Introduction: Pelvic floor rehabilitation is often indicated as first-line therapy for patients with fecal incontinence. Its short-term effectiveness has been demonstrated in these patients. However, long-term results are controversial. Aim: Our objective is to evalúate long-term functionality and quality of life in patients with fecal incontinence treated with pelvic floor rehabilitation. Materials and Method: Quasi- experimental study conducted at a single tertiary care center. We included patients with fecal incontinence treated by pelvic floor rehabilitation at our center between 2007-2014 who did not require surgery. Wexner functional score and quality of life using FIQLS were measured pre (T1) and post-treatment (T2). Poste - riorly, an-e-mail survey was conducted to retrieve scores three to 10 years after treatment (T3). Results: Of the 215 patients, 182 met the inclusion criteria. 96 (52.8%) patients responded at T3 and were therefore included. The median follow-up period was of 4.5 years (3-10). The mean age at the time of the study was 60.8 ± 13.1 years and 88.4% were women. The median Wexner score was 16 (6-20) in T1 and 7 (0-18) in T2, (p = 0.000). Quality of life improved significantly in its four dimensions when comparing T1 and T2. In T3, Wexner and the quality of life scores were significantly lower than T2. However, in T3, both scales had better means than T1, (p = 0.000). There was no association between the follow-up time and the functional result in T3. Conclusions: Patients with fecal incontinence treated by pelvic floor rehabilitation improve their functionality and quality of life significantly. This benefit decreases over time but remains above its baseline.

Resumen Introducción: La rehabilitación del piso pélvico es frecuentemente indicada a los pacientes con incontinencia fecal. Su efectividad a corto plazo ha sido demostrada. Sin embargo, sus resultados en el largo plazo son controversiales. Objetivo: Nuestro objetivo es evaluar los resultados funcionales y calidad de vida a largo plazo de los pacientes con incontinencia fecal tratados mediante rehabilitación del piso pélvico. Materiales y Método: Estudio cuasi-experimental. Se incluyeron los pacientes con incontinencia fecal tratados mediante rehabilitación del piso pélvico entre 2007-2014 en nuestro centro, sin necesidad de cirugía. Se midió el puntaje funcional de Wexner y de calidad de vida (FIQLS) antes (T1) y después del tratamiento (T2). Se realizó encuesta vía correo electrónico para obtener dichos puntajes entre 3-10 años posterior al tratamiento (T3). Resultados: De 215 pacientes, 182 cumplían criterios de inclusión. 96 (52,8%) de ellos respondieron la encuesta en T3. La mediana de seguimiento fue de 4,5 (3-10) años. La edad promedio al tiempo del estudio fue de 60,8 ±13,1 años. 88,4% fueron mujeres. La mediana del puntaje funcional fue 16 (6-20) en T1 y 7 (0-18) en T2, p = 0,000. La calidad de vida mejoró significativamente en sus 4 dimensiones entre T1 y T2. En T3, ambos puntajes presentaron mejores promedios que en T1, p = 0,000. No hubo asociación entre el tiempo de seguimiento y el resultado funcional en T3. Conclusión: Los pacientes con incontinencia fecal tratados mediante rehabilitación del piso pélvico mejoran significativamente su funcionalidad y calidad de vida. El beneficio disminuye en el tiempo, pero persiste mejor que previo al tratamiento.

Abstract Unilateral hearing loss (UHL) defined as hearing loss of any degree in only one ear has a school-age prevalence of 3% to 6%. The etiology is unknown in most cases, but severe anatomical abnormalities stand out as opposed to bilateral hearing loss, which gives importance to the study of images. Ophthalmological evaluation is also recommended. The impact of UHL is observed in sound localization, speech recognition, language development, social performance and behavior, but above all in academic performance. In this sense, it is relevant to mention that in addition to having a higher probability of repeating the course, it is necessary to have more individualized educational support to avoid this repetition or achieve the same academic success as a normal listener. Regarding the diagnosis, there are still missing norms or protocols, this being a challenge in areas where there is no universal screening. The importance of surveys to carry out evaluations and follow-up in these cases is discussed. Finally, the available intervention strategies are discussed, in addition to an individualized plan considering the child, his family and his expectations, particularly, the factors to be taken into account at the time of adaptation, in order to achieve a success treatment.

