Abstract Background: lifestyle and cardiometabolic risk factors information is scarce regarding youth and adults of Latin-American ethnics. Objective: the primary aim was to describe the lifestyle and cardiometabolic risk factors for arterial hypertension (HTN) and diabetes in ethnic Latin-American groups (Mapuche and Aymara) and other non-ethnics > 15 years of age in the Chilean population. A secondary aim was to determine the association between physical activity ‘intensity' with HTN and diabetes markers. Material and methods: a representative sample from the National Chilean Health Survey 2016-2017, included Mapuche (EG-Map; women n = 166, men n = 300; total n = 466), Aymara (EG-Aym; women n = 96, men n = 55; total n = 151), and a non-ethnic population group (No-EG; women n = 2057, men n = 3445; total n = 5502). The main outcomes were; systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting plasma glucose (GL), and secondary outcomes were other anthropometric, lipid profile, and lifestyle parameters. Results: GL was significantly associated with nutrition (0.9 %, p < 0.0001), tobacco and alcohol habits (0.6 %, p < 0.0001). SBP was significantly associated with nutrition (whole-grains 0.04, p = 0.001; water consumption 0.07, p < 0.0001), sleep hygiene (week 0.04, p = 0.030; on weekends -0.04, p = 0.026), and alcohol consumption (-0.06, p < 0.0001). Conclusion: in conclusion, lifestyle differences among Mapuche and Aymara ethnic groups in comparison with non-ethnic Chilean peers > 15 years are significantly associated with blood pressure and glycemia.

Resumen Antecedentes: la información sobre estilos de vida y factores de riesgo cardiometabólico es escasa en jóvenes y adultos de etnia latinoamericana. Objetivo: el objetivo principal fue describir el estilo de vida y los factores de riesgo cardiometabólico para la hipertensión arterial (HTA) y la diabetes en grupos étnicos latinoamericanos (Mapuche y Aymara) y otros no étnicos > 15 años de la población chilena. Un objetivo secundario fue determinar la asociación de la "intensidad" de la actividad física con la HTA y los marcadores de diabetes. Material y métodos: muestra representativa de la Encuesta Nacional de Salud de Chile 2016-2017, compuesta por mapuches (EG-Map; mujeres n = 166, hombres n = 300; total n = 466), aymaras (EG-Aym; mujeres n = 96, hombres n = 55; total n = 151) y un grupo poblacional no étnico (No-GE; mujeres n = 2057, hombres n = 3445; total n = 5502). Las principales evaluaciones fueron la presión arterial sistólica (PAS), la presión arterial diastólica (PAD) y la glucosa plasmática en ayunas (GL), y los resultados secundarios fueron otros parámetros antropométricos, del perfil lipídico y del estilo de vida. Resultados: la GL se asoció significativamente a los hábitos nutricionales (0,9 %, p < 0,0001) y los hábitos de tabaco y alcohol (0,6 %, p < 0,0001). La PAS se asoció significativamente con la nutrición (cereales integrales 0,04, p = 0,001; consumo de agua 0,07, p < 0,0001), higiene del sueño (semana 0,04, p = 0,030; fines de semana -0,04, p = 0,026) y consumo de alcohol (- 0,06, p < 0,0001). Conclusión: en conclusión, las diferencias de estilo de vida entre las etnias mapuche y aymara en comparación con sus pares chilenos no étnicos mayores de 15 años se asocian significativamente con la presión arterial y la glucemia.

ABSTRACT In the establishment of conservation areas, the technical and scientific criteria used are often unknown. Despite the existence of selection methods that help to make an efficient selection of the territory, conservation areas are still decreed that are not useful for this purpose or generate conflicts with the population. In this study, specialized tools were used in the optimal selection of potential areas for the conservation of forest ecosystems. In a first stage, four ecosystems were identified that are not included in Protected Natural Areas (ANP) and nine are underrepresented. Subsequently, the spatial optimization algorithm was used to efficiently identify the area required to cover the conservation deficit. It was found that 64% of the territory is relevant for conservation. However, with the execution of the optimization algorithm, 18% of the surface was selected. This result is useful to cover the current conservation deficit. It was concluded that the use of spatial optimization algorithms allows the efficient, explicit and transparent location of areas that are important for conservation.

