Jorge Rodríguez T

Descripción del consumo de drogas lícitas e ilícitas por género a través de la metodología de pares

Background: It is possible that men consume a higher amount of legal and illegal drugs than women. This can be assessed using the peer methodology, that is an adaptation of the privileged access interviewers (PAI) method and allows to identify populations in which there may be a tendency to under state a phenomenon (hidden populations) Aim: To compare the consumption of legal and illegal drugs by gender. Material and methods: Drug consumption was assessed using a peer methodology in university students between 18 and 26 years of age. Results: A random sample of 56 women (mean age 21.6 years) and 86 men (mean age 21.5 years), was studied. Women tended to report a higher proportion of tobacco consumption than men. Both genders had a similar consumption behavior of alcohol, total legal drugs, marihuana, cocaine, ecstasies and total illegal drugs. Among subjects that recognized the consumption of legal drugs, men have a higher proportion of illicit drug use and women have a higher proportion of smoking. Men have a higher awareness of the damages caused by drug consumption. Conclusions: The results in these small population sample do not support the hypothesis that men have a higher frequency and proportion of illicit drug consumption (Rev Med Chile 2007; 135: 449-56). (Key words: Alcohol drinking; Cannabis; Gender identity; Street drugs; Tobacco)

Estudio de salud mental en dos cohortes de niños escolares de Santiago occidente: IV: desordenes psiquiátricos, diagnóstico psicosocial y discapacidad.

Introduccion. Se revisan los estudios de diagnosticos psiquiatricos en nino sescolares de poblacion general. Objetivos. Estudiar la prevalencia de desordenes psiquiatricos, comorbilidad, discapacidad y condiciones asociadas en ninos de dos cohortes de 7 colegios del Area Occidente de Santiago. Explorar las diferentes causas de discapacidad. Evaluar las continuidades y cambios en la psicopatologia. Sujetos y metodo. Becados de Psiquiatria efectuaron una evaluacion psiquiatrica y diagnostico multiaxial CIE-10 en 162 ninos en 1 basico y 210 ninos en 6 basico. Resultados. La prevalencia de desordenes psiquiatricos fue 45,7%, reduciendose a 15,7% al asociar con discapacidad en 6 basico. 39,4% de los ninos con discapacidad y diagnostico psiquiatrico presenta comorbilidad. La comorbilidad se asocia a la discapacidad. Al analizar solo los 38 ninos con discapacidad; 33 de ellos tienen diagnostico psiquiatrico, 3 presentan ademas un desorden del desarrollo y todos estan sometidos a situaciones psicosociales anormales. Conclusiones. Es necesario ajustar la prevalencia agregando los criterios de discapacidad para diferenciar a aquellos ninos que requieren atencion especializada. Tanto los desordenes psiquiatricos, como los trastornos de desarrollo y las situaciones psicosociales anormales contribuyen a causar discapacidad. El registro de los seis ejes de la clasificacion CIE-10 permite al clinico entender mejor esta multicausalidad.

La mejoría electrocardiográfica con el tratamiento de la enfermedad de Chagas crónica, es independiente de la persistencia de Trypanosoma cruzi

BACKGROUND At the present time the assessment of results of treatment of Chagas disease is mainly parasitological. Anti Trypanosoma cruzi IgGs remain positive practically lifelong and electrocardiographic tracings are not usually used as criteria of improvement. AIM To determine, in a long term follow up, if electrocardiographic evolution is associated with the persistence of the parasite in treated patients with chronic Chagas disease. MATERIAL AND METHODS Thirty patients with chronic Chagas disease that participated in a randomized trial of treatment with itraconazole or allopurinol, were studied. Seven years after treatment, patients were classified in group I if they had a positive xenodiagnosis test, polymerase chain reaction and hybridization in blood or in group II if they had negative tests. A 12 lead electrocardiogram (EKG) was performed each year to all patients. RESULTS Seventeen patients were classified in group I and 13 in group II. At baseline 10 patients in group I and 8 in group II had a normal EKG. Six years after treatment 13 patients in group I and 10 in group II had a normal tracing. Of those with a normal tracing at baseline, only one patient in each group presented alterations after six years. A regression of abnormal tracings was observed in four and three patients of groups I and II respectively. CONCLUSIONS There is no association between the persistence of the parasite in treated patients with Chagas disease and the evolution of electrocardiographic tracings.

