RESUMEN

The double burden of diseases and scarce resources in developing countries highlight the need to change the conceptualization of health problems and translational research. Contrary to the traditional paradigm focused on genetics, the exposome paradigm proposed in 2005 that complements the genome is an innovative theory. It involves a holistic approach to understanding the complexity of the interactions between the human being's environment throughout their life and health. This paper outlines a scalable framework for exposome research, integrating diverse data sources for comprehensive public health surveillance and policy support. The Chilean exposome-based system for ecosystems (CHiESS) project proposes a conceptual model based on the ecological and One Health approaches, and the development of a technological dynamic platform for exposome research, which leverages available administrative data routinely collected by national agencies, in clinical records, and by biobanks. CHiESS considers a multilevel exposure for exposome operationalization, including the ecosystem, community, population, and individual levels. CHiESS will include four consecutive stages for development into an informatic platform: (1) environmental data integration and harmonization system, (2) clinical and omics data integration, (3) advanced analytical algorithm development, and (4) visualization interface development and targeted population-based cohort recruitment. The CHiESS platform aims to integrate and harmonize available secondary administrative data and provide a complete geospatial mapping of the external exposome. Additionally, it aims to analyze complex interactions between environmental stressors of the ecosystem and molecular processes of the human being and their effect on human health. Moreover, by identifying exposome-based hotspots, CHiESS allows the targeted and efficient recruitment of population-based cohorts for translational research and impact evaluation. Utilizing advanced technologies such as Artificial Intelligence (AI), Internet of Things (IoT), and blockchain, this framework enhances data security, real-time monitoring, and predictive analytics. The CHiESS model is adaptable for international use, promoting global health collaboration and supporting sustainable development goals.

Asunto(s)

RESUMEN

In the present work, different configurations of nt iartificial neural networks (ANNs) were analyzed in order to predict the experimental diameter of nanofibers produced by means of the electrospinning process and employing polyvinyl alcohol (PVA), PVA/chitosan (CS) and PVA/aloe vera (Av) solutions. In addition, gelatin type A (GT)/alpha-tocopherol (α-TOC), PVA/olive oil (OO), PVA/orange essential oil (OEO), and PVA/anise oil (AO) emulsions were used. The experimental diameters of the nanofibers electrospun from the different tested systems were obtained using scanning electron microscopy (SEM) and ranged from 93.52 nm to 352.1 nm. Of the three studied ANNs, the one that displayed the best prediction results was the one with three hidden layers with the flow rate, voltage, viscosity, and conductivity variables. The calculation error between the experimental and calculated diameters was 3.79%. Additionally, the correlation coefficient (R2) was identified as a function of the ANN configuration, obtaining values of 0.96, 0.98, and 0.98 for one, two, and three hidden layer(s), respectively. It was found that an ANN configuration having more than three hidden layers did not improve the prediction of the experimental diameter of synthesized nanofibers.

RESUMEN

BACKGROUND: Major Depressive Disorder (MDD) is a public health problem of increasing severity in Chile. However, prevalence studies of MDD yield discordant results. Reconciling these discordances, at least in part, requires improving the estimate of MDD prevalence in Chile. AIM: To improve the estimate of MDD prevalence in Chile, by combining data from the 2016/17 Chilean National Health Survey (ENS) with data from the mandatory notifications of users of the Explicit health guaranties (GES acronym in Spanish) program of the Ministry of Health for MDD treatment. MATERIAL AND METHODS: The 2016/17 ENS, applied a Composite International Diagnostic Interview (CIDI) module (n = 3,403), to diagnose individuals with MDD. This article presents an approach that combines the CIDI/ENS diagnoses with GES depression notifications for this period. This dataset combination was applied first to individual macro-zones, then at a national level. RESULTS: The analysis with ENS 2016/17 data only, yields a prevalence of MDD in subjects 18 years or older of 6.19% (95% CI: 4.51-8.43). However, the analysis of the combined data sources yields a prevalence that increases to 6.65% (95% CI: 4.63-8.67). In terms of number of cases, this prevalence increase translates into 63,474 additional MDD cases per year. CONCLUSIONS: The MDD prevalence that results from combining ENS 2016/17 and GES data is greater than the prevalence reported by the ENS 2016/17 alone. This increase in cases allows policymakers to improve budgeting and implementation of public policies concerning the prevention and treatment of MDD.

