Abstract This article analyzes how different activisms in Chile feminists, LGTBIQ+, antihegemonic masculinities, and groups opposing sexual and reproductive rights contested the gender order during the country’s constituent process, which unfolded between 2020 and 2023. In particular, we explore the way in which anti-abortion groups mobilized, showing that they not only oppose the interruption of pregnancy, but they also try to re-signify gender as a social construct. From the logic of methodological assemblage, we combined the observation of street demonstrations and digital ethnography through a series of interviews with cyber-activists of “pro-life” organizations. From the analysis conducted on the practices and discourses of these groups, three types of political operations have been identified: a redefinition of the framework of rights at stake when debating abortion; a broadening of the affected subject otherwise restricted to the fetus; and a resignification of feminism. These findings allow us to conclude that such activisms do not represent “anti-gender” positions but rather correspond to a neoconservative gender countermovement.

Resumen En el presente artículo se analiza la forma en que los diferentes activismos en Chile feministas, LGTBIQ+, masculinidades antihegemónicas y grupos que se oponen a los derechos sexuales y reproductivos disputaron el orden de género durante el proceso constituyente del país, desarrollado entre 2020 y 2023. En particular, se explora el modo en que los grupos antiabortistas se movilizaron con el fin de comprender que no solo se oponen a la interrupción del embarazo, sino que tratan de resignificar el género como constructo social. Desde la lógica del ensamblaje metodológico, se combinó la observación de manifestaciones callejeras y la etnografía digital, a través de una serie de entrevistas a ciberactivistas de organizaciones “provida”. A partir del análisis realizado sobre las prácticas y discursos de estos grupos, se han identificado tres tipos de operaciones políticas: una redefinición del marco de los derechos en juego al debatir sobre el aborto; una ampliación del sujeto afectado restringido al feto; y una resignificación del feminismo. Estos hallazgos permiten concluir que tales activismos, más que a posiciones “antigénero”, corresponden a un contramovimiento neoconservador de género.

Abstract Background and aims: Alcohol-attributable burdens of disease and social costs are a public health concern in Chile. Besides population-wide preventive policy, individual screening and brief counseling are effective ways to lower this burden. This study aims to estimate the national coverage and characteristics of healthcare provider-led alcohol quantity consumption screening (AQS) in Chile. Methods: The study included a random national household sample of 5,240 participants of the Chilean National Health Survey 2017. Estimates -in percentages with confidence intervals (CI)- were weighted by differences in selection probability and nonresponse rates. Logistic regressions were used to test differences between subgroups, adjusting by age, sex, area and region, adjusted for confounders. Results are shown as odds ratios (OR) with CI. Results: Last year, the national AQS prevalence was 30% (95% confidence interval (CI): 27.8-32.5), 31.6% (95% CI: 28.1-35.3), and 28.8% (95% CI: 25.7-31.9) for men and women respectively. The lowest prevalence was observed in 15 to 24 year old participants (25.1%, 95% CI: 19.8-31.1) and the highest (33%, 95% IC: 29.5-37.3) in the 45-64 year old population. Only age (odd rate (OR): 1.06, IC) and hepatotoxic drug use (OR: 1.45, IC) were associated to AQS in multivariable models. Conclusion: These results show that there are low rates of healthcare provider alcohol enquiry in the Chilean health system. Updated data and a more rigorous assessment of this subject are needed to aid in future public health policy design.

Resumen Antecedentes y objetivos: la carga de enfermedad y los costos asociados al consumo de alcohol son un problema de salud pública. Formas eficaces de combatir este problema son la detección individual y la consejería breve. El objetivo de este estudio es estimar y describir la cobertura nacional de consulta sobre consumo de alcohol (CCA) dirigida por profesionales de salud en Chile. Métodos: se incluyó una muestra nacional aleatoria de 5.240 participantes de la Encuesta Nacional de Salud de Chile 2017. Las estimaciones fueron ponderadas según diferencias en la probabilidad de selección y las tasas de falta de respuesta. Resultados expresados en porcentajes con intervalo de confianza (IC). Se realizaron regresiones logísticas univariadas por edad, sexo, zona y región, ajustadas por confundentes. Resultado expresado en odds ratio (OR) junto con IC. Resultados: la prevalencia nacional de CCA fue de 30% (IC 95 %: 27,8-32,5), y de 31,6 % (IC 95 %: 28,1-35,3) y 28,8 % (IC 95%: 25,7-31,9) para hombres y mujeres respectivamente. La prevalencia más baja fue en participantes de 15 a 24 años (25,1%, IC 95%: 19,8-31,1) y la más alta (33%, IC 95%: 29,5-37,3) en la población de 45 a 64 años. En los modelos de regresión, la edad (OR: 1,06; IC 95% 1,00-1,11, por diez años de aumento en la edad) y el uso de drogas hepatotóxicas (OR: 1,45; IC 95%: 1,10-1,90), fueron las únicas variables que se asociaron significativamente con mayor CCA. Conclusión: este estudio encontró bajos porcentajes de CCA en Chile. Hace falta estudiar a mayor profundidad esta problemática para la mejoría o generación de nuevas políticas.

