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Edad de menarquia y bienestar en mujeres de Valparaíso, Chile (1851-1895): un análisis histórico antropométrico
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Lacueva Muñoz, Jaime J.

; Arancibia Martini, Héctor

; Pastén González, Benjamín Guillermo

; Villarroel Durán, Juan Luis

; Santibáñez Garviso, Johanna

Autoctonía (Santiago)

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dec 2023, Volume 7 N. 2 Pages 1039 - 1075

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract: Menarche marks the beginning of female reproductive cycle and constitutes an important milestone of female growth. Age at menarche varies according to genetic and socio-environmental factors, so it stands as an interesting indicator of biological wellbeing of the population. Based on an initial sample of 445 women from Valparaiso, born in 1851-1895, we examine the impact of socio-environmental factors on age of menarche in a historical context characterized by a strong GDP growth and intense, although uneven, urban development. Although results indicate a tendency for menarche to present itself at increasingly younger ages, this tendency is not statistically significant (p > .05). Factors like rural/urban origin, size of the household and intra-household stress do not seem to affect age of menarche in the sample, characterized by a low socio-economic status. Urban penalty phenomena, typical of early processes of modernization, could be partially explaining the results obtained.

Resumen: La menarquia señala el inicio del periodo reproductivo y constituye un importante marcador del crecimiento humano femenino. La edad en la que se presenta depende de la interacción de factores genéticos y socioambientales, por lo que resulta un interesante indicador del bienestar biológico de las poblaciones. Con una muestra inicial de 445 mujeres residentes en Valparaíso y nacidas entre los años 1851-1895, evaluamos la incidencia de factores socioambientales en la edad de la menarquia en un contexto histórico caracterizado por un fuerte incremento del Producto Interno Bruto y un intenso, pero inarmónico desarrollo urbano. Aunque los resultados muestran una tendencia al adelanto de la edad de menarquia, este no resulta estadísticamente significativo (p > .05). El origen rural/urbano, el tamaño familiar y el estrés intrafamiliar no parecen incidir en la edad de menarquia de la población de la muestra. El fenómeno de penalización urbana podría explicar en parte los resultados.

https://doi.org/10.23854/autoc.v7i2.320

Síndrome hemorrágico asociado a contacto con Lonomia sp (Lepidoptera, Saturniidae) en Venezuela
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Hernández Villarroel, Luis Alfredo

Revista Cubana de Medicina Tropical

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dec 2023, Volume 75 N. 3 elocation e1039

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT Introduction: Among the Lepidoptera, belonging to the class Insecta, only the larval forms of the genus Lonomia can cause systemic reactions in humans. So far, only two species have been formally linked to poisoning accidents: Lonomia achelous and Lonomia obliqua. Its venom is composed of proteins, serine proteases, and other components with inflammatory, procoagulant, and hemolytic activity. Objective: Describe a case of hemorrhagic syndrome associated with contact with Lonomia achelous. Thus, trying to provide information on a condition of great clinical and health relevance for the Latin American region. Clinical case: A 12-year-old patient, from a rural area, with no relevant family or personal history, who after contact with a caterpillar on the left forearm, presented local pain, fever, bruising in the submental region, right upper extremity and both lower extremities. In blood analysis, prolonged coagulation times were evidenced. Therefore, the diagnosis was considered lonomic accident. Two units of fresh frozen plasma and ε-aminocaproic acid were administered, presenting progressive clinical and analytical improvement, with normalization of coagulation parameters on the fifth day after admission. Conclusions: For its diagnosis, the clinical manifestations presented by the patient with the observation of the caterpillar was important. The administration of antilonomic serum is the recommended treatment in Brazil, however, in this case good results were obtained with the administration of ε-aminocaproic acid. Due to his presentation in different Latin American countries, it is important to provide health professionals with knowledge about its diagnosis and therapeutic management.

RESUMEN Introducción: Entre los Lepidoptera, pertenecientes a la clase Insecta solo las formas larvales del género Lonomia pueden causar reacciones sistémicas en humanos. Hasta el momento, solo dos especies se han relacionado formalmente con accidentes por envenenamiento: Lonomia achelous y Lonomia obliqua. Su veneno está compuesto por proteínas, serina proteasas y otros componentes con actividad inflamatoria, procoagulante y hemolítica. Objetivo: Describir un caso de síndrome hemorrágico asociado a contacto con Lonomia achelous. Intentando así proveer información sobre una condición de gran relevancia clínica y sanitaria para la región de Latinoamérica. Caso clínico: Paciente de 12 años, proveniente de área rural, sin antecedentes familiares o personales de relevancia, quien posterior a contacto con oruga en antebrazo izquierdo, presentó dolor local, fiebre, hematomas en región submentoniana, extremidad superior derecha y en ambas extremidades inferiores. En analítica sanguínea, se evidenciaron tiempos de coagulación prolongados. Por lo que se consideró el diagnóstico accidente lonómico. Se administraron 2 unidades de plasma fresco congelado y ácido ε-aminocaproico, presentando mejoría clínica y analítica progresiva, con normalización de los parámetros de coagulación al quinto día de su ingreso. Conclusiones: Para su diagnóstico fue importante el cuadro clínico presentado por el paciente junto con la observación de la oruga. La administración de suero antilonómico es el tratamiento recomendado en Brasil, sin embargo, en este caso se obtuvieron buenos resultados con la administración de ácido ε-aminocaproico. Dada su presentación en diferentes países de Latinoamérica, es importante proveer de conocimiento a los profesionales de salud sobre su diagnóstico y manejo terapéutico.