Pesquisa de maltrato infantil y juvenil

A method for detection and registration of child abuse (demonstrated or suspected) was experimentally applied ata suburban community of Santiago Chile as a contribution to the understanding of the problem in the country and tofuture development of a national case register. The questionnaire was applied by trained personnel or health,education ana justice institutions to cases detected at health centers, schools, police stations and justice courts and ro apaired control sample of unrelated cases from the same institutions. Childrens characteristics, type of abuse andbiological, social and family risk factors were recorded. Characteristics of 145 cases and 125 controls werecompared, as well as subtypes of abuse, and different maternal ages. Significant differences were respectivelyrecorded in the frequency of family members with mental diseases (23.8% vs. 1 1.2%) that lived in the same householdas the abused case (67.6% vs. 14.3%); absence of alcohol comsumplion, (21% vs. 44%) , problem alcohol drinkers(23.8% vs. 7.2%) and illicit drug consumtion {15.5% vs. 7.2%) among family members; behaviour problems of thechild [54% ante 16,8%]; use of social aid programmes (26.9% vs. 12,8%); attendance to public townhall managedschools [79.4% vs. 66.3%); good quality housing [68.8% vs. 88.9%), provissional housing [31,4% vs. 11,5%);participation in community (6.2% vs. 1 3.6/0). These results remain however provissional till completion of wider studieswilh more refined instruments.(Keywords: battered child syndrome, child abuse.)

Prueba múltiple para inmunidad celular en niños con infecciones recurrentes

Cell-mediated immune response was evaluated by multitest for cutaneous delayed hypersensitivity with seven recall antigens and a glycerol diluent control in children with recurrent infections. Fifty patients, aged 4.9 years mean (range 1 to 14 years), were selected by a score based on frequency, localization, severity and etiology of infectious episodes (Hosking)13. Results were confronted with those obtained from 21 healthy children aged 4.4 years mean (range 1 to 4 years, p; ns). Patients had lower number of positive reactions (2.06 vs 3.95) and lower sum up diameter of all positive indurations (7.29 vs 13.69) than controls (p < 0.01). Responses to tetanic, diphteric, tuberculin and Proteus mirabitis antigens were significantly lower in patients versus controls (magnitudes). Anergy was detected in 20% of patients. Diminished cellular immune response in children with recurrent infections may be adquired and transient. This alteration may worsen their pathological conditions or it mat be the consequence of multiple infectious episodes.

Estudio de validación de un cuestionario de apego en adolescentes

Validation study of attachment questionnaire in adolescents introduction: there are not enough specially developed tools to study attachment during adolescence in our country. the objective of this research is to adapt and validate the aaQ (adolescent attachment Ques- tionnaire) for the chilean population. Patients and Method: a cross-sectional study was conducted in 199 adolescents between 11 and 19 years old. the aaQ is a self-report questionnaire consisting of 9 items, three scales of three statements each: a) availability scale; b) goal corrected partnership scale and c) angry distress scale. the items were answered with likert-type responses. the aaQ was originally validated in a sample of 824 adolescents, 691 of which corresponded to non-clinical population and 133 corresponded to clinical population, demonstrating satisfactory internal reliability. t o create the spanish version of the questionnaire, a translation-retranslation procedure was used evaluating semantic, content, construct and reliability validity. results: the results showed adequate internal consistency of the instrument with cronbach alphas values between 0.52 and 0.74. also, the factorial structure of the aaQ english version was replicated. Finally, tem porary rules for the interpretation of results that consider age differences for one of the 3 scales are presented. conclusions: it is concluded that the instrument is suitable for use because it is a short self-administered questionnaire that shows similar psychometric characteristics to the original english version. (Key words: v alidation, attachment, adolescence, questionnaire). Rev chil pediatr 2014; 85 (4): 437-442INTRODUCTION There are not enough specially developed tools to study attachment during adolescence in our country. The objective of this research is to adapt and validate the AAQ (Adolescent Attachment Questionnaire) for the Chilean population. PATIENTS AND METHOD A cross-sectional study was conducted in 199 adolescents between 11 and 19 years old. The AAQ is a self-report questionnaire consisting of 9 items, three scales of three statements each: a) Availability scale; b) Goal corrected Partnership scale and c) Angry distress scale. The items were answered with Likert-type responses. The AAAQ was originally validated in a sample of 824 adolescents, 691 of which corresponded to non-clinical population and 133 corresponded to clinical population, demonstrating satisfactory internal reliability. To create the spanish version of the questionnaire, a translation-retranslation procedure was used evaluating semantic, content, construct and reliability validity. RESULTS The results showed adequate internal consistency of the instrument with Cronbach alphas values between 0.52 and 0.74. Also, the factorial structure of the AAQ English version was replicated. Finally, temporary rules for the interpretation of results that consider age differences for one of the 3 scales are presented. CONCLUSIONS It is concluded that the instrument is suitable for use because it is a short self-administered questionnaire that shows similar psychometric characteristics to the original English version.

