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The management of heart failure (HF) in patients with type 2 diabetes has significantly evolved with the introduction of sodium-glucose cotransporter 2 (SGLT2) inhibitors. This article aims to consolidate existing knowledge on the efficacy of these inhibitors in managing HF in this patient population. Major medical databases, including PubMed, Scopus, and Web of Science, were reviewed, prioritizing research from the last decade. The results of this review highlight the mechanisms of action of SGLT2 inhibitors, their clinical benefits, challenges in patient management, and outcomes associated with their use. These medications were found to not only improve glycemic control but also offer significant cardiovascular and renal benefits, reducing cardiovascular mortality and major adverse cardiovascular events. However, challenges and knowledge gaps persist, particularly regarding long-term effects and safety in diverse populations. The conclusions of this review underscore the importance of updating clinical guidelines to incorporate these findings and propose the need for future research to address existing gaps and optimize the use of SGLT2 inhibitors in clinical practice.

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Background: Non-ischemic dilated cardiomyopathy (NIDCM) is a form of heart failure with a poor prognosis and unclear optimal management. The aim of the study was to systematically review the literature and assess the efficacy and safety of beta-blockers and angiotensin-converting enzyme (ACE) inhibitors in the management of chronic heart failure secondary to NIDCM and explore their putative mechanisms of action. Methods: Studies from 1990 to 2023 were reviewed using PubMed and EMBASE, focusing on their effects on left ventricular ejection fraction (LVEF) in NIDCM patients, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: Beta-blockers showed a significant beneficial effect on LVEF improvement in NIDCM, with an overall effect size of Cohen's d = 1.30, 95% confidence interval (CI) (0.76, 1.84), high heterogeneity (Tau2 = 0.90; Chi2 = 162.05, df = 13, P < 0.00001; I2 = 92%), and a significant overall effect (Z = 4.72, P < 0.00001). ACE inhibitors also showed a beneficial role, but with less heterogeneity (Tau2 = 0.02; Chi2 = 1.09, df = 1, P = 0.30; I2 = 8%) and a nonsignificant overall effect (Z = 1.36, P = 0.17), 95% CI (-0.24, 1.31). Conclusions: The study highlights the efficacy of carvedilol in improving LVEF in NIDCM patients over ACE inhibitors, recommends beta-blockers as first-line therapy, and advocates further research on ACE inhibitors.

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Fluid status (FS) is a diagnostic challenge in critically ill patients with COVID-19. Here, we compared parameters related to FS derived from cumulative fluid balance (CFB), bioelectrical impedance analysis (BIA) and venous congestion assessed by ultrasound (VExUS) to predict mortality. We retrospectively reviewed the medical records of individuals with severe pneumonia due to COVID-19 between July and November 2021 in a single center. Comorbidities, demographic, clinical and laboratory data as well as results from CFB, BIA and VExUS measurements were collected on admission and weekly afterwards for two consecutive evaluations. Seventy-nine patients were included, of which eighteen (14.2%) died. Abnormalities of FS were only identified by BIA. Extracellular water/total body water ratio (ECW/TBW) > 0.394 (overhydrated) by BIA was a good predictor of mortality (AUC = 0.78, 95% CI: 0.067-0.89). Mortality risk was higher in overhydrated patients (OR: 6.2, 95% CI: 1.2-32.6, p = 0.02) and in persistently overhydrated patients (OR: 9.57, 95% CI: 1.18-77.5, p = 0.03) even after adjustment to age, serum albumin and acute kidney injury (AKI) in stages 2-3. Time to death was shorter in overhydrated patients (HR: 2.82, 95% CI: 1.05-7.5, log-rank test p = 0.03). Abnormalities in FS associated with mortality were only identified by BIA in critically ill patients with COVID-19.

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Comprender desde la determinación social de la salud el papel de los procesos generales, particulares y singulares sobre la realización del derecho a salud bucal de mujeres en periodo de post-parto en Santiago de Chile. Diseño cualitativo exploratorio con mujeres primíparas o multíparas en primer trimestre postparto, beneficiarias FONASA usuarias de Chile Crece Contigo. Se aplicó encuesta de clasificación social, exámenes clínicos, entrevistas semiestructuradas o grupos de discusión. Para el nivel general se analizó profusa información referencial. Existen procesos generales que favorecen la realización del derecho a salud bucal como las políticas de protección integral a la infancia, la priorización de la atención en salud en gestantes; la existencia de derechos adquiridos para la embarazada: permiso pre y post natal y fuero maternal. Desfavorece el modelo de desarrollo neoliberal y consecuentes condiciones de pobreza, la inequidad de género y el énfasis cultural en la responsabilidad femenina sobre el cuidado. Los procesos críticos actúan en los tres niveles del modelo teórico. Si bien en el nivel particular se identifica un avance en las políticas públicas, este no redunda en una efectiva realización del derecho a nivel singular pues enfrenta elementos estructurales del nivel general, sobre todo en el ámbito laboral y cultural.