Abstract The ‘Blue Book’: a Future for Family Medicine in Portugal, edited in 1990 by the Portuguese Association of General Practice and Family Medicine, influenced the subsequent years and built the foundation for the Primary Healthcare Reform, initiated in 2005, but not fully implemented. In the current moment of low professional satisfaction, reviewing the principles that should guide family medicine in the future is important. The family doctor is the individual’s physician, who accompanies people's health throughout their life. Family doctors are specialists in primary healthcare and act according to the core values of family medicine as defined by the WONCA. Their actions form the basis of the health system and are associated with better health outcomes. Therefore, their actions must be centred on the person and the provision of differentiated care, reducing bureaucratic tasks and those with low health value. Physical spaces, equipment, and human resources should be adequately ensured, including the adjustment of the size of patients’ lists to ensure quality and dignified work by the Family Doctor, in every working setting. The Portuguese Association of General Practice and Family Medicine advocates for a performance-based remuneration model appropriate to the family doctor’s activity that compensates and prioritizes value-based healthcare, focusing their actions on the individual and reducing inefficiencies and duplications. This model is based on a new, simplified, and modern quality system grounded in the classic Structure - Process - Results framework but considering the dimensions of patient and professional satisfaction and adequately rewarding clinical work, teamwork, and citizen-centeredness. The present document is an adaptation and translation into English of the book 'A New Future for General and Family Medicine', edited by the Portuguese Association of General Practice and Family Medicine, in 2023.

Resumo O Livro Azul: um futuro para a Medicina de Família em Portugal, editado em 1990 pela Associação Portuguesa de Médicos de Clínica Geral, marcou os anos seguintes e conceptualizou a Reforma dos Cuidados de Saúde Primários, iniciada em 2005, mas não implementada na totalidade. No momento atual de insatisfação profissional é importante rever os princípios que nortearão a medicina geral e familiar no futuro. O médico de família é Médico da Pessoa. É nessa condição que faz o acompanhamento médico ao longo da sua vida. É especialista em cuidados de saúde primários e atua de acordo com os valores da medicina de família definidos pela WONCA. A sua ação é a base do sistema de saúde em que atua e está associada a melhores resultados de saúde. É, por isso, fundamental que a sua ação seja centralizada na pessoa e na prestação de cuidados diferenciados a esta, reduzindo as tarefas burocráticas e de baixo valor em saúde. Devem ser dadas condições materiais, de espaços físicos e de recursos humanos, incluindo adequação do tamanho das listas para garantir um trabalho digno e de qualidade ao médico de família. A APMGF defende um modelo de remuneração pelo desempenho adequado à atividade do médico de família que compense e priorize o valor em saúde, que centre a sua ação na pessoa e que reduza as ineficiências e duplicações. Este modelo assenta num novo sistema da qualidade simplificado e moderno assente no clássico Estrutura - Processo - Resultados, mas que considere as dimensões de satisfação de utentes e profissionais e que compense adequadamente o trabalho clínico, em equipa e centralidade do cidadão. O presente documento é uma adaptação e tradução para inglês do livro “Um Novo Futuro para a Medicina Geral e Familiar”, editado pela Associação Portuguesa de Medicina Geral e Familiar, em 2023.

