Resumen: Objetivo: Caracterizar el comportamiento de COVID-19 en niños chilenos hospitalizados en unidades de paciente crítico pediátrico (UPCP) y evaluar factores de riesgo para COVID-19 severo. Pacientes y Método: Estudio multicéntrico cohorte prospectivo, pacientes 0-18 años con SARS-CoV-2 confirmado hospitalizados en UPCP. Se registraron variables clínicas, laboratorio, imagenológicas y terapéuticas. Se comparó “COVID-19 leve/moderado” versus “COVID-19 severo” utilizando mediana con rango intercuartil (RIC), test U Mann-Whitney, Test Fisher de dos colas y análisis multivariado binario forward para ajuste de variables para “COVID-19 severo”. Significativo p < 0,05. Resultados: 219 pacientes, 55,3% hombres, mediana edad 86 meses (RIC: 13,5-156). Comorbilidades principales: obesidad, enfermedades respiratorias. Mortalidad global: 3,6%. “COVID-19 severo” (26,5%) mostró más leucopenia, linfopenia, más inflamación y alteración de órganos (p < 0,05). También desarrolló más Sepsis/shock, SDRA y disfunción de órganos, requirió más terapia hemodinámica, antiinflamatoria, anticoagulación, antibioterapia, con mayor estadía en UPCP/hospitalaria (p < 0,05) y mortalidad de 13,8%. Factores de riesgo asociados a “COVID-19 severo”: shock al ingreso (aOR 28,44 [IC95%: 10,45-77,4]), obesidad (aOR 3,55 [IC95%: 1,3-9,6]), condensación (aOR 3,1 [IC95%: 1,1-8,7]), atelectasia (aOR: 8.7 [IC95%: 1,17-64,3]), corticoides dosis de estrés (aOR 7,7 [IC95%: 1,9-30,6]), antibioterapia precoz (aOR: 12,02 [IC95%: 1,11-130,02]), inmunodeficiencia adquirida/ congénita (aOR: 19,2 [IC95%: 1,19-321]) y patología oncológica (aOR: 10,7 [IC95%: 2,14-47,8]). Conclusión: En esta cohorte pediátrica chilena, el perfil de paciente que ingresó a UPCP fue de sexo masculino en edad escolar con comorbilidad asociada. Factores de riesgo asociados a COVID-19 severo fueron: presencia de comorbilidades (inmunodeficiencia adquirida/congénita, patología oncológica y obesidad), shock al ingreso y condensaciones en las imágenes radiológicas.

Abstract: Objectives: To characterize the COVID-19 disease profile in Chilean children hospitalized in pediatric intensive care units (PICU) and to evaluate risk factors associated with severe COVID-19. Patients and Method: A multicenter prospective cohort study with patients 0-18 years of age with confirmed SARS-CoV-2 hospitalized in PICU. Clinical, laboratory, imaging, and therapeutic variables were recorded. We compared ”mild/moderate COVID-19” with ’’severe COVID-19” using median with interquartile range (IQR), Mann-Whitney U test, two-tailed Fisher’s test, and forward binary multivariate analysis to adjust variables for “severe COVID-19”. A p < 0.05 was considered significant. Results: From 16 PICUs, 219 patients were recruited, 55.3% were male, with a median age of 86 months (IQR: 13.5-156). The most frequent comorbidities were obesity and respiratory diseases. Overall mortality was 3.6%. “Severe COVID-19” (26.5%) showed more leukopenia, lymphopenia, increased inflammatory parameters, and altered organ function (p < 0.05). It also developed more sepsis/shock, ARDS, and organ dysfunction, requiring more hemodynamic, anti-inflammatory, anticoagulation, and antibiotic therapy, with a longer stay in the PICU/hospital (p < 0.05), and 13.8% of mortality. Risk factors associated with “severe COVID-19” were shock on admission to the PICU [aOR 28.44 (95%CI 10.45-77.4)], obesity [aOR 3.55 (95%CI 1.3-9.6)], consolidation [aOR 3.1 (95%CI 1.1 -8.7)], atelectasis [aOR: 8.7 (95%CI 1.17-64.3)], stress dose of corticosteroids [aOR 7.7 (95%CI 1.9-30.6)], early antibiotic therapy [aOR: 12.02 (95%CI 1.11-130.02)], acquired/congenital immunodeficiency [aOR: 19.2 (95%CI: 1.19-321)], and oncological pathology [aOR 10.7 (95%CI 2.14-47.8)]. Conclusion: In this Chilean pediatric cohort, most patients with COVID-19 admitted to de PICU were male, of school age, with associated comorbidity. Risk factors for developing severe COVID-19 were the presence of comorbidities such as acquired/congenital immunodeficiency, oncological pathology, and obesity, in addition to shock on admission and consolidations on X-rays.