Mortalidad en recién nacidos de muy bajo peso al nacer en la Red Neonatal NEOCOSUR: causalidad y temporalidad
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Toso, Alberto

; Vaz Ferreira, Catalina

; Herrera, Tamara

; Villarroel, Luis

; Brusadin, Mariana

; Escalante, María J.

; Masoli, Daniela

; D’Apremont, Ivonne

; Mariani, Gonzalo

; Tapia, José L.

Archivos argentinos de pediatría

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oct 2022, Volume 120 N. 5 Pages 1 - 10

Abstract: Es | Text: Es | PDF: Es

https://doi.org/10.5546/aap.2022.296

Influencia de parámetros claves de cargas cíclicas sobre el comportamiento de un suelo estabilizado químicamente no reforzado y reforzado con fibras
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Villarroel-Ortega, Jorge A.

; Correia, Antonio A.S.

; Venda Oliveira, Paulo J.

; Lemos, Luís J.L.

Obras y proyectos

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jun 2022, N. 31 Pages 29 - 34

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

In this work the effect of the number of cyclic loads on the mechanical behaviour of a chemically stabilised soft soil, reinforced with synthetic polypropylene fibres, and not reinforced, are analysed. This experimental study was carried out on a Portuguese soft soil collected in the Baixo Mondego area in the centre of the country. The laboratory work is based on the following tests: i) monotonic unconfined compression test (UCS), ii) cyclic unconfined compression test performed with different numbers of cycles (2500, 5000, 10000) and several frequencies (0.25, 0.5, 1.0, 2.0 Hz) for a load corresponding to 50% of the strength evaluated in the monotonic tests (UCS) and iii) monotonic UCS tests performed after the cyclic loading stag (UCSpc). The analysis is complemented with the study of the accumulated permanent axial deformation developed during the cyclic stage. The results show that the accumulated permanent axial strain increases with the number of cycles, also the strength and stiffness after the cyclic loading stage increase their values.

En este trabajo se analiza el efecto de parámetros claves de la solicitud cíclica en el comportamiento mecánico de un suelo blando químicamente estabilizado, no reforzado y reforzado con fibras sintéticas de polipropileno. Este estudio experimental se realizó en un suelo blando portugués recogido en la zona del Baixo Mondego en el centro del país. El trabajo de laboratorio se llevó a cabo desarrollando las siguientes pruebas: i) monotónico de compresión no confinada (UCS), ii) prueba cíclica de compresión no confinada realizada con diferentes números de ciclos (2500, 5000, 10000) y diferentes frecuencias (0.25, 0.5, 1.0, 2.0 Hz) para una carga correspondiente al 50% de la resistencia evaluada en las pruebas monotónicas (UCS) y iii) pruebas de UCS monotónicas realizadas luego de la etapa cíclica (UCSpc. El análisis se complementa con el estudio de la deformación axial permanente acumulada desarrollada durante la etapa cíclica. Los resultados muestran que la deformación axial permanente acumulada aumenta con el número de ciclos, también se observa que aumenta la resistencia y la rigidez después de la etapa de carga cíclica.

https://doi.org/10.4067/s0718-28132022000100029 37 downloads

Riesgo cardiometabólico en niños con obesidad grave
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López Lucas, María José

; Barja, Salesa

; Villarroel del Pino, Luis

; Arnaiz, Pilar

; Mardones, Francisco

Nutrición Hospitalaria

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apr 2022, Volume 39 N. 2 Pages 290 - 297

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract Introduction: severe obesity has had a greater increase than non-severe obesity in Chilean schoolchildren during the last years. We do not know whether the cut-off point currently used to define severe obesity in children (BMI ≥ + 3 DE, WHO-2007 curves) is associated with a greater biological risk in our population. Objective: to describe and compare cardiometabolic risk in schoolchildren with severe vs. non-severe obesity. Methods: a secondary analysis of a sample of 3,325 schoolchildren was performed, in which cardiometabolic risk factors were studied. The prevalence of these was compared in the subsample of 589 schoolchildren with obesity according to whether it was severe or not, and the respective ORs were calculated. Results: mean age was 11.4 ± 0.98 years, 46 % were girls, and 11.5 % of the sample had severe obesity, with a higher prevalence of most of the factors studied and no differences in chronic disease, obesity or education in parents, or physical activity of the child. The risk of those with severe obesity for central obesity, insulin resistance, high blood pressure, and metabolic syndrome reached an OR of 12.9, 3.2, 2.67, and 1.92, respectively, as compared to those with non-severe obesity. Conclusion: this definition of severe obesity in childhood favors the identification of children with higher cardiometabolic comorbidity, which allows to focus the efforts of secondary prevention and its most timely treatment.