Asunto(s)

RESUMEN

BACKGROUND: Major Depressive Disorder (MDD) is a public health problem of increasing severity in Chile. However, prevalence studies of MDD yield discordant results. Reconciling these discordances, at least in part, requires improving the estimate of MDD prevalence in Chile. AIM: To improve the estimate of MDD prevalence in Chile, by combining data from the 2016/17 Chilean National Health Survey (ENS) with data from the mandatory notifications of users of the Explicit health guaranties (GES acronym in Spanish) program of the Ministry of Health for MDD treatment. MATERIAL AND METHODS: The 2016/17 ENS, applied a Composite International Diagnostic Interview (CIDI) module (n = 3,403), to diagnose individuals with MDD. This article presents an approach that combines the CIDI/ENS diagnoses with GES depression notifications for this period. This dataset combination was applied first to individual macro-zones, then at a national level. RESULTS: The analysis with ENS 2016/17 data only, yields a prevalence of MDD in subjects 18 years or older of 6.19% (95% CI: 4.51-8.43). However, the analysis of the combined data sources yields a prevalence that increases to 6.65% (95% CI: 4.63-8.67). In terms of number of cases, this prevalence increase translates into 63,474 additional MDD cases per year. CONCLUSIONS: The MDD prevalence that results from combining ENS 2016/17 and GES data is greater than the prevalence reported by the ENS 2016/17 alone. This increase in cases allows policymakers to improve budgeting and implementation of public policies concerning the prevention and treatment of MDD.

Asunto(s)

RESUMEN

Regulation of cellular excitability and oscillatory behavior of resting membrane potential in nerve cells are largely mediated by the low-voltage activated T-type calcium channels. This calcium channel family is constituted by three isoforms, namely, CaV3.1, CaV3.2, and CaV3.3, that are largely distributed in the nervous system and other parts of the body. Dysfunction of T-type calcium channels is associated with a wide range of pathophysiologies including epilepsy, neuropathic pain, cardiac problems, and major depressive disorders. Due to their pharmacological relevance, finding molecular agents able to modulate the channel's function may provide therapeutic means to ameliorate their related disorders. Here we used electrophysiological experiments to show that genistein, a canonical tyrosine kinase inhibitor, reduces the activity of the human CaV3.3 channel in a concentration-dependent manner. The inhibitory effect of genistein is independent of tyrosine kinase modulation and does not affect the voltage-dependent gating of the channel. Subsequently, we used computational methods to identify plausible molecular poses for the interaction of genistein and the CaV3.3 channel. Starting from different molecular poses, we carried out all-atom molecular dynamics (MD) simulations to identify the interacting determinants for the CaV3.3/genistein complex formation. Our extensive (microsecond-length) simulations suggest specific binding interactions that seem to stabilize the protein/inhibitor complex. Furthermore, our results from the unbiased MD simulations are in good agreement with the recently solved cryoelectron microscopy structure of the CaV3.1/Z944 complex in terms of both the location of the ligand binding site and the role of several equivalent amino acid residues. Proposed interacting complex loci were subsequently tested and corroborated by electrophysiological experiments using another naturally occurring isoflavone derivative, daidzein. Thus, by using a combination of in vitro and in silico techniques, we have identified interacting determinants relevant to the CaV3.3/genistein complex formation and propose that genistein directly blocks the function of the human CaV3.3 channel as a result of such interaction. Specifically, we proposed that a combination of polar interactions involving the three hydroxyl groups of genistein and an aromatic interaction with the fused rings are the main binding interactions in the complex formation. Our results pave the way for the rational development of improved and novel low-voltage activated T-type calcium channel inhibitors.

