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Background: The CLOCK (circadian locomotor output cycle kaput) gene is a central regulator of circadian rhythm. The CLOCK gene has been related to energy intake and therefore to nutritional status. However, its specific associations with aspects of food behaviour in children have been scarcely investigated.Aim: To determine the association between the CLOCK gene polymorphism 3111 T > C and eating behaviours in children based on nutritional status.Methods: A cross-sectional study of the association between a CLOCK gene variant and eating behaviour in children (n = 256) was performed. Eating behaviour was evaluated by the Child Eating Behaviour Questionnaire (CEBQ). In addition, the genotype of the CLOCK 3111 T > C (TT, CC, TC) gene polymorphism and BMI were determined.Results: The obese carriers of the C allele of the polymorphism had lower scores in the dimensions "response to satiety" and "slowness to eat" (p < 0.001), both of which constitute an anti-intake dimension and are related to food satiety.Conclusions: The C allele CLOCK gene could be considered a genetic risk factor for satiety-altered eating behaviour dimensions.

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The toxin-antitoxin (TA) systems are operons involved in the formation of persistent cells and in stress situations in microorganism. TA systems are widely distributed in Mycobacterium tuberculosis (MTB). The objective of this study was to determine the distribution and variability of protein sequences of TA systems in seven MTB lineages. Protein prediction on 73 genomes of different lineage was made using Prodigal, and profile hidden Markov models (PHMMs) of 225 reference TA proteins were constructed with HMMER. An homology search was made comparing the predicted proteins to PHMMs. Consecutive proteins that matched PHMMs (forming an operon) were selected. Thereafter, clustering of orthologous genes was made for further mutation scanning through multiple alignments. All proteins found belong to TA types II and IV, and 45 proteins were found completely conserved. Six uncharacterized antitoxins homologous to VapB11, VapB5, VapB45, VapB13, ParD1 and RelB were found. Multiple alignments revealed differences among lineages with specific mutations suitable for genotyping. Significant changes in amino acid sequences caused by frameshift mutations were found in 46 TA proteins.

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INTRODUCCIÓN El tratamiento de la apendicitis aguda por vía laparoscópica reduce el riesgo de infección de la herida operatoria, disminuye el tiempo de hospitalización y acelera el retorno a las actividades. Sin embargo, aumenta el riesgo de infecciones intraabdominales, lo cual constituye uno de las principales riesgos del tratamiento quirúrgico laparoscópico de la apendicitis complicada. MÉTODOS Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES Identificamos seis revisiones sistemáticas que en conjunto incluyen 55 estudios primarios, de los cuales, cuatro corresponden a ensayos aleatorizados. Concluimos que la laparoscopía, en comparación con la cirugía abierta, probablemente disminuye el tiempo de estadía hospitalaria, y podría disminuir el riesgo de infección de la herida operatoria, pero no está claro si existen diferencias en la incidencia de absceso intraabdominal porque la certeza de la evidencia es muy baja.

INTRODUCTION The treatment of acute appendicitis using laparoscopy reduces the risk of wound infection, hospitalization time and return to normal activity. However, it increases the risk of intra-abdominal abscess, which is one the main complications of complicated appendicitis. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified six systematic reviews including 55 studies overall, of which four were randomized trials. We concluded that the used of laparoscopy, compared to open appendectomy, probably reduces the time of hospital stay, and may reduce the risk of wound infection, but there's no clarity regarding the incidence of intra-abdominal abscess due to the very low certainty of the evidence available.

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El desarrollo fonético-fonológico es abordado de diferentes formas cuando se estudia el tema. Una de ellas se basa en el establecimiento de edades de adquisición de los fonemas de una lengua. Una revisión de la literatura al respecto evidencia que las distintas investigaciones en esta temática no siempre utilizan los mismos criterios en el análisis de los datos, en la selección de la muestra o en el juicio clínico para definir adquisición, entre otros puntos relevantes. Por esta razón, los objetivos del presente artículo son comparar distintos criterios de análisis y determinar de qué manera la elección de uno u otro influye en la edad de adquisición de los fonemas estudiados. Para llevar a cabo los objetivos, se evaluaron 84 niños de entre 3 años y 4 años 11 meses, organizados en cuatro grupos de 21 niños según rango etario. En todos ellos se evaluó la producción de los fonemas lateral / l / y róticos / ɾ / y / r / en distintos contextos fonológicos. Luego, a la muestra de fonemas obtenida, se le aplicaron los diferentes criterios que se pretendía comparar. Los resultados muestran que la edad de adquisición de los fonemas estudiados varía según el criterio utilizado, incluso en algunos casos existen al menos dos años de diferencia. A partir de los resultados, se discute la importancia de explicitar los criterios que se utilizan para estudiar edades de adquisición y, sobre todo, la implicancia que puede tener seleccionar uno u otro criterio en el ejercicio fonoaudiológico.

