Background: Long-term outcomes of Off-Pump Coronary Artery Bypass Grafting (OPCAB) as an alternative to the traditional Coronary Artery Bypass Grafting (CABG) technique with cardiopulmonary bypass (CPB) are not well defined. Aim: To compare 10-year survival of isolated OPCAB versus CABG with CPB. Material and Methods: Analysis of information obtained from databases, clinical records and surgical protocols of patients treated with isolated CABG between January 2006 and November 2008 at a Regional Hospital. Of 658 isolated CABG, 192 (29.2%) were OPCAB and 466 (79.9%) CPB. Propensity Score Matching (PSM) was performed to compare both groups. After PSM, two groups of 192 cases were obtained. Mortality data was obtained from the Chilean public identification service. Ten-year survival was calculated and compared with Kaplan-Meier and log-rank methods. Results: Follow-up data was obtained in all cases. No statistically significant differences were found when comparing 10-year survival between OPCAB versus CPB (78.6% and 80.2% respectively, p 0.720). There was also no statistical difference in cardiovascular death free survival (90.1% with CPB versus 89.1% OPCAB, p 0.737). Survival was comparable when analyzing subgroups with diabetes mellitus, left ventricular dysfunction or chronic kidney disease, among others. Conclusions: In our series, OPBAB has a comparable 10-year survival with CABG with CPB.

Background: The adoption of sanitary measures due to the SARS-CoV-2 pandemic hampered teaching and learning methods in medicine. Aim: To communicate the results of a wound suture training workshop, based on the Basic Procedural Skills Training methodology and adapted to the pandemic context. Material and Methods: One hundred fourteen students were randomized in small groups due to sanitary measures and trained with a modification of the Basic Procedural Skills Training methodology. An informed consent was obtained from every student. The suturing skills were evaluated before and after the intervention with “The Objective Structured Assessment Of Technical Skills” (OSATS) instrument. The perception of the workshop and the implementation of the COVID-19 prevention measures were also evaluated. Results: The students showed a statistically significant improvement after the intervention. In the OSATS verification list, the average score increased from 4.5 to 8.6 (p < 0.01). In the OSATS global scale, the average score increased from 13.0 to 25.3 (p < 0.01). The perception of the workshop and the prevention measures were well evaluated. Conclusions: Despite all the limitations of the pandemic context, we achieved a significant improvement after the intervention and a very good perception by the students.

Background: Coronary artery bypass grafting (CABG) is the treatment of choice for a broad spectrum of patients with coronary disease. Aim: To describe global survival and factors associated with lower long-term survival in patients operated with isolated CABG. Material and Methods: Analysis of a cohort of patients who underwent CABG between January 2006 and December 2008 at a public hospital. The database and operation records of 1.003 cardiac surgeries were reviewed. Of these, an isolated CABG was performed in 658 patients aged 62 ± 9 years including 516 male (78%). Survival data were obtained from the Chilean Civil Registry Office and a complete ten-year follow up was accomplished. Survival was analyzed with Kaplan-Meier method with log-rank test and Cox regression. Results: Operative mortality occurred in 13 patients (2%). Survival at 1, 3, 5 and 10 years was 97, 94, 91 and 76%, respectively. One, 3, 5 and 10-year free of cardiovascular death survival was 98, 97, 95 y 89%, respectively. Factors associated with long-term survival were chronic kidney disease in hemodialysis (Hazard ratio (HR) 7.9; 95% confidence intervals (CI) 4.6-13.6), chronic obstructive pulmonary disease (HR 2.3; 95% CI 1.4-3.7), chronic arterial occlusive disease (HR 2.2; 95% CI 1.4-3.4) and diabetes mellitus (HR 1.9; 95% CI 1.4-2.6). According to EuroSCORE, 10-year survival was 86, 75 and 62% (p < 0.01) in low, medium and high-risk patients, respectively. Conclusions: These patients had a 10-year survival comparable to large international series. Groups associated with lower 10-year survival were identified.