RESUMEN En el establecimiento de áreas de conservación con frecuencia se desconocen los criterios técnicos y científicos utilizados. A pesar de la existencia de métodos de selección que ayudan a realizar una selección eficiente del territorio, aún se decretan áreas de conservación que no son útiles para este fin o generan conflictos socioambientales. En este estudio se emplearon herramientas especializadas en la selección óptima de áreas potenciales para la conservación de ecosistemas forestales. En una primera etapa, se identificaron cuatro ecosistemas que no están incluidos en Áreas Naturales Protegidas (ANP) y nueve están subrepresentados. Posteriormente, se usó el algoritmo de optimización espacial que identifica de forma eficiente la superficie requerida para cubrir el déficit de conservación. Se encontró que el 64% del territorio es relevante para la conservación. Sin embargo, con la ejecución del algoritmo de optimización se seleccionó el 18% de la superficie. Este resultado es útil para cubrir el déficit de conservación actual. Se concluyó que la utilización de algoritmos de optimización espaciales, permiten ubicar de manera eficiente, explícita y transparente las áreas que son importantes para la conservación.

Abstract Aim: to verify the effect of a physical education program at school on physical fitness and mental health in children and to determine the individual prevalence of responders. Methods: This is a quasi-experimental study, developed with 67 children aged between 6 and 11 years old. (8.09 ± 1.81). A 21-week intervention was performed, that intervention condition (IC) consisted of sports and circuit training, and nutritional education. For the control condition (CC) classes followed to the Common Curricular National Base. The following variables were evaluated at baseline and post-intervention: physical fitness and mental health through the strength and difficulties questionnaire. Mixed analysis of variance and the prevalence of responders were used for statistical analysis. Results: The main results indicate that there were improvements in the IC in the components of physical fitness (cardiorespiratory fitness, speed, and agility) and mental health indicators (total difficulties, emotional symptoms, problems with peers, and prosocial behavior) after a school physical education program in comparison with the CC. Concerning the prevalence of responders between groups, it was found differences in cardiorespiratory fitness (CC: 33.33%; IC: 65.38%), agility (CC: 36.66%; IC: 73.07%), speed (CC: 43.33%; IC: 79.16%), emotional symptoms (CC: 28.57%; IC: 50.00%), and prosocial behavior (CC: 17.14%; IC: 46.87%). Conclusion: It is reinforced that well-planned physical education classes and simple intervention programs can be adopted at the school level and are capable of promoting children's physical and mental health.

Resumen Introducción: El volumen medio plaquetario (VMP) es un biomarcador utilizado en el abordaje integral de la sepsis. Objetivo: Evaluar la asociación entre VMP con la mortalidad en pacientes con sepsis. Métodos: Se realizó una revisión sistemática de estudios observacionales en cinco bases de datos. Se analizó la mortalidad asociada con la sepsis; las intervenciones consideradas fueron VMP, APACHE y lactato sérico. Resultados: Respecto a la mortalidad asociada a sepsis, se encontró un valor significativo en la VMP a las 72 horas (200 fallecidos versus 654 no fallecidos; MD 0.83 IC95% 0.53-1.13, p=< 0.0001, I2 =72.9%); así como el valor de APACHE II (220 muertos frente a 604 no fallecidos; MD 0.81 IC95% 0.62-1.0, p= 0.0001, I2 =32%). No se encontró significancia estadística para las demás variables clínicas. Conclusiones: El aumento de la VMP se asocia con mayor riesgo de mortalidad en pacientes con sepsis, especialmente después de 72 horas de evolución de las características clínicas.

