ABSTRACT Introduction: Intrathecal chemotherapy is a mainstay component of acute lymphoblastic leukemia treatment. In Mexico, there is a considerable practice variability in aspects, such as the manner of preparation and the administration technique. Objective: Our objective was to describe the different techniques used for the application of ITC and review the existing recommendations in the literature. Method: A cross-sectional, nationwide survey study was conducted by an electronic questionnaire sent to hematologists and oncologists in Mexico. We collected demographic data, personal experience, intrathecal chemotherapy techniques, drug preparation and postprocedural conduct. Results: We received 173 responses. Twenty percent had an anesthesiologist administering sedation and pain management. The platelet count considered safe was 50 × 109/L in 48% of the participants. In 77% (n = 133) of the cases, the conventional needle with stylet used was, 49% did not receive any added diluent in the intrathecal chemotherapy and only 42% were recommended to rest in a horizontal position for more than 30 min. Conclusion: We identified a considerable variation in the administration of intrathecal chemotherapy across the hematologists in Mexico. We discuss the implications and opportunities in reducing the variation in our setting, highlighting the unmet need to establish guidelines that should be evaluated by the Mexican professional society to produce a position paper regarding practice standardization.

Abstract: The main objective of this study is to assess the impact on students of applying active teaching methodologies for programming in the Ingeniería Civil Informática degree program at the Universidad Viña del Mar (Chile). First year programming courses are found in nearly all engineering degree programs, especially in computer science. A questionnaire is applied to assess the relationship between students and course contents, at the beginning and at the end of the semester, by asking questions related to the first levels of Bloom's taxonomy. The results show that the application of active methodologies improves both course pass rates and the students’ abilities of remembering and understanding. However, there is no evidence to suggest that the ability to apply concepts is affected by active methodologies. It is concluded that active methodologies are effective when applied for teaching programming courses.

Resumen: El objetivo de este estudio es monitorear el impacto de la aplicación de metodologías activas de enseñanza para programación en la carrera de Ingeniería Civil Informática de la Universidad Viña del Mar (Chile). Los cursos de programación se encuentran actualmente en casi todos los primeros niveles de las carreras de ingeniería, especialmente los relacionados con informática. Se aplica un cuestionario para diagnosticar la relación de los estudiantes con los contenidos, al inicio y al término del semestre, realizando preguntas relacionadas con los primeros niveles de la taxonomía de Bloom. Los resultados muestran que la aplicación de metodologías activas mejora la tasa de aprobación de la asignatura y mejora las habilidades de recordar y comprender de los estudiantes. Sin embargo, no hay evidencia que demuestre si en la habilidad de aplicación hay algún impacto. Se concluye que las metodologías activas funcionan cuando son aplicadas en cursos de programación de computadoras.

RESUMO Introdução: O neurinoma plexiforme gigante é um neuroectoderma e uma doença hereditária. É um tumor cutâneo incomum associado à NF1, caracterizado como um tumor benigno da bainha do nervo periférico envolvendo múltiplos fascículos nervosos. Os objetivos da reconstrução da cobertura do antebraço são proteger as estruturas que vão até o punho e a mão e evitar cicatrizes que levem à perda de movimento. Tanto o antebraço quanto a mão desempenham papéis funcionais e sociais. O manejo bem-sucedido de feridas complexas é necessário para a reabilitação funcional geral desses pacientes. Relato do Caso: Paciente do sexo feminino, 31 anos, apresentou-se na divisão de cirurgia plástica com neurofibroma plexiforme gigante no antebraço direito. Após ressecção cuidadosa, todos os tendões anteriores do antebraço foram expostos. O defeito foi coberto com Pelnac T enxertável (espessura de 3mm e tamanho 12 X 24cm2), fixados com pontos monocryl 4-0. Após 10 dias, a matriz dérmica acelular foi removida e um enxerto de malha de pele de espessura parcial foi colocado. No dia 7, a matriz dérmica acelular apresentou bons sinais de ingestão. No dia 17, observamos uma sobrevida do enxerto de 95%. No seguimento de 3 meses, a reconstrução estava estável, sem defeitos de contorno, a mão apresentava amplitude de movimento completa e o paciente não apresentava problemas nas atividades diárias. Conclusões: A matriz dérmica acelular parece ser uma opção útil na cobertura de defeitos complexos no antebraço, permitindo menor morbidade e rápida recuperação funcional.