Asunto(s)

RESUMEN

Over the last decade, copper and vanadium complexes have shown promising properties for the treatment of several types of cancer. In particular, Casiopeinas®, a group of copper-based complexes, has received specific attention, and their mechanism of action has been extensively studied since their structure is simple and their synthesis may be affordable. Similarly, vanadium-containing compounds in the form of complexes and simple polyoxovanadates have also been studied as antitumor agents. Here, potential prodrugs that would release the two metals, V and Cu, in usable form to act in conjunction against cancer cells are reported. The new series of Casiopeinas-like compounds are bridged by a cyclotetravanadate ion with the generic formula [Cu(N,N')(AA)]2•(V4O12), where (N,N') represent 1,10-phenanthroline and 2,2'-bipyridine, and (AA) are aminoacidate ions (Lysine and Ornithine). The compounds were characterized by elemental analysis, single-crystal X-ray diffraction and Visible, FTIR, and Raman spectroscopies, as well as 51V NMR, EPR, and Thermogravimetric Analysis. Additionally, theoretical calculations based on the Density Functional Theory (DFT) were carried out to model the compounds. Optimized structures, theoretical IR, and Raman spectra were also obtained, as well as docking analysis to test DNA interactions with the casiopeina-like complexes. The compounds may act as prodrugs by providing acting molecules that have showed potential pharmacological properties for the treatment of several types of cancer.

Asunto(s)

RESUMEN

INTRODUCTION: Kidney chronic disease patients are being increasingly identified. The disability generated by this disease must consider physical and social effects given the lack of attention and the socioeconomic conditions that generate it. Therefore, access to services to treat kidney chronic disease is determined by social and biological factors. OBJECTIVE: To analyze the effect of the social components on kidney chronic disease in a sector of the Mexican population that suffers from the disease, particularly in the case of women. METHODS: The Poisson generalized linear model was applied, selecting the variables related to equity in the administration of health services. Statistical data reported by the National Institute of Statistics and Geography of Mexico in the period 2009-2015 in women was taken. The variables considered were the level of schooling, occupation, access to health, geographical region and habitable zone, as well as stage of life. RESULTS: The highest incidence rate for kidney chronic disease is attributed to the intermediate adult woman, who works in informal services legally excluded from institutional health coverage, has low schooling and lives in a rural area of the Center zone, while the young adult woman that lives in an urban metropolis in the North zone presents lowest incidence profile. CONCLUSIONS: The economic determinants derived from people’s activities, as well as their age, the educational level and the environment in which they live influence both the acquisition of the disease and the possibilities of managing it successfully.

INTRODUCCIÓN: La insuficiencia renal crónica es una enfermedad que se encuentra en un estado de constante crecimiento. La discapacidad que genera esta enfermedad debe considerar efectos físicos y sociales, dada la falta de atención y a las condiciones socioeconómicas que la generan. Por lo tanto, el acceso a los servicios para tratar la insuficiencia renal crónica está condicionado a factores de tipo social y de tipo biológico. OBJETIVO: Analizar el efecto de los componentes sociales en la insuficiencia renal crónica en un sector de la población de México que padece la enfermedad, en particular para el caso de la mujer. MÉTODOS: Se aplicó el modelo lineal generalizado de Poisson, seleccionando las variables relacionadas con la equidad en la aplicación de los servicios de salud. Se tomaron datos estadísticos reportados en mujeres por el Instituto Nacional de Estadística y Geografía de México en el periodo 2009-2015. Las variables consideradas fueron grado de escolaridad, ocupación, acceso a la salud, región geográfica y zona habitable, así como le etapa de vida. RESULTADOS: La mayor tasa de incidencia para la insuficiencia renal crónica corresponde a la mujer adulta intermedia, que trabaja en servicios informales excluidos legalmente de la cobertura institucional de salud, tiene baja escolaridad y vive en un área rural de la zona centro; mientras que la mujer adulta joven que vive en una metrópoli urbana de la zona norte presenta el perfil de menor incidencia. CONCLUSIONES: Los determinantes económicos derivados de la actividad de las personas, así como la edad, el nivel educativo y el entorno en el que habitan, influyen tanto en el padecimiento de la enfermedad como en las posibilidades de enfrentarla con éxito.

Asunto(s)

RESUMEN

Resumen Objetivo: Analizar el acceso a los servicios de salud con equidad para el caso de México desde un enfoque institucional reflejado en la esperanza de vida al nacer. Materiales y métodos: Es un estudio econométrico utilizando la metodología panel con variables instrumentales; para ello se consideraron cinco variables para determinar su influencia, consideradas institucionales en acceso con equidad en México. Resultados: Se encontró que la inequidad de acceso a los servicios de salud, reflejada en los años de vida al nacer, está determinada de manera negativa por el analfabetismo, la pobreza, la falta de incorporación a una institución de salud, mientras que la educación que logra una persona en su sociedad, impacta de manera positiva en la esperanza de vida de las personas, aumentando su funcionamiento; estas variables están relacionadas de manera directa con las instituciones estatales. Conclusión: Dado el arreglo institucional en el México dual, las instituciones influyen significativamente en la esperanza de vida al nacer, en función de la inserción en el mercado laboral, reconociendo solo a los del sector formal y excluyendo a los del informal. Por lo tanto, la inequidad está en función del arreglo institucional que emana de la Constitución y que se materializa en la forma de organización del sistema de salud, dado que solo ofrece los servicios de salud al grupo minoritario -formal - creando una estructura ad hoc.