Resumen Introducción: la obesidad grave ha tenido un mayor aumento que la obesidad no grave en los escolares chilenos durante los últimos años. Desconocemos si el punto de corte actualmente utilizado para definir la obesidad grave (IMC ≥ + 3 DE, curvas OMS-2007) se asocia a un mayor daño biológico en nuestra población pediátrica. Objetivo: describir y comparar el riesgo cardiometabólico en escolares con obesidad grave y no grave. Método: se realizó un análisis secundario de una muestra de 3325 escolares en los que se estudiaron los factores de riesgo cardiometabólico. Se comparó la prevalencia de estos factores en los que presentaban obesidad según fuera esta grave o no, calculándose los OR respectivos. Resultados: de los 589 sujetos con obesidad, con una media de edad de 11,4 ± 0,98 años, el 46 % eran de género femenino y el 11,5 % presentaban obesidad grave, con mayor prevalencia de la mayoría de los factores estudiados y sin diferencias en cuanto a antecedentes parentales de enfermedad crónica u obesidad, educación de los padres y actividad física del niño. Los niños con obesidad grave tenían un mayor riesgo de obesidad central (OR: 12,9), resistencia insulínica (OR: 3,2), HTA (OR: 2,67) y síndrome metabólico (OR:1,92). Conclusión: esta definición de obesidad grave en la niñez favorece la identificación de los niños con mayor comorbilidad cardiometabólica, lo cual permite focalizar los esfuerzos de prevención secundaria y su tratamiento más oportuno.

https://doi.org/10.20960/nh.03829

CELOS Y CIBERVIOLENCIA EN EL POLOLEO EN UNIVERSITARIOS CHILENOS
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Salas-Herrera, José Luis

; Condeza Díaz, Jazmín Valentina

; Figueroa Mora, Nathaly Andrea

; Oliva Rivera, Diego Ignacio

; Villarroel Avendaño, Annette Steffania

; Vera Jiménez, Valesca Aracely

Límite (Arica)

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2022, Volume 17 elocation 13

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT The purpose of this study was to understand the manifestations of cyberviolence in the pololeo in Chilean university students. A qualitative approach was used, from the constructivist grounded theory. The instruments for the production of meanings were a virtual questionnaire, semi-structured interviews and focus groups, achieving the participation of 143 Chilean university students, men and women, between 20 and 25 years old. As a result, we have that cyberviolence in the pololeo is a multidimensional phenomenon, preceded mainly by jealousy, insecuri ties and myths of romantic love. In turn, cyberviolence appears causally related to different damages in the quality of life of the victims, which translates into the affectation of their different vital areas by the perception of negative emotions, which prompts them to resort to support networks social and institutional. It is suggested to strengthen and periodically update the research on cyberviolence in the pololeo, taking into account the multidimensionality and dynamism of the phenomenon. Similarly, in future research it will be relevant to include minority and/or risk groups in adolescence, such as members of the LGBTQI+ community.

RESUMEN El propósito de este estudio fue comprender las manifestaciones de la ciberviolencia en el pololeo en estudiantes universitarios chilenos. Se usó una aproximación cualitativa, desde la teoría fundamentada constructivista. Los instrumentos de producción de datos consistieron en un cuestionario virtual, entrevistas semiestructuradas y grupos focales; logrando la participación de 128 estudiantes universitarios chilenos, hombres y mujeres, entre 20 y 25 años. Como resultado tenemos que la ciberviolencia en el pololeo es un fenómeno multidimensional, precedido principalmente por los celos, inseguridades y mitos del amor romántico. A su vez, la ciberviolencia aparece relacionada causalmente con diferentes perjuicios en la calidad de vida de las víctimas, lo que se traduce en la afectación de sus diferentes áreas vitales por la percepción de emociones negativas, lo que les impulsa a recurrir a redes de apoyo sociales e institucionales. Se sugiere robustecer y actualizar periódicamente la investigación respecto de ciberviolencia en el pololeo, atendiendo a la multidimensionalidad y dinamismo del fenómeno. Del mismo modo, en investigaciones futuras será relevante incluir grupos minoritarios o de riesgo en la adolescencia, como integrantes de la comunidad LGBTQI+.