ABSTRACT Introduction: Giant plexiform neurinoma is a neuroectoderm and inherited disease. It is an uncommon skin tumor associated with NF1, characterized as a benign peripheral nerve sheath tumor surrounding multiple nervous fascicles. The goals of forearm coverage reconstruction are to protect the structures running to the wrist and hand and prevent scarring that leads to movement loss. Both forearm and hand play functional and social roles. Successful management of complex wounds is necessary for the overall functional rehabilitation of these patients. Case Report: A 31-year-old woman presented at the plastic surgery division with a giant plexiform neurofibroma in the right forearm. After careful resection, all anterior forearm tendons were exposed. The defect was covered with graftable Pelnac T (thickness of 3mm and sizing 12 X 24cm2), fixed with 4-0 monocryl sutures. After 10 days, the acellular dermal matrix silicone layer was removed, and a split-thickness skin meshed graft was placed. On day 7, the acellular dermal matrix showed good signs of intake. On day 17, we observed a 95% graft survival. At the 3-month follow-up, reconstruction was stable without contouring defects, the hand had full range of motion, and the patient had no problems in daily activities. Conclusions: Acellular dermal matrix appears to be a useful option in covering complex defects in the forearm, allowing for less morbidity and rapid functional recovery.

Resumen: Antecedentes y Objetivos: Los individuos de Balmea stormiae (Rubiaceae) son árboles o arbustos hemiepífitos que habitan malpaíses con bosques de pino-encino en poblaciones disyuntas en Centroamérica y México. La especie se considera en peligro de extinción y particularmente se ha documentado que las poblaciones de Michoacán han estado expuestas a fuertes presiones antropogénicas. Por tal motivo, en este estudio se estimó la diversidad genética en cuatro poblaciones de Michoacán, contrastando esta información con la obtenida en una población de Jalisco, ambas regiones ubicadas en el centro-occidente de México. Métodos: Las muestras vegetales fueron recolectadas en cinco poblaciones de la región occidente del Cinturón Volcánico Transmexicano. Para evaluar la diversidad genética, se utilizó el intrón rps16 del ADN de cloroplasto, el espaciador transcrito externo (ETS) del ADN ribosomal nuclear y marcadores dominantes ISSR de ADN nuclear (Inter Secuencias Simples Repetidas por sus siglas en inglés). Resultados clave: Los marcadores moleculares revelaron alta diferenciación genética entre las poblaciones de Jalisco y Michoacán, la cual se atribuye a la baja conectividad entre estas. Posiblemente se deba a la baja capacidad de dispersión a larga distancia de las semillas y el polen. Se detectó flujo genético moderado y expansión demográfica reciente en las poblaciones de Michoacán. Los niveles de variación genética en las poblaciones de Michoacán concuerdan con la edad de los flujos de lava, siendo Arocutín y Zacapu las poblaciones más diversas sobre los flujos de lava más antiguos. Conclusiones: Los resultados podrían explicarse por el origen relativamente reciente, producto de la actividad volcánica del Holoceno, de los ambientes en los que habita esta especie, sumado a la perturbación recurrente relacionada con grandes asentamientos prehispánicos de Michoacán.

Abstract: Background and Aims: Individuals of Balmea stormiae (Rubiaceae) are trees or hemiepiphytic shrubs that inhabit pine-oak forests on rock outcrops in disjunct populations of Central America and Mexico. The species is considered endangered and especially the populations of Michoacán have been reported as exposed to strong anthropogenic pressures. For this reason, in this study the genetic diversity of four populations of Michoacán was estimated, contrasting this information with that obtained from one population of Jalisco, both regions located in west-central Mexico. Methods: Samples were collected in five populations in the western region of the Trans-Mexican Volcanic Belt. The chloroplast rps16 intron, the external transcribed spacer of ribosomal DNA (ETS) and seven Inter-Simple Sequence Repeats of nuclear DNA (ISSR) were used to assess genetic diversity. Key results: Molecular markers revealed high genetic differentiation between the populations from Jalisco and Michoacán, attributed to the low connectivity amongst them, probably due to the low long distance dispersal capacity of seeds and pollen. Moderate genetic flow and demographic expansion were detected for populations in Michoacán. The degree of genetic diversity in Michoacán populations are consistent with the age of lava flows, whereby Arocutín and Zacapu are the most diverse populations located on the oldest lava flows. Conclusions: Results could be explained by the relatively recent origin, resulting from Holocene volcanic activity, of the environments in which the species inhabits, coupled with the recurring disturbance related to large pre-Hispanic settlements.

