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Developing instruments to screen for relevant aspects of advanced illness is key to identifying palliative needs and evaluating the effectiveness of interventions in this population. The objective of this project is to validate the Death and Dying Distress Scale in Spanish (DADDS-Sp) for screening anxiety about death and evaluating psychometric properties for people with advanced cancer.DADDS is a 15-item self-administered questionnaire that assesses thoughts and feelings related to death and the process of dying. A cross-sectional, descriptive, psychometric validation study was conducted in two cancer centres in Santiago de Chile. Included were patients over 18 years of age with incurable and/or metastatic cancer, fluent in Spanish, and a life expectancy of more than 3 months. Reliability was analysed using Cronbach's alpha, and confirmatory factor analysis was performed following the model of the original scale.Seventy four patients participated in the study. The median age was 63 years. Of the sample, 59% identified themselves as women. On average, participants reported low anxiety about death (mean = 21, SD = 18). Women have more death anxiety. The reliability analysis yielded a value of α = 0.93 (IC = 0.91-0.95). Factor analysis with a one-factor structure yielded Comparative Fit Index (CFI) = 0. 0.972, Root Mean Square Error of Approximation (RMSEA) = 0.092, Standardized Root Mean Square Residual (SRMR) = 0.085 and Tucker-Lewis Index (TLI) = 0.968. The model with a two-factor structure yielded CFI = 0.989, RMSEA = 0.059, SRMR = 0.075 and TLI = 0.987, suggesting that the two-factor model has a better fit for the data studied.DADDS-Sp is psychometrically valid for use in a Spanish-speaking population, yielding high reliability and internal consistency. A majority of the Chilean patients reported a low level of anxiety about death although about 10% presented with severe anxiety, so their identification for adequate clinical management is fundamental.

El Análisis de Causa-Raíz (ACR) es una forma de estudio retrospectivo de eventos adversos destinado a detectar las causas subyacentes de los mismos para proteger a los pacientes mediante la modificación de los factores dentro del sistema de salud que los provocaron y prevenir sus recurrencias. Si bien esta concepción centrada en la seguridad del paciente ha visto un importante auge en la atención médica, la odontología no ha sido llevada de igual manera probablemente por presentar daños más leves, procedimientos ambulatorios (con la consiguiente falta de seguimiento de muchos eventos adversos) y prácticas fundamentalmente privadas (cuyos conflictos afectarían potencialmente los resultados comerciales). Dado que no hay precedentes en Chile, se presenta un evento adverso producido en la Clínica Odontológica Docente Asistencial de la Facultad de Odontología de la Universidad de La Frontera y su ACR, desarrollado como primera intervención del Centro Chileno para la Observación y Gestión del Riesgo Sanitario de esa institución. Se plantean las necesidades de implementar un sistema explícito de categorización de eventos adversos en esa disciplina y de apoyar políticas de cultura en seguridad para el paciente odontológico, y se discute el papel de las instituciones universitarias para reconocer las áreas de vulnerabilidad en sus clínicas y así reforzar y mejorar la calidad de sus prácticas sanitarias.

Odor transduction in the cilia of olfactory sensory neurons involves several ATP-requiring enzymes. ATP is generated by glycolysis in the ciliary lumen, using glucose incorporated from surrounding mucus, and by oxidative phosphorylation in the dendrite. During prolonged stimulation, the cilia maintain ATP levels along their length, by unknown means. We used immunochemistry, RT-PCR, and immunoblotting to explore possible underlying mechanisms. We found the ATP-shuttles, adenylate and creatine kinases, capable of equilibrating ATP. We also investigated how glucose delivered by blood vessels in the olfactory mucosa reaches the mucus. We detected, in sustentacular and Bowman's gland cells, the crucial enzyme in glucose secretion glucose-6-phosphatase, implicating both cell types as putative glucose pathways. We propose a model accounting for both processes.