https://doi.org/10.4067/s0718-50652022000100213

Estrategias Didácticas y Organizativas: Atender a la Diversidad en las Escuelas de Cultura y Difusión Artística
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Villarroel Raimilla, Cony

; Muñoz Moreno, José Luís

Estudios pedagógicos (Valdivia)

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dec 2021, Volume 47 N. 3 Pages 321 - 342

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT: This article presents a research that aims to analyze the institutional strategies for attention to diversity developed by the Escuelas de Cultura y Difusión Artística (Chile). The study uses mixed methodology, through a case study. For this, it´s analyzed the case of the Escuela de Cultura y Difusión Artística of Puerto Montt using the techniques of documentary analysis, questionnaire, and interview. Some conclusions allow to demonstrate the work of the school with diversity through the articulation of different teaching and organizational strategies to promote the students' integral learning and facilitate processes of permanent improvement.

RESUMEN: Este artículo presenta una investigación que tiene por objetivo analizar las estrategias institucionales para la atención a la diversidad que desarrollan las Escuelas de Cultura y Difusión Artística (Chile). El estudio emplea metodología de carácter mixto, mediante un estudio de caso. Para ello, se analiza el caso de la Escuela de Cultura y Difusión Artística de Puerto Montt utilizando las técnicas de análisis documental, cuestionario y entrevista. Algunas conclusiones permiten evidenciar el trabajo del centro escolar con la diversidad mediante la articulación de diferentes estrategias didácticas y organizativas para promover el aprendizaje integral de los estudiantes y facilitar procesos de mejora permanente.

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Indice de vulnerabilidad del sector salud en México: La infraestructura hospitalaria ante la COVID-19
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Candia Calderon, Alethea Gabriela

; Olivera-Villarroel, Sazcha-Marcelo

Horizonte sanitario

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aug 2021, Volume 20 N. 2 Pages 218 - 225

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract: Objective: To build a general index of vulnerability of the health sector and a specific index of vulnerability in pneumological diseases that identify the municipalities with the least capacity to respond to the pandemic caused by the SARS-CoV-2 virus. Materials and methods: To generate the indices, we rely on three components: infrastructure and available personnel, health demand, and the scope of social and health insurance, all using the Shapley decomposition method. Results: The municipalities that present a greater resilience capacity in the face of the pandemic are mostly capital municipalities, a fact that highlights the poor spatial distribution of health services. Besides, due to the socio-economic characteristics of the country, the municipalities of the southwest region (Oaxaca, Guerrero, and Puebla); of the Sierra Tarahumara (Chihuahua) and the Huasteca (San Luis de Potosí, Querétaro, and Hidalgo) are those that present a high index of vulnerability due to not having sufficient health resources and having a large proportion of the population sensitive to the pandemic. Another critical finding is that the capital municipalities, despite having a considerable number of hospital infrastructure and medical personnel, have a high demographic density, which causes them to be more exposed to the virus. Therefore, they are heading towards the total saturation of their population. Healthcare system: such is the case of municipalities such as Iztapalapa or Ecatepec who exceeded their hospital capacity after the second wave of the pandemic. Conclusion: The vulnerability of the health sector seen through the developed indices is aggravated if the specific capacity to care for respiratory diseases is analyzed, particularly in municipalities with high and medium exposure to the COVID-19 pandemic; the findings show the importance of developing targeted protection and mitigation policies for these municipalities.

Resumen: Objetivo: Construir un índice general de vulnerabilidad del sector salud y un índice específico de vulnerabilidad en enfermedades neumológicas, que identifiquen a los municipios con menor capacidad de respuesta a la pandemia provocada por el virus SARS-CoV-2. Materiales y métodos: Para generar los índices, nos basamos en tres componentes: la infraestructura y el personal disponible; la demanda sanitaria; el alcance del seguro social y de salud, todo ello mediante el método de descomposición de Shapley. Resultados: Los municipios que presentan una mayor capacidad de resiliencia ante la pandemia, en su mayoría son municipios capitales, dato que resalta la mala distribución espacial de los servicios sanitarios. Además, por las características socio económicas del país, los municipios de la región sur oeste (Oaxaca, Guerrero y Puebla); de la sierra Tarahumara (Chihuahua) y la Huasteca (San Luis de Potosí, Querétaro e Hidalgo) son los que presentan un alto índice de vulnerabilidad, al no contar con los recursos sanitarios suficientes y por tener una gran proporción de población sensible a la pandemia. Otro hallazgo importante es que, los municipios capitales, a pesar de contar con un número considerable de infraestructura hospitalaria y personal médico, poseen una alta densidad demográfica, lo que ocasiona que estén más expuestos al virus y por ende se encaminan a la saturación total de su sistema de salud; tal es el caso de municipios como Iztapalapa o Ecatepec que tras la segunda ola de pandemia rebasaron su capacidad hospitalaria. Conclusión: La vulnerabilidad del sector salud vista a través de los índices desarrollados, se agrava si se analiza la capacidad específica de atención a enfermedades respiratorias, en particular en los municipios de alta y media exposición a la pandemia por COVID-19, los hallazgos muestran la importancia de desarrollar políticas focalizadas de protección y mitigación de estos municipios.