ABSTRACT Differential Object Marking (DOM) is a linguistic phenomenon of many languages like Spanish, in which the preposition ‘a’ appears before direct objects. Current theory states that this phenomenon is ruled by the tension between iconicity (markedness) and economy (omission), In order to test this hypothesis, a 218-million tweets corpora representing all varieties of Spanish was used. 4,967 DOM cases showing marking, omission and optional marking were found in the Colombian Spanish corpus, which were tagged manually with 12 binary features and used to study other varieties. Through statistical analysis, it was discovered that this phenomenon is ruled by two highly correlated (r=0,92) tensions that can be associated with iconicity (13,47%) and economy (86,53%). This finding suggests that these tensions are not independent but rather controlled by a common factor named, in this study, as harmonic tension. This study provides the degree of importance of the features analyzed, which is used to propose a new feature hierarchy that confirms empirically other small ones proposed before. It can be concluded that this harmonic tension is an empirical plausible model to demonstrate the percentage of DOM in Spanish.

RESUMEN La marcación diferencial del objeto es un fenómeno gramatical de varias lenguas como el español, en la cual el morfema ‘a’ aparece ante ciertos objetos directos. La teoría actual plantea que este fenómeno está dominado por la tensión entre: la iconicidad (marcación) y la economía (omisión). Para probar esta hipótesis, se utilizó un corpus de 218 millones de tuits de distintas variedades del español. Se encontraron 4.967 casos de marcación, opcionalidad y omisión de la MDO del español de Colombia que se caracterizaron manualmente con 12 rasgos semánticos binarios y que fueron utilizados para estudiar las demás variedades. El análisis estadístico arrojó que el fenómeno está gobernado por dos fuerzas altamente correlacionadas (r=0,92) que se pueden asociar a la iconicidad (13,47%) y la economía (86,53%). Estas fuerzas no son independientes; están controladas por un factor común, el cual se nombra en este estudio como tensión armónica. Se reporta el grado de importancia de los 12 rasgos para proponer una nueva jerarquía que confirma empíricamente otras antes propuestas. Se concluye que la tensión armónica es un modelo plausible con soporte empírico para modelar el porcentaje de la MDO del español.

Abstract Introduction Transanal total mesorectal excision (TaTME) has revolutionized the surgical techniques for lower-third rectal cancer. The aim of the present study was to analyze the outcomes of quality indicators of TaTME for rectal cancer compared with laparoscopic TME (LaTME). Methods A cohort prospective study with 50 (14 female and 36male) patients, with a mean age of 67 (range: 55.75 to 75.25) years, who underwent surgery for rectal cancer. In total, 20 patients underwent TaTME, and 30, LaTME. Every TaTME procedure was performed by experienced colorectal surgeons. The sample was divided into two groups (TaTME and LaTME), and the quality indicators of the surgery for rectal cancer were analyzed. Results There were no statistically significant differences regarding the patients and the main characteristics of the tumor (age, gender, American Society of Anesthesiologists [ASA] score, body mass index [BMI], tumoral stage, neoadjuvant therapy, and distance from the tumor to the external anal margin) between the two groups. The rates of: postoperativemorbidity (TaTME: 35%; LaTME: 30%; p=0.763);mortality (0%); anastomotic leak (TaTME: 10%; LaTME: 13%; p=0.722); wound infection (TaTME: 0%; LaTME: 3.3%; p=0.409); reoperation (TaTME: 5%; LaTME: 6.6%; p=0.808); and readmission (TaTME: 5%; LaTME: 0%; p=0.400), as well as the length of the hospital stay (TaTME: 13.5 days; LaTME: 11 days; p=0.538), were similar in both groups. There were no statistically significant differences in the rates of positive circumferential resection margin (TaTME: 5%; LaTME: 3.3%; p=0.989) and positive distal resection margin (TaTME: 0%; LaTME: 3.3%; p=0.400), the completeness of the TME (TaTME: 100%; LaTME: 100%), and the number of lymph nodes harvested (TaTME: 15; LaTME: 15.5; p=0.882) between two groups. Conclusion Transanal total mesorectal excision is a safe and feasible surgical procedure for middle/lower-third rectal cancer.