Resumen Antecedentes: En los pseudoaneurismas infectados de arteria femoral asociados al uso de drogas intravenosas, la ligadura primaria para el tratamiento causa controversia, sin embargo, el territorio comprometido puede continuar irrigado por vías colaterales. Objetivo: Reportar la experiencia del manejo de pseudoaneurismas en un servicio de angiología y cirugía vascular. Métodos: Estudio observacional, descriptivo de una serie de casos. Resultados: Se reportan 15 pacientes, relación hombre: mujer 14:1, promedio de edad de 42 años. Siete (46.6%) con presentación de pseudoaneurisma femoral izquierdo, 5 (33.3%) de ellos con presentación de pseudoaneurisma femoral derecho, 2 (13.3%) con pseudoaneurisma humeral derecho y uno (6.6%) con pseudoaneurisma humeral izquierdo. En 12 se realizó exclusión del pseudoaneurisma con triple ligadura; y 3 pacientes fueron sometidos a revascularización. Conclusiones: En nuestra experiencia, la ligadura primaria sin revascularización tuvo incidencia de amputación baja y supervivencia alta de los pacientes afectados, siendo la claudicación la secuela más frecuente.

Abstract Background: In intravenous drug-infected femoral pseudoaneurysms, primary ligation for treatment is controversial, but the compromised territory can remain irrigated by collateral routes. Objective: To report the experience in the management of pseudoaneurysms in our angiology and vascular surgery service. Methods: Observational, descriptive study of a series of cases. Results: 15 patients are reported, male: female ratio 14:1, average age 42 years. Seven (46.6%) presented with a left femoral pseudoaneurysm, 5 (33.3%) presented with a right femoral pseudoaneurysm, 2 (13.3%) with a right brachial pseudoaneurysm, and one (6.6%) with a left brachial pseudoaneurysm. In 12, exclusion of the pseudoaneurysm was performed with triple ligation; 3 patients underwent revascularization. Conclusions: In our experience the primary ligature without revascularization has a low incidence of amputation and high survival of affected patients, being claudication the most frequent sequel.

Abstract: Objectives: To characterize the COVID-19 disease profile in Chilean children hospitalized in pediatric intensive care units (PICU) and to evaluate risk factors associated with severe COVID-19. Patients and Method: A multicenter prospective cohort study with patients 0-18 years of age with confirmed SARS-CoV-2 hospitalized in PICU. Clinical, laboratory, imaging, and therapeutic variables were recorded. We compared ”mild/moderate COVID-19” with ’’severe COVID-19” using median with interquartile range (IQR), Mann-Whitney U test, two-tailed Fisher’s test, and forward binary multivariate analysis to adjust variables for “severe COVID-19”. A p < 0.05 was considered significant. Results: From 16 PICUs, 219 patients were recruited, 55.3% were male, with a median age of 86 months (IQR: 13.5-156). The most frequent comorbidities were obesity and respiratory diseases. Overall mortality was 3.6%. “Severe COVID-19” (26.5%) showed more leukopenia, lymphopenia, increased inflammatory parameters, and altered organ function (p < 0.05). It also developed more sepsis/shock, ARDS, and organ dysfunction, requiring more hemodynamic, anti-inflammatory, anticoagulation, and antibiotic therapy, with a longer stay in the PICU/hospital (p < 0.05), and 13.8% of mortality. Risk factors associated with “severe COVID-19” were shock on admission to the PICU [aOR 28.44 (95%CI 10.45-77.4)], obesity [aOR 3.55 (95%CI 1.3-9.6)], consolidation [aOR 3.1 (95%CI 1.1 -8.7)], atelectasis [aOR: 8.7 (95%CI 1.17-64.3)], stress dose of corticosteroids [aOR 7.7 (95%CI 1.9-30.6)], early antibiotic therapy [aOR: 12.02 (95%CI 1.11-130.02)], acquired/congenital immunodeficiency [aOR: 19.2 (95%CI: 1.19-321)], and oncological pathology [aOR 10.7 (95%CI 2.14-47.8)]. Conclusion: In this Chilean pediatric cohort, most patients with COVID-19 admitted to de PICU were male, of school age, with associated comorbidity. Risk factors for developing severe COVID-19 were the presence of comorbidities such as acquired/congenital immunodeficiency, oncological pathology, and obesity, in addition to shock on admission and consolidations on X-rays.