Abstract Madrid, A. & S. Teillier. 2021. Flora and vegetation of the dunes of Playa Grande of Cartagena, an urban beach in central Chile. Darwiniana, nueva serie 9(2): 342-363. The flora of the Playa Grande of Cartagena in the Valparaiso Region, commune of El Tabo (33°30´S, 71°36´W), is made up of 98 species of vascular plants, 61 % of which are exotics, most feral. The vegetation is made up of five units: a Carpobrotus chilensis and Chrysanthemum coronarium grassland dominated by ruderal species, mostly feral alien species, which marks the boundary between the populated area and the dune field with the sandy beach; a Ambrosia chamissonis and Poa cumingii scrub that is typical of the primary and secondary dunes and occupies the largest vegetated area in the study area; a Nolana crassulifolia scrub, a coastal rocky rocks; and two units typical of coastal wetlands: a marsh grassland with Schoenoplectus pungens and Cotula coronopifolia, and a Typha dominguensis grassland in a water body.

Resumen Madrid, A. & S. Teillier. 2021. Flora y vegetación de las dunas de la Playa Grande de Cartagena, una playa urbana en Chile central. Darwiniana, nueva serie 9(2): 342-363. La flora de la Playa Grande de Cartagena, en la Región de Valparaíso, comuna de El Tabo (33°30´S, 71°36´W), reúne a 98 especies de plantas vasculares, de las que un 61 % son exóticas, la mayoría asilvestradas. La vegetación está constituida por cinco unidades: un herbazal de Carpobrotus chilensis y Chrysanthemum coronarium dominado por especies ruderales, en su mayoría alóctonas asilvestradas, que señala el límite entre la zona poblada y el campo de dunas con la playa de arena; un matorral de Ambrosia chamissonis y Poa cumingii que es propio de las dunas primarias y secundarias y ocupa la mayor superficie vegetada de la zona de estudio; un matorral de Nolana crassulifolia, comunidad rupícola litoral; y dos unidades propias de los humedales del litoral: un herbazal de marisma con Schoenoplectus pungens y Cotula coronopifolia, y un herbazal de Typha dominguensis en un espejo de agua.

RESUMEN Introducción: Los estudiantes de educación superior son una población vulnerable a los trastornos mentales, más aún durante la pandemia por COVID-19. Su salud mental se ha visto afectada por el confinamiento, las dificultades en el desarrollo de las actividades académicas y las exigencias de las nuevas modalidades pedagógicas. Se planteó entonces la pregunta: en las instituciones de educación superior, ¿cuáles acciones en torno a a) promoción y prevención, b) atención a síntomas mentales y c) adaptaciones pedagógicas pueden desarrollarse con el fin de mejorar la salud mental de sus estudiantes? Métodos: Síntesis crítica a partir de la revisión sistemática de la literatura. Se realizó la búsqueda de artículos científicos de alcance descriptivo, analítico, experimental o evaluativo, así como recursos web de organizaciones relacionadas con el tema. Se realizó una síntesis en función de los 3 focos de la pregunta mediante comparación constante, hasta realizar la agrupación de acciones por similitud en los actores que las ejecutarían y recibirían. Se anticipó una baja calidad de la evidencia, por lo que no se realizó evaluación estandarizada. Resultados: Se exploraron 68 artículos y 99 recursos web. Después de la revisión del texto completo se incluyeron 12 artículos científicos y 11 recursos web. Como lineamentos generales, se encontró que la propuesta más frecuente es el diseño de un programa estructurado específico para el tema de salud mental en las instituciones educativas, que sea multidisciplinario, incluyente, dinámico y sensible a la cultura. Las acciones deben ser divulgadas periódicamente para que los estudiantes y demás miembros de la comunidad educativa las tengan claras, e idealmente se propone mantenerlas hasta el periodo pospandémico e incluir a los egresados. Para a) la promoción y prevención, se encontró la psicoeducación por vía electrónica, donde se expliquen estilos de vida saludable, reacciones emocionales en pandemia, estrategias de afrontamiento y signos de alarma. Se propone la participación de los pares como estrategia de apoyo y espacios de interacción social que no se enfoquen únicamente en aspectos académicos. Se reporta la necesidad de cribar síntomas mentales por medio de envío frecuente de formularios en línea o aplicaciones móviles, donde también se indague por la satisfacción de las necesidades básicas y tecnológicas. En cuanto a b) atención de síntomas mentales, una de las acciones que se encontró con mayor frecuencia es disponer de un centro de consultoría que sea capaz de realizar atención en salud mental por vía telefónica, por tecnologías e incluso presencial, con atención permanente las 24 h o equipos de respuesta rápida ante una situación de crisis, como la conducta suicida y la violencia doméstica. Para c) las adaptaciones pedagógicas, se señala como requisito indispensable la comunicación fluida para tener instrucciones claras sobre el desarrollo de las actividades académicas para disminuir la incertidumbre y, por ende, la ansiedad y favorecer la gestión del tiempo por el estudiante. Los profesores y pedagogos de la institución pueden ofrecer asesorías directas (por videollamadas o reuniones de grupos en línea) para proveer apoyo en hábitos de estudios, materias propias de cada carrera y salud mental. Conclusiones: Los recursos incluidos proponen que la institución educativa cree un programa que aborde específicamente la salud mental de los estudiantes. Esta síntesis puede proveer lineamientos que faciliten la toma de decisiones, sin perder de vista que la institución y el estudiante están inmersos en un contexto complejo, con circunstancias y otros actores en varios niveles que también intervienen en la salud mental. Se requieren investigaciones sobre la evolución de la situación de salud mental y el efecto de las acciones que se vayan tomando.