Abstract Objective: To analyze the access to health Services with equity in the case of México from an institutional approach showed in life expectancy at birth. Materials and methods: It is an econometric model using the Panel methodology with instrumental variables, for this purpose five variables were considered to determine the influence of the institutional variables considered with equity access in Mexico. Results: It was found that the inequity of access to health services in the years of life at birth is determined in a negative way by illiteracy, poverty, the lack of coverage by a health institution, while the education gets positively impact on the life expectancy at birth, increasing their performance, these variables are related directly with the State institutions. Conclusion: A Given the institutional arrangement in the dual Mexican institutions significantly influence life expectancy at birth based on the labor market recognizing only to those in the formal sector and excluding those in the informal sector. Inequality is therefore based on the institutional arrangement that emanates from the Constitution and the Organization of given health system that only provides health services to the minority group - formal - creating a structure ad hoc.

Resumo Objectivo: Analise o acesso aos serviços de saúde com equidade no caso do México, de uma abordagem institucional refletida na expectativa de vida ao nascer. Materiais e métodos: É um estudo da metodologia econométrica utilizando o painel com variável instrumental, por nós considerado cinco variáveis para determinar a influência das variáveis institucionais considerados no acesso com equidade no México. Resultados: Verificou-se que a desigualdade de acesso aos serviços de saúde nos anos de vida ao nascer é determinada de forma negativa pelo analfabetismo, pobreza, a falta de um complemento para uma instituição de saúde, enquanto a educação que uma pessoa na sua empresa impacta positivamente sobre a expectativa de vida das pessoas, aumentando o seu desempenho, essas variáveis estão relacionadas diretamente com as instituições do estado. Conclusão: Tendo em conta o arranjo institucional no México dual instituições influenciam significativamente a expectativa de vida ao nascer com base no mercado de trabalho, reconhecendo apenas para aqueles no sector formal e excluindo aqueles no sector informal. Desigualdade se baseia, portanto, o arranjo institucional que emana da constituição e a organização de dado sistema de saúde que só fornece serviçõs de saúde para o grupo minoritário, criando uma estrutura ad hoc.

Résumé Objectif: Analyser, dans le cas du Mexique et selon une approche institutionnelle, l'équité en relation a l'acces aux services de santé reflétée dans l'espérance de vie à la naissance. Matériaux et méthodes: l'étude a été réalisée avec une méthode économétrique de données de panel pour déterminer l'influence de cinq variables instrumentales, considérées institutionnelles, sur l'acces équitable aux services de santé au Mexique. Résultats: Il a été constaté une iniquité d'acces aux services de santé, reflétée en années d'espérance de vie a la naissance. Celle-ci est déterminée négativement par l'analphabétisme, la pauvreté et le manque d'affiliation a un service de santé, tandis que l'éducation obtenue dans la société impacte de fa9on positive sur l'espérance de vie en augmentant la fonctionnalité. Ces variables sont liées directement aux institutions étatiques. Conclusion: Compte tenu du dispositif institutionnel du Mexique, ou coexistent deux réalités, les institutions influencent significativement l'espérance de vie à la naissance en fonction de l'insertion dans le marché du travail. Le secteur formel est le seul reconnu, le secteur informel est donc exclut. Par conséquent, l'inégalité dépend du dispositif institutionnel émanant de la Constitution et matérialisé dans l'organisation d'un systeme de santé qui fournit seulement ses services au groupe minoritaire appartenant au marché du travail formel, a travers une structure ad hoc.