■ RESUMO Os defeitos na região palpebral são causados principalmente por excisões cirúrgicas de neoplasias cutâneas. Os objetivos da reconstrução palpebral estão fundamentados na restauração da funcionalidade desta unidade anatômica para manter a proteção ocular e a recuperação de uma aparência normal devido à importância crítica da região periocular na estética facial. O reparo dos defeitos palpebrais começa com uma cuidadosa avaliação dos componentes anatômicos que têm sido ressecados e precisam ser reconstruídos; a extensão e a localização do defeito guiarão a reconstrução. Grandes defeitos comprometendo a totalidade da espessura palpebral são um desafio para os cirurgiões plásticos. Milhares de técnicas cirúrgicas têm sido descritas para a reconstrução de defeitos palpebrais de espessura total; apresentamos neste artigo a descrição de um caso de reconstrução dinâmica da pálpebra com associação de um retalho frontal com transposição do músculo temporal após ressecção de um carcinoma basocelular infiltrativo recidivado.

■ ABSTRACT Surgical excisions of skin neoplasms mainly cause defects in the eyelid region. The objectives of eyelid reconstruction are based on the restoration of this anatomical unit’s functionality to maintain eye protection and recovery from a normal appearance due to the critical importance of the periocular region in facial aesthetics. Repair of eyelid defects begins with a careful evaluation of the anatomical components that have been resected and need to be reconstructed; the extent and location of the defect will guide the reconstruction. Large defects compromising the entire body thickness are a challenge for plastic surgeons. Thousands of surgical techniques have been described for the reconstruction of total thickness eyelid defects; we present in this article the description of a case of dynamic eyelid reconstruction with an association of a frontal flap with temporal muscle transposition after resection of a recurrent infiltrative basal cell carcinoma.

Differential Object Marking (DOM) is a linguistic phenomenon of many languages like Spanish, in which the preposition ‘a’ appears before direct objects. Current theory states that this phenomenon is ruled by the tension between iconicity (markedness) and economy (omission), In order to test this hypothesis, a 218-million tweets corpora representing all varieties of Spanish was used. 4,967 DOM cases showing marking, omission and optional marking were found in the Colombian Spanish corpus, which were tagged manually with 12 binary features and used to study other varieties. Through statistical analysis, it was discovered that this phenomenon is ruled by two highly correlated (r=0,92) tensions that can be associated with iconicity (13,47%) and economy (86,53%). This finding suggests that these tensions are not independent but rather controlled by a common factor named, in this study, as harmonic tension. This study provides the degree of importance of the features analyzed, which is used to propose a new feature hierarchy that confirms empirically other small ones proposed before. It can be concluded that this harmonic tension is an empirical plausible model to demonstrate the percentage of DOM in Spanish.

La marcación diferencial del objeto es un fenómeno gramatical de varias lenguas como el español, en la cual el morfema ‘a’ aparece ante ciertos objetos directos. La teoría actual plantea que este fenómeno está dominado por la tensión entre: la iconicidad (marcación) y la economía (omisión). Para probar esta hipótesis, se utilizó un corpus de 218 millones de tuits de distintas variedades del español. Se encontraron 4.967 casos de marcación, opcionalidad y omisión de la MDO del español de Colombia que se caracterizaron manualmente con 12 rasgos semánticos binarios y que fueron utilizados para estudiar las demás variedades. El análisis estadístico arrojó que el fenómeno está gobernado por dos fuerzas altamente correlacionadas (r=0,92) que se pueden asociar a la iconicidad (13,47%) y la economía (86,53%). Estas fuerzas no son independientes; están controladas por un factor común, el cual se nombra en este estudio como tensión armónica. Se reporta el grado de importancia de los 12 rasgos para proponer una nueva jerarquía que confirma empíricamente otras antes propuestas. Se concluye que la tensión armónica es un modelo plausible con soporte empírico para modelar el porcentaje de la MDO del español.