ABSTRACT Background: College and university students are a population vulnerable to mental disorders, especially during the COVID-19 pandemic. Their mental health has been affected by confinement, difficulties in the development of academic activities, and the demands of new pedagogical modalities. We aimed to respond to the question: what are the actions around a) promotion and prevention, b) mental symptoms care, and c) pedagogical adaptations that can be developed in order to improve the mental health of college and university students? Methods: We conducted a critical synthesis from a systematic review of the literature. A search was made for scientific articles with descriptive, analytical, empirical or evaluative designs, as well as web resources of organizations related to the topic. A synthesis was carried out based on the three aspects of the question by means of a constant comparative method, until the aggregation of actions by similarity in the actors. We anticipated low evidence quality; therefore, a standardized evaluation was not performed. Results: We explored 68 articles and 99 web resources. After reviewing the full text, 12 scientific articles and 11 web resources were included. As general guidelines, we found that the most frequent suggestion is the design of a specific structured mental health program within universities, one that should be multidisciplinary, inclusive, dynamic and culturally sensitive. All actions taken by the university should be reported and published periodically so that students and other members of the university community are clear about them. Ideally, it is suggested to keep them until the post-pandemic period and include alumni. Regarding a) promotion and prevention, digital psychoeducation was recommended, with information about healthy lifestyles, common emotional reactions to epidemics, coping strategies and warning signs. Peer participation is suggested as a support strategy, as well as spaces for social interaction that focus not only on academic aspects but also on leisure. Screening for mental symptoms is suggested through frequent submission of online forms or mobile applications. In addition to mental health, it is important to inquire about the degree of satisfaction of basic and technology-related needs. For b) the care of mental symptoms, one of the actions commonly identified was a consulting centre that can provide mental health care by telephone, by technology, and even in person -if required -, with permanent availability with rapid response teams for crisis situations, such as suicidal behavior and domestic violence. For c) pedagogical adaptations, fluent communication is an indispensable requirement; having clear instructions on academic activities can reduce uncertainty and therefore anxiety. The teaching and pedagogical staff at the institution can offer direct advice (via video calls or online group meetings) to provide support in study habits, degree-specific material and mental health. Conclusions: Included resources suggest the creation of a program that specifically addresses the mental health of students. This synthesis can provide guidelines that facilitate decision-making by the university, without losing sight of the fact that the institution and the student are immersed in a complex context, with circumstances and other actors at various levels that also intervene in mental health. Research is required on the evolution of the mental health situation and the effect of the actions that are being taken.

ABSTRACT Introduction: Lymphedema is the most common sign to appear in cancer treatment, especially breast cancer. This situation mainly affects the upper limbs, blocking the lymph nodes, generating fluid retention, affecting the quality of life. One of the alternatives to treat it is physical exercise. Materials and methods: A systematic review was carried out using databases such as EMBASE, PubMed, Medscape, MEDLINE and Google Scholar, including randomized controlled trials type studies that evaluated the effects of physical exercise on lymphedema in publications from January 2013 to June 2013, 2020. The recommendations of the Cochrane collaboration for the selection of studies for systematic reviews were taken into account, as well as the criteria of the PRISMA Declaration and the PEDro scale. Results: A total of 36 articles were included, and it was observed that in 28 studies the application of physical exercise in its different modalities generated a decrease in the circumference of lymphedema, in some cases up to 61% of the initial measurement (p <0.01) while in the remaining 8 articles it was maintained, but improving the functionality of the affected limb and adaptation to it (p <0.01). Conclusions: The application of physical exercise is an alternative to treat lymphedema which obtains positive results, improving the circumference of the affected limb, functionality, strength, sensitivity and quality of life.