RESUMO Neste trabalho, destacam-se aprendizados com pesquisa realizada pelo Núcleo Ecologias e Encontros de Saberes para a Promoção Emancipatória da Saúde (Neepes) em parceria com o Centro de Integração na Serra da Misericórdia (CEM) e o Movimento dos Sem Teto da Bahia (MSTB), que atuam em territórios periféricos no Rio de Janeiro e em Salvador. A pesquisa buscou apoiar e sistematizar conhecimentos e práticas emancipatórias de promoção da saúde protagonizados por essas experiências, tendo por base quatro eixos temáticos transversais: alimentação, cuidado, moradia e proteção ambiental, além de comunicação. No artigo, enfocaram-se as reflexões coletivas em relação ao primeiro eixo temático, envolvendo estratégias para promover agroecologia e soberania alimentar, com experiências de produção, circulação e acesso a alimentos saudáveis. Com base nessas reflexões, visou-se contribuir com discussões sobre Territórios Sustentáveis e Saudáveis (TSS), especialmente pelos aprendizados possibilitados com a sistematização das experiências territoriais com base na noção de Promoção Emancipatória da Saúde, que aponta para importantes aportes nas dimensões de justiça ambiental e cognitiva. Com a sistematização dessas experiências, destaca-se sua capacidade de resistir, a partir de um movimento de reexistência de saberes tradicionais e comunitários em periferias urbanas, que apontam caminhos possíveis para a construção de TSS em periferias urbanas. trabalho destacamse destacam se Neepes (Neepes CEM (CEM MSTB, MSTB , (MSTB) Salvador transversais alimentação cuidado comunicação artigo enfocaramse enfocaram temático alimentar produção saudáveis visouse visou TSS, (TSS) cognitiva destacase destaca resistir urbanas (MSTB (TSS

ABSTRACT In this work, we highlight lessons learned from research carried out by the Nucleus Ecologies and Encounters of Knowledge for Emancipatory Health Promotion (NEEPES) in partnership with the Center of Integration in Serra da Misericórdia (CEM) and the Movement of Homeless People of Bahia (MSTB), in peripheral territories in Rio de Janeiro and Salvador. The research sought to support and systematize knowledge and emancipatory practices of health promotion carried out by these experiences, based on four transversal thematic axes: food, care, housing and environmental protection, in addition to communication. The article focused on collective reflections on the first thematic axis, involving strategies to promote agroecology and food sovereignty, with experiences of production, circulation, and access to healthy food. Based on these reflections, we aim to contribute to discussions regarding the idea of Sustainable and Healthy Territories (SHT), especially through the lessons learned from the systematization of territorial experiences based on the notion of Emancipatory Health Promotion, which points to important contributions from the dimensions of environmental and cognitive justice. The systematization of these experiences highlights a movement of re-existence of traditional and community knowledge, which points to possible paths for the construction of SHT in urban peripheries. work NEEPES (NEEPES CEM (CEM MSTB, MSTB , (MSTB) Salvador axes care protection communication axis sovereignty production circulation SHT, (SHT) justice reexistence re existence peripheries (MSTB (SHT

Abstract This study aimed to evaluate the efficacy of nonpharmacological interventions beyond the known and effective lifestyle interventions, as an adjunct to the treatment of adult patients with hypertension, a significant risk factor for fatal cardiovascular diseases. The evaluated interventions included alternative therapies, like traditional Chinese medicine and acupuncture (three studies), mind-body therapy (10 studies) and dietetic/nutraceutical supplements (10 studies). The results suggest that some of these therapies may be promising adjuncts to antihypertensive treatment. Among the mentioned therapies, auricular acupressure, tai chi, yoga, qigong and meditation stand out. In addition, certain nutraceuticals and phytotherapeutic agents like omega-3 fatty acids, coenzyme Q10, vitamin C, probiotics, resveratrol, soy isoflavones, garlic extract and extra virgin olive oil may be recommended as part of a healthy diet, like the Mediterranean or DASH diet, known for its impact on cardiovascular risk. In conclusion, as far as public policies aimed at the comprehensive treatment of chronic noncommunicable diseases are concerned, these therapies, as part of nonpharmacological management, can effectively complement hypertension treatment, providing patients with additional options for controlling their blood pressure and improving their cardiovascular health. However, more research is needed to confirm their long-term efficacy and safety.