Resumen La hipoacusia unilateral (HUL) definida como la pérdida auditiva de cualquier grado en un solo oído tiene prevalencias en edad escolar de 3% a 6%. La etiología es desconocida en la mayoría de los casos, pero destacan las anormalidades anatómicas severas a diferencia de las hipoacusias bilaterales, lo que le otorga importancia al estudio de imágenes. También se recomienda realizar evaluación oftalmológica. El impacto de la HUL se observa en la localización sonora, reconocimiento del habla, desarrollo del lenguaje, desempeño social y conducta, pero por sobre todo en el rendimiento académico. En este sentido es relevante mencionar que además de existir mayor probabilidad de repitencia de curso, es necesario mayor apoyo educacional individualizado para evitar dicha repitencia o lograr mismo éxito académico que un normoyente. En relación al diagnóstico aún faltan normas o protocolos, siendo éste un desafío en las zonas donde no hay screening universal. Se discute la importancia de las encuestas para realizar evaluaciones y seguimiento en estos casos. Finalmente se abordan las estrategias de intervención disponibles, además de un plan individualizado considerando al niño, su familia y sus expectativas, particularmente se discuten las características o factores a tomar en cuenta en el momento de la adaptación, para así lograr un tratamiento tendiente al éxito.

Abstract Half of cases of hepatitis B around the world are produced from vertical transmission; and 90% of them can evolve to chronic hepatitis and their long term complications. Postpartum immunoprophylaxis (immunoglobulin and vaccine) is the most effective preventive measure. However, despite this prophylaxis, vertical transmission is possible if the mother presents a high viral load or e-antigen. This risk can be reduced only if screening during pregnancy and treatment if needed, are incorporated. In 2019, vaccination for hepatitis B in newborn was incorporated in Chile, but not yet prenatal screening, unlike developed countries. Chile has experienced a growth in immigration from Latin America and Caribbean, some countries with high endemicity included. Prenatal screening in Chile should be promptly incorporated.

Resumen La transmisión vertical de hepatitis B es responsable de 50% de las infecciones en el mundo e implica 90% de riesgo de evolucionar a hepatitis crónica y sus complicaciones. La inmunoprofilaxis postparto (inmunoglobulina más vacuna) es la medida de prevención más efectiva. Sin embargo, puede existir fracaso a pesar de dicha intervención, debido a factores como alta carga viral o la presencia de HBeAg en la madre, los que sólo pueden evitarse si se hace el diagnóstico y tratamiento durante la gestación. En Chile, en el año 2019 se incorporó la vacunación en los recién nacidos, pero no existe aún cribado durante el embarazo, a diferencia de los países desarrollados. En los últimos años se ha experimentado un aumento acelerado de inmigración proveniente principalmente de América latina y el Caribe, con prevalencias altas en algunos de ellos. Chile debiese avanzar prontamente hacia el cribado de hepatitis B en embarazo.

