para ser utilizadas como fuente de antioxidantes naturales en la reformulación y el desarrollo de alimentos más saludables.

Background: The early onset of sexual activity can promote the development of cervical alterations and sexually transmitted infections, especially the human papillomavirus (HPV) very common in adolescents and young people. Aim: The condition of the cervix, HPV and sexual behavior in young women under 25 years of age were analyzed. Methods: 182 university students, healthy, sexually active, 18-24 years old, without vaccine for HPV participated. Papanicolaou (Pap) test and classification of high and low risk HPV (HR and LR) were performed by real time polymerase chain reaction. The sexual behaviors were consulted in private. Results: The 46.9% of Pap presented cytological alterations, non-specific inflammation/hemorrhagic (29.4%) and atypical smear (10.2%) being de most frequent. The overall frequency of HPV-HR was 24.3%, of these 67.4% presented an altered Pap. There was an association between cytological alterations and HPV (p < 0.0001) and years of sexual activity and atypical smear or cervical intraepithelial neoplasia grade I (CIN I) (p = 0.009). 11.9% of young women (21/177) presented atypical smear or CIN I, with 66.7% of cases HPV-HR. Conclusions: These findings alert the vulnerability of these young women who would have a potential risk of viral persistence, CIN and eventually cancer. It is important to emphasize counseling and prevention prior to the regular age of admission to the screening program for cervical cancer. This study was financed by the Universidad de La Frontera through Projects DI15-0047 and DI17-0123.

Resumen Introducción: El inicio precoz de actividad sexual puede favorecer el desarrollo de alteraciones cervicales y de infecciones de transmisión sexual, en especial del virus papiloma humano (VPH) muy frecuente en adolescentes y jóvenes. Objetivo: Analizar el estado del cuello uterino, presencia del VPH y conductas sexuales en mujeres menores de 25 años. Material y Métodos: Participaron 182 estudiantes universitarias de 18-24 años, sanas, sexualmente activas y no vacunadas para VPH. Se realizó Papanicolaou (Pap) y clasificación del VPH en alto y bajo riesgo (AR y BR) mediante reacción de polimerasa en cadena en tiempo real. Las conductas sexuales fueron consultadas privadamente. Resultados: El 46,9% de los Pap presentaron alteraciones citológicas (inflamación inespecífica/hemorrágico: 29,4% y frotis atípicos (FA):10,2%). La frecuencia de los VPH-AR fue 24,3%; de éstos, 67,4% presentó un Pap alterado. Hubo asociación entre alteraciones citológicas y presencia de VPH (p < 0,0001) y años de actividad sexual y FA o neoplasia intraepitelial grado I (NIE I) (p = 0,009). El 11,9% de las jóvenes estudiadas (21/177) presentó FA o NIE I, con 66,7% de casos VPH-AR. Conclusiones: Estos hallazgos alertan la vulnerabilidad de estas jóvenes que tendrían un riesgo potencial de persistencia viral, NIE y eventualmente cáncer. Es importante enfatizar consejería y prevención previo a la edad normada de ingreso al programa de cribado para cáncer cérvico uterino en Chile.

RESUMO: Baccharis alnifolia Meyen & Walp. é uma erva altiplana nativa e medicinal, chilena que é usada como cataplasma e também consumida como uma infusão para aliviar a inflamação. Este estudo avaliou o efeito antioxidante e citotóxico do extrato etanólico de B. alnifolia e sua infusão. Verificou-se que o extrato etanólico contém 4,42 mg GAE / g de peso seco e a infusão contém 35,86 mg GAE / L de polifenóis totais. Além disso, determinou a capacidade antioxidante utilizando o poder antioxidante redutor de Fração (FRAP), Capacidade de Absorção Radical de Oxigênio (ORAC) e capacidade antioxidante equivalente de Trolox (TEAC). Além disso, sete metabólitos, entre ácidos fenólicos e flavonóides, foram identificados pela primeira vez em ambos os extratos da planta medicinal Baccharis alnifolia. Os cromatogramas UHPLC-DAD revelaram a presença majoritária de ácido ferúlico e luteolina, ambos podendo ser responsáveis pela atividade antioxidante e citotóxica. Além disso, realizamos uma triagem preliminar da citotoxicidade em diferentes linhagens de células tumorais, descobrindo que esses extratos têm potencial citotóxico nas células renais.

