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INTRODUCCIÓN: En diciembre de 2019 se reporta un brote de neumonía atípica causada por un nuevo coronavirus: SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus-2), cuya enfermedad se denomina COVID-19 (Coronavirus Disease 2019). Desde entonces su distribución se ha ampliado mundialmente causando una emergencia en los sistemas de salud. MÉTODO: Corresponde al reporte de caso clínico. Este estudio es descriptivo y se basa en el manejo realizado a paciente embarazada con COVID-19 confirmado. Esta publicación cuenta con la autorización del comité de ética local para la revisión de ficha clínica. CASO: Mujer de 40 años con un embarazo de 31 semanas, se le diagnostica COVID-19 tras contacto estrecho con caso confirmado. Evoluciona con disnea y por posibilidad de interrupción del embarazo se traslada a centro de mayor complejidad. Allí se pesquisa compromiso de función pulmonar, uso de musculatura accesoria y alteración sensorial, requiriendo oxigenoterapia. Se evalúa interdisciplinariamente decidiendo intubar y realizando manejo en unidad de cuidados intensivos (UCI). Se realiza cesárea de urgencia a las 31+4 semanas debiendo realizarse histerectomía total por inercia uterina. Tras el procedimiento evoluciona tórpidamente con deterioro de función pulmonar, describiéndose un pronóstico catastrófico con probabilidad de fallecer por insuficiencia respiratoria. Un mes después despierta con una mejoría en su función pulmonar, sin otra falla orgánica. Actualmente se encuentra en buenas condiciones y es tratada multidisciplinariamente para lograr una rehabilitación integral. DISCUSIÓN: En epidemias pasadas, las embarazadas mostraron altas tasas de letalidad y riesgo de ingreso a UCI. Basados en una revisión de reportes de casos, parece ser que COVID-19 durante el embarazo se asocia a morbilidad materna severa, riesgo que aumenta en mujeres con comorbilidades, lo cual hace cuestionarnos si la infección por COVID-19 intensifica el riesgo materno o estos casos ya eran embarazos de riesgo. Se necesitan futuras investigaciones al respecto.

INTRODUCTION: The coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, was first reported in december 2019 in China as an atypipical pneumonia. Since then its distribution has globally expanded causing a public health emergency. METHOD: Corresponds to a case report. A descriptive study about the management of a pregnant woman whith COVID-19. CASE: A 40 year old pregnant woman, 31 weeks gestational age, was admitted with a diagnosis of COVID-19. She developed dyspnea and preterm birth risk that needed a more complex hospital level. Thereafter, the patient developed respiratory distress, use of accessory breathing muscles and neurological alteration, requiring oxygen therapy. An interdisciplinary medical team evaluation decided to manage her condition at intensive care unit (ICU). Cesarean delivery was performed at 31+4 weeks. After the procedure, the pulmonary function declined to a life threatening condition. A month later, the patient woke up with improved pulmonary function, without any organ failure. Currently the patient is in a good general condition with a multidisciplinary rehabilitation treatment ongoing. DISCUSSION: In previous epidemic outbrakes, pregnant women presented high fatality rates and intensive care tratment risk. Based on a case report review, COVID-19 in pregnancy is associated with severe maternal morbidity, specially in women with associated comorbidities. This situation raises the question whether the COVID-19 infection intensifies the maternal risk or whether these cases were already a high risk pregnancies. Additional studies are needed to answer this issue.

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Introducción: Las intervenciones a nivel escolar constituyen una de las estrategias más importantes para enfrentar la obesidad en la población infantil. Objetivo: Determinar los cambios en los patrones de alimentación y estado nutricional en una intervención de 2 años de duración en alimentación saludable y actividad física en escolares. Sujetos y Método: Se intervinieron durante 2 años a 2.527 estudiantes de primero a cuarto básico de escuelas básicas de las comunas de Santiago Centro, Estación Central y Peñalolén, en Alimentación-Nutrición y Actividad física. A cada apoderado se le realizó una Encuesta de Frecuencia de Alimentos y a los escolares una evaluación antropométrica al inicio y final de la intervención. Resultados: De 2.527 estudiantes intervenidos finalizaron 1.453. La prevalencia de obesidad disminuyó de un 23,4 a 20,1%. Los escolares obesos incrementaron de forma significativa el consumo de frutas (p < 0,05), pescado (p < 0,01) y leguminosas (p < 0,05) y redujeron el consumo de bebidas gaseosas (p < 0,01) y pasteles/ dulces/chocolates (p < 0,01). Conclusión: Los resultados de este estudio demuestran que la intervención en los colegios en alimentación saludable y actividad física, puede mejorar el estado nutricional en escolares con sobrepeso y obesidad e incrementar el consumo de alimentos saludables.