Resumen Este estudio se dirigió a evaluar la eficacia de intervenciones no farmacológicas más allá de las conocidas y efectivas intervenciones en el estilo de vida como complemento al tratamiento de pacientes adultos con diagnóstico de hipertensión arterial, factor de riesgo significativo para enfermedades cardiovasculares mortales. Entre las intervenciones evaluadas, se incluyeron las terapias alternativas, como la medicina tradicional china y la acupuntura (tres estudios), las terapias mente-cuerpo (diez estudios) y la suplementación con productos dietéticos/nutracéuticos (diez estudios). Los resultados sugieren que algunas de estas terapias pueden ser prometedoras como complemento al tratamiento antihipertensivo. Entre las terapias mencionadas, se destacan la acupresión auricular, el taichi, el yoga, el qigong y la meditación. Además, ciertos nutracéuticos y fitoterapéuticos, como los ácidos grasos omega 3, la coenzima Q10, la vitamina C, los probióticos, el resveratrol, las isoflavonas de soja, el extracto de ajo y el aceite de oliva extravirgen, pueden ser recomendados como parte de una dieta saludable, como la dieta mediterránea o DASH, reconocida por su impacto en el riesgo cardiovascular. En conclusión, en lo que respecta a las políticas públicas dirigidas al manejo integral de las enfermedades crónicas no transmisibles, estas terapias, dentro del manejo no farmacológico, pueden complementar eficazmente el tratamiento de la hipertensión arterial, brindando a los pacientes opciones adicionales para controlar su presión arterial y mejorar su salud cardiovascular. Sin embargo, se necesita más investigación para confirmar su eficacia y seguridad a largo plazo.

Abstract At the time when Spanish Crown was consolidating its presence in American lands through the dispatch of its royal officials, in his treaty Sobre justicia distributiva Friar Juan Zapata y Sandoval, who belonged to the Creole elite, supports the idea that men born in the New World should enjoy ecclesiastic benefits and secular trades in their republics by election, since he considers them worthy and with enough merits to be candidates. In this paper my aim is to research his actual position on these matters within the section “Acerca de la distribución de los oficios seculares” in the same treaty, to prove that Zapata could not really sustain his defense in favor of those men born in the New World.

Resumen En la época en la que la Corona española consolidaba su presencia en tierras americanas a través del envío de funcionarios reales, el fraile Juan Zapata y Sandoval, perteneciente a la élite novohispana, defiende, en su tratado Sobre justicia distributiva, que los nacidos en el Nuevo Mundo deben ser elegidos para desempeñar los beneficios eclesiásticos y los oficios seculares de sus repúblicas, por considerarlos candidatos dignos y con los méritos suficientes. El objetivo de este artículo es analizar su postura al respecto, en el apartado “Acerca de la distribución de los oficios seculares” del mismo tratado, para mostrar que, en realidad, Zapata no pudo sostener su defensa a favor de los nacidos en el Nuevo Mundo.

RESUMEN Se describe el caso clínico de una Boa constrictor, hembra, adulta, de baja condición corporal, deshidratada, con disecdisis, abultamiento en cloaca, y con evidente dolor a la palpación. Al examen clínico y toma de imágenes radiográficas se confirma la presencia de estructura ovalada radiopaca en el último tercio próximo a la cloaca. La paciente fue sometida a laparotomía exploratoria, donde se extrae una masa esferoide amarilla de aproximadamente 8x4 cm y de consistencia dura, de la cavidad celómica, y un fecaloma de 4x4cmubicadoenel colon. La paciente muere a los 6 días de la cirugía. A la necropsia se reporta presencia de tres granulomas de 5x5, 3x2 y 2x1 cm entre los oviductos. En los hallazgos microscópicos se reportan estructuras parasitarias protozoarias compatibles con Cryptosporidium spp en el mesotelio, así como el folículo vitelogénico con varios focos de bacterias. El estudio histopatológico determinó celomitis severa relacionado a un proceso distócico obstructivo por huevo.

ABSTRACT The clinical case of an adult female Boa constrictor is described, with low body condition, dehydration, dysecdysis, and swelling at the cloacal level, with evident pain on palpation. Clinical examination and radiographic imaging confirmed the presence of a radiopaque oval structure in the last third next to the cloaca. The patient underwent exploratory laparotomy, where a yellow spheroid mass of approximately 8x4 cm and hard consistency was removed from the coelomic cavity, and a 4x4 cm fecaloma located in the colon. The patient died 6 days after surgery. At necropsy, the presence of three granulomas of 5x5, 3x2 and 2x1 cm between the oviducts was reported. In the microscopic findings, protozoan parasitic structures compatible with Cryptosporidium spp in the mesothelium and the vitellogenic follicle with several foci of bacteria were reported. The histopathological study determined severe coelomitis related to an obstructive dystocic process due to an egg.