ABSTRACT: Baccharis alnifolia Meyen & Walp. is a native and medicinal, Chilean Altiplano herb that is used as a poultice and also consumed as an infusion to relieve inflammation. This study evaluated the antioxidant and cytotoxic effect of the ethanolic extract of B. alnifolia and their infusion. It was reported that the ethanol extract contains 4.42 mg GAE/g of dry weight and the infusion contains 35.86 mg GAE/L of total polyphenols. Also, it determined the antioxidant capacity using Ferric reducing antioxidant power (FRAP), Oxygen Radical Absorbance Capacity (ORAC) and Trolox equivalent antioxidant capacity (TEAC) assay. Moreover, seven metabolites including between phenolic acids and flavonoids were identified for the first time in both extracts of the medicinal plant Baccharis alnifolia. The UHPLC-DAD chromatograms revealed the majority presence of ferulic acid and luteolin, both could be responsible for the antioxidant and cytotoxic activity. Furthermore, we realized a preliminary screening of cytotoxicity in different tumor cell lines, finding that these extracts have cytotoxic potential on kidney cells.

Abstract: Introduction: Silicosis is a progressive lung disease, irreversible, but potentially preventable. Knowing the perception of risk in workers exposed to silica is necessary to intervene and reduce the incidence of silicosis and other related diseases. The objective of this study was to validate a Questionnaire of risk perception of occupational expo sure to silica (CuPREOS) in exposed workers, in different work activities in Temuco, Chile. Material and method: A stage of explo ration with phenomenological/naturalist approach allowed to create categories of first and second order, which ended in a first version of the instrument. The second stage included exploratory and con firmatory factor analysis. Results: two underlying dimensions were revealed: a) evidence of risk, in which worker states to evaluate signals of alarm and b) absence of risk, in which he weighs aspects that counteract the previous ones. Both set up the conceptual frame work that sustain the CuPREOS of 9 items/questions, with a reliabil ity of 0.84 (Cronbach alfa). The confirmatory analysis indicators show a good fit of the model. Discussion: the perception of risk is a construct involving social and cultural complexities, its measurement should be simple and practical; its knowledge would enable more effective decision-making in prevention and intervention.

Resumen: Introducción: La silicosis es una enfermedad pulmonar progresiva, irreversible, pero potencialmente prevenible. Conocer la percepción de riesgo en trabajadores expuestos a sílice es necesario para intervenir y reducir la incidencia de silicosis y otras enfermedades relacionadas. El objetivo de este estudio fue validar un Cuestionario de Percepción de Riesgo de Exposición Ocupacional a Sílice (CuPREOS) en trabajadores expuestos, en distintas actividades laborales en Temuco, Chile. Material y método: Una etapa de exploración con enfoque fenomenológico/ naturalista permitió conformar categorías de primer y segundo orden, que concluyó en una primera versión del instrumento. Una segunda etapa incluyó análisis factorial exploratorio y confirmatorio. Resultados: Se develaron dos dimensiones subyacentes: a) evidencia de riesgo, en la que el trabajador manifiesta evaluar señales de alarma y b) ausencia de riesgo, en la que sopesa aspectos que contrarrestan las anteriores. Ambas configuran la estructura conceptual que conforma el CuPREOS de 9 ítems/preguntas, con una confiabilidad de 0.84 (alfa Cronbach). Los indicadores del análisis confirmatorio revelan un buen ajuste del mode lo. Discusión: la percepción de riesgo es un constructo que involucra complejidades sociales y culturales, su medición debe ser sencilla y práctica; su conocimiento permitiría decisiones más efectivas en pre vención e intervención.

Resumen: El objetivo de la investigación fue conocer la capacidad diagnóstica de las escalas Braden Q y Norton para el desarrollo de úlceras por presión en pacientes pediátricos de Unidades Críticas en un hospital de alta complejidad en Chile. Es un estudio transversal de comparación de pruebas diagnósticas en pacientes ingresados a unidades críticas. La muestra fue no probabilística, por conveniencia de 118 niños. Se analizaron ambas escalas respetando los preceptos, para comparar la capacidad discriminativa de dos pruebas diagnósticas y verificar que ambas sean medidos simultáneamente aplicadas sobre los mismos sujetos. La investigación contó con aprobación de comité de Ética Servicio de Salud y Consentimiento Informado firmado de los padres de los niños. Se determinó que la sensibilidad de la escala Braden Q, a las 24 y 48 horas, es menor que la presentada por la Norton en las mismas evaluaciones; presenta valor predictivo positivo más alto en ambas mediciones, como también la razón de probabilidad (+). Se concluye que Braden Q es la escala idónea para valorar el riesgo de desarrollar UPP en la población pediátrica; presenta mayor confiabilidad