RESUMEN

Cytosine, a DNA and RNA building-block, and Metformin, the most widely prescribed drug for the treatment of Type 2 Diabetes mellitus were made to react separately with ammonium or sodium metavanadates in acidic aqueous solutions to obtain two polyoxovanadate salts with a 6:1 ratio of cation-anion. Thus, compounds [HCyt]6[V10O28]·4H2O, 1 and [HMetf]6[V10O28]·6H2O, 2 (where HCyt = Cytosinium cation, [C4H6N3O]+ and HMetf = Metforminium cation, [C4H12N5]+) were obtained and characterized by elemental analysis, single crystal X-ray diffraction, vibrational spectroscopy (IR and Raman), solution 51V-NMR, thermogravimetric analysis (TGA-DTGA), as well as, theoretical methods. Both compounds crystallized in P 1 ¯   space group with Z' = 1/2, where the anionic charge of the centrosymmetric ion [V10O28]6- is balanced by six Cytosinium and six Metforminium counterions, respectively. Compound 1 is stabilized by π-π stacking interactions coming from the aromatic rings of HCyt cations, as denoted by close contacts of 3.63 Å. On the other hand, guanidinium moieties from the non-planar HMetf in Compound 2 interact with decavanadate µ2-O atoms via N-H···O hydrogen bonds. The vibrational spectroscopic data of both IR and Raman spectra show that the dominant bands in the 1000-450 cm-1 range are due to the symmetric and asymmetric ν(V-O) vibrational modes. In solution, 51V-NMR experiments of both compounds show that polyoxovanadate species are progressively transformed into the monomeric, dimeric and tetrameric oxovanadates. The thermal stability behavior suggests a similar molecular mechanism regarding the loss of water molecules and the decomposition of the organic counterions. Yet, no changes were observed in the TGA range of 540-580°C due to the stability of the [V10O28]6- fragment. Dispersion-corrected density functional theory (DFT-D) calculations were carried out to model the compounds in aqueous phase using a polarized continuum model calculation. Optimized structures were obtained and the main non-covalent interactions were characterized. Biological activities of these compounds are also under investigation. The combination of two therapeutic agents opens up a window toward the generation of potential metalopharmaceuticals with new and exciting pharmacological properties.

RESUMEN

INTRODUCTION: Health-related quality of life (HRQoL) deterioraton is a risk factor for suicide in adults, however, this aspect has been little studied in adolescents. OBJECTIVE: To evaluate the asso ciation between HRQoL (measured with EQ-5D-5L) and suicidal risk in adolescents and its capacity for cross-sectional detection of suicidal risk. PATIENTS AND METHOD: 128 adolescents (15-19 years old) from Puerto Aysen (Chile) responded to the EQ-5D-5L questionnaire, the Okasha Suicide Scale and two anchoring questions of imminent suicide risk. A suicide risk case was considered to have a > 5 score on the Okasha scale or the affirmative answer to one of the anchoring questions. The index value of EQ-5D-5L was calculated and Odds Ratios (ORs) were estimated with confidence intervals (95% CI), adjusted for confounders. Areas under the ROC curve (AUC-ROC) were calculated to assess the discriminatory performance of EQ-5D-5L. RESULTS: 21 (16.4%) adolescents were at suicidal risk. Controlling for confounders, the EQ-5D-5L dimensions associated with suicidal risk were pain/ discomfort (OR: 2.5; 95% CI 1.1-6.1) and anxiety/depression (OR: 2.2; 95% CI 1.3-3.6). The AUC- ROC for both dimensions was 85% (95% CI 0.75-0.91) and 81% for the EQ-5D-5L index value (95% CI 0.72-0.89). CONCLUSIONS: HRQoL could be a risk factor for suicide in adolescents and in this way, the EQ-5D-5L could help in searching for high risk and hidden cases of suicidal risk.

Asunto(s)