Abstract: El objetivo principal de este trabajo es analizar el fenómeno de la formación y éxito de nuevos partidos en el período de redemocratización y retorno del multipartidismo brasileño (1979-2018). Aunque el fenómeno es recurrente en Brasil, pocos estudios han abordado el tema de forma más directa en este país. ¿Cuáles son los determinantes de la formación continua de nuevos partidos? Nuestra respuesta apunta a estrategias partidarias combinadas con incentivos contenidos por reglas electorales fluctuantes. Utilizamos metodologías anteriores y conceptualizamos los partidos nuevos como aquellos que son nuevos desde el punto de vista organizativo (obtienen un nuevo registro) y obtienen al menos un escaño en la Cámara de Diputados. Dividimos a los partidos en función de si fueron fundados como partidos de contestación o de coaptación para evaluar el diferente impacto de las variables institucionales y económicas sobre ellos. Nuestros resultados indican que a los partidos totalmente "fuera del sistema" (los de contestación) les resulta más difícil llegar a ser competitivos, lo que demuestra que el fenómeno de la aparición de nuevas siglas está más vinculado a una reorganización estratégica de las élites que a una demanda de los votantes.

Resumen: The main objective of this paper is to analyze the phenomenon of the formation and success of new parties in the period of redemocratization and the return of the Brazilian multiparty system (1979-2018). Although the phenomenon is recurrent in Brazil, few studies have looked more directly at the subject in Brazil. What are the determinants of the continuous formation of new parties? Our answer points to party strategies combined with incentives contained by fluctuating electoral rules. We used previous methodologies and conceptualized new parties as those that are organizationally new (gain a new registration) and win at least one seat in the Chamber of Deputies. We divided the parties by whether they were founded as contestation or coaptation parties in order to assess the different impact of institutional and economic variables on them. Our findings indicate that parties totally "outside the system" (those of contestation) find it more difficult to become competitive, demonstrating that the phenomenon of the emergence of new acronyms is linked more to a strategic reorganization of the elites than to a demand from voters.

Abstract Objective: to carry out a scoping review with the purpose of mapping the scientific evidence on the use of the neutropenic diet in neutropenic pediatric cancer patients. Source of data: The scoping review protocol was prepared in accordance with the PRISMA-ScR and the checklist before the literature search was performed. Articles on nutritional management in adults or on the treatment of other diseases, and articles that were not in Portuguese or English and published before the year 2000, were excluded. Data were extracted based on the Cochrane Consumer and Communication Review Group form. Summary of the findings: Three hundred and forty scientific articles were identified, with the final sample of this review consisting of nine studies. Although the neutropenic diet has been part of the nutritional management of pediatric cancer patients for more than 20 years, there is still great variation in the criteria for indicating use and starting and discontinuing it, as well as in the nutritional composition of the diet. Furthermore, there is no consensus on the impact of using a neutropenic diet on different clinical and nutritional outcomes. Conclusion: In the absence of guidelines that standardize the use of a neutropenic diet in pediatric patients with neutropenia, there are heterogeneous approaches reported in the literature, even within the same institution. The available literature presents an absence of evidence on the use, viability, and effectiveness of the neutropenic diet in oncological children with neutropenia. More studies are needed to identify the real impact of the neutropenic diet on clinical and nutritional outcomes. Objective data PRISMAScR PRISMA ScR performed diseases 2000 excluded form findings identified 2 years it Furthermore outcomes Conclusion neutropenia institution viability 200

Abstract: During the winter of 2023, Chile faced a complex situation related to the respiratory syncytial virus (RSV). After experiencing a decline in RSV circulation during the years of the SARS-CoV-2 pandemic, a late outbreak was observed in the spring of 2022 and an early onset of the outbreak in 2023, with a significant increase in the number of serious cases. The ineffectiveness of strategic planning and risk communication contributed to the complexity of the situation. To avoid the above next winter, measures such as active surveillance, unification of definitions for acute respiratory infections, identification of RSV variants, public education about infections and advance preparation regarding hospital beds and health personnel are suggested. The importance of immunization and intersectoral collaboration to acquire new preventive alternatives is highlighted, as well as the need for early communication about the importance of immunization and identification of high-risk groups, improvement in training of medical personnel and strategic planning of the Ministry of Health. seeking a proactive and collaborative approach to address the complex RSV situation in future winters. The Chilean Immunization Advisory Committee has already carried out an analysis and recommendation on a new prevention alternative. This working group will support any decision of the Ministry of Health in public policies that attempt a change in the paradigm of control of this disease for the health of the children of our country.