https://doi.org/10.19136/hs.a20n2.3891 327 downloads

Reacciones de hipersensibilidad asociadas al uso de asparaginasa en niños con leucemia linfoblástica aguda
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Ovalle B., Pilar

; Azócar M., Manuel

; Nicklas D., Carolina

; Villarroel C., Milena

; Morales V., Jorge

Andes pediatrica

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apr 2021, Volume 92 N. 2 Pages 182 - 192

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract: Introduction: The treatment of acute lymphoblastic leukemia (ALL) includes the use of asparaginase (ASP), a drug associated with hypersensitivity reactions (HSR) that requires discontinuing its use. Objective: To determine the incidence of HSR associated with ASP that require discontinuation of its use and des cribe them, and to verify if there is a relationship between HSR incidence and protocols or survival. Patients and Method: Retrospective study. Clinical records of all patients (1-15 years) diagnosed with ALL between January 2010 and December 2015 at the Hospital Luis Calvo Mackenna were reviewed. The incidence of HSR to ASP was determined and classified according to the CTCAE v5.0 severity score. We analyzed the relative risk of HSR using Fisher’s test and the survival with the Kaplan-Meier estimator. Results: 110 patients were collected. During the first treatment (ALL-IC- BFM), the incidence of HSR to L-ASP was 55%, therefore it was changed to PEG-ASP as second-line treatment, and 44% of them had HSR, and ASP should discontinued in 25% of patients. Of all the HSR to ASP, 77% were anaphylactic (CTCAE 3-5). Patients treated with augmented IB protocol were at higher risk of not completing ASP treatment due to HSR, RR 3.81 (95% CI, 1.98-7.31, p = 0.0001). Patients without HSR in ALL-IC-BFM were at lower risk of relapse, HR 0.29 (95% CI, 0.14-0.62, p = 0.0013). Considering all treatments (ALL-IC-BFM and relapse), patients who completed the ASP treatment had higher overall survival, HR 0.20 (95% CI, 0.07-0.57, p = 0.0026). Conclusions: HSR to ASP that require discontinuation of treatment are frequent in children with ALL, most of them were severe anaphylactic reactions. This study suggests a better prognosis in patients without HSR to ASP.

Resumen: Introducción: El tratamiento de la leucemia linfoblástica aguda (LLA) incluye el uso de asparaginasa (ASP), medi camento asociado a reacciones de hipersensibilidad (RHS) que requieren discontinuar su uso. Ob jetivo: Determinar la incidencia de RHS asociadas a ASP que requieran discontinuar su uso y describirlas, y verificar si hay asociación entre incidencia de RHS y protocolos o sobrevida. Pacientes y Método: Estudio retrospectivo. Se revisaron los registros clínicos de todos los pacientes (1-15 años) diagnosticados de LLA entre enero de 2010 y diciembre de 2015 en el Hospital Luis Calvo Macken na. Se determinó incidencia de RHS a ASP, se clasificaron según score de gravedad CTCAE v5.0, se analizó riesgo relativo de RHS con test de Fisher y sobrevida con estimador Kaplan-Meier. Resulta dos: Se recopilaron 110 pacientes. Durante el primer tratamiento (ALL-IC-BFM), la incidencia de RHS a L-ASP fue 55%, cambiándose a PEG-ASP como segunda línea. De estos, 44% presentó RHS, debiendo discontinuarse ASP definitivamente en 25% de los pacientes. De todas las RHS, 77% fueron anafilácticas (CTCAE 3-5). Los pacientes en protocolo IB aumentado tuvieron mayor riesgo de no completar tratamiento con ASP, RR 3,81 (IC 95%, 1,98-7,31, p = 0,0001). Los pacientes sin RHS en ALL-IC-BFM presentaron menor riesgo de recaer, HR 0,29 (IC 95%, 0,14-0,62, p = 0,0013). Consi derando todos los tratamientos (ALL-IC-BFM y recaídas), los que completaron tratamiento con ASP tuvieron mayor sobrevida global, HR 0,20 (IC 95%, 0,07-0,57, p = 0,0026). Conclusiones: Las RHS a ASP que requieren suspensión de tratamiento son frecuentes en niños con LLA, siendo mayormente reacciones anafilácticas graves. Este estudio sugiere mejor pronóstico en pacientes sin RHS a ASP.

https://doi.org/10.32641/andespediatr.v92i2.2151 157 downloads

10.