RESUMEN Introducción: el linfedema es el signo más común en aparecer en el tratamiento de cáncer, especialmente, en el de mama. Esta situación afecta principalmente los miembros superiores, bloqueando los ganglios linfáticos, generando una retención de líquidos, afectando la calidad de vida. Una de las alternativas para tratarlo es el ejercicio físico. Materiales y métodos: se realizó una revisión sistemática utilizando bases de datos como EMBASE, PubMed, Medscape, MEDLINE y Google Scholar, incluyendo estudios tipo ensayos controlados aleatorios que evaluaran los efectos del ejercicio físico en el linfedema en publicaciones desde enero del 2013 a junio del 2020. Se tomaron en cuenta las recomendaciones de la colaboración Cochrane para la selección de estudios para revisiones sistemáticas, al igual que los criterios de la Declaración PRISMA y la escala de PEDro. Resultados: se incluyeron un total de 36 artículos, en donde se observó que en 28 estudios la aplicación del ejercicio físico en sus diferentes modalidades generó una disminución de la circunferencia del linfedema, en algunos casos hasta 61% de la medición inicial (p<0,01) y en los 8 artículos restantes se mantuvo, pero mejorando la funcionalidad del miembro afectado y adaptación al mismo (p<0,01). Conclusiones: la aplicación del ejercicio físico es una alternativa para tratar el linfedema el cual obtiene resultados positivos, mejorando la circunferencia del miembro afectado, funcionalidad, fuerza, sensibilidad y la calidad de vida.

ABSTRACT: Introduction: Successful root canal therapy (endodontic treatment) requires complete disinfection of the root canal system. Traditionally, disinfection of the root canal system involves rotary or manual instrumentation and chemical irrigation. Various rotary instrumentation techniques have emerged as an alternative to manual instrumentation, but its benefits against manual techniques need to be clarified. Methods: We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. Results and conclusions: We identified five systematic reviews that together included 15 primary studies, of which 10 correspond to randomized trials. We conclude that the use of rotary instrumentation compared to manual instrumentation probably reduces the incidence of pain. Also, rotatory instrumentation may reduce the use of postoperative analgesics. However, it could result in little or no difference in pain intensity, but the certainty of the evidence is low. Furthermore, it is not possible to clearly establish whether the use of rotary instrumentation increases apical repair as the certainty of the evidence has been assessed as very low.

RESUMEN: Introducción: El éxito del tratamiento endodóntico requiere de la desinfección completa del sistema de canales radiculares. Convencionalmente este procedimiento se realiza a través de maniobras de instrumentación rotatoria o manual e irrigación química. Dentro de las diferentes técnicas de instrumentación, la de tipo rotatoria ha surgido como una alternativa a la instrumentación manual, cuyos beneficios en comparación a ésta aún deben ser dilucidados. Métodos: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. Resultados y conclusiones: Identificamos cinco revisiones sistemáticas que en conjunto incluyeron 15 estudios primarios, de los cuales, 10 corresponden a ensayos aleatorizados. Concluimos que el uso de instrumentación rotatoria en comparación a instrumentación manual probablemente disminuye la incidencia del dolor postoperatorio. Además, la instrumentación rotatoria podría disminuir el uso de analgésicos post tratamiento endodóntico. Sin embargo, podría resultar en poca o nula diferencia en la intensidad del dolor, pero la certeza de la evidencia es baja. Además, no es posible establecer con claridad si el uso de instrumentación rotatoria en comparación a la instrumentación manual aumenta la reparación apical debido a que la certeza de la evidencia existente ha sido evaluada como muy baja.