Abstract Introduction: Platelet mean volume (MVP) is a biomarker used in the integral approach to sepsis. Objective: To assess the association between MVP and mortality in patients with sepsis. Methods: A systematic review of observational studies in five databases was performed. Mortality associated with sepsis was analysed; interventions considered were MPV, APACHE and serum lactate. Results: Regarding mortality associated with sepsis, a significant value was found in the MVP at 72 hours (200 deceased versus 654 not deceased; MD 0.83 IC95% 0.53-1.13, p=<0.0001, I2 =72.9%); as well as the value of APACHE II (220 dead versus 604 not deceased; MD 0.81 IC95% 0.62-1.0, p= 0.0001, I2 =32%). No statistical significance was found for the other clinical variables. Conclusions: Increased MVP is associated with increased risk of mortality in patients with sepsis, especially after 72 hours of evolution of clinical features.

Resumen Introducción. El control prenatal corresponde a una estrategia encaminada a prevenir las posibles complicaciones del embarazo, el parto y el puerperio. Diversos estudios aislados se han realizado para identificar factores que pueden afectar de forma negativa el control prenatal. Objetivo. Realizar una síntesis cualitativa de la literatura respecto al impacto de las condiciones sociodemográficas sobre el control prenatal en Latinoamérica. Materiales y métodos. Se realizó una búsqueda de la literatura a junio de 2018 en las bases de datos EBSCO, Embase, ScienceDirect, LILACS, SciELO, Cochrane Library, MEDLINE-PubMed y Google Scholar, con los términos "prenatal care" AND "Health services accessibility" AND "Pregnancy, Health services accessibility" AND "Pregnancy, prenatal care" AND "Health services accessibility" y sin límite de tiempo. Resultados. Se encontraron 13 artículos con información relevante para el desarrollo de la presente revisión. Conclusiones. La literatura disponible sugiere que condiciones sociodemográficas desfavorables podrían incidir de manera negativa sobre el control prenatal. El cuidado del hogar, la atención de otros hijos, la afiliación al sistema de seguridad social, la obligación laboral y el desempleo parecen ser los principales factores que afectan la calidad del mismo.

Abstract Introduction: Prenatal care is a strategy aimed at preventing the possible complications of pregnancy, childbirth and the postpartum period. Several isolated studies have been conducted to identify factors that may negatively affect prenatal care. Objective: To make a qualitative synthesis of the literature regarding the impact of sociodemographic conditions on prenatal care in Latin America. Materials and methods: A literature search was conducted in June 2018 on the EBSCO, Embase, ScienceDirect, LILACS, SciELO, Cochrane Library, MEDLINE-PubMed and Google Scholar databases using the following terms: "prenatal care" AND "Health services accessibility" AND "Pregnancy, Health services accessibility" AND "Pregnancy, prenatal care" AND "Health services accessibility". No time limits were considered in the search. Results: Thirteen articles with information relevant to the development of the present review were found. Conclusions: The available literature suggests that unfavourable socio-demographic conditions may have a negative impact on prenatal care. Household care, care of other children, affiliation to the social security system, obligation to work and unemployment seem to be the main factors affecting the quality of prenatal care.

Background: Housewives represent a important proportion of the Chilean population. However, there is limited evidence about their lifestyles. Aim: To characterize lifestyles and determine the level of compliance with healthy lifestyles guidelines of housewives in Chile. Material and Methods: Housewives from the 2009-2010 National Health Survey were included. The variables studied included levels of physical activity (PA), sedentary behavior, diet, hours of sleep and smoking. Compliance with healthy lifestyle behaviors was evaluated through logistic regression, granting a value of 1 for compliance and 0 for non-compliance. A healthy lifestyle was defined as meeting at least four healthy behaviors. Results: Housewives aged > 55 years had a higher BMI and waist circumference compared to those aged < 40 years. Housewives were also more likely to report moderate alcohol consumption and were more likely to meet a healthier lifestyle score (Odds ratio = 1.52 [95% confidence intervals: 1.09 to 2.11], p = 0.013). No significant age trends were observed for other lifestyle behaviors. Conclusions: Housewives had high levels of central obesity, excess body weight and high levels of salt intake but low alcohol intake. Their healthy lifestyles behaviors increased along with increasing age.