Introduction: School interventions are one of the most important strategies to combat obesity in children. Objective: To determine changes in eating patterns and nutritional status after an intervention of two years long that promoted healthy eating and physical activity in school children. Subjects and Method: 2,527 students, between first and fourth grade, were intervened for two years in the districts of Santiago Centro, Estacion Central and Peñalolen regarding Food, Nutrition and Physical Activity. Each parent underwent a Food Frequency Survey and the students were anthropometrically assessed at the beginning and at the end of the intervention. Results: 1,453 out of 2,527 completed the whole process. The prevalence of obesity decreased from 23.4 to 20.1%. Obese schoolchildren significantly increased fruit consumption (p < 0.05), fish (p < 0.01) and legumes ( p < 0.05 ) and reduced the consumption of soft drinks (p < 0.01) and cakes/candy/chocolates (p < 0.01). Conclusion: The results of this study demonstrate that interventions in schools on healthy eating and physical activity can improve the nutritional status of obese and overweighed children and increase healthy food consumption.

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Cultivated grapevine (Vitis labrusca and V. vinifera) is of considerable economic importance to the Brazilian fruit industry for both fresh market consumption and for the production of wines, sparkling beverages, and juices. Black foot disease is caused by fungi of the genera Ilyonectria P. Chaverri & C. Salgado (anamorph: Cylindrocarpon Wollew.), Campylocarpon Halleen, Schroers & Crous, and Cylindrocladiella Boesew. In 2012, 4- to 40-year-old grapevines (Vitis spp.) showing reduced vigor, vascular lesions, necrotic root lesions, delayed budding, vine decline, and death were collected from seven locations at Rio Grande do Sul state, Brazil. Fungal isolations were made from root fragments and crown lesions (at least 2 cm above the bottom) on potato dextrose agar (PDA) medium added with 0.5 g L-1 streptomycin sulfate. Eight isolates were obtained and identified on the basis of morphological features and multi-gene analysis (rDNA-ITS, ß-tubulin, and histone H3) as Ilyonectria macrodidyma (Halleen, Schroers & Crous) P. Chaverri & C. Salgado. One representative isolate (Cy5UFSM) was used for more detailed morphological and molecular characterization, and pathogenicity confirmation. When incubated in the dark at 20°C for 7 to 10 days, colonies of felty straw-colored mycelium (3) 4.79 cm diameter on average were observed. No sporodochia or other fruiting bodies were produced on carnation leaf agar (CLA) medium after 30 days. Microconidia that were produced after 5 weeks on spezieller nährstoffarmer agar (SNA) medium with addition of two pieces of 1 cm2 filter paper showed ovoid and ellipsoid shape (6.4 × 3.6 µm) and one-septate macroconidia (17.3 × 4.1 µm). To confirm the species, primer pairs ITS1 and ITS4 (4); Bt2a and Bt2b; and H3-1a and H3-1b (2) were used to amplify the ITS1-5.8S rRNA-ITS2, part of the ß-tubulin and histone H3 genes, respectively. Sequences of these three regions showed 99, 100, and 100% of homology with I. macrodidyma, respectively. To confirm pathogenicity, 4-month-old rooted cuttings of V. labrusca cv. Bordô were inoculated by immersing them in a conidial suspension of the isolate (106 conidia ml-1) for 60 min (1). Thirty days later, inoculation was performed again by drenching the crown with 40 ml of 106 conidia ml-1 suspension to ensure infection of the roots. In the control treatment, plants were inoculated with sterile distilled water. Plants inoculated with I. macrodidyma showed necrosis of the leaf ribs, reduction in root mass, root and crown necrosis, browning of vessels, drying of shoots, and death. I. macrodidyma was re-isolated from the crown necrosis and vascular lesions, confirming Koch's postulates. To our knowledge, this is the first report of I. macrodidyma associated with black foot disease of grapevine in Brazil, which poses considerable threat to the industry unless management options are realized. References: (1) A. Cabral et al. Phytopathol. Mediterr. 51:340, 2012. (2) N. L. Glass et al. Appl. Environ. Microbiol. 61:1323, 1995. (3) R. W. Rayner. A Mycological Colour Chart. Commonwealth Mycological Institute and British Mycological Society, 1970. (4) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, CA, 1990.