Abstract Background: Helicobacter pylori is detected by pathogen recognition receptors including toll–like receptors (TLR) and nucleotide–binding oligomerization domain (NOD)–like receptors, eliciting an innate immune response against this bacteria. The aim of this study was to assess if polymorphisms of TLR2, TLR4, TLR5, NOD1 and NOD2 genes are associated with gastric cancer, in particular in individuals infected with H. pylori. Results: A case–control study of 297 gastric cancer patients and 300 controls was performed to assess the association of 17 polymorphisms. Analyses performed under the allele model did not find association with gastric cancer. However, NOD1 rs2075820 (p.E266K) showed association with intestinal–type gastric cancer among H. pylori infected subjects (OR = 2.69, 95% CI 1.41–5.13, p = 0.0026). The association was not statistically significant in diffuse–type gastric cancer cases (OR = 1.26, 95% CI 0.63–2.52, p = 0.51). When the analyses were performed in patients carrying H. pylori strains harboring the cag pathogenicity island (cagPAI), we noticed significant association with NOD1 rs2075820 (OR = 4.90, 95% CI 1.80–3.36, p = 0.0019), in particular for intestinal–type gastric cancer cases (OR = 7.16, 95% CI 2.40–21.33, p = 4.1 × 10−4) but not among diffuse–type gastric cancer cases (OR = 3.39, 95% CI 1.13–0.10, p = 0.03). Conclusions: NOD1 rs2075820 increases the risk of intestinal–type gastric cancer among individuals infected with H. pylori, particularly in those harboring the cagPAI.

Posterior reversible encephalopathy syndrome (PRES) is a poorly recognized and reversible condition in systemic lupus erythematosus (SLE) that could mimic neuropsychiatric lupus. The manifestations of PRES are headache, seizures, altered level of consciousness and blindness. In most cases, computed tomography of the brain shows hypodense lesions in the parieto-occipital lobe. Although this syndrome is rare, rapid and accurate recognition allows early treatment with favorable results. We present a case report of a patient with the onset of SLE following the episode of eclampsia, and who during the late puerperium presented sustained hypertension associated with seizures and deterioration of the level of consciousness in the context of PRES.

El síndrome de encefalopatía posterior reversible (PRES) es una condición reversible, poco conocida en el lupus eritematoso sistémico (LES) que puede semejar al lupus neuropsiquiátrico. Las manifestaciones de PRES son cefalea, convulsiones, alteración del nivel de conciencia y amaurosis. En la mayoría de los casos, la TC (tomografía computarizada) del cerebro muestra lesiones hipodensas en el lóbulo parieto-occipital. Aunque este síndrome es poco común, el reconocimiento rápido y preciso permite un tratamiento temprano con resultados favorables. Presentamos un caso clínico de una paciente con debut de LES posterior a episodio de eclampsia, y que durante el puerperio tardío presenta hipertensión sostenida asociada a convulsiones y deterioro del nivel de conciencia en contexto de PRES.

Resumo O Brasil é um dos principais produtores de óleo de palma, porém as lagartas desfolhadoras Opsiphanes invirae Hübner e Brassolis sophorae L. (Lepidoptera: Nymphalidae) podem comprometer a produtividade dessa cultura. O objetivo deste trabalho foi avaliar o desenvolvimento e aspectos reprodutivos do parasitoide Trichospilus diatraeae Cherian & Margabandhu (Hymenoptera: Eulophidae) em pupas desses desfolhadores da palma de óleo. Dez pupas de O. invirae ou de B. sophorae com até dois dias de idade, foram expostas, cada uma, ao parasitismo por 30 fêmeas de T. diatraeae , por 48 horas. O parasitismo e a emergência da progênie de T. diatraeae foram semelhantes em pupas de ambas as espécies de lepidópteros desfolhadores da palma de óleo. O ciclo de vida desse parasitoide foi mais curto em pupas de O. invirae (21,50 ± 0,42 dias) que com as de B. sophorae (27,60 ± 1,80 dias). O número de progênie (669,00 ± 89,62) e de imaturos mortos (217,13 ± 58,18) de T. diatraeae foram maiores em pupas de B. sophorae que naquelas de O. invirae com 447,83 ± 51,52 e 13,50 ± 5,23, respectivamente. A razão sexual e a longevidade de fêmeas e machos de T. diatraeae emergidos desses hospedeiros foram semelhantes. As características reprodutivas, especialmente, o número de indivíduos (progênie) de T. diatraeae foram melhores com pupas de B. sophorae que com as de O. invirae .