Phonological development is approached in different ways in the literature. One is based on the establishment of the age of acquisition of the phonemes of a language. A review of the literature showed that in this area researchers do not always use the same criteria in the analysis of data in the selection of the sample or clinical judgment to determine acquisition, among other important points. Therefore, the aim of this study is to compare different approaches and determine how the choice of one or the other influences the age of acquisition of the phonemes studied. To accomplish the objectives, 84 children aged between 3 and 4 organized into 4 groups of 21 children were evaluated according to age range. They were evaluated in the production of the lateral / l / and rhotic phonemes / ɾ / and / r / in different phonological contexts. Then different criteria were applied to the sample of obtained phonemes to compare them. The results showed that the age of acquisition of phonemes studied varies according to the criteria used, in some cases up to two years apart. From the results, there is a discussion of the importance of explaining the criteria used when considering the age of acquisition and especially the implications it may have when different criteria is chosen for a speech therapy exercise.

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Prenatal glucocorticoids, commonly used in women at risk of preterm delivery, can predispose the newborn to disease in later life. Since male reproductive function is likely to reflect testis development during fetal life, we studied the effects of prenatal glucocorticoids on two key intra-testicular factors that play roles in cellular proliferation and differentiation, 3ß-hydroxysteroid dehydrogenase (3ß-HSD) and inhibin-α. Pregnant sheep (n=42) were treated with betamethasone (0.5 mg/kg) or saline (control) at 104, 111 and 118 days of gestation (DG). Testicular tissue was sampled from fetuses at 121 and 132DG, and from lambs at 45 and 90 postnatal days (PD). Within the betamethasone treated group, 3ß-HSD immunostaining area was greater at 121DG than at 90PD (P=0.04), but the intensity of immunostaining was higher at 90PD than at 121DG (P=0.04), 132DG (P=0.04) and 45PD (P=0.03). Control animals showed no changes in 3ß-HSD area or intensity of immunostaining. No significant differences were observed between treated and control animals in immunostaining area, but immunostaining was more intense in the treated group than in the control group at 90PD (P=0.03). For inhibin-α, the proportion of immunostaining area declined in treated offspring from 121DG to 45PD, in contrast to control values, but recovered fully by 90PD, concomitantly with the onset of spermatogenesis. In conclusion, prenatal betamethasone increased the postnatal testicular expression of inhibin-α but reduced the expression of 3ß-HSD. These effects could compromise androgen-mediated testicular development and therefore adult capacity for spermatogenesis.

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La histerectomía afecta a un 20 por ciento de la población femenina en Chile; su mayor incidencia es en mujeres fértiles entre los 35-49 años. Esta cirugía, al poner fin a la vida reproductiva de la mujer, amenaza fuertemente su sentido de feminidad, puede provocar una alteración de la autoestima, disfunción de la relación de pareja, conflicto con el medio social, entre otros. La presente revisión pretende dar a conocer como la histerectomía afecta la calidad de vida y sus diferentes dimensiones en las usuarias, con el propósito de contribuir al conocimiento del tema y colaborar para un mejor enfrentamiento de estas usuarias. A pesar del impacto de la histerectomía en la calidad de vida de estas mujeres, son escasas las investigaciones que estudien dicha relación. Al comparar la calidad de vida entre mujeres sanas y mujeres histerectomizadas, estas tuvieron similares niveles de calidad de vida, en los dominios: funcionamiento físico, dolor corporal, funcionamiento sexual y dimensión psicológica. La mujer histerectomizada evidencia mejor calidad de vida que la mujer con trastornos ginecológicos, en los dominios anteriormente nombrados. Se concluye que la histerectomía por sí sola, no afecta la calidad de vida de estas mujeres, sin embargo, surge la necesidad de nuevas investigaciones sobre el tema. Al respecto cabe destacar la importancia en el apoyo y educación a la mujer sometida a este proceso quirúrgico.