RESUMEN

INTRODUCCIÓN: El deterioro de la calidad de vida relacionada con la salud (CVRS) es un factor de riesgo de suicido en adultos; no obstante, poco se ha estudiado esta dimensión en adolescentes. OBJETIVO: Evaluar la asociación entre calidad de vida relacionada con la salud, medido con el EQ-5D-5L, y riesgo suicida en adolescentes y su capacidad de detección transversal de riesgo suicida. PACIENTES Y MÉTODO: 128 jóvenes (15-19 años) de la comuna de Puerto Aysén (Chile) respondieron transversalmente el EQ-5D-5L, la escala de suicidalidad de Okasha y dos preguntas de anclaje de riesgo in minente de suicidio. Se consideró como caso de riesgo suicida a un puntaje > 5 en la escala Okasha o la respuesta afirmativa a una de las preguntas de anclaje. Se calculó el valor índice con los perfiles de salud del EQ-5D-5L. Se estimaron Odds Ratios (OR's) con intervalos de confianza (IC95%), ajustando por confusores y se calcularon áreas bajo la curva ROC (AUC-ROC) para evaluar la capacidad de pesquisa del EQ-5D-5L. RESULTADOS: 21 (16,4%) adolescentes fueron considerados como casos de riesgo suicida. Controlando por confusores, las dimensiones del EQ-5D-5L que se asociaron con riesgo suicida fueron: dolor/malestar (OR: 2,5; IC95% 1,1-6,1) y ansiedad/depresión (OR: 2,2; IC95% 1,3-3,6). El AUR-ROC para ambas dimensiones fue del 0,85% (IC95% 0,75-0,91) y de 0,81% para el valor del índice del EQ-5D-5L (IC95% 0,72-0,89). CONCLUSIONES: La CVRS podría ser un factor de riesgo de suicidio en adolescentes; y el EQ-5D-5L que mide esta dimensión, podría ayudar a pesquisar futuros casos y casos ocultos de riesgo suicida.

INTRODUCTION: Health-related quality of life (HRQoL) deterioraton is a risk factor for suicide in adults, however, this aspect has been little studied in adolescents. OBJECTIVE: To evaluate the asso ciation between HRQoL (measured with EQ-5D-5L) and suicidal risk in adolescents and its capacity for cross-sectional detection of suicidal risk. PATIENTS AND METHOD: 128 adolescents (15-19 years old) from Puerto Aysen (Chile) responded to the EQ-5D-5L questionnaire, the Okasha Suicide Scale and two anchoring questions of imminent suicide risk. A suicide risk case was considered to have a > 5 score on the Okasha scale or the affirmative answer to one of the anchoring questions. The index value of EQ-5D-5L was calculated and Odds Ratios (ORs) were estimated with confidence intervals (95% CI), adjusted for confounders. Areas under the ROC curve (AUC-ROC) were calculated to assess the discriminatory performance of EQ-5D-5L. RESULTS: 21 (16.4%) adolescents were at suicidal risk. Controlling for confounders, the EQ-5D-5L dimensions associated with suicidal risk were pain/ discomfort (OR: 2.5; 95% CI 1.1-6.1) and anxiety/depression (OR: 2.2; 95% CI 1.3-3.6). The AUC- ROC for both dimensions was 85% (95% CI 0.75-0.91) and 81% for the EQ-5D-5L index value (95% CI 0.72-0.89). CONCLUSIONS: HRQoL could be a risk factor for suicide in adolescents and in this way, the EQ-5D-5L could help in searching for high risk and hidden cases of suicidal risk.

Asunto(s)

RESUMEN

OBJECTIVE: We present the preliminary results of the implementation of RADAR: a community suicide prevention program in adolescents implemented in two high schools in a south region of Chile. METHOD: In a pilot study, during 2016, we implemented RADAR in two high schools of Puerto Aysen, in in the Region of Aysen of Chile. A total of 409 actors were trained (among students, school teachers, caregivers and health professionals) for the screening and referral of high suicide risk adolescents. RESULTS: Out of a total of 144 students who passed the RADAR screening systems, 29 cases were detected as suicide risk (20%) and 27 of them were opportunely referred to the Emergency Service of the Hospital of Puerto Aysen. In the second RADAR screening campaign, 3 months later, 90% of the cases no longer presented suicide risk. CONCLUSION: These results show the high proportion of ado lescents at risk of suicide who are not visible by the health system and the feasibility of implementing RADAR in the community as an effective suicide prevention intervention.