Abstract Brazil is a leading palm oil producer, but the defoliating caterpillars Opsiphanes invirae Hübner Brassolis sophorae L. (Lepidoptera: Nymphalidae) can reduce the productivity of this crop. The aim of this study was to evaluate the development and reproduction of the parasitoid Trichospilus diatraeae Cherian & Margabandhu (Hymenoptera: Eulophidae) in pupae of these oil palm defoliators. Ten O. invirae or B. sophorae pupae with up to two days old were exposed each to 30 T. diatraeae females for 48 hours. Parasitism and emergence of the progeny of T. diatraeae were similar in pupae of both Lepidoptera defoliators. The life cycle of this parasitoid was shorter in O. invirae (21.50 ± 0.42 days) pupae than with those of B. sophorae (27.60 ± 1.80 days). The number of the progeny (669.00 ± 89.62) and dead immature (217.13 ± 58.18) of T. diatraeae were higher in B. sophorae pupae than in those of O. invirae with 447.83 ± 51.52 and 13.50 ± 5.23, respectively. The sex ratio and female and male longevity of T. diatraeae emerged from these hosts were similar. The reproductive traits, especially the number of individuals (offspring) of T. diatraeae were better with B. sophorae pupae than with those of O. invirae.

Resumo Na Amazônia brasileira dois gêneros mono-específicos, Harpia e Morphnus, caracterizam-se por baixa densidade e estão classificados pelo IUCN como Quase Ameaçados, porém ocorrem sobre grande parte do território nacional, suas principais ameaças são a fragmentação florestal, a degradação de hábitat e a caça. Neste estudo avaliamos a abundância destas duas grandes aves de rapina utilizando a base de dados dos programas ambientais da UHE Belo Monte, integrando-se dois métodos para construir um mapa de distribuição ao longo de 245 km do rio Xingu. Os levantamentos terrestres pelo método RAPELD mostraram-se mais eficientes para os registros de grandes águias quando comparado aos esforços padronizados aquáticos, entretanto estes foram complementares na ausência de módulos. Cinquenta e tres por cento foram registros ocasionais durante a supressão da vegetação, afugentamento ou deslocamento. Entre 2012-2014 quatro harpias foram removidas da natureza, dois indivíduos alvo de disparos, uma por colisão com rede elétrica, e outra por atropelamento. Sete ninhos mapeados, a distância média entre os registros de harpia na calha e margens do rio foi de 15 km, 20 km distância média entre ninhos, o que permitiu estimar um total de 20 casais utilizando as florestas aluviais em uma distancia de 270 km, incluindo matas ciliares e os fragmentos fora da margem do rio. Estimamos que territórios de outros 10 casais usando a Volta Grande longe do rio principal também serão afetados pela inundação. A distância média entre os registros de Morphnus foi 16 km ao longo do rio, o único ninho mapeado estava distante 1.3 km do ninho de Harpia. Estes fragmentos florestais estão sendo substituídos por pastagens, ressaltando-se a importância da manutenção das áreas de preservação permanentes (APP) e a proteção destes fragmentos em diversos formatos de áreas de proteção, para diminuir a degradação dos mesmos e garantir a manutenção das populações destes grandes predadores na região do rio Xingu.

Abstract In the Brazilian Amazon, two monospecific genera, the Harpy Eagle and Crested Eagle have low densities and are classified by IUCN as Near Threatened due to habitat loss, deforestation, habitat degradation and hunting. In this study, we evaluate occurrence of these large raptors using the environmental surveys database from Belo Monte Hydroelectric Power Plant. Integrating the dataset from two methods, we plotted a distribution map along the Xingu River, including records over a 276-km stretch of river. Terrestrial surveys (RAPELD method) were more efficient for detecting large raptors than standardized aquatic surveys, although the latter were complementary in areas without modules. About 53% of the records were obtained during activities of wildlife rescue/flushing, vegetation suppression or in transit. Between 2012 and 2014, four Harpy Eagles were removed from the wild; two shooting victims, one injured by collision with power lines and one hit by a vehicle. Also, seven nests were mapped. The mean distance between Harpy Eagle records was 15 km along the river channel, with a mean of 20 km between nests near the channel, which allowed us to estimate 20 possible pairs using the alluvial forest, riverine forest and forest fragments. Territories of another ten pairs will probably be affected by inundation of the Volta Grande channel, which is far from the main river. The average distance between Crested Eagle records was 16 km along the river channel. The only nest found was 1.3 km away from a Harpy Eagle nest. The remnant forests are under threat of being replaced by cattle pastures, so we recommend that permanently protected riparian vegetation borders (APP) be guaranteed, and that forest fragments within 5 km of the river be conserved to maintain eagle populations.