Resumen: Durante el invierno de 2023, Chile enfrentó una compleja situación relacionada con al virus respiratorio sincicial (VRS). Después de experimentar una disminución en la circulación del VRS durante los años de la pandemia de SARS-CoV-2, se observó un brote tardío en la primavera de 2022 y un inicio anticipado del brote en 2023, con un aumento significativo en el número de casos graves. La poca efectividad en la planificación estratégica y comunicación de riesgo contribuyeron a la complejidad de la situación. Para evitar lo anterior el próximo invierno, se sugieren medidas como vigilancia activa, unificación de definiciones para infecciones respiratorias agudas, identificación de variantes del VRS, educación pública sobre contagios y preparación anticipada respecto a camas hospitalarias y personal de salud. Se destaca la importancia de la inmunización y colaboración intersectorial para adquirir nuevas alternativas preventivas como también la necesidad de una comunicación temprana sobre la importancia de la inmunización e identificación de grupos de alto riesgo, mejora en capacitaciones del personal médico y planificación estratégica del Ministerio de Salud buscando un enfoque proactivo y colaborativo para abordar la compleja situación del VRS en futuros inviernos. El Comité Asesor en Vacunas y Estrategias de Inmunización de Chile ya realizó un análisis y recomendación sobre una nueva alternativa de prevención. Este grupo de trabajo apoyará cualquier decisión del Ministerio de Salud en políticas públicas que intenten un cambio en el paradigma del control de esta enfermedad por la salud de los niños/as de nuestro país.

ABSTRACT Introduction: International guidelines on aid prior to invasive procedures usually generate longer aid than in intensive care (IT) patients. This fact represents a high risk of malnutrition and, consequently, a worse prognosis. The objective of the present investigation was to analyze the degree of association between the fasting time prior to tracheostomy of patients under mechanical ventilatory assistance (MVA) and the appearance of pneumonia. Methods: Retrospective cohort study that included patients admitted to our IT from 10/01/2018 to 08/31/2022 and with a tracheostomy performed. Two cohorts were defined characterized by fasting ≤3 hours vs. >3 hours. Fisher's exact test and Mann-Whitney test were used for bivariate analysis. A p value <0.05 was shown to be significant. Results: 141 patients were hospitalized with a tracheostomy, 9 were excluded, leaving 132 patients. The cohort with fasting ≤3 hours was made up of 15 patients and the one with fasting >3 hours was made up of 117, the latter presented an average fast of 2.5 hours (IR 2-3), days of AVM prior to the procedure of 13 days (IR 12-18), while the other cohort presented an average fast of 6 hours (IR 5-8), days of AVM prior to the procedure of 12 days (IR 10-14.5). When analyzing the association between the type of fasting and the appearance of pneumonia, an OR of 0.958 (95% CI: 0.32-2.87) was obtained, p value of 0.743. Conclusions: No significant differences were found regarding fasting time and the appearance of pneumonia as referred to in the international literature.

RESUMEN Introducción: Las pautas internacionales sobre la práctica del ayuno previo a procedimientos invasivos generalmente ocasionan ayunos más prolongados que en los casos de pacientes internados en las Unidades de Cuidados Intensivos (UCI). Este hecho representa un alto riesgo de desnutrición y, consecuentemente, un pronóstico más negativo. El objetivo de la presente investigación fue analizar el grado de asociación entre el tiempo de ayuno previo a la traqueostomía de pacientes bajo asistencia ventilatoria mecánica (AVM) y la aparición subsecuente de neumonía. Métodos: Fue un estudio de cohorte retrospectivo que incluyó a pacientes ingresados en nuestra UCI desde el 01/10/2018 hasta el 31/08/2022, quienes habían sido sometidos a una traqueostomía. Se definieron dos cohortes caracterizadas por ayuno inferior o igual a tres horas y superior a tres horas. Se utilizó la prueba exacta de Fisher y la prueba U de Mann-Whitney para el análisis bivariado. Un valor de p < 0.05 se consideró significativo. Resultados: Se hospitalizaron 141 pacientes con traqueostomía, 9 fueron excluidos, quedando 132 pacientes. La cohorte con ayuno ≤ 3 horas estuvo compuesta por 15 pacientes y la de ayuno > 3 horas estuvo compuesta por 117; esta última presentó un ayuno promedio de 2.5 horas (RIC 2-3) y 13 días de AVM previos al procedimiento (RIC 12-18), mientras que la otra cohorte presentó un ayuno promedio de 6 horas (RIC 5-8) y 12 días de AVM previos al procedimiento (RIC 10-14.5). Al analizar la asociación entre el tipo de ayuno y la aparición de neumonía, se obtuvo un OR de 0.958 (IC del 95%: 0.32-2.87) y valor de p de 0.743. Conclusiones: No se encontraron diferencias significativas respecto al tiempo de ayuno y la aparición de neumonía, tal como se refleja en la literatura internacional.