Asunto(s)

RESUMEN

OBJETIVO: Dar a conocer los resultados preliminares del programa comunitario RADAR (Red para la Atención y Derivación de Adolescentes en Riesgo suicida). MÉTODO: Durante el 2016, RADAR fue implementado como prueba de concepto en dos colegios de Puerto Aysén de la Región de Aysén, Chile. Se capacitó un total de 409 participantes (entre alumnos, profesores de los colegios, apoderados y profesionales de la salud) para la pesquisa y derivación de adolescentes en riego de suicidio. RESULTADOS: De un total de 144 alumnos que pasaron los sistemas de pesquisa de RADAR, se detectaron 29 casos en riesgo suicida (20%) y 27 fueron derivados oportunamente al Servicio de Urgencia del Hos pital de Puerto Aysén. En la segunda campaña de pesquisa de RADAR, 3 meses después, el 90% de los casos ya no presentaba riesgo suicida. CONCLUSIÓN: Estos resultados muestran la alta proporción de adolescentes en riesgo suicida que no son visibilizados por el sistema de salud y la factibilidad de implementar RADAR en la comunidad como una intervención preventiva efectiva.

OBJECTIVE: We present the preliminary results of the implementation of RADAR: a community suicide prevention program in adolescents implemented in two high schools in a south region of Chile. METHOD: In a pilot study, during 2016, we implemented RADAR in two high schools of Puerto Aysen, in in the Region of Aysen of Chile. A total of 409 actors were trained (among students, school teachers, caregivers and health professionals) for the screening and referral of high suicide risk adolescents. RESULTS: Out of a total of 144 students who passed the RADAR screening systems, 29 cases were detected as suicide risk (20%) and 27 of them were opportunely referred to the Emergency Service of the Hospital of Puerto Aysen. In the second RADAR screening campaign, 3 months later, 90% of the cases no longer presented suicide risk. CONCLUSION: These results show the high proportion of ado lescents at risk of suicide who are not visible by the health system and the feasibility of implementing RADAR in the community as an effective suicide prevention intervention.

Asunto(s)

RESUMEN

Resumen Más de la mitad de los pacientes con trastorno de personalidad limítrofe (TPL) han realizado al menos un intento suicida durante su vida y el 70% ha tenido al menos una hospitalización psiquiátrica. La presente investigación tiene como objetivo evaluar la efectividad de la Terapia Conductual Dialéctica (TCD) en pacientes con trastorno de personalidad limítrofe. Método: A través de un diseño observacional retrospectivo se evaluó el número de intentos suicidas, el número de hospitalizaciones psiquiátricas y el impacto clínico previo al tratamiento con TCD y posterior a éste. Se analizó la información disponible de 144 pacientes de la Unidad de Terapia Conductual Dialéctica del Servicio de Psiquiatría del Hospital del Salvador, de Santiago de Chile, entre los años 2006-2012. Los datos fueron recolectados a través de registros electrónicos, análisis de ficha clínica, mediante el cuestionario OQ-45.2 y contacto telefónico. Resultados: En cuanto a los resultados, a través del método estadístico de Wilcoxon, se demostró una diferencia significativa (p = 0,000) en el número de hospitalizaciones psiquiátricas pre y post tratamiento, una disminución (p = 0,000) del número de intentos suicidas posterior al tratamiento y mejoría en los puntajes del cuestionario OQ-45.2. Conclusión: La TCD fue efectiva en disminuir las 3 variables estudiadas en la población escogida.

More than half of patients diagnosed with borderline personality disorder have made at least one suicide attempt during their lifetime and 70% have been admitted to an inpatient psychiatric unit. This research aims to assess the effectiveness of Dialectical Behavior Therapy (DBT) in patients with borderline personality disorder. Methods: Using a retrospective observational design, the number of suicide attempt and psychiatric hospitalizations was measured pre and post DBT treatment. Data from 144 patients from Dialectical Behavior Therapy Unit at Hospital Salvador in Santiago de Chile was analyzed during 2006 and 2012. The data were gathered from electronic files of clinical records, a OQ-45.2 questionnaire and telephone calls. Results: The Wilcoxon statistical test showed a significant difference (p = 0.000) in the number of psychiatric hospitalizations pre and post-treatment, as well as a reduction (p = 0.000) in the number of post-treatment suicide attempt. Conclusion: The Dialectical Behavior Therapy was effective in the 3 studied events in the selected population.