La elección del material restaurador a usar, puede ser una decisión crítica, especialmente en pacientes pediátricos de alto riesgo cariogénico y corta edad, debido a que idealmente, las restauraciones debieran acompañar al diente primario a su exfoliación natural, por lo que la indicación debe estar estrechamente ligada al riesgo cariogénico del paciente. El objetivo de este trabajo fue determinar si hay diferencias en la indicación y sobrevida de los materiales de restauración utilizados en la clínica pediátrica. Se llevo a cabo un estudio observacional retrospectivo. Se seleccionaron 60 pacientes de un universo de 369, de entre 4 y 9 años de edad, atendidos en la clínica Docente Asistencial de La Universidad de la Frontera, durante el año 2010, que cumplieron con los criterios de inclusión de esta investigación: pacientes con alto riesgo cariogénico, molares primarios con tratamiento pulpar vital, restaurados con cemento de vidrio ionómero convencional, amalgama, resina compuesta o coronas de acero pediátricas. Para el análisis estadístico de los datos se utiliza el paquete estadístico Stata 8.0, realizándose un exploratorio de los datos, test de Fisher y el estimador de Kapan Meier para el análisis de sobrevida. Fueron estudiados 150 molares primarios de 60 pacientes, con una edad promedio de 6,8 años (DE±1,5 años). El tiempo de observación promedio fue de 10,4 meses (DE±3,7 meses). No se observó diferencias estadísticamente significativa entre los diferentes materiales de restauración, comparados entre si, excepto entre las amalgamas y los vidrios ionómeros (P=0,0510). El análisis de las tablas de sobrevida demuestra que la longevidad de las amalgamas y las coronas es similar, mientras que la restauración que presenta menor sobrevida son las realizadas con vidrio ionómeros.

The accounting professional in recent times, as a major player, has been questioned in the performance of his work and even frequently involved with corporate financial scandals, putting into question the social responsibility of his profession. However, here, the analysis of the accounting profession is directed specifically to watch the behavior of the accountant in a particular sector such as mining, mainly in relation to the advise in the exploitation of coal. This paper presents the results of the investigation on public accountants who provide advisory services to entrepreneurs in the mining sector. It inquires also on issues related to the level and quality of the advice that they provide in different topics such as economic, administrative , tax, labor , social and environmental issues in relation to the development of the activity. Similarly the accountant has an ethical commitment to both organizations and the different groups that are linked directly or indirectly to maintain balance in organizations through the provision of information to related parties on their rights that correspond to them in the development of the activity, and as an administrator and manager of information in decision-making contributes to the generation of the common welfare. Finally, the social responsibility of the public accountant goes beyond the commitment to the State and the organizations in which they work, because there is a commitment to other stakeholders including the environment and society.

Este artículo dedicado a Eduardo Caballero Calderón se aproxima a su obra ensayística tan poco estudiada y divulgada en el medio académico. Se hará una exploración descriptiva de sus juicios críticos más relevantes. Entre ellos asuntos tan diversos como la relación entre América y Europa, las situaciones políticas, económicas y culturales en Latinoamérica y Colombia, el tema de las regiones de Colombia y su geografía y, algunos tópicos de carácter filosófico. Se busca incitar en el ánimo del lector académico o desprevenido el interés por la lectura del género ensayístico que tan bien practicó el autor de El cristo de espaldas, su obra más reconocida.