Resumen: Objetivo: Caracterizar el comportamiento de COVID-19 en niños chilenos hospitalizados en unidades de paciente crítico pediátrico (UPCP) y evaluar factores de riesgo para COVID-19 severo. Pacientes y Método: Estudio multicéntrico cohorte prospectivo, pacientes 0-18 años con SARS-CoV-2 confirmado hospitalizados en UPCP. Se registraron variables clínicas, laboratorio, imagenológicas y terapéuticas. Se comparó “COVID-19 leve/moderado” versus “COVID-19 severo” utilizando mediana con rango intercuartil (RIC), test U Mann-Whitney, Test Fisher de dos colas y análisis multivariado binario forward para ajuste de variables para “COVID-19 severo”. Significativo p < 0,05. Resultados: 219 pacientes, 55,3% hombres, mediana edad 86 meses (RIC: 13,5-156). Comorbilidades principales: obesidad, enfermedades respiratorias. Mortalidad global: 3,6%. “COVID-19 severo” (26,5%) mostró más leucopenia, linfopenia, más inflamación y alteración de órganos (p < 0,05). También desarrolló más Sepsis/shock, SDRA y disfunción de órganos, requirió más terapia hemodinámica, antiinflamatoria, anticoagulación, antibioterapia, con mayor estadía en UPCP/hospitalaria (p < 0,05) y mortalidad de 13,8%. Factores de riesgo asociados a “COVID-19 severo”: shock al ingreso (aOR 28,44 [IC95%: 10,45-77,4]), obesidad (aOR 3,55 [IC95%: 1,3-9,6]), condensación (aOR 3,1 [IC95%: 1,1-8,7]), atelectasia (aOR: 8.7 [IC95%: 1,17-64,3]), corticoides dosis de estrés (aOR 7,7 [IC95%: 1,9-30,6]), antibioterapia precoz (aOR: 12,02 [IC95%: 1,11-130,02]), inmunodeficiencia adquirida/ congénita (aOR: 19,2 [IC95%: 1,19-321]) y patología oncológica (aOR: 10,7 [IC95%: 2,14-47,8]). Conclusión: En esta cohorte pediátrica chilena, el perfil de paciente que ingresó a UPCP fue de sexo masculino en edad escolar con comorbilidad asociada. Factores de riesgo asociados a COVID-19 severo fueron: presencia de comorbilidades (inmunodeficiencia adquirida/congénita, patología oncológica y obesidad), shock al ingreso y condensaciones en las imágenes radiológicas.

Abstract Background Skeletal muscle generates force and movements and maintains posture. Under pathological conditions, muscle fibers suffer an imbalance in protein synthesis/degradation. This event causes muscle mass loss and decreased strength and muscle function, a syndrome known as sarcopenia. Recently, our laboratory described secondary sarcopenia in a chronic cholestatic liver disease (CCLD) mouse model. Interestingly, the administration of ursodeoxycholic acid (UDCA), a hydrophilic bile acid, is an effective therapy for cholestatic hepatic alterations. However, the effect of UDCA on skeletal muscle mass and functionality has never been evaluated, nor the possible involved mechanisms. Methods We assessed the ability of UDCA to generate sarcopenia in C57BL6 mice and develop a sarcopenic-like phenotype in C2C12 myotubes and isolated muscle fibers. In mice, we measured muscle strength by a grip strength test, muscle mass by bioimpedance and mass for specific muscles, and physical function by a treadmill test. We also detected the fiber's diameter and content of sarcomeric proteins. In C2C12 myotubes and/or isolated muscle fibers, we determined the diameter and troponin I level to validate the cellular effect. Moreover, to evaluate possible mechanisms, we detected puromycin incorporation, p70S6K, and 4EBP1 to evaluate protein synthesis and ULK1, LC3 I, and II protein levels to determine autophagic flux. The mitophagosome-like structures were detected by transmission electron microscopy. Results UDCA induced sarcopenia in healthy mice, evidenced by decreased strength, muscle mass, and physical function, with a decline in the fiber's diameter and the troponin I protein levels. In the C2C12 myotubes, we observed that UDCA caused a reduction in the diameter and content of MHC, troponin I, puromycin incorporation, and phosphorylated forms of p70S6K and 4EBP1. Further, we detected increased levels of phosphorylated ULK1, the LC3II/LC3I ratio, and the number of mitophagosome-like structures. These data suggest that UDCA induces a sarcopenic-like phenotype with decreased protein synthesis and autophagic flux. Conclusions Our results indicate that UDCA induces sarcopenia in mice and sarcopenic-like features in C2C12 myotubes and/or isolated muscle fibers concomitantly with decreased protein synthesis and alterations in autophagic flux.