Impacto sobre el tamaño de las muestras en estudios nacionales si cambiara el nivel de significación estadística de α= 0,05 a α = 0,005
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Villarroel del Pino, Luis

Revista médica de Chile

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jan 2021, Volume 149 N. 1 Pages 45 - 51

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Background: The statistical significance α = 0.05 is the cut-off point used to decide whether a hypothesis is statistically significant. When p-value is less than 0.05, we reject the null hypothesis. Although this criterion has been used for almost a century to generate new knowledge, there is currently an international discussion about the need to decrease the significance to α = 0.005. Aim: To determine the effects that changing the p value would have on the sample size of different types of studies. Material and Methods: A series of formulas for calculating the sample size of cross-sectional and comparative studies were used to create case scenarios. Results: By changing α = 0.05 to α = 0.005, the sample sizes in cross-sectional studies would double and in comparative studies would increase between 60% and 70%, depending on the statistical power chosen. Conclusions: Considering the sample size implications, the change in the level of significance would have important effects on the Chilean science. The cost of a randomized clinical trial could increase by at least 27% to 32%. This increase could be similar for cross-sectional studies. With an investment of less than 0.4% of gross domestic product in science and technology, national scientific research would become more expensive, distributing the few available resources among fewer projects. This effect should be considered in any discussion about national budget for science and technology.

161 downloads

11.

Estudio de metales urinarios y plomo en sangre: parámetros poblacionales en Antofagasta, 2018
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Ríos, Juan Carlos

; Villarroel, Luis

; Torres, Marisa

; Astaburuaga, Juan Pablo

; Leiva, Cinthya

; Cook, Paz

; Medel, Patricio

; Cortés, Sandra

Revista médica de Chile

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jun 2020, Volume 148 N. 6 Pages 746 - 754

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Background: The presence of toxic metals in human populations is strongly associated with chronic diseases. Aim: To determine levels of lead, chromium, cadmium, mercury and inorganic arsenic (AsIn) in the general population aged over 5 years in Antofagasta, Chile. Material and Methods: People living in Urban Antofagasta for at least five years were considered eligible. Biological samples were obtained to measure heavy metals. Results: One thousand two hundred three participants with a median age of 43 years (656 women) were studied. Their mean time of residence in the city was 30 years, and 52% smoked. Eight percent of the adult population and 12% of children had AsIn values above 35 µg/L, while 75% of the population had levels below 21.9 µg/L. The other metals were below the risk levels defined by the health authority (10 µg/L for chromium, 10 µg/L for mercury, 2 µg/L for cadmium, 5 and 10 μg/dL for blood lead for children and adults, respectively). The factors associated with high levels of AsIn in adults were male sex, living more than 200 meters from monitoring points, and low schooling. In children, the associated variables were high intake of seafood products and having a caregiver with less than 8 years of schooling. Contrary to expectations, the greatest risk of presenting altered levels of the metals occurred in the population living more than 500 meters from the identified risk sources (90% of the population). Conclusions: The findings of this study suggest that all potential sources of exposure to AsIn should be evaluated, and surveillance actions should be established to reduce involuntary exposure to this metalloid.

926 downloads

12.

Condición física de escolares chilenos de 8° año básico y su relación con el rendimiento académico
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Ahumada-Padilla, Ericka

; Villarroel del Pino, Luis

; Bustamante-Ara, Natalia

Revista chilena de pediatría

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feb 2020, Volume 91 N. 1 Pages 58 - 67

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Abstract: Introduction: Good physical fitness (PF) is related, among many benefits, to functional and structu ral brain changes that favor learning. Objective: To analyze the association between PF and academic performance (AP) in Chilean schoolchildren according to sex, and to determine if the kind of school dependency influences this association. Subjects and Method: Cross-sectional study analyzing po pulation data of 8th-grade students evaluated by the SIMCE-2011 test. The sample included only 13 and 14 years old students, of both sexes, with all PF and AP tests taken. The results of PF and AP tests were categorized as poor, regular, and good. A binary logistic regression was performed explaining a good AP from the PF categories according to sex, and kind of school dependency, adjusting for age, nutritional status, parents’ educational level, and school socioeconomic level. Results: Out of 19,929 records, 12,338 schoolchildren were considered, where 47.9% were female. 33.4% of girls and 49.5% of boys presented good PF, and 16.9% and 21.5% presented good AP respectively. Schoolchildren with good PF had more chances of achieving good AP than those with poor PF (girls 84% and boys 78%, both p < 0.001). Considering the kind of school dependency, good PF in girls attending public schools increased the chances of achieving good AP by 334% (p < 0.001) and in boys attending sub sidized private schools by 91% (p = 0.01). Conclusion: Both girls and boys with good PF have more chances of achieving a good AP. By including the kind of school dependency, the association persists in girls attending public schools and boys attending subsidized private schools.