Abstract The fishing industry generates large quantities of by-products, most of which are not used and are therefore discarded. The objective of the present research was the elaboration of a pâté-type sausage from mechanically recovered meat of rainbow trout (Oncorhynchus mykiss). The meat was obtained from trout skelons, which were passed through a grinder and sprayed with a mixture of α-tocopherol (0.02%) and ascorbic acid (0.05%). The formulation of the pate was as follows: mechanically recovered trout meat (74.4%), salt (1.3%), sodium tripolyphosphate (0.8%), starch (2%), soy protein isolate (2.4%), margarine (16.7%), soy lecithin (1.9%), onion powder (0.2%), garlic powder (0.2%) and pepper powder (0.1%). Three formulations were prepared: PCR1 (80% cooked meat and 20% raw meat), PCR2 (90% cooked meat and 10% raw meat) and PCR3 (100% cooked meat). For each formulation, the following were evaluated: texture profile, color and sensory evaluation, the latter with the participation of 30 untrained panelists using a 9-point hedonic scale, in which each formulation obtained an average of 6 ("I like it moderately"). The best formulation was PCR3, whose proximate composition was determined: 64% moisture, 16% fat, 12.5% protein, and 3.5% ash. The pâté of mechanically recovered trout meat proved to have a high nutritional value and a good level of sensory acceptance, demonstrating that it is a good alternative for the use of trout fillet by-products.

Resumen La industria pesquera genera grandes cantidades de subproductos que en su mayoría no son aprovechados y por ende son desechados. El objetivo de la presente investigación fue la elaboración de un embutido tipo paté a partir de carne mecánicamente recuperada de trucha arcoíris (Oncorhynchus mykiss). Se obtuvo la carne a partir de esquelones de trucha, los cuales pasaron por una moledora y se les roció una mezcla de α-tocoferol (0,02%) y ácido ascórbico (0,05%). La formulación del paté fue la siguiente: carne mecánicamente recuperada de trucha (74,4%), sal (1,3%), tripolifosfato de sodio (0,8%), almidón (2%), proteína aislada de soya (2,4%), margarina (16,7%), lecitina de soya (1,9%), cebolla en polvo (0,2%), ajo en polvo (0.2%) y pimienta en polvo (0,1%). Se elaboraron 3 formulaciones: PCR1 (80% carne cocida-20% carne cruda), PCR2 (90% carne cocida-10% carne cruda) y PCR3 (100% carne cocida). Para cada formulación se evaluaron: perfil de textura, color y evaluación sensorial, esta última con la participación de 30 panelistas no entrenados usando una escala hedónica de 9 puntos, en la que cada fórmula obtuvo un promedio de 6 («me gusta moderadamente»). La mejor formulación fue la PCR3, a la cual se le determinó su composición proximal: humedad - 64%; grasa - 16%; proteína - 12,5%; cenizas - 3,5%. El paté de carne mecánicamente recuperada de trucha demostró tener un gran valor nutritivo y buen nivel de aceptación sensorial, demostrando que es una buena alternativa para el aprovechamiento de los subproductos del fileteado de trucha.

RESUMO Introdução: A abdominoplastia é um procedimento com índice considerável de complicações, ainda que, em sua maioria, de bom prognóstico. Algumas complicações, entretanto, podem ser catastróficas, como a necrose extensa de pele e as complicações infecciosas graves. Dentre as causas incomuns de perda extensa de pele no pós-operatório, podemos citar o pioderma gangrenoso (PG), doença de curso crônico, recidivante, com comportamento imprevisível e de etiologia ainda desconhecida. No âmbito da cirurgia plástica, essa doença pode mimetizar clinicamente complicações pós-operatórias isquêmicas ou infecciosas, cujos tratamentos diferem por completo do tratamento do PG. Relato de Caso: Paciente feminina, 41 anos, previamente hígida, foi submetida à abdominoplastia associada à lipoaspiração e mamoplastia de aumento com colocação de próteses mamárias. Evoluiu com edema, calor hiperemia e dor em incisão de abdominoplastia, além de comprometimento clínico sistêmico. Submetida a desbridamentos cirúrgicos e tratamento sistêmico, com piora progressiva das lesões. Diante do insucesso dos tratamentos propostos, aventada a hipótese diagnóstica de pioderma gangrenoso. Conclusão: O PG, apesar de raro, deve ser aventado como diagnóstico diferencial em casos de complicações pós-operatórias com perda e necrose de pele que não respondem às medidas iniciais de tratamento, além de quadros aparentemente infecciosos que não respondem às terapias antibióticas adotadas.