ABSTRACT: Our goal was to assess whether free-ranging foxes have been exposed to canine distemper virus (CDV) in the Araucanía region in Chile. The study was conducted at three sites in rural areas where free-ranging foxes were trapped and bled from 2009 to 2012. We sampled two species of foxes: the culpeo (Lycalopex culpaeus) (n=13) and the chilla (Lycalopex griseus) (n=14). A serum virus neutralization assay was used to detect the presence and magnitude of functional systemic antibodies to CDV. Overall, CDV seroprevalence in culpeo and chilla foxes was 7.7 and 21.4%, respectively. Exposure to CDV did not differ among the sites. Despite the relatively low seroprevalence found in free-ranging foxes, the presence of CDV-seropositive dogs previously reported in rural sites nearby, suggests a potential risk of pathogen spill over from domestic dogs to foxes in the area.

Resumen El objetivo del estudio fue caracterizar el nivel tecnológico (NT) de las unidades de producción (UP) de ganaderos de los distritos de desarrollo rural (DDR) 01 y 02 en Guerrero, México, y conocer su percepción sobre la transferencia de embriones (TE). Se estudiaron 31 UP de los DDR 01 (n = 16) y 02 (n = 15). La edad, escolaridad y experiencia (años) promedio de los productores fue 50.0 ± 11.4, 10.6 ± 1.4 y 24.5 ± 7.9, respectivamente (p < 0.05). El NT se determinó con base en sus variables técnico-productivas y se clasificó en bajo, medio y alto. Se obtuvo NT bajo, medio y alto en 37.5%, 43.8% y 18.8%, respectivamente, de las UP del DDR 01, así como 33.3%, 20.0% y 46.7%, respectivamente, de las del DDR 02 (p < 0.05). Los ganaderos de UP con NT alto tienen mejor percepción sobre la TE (7/10, 70%), comparados con los de UP de NT bajo (0/11, 0%) y medio (2/10, 20%). En conclusión, se observó mejor percepción sobre la TE a medida que aumenta el NT de la UP, independientemente del DDR.

Abstract The objective of the study was to characterize the technological level (TL) of production units (PU) belonging to cattle producers from the rural development districts (RDD) 01 and 02 in Guerrero, Mexico, and to know their perception about embryo transfer (ET). Thirty-one PU from RDD 01 (n = 16) and 02 (n = 15) were studied. The average age, education, and experience (years) of the producers were 50.0 ± 11.4, 10.6 ± 1.4, and 24.5 ± 7.9, respectively (p < 0.05). The TL was determined based on the technical-productive variables of the PU and was classified as low, medium, and high. Low, medium, and high TL was obtained in 37.5%, 43.8%, and 18.8% of PU from RDD 01, respectively, as well as 33.3%, 20.0%, and 46.7% of PU from RDD 02, respectively (p < 0.05). Cattle producers from PU with high TL have better perception about ET (7/10, 80%), compared with those from PU with low (0/11, 0%) and medium (2/10, 20%) TL. In conclusion, better perception about ET was observed as the TL of the PU increases, independently of the RDD.