Resumen: Introducción: Una buena condición física (CF) se relaciona, entre muchos beneficios, a modifica ciones funcionales y estructurales cerebrales que favorecen el aprendizaje. Objetivo: Analizar la aso ciación entre CF y rendimiento académico (RA) en escolares chilenos según sexo y determinar si la dependencia administrativa de la escuela influye en dicha asociación. Sujetos y Método: Estudio transversal sobre datos poblacionales de escolares de 8° básico evaluados por SIMCE-2011. La mues tra incluyó solo escolares de 13 y 14 años, de ambos sexos, con todas las pruebas de CF y RA rendidas. Los resultados de CF y RA fueron categorizados en malo, regular y bueno. Se realizó una regresión logística binaria explicando un buen RA a partir de las categorías de CF según sexo y dependencia administrativa, ajustando por edad, estado nutricional, nivel educacional de los padres y nivel so cioeconómico de la escuela. Resultados: De 19.929 registros se consideraron 12.338 escolares donde 47,9% fueron mujeres. Presentaron buena CF 33,4% de las mujeres y 49,5% de los hombres, y buen RA 16,9% y 21,5%, respectivamente. Escolares con buena CF presentaron más chances de alcanzar buen RA que escolares con mala CF (mujeres: 84% y hombres 78% más; p < 0,001). Considerando la dependencia administrativa, buena CF en mujeres de colegios municipales aumentó las posibilidades en 334% (p < 0,001) y en hombres de colegios particulares subvencionados, en 91% (p = 0,01). Con clusión: Tanto mujeres como hombres con buena CF tienen más posibilidades de alcanzar un buen RA. Al incluir la dependencia administrativa la asociación persiste en mujeres de colegios municipa les y en hombres de colegios particulares subvencionados.

https://doi.org/10.32641/rchped.v91i1.1143 966 downloads

13.

Niveles de colesterol no HDL en la población chilena y su asociación con enfermedad cardiovascular y diabetes mellitus: estudio de corte transversal en Encuesta Nacional de Salud 2009-2010
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ALÉ, MARÍA CONSUELO

; ECHEVERRÍA, GUADALUPE

; JUGO, ARANZAZU

; VILLARROEL, LUIS

; MAIZ, ALBERTO

; RIGOTTI, ATTILIO

Revista médica de Chile

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nov 2019, Volume 147 N. 11 Pages 1365 - 1373

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Background Despite aggressive treatment aimed at lowering LDL cholesterol (LDL-C) levels with statins, there is a high residual prevalence of cardiovascular diseases, which may depend on plasma cholesterol transported in other atherogenic lipoproteins. Aims To describe non-HDL cholesterol (non-HDL-C) levels in the Chilean population and their association with diabetes mellitus and cardiovascular disease. To evaluate compliance with non-HDL-C therapeutic goals -according to individual cardiovascular risk- at different levels of triglycerides, in comparison with LDL-C goal achievement. Material and Methods: We analyzed data from 2,792 Chilean subjects aged ≥ 15 years who were included in the 2009-2010 National Health Survey and had valid data for blood lipids, diabetes, and cardiovascular disease. Results Forty five percent of subjects had high non-HDL-C levels. The proportion of diabetic and non-diabetic subjects with high non-HDL-C levels was 81 and 42%, respectively (p < 0.01). A significant discordance was observed in the achievement of therapeutic objectives when LDL-C or non-HDL-C levels were considered, particularly in presence of triglycerides ≥ 150 mg/dl. Namely, 8% of the population showed elevated levels of high non-HDL-C despite adequate LDL-C levels. Conclusions Evaluation and management of elevated non-HDL-C in patients with adequate levels of LDL-C seems worthwhile considering the discordance observed between these blood cholesterol fractions. This strategy may be effective to reduce the residual cardiovascular risk in the Chilean population.

2249 downloads

14.

Actualización de diagnóstico y tratamiento de la insuficiencia cardíaca de etiología chagásica
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Giménez, Luisa J.

; Mitelman, Jorge E.

; Piñeiro, Daniel J.

; Núñez Burgos, Federico

; Sabra, Ahmad

; Feitosa, Gilson

; de Oliveira Junior, Wilson

; Fernández Chamorro, Felipe Nery Gervacio

; Blandón Calderón, Roberto

; Aguirre, Fernando

; Rosas Andrade, Fernando

; Uriona Villarroel, Juan

; Bulla Fernández, Daniel

; Linárez Ochoa, Nery E.