ResumenObjetivoEvaluar la relación entre la lactancia materna (LM) y el desarrollo de enfermedades alérgicas (EA).DiseñoEstudio de casos y controles.EmplazamientoHospital Universitario de Santander, Bucaramanga, Colombia, América del Sur. Nivel II de atención.ParticipantesMil cuatrocientos sesenta niños entre 3 y 7 años asistentes a la consulta externa. Las mediciones principales fueron la proporción de LM y LM exclusiva (LME), la asociación entre la presencia de enfermedades alérgicas y la LM y la LME ajustando, mediante regresión logística, la confusión dada por otras exposiciones.ResultadosDe 1.460 pacientes, recibieron LME el 41,6% (intervalo de confianza [IC] del 95%: 39,0 a 44,2), mientras que al 44,4% (IC del 95%: 41,9 a 47,0) se les suministró LM no exclusiva. Entre quienes presentaron alergia, el 34,8% (IC del 95%: 32,4 a 37,3) refería rinitis, el 27,8% (IC del 95%: 25,6 a 30,2) refería asma y el 11,6% (IC del 95%: 10,0 a 13,4) refería dermatitis atópica; el 7,0% (IC del 95%: 5,1 a 9,3) presentaba las 3 condiciones. El lactar de manera exclusiva por 3 o más meses es factor protector para las EA (odds ratio [OR] de 0,70; IC del 95%: 0,48 a 1,03). El lactar menos de 3 meses, independientemente de si es de manera exclusiva o no, es factor de riesgo para las EA (OR de 2,05; IC del 95%: 1,47 a 2,86).ConclusionesLa recomendación de lactar exclusivamente el mayor tiempo posible sigue siendo válida al encontrarse un significativo impacto preventivo del tiempo de duración de la LM en el desarrollo de las EA. Es necesario realizar estudios prospectivos que incluyan pruebas de función pulmonar y análisis inmunológicos para confirmar estos hallazgos.AbstractObjectiveTo evaluate the relationship between breastfeeding and the development of allergic diseases (AD).DesignA cases-controls study.SettingSantander University Hospital, Bucaramanga, Colombia, South America. Level II health care.ParticipantsA total of 1460 boys and girls between 3 and 7 years old attending an outpatient clinic.Main measurementsPartial (BF) and exclusive breastfeeding (EBF); relationship between the presence of allergic diseases and BF and EBF, adjusting for the confounding factors due to other exposures using logistic regression.ResultsOut of a total of 1460 patients, 41.6% (95%CI 39.0–44.2) received EBF, while 44.4% (95%CI 41.9–47.0) were partially breastfed. Among those who had an allergy, 34.8% (95%CI 32.4–37.3) had rhinitis, 27.8% (95%CI 25.6–30.2) asthma and 11.6% (95%CI 10.0–13.4) atopic dermatitis; 7.0% (95%CI 5.1–9.3) had the three conditions. To breastfeed exclusively for ⩾3 months is a protective factor for AD (OR 0.70, 95%CI 0.48–1.03). Breastfeeding for 3 months, regardless of whether or not it is exclusive, is a risk factor for AD (OR 2.05, 95%CI 1.47–2.86).ConclusionsThe recommendation to exclusively breastfeed for as long as possible continues to be valid, as there was a significant preventive impact on the development of AD with the length of time breastfed. Prospective studies including lung function tests and immunological analyses need to be performed to confirm these findings.

Biochemical, serological and molecular properties of a group of 14 Vibrio ordalii strains isolated from cultured Atlantic salmon Salmo salar in Chile in recent years were studied. The charac- teristics of isolates were compared with the type strain V. ordalii ATCC 33509 T. The Chilean V. ordalii represented a biochemically homogenous group; however, some minor differences with the type strain were observed. The serological relationships among isolates, as well as the study of their anti- genic determinant (LPS) revealed a strong reaction with antisera raised against Atlantic salmon strains and the antiserum raised against Listonella anguillarum serotype O2. However, LPS elec- trophoretic patterns were completely different from the V. ordalii type strain, regardless of the serum employed, suggesting the possibility that the Chilean strains constitute a new serological subgroup within this bacterial species. Genetic analyses by PFGE, RAPD, REP-PCR and ERIC-PCR demon- strated that all V. ordalii strains were genetically homogenous, displaying similar DNA patterns, regardless of the techniques used. Moreover, the analysis of DNA banding patterns generated by ERIC-PCR and REP-PCR also clearly separated the type strain from the Chilean strains. This is the first report of characterization of V. ordalii strains from the Southeastern Pacific area, the results of which should facilitate the development of vaccines for protecting cultured Atlantic salmon against vibriosis in this area.