Resumen El águila real (Aquila chrysaetos) es una especie amenazada, considerada prioritaria para la conservación en México, donde es importante la prospección de nuevos territorios de anidación, y el seguimiento de la anidación. En este estudio, identificamos un nuevo territorio de anidación en el estado de Jalisco, México, y determinamos el estatus de ocupación, número de nidos y de individuos de águila real. Las observaciones se realizaron en 2015, 2021 y 2022, en el Cañón El Espía, situado en los límites de Ojuelos de Jalisco y Lagos de Moreno, Jalisco. En este periodo, observamos a cinco individuos de águila real, entre adultos e inmaduros. Cada año una pareja anidó, aunque la pareja del 2015 no fue la misma del 2021 y 2022. La productividad de anidamiento fue de 0.333 volantones/ nido. Notamos un recambio de individuos adultos por inmaduros, que sugiere una elevada mortandad de individuos de águila real y pudo provocar la baja productividad observada. La persecución por ganaderos y conflicto con los parques eólicos, son dos amenazas potenciales hacia los individuos de águila real presentes en el territorio de anidación descubierto. Nuestro hallazgo es relevante para la conservación del águila real en el estado de Jalisco.

Abstract The Golden Eagle (Aquila chrysaetos) is a threatened species, considered of conservation priority in Mexico, where prospection of new nesting territories, and nest studies are of importance. In this study, we identified a new nesting territory in the State of Jalisco, Mexico, and determined occupancy, number of nests and number of Golden Eagles. Observations were carried out in 2015, 2021 and 2022 in Cañón El Espía, at the Ojuelos de Jalisco-Lagos de Moreno border. In this period, we observed five Golden Eagles, including adults and immatures. Each year a breeding pair nested in the canyon, although the nesting pair in 2015 was not the same as that in 2021 and 2022. Nesting productivity was 0.333 fledglings/nest. We noted turnover of adult individuals replaced by juveniles that may indicate high Golden Eagle mortality, and could provoke the low productivity observed. Persecution by cattle ranchers and conflict with wind farms are two potential threats to Golden Eagles in this newly discovered nesting territory. Our findings are of relevance for conservation of the Golden Eagle in the state of Jalisco.

Resumen Introducción: Los medicamentos antiulcerosos son utilizados frecuentemente en pacientes hospitalizados, sin embargo, a menudo este uso no está indicado. Objetivo: Describir la frecuencia de prescripción e indicación de medicamentos para prevenir el sangrado gastrointestinal en pacientes hospitalizados. Materiales y métodos: Estudio de corte trasversal, descriptivo, prospectivo del servicio de Medicina Interna de la Sociedad de Cirugía de Bogotá- Hospital de San José de Bogotá, Colombia. Se excluyeron pacientes con diagnóstico de sangrado gastrointestinal o antecedente de alergia a los medicamentos antiulcerosos. Se recolectaron datos demográficos, así como fármacos prescritos. Se determinó si la indicación del fármaco era adecuada y se identificó el tipo de error de prescripción. Resultados: Se incluyeron 179 pacientes, 102 (57%) mujeres. Promedio de edad de 61,3 años (±20,2). El principal diagnóstico de ingreso fue enfermedad infecciosa 76 (42,4%). Del total de pacientes, 165 (92,17%) recibieron medicamento para prevención del sangrado gastrointestinal. La indicación fue adecuada en 75 pacientes (41,89%). El error más frecuente fue el uso en pacientes de bajo riesgo de sangrado, 101 (97,1%). Conclusión: Un alto porcentaje de los pacientes recibió medicación para la prevención del sangrado gastrointestinal. En aproximadamente la mitad de estos no estaba indicada.

Abstract Introduction: Anti-ulcer medications are frequently used in hospitalized patients, yet their use is not usually indicated. Objective: To describe the frequency of prescription and indication of medications to prevent gastrointestinal bleeding in hospitalized patients. Materials and methods: A cross-sectional, descriptive, prospective study was carried out in the Internal Medicine service of the Surgery Society of Bogota-San Jose Hospital of Bogota (Colombia). Excluded patients were those with either a gastrointestinal bleeding diagnosis or a history of allergy to anti-ulcer medications. Demographic data and information regarding prescribed medications were collected. It was determined whether the medicine indication was adequate and the type of prescription error was identified. Results: 179 patients were included in the study, 57% (102) of which were women. The average age was 61.3 (±20.2) years old. Infectious disease was the main admission diagnosis (76; 42.4%). A 92.17% (165) of the total number of patients received medications to prevent gastrointestinal bleeding. This indication was adequate for 75 (41.89%) patients. The most frequent error was their use in bleeding low-risk patients (101; 97.1%). Conclusion: A high percentage of patients received medication to prevent gastrointestinal bleeding. However, in about half of these patients it was not indicated.