ABSTRACT Introduction: Abdominoplasty is a procedure with a considerable rate of complications, even though, for the most part, it has a good prognosis. Some complications, however, can be catastrophic, such as extensive skin necrosis and serious infectious complications. Among the unusual causes of extensive skin loss in the postoperative period, we can mention gangrenous pyoderma (PG), a chronic, recurrent disease with unpredictable behavior and an unknown etiology. In the field of plastic surgery, this disease can clinically mimic ischemic or infectious postoperative complications, whose treatments differ completely from the treatment of PG. Case Report: A 41-year-old female patient, previously healthy, underwent abdominoplasty associated with liposuction and breast augmentation with the placement of breast implants. The patient evolved with edema, hyperemia and pain in an abdominoplasty incision, in addition to systemic clinical involvement. She was submitted to surgical debridement and systemic treatment, with progressive worsening of the lesions. In view of the failure of the proposed treatments, the diagnostic hypothesis of gangrenous pyoderma was raised. Conclusion: PG, although rare, should be considered as a differential diagnosis in cases of postoperative complications with skin loss and necrosis that do not respond to initial treatment measures, in addition to apparently infectious conditions that do not respond to adopted antibiotic therapies.

Resumo Objetivo: Associar a tendência empreendedora geral e o suporte familiar percebido entre estudantes de Enfermagem do Brasil e Chile. Métodos: Estudo transversal com dados de estudantes de cinco instituições superiores de ensino, coletados de março a setembro de 2018. Foram utilizados: formulário para avaliação sociodemográfica, questionário de Tendência Empreendedora Geral (TEG) e Inventário de Percepção de Suporte Familiar (IPSF). Foram ajustados modelos de regressão logística simples e modelos de regressão multinomial. Resultados: Dos 889 estudantes participantes, 82% eram mulheres, 60% tinham idade entre 20 e 25 anos e 55% eram de instituição particular de ensino. TEG baixa ou muito baixa foi predominante nos dois países (Brasil=83,5%; Chile=78,4%), além de baixos índices de percepção de suporte familiar. Não foram encontradas associações diretas entre o TEG e o IPSF. No Chile houve associação positiva entre a chance de a categoria impulsividade que compõe a TEG ser médio e alto com o fator autonomia familiar ser alto [OR=1,16 (1,07-1,26);p<0,01]. Conclusão: A autonomia familiar percebida pode moderar, ainda que discretamente, características importantes como a impulsividade, não sendo suficiente para elevar a tendência empreendedora desses estudantes a patamares satisfatórios. O apoio social mais adequado para promover o comportamento empreendedor dos estudantes parece ser o incentivo acadêmico na instituição educacional, tornando-se necessária a adequação pedagógica ao público feminino e às características culturais de cada país. Outras pesquisas devem ser realizadas.

Abstract Objective: To associate the general entrepreneurial tendency and perceived family support among nursing students from Brazil and Chile. Methods: A cross-sectional study with data from students from five higher education institutions, collected from March to September 2018. A form, a General Enterprising Tendency (GET) test and a Perceived Family Support Inventory (Inventário de Percepção de Suporte Familiar - IPSF) were used for sociodemographic assessment. Simple logistic regression models and multinomial regression models were adjusted. Results: Of the 889 participating students, 82% were women, 60% were between 20 and 25 years old and 55% were from a private educational institution. Low or very low GET was predominant in both countries (Brazil=83.5%; Chile=78.4%), in addition to low levels of perception of family support. No direct associations were found between GET and IPSF. In Chile, there was a positive association between the chance that the drive category that makes up the GET is medium and high with the family autonomy factor being high [OR=1.16 (1.07-1.26); p<0.01]. Conclusion: Perceived family autonomy can moderate, albeit discreetly, important characteristics such as drive, not being enough to raise the entrepreneurial tendency of these students to satisfactory levels. The most appropriate social support to promote students’ entrepreneurial behavior seems to be academic incentive in the educational institution. Thus, it is necessary to adapt pedagogically to the female audience and to the cultural characteristics of each country. Further research must be carried out.