El salivazo de la caña de azúcar, Aeneolamia varia(Hemiptera: Cercopidae),es plaga de importancia económica en el valle del río Cauca, Colombia, desde 2007. Aislamientos nativos de M. anisopliae mantenidos en el Centro de Investigación de la Caña de azúcar de Colombia (Cenicaña), y otros obtenidos a partir de larvas de Galleria mellonella, usadas como cebos en muestras de suelo, y aislados de salivazos con signos de infección, se caracterizaron en relación con su virulencia, producción de conidias, crecimiento radial, germinación y aspectos de la colonia. Con el fin de evaluar y comparar la virulencia de estas cepas,se llevaron a cabo bioensayos sobre adultos y ninfas de A. varia. La eficacia sobre adultos se evaluó en laboratorio infestando plantas de braquiaria con adultos tenerales (< 24 horas), asperjando 15 ml de una suspensión de conidias de los hongos a una concentración de 1 x 107 conidias/ml. La evaluación de la virulencia sobre ninfas se realizó en un invernadero, asperjando 4 ml de suspensión de conidias de las cepas de los hongos, a una concentración de 1x109 conidias/ml sobre la rizosfera de la planta. Las cepas nativas CCMa0906, CCMa1005 y CCMa1008 produjeron mortalidades entre 76,0% y 90,7% sobre el estado adulto. Para el control de ninfas la mayor eficacia se presentó en las cepas CCMa0906, CCMa1001, CCMa1005 y CCMa1008, con mortalidades de 75,7%, 58,2%, 58,8% y 59,6%, respectivamente. Solo el producto comercial CCMa01 se seleccionó por su capacidad de control y calidad de la formulación.

The sugarcane spittlebug, Aeneolamia varia (Hemiptera: Cercopidae) is an important economic pest in the Cauca valley, Colombia since 2007. Native strains of M. anisopliae maintained at the Sugarcane Research Center of Colombia (Cenicaña), and others isolated from larvae of Galleria mellonella, used as a trap in soil samples, and spittlebugs with signs of infection, were characterized in relation to virulence, spore production, radial growth, germination and characteristics of the colony. To evaluate the virulence of native strains, a bioassay was designed, including reference strains and commercial formulations. Braquiaria plants in laboratory were infested with teneral adults (< 24 hours), then were sprayed with 15 ml of fungi at a concentration of 1x107 spores/ml. Virulence on nymphs was evaluated under greenhouse conditions, spraying at the plant rhizosphere, 4 ml of fungi preparations with a concentration of 1x109 spores/ml. The native strains CCMa0906, CCMa1005 and CCMa1008, showed the best physiological characteristics and adult virulence (76.0-90.7% of dead individuals). Four native strains of M. anisopliae (CCMa0906, CCMa1001, CCMa1005 and CCMa1008) showed higher virulence against nymphs of A. varia, causing mortalities of 75.7%, 58.2%, 58.8% and 59.6%, respectively. Only one commercial product coded CCMa01, was selected due to mortality on A. varia and quality control of its formulation.

Se describe e ilustra una nueva especie del género Potamobates (Insecta: Hemiptera: Gerridae: Cylindrostethinae) a partir de machos capturados en el Pacífico Colombiano. Potamobates bilobulatus Morales, Molano & Castro sp. nov., se diferencia de otras especies del género por caracteres de los órganos genitales del macho y de las conexivas de las hembras.