Abstract: Respiratory conditions are the most common reason for admission to the neonatal unit for both term and premature newborns. It is known that nutritional imbalances during pregnancy affect the maturation and functional capacity of organs. Objective: to describe the pulmonary histomorphology of newborn rats due to maternal sugar intake by light microscopy. Material and Method: Twenty 4-week-old female Wistar rats divided into control and experimental groups with sucrose before and during pregnancy were used. At week 15, the females mated with males overnight. We recorded va lues from the body and lung weight of the newborns. The lungs were stained using Hematoxylin and Eosin, Masson’s trichrome, Periodic acid-Schiff, and Verhoeff. Results: Newborns from the experi mental group presented significantly lower body and lung weight (6.980 ± 0.493* g, 0.164 ± 0.022* g; *p < 0,05) compared with controls (7.854 ± 0.497 g, 0.189 ± 0.005 g). The lungs of the experimental group showed structural alterations in the lung parenchyma, as well as changes in glycogen deposits, collagen fibers, and elastin compared with the control group. Conclusion: Alterations in newborn lung growth and development are associated with maternal sucrose intake. It is important to re member that interventions on the maternal diet have beneficial effects for both the mother and the newborn.

Resumen: Introducción: Las afecciones respiratorias son el motivo más común de ingreso a la unidad neonatal tanto de recién nacidos a término como en prematuros. Los desequilibrios nutricionales durante la gestación reper cuten en la maduración y capacidad funcional de órganos. Objetivo: Describir la histomorfología pulmonar de rata recién nacida por ingesta materna de azúcar mediante microscopía óptica. Material y Método: Se utilizaron 20 ratas wistar hembras de 4 semanas de edad divididas en grupo control y experimental con sacarosa antes y durante el embarazo. En la semana 15 las hembras se aparearon con machos durante la noche. Registramos peso corporal y pulmonar de los recién nacidos. Los pulmones se tiñeron con hematoxilina y eosina, tricrómico de Masson, ácido periódico de Schiff y Verhoeffe. Resultados: Los recién nacidos del grupo experimental, fueron de menor peso corporal y pulmonar (6,980 ± 0,493* g; 0,164 ± 0,022* g; * p < 0,05) que del grupo control (7,854 ± 0,497 g; 0,189 ± 0,005 g). Los pulmones del grupo experimental mostraron alteraciones estructurales en el parénquima pulmonar, así como cambios en depósitos de glucógeno, fibras de colágeno y elastina comparado con el control. Conclusión: En el presente estudio demostramos que, las alteraciones en el crecimiento y desarrollo pulmonar del recién nacido están asociadas con la ingesta materna de sacarosa.

Abstract Hansen’s disease or leprosy is a chronic infectious disease caused by Mycobacterium leprae, mainly affecting the skin and peripheral nerves. In recent years, a better control of the disease has been achieved globally. However, in Chile the incidence of leprosy has continued to increase. We present a case of a 40-year-old patient Haitian nationality with lesions and histopathology compatible with tuberculoid leprosy. We discuss the importance of education on less prevalent diseases in Chile, in conjunction with a review of the pathophysiology, clinic, and classification of Hansen’s disease.

Resumen La enfermedad de Hansen o lepra es una enfermedad infecciosa crónica causada por Mycobacterium leprae, y que afecta principalmente la piel y nervios periféricos. En los últimos años, se ha logrado un mejor control de la enfermedad en forma global. Sin embargo, en Chile la incidencia de la lepra ha ido en aumento. Presentamos el caso clínico de un paciente de 40 años, haitiano, con lesiones e histopatología compatibles con una lepra tuberculoide. Se discute la importancia en la educación sobre enfermedades menos prevalentes en Chile y se hace una revisión sobre la fisiopatología, clínica y clasificación de la enfermedad de Hansen.