Abstract: Objective: To use a new methodology to classify the level of physical activity (PA) by combining the levels of PA and sedentary time (SED) in order to establish its association with metabolic syndrome (MS). Materials and methods: A representative sample of Chilean adults (≥18 years old) who participated in the National Health Survey (ENS 2009-2010) was included in this study (n=5 040). Four categories were created using a combination of PA and SED levels through the GPAQ questionnaire. MS was defined according to the norms established by NCEP ATP-III. Results: A lower probability of MS was observed only in the categories that comply with the international recommendations of PA, “active and low-SED” (OR=0.72 [0.57 to 0.91]) and “active and high-SED” (OR=0.63 [0.49 to 0.81]). While the level of SED (high/low) was not associated with a significant reduction of MS in any of the groups. Conclusions: This type of classification demonstrates that the main strategy to reduce the risk of MS should be associated with compliance with the recommendations of PA.

Resumen: Objetivo: Asociar una nueva e integradora clasificación de actividad física (AF) y sedentarismo con riesgo de síndrome metabólico (SM) en una muestra representativa de adultos chilenos. Material y métodos: Se incluyeron 5040 participantes de la Encuesta Nacional de Salud de Chile 2009-2010. Fueron creadas cuatro categorías mediante una combinación entre niveles de AF y sedentarismo (SED) usando el cuestionario GPAQ. El SM fue definido según las normas del NCEP ATP-III. Resultados: Se observa una menor probabilidad de presentar SM sólo en las categorías que cumplen con las recomendaciones internacionales de AF (p<0.05), “activo y bajo-SED” (RM=0.72 [0.57 a 0.91]) y “activo y alto-SED” (RM=0.63 [0.49 a 0.81]). El nivel de sedentarismo (alto/bajo) no se asoció con una reducción significativa de SM en ninguno de los grupos. Conclusiones: Este tipo de clasificación demuestra que la principal estrategia para reducir el riesgo de SM debiera estar asociada con cumplir las recomendaciones de AF.

Abstract: Objective: To use a new methodology to classify the level of physical activity (PA) by combining the levels of PA and sedentary time (SED) in order to establish its association with metabolic syndrome (MS). Materials and methods: A representative sample of Chilean adults (≥18 years old) who participated in the National Health Survey (ENS 2009-2010) was included in this study (n=5 040). Four categories were created using a combination of PA and SED levels through the GPAQ questionnaire. MS was defined according to the norms established by NCEP ATP-III. Results: A lower probability of MS was observed only in the categories that comply with the international recommendations of PA, “active and low-SED” (OR=0.72 [0.57 to 0.91]) and “active and high-SED” (OR=0.63 [0.49 to 0.81]). While the level of SED (high/low) was not associated with a significant reduction of MS in any of the groups. Conclusions: This type of classification demonstrates that the main strategy to reduce the risk of MS should be associated with compliance with the recommendations of PA.

Resumen: Objetivo: Asociar una nueva e integradora clasificación de actividad física (AF) y sedentarismo con riesgo de síndrome metabólico (SM) en una muestra representativa de adultos chilenos. Material y métodos: Se incluyeron 5040 participantes de la Encuesta Nacional de Salud de Chile 2009-2010. Fueron creadas cuatro categorías mediante una combinación entre niveles de AF y sedentarismo (SED) usando el cuestionario GPAQ. El SM fue definido según las normas del NCEP ATP-III. Resultados: Se observa una menor probabilidad de presentar SM sólo en las categorías que cumplen con las recomendaciones internacionales de AF (p<0.05), “activo y bajo-SED” (RM=0.72 [0.57 a 0.91]) y “activo y alto-SED” (RM=0.63 [0.49 a 0.81]). El nivel de sedentarismo (alto/bajo) no se asoció con una reducción significativa de SM en ninguno de los grupos. Conclusiones: Este tipo de clasificación demuestra que la principal estrategia para reducir el riesgo de SM debiera estar asociada con cumplir las recomendaciones de AF.