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Since 1999, the decline of American grapevines (Vitis labrusca L.) has been common in Rio Grande do Sul, Brazil (1). In August 2012, V. labrusca with black foot symptoms were collected in vineyards in the Serra Gaúcha Region. Symptomatic plants had low vigor, vascular lesions, delayed budding, and decline and death of vines. Symptomatic roots had necrotic lesions and reduced biomass. Fungal isolations were made from necrotic root and crown fragments (own-rooted cultivar) on potato dextrose agar (PDA) medium amended with 0.5 g L-1 streptomycin sulfate. Putative colonies of "Cylindrocarpon" pauciseptatum Schroers & Crous were obtained from single macroconidia isolations. Two isolates were used to confirm the identity of isolated colonies: Cy12UFSM and Cy13UFSM. After incubation in the dark for 10 days at 20°C, the isolated mycelial colonies, which were cottony white to felty in texture, became dark orange to brown. Both isolates produced chlamydospores in chains at 40 days. Chlamydospores of Cy12UFSM and Cy13UFSM were 9 to 12 µm and 5 to 11.5 µm in diameter. Sporodochia formation on carnation leaf agar (CLA) medium was observed after 30 days. To encourage development of conidia, the isolates were grown on spezieller nährstoffarmer agar (SNA) medium for five weeks at 20°C with addition of two pieces of 1 cm2 filter paper. Microconidia of Cy12UFSM were 4 to 8.5 × 3.5 to 5 µm and those of Cy13UFSM were 3.5 to 7.5 × 3 to 5 µm. Macroconida were predominantly 3-septate (Cy12UFSM was 36 to 45 × 7.5 to 9 µm and Cy13UFSM was 30 to 38 × 7.5 to 8 µm), but 1-, 2- septate macroconidia were observed. The sizes of the three spore types and colony morphology for our isolates were similar to those described by Schroers et al. (3) for "C." pauciseptatum. To further confirm the identity of Cy12UFSM and Cy13UFSM, multi-gene DNA sequence analysis (rDNA-ITS, ß-tubulin, and histone H3) was conducted using primer pairs ITS1 and ITS4 (4), Bt2a and Bt2b, and H3-1a and H3-1b (2), which amplify the ITS1-5.8S rRNA-ITS2 genes, part of the ß-tubulin gene, and the histone H3 gene, respectively. Sequences of these three regions had 99, 99, and 97% similarity with references sequences of "C." pauciseptatum (isolate Cy238; accessions ITS [JF735307]; ß-tubulin [JF735435], and histone H3 [JF735582], respectively). To evaluate pathogenicity, 4-month-old rooted cuttings of V. labrusca cv. Bordô were inoculated with two isolates by immersing them in a conidial suspension (106 conidia ml-1) for 60 min. Ten single-vine replicates were used for each isolate, and 10 water-inoculated vines were included as controls. Thirty days after inoculation, vines were re-inoculated with 40 ml of a 106 conidia ml-1 suspension to ensure root infection. After 4 months, the inoculated plants had reduced root mass relative to controls (39.18% for Cy12UFSM and 18.27% for Cy13UFSM). Inoculated plants also had root and crown necrosis, vascular lesions, shoot decline, and vine mortality (60 and 80% mortality for Cy12UFSM and Cy13UFSM, respectively). All water-inoculated control plants remained symptomless. The fungi Cy12UFSM and Cy13UFSM were re-isolated from infected woody tissues, confirming Koch's postulates. To our knowledge, this is the first report of "C." pauciseptatum associated with black foot disease of grapevine in Brazil, which may potentially impact the sustainability of grapevine nurseries and vineyard productivity. References: (1) L. R. Garrido et al. Fitopatol. Brasil. 29:548, 2004. (2) N. L. Glass et al. Appl. Environ. Microbiol. 61:1323, 1995. (3) H. J. Schoers et al. Mycol. Res. 112:82, 2008. (4) T. J. White et al. Amplification Pages 315-322 in: PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, CA, 1990.