Resumen: El estudio analiza los factores que determinan la transferencia del conocimiento en pequeñas y medianas empresas (pymes) del área industrial de la región de Coquimbo, Chile, basado en la teoría SECI de Nonaka y Takeuchi (1995). A través del análisis estadístico multivariado de 75 cuestionarios aplicados a ejecutivos, se determinó la existencia de una relación significativa y directa entre la transferencia del conocimiento y la codificación y la facilidad de enseñanza, lo que reafirma la relevancia del desarrollo de conocimiento explícito para el éxito de su transferencia. Por otro lado, se determinó que los atributos incertidumbre y complejidad influyen significativa e inversamente en la transferencia del conocimiento, lo cual provoca que esta sea menos probable cuando no son gestionadas adecuadamente. Por último, se configura una propuesta metodológica, cuya implementación se espera que contribuya a desarrollar una organización adaptada a las circunstancias de un entorno complejo y cambiante.

Abstract: This study assesses the factors of knowledge transfer in small and medium industrial businesses (SMEs) in Coquimbo, Chile, as per the SECI theory of Nonaka and Takeuchi (1995). Through the multivariate statistical analysis of 75 surveys applied to company executives, the existence of significant and direct relations among knowledge transfer, coding, and teaching accessibility was determined, thus reasserting the relevance of developing explicit knowledge to guarantee transfer success rates. However, it was determined that attributes such as uncertainty and complexity significantly and inversely influence knowledge transfer, the likelihood of which decreases when not managed properly. Finally, the authors set forth a methodological proposal, whose implementation is expected to contribute in the development of an organization adapted to the circumstances of a complex and changing environment.

Resumo: O estudo analisa os fatores que determinam a transferência de conhecimento em pequenas e médias empresas (PMEs) em Coquimbo, Chile, com base na teoria SECI de Nonaka e Takeuchi (1995). Por meio da análise estatística multivariada de 75 questionários aplicados a executivos, foi determinada a existência de uma relação significativa e direta entre transferência de conhecimento, codificação e facilidade de ensino, o que reafirma a relevância do desenvolvimento de conhecimento explícito para o sucesso da sua transferência. Por outro lado, determinou-se que os atributos incerteza e complexidade influenciam de forma significativa e inversa a transferência de conhecimento, o que faz com que esta seja menos provável quando não gerenciada adequadamente. Por fim, é configurada uma proposta metodológica, cuja implementação deverá contribuir para o desenvolvimento de uma organização adaptada às circunstâncias de um ambiente complexo e em mudança.

ABSTRACT The Nature Sanctuary “Serranía El Ciprés” is considered as a hotspot for the conservation of biodiversity at regional and national level in Chile. It is located administratively in the Valparaiso Region. in the Mediterranean eco-region. The objective of this work is to study the richness and composition of its vascular flora. The results indicate that there are at least 297 taxa in the area, belonging to 293 species, 183 genera and 74 families. The best represented families are Asteraceae, Fabaceae and Poaceae. The species richness in relation to the area is greater than expected in central Chile (226-272), where 272 (92.8%) are native, of which 145 (53.3%) are endemic to Chile and 21 (7.2%) are foreign. The predominant Raunkiaer life forms were hemicryptophytes (26.4%), terophytes (23.5%) and camephytes (17.7%). Ten species were officially classified in some categories of conservation, five of them as “vulnerable”, they are Citronella mucronata, Eriosyce aurata, Placea ornata, Porlieria chilensis and Prosopis chilensis. There are also seven new species for the Region.

RESUMEN El Santuario de la Naturaleza “Serranía El Ciprés” es un sitio prioritario para la conservación de la biodiversidad al nivel regional y nacional en Chile. Se ubica administrativamente en la Región de Valparaíso, en la ecorregión mediterránea. El objetivo de este trabajo es estudiar la riqueza y la composición de su flora vascular. Los resultados indican que en el área existen al menos 297 taxa, pertenecientes a 293 especies, 183 géneros y 74 familias. Las familias mejor representadas son Asteraceae, Fabaceae y Poaceae. La riqueza de especies en relación con la superficie es mayor a la esperada en Chile central (226-272), donde 272 (92,8%) son nativas, de las que 145 (53,3%) son endémicas de Chile y 21 (7,2%), alóctonas asilvestradas. Las formas de vida de Raunkiaer predominantes fueron las hemicriptófitas (26,4%), las terófitas (23,5%) y las caméfitas (17,7%). Se encontraron diez especies clasificadas oficialmente en alguna categoría de conservación, cinco de ellas como “vulnerable”, ellas son Citronella mucronata, Eriosyce aurata, Placea ornata, Porlieria chilensis y Prosopis chilensis. Se registran, además, siete especies nuevas para la Región.