BACKGROUND Despite the increasing frequency of adenocarcinomas of the uterine cervix, little is known regarding inactivation of tumor suppressor genes (TSGs) in this tumor type. The authors analyzed loss of heterozygosity (LOH) in 36 carcinomas of the cervix with glandular differentiation, and 5 adenocarcinoma in situ in 40 patients. METHODS The authors analyzed samples using laser capture microdissection from archival material and DNA amplified with microsatellite markers on the following loci: 3p14.2 (D3S1234, D3S1300), 3p21.3 (D3S1029, D3S1447), 3p22-24 (D3S1537, D3S1351), 6q21-23.3 (D6S250), 6q25.1 (ESR), 6q25.2 (D6S255), 8p21 (D8S136, D8S1820), 13q12.3 (D13S220, D13S267), 17q21 (D17S579, D17S855). Eight additional markers spanning the short arm of chromosome 3 (3p12-p25) and six spanning the long arm of chromosome 6 (6q11-q27) were studied in the cases showing LOH to further define the deletion intervals. RESULTS The frequency of allelic loss in cancers was chromosome 3p: 49% (p14.2: 35%, p21.3: 23%, p22-24: 41%), 6q: 48% (q21-23.1: 39%, q25.1: 45%, q25.2: 7%), 13q: 22%, 17q: 6%, and 8p: 18%. On chromosome arm 3p, the authors' data suggest at least two discrete areas of deletion: a proximal area between markers D3S1234 (p12) and D3S1766 (p14.2-14.3), and a second distal interval, telomeric from marker D3S4623 (p21.3). On chromosome 6q, the deletion area is between marker D6S300 (q22) and D6S255 (q25.2). Two of five preneoplastic lesions showed LOH on chromosome arm 3p, and two five showed allelic loss on chromosome arm on 6q, suggesting the genes might be inactivated early in cervical tumorigenesis. CONCLUSIONS The authors have identified three chromosomal regions that may harbor TSGs involved in the development/progression of adenocarcinomas of the uterine cervix, 3p12-14.2, 3p21.3-pter, and 6q22-25.2. Deletions also were detected in adenocarcinoma in situ, suggesting the genes may be inactivated early in cervical tumorigenesis. Cancer 2002;94:793–802. © 2002 American Cancer Society. DOI 10.1002/cncr.10275

The metabolism of chloroguaiacols by a soil bacterium was studied. The strain was isolated by enrichment with guaiacol as the sole carbon and energy source, and identified as a Rhodococcus ruber CA16. None of seven chlorinated, guaiacols supported bacterial growth. However, ultraviolet spectroscopy chloride release, and oxygen consumption showed that resting cells grown on guaiacol degraded completely 4-chloroguaiacol 5-chloroguaiacol and 6-chloroguaiacol and, to a lesser extent, 4,5-dichloroguaiacol Gas chromatographic analysis suggested microbial formation of 4-chlorocatechol and 4,5-dichlorocatechol from 4-chloroguaiacol and 4,5-dichloroguaiacol, respectively. Although mono-and dichloroguaiacols did not affect the strain's ability to grow on guaiacol, chlorocatechols completely arrested growth. The role of chlorocatechols in chloroguaiacol metabolism by this guaiacol-degrading bacterial strain is discussed.

The metabolism of chlorinated guaiacols by a pure bacterial strain identified by its ability to use guaiacol as the sole carbon and energy source was studied. This strain, identified as Acinetobacter junii 5ga, was unable to grow on several chlorinated guaiacols and catechols. However, strain 5ga grown on guaiacol degraded 4- and 5-chloroguaiacol and 4,5-dichloroguaiacol. Under the same conditions, these cells did not degrade 6-chloroguaiacol, 4,6-dichloroguaiacol, 4,5,6-trichloroguaiacol, or tetrachloroguaiacol, suggesting that the substitution at the 6 position in the ring prevents metabolism of the compound. Degradation of 4-chloroguaiacol was dependent on the initial ratio between the chlorinated compound and viable cells. Transient formation of chlorocatechols resulting from incubation of cells with 4-chloroguaiacol or 4,5-dichloroguaiacol was suggested by UV spectroscopy. Gas chromatography analyses of samples from cultures of strain 5ga grown on guaiacol and incubated with 4- and 4,5-dichloroguaiacol confirmed the presence of 4-chlorocatechol and 4,5-dichlorocatechol, respectively. The formation of the latter was corroborated by gas chromatography-mass spectrometry. Thus, this strain is able to initiate metabolism of specific chlorinated guaiacols by O-demethylation. The starting chlorinated guaiacols and their O-demethylated metabolites inhibited the growth of A. junii 5ga on guaiacol.