; Barisani, José Luis

; Romero, Analía

; González, Marcos

; Melnikov, Valery

; Macedo Linares, Ana María

; Buitrago Rodríguez, María Fernanda

; Gutiérrez Perucho, Ernesto

; Justiniano Encina, Juan

; Gutiérrez Sotelo, Oswaldo

; Bonilla, Rafael

; Guzmán Melgar, Ismael

; Almonte, Claudia

; Echeverría Frías, Carlos

; Mendoza, Iván

; Newton-Sánchez, Oscar

; Dones Figueroa, Wistremundo

; Simeone, Andrea

Insuficiencia cardíaca

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sep 2019, Volume 14 N. 3 Pages 96 - 110

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

A doença de Chagas é um importante problema de saúde pública nas Américas, amplamente disseminado em todo o mundo, tanto por migrações externas quanto internas, sendo a insuficiência cardíaca uma das complicações mais graves da cardiomiopatia chagásica, com um impacto severo em ambos os casos. individual como em sua família, não apenas com afetação na qualidade de vida, mas com um número significativo de complicações cardiológicas, como arritmias severas e complexas, acidentes vasculares cerebrais e até mesmo a morte súbita. Também é de alto custo em tratamentos médicos, hospitalizações, uso de dispositivos eletrônicos; transplantes, etc. Um grupo de especialistas latino-americanos realizou uma atualização com base em sua experiência, acompanhada de uma importante revisão bibliográfica, a fim de atualizar os diagnósticos clínicos e complementares usuais e de alta complexidade, bem como os tratamentos atualmente disponíveis para essa complicação, e deve adaptar os mesmos para a disponibilidade de centros de saúde.

Chagas disease is a important public health problem throughout America, extended worldwide, both by external and internal migrations, with heart failure being one of the most serious complications of chagasic cardiomyopathy, with severe repercussions on both the individual and his family, not only with involvement in the quality of life, but with a significant number of cardiological complications such as severe and complex arrhythmias, strokes and even sudden death. As well, It is expensive in medical treatments, hospitalizations, use of electronic devices; transplants, etc. A group of Latin American experts have made an update based on their experience accompanied by an important bibliographic review in order to update the usual clinical and complementary diagnoses and of high complexity, as well as the treatments currently available for this complication, and they must be adapted to the availability of health care centers.

La enfermedad de Chagas es un importante problema de salud pública en toda América, extendida a nivel mundial, tanto por las migraciones externas como las internas, siendo la insuficiencia cardíaca una de las complicaciones más graves de la miocardiopatía chagásica, con severa repercusión tanto en el individuo como en su familia, no sólo con afectación en la calidad de vida, sino con un número importante de complicaciones cardiológicas como las arritmias severas y complejas, los accidentes cerebrovasculares y aun la muerte súbita. También es de alto costo en tratamientos médicos, internaciones, utilización de dispositivos electrónicos; trasplantes, etc. Un grupo de expertos latinoamericanos han realizado una actualización basada en la experiencia del mismo acompañado de una importante revisión bibliográfica con la finalidad de actualizar los diagnósticos clínicos y complementarios habituales y de alta complejidad, así como los tratamientos disponibles actualmente para esta complicación, debiéndose adecuar los mismos a la disponibilidad de los centros de atención sanitaria.

831 downloads

15.

Experiencia de educación continua en línea en gastroenterología para médicos no especialistas
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Isbej, Lorena

; Uribe, Javier

; Carrasco, Olga

; Villarroel, Isaac

; Pizarro, Margarita

; Jirón, María Isabel

; Sanhueza, Edgar

; Álvarez-Lobos, Manuel

; Hernández-Rocha, Cristián

; Rollán, Antonio

; Monsalve, Ximena

; Díaz, Luis Antonio

; Cerda, María Alejandra

; Kramer, Tomás

; Munizaga, Fernando

; Riquelme, Arnoldo

Revista médica de Chile

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aug 2019, Volume 147 N. 8 Pages 1059 - 1066

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Background: Continuing education is essential for health professions and online courses can be a good way for professional development. Aim: To describe the experience with online courses for continuing education in hepatology and gastroenterology and to analyze their educational impact. Material and Methods: A three years' experience in courses on liver diseases and digestive tract is described. Their curricular design, methodology, and the educational impact was analyzed using the four levels of the Kirkpatrick's model. Results: On average, there were 321 students per course (2015-2017). 94% were Chilean and 6% from abroad (20 countries). In the educational impact analysis, in level 1 “reaction”: 93% said that the course fulfilled their expectations and 92% would recommend it. In level 2 “learning”: 42% approved the courses. Level 3 “behavior” was not evaluated and level 4 “organizational change” highlighted that the traditional face-to-face continuing education model of Chilean Gastroenterology Society (SChG) changed to full distance model in these three courses, with 1284 students from South America, Asia and Europe, in a 3-years-period. Additionally, these programs were included in the Medical Society of Santiago (SMS) continuing education agenda. Conclusions: The alliance between the SMS and the SChG generated on line courses that meet the educational needs of physicians and medical students, with excellent results and student perception.

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