RESUMO RACIONAL: A pandemia de COVID-19 teve um efeito negativo na educação cirúrgica na América Latina, diminuindo o treinamento cirúrgico dos residentes e a prática clínica supervisionada. OBJETIVOS: Identificar estratégias que foram propostas ou implementadas para adaptar o treinamento cirúrgico e a prática clínica supervisionada às limitações relacionadas ao COVID-19 na América Latina. MÉTODOS: Foi realizada revisão de literatura entre abril-maio de 2021, dividida em duas buscas. O primeiro procurou identificar estratégias de adaptação em América Latina para treinamento cirúrgico e prática clínica supervisionada. A segunda foi realizada como complemento para identificar metodologias propostas no resto do mundo. RESULTADOS: Na primeira busca, foram selecionados 16 dos 715 artigos. Na segunda, foram selecionados 41 dos 1.637 artigos. Estratégias adaptativas propostas na América Latina com foco em videoconferência e simulação. No resto do mundo, foram sugeridas análises críticas remotas de cirurgias gravadas/ao vivo, tele-mentoria intra-cirúrgica e gravação de cirurgia com feedback pós-operatório. CONCLUSÕES: Múltiplas estratégias de adaptação para educação cirúrgica durante a pandemia de COVID-19 foram propostas na América Latina e no resto do mundo. Há uma oportunidade de implementar novas estratégias a longo prazo para treinamento cirúrgico e prática clínica supervisionada, embora mais estudos prospectivos sejam necessários para gerar recomendações baseadas em evidências.

ABSTRACT BACKGROUND: The COVID-19 pandemic has had a negative effect on surgical education in Latin America, decreasing residents’ surgical training and supervised clinical practice. AIMS: This study aimed to identify strategies that have been proposed or implemented to adapt surgical training and supervised clinical practice to COVID-19-related limitations in Latin America. METHOD: A literature review was performed between April and May 2021, divided into two searches. The first one sought to identify adaptation strategies in Latin America for surgical training and supervised clinical practice. The second one was carried out as a complement to identify methodologies proposed in the rest of the world. RESULTS: In the first search, 16 of 715 articles were selected. In the second one, 41 of 1,637 articles were selected. Adaptive strategies proposed in Latin America focused on videoconferencing and simulation. In the rest of the world, remote critical analysis of recorded/live surgeries, intrasurgical tele-mentoring, and surgery recording with postoperative feedback were suggested. CONCLUSIONS: Multiple adaptation strategies for surgical education during the COVID-19 pandemic have been proposed in Latin America and the rest of the world. There is an opportunity to implement new strategies in the long term for surgical training and supervised clinical practice, although more prospective studies are required to generate evidence-based recommendations.

Abstract Background Obsessive–compulsive disorder (OCD) is a severe neuropsychiatric condition affecting 1–3% of the worldwide population. OCD has a strong genetic component, and the SLC1A1 gene that encodes neuronal glutamate transporter EAAT3 is a strong candidate for this disorder. To evaluate the impact of reduced EAAT3 expression in vivo, we studied male EAAT3 heterozygous and wild-type littermate mice using a battery of behavioral paradigms relevant to anxiety (open field test, elevated plus maze) and compulsivity (marble burying), as well as locomotor activity induced by amphetamine. Using high-performance liquid chromatography, we also determined tissue neurotransmitter levels in cortex, striatum and thalamus—brain areas that are relevant to OCD. Results Compared to wild-type littermates, EAAT3 heterozygous male mice have unaltered baseline anxiety-like, compulsive-like behavior and locomotor activity. Administration of acute amphetamine (5 mg/kg intraperitoneally) increased locomotion with no differences across genotypes. Tissue levels of glutamate, GABA, dopamine and serotonin did not vary between EAAT3 heterozygous and wild-type mice. Conclusions Our results indicate that reduced EAAT3 expression does not impact neurotransmitter content in the corticostriatal circuit nor alter anxiety or compulsive-like behaviors.

This paper discusses the pre-Hispanic sequence of historical development in the semiarid north of Chile through the study of spatial and temporal dynamics of human occupation in the Limari valley. Based on the study of settlements, museum collections and rock art, a sequence of transformations and development between the Early Archaic and Inca Period is observed that differs from what is traditionally known of the area. In this timeframe, social changes such as the adoption ofpottery and the constitution of an agrarian way of life, occur at different paces in both time and space within the same Limari valley. We discuss spatial and representational characteristics of rock art in relation to pre-hispanic social processes, emphasizing the links between audiences, flows of information and the dynamics of social life.

Este trabajo discute la secuencia de desarrollo histórico prehispánico en el Norte Semiárido de Chile a partir del estudio de las dinámicas espaciales y temporales de las ocupaciones humanas en la cuenca hidrográfica del río Limarí. A partir del estudio de asentamientos, materiales depositados en colecciones y arte rupestre se observa una secuencia de transformaciones y desarrollo desde el Arcaico Temprano hasta el período Incaico que diverge de lo tradicionalmente planteado para la región, reconociéndose ritmos de cambios sociales diferenciales dentro de la misma zona, especialmente en relación con la tradicional asociación entre incorporación de cerámica y la constitución de un modo de vida agrícola. La incorporación del arte rupestre permite articular sus características espaciales y representacionales con procesos más amplios, discutiéndose las relaciones establecidas entre dinámicas y cambios sociales con los flujos de información que producen las representaciones rupestres y sus respectivas audiencias.