Abstract The present study analyzes the preferred attributes for teaching of the Business Administration subject, a fundamental course of the career with the highest enrollment in Chile: Commercial Engineering. Based on a bibliographical review, interviews and focus group, five relevant attributes were selected: level of demand, class type, use of information and communication technologies, number of teachers and teaching style. These attributes were examined using the multivariate Conjoint Analysis technique. The results show that, independent of gender and age, students prefer a high-level requirement class, with an equal number of hours of theory and practice, which use multimedia technology and which is taught by a single teacher with an integrating teaching style. It is expected that the preferences declared by the students will contribute to adjusting the educational practices in order to improve their motivation and academic performance.

Resumen El presente estudio analiza los atributos preferidos en la enseñanza de la asignatura Administración de Empresas, materia basal de la carrera universitaria de mayor matrícula en Chile: Ingeniería Comercial. En base a la revisión bibliográfica, entrevistas y grupos de discusión, se seleccionaron cinco atributos relevantes: nivel de exigencia, tipo de clase, uso de tecnologías de información y comunicación, número de profesores y estilo docente. Estos atributos fueron examinados a través de la técnica multivariante de Análisis Conjunto. Los resultados muestran que, independientemente del género y edad, los estudiantes se inclinan por una clase con alto nivel de exigencia, que distribuye equilibradamente las horas de teoría-práctica, que emplea tecnología multimedia y que es dictada por un solo profesor con un estilo integrador de enseñanza. Se espera que las preferencias declaradas por el alumnado contribuyan a ajustar las prácticas educativas a objeto de mejorar su motivación y rendimiento académico.

Antecedentes: La coinfección por virus de inmunodeficiencia humana (VIH) y micobacterias tiene un efecto dual; el riesgo de enfermedad extrapulmonar y diseminada por micobacterias se incrementa y la progresión de la enfermedad VIH se acelera. La tuberculosis (TB) es la entidad que más amenaza la vida en estos pacientes. Metodología: Estudio observacional, descriptivo, retrospectivo. Objetivo: Determinar las características epidemiológicas, clínicas y el perfil de resistencia en los pacientes con coinfección VIH y micobacterias. Resultados: De 159 pacientes con diagnóstico de infección por VIH, 44 (27,7%) tenían coinfección por micobacterias. La edad promedio fue de 36,7 años ± 11,3. El 86% fueron hombres. Al ingreso 66% tenía síndrome de inmunodeficiencia adquirida (SIDA), 20% historia de TB y 11% historia de otras enfermedades de transmisión sexual. El 50% tenía linfocitos T CD4 <50/mm³. Las principales comorbilidades fueron neoplasias hematológicas 11%, insuficiencia cardiaca 4,5% y enfermedad linfoproliferativa 4,5%. La incidencia anual fue de 4,6%. Las formas diseminadas fueron el 54% de los casos. Se identificó M. tuberculosisen 77,3%, micobacterias no tuberculosas (MNT) en 18,3% y en el 4,5% no fue posible establecerla especie. El 2,5% de los aislamientos de M. tuberculosis fueron multifarmacorresistentes (TB-MDR) y en 18,2% se identificó resistencia a un solo fármaco o resistencia combinada. En el 54%de los pacientes se documentó compromiso pulmonar. La letalidad fue del 9,1%. Conclusión: En nuestros pacientes, la infección por M. tuberculosis es la más frecuente y es llamativa la alta prevalencia de resistencia al menos a un fármaco y la TB-MDR. Las infecciones por MNT son cada vez más frecuentes. Las formas diseminadas y extrapulmonares son muy importantes. La incidencia anual es alta.