Resumen Objetivo: Relacionar la tendencia emprendedora general y el apoyo familiar percibido en estudiantes de enfermería de Brasil y Chile. Métodos: Estudio transversal con datos de estudiantes de cinco instituciones de educación superior, recolectados de marzo a septiembre de 2018. Se utilizó un formulario para la evaluación sociodemográfica, el cuestionario Tendencia Emprendedora General (TEG) y el Inventario de Percepción de Apoyo Familiar (IPAF). Fueron ajustados modelos de regresión logística simple y modelos de regresión multinomial. Resultados: De los 889 estudiantes participantes, el 82 % eran mujeres, el 60 % tenían entre 20 y 25 años y el 55 % pertenecían a una institución educativa privada. La TEG baja o muy baja fue predominante en los dos países (Brasil = 83,5 %; Chile = 78,4 %), además de índices bajos de percepción de apoyo familiar. No se encontraron relaciones directas entre la TEG y el IPAF. En Chile, hubo una relación positiva entre la posibilidad de que la categoría impulsividad que compone la TEG sea media y alta y el factor autonomía familia sea alto [OR=1,16 (1,07-1,26);p<0,01]. Conclusión: La autonomía familiar percibida puede moderar, aunque sea de forma discreta, características importantes como la impulsividad, pero no es suficiente para elevar la tendencia emprendedora de estos estudiantes a niveles satisfactorios. El apoyo social más adecuado para promover el comportamiento emprendedor de los estudiantes parece ser el incentivo académico en la institución educativa, por lo que se torna necesaria una adaptación pedagógica al público femenino y a las características culturales de cada país. Deben realizarse otras investigaciones.

ABSTRACT Introduction: The acute infection by Chikungunya generates a high burden of illness and disability mainly due to polyarthralgias in acute phase and artritis in chronic phase. However, it presents symptoms similar to other arboviruses, specially like dengue, which difficults its diagnosis. Objective: To characterize the clinical manifestations of the acute infection by Chikungunya in patients attended in the emergencies service of Ibagué city, Colombia, during the epidemic outbreak that occured from October, 2015 to October, 2016. Methods: Descriptive, cross-sectional study in which were described the clinical manifestations of the acute infection by chikungunya using an instrument developed from the review of the literature that comprises the main clinical manifestations of the infection by chikungunya in its acute phase, as an information attached to the epidemiologic records of individual obligatory notification of the National Institute of Health, which are reported to Ibagué-Tolima Municipal Secretary. Results: There were collected 6752 records of patients attended in emergency services, whom experienced fever of 38,5 ºC from 1 to 7 days (91,3%), myalgias (81,3%), maculopapular erythema (74,3%), severe arthralgias (70,6%), polyarthritis (41,1%) and retroarticular adenomegalies (8%). Conclusions: The results obtained in the present study provide important information for the clinical diagnosis of chikungunya in places with similar characteristics to the hyperepidemic cities and it facilitates to differentiate the disease in its acute phase among the different current arboviruses with signs of myalgia, retroarticular adenopathies and severe arthralgia.