Resumen: Durante el invierno de 2023, Chile enfrentó una compleja situación relacionada con al virus respiratorio sincicial (VRS). Después de experimentar una disminución en la circulación del VRS durante los años de la pandemia de SARS-CoV-2, se observó un brote tardío en la primavera de 2022 y un inicio anticipado del brote en 2023, con un aumento significativo en el número de casos graves. La poca efectividad en la planificación estratégica y comunicación de riesgo contribuyeron a la complejidad de la situación. Para evitar lo anterior el próximo invierno, se sugieren medidas como vigilancia activa, unificación de definiciones para infecciones respiratorias agudas, identificación de variantes del VRS, educación pública sobre contagios y preparación anticipada respecto a camas hospitalarias y personal de salud. Se destaca la importancia de la inmunización y colaboración intersectorial para adquirir nuevas alternativas preventivas como también la necesidad de una comunicación temprana sobre la importancia de la inmunización e identificación de grupos de alto riesgo, mejora en capacitaciones del personal médico y planificación estratégica del Ministerio de Salud buscando un enfoque proactivo y colaborativo para abordar la compleja situación del VRS en futuros inviernos. El Comité Asesor en Vacunas y Estrategias de Inmunización de Chile ya realizó un análisis y recomendación sobre una nueva alternativa de prevención. Este grupo de trabajo apoyará cualquier decisión del Ministerio de Salud en políticas públicas que intenten un cambio en el paradigma del control de esta enfermedad por la salud de los niños/as de nuestro país.

Abstract: During the winter of 2023, Chile faced a complex situation related to the respiratory syncytial virus (RSV). After experiencing a decline in RSV circulation during the years of the SARS-CoV-2 pandemic, a late outbreak was observed in the spring of 2022 and an early onset of the outbreak in 2023, with a significant increase in the number of serious cases. The ineffectiveness of strategic planning and risk communication contributed to the complexity of the situation. To avoid the above next winter, measures such as active surveillance, unification of definitions for acute respiratory infections, identification of RSV variants, public education about infections and advance preparation regarding hospital beds and health personnel are suggested. The importance of immunization and intersectoral collaboration to acquire new preventive alternatives is highlighted, as well as the need for early communication about the importance of immunization and identification of high-risk groups, improvement in training of medical personnel and strategic planning of the Ministry of Health. seeking a proactive and collaborative approach to address the complex RSV situation in future winters. The Chilean Immunization Advisory Committee has already carried out an analysis and recommendation on a new prevention alternative. This working group will support any decision of the Ministry of Health in public policies that attempt a change in the paradigm of control of this disease for the health of the children of our country.

RESUMO Objetivo: Avaliar se o uso terapêutico de cafeína para recém-nascidos prematuros se associa a alterações nos hábitos de sono e à presença de apneia obstrutiva do sono na infância. Métodos: Este é um estudo unicêntrico transversal no qual os responsáveis por 87 crianças com idades entre cinco e dez anos, nascidas a termo ou pré-termo e tratadas ou não com cafeína no período neonatal responderam a questionários para triagem de apneia obstrutiva do sono (Pediatric Obstructive Sleep Apnea Screening Tool – PosaST) e para a caracterização dos hábitos de sono (Children's Sleep Habits Questionnaire – CSHQ) de seus filhos. Foram realizados testes de variância (ANOVA) e de regressão linear para verificar possíveis diferenças entre os grupos. Resultados: As crianças nascidas prematuras que foram tratadas com cafeína acordaram significativamente mais tarde nos dias de semana do que as nascidas a termo (09h±00h58 e 07h43±1h15, respectivamente, p=0,022) e tiveram maior tempo total de sono diário também comparadas às nascidas a termo (10h24±1h08 e 09h29±1h08, respectivamente, p<0,001). Não houve diferença significativa entre os três grupos na pontuação geral dos questionários PosaST e CSHQ. Conclusões: O uso de cafeína no período neonatal não prejudicou tardiamente os hábitos de sono e não levou ao aumento dos escores de apneia obstrutiva do sono de crianças nascidas prematuras quando comparadas com crianças nascidas a termo. Objetivo recémnascidos recém nascidos infância Métodos 8 anos prétermo pré Pediatric Childrens Children s CSHQ filhos ANOVA (ANOVA Resultados 09h±00h58 09h00h58 hh 09h 00h58 h (09h±00h5 07h431h15 07h43 1h15 07h43±1h15 respectivamente p=0,022 p0022 p 0 022 10h24±1h08 10h241h08 10h24 1h08 (10h24±1h0 09h291h08 09h29 09h29±1h08 p<0,001. p0001 p<0,001 . 001 p<0,001) Conclusões 09h±00h5 09h00h5 00h5 (09h±00h 07h431h1 07h4 1h1 07h43±1h1 p=0,02 p002 02 10h24±1h0 10h241h0 10h2 1h0 (10h24±1h 09h291h0 09h2 09h29±1h0 p000 p<0,00 00 09h±00h 09h00h 00h 07h431h 07h 1h 07h43±1h p=0,0 p00 10h24±1h 10h241h 10h 09h291h 09h29±1h p<0,0 p=0, p0 p<0, p=0 p<0 p= p<