ABSTRACT Although physical activity (PA) is a protective factor against non-communicable diseases, there is an important proportion of the population who do not meet PA guidelines. Our aim was to investigate how adherence to PA guidelines varies across different age groups in the Chilean population. 5,133 participants from the 2009-2010 Chilean Health Survey were included in this study. PA was measured using the Global Physical Activity Questionnaire (GPAQ). Physical inactivity was defined as <600 MET/min/week of moderate to vigorous intensity PA. Logistic regression was used to investigate the association of PA with age. The main finding of this shows that women were more likely to be inactive than men (p<0.0001). Physical inactivity prevalence varied slightly between 20 and 59 years. However, among those individuals aged >60 years the prevalence increased markedly, reaching 63% and 56% for women and men aged >80 years, respectively. These findings confirm the necessity of promoting PA across the lifespan, but more importantly, these results suggest that more promotion and opportunities for engaging in PA should be created especially for older adults, who are more likely to be physically inactive.

RESUMEN A pesar de que la actividad física (AF) es un factor protector contra las enfermedades crónicas no transmisibles, un gran porcentaje de la población no cumple los niveles mínimos recomendados. El objetivo fue investigar como varían los niveles de práctica de AF entre los diferentes grupos etarios en la población chilena. Se incluyeron 5.133 participantes de la Encuesta Nacional de Salud 2009-2010. La AF fue determinada utilizando el cuestionario GPAQ. La inactividad física fue definida como <600 MET/min/semana de AF moderada a vigorosa. La asociación entre AF y edad fue investigada por sexo mediante regresión logística. Las mujeres presentaron una mayor probabilidad de ser físicamente inactivas en comparación a los hombres (p<0,0001). Al analizar la prevalencia de inactividad física por sexo y grupo etario, esta cambió ligeramente entre los 20 a 59 años, pero a partir de los 60 se observó un incremento importante en la prevalencia llegando a 63% y 56% para mujeres y hombres >80 años, respectivamente. Los resultados obtenidos confirman la necesidad de seguir fomentando la práctica regular de AF física a través de todo el ciclo vital, pero en especial sobre los 60 años, ya que este grupo presenta una mayor probabilidad de ser físicamente inactivo.

RESUMO Objetivo: Determinar a eficácia e segurança de hastes de crescimento no tratamento de escoliose em crianças menores de 10 anos. Métodos: Revisão retrospectiva de prontuários de pacientes menores de 10 anos com escoliose, tratados com hastes de crescimento entre 1997 e 2012. Resultados: Identificamos 35 pacientes, que foram tratados com hastes de crescimento, que satisfizeram os critérios de seleção. A idade média no início do tratamento foi de 5,9 ± 2,3 anos. A maioria dos pacientes (51,4%) apresentou escoliose de etiologia idiopática. A alteração radiográfica pré e pós-operatória mostra uma redução de 47,7% do ângulo de Cobb (p> 0,001). Foram identificados 8 pacientes com alguma complicação, sendo falha de instrumentação a mais prevalente (229%). O único fator preditivo para complicações pós-operatórias foi o número total de alongamentos realizados (OR = 7,03; IC95% [1,1-45,4]; p = 0,040). Conclusão: O tratamento para escoliose em pacientes com menos de 10 anos com hastes de crescimento alcançou uma redução significativa na magnitude da deformidade antes da fusão óssea final. No entanto, a frequência de complicações é bastante alta e, para isso, recomendamos reduzir ao mínimo a frequência de alongamentos, a fim de manter a correção e o crescimento longitudinal da coluna. Nível de Evidência IV; Série de casos.

ABSTRACT Objective: To determine the efficacy and safety of growing rods in the treatment of scoliosis in children aged under 10 years. Methods: A retrospective review of medical records of patients under 10 with scoliosis, treated with growing rods from the period between 1997 and 2012. Results: We identified 35 patients treated with growing rods who met the selection criteria. The average age at the start of treatment was 5.9 ± 2.3 years. Most of the patients (51.4%) showed idiopathic etiology scoliosis. Pre-surgery and post-surgery radiographic change showed a 47.7% reduction in Cobb angle (p>0.001). We identified 8 patients with some complication, the most prevalent being instrumentation failure (22.9%). The only predicting factor for post-operative complications was the total number of lengthenings performed (OR=7.03; CI 95% [1.1-45.4]; p=0.040). Conclusions: Treatment of scoliosis with growing rods in patients aged under 10 achieved a significant reduction in the magnitude of the deformity before final bone fusion. However, the rate of complications is rather high, therefore we recommend reducing the frequency of lengthenings to the minimum needed to maintain correction and longitudinal growth of the spine. Level of Evidence IV; Case series.