Factores predictores del riesgo de consumo de drogas lícitas en escolares de 4° a 7° básico

Drug consumption is a problem of global concern primarily in terms of prevention. The objective of this research was to identify the factors that predict initial legal drug consumption in school children from 4 th to 7 th grade. The peer methodology (Rodriguez & Hernandez, 2005) was applied to 234 participants from two counties in Santiago. The results showed that although drug consumption in the past month was in decline, school children are starting legal drug consumption earlier, which will increase its general use in the future. The main factors that predict the risk of legal drug consumption are not living with on of the parents and involvement in street fights. The feminine gender was the main protective factor for beginning drug consumption at this age.

Colangioresonancia (CPRM) vs ultrasonido (US) focalizado en pacientes con ictericia o sospecha de obstrucción de la vía biliar: resultados preliminares

Abstract: Between January and July, 2003, a singleblinded matched trial was done to assess focalizedbiliary ultrasound (US) and MR cholangiography(MRCP) compared with ERCP or surgery as referencestandard in patients with suspected biliary obstruction.Focalized US was performed 24 hrs before/afterMRCP. Patients were triage according symptoms,signs and laboratory in high, intermediate and lowrisk for obstruction. Radiologists sonographers weredivided in low and highly experienced. None of theradiologist who reported either US or MRCP wasaware to the other test results. Sensitivity, Specificity,PPV and NPV, (LR) Likelihood Ratios and pre andpost-test odds for positive and negative test wereestimated. We analized 64 out of 76 sampled patients, theprevalence of obstruction was 37 % (24 out of 64patients). US found biliary tree dilated in 50% andMRCP in 48% of the patients. Main cause ofobstruction was common bile duct stones in (16) 25%.and tumors were the second more common cause.US shown a Sensitivity (S) 58.3% when a nonexperienced radiologist perform the exam, and 70%when an experienced radiologist doest it. Specificity(Sp) 82,5%, PPV 66.7% and NPV 76.7%. RMCPShown S 95.8%, Sp 87.5%, PPV 82.1%, NPV 97.2%For common bile duct stones US shown a PPV 53.3%and NPV 83.6% on the other hand MRCP a PPV 70%and NPV 95.4%. MRCP perform better than focalizedUS in overall patients with high risk of obstruction(37.5%), detecting the cause of obstruction but usingaditional sequences rising the examination time andcosts. With a positive ultrasound and LR(+) 3.3 pre-test odds rise from 0.37/37% to a post-test odds of0.55/55% and with negative test result and LR(-) 0.49pre-test odds 0.37/37% will decrease to post-test oddsof 0.2/20%. With MRCP a positive test with LR(+) 7.7initial pre-test odds 0.37/37.5% to post-test odds of0.8/ 80% and with a negative test result LR(-) 0.05pretest odds 0.37/37% will decrease to post-test oddsof 0.03%. Ultrasound performed by experiencedsonographers has a Specificity and NPV over 80%,and perform similar to MRCP for detecting biliarytree dilatation the best predictor of obstruction. Inpatients with low pre-test odds (low risk) of obstruction,to use focalized US and then MRCP, when the causeof obstruction is not diagnosed could be the more cost/efective initial alternative in this patients. This data mustbe confirmed with further studies with cost/effectivenesanalysis.Keywords: Bile ducts, Magnetic Resonance,Ultrasonography, RMCP, Sensitivity, Specificity,Predictive values.Resumen: Introduccion. Existe controversia en elalgoritmo de estudio de obstruccion de la via biliar