ABSTRACT Objective: This study aimed to evaluate whether the therapeutic use of caffeine for premature newborns is associated with changes in sleep habits and the presence of obstructive sleep apnea in childhood. Methods: This is a cross-sectional single-center study in which the caretakers of 87 children aged 5–10 years, born full-term or preterm, treated or not with caffeine in the neonatal period, answered questionnaires to screen for obstructive sleep apnea (Pediatric Obstructive Sleep Apnea Screening Tool [PosaST]) and to characterize the sleep habits (Children's Sleep Habits Questionnaire [CSHQ]) of their children. ANOVA and linear regression tests were performed to verify possible differences between the groups. Results: Children born prematurely who were treated with caffeine woke up significantly later on weekdays than those born at term (09h±00h58 and 07h43±1h15, respectively, p=0.022) and had longer total daily sleep time also compared to those born at term (10h24±1h08 and 09h29±1h08, respectively, p<0.001). There was no significant difference between the three groups in overall PosaST and CSHQ scores. Conclusions: Caffeine use in the neonatal period did not impair sleep habits later in life and did not lead to increased obstructive sleep apnea scores in prematurely born children compared to those born at term. Objective childhood Methods crosssectional cross sectional singlecenter single center 8 510 5 10 5–1 years fullterm full preterm Pediatric [PosaST] Childrens s [CSHQ] Results 09h±00h58 09h00h58 hh 09h 00h58 h (09h±00h5 07h431h15 07h43 1h15 07h43±1h15 respectively p=0.022 p0022 p 0 022 10h24±1h08 10h241h08 10h24 1h08 (10h24±1h0 09h291h08 09h29 09h29±1h08 p<0.001. p0001 p<0.001 . 001 p<0.001) Conclusions 51 1 5– [PosaST [CSHQ 09h±00h5 09h00h5 00h5 (09h±00h 07h431h1 07h4 1h1 07h43±1h1 p=0.02 p002 02 10h24±1h0 10h241h0 10h2 1h0 (10h24±1h 09h291h0 09h2 09h29±1h0 p000 p<0.00 00 09h±00h 09h00h 00h 07h431h 07h 1h 07h43±1h p=0.0 p00 10h24±1h 10h241h 10h 09h291h 09h29±1h p<0.0 p=0. p0 p<0. p=0 p<0 p= p<

Abstract Anthropogenic interventions have had a compromising effect on environmental health, intensifying the degradation of ecosystems, and the quantity of chemical pollutants released into nature. Therefore, research areas within the scope of environmental assessments and monitoring such as ecotoxicology have contributed to the determination of the toxic potential of contaminants. A small cyprinid known as the zebrafish (Danio rerio), the use of which has exponentially grown, is an alternative vertebrate model for scientific research, mainly in the assessment of environmental risks. The species exhibits several advantages for breeding in a laboratory, in addition to presenting multi-biomarkers of environmental toxicity. Thus, this review aims to present the main characteristics and advantages of working with this species, as well as show studies related to ecotoxicology involving biomarkers of toxicity in zebrafish. The results show a progressive trend towards employing the species in environmental risk analyses, it is an increasingly recommended species in the assessment of the toxicity level of a range of chemical pollutants. The development of future technologies must contribute to scientific advancement, rendering the potential application of this model organism an even more widespread one, which will certainly help in bridging knowledge gaps in various areas of study. health ecosystems nature Therefore contaminants Danio rerio, rerio , rerio) grown risks laboratory multibiomarkers multi Thus analyses advancement one study