RESUMEN Objetivo: Determinar la eficacia y seguridad de las barras de alargamiento en el tratamiento de la escoliosis en niños menores de 10 años. Métodos: Revisión retrospectiva de registros médicos de pacientes menores de 10 años con escoliosis, tratados mediante barras de alargamiento entre 1997 y 2012. Resultados: Se identificaron 35 pacientes tratados con barras de alargamiento que satisfacían los criterios de selección. El promedio de edad al inicio del tratamiento fue de 5,9 ± 2,3 años. La mayoría de los pacientes (51,4%) tenían escoliosis de etiología idiopática. El cambio radiográfico prequirúrgico y postquirúrgico mostró reducción del 47,7% en el ángulo de Cobb (p > 0,001). Se identificaron 8 pacientes con alguna complicación, siendo el fallo del instrumental más prevalente (22,9%). El único factor predictor de complicaciones postoperatorias fue el número total de alargamientos realizados (OR = 7,03; IC 95% [1,1-45,4]; p = 0,040). Conclusiones: El tratamiento de la escoliosis con barras de alargamiento en pacientes menores de 10 años logró una reducción significativa de la magnitud de la deformidad antes de la fusión ósea definitiva. Sin embargo, la tasa de complicaciones es bastante alta, por lo cual se recomienda disminuir la frecuencia de alargamientos al mínimo necesario para mantener la corrección y el crecimiento longitudinal de la columna vertebral. Nivel de Evidencia IV; Serie de Casos.

RESUMO Objetivo: Os tratamentos cirúrgicos tradicionais, como a fusão no local e o hemiepifisiodese, não abordam a deformidade torácica em suas três dimensões e, em geral, revelam-se insuficientes e imprevisíveis para o tratamento da escoliose congênita e neuromuscular. A aplicação de Rib Vertical de Titânio Protético Expansível (VEPTR) é uma técnica desenvolvida para tratar a escoliose progressiva de início precoce, que alonga a parede da coluna e do tórax, permitindo um desenvolvimento pulmonar adequado. Métodos: Foi realizado um estudo retrospectivo de série de casos. Foram incluídos 23 pacientes, incluindo quinze mulheres e oito homens diagnosticados com escoliose congênita e neuromuscular, que foram tratados com implantes do tipo VEPTR entre janeiro de 2008 e maio de 2014. Foram obtidos dados sobre o implante; imagens radiográficas pré e pós-operatórias para avaliar a magnitude da curva e medimos o ângulo de Cobb e o comprimento após o alongamento, assim como avaliamos as complicações encontradas. Resultados: Melhora no ângulo pós-operatório de Cobb. Nos pacientes com escoliose congênita, a correção da deformidade foi de 8,6% (p = 0,014), e na escoliose neuromuscular observamos uma correção da deformidade de 19,5% (p = 0,009). Da mesma forma, encontramos ganhos na altura torácica através do dispositivo, o que resulta em uma média de 10% de alongamento da coluna vertebral na escoliose congênita. Neste estudo, identificamos complicações como migração de material, sinostose de costelas, zonas de pressão, fratura de costela, hemotórax e infecção profunda da ferida. Conclusão: A história natural da deformidade da coluna vertebral progressiva melhorou na maioria dos menores, através do uso de VEPTR. Isso nos permite continuar administrando pacientes no futuro, a fim de fazer uma avaliação mais profunda de seu desempenho no tratamento da escoliose de início precoce. Nível de evidência III; Estudos terapêuticos - Investigação dos resultados do tratamento.