RESUMEN Introducción: La infección aguda por chikungunya genera una alta carga de enfermedad y discapacidad dada principalmente por poliartralgias en fase aguda y artritis en fase crónica, sin embargo, presenta una sintomatología similar a otras arbovirosis, particularmente a las del dengue, lo que dificulta su diagnóstico. Objetivos: Caracterizar las manifestaciones clínicas de la infección aguda por chikungunya en los pacientes atendidos en el departamento de urgencias de la ciudad de Ibagué, Colombia, durante el brote epidémico transcurrido entre octubre de 2015 y octubre de 2016. Métodos: Estudio descriptivo, de corte transversal, en el cual se describieron las manifestaciones clínicas de la infección aguda por chikungunya, a través del instrumento desarrollado a partir de la revisión de la literartura que recogía las principales manifestaciones clínicas de la infección en fase aguda por chikungunya, como anexo a las fichas epidemiológicas de notificación obligatoria individual del Instituto Nacional de Salud que se reportan a la Secretaría Municipal de Ibagué-Tolima. Resultados: Se recolectaron 6752 fichas de pacientes atendidos en los servicios de urgencias, los que experimentaron fiebre de 38,5 ºC de 1-7 días (91,3 %), mialgias (81,3 %), eritema maculopapular (74,3 %), artralgias severas (70,6 %), poliartritis (41,1 %) y adenomegalias retroauriculares (8 %). Conclusiones: Los resultados obtenidos en el presente estudio aportan información importante para el diagnóstico clínico del chikungunya en sitios con características similares a las de ciudades hiperendemicas y facilita distinguir la enfermedad en fase aguda entre las diferentes arbovirosis circulantes con signos como las mialgias, adenoapatias retro-auriculares y artralgia severa

ABSTRACT Introduction: The acute infection by Chikungunya generates a high burden of illness and disability mainly due to polyarthralgias in acute phase and artritis in chronic phase. However, it presents symptoms similar to other arboviruses, specially like dengue, which difficults its diagnosis. Objective: To characterize the clinical manifestations of the acute infection by Chikungunya in patients attended in the emergencies service of Ibagué city, Colombia, during the epidemic outbreak that occured from October, 2015 to October, 2016. Methods: Descriptive, cross-sectional study in which were described the clinical manifestations of the acute infection by chikungunya using an instrument developed from the review of the literature that comprises the main clinical manifestations of the infection by chikungunya in its acute phase, as an information attached to the epidemiologic records of individual obligatory notification of the National Institute of Health, which are reported to Ibagué-Tolima Municipal Secretary. Results: There were collected 6752 records of patients attended in emergency services, whom experienced fever of 38,5 ºC from 1 to 7 days (91,3%), myalgias (81,3%), maculopapular erythema (74,3%), severe arthralgias (70,6%), polyarthritis (41,1%) and retroarticular adenomegalies (8%). Conclusions: The results obtained in the present study provide important information for the clinical diagnosis of chikungunya in places with similar characteristics to the hyperepidemic cities and it facilitates to differentiate the disease in its acute phase among the different current arboviruses with signs of myalgia, retroarticular adenopathies and severe arthralgia.

RESUMEN Introducción: La infección aguda por chikungunya genera una alta carga de enfermedad y discapacidad dada principalmente por poliartralgias en fase aguda y artritis en fase crónica, sin embargo, presenta una sintomatología similar a otras arbovirosis, particularmente a las del dengue, lo que dificulta su diagnóstico. Objetivos: Caracterizar las manifestaciones clínicas de la infección aguda por chikungunya en los pacientes atendidos en el departamento de urgencias de la ciudad de Ibagué, Colombia, durante el brote epidémico transcurrido entre octubre de 2015 y octubre de 2016. Métodos: Estudio descriptivo, de corte transversal, en el cual se describieron las manifestaciones clínicas de la infección aguda por chikungunya, a través del instrumento desarrollado a partir de la revisión de la literartura que recogía las principales manifestaciones clínicas de la infección en fase aguda por chikungunya, como anexo a las fichas epidemiológicas de notificación obligatoria individual del Instituto Nacional de Salud que se reportan a la Secretaría Municipal de Ibagué-Tolima. Resultados: Se recolectaron 6752 fichas de pacientes atendidos en los servicios de urgencias, los que experimentaron fiebre de 38,5 ºC de 1-7 días (91,3 %), mialgias (81,3 %), eritema maculopapular (74,3 %), artralgias severas (70,6 %), poliartritis (41,1 %) y adenomegalias retroauriculares (8 %). Conclusiones: Los resultados obtenidos en el presente estudio aportan información importante para el diagnóstico clínico del chikungunya en sitios con características similares a las de ciudades hiperendemicas y facilita distinguir la enfermedad en fase aguda entre las diferentes arbovirosis circulantes con signos como las mialgias, adenoapatias retro-auriculares y artralgia severa