Based on males collected in the Colombian Pacific, a new species of the genus Potamobates (Hemiptera: Gerridae: Cylindrostethinae) is described and illustrated. Potamobates bilobulatus Morales, Molano & Castro sp. nov., is differentiated from other species of the genus by features of the male genitalia and of the female connexives.

This study evaluated the proximate components, concentration of total polyphenols, antioxidant activity, and capsaicin and dihydrocapsaicin in the Cumari chili pepper from Pará, Brazil (Capsicum chinense Jacqui) both fresh and after subjected to three different drying temperatures. The results showed that the contents of ash and vitamin C for the dried pepper differed significantly (P <0.05) compared with the fresh pepper. There was a significant difference in concentrations of total phenolics, antioxidant activity and capsaicinoids between the fresh pepper and those submitted to the drying treatments. It was concluded that higher temperatures increase shelf life and decrease the volume of the product, preserve macronutrients and degrade micronutrients, antioxidants and the spicy hotness of the Cumari pepper.

Los salivazos (Hemiptera: Cercopidae) amenazan con convertirse en plagas de la caña de azúcar en Colombia. Desde el 2007, se detectó Aeneolamia varia en la zona central del Valle del Cauca, lo cual motivó a los productores de caña de azúcar a tomar medidas de emergencia para controlar estas infestaciones. Otra especie Zulia carbonaria también se registra atacando caña de azúcar y se usó en este estudio debido a restricciones cuarentenarias impuestas a A. varia. Se usaron larvas de Galleria mellonella como trampa en el suelo, para obtener los hongos entomopatógenos. Los aislamientos se reactivaron sobre Z. carbonaria y se caracterizaron en relación con su tasa de crecimiento, esporulación, germinación y patogenicidad. Se obtuvieron 26 hongos entomopatógenos (15 aislamientos de Metarhizium anisopliae y 11 de Paecilomyces lilacinus). Solo ocho aislamientos de M. anisopliae y seis de P. lilacinus resultaron patogénicos al salivazo. Las cepas de M. anisopliae CCMa0907 y de P. lilacinus: CCPL0801, CCPL0904, CCPL0802 y CCPL0805, presentaron características ideales de esporulación, tasa de crecimiento y porcentaje de germinación. Finalmente, se desarrolló el protocolo para realizar bioensayos en invernadero, para evaluar el potencial patogénico de hongos para el control de salivazos de la caña de azúcar.

Spittlebugs (Hemiptera: Cercopidae) can become into a menace to the sugar cane pest in Colombia. Aeneolamia varia was detected in 2007 in the central area of Cauca Valley, which made sugar cane producers to take emergency measures to control this pest. Another species Zulia carbonaria is also present infesting sugar cane, but due to A. varia quarantine restrictions, Z. carbonaria was used in this research. Galleria mellonella larvae were used as a bait to obtain entomopathogenic fungi from soil samples. Fungi isolates were reactivated using adults of Z. carbonaria and characterized by measuring the speed of development, sporulation, viability and pathogenicity. Twenty-six entomopathogenic fungi were obtained 15 strains of Metarhizium anisopliae and 11 strains of Paecilomyces lilacinus, but only eight strains of M. anisopliae and six of P. lilacinus, were pathogenic to adults of Z. carbonaria. The isolates of M. anisopliae: CCMa0907 and P. lilacinus: CCPL0801, CCPL0904, CCPL0802, CCPL0805, had the best characteristics of growth, viability and sporulation. Finally, a protocol to conduct a bioassay was developed, under greenhouse conditions, to test strains of pathogenic fungi to control sugarcane spittlebugs.