Resumo: O objetivo da investigação foi conhecer a capacidade diagnóstica das escalas Braden Q e Norton, para o desenvolvimento de úlceras de pressão (UPP) em pacientes pediátricos de unidades críticas, em um hospital altamente complexo, no Chile. É um estudo transversal que compara testes diagnósticos em pacientes admitidos em unidades críticas. A amostra não era probabilística, para a conveniência de 118 crianças. Ambas as escalas foram analisadas respeitando os preceitos, para comparar a capacidade discriminativa de dois testes de diagnóstico e verificar que ambos são medidos simultaneamente, aplicados nos mesmos assuntos. A pesquisa foi aprovada pelo Comitê de Ética, Serviço de Saúde e Consentimento Informado assinado por pais de crianças. Determinou-se que a sensibilidade da escala de Braden Q, às 24 e 48 horas, é menor que a apResentada por Norton nas mesmas avaliações, possui maior valor preditivo positivo em ambas as medidas, bem como a razão de probabilidade (+). Conclui-se que Braden Q é a escala ideal para avaliar o risco de desenvolver UPP na população pediátrica, e apresenta maior confiabilidade

Abstract: The objective of the investigation was to evaluate the diagnostic capacity of the Braden Q and Norton scales for the development of pressure ulcers in pediatric patients of Critical Units in a highly complex hospital in Chile. It is a cross-sectional study comparing diagnostic tests in patients admitted to critical units. The sample was non-probabilistic, for the convenience of 118 children. Both scales were analyzed respecting the precepts, in order to compare the discriminative capacity of two diagnostic tests verifying that both are measured simultaneously while applied on the same subjects. The research was approved by the Ethics Committee, Health Service and Informed Consent signed by the parents of the children. It was determined that the sensitivity of the Braden Q scale, at 24 and 48 hours, is lower than Norton´s in the same evaluations; it has a higher positive predictive value in both measurements, as well as the probability ratio (+). It is concluded that Braden Q is the ideal scale to assess the risk of developing pressure ulcers in the pediatric population; it presents greater reliability

Background: Vitamin K antagonists significantly decrease the incidence of stroke but increase the risk of bleeding. Aim: To assess the effectiveness and risk of bleeding of vitamin K antagonists in non-valvular atrial fibrillation. Material and Methods: Retrospective cohort study of 524 patients, 236 women (45%) and 288 men (55%) with non-valvular atrial fibrillation (NVAF) admitted to the oral anticoagulation treatment (OAT) clinic at four public hospitals, between 2009 and 2012. They were followed until March 2013, measuring the quality of OAT, ischemic and bleeding events. Results: The mean follow-up was 26.1 months, with 1,154.7 person-years of follow-up accrued. The percentage of time in therapeutic range (TTR) was 35.2 ± 18%; this was deemed to represent the quality of OAT. The cumulative incidence of ischemic events, either stroke or systemic embolism, was 2.25/100 person-years, being greater in patients with previous embolism (Risk ratio 5.21, 95% confidence intervals 2.31– 11.73, p < 0.01). The cumulative incidence of major bleeding events-extracranial and intracraneal-was 4.08/100 person-years. The main site of extracranial major bleeding was the gastrointestinal tract (32%). Conclusions: In our clinical practice, the effectiveness of OAT with acenocoumarol in NVAF patients is similar to that published abroad. However, the incidence of bleeding complications is higher. The quality of the OAT measured by the TTR was lower than abroad.

Background: Parasitic infections in children reflect social inequalities throughout the world, especially in urban and rural territories. Aim: To assess inequalities in the prevalence of infections by protozoa and intestinal helminths and associated factors in children of different geographical areas from the commune of Puerto Montt. Material and Methods: Cross-sectional study carried out in 103 students from one urban and two rural schools in the commune of Puerto Montt. A socio-demographic survey was applied and the presence parasitic infections was evaluated in serial stool samples. Results: The prevalence of Protozoan and intestinal helminthic infections were 37.5 and 68.1% in urban and rural areas respectively. A regression analysis showed that the differences between rural and urban children, disappear when the results are adjusted by family income and the quality of sewage disposal. In urban children, the prevalence of parasitic infections increases along with the decrease in family income. Conclusions: Income and sanitary conditions rather than being or urban or rural origin explain the variations in rates of childhood parasitic infections. Infections with protozoa and intestinal helminths are an indicator of social inequality in health.