La maloclusion representa un problema de salud publica en Chile. Politicas del Gobierno han creado programas preventivos e interceptivos para estas condiciones. Sin embargo, no existen criterios uniformes para la seleccion de los pacientes que necesitan tratamiento temprano, la decision es tomada por un especialista durante el tratamiento ortodoncico. Aqui, proponemos el indice de Intervencion Temprana (IIT) para la deteccion temprana de maloclusiones. Tratamos maloclusiones con un simple tratamiento de intercepcion para minimizar o eliminar la necesidad de un tratamiento de ortodoncia en una poblacion infantil. Ademas, el IIT puede ser utilizado en odontologia general como un metodo de tamizaje. El objetivo de este estudio fue comparar la confiabilidad y validez de un indice utilizado para evaluar la necesidad de un tratamiento de ortodoncia, en comparacion con la opinion de un panel de expertos formado por tres ortodoncistas. Se utilizo un conjunto de 55 modelos de estudio que representan todos los tipos de maloclusion. La precision del diagnostico o la validez de cada indice se ha calculado utilizando las opiniones de tres calificadores de ortodoncia como un "gold standard", estas medidas obtuvieron un acuerdo de 0,82. Las curvas de las caracteristicas operativas del receptor fueron trazadas para el indice. La precision diagnostica fue determinada por el area bajo la curva, el punto de corte fue de 20, la sensibilidad fue del 0,977 y la especificidad fue del 0,167. Este indice oclusal proporciono informacion valiosa para la seleccion de los ninos que necesitan un tratamiento de ortodoncia temprano y simple.

OBJECTIVE: To evaluate the relationship between breastfeeding and the development of allergic diseases (AD). DESIGN: A cases-controls study. SETTING: Santander University Hospital, Bucaramanga, Colombia, South America. Level II health care. PARTICIPANTS: A total of 1460 boys and girls between 3 and 7 years old attending an outpatient clinic. MAIN MEASUREMENTS: Partial (BF) and exclusive breastfeeding (EBF); relationship between the presence of allergic diseases and BF and EBF, adjusting for the confounding factors due to other exposures using logistic regression. RESULTS: Out of a total of 1460 patients, 41.6% (95%CI 39.0–44.2) received EBF, while 44.4% (95%CI 41.9–47.0) were partially breastfed. Among those who had an allergy, 34.8% (95%CI 32.4–37.3) had rhinitis, 27.8% (95%CI 25.6–30.2) asthma and 11.6% (95%CI 10.0–13.4) atopic dermatitis; 7.0% (95%CI 5.1–9.3) had the three conditions. To breastfeed exclusively for ⩾3 months is a protective factor for AD (OR 0.70, 95%CI 0.48–1.03). Breastfeeding for 3 months, regardless of whether or not it is exclusive, is a risk factor for AD (OR 2.05, 95%CI 1.47–2.86). CONCLUSIONS: The recommendation to exclusively breastfeed for as long as possible continues to be valid, as there was a significant preventive impact on the development of AD with the length of time breastfed. Prospective studies including lung function tests and immunological analyses need to be performed to confirm these findings.

Saccharomyces boulardii es una levadura recomendada para la prevención y el tratamiento de la diarrea. Se presentan los resultados de la comparación de la actividad relativa de varias presentaciones de esta levadura disponibles en Chile. La comparación se realizó midiendo: i) la rapidez de crecimiento en el producto suspendido en un medio de cultivo y ii) el número de células vivas después de re-hidratar los productos. En las diferentes experiencias, la presentación Perenteryl® mostró un crecimiento más rápido, alcanzando los valores máximos de concentración de células alrededor de tres a cinco horas antes que los otros productos. Aunque el número total de células fue prácticamente igual en todas las presentaciones, el número de células vivas fue muy superior en las presentaciones Perenteryl® Saccharomyces boulardii is a yeast employed in the treatment of diarrhea. We present here the results of a study measuring the relative activity of this yeast in four different formulations available in Chile. The activity was assessed by determining both the number of live cells after re-hydrating the products and the growth observed in the product suspended in culture medium. In each experience the product Perenteryl® showed a faster growth, reaching maximum cell density values three to five hours earlier that the other products. Though the total number of cells was practically the same in each product, the number of live cells was larger in the product Perenteryl®

The objective of this work was to determine the ruggedness of the skin with benign and malignant lesions. Latex impressions were taken from lesions of skin’s patients and were analyzed by the MICROTOP 03.MFC inspection system. For the melanoma lesion it was observed that the average rugosity of this tumor was increased 67% compared with the rugosity of healthy skin. These measures allow us to distinguish significantly from other tumors, as it is the case of the basal cell carcinoma (49%), and benign lesions as the epidermoid cyst (37%) and the seborrhea keratosis (4%). It was observed a direct relation between the rugosity and the malignancy of the lesions. These results indicate that the rugosity is a characteristic that could be useful in the diagnosis of skin cancer.