This paper aimed to determine the excretion period of B19 vaccine strain during a complete reproductive cycle (from estrus synchronization, artificial insemination, pregnancy and until 30 days after parturition) of dairy cows from 3 to 9 years old that were previously vaccinated from 3 to 8 months. Three groups were monitored with monthly milk and urine collection during 12 months: G1 with seven cows from 3 to 4 years old; G2 with three cows from 5 to 6 years old; and G3 with four cows from 7 to 9 years old. Urine and milk samples were submitted to bacteriological culture and urine and PCR reactions for detection of Brucella spp. and PCR-multiplex for B19 strain identification. Ring test (RT) was also performed in the milk samples, and serum samples were tested by buffered acidified plate antigen test (BAPA). All animals were serologically negative at BAPA and Brucella spp. was not isolated from both urine and milk samples. RT revealed 13/210 (6.2%) positive milk samples. PCR reactions detected DNA of Brucella spp. in 86/420 (20.5%) samples. In urine it was found a significantly higher frequency (35.2%; 74/210) than in milk (5.7%; 12/210), more frequently from the estrus to 150 days of pregnancy and after parturition (6.7%; 10/150), and from 150 days of pregnancy to parturition (3.4%; 2/60), and they were all identified as B19 strain. In three groups, intermittent excretion of B19 strain was detected mainly in urine samples, which confirmed its multiplication and persistence in cows for until 9 years.

Objectives: To evaluate the effectiveness of NEPs in prison to reduce the prevalence of infections associated with intravenous drug use and to know more about acceptance of the program by inmates and staff. Material and methods: cross-sectional observational study at baseline, 6 and 12 months and 10 years of program development. Interviews were conducted with program users, as well as random sample surveys of officials at the various cuts, and a random sample of inmates from the centre after10 years. Activity indicators of the program were recorded continuously, and the prevalence of HIV, HBV and HCV at baseline and after 10 years was evaluated. For the statistical analysis, the chi-square test was used with the Yates correction when necessary. Results: In ten years we have supplied a total of 15,962 syringes to 429 users, (average 20.2 users/month), and 11,327 (70.9%) were returned. The prevalence of HIV infection decreased from 21% in 1999 to 8.5% in 2009, HCV prevalence from 40% to 26.1% (p <0.01), finding no significant differences in the prevalence of HBsAg +. Most of the inmates and civil servants believe that the program did not increase intravenous drug use and improves hygienic living conditions in prison. Conclusions: After ten years of development of the NEP, there was a significant decrease in the prevalence of HIV and HCV in the prison population at the centre, and the program is accepted as beneficial by most of the inmates and staff participating in the survey.

Objetivos: Evaluar la eficacia de un programa de intercambio de jeringuillas (PIJ) en una prisión para reducir la prevalencia de infecciones asociadas al uso de drogas intravenosas, y conocer la aceptación del programa por internos y funcionarios del centro penitenciario. Material y métodos: Estudio observacional con cortes transversales al inicio, 6 y 12 meses y 10 años de desarrollo del programa. Se realizaron entrevistas a los usuarios del programa y encuestas a muestras accidentales de funcionarios en los distintos cortes, y a una muestra aleatoria de internos a los 10 años. Se registraron diariamente los indicadores de actividad del programa, y se valoró la prevalencia de infección por VIH, hepatitis B y C al inicio y a los 10 años. Para el análisis estadístico utilizamos la prueba ji-cuadrado con la corrección de Yates en caso necesario. Resultados: Durante estos diez años se suministraron 15.962 jeringuillas a 429 usuarios (media de 20,2 usuarios/mes), recuperándose 11.327 (70,9%). La prevalencia de infección por VIH pasó del 21% en 1999 al 8,5% en 2009, la de VHC del 40% al 26,1% (p<0,01). La mayoría de internos y funcionarios consideran que el programa no incrementa el consumo de drogas intravenosas y que mejora las condiciones higiénicas de vida en la prisión. Conclusiones: Tras diez años de PIJ, se observa un significativo descenso en la prevalencia de infección por VIH y por VHC en la población reclusa del centro, y el programa es aceptado como beneficioso por la mayoría de los internos y funcionarios encuestados.