For successful endodontic treatment a correct diagnosis for pulp diseases is essential. Controversy exists regarding the validity of diagnostic methods commonly used in daily practice by the dentist to determine the condition of the pulp state. The aim of this study was to determine the validity of two thermal tests (cold and heat stimuli) most commonly used by undergraduates students in patients in patients treated in endodontic dental clinic. Cross-sectional study was performed in 49 patients (54 teeth) who needed endodontics treatment, and meeting the criteria of this study. Sensitivity to cold and heat test was 75.9% and the combined test (hot and cold) was 69%. The specificity for the cold test was 80%, for the heat test was 76%, and for the combined test 84%. The cold or heat test alone, shows more sensitivity than the combination. However, higher specificity was achieved by combining both tests.

Para el éxito de un tratamiento endodóntico es fundamental un correcto diagnóstico pulpar. Existen controversias con respecto a la validez de los métodos diagnósticos comúnmente utilizados en la práctica diaria por el odontólogo para determinar la condición del estado pulpar. El objetivo fue determinar la validez de dos de las pruebas pulpares (de frío y calor) más comúnmente usadas por estudiantes de pregrado en pacientes que acuden a una clínica de endodoncia. Se realizó un estudio de corte transversal, en 49 pacientes (54 dientes) que acudieron para atención de endodoncia, y que cumplían con los criterios de selección de este estudio. La sensibilidad para la prueba de frío y calor fue 75,9% y para la prueba combinada (frío y calor) fue 69% versus sangrado cameral. La especificidad para la prueba de frío fue 80%, para la prueba de calor 76% y para la prueba combinada 84%. La prueba de frío o del calor por sí sola tiene mayor sensibilidad que aplicada de manera combinada. En cambio, se consiguió una mayor especificidad al combinar ambas pruebas diagnósticas, que por sí solas.

Introduction: The association between coronary artery (CAD) and dysglicemia is well established. Diabetes (DM) is recognized as one of the most important coronary risk factors, but the association of CAD and metabolic syndrome (MS) is less well defined. Our objective was to evaluate the degree of coronary atherosclerotic disease in relation to the presence of MS and DM . Patients and Method: The data of 413 patients electively studied with coronary angiography over a period of one year was analyzed. Patients were divided into three groups: Patients with DM, patients with MS (without DM) and patients without a metabolic disorder (no DM, no MS). The severity of CAD was measured by the Gensini Score. Results: Mean age was 63,8 ±11,17 years. The prevalence of patients with MS was 38% (n=158), with DM 45% (n=186) and without a metabolic disorder 17% (n=69). The global prevalence of CAD was 52,7%. The prevalence of CAD in the different groups was as follows: Absence of metabolic disease 33.9%, patients with MS 52.2% and patients with DM 62.2% (p< 0.001). Conclusions: This observational study suggests that, compared to subjects without metabolic disease, the prevalence and severity of CAD are higher in patients with MS and even higher in patients with DM

Introducción: La asociación entre cardiopatía coronaria (CC) y estados de disglicemia está bien establecida. Sin embargo, aún cuando la diabetes mellitus (DM) corresponde a uno de los principales factores de riesgo para CC, la asociación con el síndrome metabólico (SM) parece menos clara. Nuestro objetivo fue evaluar el grado de compromiso aterosclerótico del árbol coronario de acuerdo a la existencia de SM y DM. Pacientes y método: Se analizó los datos de 413 pacientes sometidos a coronariografía electiva en el período de un año. Se dividió la muestra en 3 grupos: pacientes diabéticos, pacientes con SM (no diabéticos) y pacientes sin enfermedad metabólica (no SM, no DM). Se consideró como portador de CC a todo paciente con estenosis >50% en cualquier arteria coronaria, la severidad de la enfermedad coronaria fue medida por el Score de Gensini. Se utilizó análisis de varianza (Barlett) con comparación múltiple de Scheffe y prueba no paramétrica de Krus-kal-Wallis en aquellos grupos con varianzas distintas. El protocolo fue aprobado por el Comité Ético Científico del Servicio de Salud Araucanía Sur. Resultados: La edad promedio fue 63.8 ± 11,17 años. La prevalencia de SM fue 38% (n=158), DM 45% (n=186) y no tenían alteraciones metabólicas 17% de los pacientes (n=69). La prevalencia global de enfermedad coronaria fue 52,7%. La prevalencia en los distintos grupos fue 33.9% en aquellos sin enfermedad metabólica, 52.2% en los portadores de SM y 62.2% en los pacientes con DM (p=0.001). En cuanto a la severidad de la CC, el score de Gensini fue 18, 22,04 y 29,6 respectivamente (p=0,04). Conclusiones: Este estudio observacional sugiere que, comparados con sujetos sin enfermedad metabólica tanto la prevalencia de CC, como su severidad son mayores en pacientes con SM aislado y mayores aún en portadores de DM.