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BACKGROUND: Among hypertensive patients, other risk factors for mortality and morbidity, besides blood pressure, must be considered when therapeutic decisions are done. AIM: To assess the incidence and relevance of cardiovascular risk factors in a cohort of patients with essential hypertension. MATERIAL AND METHODS: A cohort of 1,072 treated patients with essential hypertension was followed for a period up to 25 years. Four hundred eighty six were men and 586 were women, age ranged from 31 to 70 years. At entry, 56% of subjects did not have any organic complications associated to hypertension (stage I WHO criteria), 30% had mild alterations (Stage II) and 14% had major complications (myocardial infarction, stroke, heart failure or renal failure). Likewise, 43.8% had mild, 14.5%, moderate and 41.7%, severe hypertension. Patients were treated with monotherapy or combined therapy based on diuretics, beta blockers, calcium antagonists and angiotensin converting enzyme inhibitors. Goal of therapy was 140/90 mm Hg. Risk factors associated diseases and complications were registered carefully. Causes of death were obtained from hospital records and death certificates. Mortality was analyzed using life tables (intention to treat method included). RESULTS: Blood pressure dropped significantly during follow up from a mean of 182/110 to 154/92 mm Hg. During follow up, 143 patients died and 429 complications (lethal or non lethal) were recorded. Twenty four percent of patients smoked, 24% reported alcohol intake, 56% had hypercholesterolemia, 11% were obese, 13% had diabetes and 3% had gout. The proportional hazard model showed that the existence of previous complications, the presence of more than 3 risk factors, and age over 60 and mean systolic and diastolic pressure during therapy, were independent and significant risk factors for mortality. CONCLUSIONS: The incidence of risk factors among our hypertensive patients is very similar to that of other national or international cohorts.

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BACKGROUND: Acinetobacter baumannii is an important etiological agent causing nosocomial infections. High level of resistance for different kind of antimicrobials has been observed, including beta-lactam antibiotics. This feature, chromosomal or plasmid encoded, has been associated to integrons harbouring antibiotic resistance gene cassettes. AIMS: To investigate the presence of integrons among clinical isolates resistant to third generation cephalosporins (3GC). MATERIAL AND METHODS: One hundred A. baumannii strains isolated from several Chilean hospitals were included in this study. Minimal inhibitory concentrations (MIC) of 3GC by an agar dilution method were carried out. Integrons class 1, 2 and 3 were investigated by colony blot hybridisation and confirmed by PCR. RESULTS: High level of resistance to all assayed 3GC was observed. On the other hand, integrón class 2 was the most prevalent (77% of isolates) followed by integron class 1 (52%). Forty six percent of isolates hybridised with probes for both of them. However, no positive hybridisation was detected for integron class 3. CONCLUSIONS: Nevertheless, most isolates harboured one or both class of integron; there was no direct relationship between the presence of these genetic structures and the resistance to this kind of beta-lactam antibiotics.

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Se realizó una revisión de 32 historias clínicas de los pacientes admitidos en el Hospital Militar Central de las FF.AA. "Dr Carlos Arvelo", durante el período comprendido entre 1993-1997, con el diagnóstico de AS, el 47 por ciento de los casos tenían menos de 10 años, presentando con mayor frecuencia en el sexo masculino. Los principales signos y síntomas fueron dolor [94 por ciento], limitación funcional [91 por ciento], fiebre [78 por ciento], edema [59 por ciento], calor local [31 por ciento] y rubor [25 por ciento]. La afección se caracteriza por su presentación monoarticular [rodilla]. La fórmula y cuenta blanca, la VSG, la PCR, y el Gram del líquido sinovial resultó alterado en un alto porcentaje de los casos, pocas fueron las complicaciones y secuelas registradas, resaltando entre otras una necrosis avascular en un paciente incluido en el protocolo para artroplasia reconstructiva de cadera balante

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