ABSTRACT Objective: Traditional surgical treatments, such as on-site fusion and hemiepiphysiodesis, have not addressed chest deformity in its three dimensions, and are usually insufficient and unpredictable for the management of congenital and neuromuscular scoliosis. The application of the Vertical Expandable Prosthetic Titanium Rib (VEPTR) is a technique developed to treat early-onset progressive scoliosis that elongates the spine and thoracic wall, allowing adequate lung development. Methods: A case series retrospective study was conducted. We included 23 patients, including fifteen females and eight males diagnosed with congenital and neuromuscular scoliosis, who were treated with VEPTR type implants between January 2008 and May 2014. We obtained data about the implant and pre and postoperative radiographic images to assess the magnitude of the curve, and we measured the Cobb angle and length after lengthening, as well as evaluating the complications found. Results: There was an improvement in the postoperative Cobb angle. In patients with congenital scoliosis, deformity correction was 8.6% (p=0.014), and in neuromuscular scoliosis, we observed deformity correction of 19.5% (p=0.009). Likewise, we found gains in thoracic height through the device, which results in an average 10% lengthening of the spine in congenital scoliosis. In this study, we identified complications such as material migrations, rib synostosis, pressure zones, rib fracture, hemothorax, and deep wound infection. Conclusion: The natural history of progressive spinal deformity was improved in most of the minors, through the use of VEPTR. This allows us to continue managing patients in the future, in order to make a deeper assessment of its performance in treatment of early onset scoliosis. Level of Evidence III; Therapeutic studies - Investigating the results of a treatment.

RESUMEN Objetivo: Los tratamientos quirúrgicos tradicionales, como la fusión in situ y la hemiepifisiodesis no abordan la deformidad torácica en sus tres dimensiones y, en general, resultan insuficientes e impredecibles para el tratamiento de la escoliosis congénita y neuromuscular. El uso del sistema VEPTR (prótesis vertical expansible de titanio) es una técnica desarrollada para tratar la escoliosis progresiva de inicio temprano alargando la pared de la columna y del tórax, que permite el desarrollo pulmonar adecuado. Métodos: Se realizó un estudio retrospectivo de serie de casos. Se incluyeron 23 pacientes, quince mujeres y ocho hombres con diagnóstico de escoliosis congénita y neuromuscular, tratados con implante tipo VEPTR entre enero de 2008 y mayo de 2014. Se obtuvieron datos sobre el implante e imágenes radiográficas pre y posoperatorias para evaluar la magnitud de la curva, y se midieron el ángulo de Cobb y la longitud luego del alargamiento, así como evaluamos complicaciones encontradas. Resultados: Se demostró mejoría en el ángulo de Cobb postoperatorio. En los pacientes con escoliosis congénita, la corrección de la deformidad fue del 8,6% (p = 0,014) y en la escoliosis neuromuscular, observamos corrección del 19,5% (p = 0,009). De la misma forma, encontramos aumentos en la altura torácica con el dispositivo, lo que resulta en un alargamiento promedio del 10% de la columna vertebral en escoliosis congénita. En este estudio, identificamos complicaciones como migración de material, sinostosis de costillas, zonas de presión, fractura de costillas, hemotórax e infección profunda de la herida. Conclusión: La historia natural de la deformidad progresiva de la columna vertebral mejoró en la mayoría de los niños con el uso del VEPTR. Esto nos permite seguir tratando pacientes en el futuro, a fin de hacer una evaluación más profunda de su desempeño en el tratamiento de la escoliosis de inicio temprano. Nivel de evidencia III; Estudios terapéuticos - Investigación de los resultados del tratamiento.

Abstract Introduction: several public health programs are being implemented to combat childhood obesity in the world. However, the impact of Chilean Law n.o 20,606, which regulates the sale and advertising of foods high in critical nutrients ("Super 8 Law") about a critical period in the increase of body weight in schoolchildren, such as National Holiday (NH), has not yet been evaluated. Objective: establish the effect of NH on various body composition indicators before and after the implementation of the Super 8 Law. Methods: 110 schoolchildren between 10 and 13 years of age participated in this study, and 48 finished it after one year of follow-up (23 children and 25 girls). Body weight, body mass index (Zscore-BMI), triponderal mass index (TMI), fat mass index (FMI), percentage of fat mass and muscle mass during the four weeks of September 2015 (without law) and 2016 (with law). An ANOVA for repeated measures and adjusted for covariates was applied. Results: body weight (0.327 and 0.556 kg), Zscore-BMI (0.057 and 0.085) and fat percentage (0.1 and 0.9%) increased significantly during both NH (without and with law, respectively). Compared to 2015, FMI and TMI do not show significant increases during 2016, however, there are no significant differences in any of the variables studied after the implementation of the law. Conclusion: despite observing slight advances in certain parameters of body composition between one year and another, the implementation of the Super 8 Law in Chile does not seem to generate a preventive effect during NH.