Background: Epidemiological differences suggest that treatments for H. pylori eradication should be locally validated. Aim: To perform a cost benefit study of different treatment options for H. pylori infection. Patients and methods: One hundred and sixty-seven patients with active duodenal ulcer and H. pylori infection who completed a 2-week treatment with one of the following regimens were included: famotidine plus amoxycillin plus metronidazole (FAM), omeprazole plus amoxycillin plus tinidazole (OAT) or lansoprazole plus clarithromycin plus amoxycillin in 3 (LAC1) or 2 (LAC2) daily doses. We compared efficacy, adverse effects and cost. Results: Eradication rate was 74.6, 72.9, 96.4 y 91.7% for FAM, OAT, LAC1 and LAC2 respectively (p

OBJECTIVE: The aim of this study was to evaluate the effect of Helicobacter pylori (H. pylori) eradication on the natural history of duodenal ulcer disease and the reinfection rate after treatment in a developing country. METHODS: A total of 111 H. pylori-infected patients with duodenal ulcer were treated with either omeprazole or famotidine plus two antibiotics for 2 wk. Those failed to respond to treatment were retreated with bismuth-based triple therapy. RESULTS: The radication rate was 76% (95% CI: 67–83%). Eventually, H. pylori was eradicated in 96 of the 111 patients (86%), who were followed-up clinically and endoscopically for a mean of 37.2 months. The cumulative reinfection rate after eradication (Kaplan-Meier) was 8% ± 3% in yr 1, 11% ± 4% in yr 2, and 13% ± 4% in yr 3. Nine of the 12 reinfections occurred during yr 1. Recurrence of duodenal ulcer was detected in five patients (5.2%), all of them during yr 1 of follow-up. Histologically, gastritis scores (according to the Sydney system) improved significantly after eradication. CONCLUSIONS: In a high prevalence setting, H. pylori eradication and early reinfection rates after treatment are similar to rates observed in a low prevalence environment, whereas the late reinfection rate seems to be higher. However, up to 3 yr after treatment, most treated patients are free of H. pylori infection and/or ulcer activity. Even longer follow-up studies are necessary to determine whether specific retreatment policies are necessary to maintain long term eradication in developing countries.

El profesional contable en los últimos tiempos, como actor principal, ha sido cuestionado en el desempeño de su actividad e incluso involucrado frecuentemente con escándalos financieros de grandes empresas, poniendo en tela de juicio la responsabilidad social de su profesión. Sin embargo, aquí el análisis de la profesión contable se dirige específicamente a mirar el comportamiento del contador en un sector especial como es el minero, principalmente en lo relacionado con la asesoría en la explotación del carbón. En este artículo se presentan los resultados de la investigación realizada a los contadores públicos que prestan sus servicios de asesoría a empresarios del sector minero, se indaga sobre temas relacionados con el nivel y calidad de la asesoría que les proporcionan estos en los diferentes temas económicos, administrativos, fiscales, laborales, sociales y ambientales, en lo relativo al desarrollo de la actividad. Del mismo modo, el contable tiene un compromiso ético, tanto con las organizaciones como con los diferentes grupos que se vinculan directa e indirectamente a estas, de mantener el equilibrio en las organizaciones mediante el suministro de información a las partes vinculadas sobre los derechos que le corresponden en el desarrollo de la actividad. Y como administrador de la información y gestor en la toma de decisiones contribuye a la generación del bienestar común. Por último, la responsabilidad social del contador público va más allá del compromiso con el Estado y las organizaciones en las que labora, puesto que existe un compromiso con los demás grupos de interés, incluidos el medioambiente y la sociedad.