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Introducción: Las intervenciones a nivel escolar constituyen una de las estrategias más importantes para enfrentar la obesidad en la población infantil. Objetivo: Determinar los cambios en los patrones de alimentación y estado nutricional en una intervención de 2 años de duración en alimentación saludable y actividad física en escolares. Sujetos y Método: Se intervinieron durante 2 años a 2.527 estudiantes de primero a cuarto básico de escuelas básicas de las comunas de Santiago Centro, Estación Central y Peñalolén, en Alimentación- Nutrición y Actividad física. A cada apoderado se le realizó una Encuesta de Frecuencia de Alimentos y a los escolares una evaluación antropométrica al inicio y final de la intervención. Resultados: De 2.527 estudiantes intervenidos finalizaron 1.453. La prevalencia de obesidad disminuyó de un 23,4 a 20,1 por ciento. Los escolares obesos incrementaron de forma significativa el consumo de frutas (p < 0,05), pescado (p < 0,01) y leguminosas (p < 0,05) y redujeron el consumo de bebidas gaseosas (p < 0,01) y pasteles/dulces/chocolates (p < 0,01). Conclusión: Los resultados de este estudio demuestran que la intervención en los colegios en alimentación saludable y actividad física, puede mejorar el estado nutricional en escolares con sobrepeso y obesidad e incrementar el consumo de alimentos saludables.

Introduction: School interventions are one of the most important strategies to combat obesity in children. Objective: To determine changes in eating patterns and nutritional status after an intervention of two years long that promoted healthy eating and physical activity in school children. Subjects and Method: 2,527 students, between first and fourth grade, were intervened for two years in the districts of Santiago Centro, Estacion Central and Peñalolen regarding Food, Nutrition and Physical Activity. Each parent underwent a Food Frequency Survey and the students were anthropometrically assessed at the beginning and at the end of the intervention. Results: 1,453 out of 2,527 completed the whole process. The prevalence of obesity decreased from 23.4 to 20.1 percent Obese schoolchildren significantly increased fruit consumption (p < 0.05), fish (p < 0.01) and legumes ( p < 0.05 ) and reduced the consumption of soft drinks (p < 0.01) and cakes/candy/chocolates (p < 0.01). Conclusion: The results of this study demonstrate that interventions in schools on healthy eating and physical activity can improve the nutritional status of obese and overweighed children and increase healthy food consumption.

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La Organización del Trabajo se define como la forma en que el trabajo es diseñado y a los factores económicos que influyen en el diseño de éste. La teoría de rol y los principios de la comunidad ocupacional proveyeron el marco interpretativo para explorar cómo la organización del trabajo predice el estrés en los trabajadores de planta y subcontratados. Se realizó una encuesta a 451 trabajadores en 4 ciudades mineras del norte de Chile, más preguntas abiertas acerca de la percepción del trabajo. La serie de regresiones jerárquicas realizadas mostró que los factores de organización del trabajo asociados a roles explicaron la mayor varianza en el estrés. Respecto a las preguntas abiertas, los trabajadores valoraron la amistad como la principal fuente de bienestar y la falta de apoyo organizacional como la principal fuente de problemas. La diferencia de resultados entre grupos (planta y subcontratados) pone de relieve las inequidades sociales y laborales. Los programas de prevención de riesgos en este ámbito debieran considerar los principios de la comunidad ocupacional en los trabajadores de planta. Asimismo, se sugiere educar en organización del trabajo a los subcontratistas, para promover la salud ocupacional y la seguridad hacia estándares mínimos.