Resumen La canasta básica es un indicador importante de los ingresos de los habitantes de un país, que consiste en un el conjunto de alimentos que permiten cubrir las necesidades básicas de las familias. En el presente trabajo de investigación se realizó un estudio de la evolución del costo de la canasta básica en Ecuador durante el periodo 2000 - 2019. Fueron examinados cinco periodos presidenciales para determinar de qué manera las políticas económicas y sociales implementadas, así como aquellos factores que pudieron influir en el precio de los productos que componen la canasta básica; corresponde a una investigación de tipo documental, considerando el método analítico - sintético. En la última década, estadísticamente se demuestra un incremento en el ingreso de las familias y en el mejoramiento de su calidad de vida, pero es necesario destacar que gran parte de la población económicamente activa en el Ecuador, no tiene ingresos económicos estables y por lo tanto, no puede acceder al conjunto total de productos que la componen. Los resultados demuestran que después de la dolarización, el país entró en cierto periodo de estabilización de los precios, influenciado por las decisiones de política económica y social de cada régimen presidencial. Las conclusiones que se obtienen del presente estudio evidencian que, gran parte de la población económicamente activa en el Ecuador no tiene ingresos económicos estables y por lo tanto, no puede acceder a este conjunto de producto.

Abstract The market basket is an important indicator of the income of the inhabitants of a country, which consists of a set of foods that allow covering the basic needs of families. The present research work studied the evolution of the cost of the market basket in Ecuador during the period 2000 - 2019. Five presidential periods were examined to determine how the economic and social policies implemented, as well as those factors that may have influenced the price of the products that make up the market basquet; corresponds to a documentary type investigation, considering the analytical method -synthetic. In the last decade, statistically, there has been an increase in family income and an improvement in their quality of life, but it should be noted that a large part of the economically active population in Ecuador does not have a stable income and therefore cannot access the total set of products that make up the market basket. The results show that after dollarization the country entered a certain period of price stabilization influenced by the economic and social policy decisions of each presidential regime.The conclusions obtained from the present study analyzed, a large part of the economically active population has not had a stable economic income and therefore has not been able to access to this consumer goods.

ABSTRACT Forage-legume systems are a sustainable and competitive alternative for improving pasture yield and quality because of the symbiotic nitrogen fixation capacity and high nutritional value of legumes. This study aimed to evaluate the forage mass, nutritional value, and nutrient export rate in three forage systems (FS): FS1, with elephant grass (Pennisetum purpureum) (EG), annual ryegrass (Lolium multiflorum) (AR), and spontaneous growth species (SGS); FS2, with EG + AR + SGS + arrowleaf clover (Trifolum vesiculosum); and FS3, with EG + AR + SGS + forage peanut (Arachis pintoi ). The experiment was arranged in a completely randomized design, with three replicates, and repeated measures over time. Results of pre-grazing forage mass were 3.5, 3.8, and 3.9 t/ha, and crude protein export were 1.4, 2.1, and 2.3 t/ha, for the treatments FS1, FS2 and FS3, respectively. Highest crude protein, in situ dry matter digestibility and total digestible nutrients, and lowest neutral detergent fiber were found in the intercropping system with forage peanut, especially in winter. Nutritional values were also better in legume-systems than the non-legume system.

A doença de Chagas é uma doença parasitária (Trypanosoma cruzi), endêmica em 21 países da América e que as migrações a dispersaram em diferentes continentes. Uma das primeiras manifestações desta doença são as alterações disautonômicas ou disfunção autonômica. A gravidade desse funcionamento inadequado do sistema nervoso autônomo é mensurável, de modo que a evolução e/ou progressão da doença pode ser verificada alterando os estudos clínicos e detectando anticorpos antimuscarínicos. Esses anticorpos estão presentes em 30% dos infectados e aparecem muito cedo, uma vez instalada a parasitose; Além disso, outros estudos, como a dispersão do QT (> 65 mseg) e a variabilidade da freqüência cardíaca (<100 mseg), mostram valores anormais. A utilização de novos paradigmas de atendimento, diagnóstico e tratamentos adequados são essenciais para prevenir o desenvolvimento desta doença cardíaca.