Asunto(s)

RESUMEN

BACKGROUND: Despite the many studies trying to evaluate the magnitude of suicide in Chile, none of them include the new valid data, recently published by the DEIS of the Chilean Health Ministry. AIM: This paper sought to describe how suicide rates changed among Chileans who were at least 15 years of age during the period of 2001-2010; these rates were stratified by sex, age, urban/rural status, and region of the country. METHOD: An exploratory and temporal study was conducted. Suicide mortality rates were calculated by collecting information from the Chilean Ministry of Health's death registry between 2001 and 2010 among subjects who were at least 15 years of age. Crude and age-adjusted mortality rates were computed. RESULTS: The standardized suicide rate in Chile during 2001-2010 was 14.7 deaths per 100,000, the highest in South America. The minimum age-adjusted suicide rate observed during the examined period was 13.49 per 100,000 in 2005, and the maximum, 16.67 per 100,000 in 2008. Suicide rates among men were up to 4.8 times the suicide rates among women. In addition, rates in rural areas were double compared with urban areas. Hanging was the most common suicide method, followed by use of firearms and explosives in men and poisoning in women. Finally, there was a progressive increase in suicide rates in the southernmost regions of the country. CONCLUSION: Suicide rates in Chile are relatively high among male subjects in rural areas. There is a disturbing increase in suicide rates among younger individuals and women, although these rates remain lower among younger individuals and women than among adults in general.

Asunto(s)

RESUMEN

Our group has recently initiated a study on the development of new prototypes for bioreductive prodrugs, based on Co(III) complexes with the ligand 2,2'-bis(3-hydroxy-1,4-naphthoquinone), H2bhnq. The focus of this work is to investigate the dissociation of bhnq(-2) from the complex upon reduction, and the effects of pH, redox potential, oxygen concentration and nature of the auxiliary ligands on this reaction. The bhnq(2-) ligand is a "non-cytotoxic" agent that was chosen as a probe for the reactivity studies due to its suitable chromophoric properties, at the same time that it resembles more cytotoxic naphthoquinones relevant for cancer therapy. In this way, two Co(III) complexes [Co(bhnq)(L1)]BF4·H2O (1) and [Co(bhnq)(L2)]BF4·H2O (2) (L1=N,N'-bis(pyridin-2-ylmethyl)ethylenediamine and L2=N,N'-dimethyl-N,N'-bis(pyridin-2-ylmethyl)ethylenediamine) were synthesized and fully characterized. The gallium analogs [Ga(bhnq)(L1)]NO3·3H2O (3) and [Ga(bhnq)(L2)]NO3·3H2O (4) were also prepared for helping with the assignments of the redox properties of the cobalt complexes and the structure of 2. Cyclic voltammetry analysis revealed a pH-independent quasi-reversible Co(III)/Co(II) process at -0.22 and -0.08V vs NHE for 1 and 2, respectively. An O2-dependent dissociation of bhnq(2-) was observed for the reaction of 1 with ascorbic acid. For 2, the dissociation of bhnq(2-) was found to be independent on the concentration of O2 and faster than in 1, with little influence of the pH on both complexes. The difference in reactivity between 1 and 2 and their redox properties, among other factors, suggests that 1 undergoes redox cycling, pointed out as a key feature for a prodrug to achieve hypoxic selectivity.

Asunto(s)

RESUMEN

Dimerization of lawsone occurs upon reaction with Co(BF(4))(2)·6H(2)O and N,N'-bis(pyridin-2-ylmethyl)ethylenediamine (py(2)en) to produce the mononuclear complex [Co(III)(bhnq)(py(2)en)]BF(4)·H(2)O (1). This complex has been investigated as a prototype of a bioreductive prodrug, where the bhnq(2-) ligand acts as a model for cytotoxic naphthoquinones. Cyclic voltammetry data in aqueous solution have shown a quasi-reversible Co(III)/Co(II) process at E(1/2) = -0.26 V vs Fc/Fc(+). Reactivity studies revealed the dissociation of bhnq(2-) from the complex upon reduction of 1 with ascorbic acid, and a dependence of the reaction rate on the oxygen concentration suggests the occurrence of redox cycling.

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

The attention deficit hyperactivity disorder (ADHD) is the most common diagnosis in child psychiatry, and persists very often in adulthood. These patients have poor lifestyles, especially in affective, work and social areas. Although patients with ADHD have a high rate of comorbidity (e.g. drug and alcohol abuse, depressive and anxiety disorders), this diagnosis is missed by the general physician, deferring its identification and opportune treatment. This article is a review about this disorder and gives tools for its recognition and derivation.

Asunto(s)