Work organisation refers to the way work is designed and managed, and to the economic factors that shape job design. Role theory and occupational community notions provided the framework for exploring how work organisation predicts work stress in staff and subcontractor groups in the mining industry. A survey was carried out on 451 workers in four Chilean mining cities to explore work organisation and stress issues. Open-ended questions about job perceptions were also asked. A series of hierarchical regressions showed that work organisation factors based on role relationships explain the main variance observed in strains and organisational hazards. Workers' opinions highlight work mates' friendship as the most important source of well-being, and lack of organisational support as the main source of problems. Differences between groups highlight social and work inequalities. Intervention programmes addressing work organisation and stress in this sector should consider occupational community principles for the staff group. Education in work organisation is recommended to raise occupational health and safety minimum standards in subcontractor companies.

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OBJECTIVE: To verify whether the long-term retention of an emotionally arousing story is stronger than the retention of a neutral story, and the enhancing effects of emotional arousal on declarative memory in Alzheimer's disease (AD) patients. METHOD: Twenty subjects (10 with AD and 10 controls matched for age and educational level) were studied. After the audiovisual presentation (neutral story), the subjects rated the narrative's emotionality. Later, they answered a multiple-choice questionnaire about the stories. Two weeks later, they watched the emotionally arousing story. RESULTS: Subjects who watched the emotionally arousing story assigned a score of emotionality higher than the subjects in the neutral group (P = 0.023). In addition, the participants remembered more details of the arousing story, and had a higher score in the questionnaire (P < 0.001). CONCLUSIONS: We demonstrated that an emotionally arousing content enhances long-term declarative memory in AD. Furthermore, present finding supports the use of this instrument for clinical and research purposes.

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El cuidado óptimo del paciente quirúrgico incluye el control del dolor postoperatorio, pero la incidencia de dolor postoperatorio moderado y severo sigue siendo alta. Las complicaciones relacionadas con el trauma quirúrgico y el dolor asociado a éste justifican un manejo enérgico. En 1988 Ready y col. describió el concepto de Servicio de Dolor Agudo (SDA) como una entidad multiprofesional dedicada a evaluar el dolor, administrar la analgesia y monitorizarla en el postoperatorio. En noviembre de 1996 y dependiendo del Departamento de Anestesiología se da inicio al Programa de Dolor Agudo (PDA) de Clínica Las Condes. Hasta noviembre del 2006 se han atendido 6.913 pacientes. Junto a los pacientes postquirúrgicos, el PDA recibe un número significativo de pacientes no quirúrgicos (15,2 por ciento). Nuestros resultados muestran una caída significativa del dolor a las 12 horas estabilizándose en EVA 2 y efectos colaterales bajos. La incidencia de complicaciones severas es muy bajo. 90 por ciento de los pacientes encuestados se mostraron satisfechos o muy satisfechos con la atención recibida.

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La bronquiolitis respiratoria es una lesión que se desarrolla en los pulmones de pacientes fumadores. Recientemente ha sido señalado que esta enfermedad puede evolucionar hacia la fibrosis pulmonar y se denomina Bronquiolitis Respiratoria-Fibrosis pulmonar. Histologicamente: La lesión se caracteriza por fibrosis peribronquiolar con macrófagos alveolares con un pigmento citoplasmático, finamente granular PAS positivo y Azul de Prusia débilmente positivo localizados en los espacios bronquiolares y alveolares, enfisema centrolobulillar e hiperplasia de neumocitos tipo II. A la ultraestrctura se observa en el citoplasma de los macrófagos alveolares intraluminales, fagolisosomas complejos que contienen un material amorfó electro-denso y particulas electrón lúcidas en forma de agujas conocidas como "inclusiones del fumador". Estudiamos tres (3) biopsias pulmonares con diagnóstico clínico de Enfermedad Pulmonar Intersticial. A través del estudio morfológico correlacionado con la clínica y la radiología concluimos que se trataba de una BR-FP. Enfatizamos la importancia de los criterios diagnósticos morfológicos y el diagnóstico diferencial de esta entidad, ya que se describe que tiene buena respuesta a la terapia con esteroides y al cese del hábito de fumar, por lo cual se considera de mejor pronóstico que otras enfermedades pulmonares intersticiales

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We report a 29 years old male, with a history of cocaine abuse and excessive alcohol intake, who was admitted to the hospital with an acute peritonitis. The patient was operated and multiple perforations of the cecum were found. A right hemicolectomy was performed and the pathological study of the surgical piece showed an ischemic colitis. A literature review reveals 22 reported cases of ischemic colitis associated to cocaine abuse

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