Resumen Introducción: diversos programas de salud pública están siendo implementados para combatir la obesidad infantil en el mundo. No obstante, el impacto de la Ley chilena n.o 20.606 que regula la venta y publicidad de alimentos altos en nutrientes críticos ("Ley Súper 8") sobre un periodo crítico en el aumento de peso corporal en escolares, como son las vacaciones de Fiestas Patrias (VFP) aún no ha sido evaluado. Objetivo: establecer el efecto de las VFP sobre diversos indicadores de composición corporal antes y después de la implementación de la Ley Súper 8. Metodología: participaron 110 escolares entre 10 y 13 años de edad y finalizaron 48 tras 1 año de seguimiento (23 niños y 25 niñas). Se evaluó el peso corporal, índice de masa corporal (Zscore-IMC), índice de masa triponderal (IMT), índice de masa grasa (IMG), porcentaje de masa grasa y masa muscular durante las 4 semanas del mes de septiembre de 2015 (sin ley) y de 2016 (con ley). Se aplicó un ANOVA para medidas repetidas y ajustada a covariables. Resultados: el peso corporal (0,327 y 0,556 kg), Zscore-IMC (0,057 y 0,085) y porcentaje de grasa (0,1 y 0,9%) aumentan significativamente durante ambas VFP (sin y con ley, respectivamente). En comparación a 2015, el IMG e IMT no muestran aumentos significativos durante 2016, sin embargo, no existen diferencias significativas en ninguna de las variables estudiadas tras la implementación de la ley. Conclusión: a pesar de observar ligeros avances en ciertos parámetros de composición corporal entre un año y otro, la implementación de la Ley Súper 8 en Chile no parece generar un efecto preventivo durante las VFP.

Background: Obesity and sedentary behavior are risk factors acting independently in the development of type 2 diabetes. Aim: To investigate whether the association between diabetes and obesity is modified by the levels of sitting time (ST) in the Chilean population. Material and Methods: We included 4,611 participants from the cross-sectional 2009-2010 Chilean National Health Survey in this study. Diabetes was determined as fasting glucose levels ≥126 mg/dl. Body mass index (BMI) and waist circumference (WC) were measured using standardized protocols. Sitting time was assessed using the Global Physical Activity Questionnaire. The association among diabetes, obesity and ST was determined using logistic regression. Results: The odds for diabetes increased by 3.1-fold in people with high levels of ST and obesity in comparison to those with low levels of ST and normal BMI (Odds ratio (OR): 4.17 [95% confidence intervals (CI): 2.87 to 6.05], P < 0.01). The odds for diabetes increased by 2.7- fold in highly sedentary subjects with central obesity (OR: 3.73 [95% IC: 2.61 to 5.33], P < 0.01) in comparison to those with low levels of ST and normal WC. Conclusions: Elevated levels of sitting time and obesity are associated with a higher odds of developing diabetes.

Background: A high percentage of Chilean university students are inactive. Aim: To determine differences in physical activity (PA) levels and energy expenditure in a group of university students according to their length of stay in the university. Material and Methods: We studied 56 students aged 22 ± 2 years (29 women). They wore a triaxial accelerometer during seven days, determining steps/day, steps/min, sedentary time and PA levels. Participants also answered a PA questionnaire. Their weight and height were measured. They were divided in two groups according to the time spent at university (1-2 years and 3-5 years). Results: No significant differences in energy expenditure were observed between both groups of students. The number of steps/day and steps/ min was significantly higher in the group with 3 to 5 years in the university than their counterparts with 1-2 years. Conclusions: As the university years increase, there is a tendency to increase the time spent walking (18.3%) but without an increase in the moderate-vigorous PA.