Improving human activities requires an evaluation process, in more cases based on tangible or material things. However, assessing the quality of dental care from users perspective is becoming more common, using a satisfaction concept as a good predictor. The questionnaire and its implementation is one of the most effective methods for evaluating customer/users satisfaction levels, bearing in mind the respect for sensitivities and emotions that can leave some hidden or oversized answers. This study was design to determine the quality of public dental care service, using a private service validated scale "SERVPERF", that is based on intangible considerations of registered users from Family Health Centers of Urban Primary Health Care. A sample of 405 people from a population of 48,746 was taken, 5% error and 95% of confidence level was allowed and a specially prepared survey was applied at home. The lowest rating obtained was 4.85 for the brochures and recipes on a scale from 1 to 7, being the last one the best. A note 6.84 was assigned to the data collection system and a 4.91 for the other members of the service. For dentist who provides the service, the score was 5.79. The empathy criterion proved to be the smallest average obtained from all others concepts (p <0.004). We conclude that it is necessary to explain to the authorities the utility of equipment and infrastructure, and there must be a support to the growth of human capital as an important complement for the users satisfaction.

Mejorar las actividades humanas requiere un proceso de evaluación y lo frecuente es basarse en las cosas tangibles o materiales. Sin embargo, evaluar la calidad de la atención odontológica desde la perspectiva del usuario es cada vez más frecuente, siendo la satisfacción un buen predictor. El cuestionario y su aplicación es uno de los métodos más eficaces para la detección de los niveles de satisfacción del cliente/usuario, teniendo presente el respeto a las sensibilidades y emociones que pueden dejar oculto o sobredimensionado algún indicador. El presente trabajo utilizó la escala SERVPERF, validada en empresas privadas de servicio, para determinar la calidad de atención Odontológica Pública, basada en consideraciones intangibles de los usuarios registrados en Centros de Salud Familiar de Atención Primaria Urbana. Se tomó una muestra de 405 personas de un universo poblacional de 48.746, permitiéndose un error del 5% con un nivel de confianza del 95% y se aplicó en sus hogares una encuesta elaborada para la ocasión. La valoración más baja fue la folletería y recetarios con un 4,85 en la escala 1 a 7, siendo este último lo mejor. Un 6,84 fue la nota asignada al sistema de acopio de datos y un 4,91 para los demás miembros del consultorio. Un 5,79 es la nota que obtienen los odontólogos que otorgan la prestación. El criterio Empatía resultó ser la media más baja y distinta a todos (p< 0,004). Se puede concluir que es necesario explicar a las autoridades, que si bien los esfuerzos en equipamiento e infraestructura son útiles, debe haber un apoyo al crecimiento del capital humano ya que su valoración es un complemento importante en la satisfacción del usuario.

Listeria monocytogenes is Gram-positive facultative intracellular pathogen often foodborne and found elsewhere. It is an uncommon cause of illness in the general population. However, it is an important cause of severe infection in neonates, pregnant women, elderly and immunosuppressed patients. Listeriosis has unique preference for pregnant women. Maternal listeriosis is a diagnostic challenge, and intrauterine infection can lead to severe complications such as amnionitis, preterm labor, spontaneous abortion, stillbirth and neonatal sepsis. From 2001 to 2005, 16 patients with L. monocytogenes were identified in this hospital; four (25%) were pregnant women. Clinical and laboratory findings are described. There were 3 preterm deliveries and 1 spontaneous second trimester abortion. Three women with listeriosis had no predisposing factors other than pregnaney. One patient was on immunosupressive drugs for ulcerative colitis. Fever was the most common symptom. Infected neonates were most commonly diagnosed with early-onset listeriosis (two cases) or fetal demise (one case). Pregnaney can be the only risk factor for listeriosis. Listeriosis should be considered during the evaluation of febrile syndrome in pregnaney as this condition can be the only risk factor. Blood and amniotic fluid cultures are useful diagnostic tests. Perinatal complications remains high.

Listeria monocytogenes es un bacilo grampositivo, intracelular facultativo, que se encuentra ampliamente difundido en la naturaleza, frecuentemente en alimentos. Las infecciones afectan principalmente a pacientes inmunocomprometidos, ancianos, mujeres embarazadas y neonatos. La infección intrauterina puede producir importantes complicaciones como corioamnionitis, parto de pre-término, aborto espontáneo de primer o segundo trimestre, mortinatos y sepsis neonatal. En el período 2001-2005, 16 pacientes con infección por L. monocytogenes fueron identificados en nuestro hospital. Cuatro de ellos (25%) se presentaron en mujeres embarazadas; se describen sus características clínicas y de laboratorio. Hubo tres partos de pre-término y un aborto espontáneo de segundo trimestre. En tres de las cuatro pacientes, el único factor de riesgo fue el embarazo. Una paciente recibía terapia inmunosupresora por una colitis ulcerosa. Fiebre fue el síntoma más frecuente. El compromiso feto-neonatal se manifestó por listeriosis neonatal precoz (dos casos) y mortinato (un caso). El embarazo puede ser el único factor predisponente a desarrollar listeriosis. Ésta debe considerarse en la evaluación del síndrome febril de una mujer embarazada. Los cultivos de sangre y líquido amniótico son útiles para su diagnóstico. La tasa de complicaciones perinatales permanece elevada.