Chagas disease is a parasitic disease (Trypanosoma cruzi), endemic in 21 countries of America and that migrations have dispersed it in different continents. One of the earliest manifestations of this disease is dysautonomic alterations or autonomic dysfunction. The severity of this inadequate functioning of the autonomic nervous system is measurable, so that the evolution and/or progression of the disease can be verified by altering clinical studies and detecting antimuscarinic antibodies. These antibodies are present in 30% of those infected and appear very early once the parasitosis is installed; In addition, other studies, such as QT dispersion (> 65 ms) and heart rate variability (<100 ms) show abnormal values. The use of new paradigms of care, diagnosis and appropriate treatments are essential to prevent the development of this heart disease.

La enfermedad de Chagas es una enfermedad parasitaria (Trypanosoma cruzi), endémica en 21 países de América y que las migraciones la han dispersado en distintos continentes. Una de las manifestaciones más precoces de esta enfermedad son las alteraciones disautonómicas o disfunción autonómica. La severidad de este inadecuado funcionamiento del sistema nervioso autónomo resulta mensurable, de modo que la evolución y/o progresión de la enfermedad puede constatarse mediante la alteración de estudios clínicos y detección de anticuerpos antimuscarínicos. Estos anticuerpos están presentes en un 30% de los infectados y aparecen muy precozmente una vez instalada la parasitosis; además otros estudios, como la dispersión del QT (>65 mseg) y la variabilidad de la frecuencia cardíaca (<100 mseg) presentan valores anormales. La utilización de nuevos paradigmas de atención, diagnóstico y tratamientos adecuados son imprescindibles para prevenir el desarrollo de esta cardiopatía.

RESUMEN Objetivo: evaluar el rendimiento diagnóstico de la tomografía abdominal sin medio de contraste oral en pacientes con dolor abdominal. Materiales y métodos: se incluyeron tomografías de pacientes con dolor abdominal entre el 1 de septiembre y 31 de diciembre del 2015 en el Hospital Universitario San Vicente Fundación. Se analizó el desempeño de las tomografías con o sin contraste oral y se consideró como prueba de referencia el resultado diagnóstico definitivo en la intervención quirúrgica o por diagnóstico clínico. Se calculó la sensibilidad, especificidad y los valores predictivos positivos y negativos con intervalos de confianza del 95 %. Resultados: fueron evaluadas un total de 128 tomografías de abdomen, 91 con contraste oral y 37 sin él. La tomografía sin contraste oral tuvo una sensibilidad y especificidad muy similar a la que sí lo tenía, con valores de 84 % y 91,6 %, respectivamente. Conclusión: el rendimiento global de la tomografía con contraste oral fue similar a la que no lo tenía, con valores cercanos al 90 %. La adquisición de la tomografía con contraste oral tomó casi 3 veces más tiempo que el requerido en los estudios sin contraste oral.

SUMMARY Objective: Evaluate the diagnostic performance of abdominal tomography without oral contrast medium in patients with abdominal pain. Materials and methods: Abdominal tomographies of patients with abdominal pain were included, between September 1 and December 31, 2015 at the Hospital Universitario San Vicente Fundación. For the analysis of the tomographies with or without oral contrast, the definitive diagnostic result in the surgical intervention or by clinical diagnosis was considered as a reference test. We calculated the sensitivity, specificity and positive and negative predictive values with their respective 95% confidence intervals for tomography with and without oral contrast. Results: 128 abdominal tomographies, 91 with oral contrast and 37 without this type of contrast were evaluated. The tomography without oral contrast had a sensitivity and specificity very similar to the tomography with contrast, with values of 84% and 91.6%, respectively. Conclusion: The performance of the tomography with oral contrast was similar to the tomography without oral contrast, with values close to 90%. The acquisition of tomography with oral contrast took almost 3 times longer than that required in the studies without oral contrast.

Abstract: When words become fashionable, their use modifies their meaning. By understanding this performative condition, this text analyzes the current implications of the concepts of sustainability, resilience, and integration. Then, it argues the need to overcome the neoliberal city if we want these meanings to become real.

Resumen: Cuando las palabras se ponen de moda, su uso modifica su significado. Asumiendo esacondición performativa, este texto analiza los significados actuales de sustentabilidad, resiliencia e integración. Así, argumenta que debemos superar la ciudad neoliberal para que los significados de estos conceptos se concreten.