Background: Co-infection with the human inmunodeficiency virus (HIV) and mycobacteria hasa synergistic effect; the risk of extrapulmonary and disseminated mycobacterium disease isincreased and the progression of HIV disease is accelerated. Tuberculosis (TB) is the entity thatis most life threatening to these patients. Methodology: Observational, descriptive and retrospective study. Objective: To determine the epidemiological and clinical characteristics and the resistanceprofile in patients coinfected with HIV and mycobacteria. Results: Of 159 patients diagnosed with HIV, 44 (27.7%) patients were co-infected with myco-bacteria. The average age was 36.7 years ± 11.3. Some 86% were men. At admission, 66% hadacquired immune deficiency syndrome (AIDS), 20% a history of TB and 11% a history of othersexually transmitted diseases. A total of 50% reported a count of CD4 lymphocytes less than50 cells/mm 3 . Major comorbidities were haematological malignancies in 11%, heart failure in4.5%, and lymphoproliferative disease in 4.5%. The annual incidence was 4.6%. Disseminatedforms were found in 54% of cases. M. tuberculosis was identified in 77.3%, non-tuberculousmycobacteria (NTM) in 18.3% and in 4.5%, it was not possible to establish the species. Some2.5% of isolates of M. tuberculosis were multidrug-resistant (MDR-TB) and 18.2% were resistantto a single drug or had combined resistance. There was documented pulmonary involvement In54% of patients. Mortality was 9.1%. Conclusion: In our patients, infection with M. tuberculosis was the most common and the highprevalence of resistance to at least one drug and MDR-TB was striking. NTM infections are becoming more common. The extra-pulmonary and disseminated forms are common, and annual incidence is high.

ABSTRACT Background The United States Food and Drug Administration (FDA) has warned about the increased suicidality risk associated with the use of selective serotonin reuptake inhibitors (SSRI) and venlafaxine in children and adolescents. Objectives To critically appraise the available evidence supporting the FDA Black box warning concerning to the use of antidepressants in child and adolescents. Methods A critical review of articles in Medline/PubMed and SciELO databases regarding the FDA Black box warning for antidepressants, and the impact of FDA warnings on antidepressant prescriptions and suicide rates. Results The warning was based on surveys that did not report either cases of suicide nor a significant difference supporting an increased suicidality rate. The concept was defined in an ambiguous way and there is currently more available evidence to support such definition. The use of SSRI and venlafaxine has been associated to lower suicidality rates, but the prescription fall due to the warning increased suicide rates. Discussion Suicidality is an inherent feature of depressive disorders so it would be desirable to consider how much of the phenomenon may be attributed to antidepressants per se. It would be appropriate to consider that suicide rates might increase also as a consequence of the warning.

Resumo: A partir de 41 histórias de vida de homens e mulheres (de 19 a 45 anos), ex-estudantes de três tipos de colégios privados de elite em Santiago do Chile, este artigo analisa o processo de construção de masculinidades hegemônicas na classe dominante chilena. Examina-se a forma como a produção de distintos padrões de masculinidades se relaciona com mudanças na parte alta da estrutura social e se analisa o modo como a sexualidade conecta a formação simultânea destas masculinidades e da classe dominante. Contrasta-se a forma como estes colégios abordam a sexualidade e as práticas sexuais de ex-estudantes homens com mulheres de distintas classes sociais, especialmente o que os entrevistados chamam de "chaneo". Finalmente, discute-se as implicâncias destes achados para o estudo do poder e do privilégio em uma sociedade de mercado.

Abstract: Based on 41 life-history interviews with men and women (19-45 years-old), former students of three different types of elite private schools in Santiago, this paper analyses the construction of hegemonic masculinities in the Chilean ruling class. The paper examines the way in which the production of different patterns of masculinities is related to changes in the top-end of the social structure, and analyzes the way in which sexuality connects the simultaneous making of these masculinities and the ruling class. The ways schools address sexuality is contrasted with former students' sexual practices with women from different social classes, particularly, the practice that they call "chaneo". Finally, the paper discusses the implications of these findings for the study of power and privilege in a market society.

Resumen: Sobre la base de 41 historias de vida, de hombres y mujeres (de 19 a 45 años), ex-estudiantes de tres tipos de colegios privados de elite en Santiago de Chile, este artículo analiza el proceso de construcción de masculinidades hegemónicas en la clase dominante chilena. Se examina la forma en que la producción de distintos patrones de masculinidades se relaciona con cambios en la parte alta de la estructura social y se analiza el modo en que la sexualidad conecta la formación simultánea de estas masculinidades y de la clase dominante. Se contrasta la forma como estos colegios abordan la sexualidad y las prácticas sexuales de ex-estudiantes varones con mujeres de distintas clases sociales, especialmente, lo que los entrevistados llaman el "chaneo". Finalmente, se discuten las implicaciones de estos hallazgos para el estudio del poder y del privilegio en una sociedad de mercado.