Objective: To understand from the framework of social determination of health the role of general, particular and singular processes in the realization of the right to oral health for women in the postpartum period and their newborn children during the first year of life, in Santiago de Chile. Materials and Methods: Exploratory qualitative design with FONASA beneficiary women and newborn children. A social classification survey, semi-structured interviews and focus groups were applied to primiparous or multiparous women of childbearing age in the first postpartum trimester, beneficiaries of the Intersectoral Program ÒChile Crece ContigoÓ. Discussion: For the general level, extensive reference information was analyzed. Results: Some general processes favor the realization of the right to oral health, such as comprehensive protection policies for children, the dynamics of the health care system, and the existence of acquired rights for pregnant women, such as pre and post-natal, and maternity leave. The processes that disfavor its realization are the neoliberal development model, the conditions of poverty, gender inequity (income, employment/unemployment) and cultural factors such as the emphasis on female responsibility for care. Conclusions: The critical processes for the realization of the right to oral health act at the three levels of the theoretical model. There is an advance in public policies at the individual level. However, this does not result in an effective realization of the right at a singular level since it confronts structural elements of the general level, especially in the work and cultural field.

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Resumen Introducción: el parto pretérmino es una importante causa de morbimortalidad perinatal; entre las principales etiologías está la infección inflamación intraamniótica que se asocia a resultados perinatales adversos. El objetivo del presente estudio fue evaluar la asociación de la antibioticoterapia con los desenlaces maternos, fetales y perinatales en gestantes con sospecha de infección intraamniótica en un centro de alta complejidad obstétrica. Métodos: estudio analítico de cohortes ambispectivo en gestantes con embarazo simple con edad gestacional ≥ 24 semanas atendidas en la Clínica Universitaria Bolivariana (CUB) con sospecha diagnóstica de infección/inflamación intramniótica subclínica desde enero del 2011 a diciembre del 2021. Se evaluó la asociación entre el uso de antimicrobianos y los desenlaces clínicos materno y perinatales. Resultados: entre los hallazgos clínicos, ecográficos y paraclínicos se destacó el dolor abdominal, sangrado y la presencia de sludge en la cervicometría. La prevalencia del uso de antimicrobianos entre quienes tenían sludge fue 1,88 veces comparado con quienes no tenían este hallazgo ecográfico, (IC95% 1,23- 2,88), p 0,0009; mientras que la de la dinámica uterina fue 1,43 veces (IC95% 1,06- 1,94), p 0,050. La diferencia de medianas de los leucocitos en líquido amniótico reportó un exceso del número de leucocitos por campo entre las que recibieron antimicrobianos, diferencia de 9 (IC95% 5- 25), p <0,0001. El parto pretérmino fue más frecuente en las pacientes que tenían indicación clínica de uso de antimicrobianos (RR 1,58 IC95% 0,96- 2,61), tras de ajustar el análisis por tiempo de latencia entre la sospecha de infección y el parto se observó que el uso de antimicrobianos reduce en un 46% el riesgo de parto pretérmino, RR 0,54 (IC95% 0,35- 0,83). En las pacientes con cultivo positivo de líquido amniótico la mediana de latencia hasta el parto fue de 4 semanas (RIQ 0- 9) y de 11 (RIQ 8- 15) en las que no se obtuvo aislamiento, con una diferencia de medianas de 6 semanas (IC95% 1- 10). Conclusiones: en las pacientes con sospecha de infección inflamación intraamniótica la terapia antibiótica se relacionó con un menor riesgo de parto pretérmino, y el cultivo positivo en líquido amniótico con una menor latencia de la gestación.

Abstract Introduction: preterm birth is an important underlying cause of perinatal morbidity and mortality; one of the primary etiologies is intra-amniotic inflammation/infection, which are associated with adverse perinatal outcomes. The purpose of this study was to assess the relationship between antimicrobial treatment and maternal, fetal, and perinatal clinical outcomes in pregnant patients with suspected intra-amniotic inflammation/infection seen at a nationally- and internationally- recognized university hospital for high-risk obstetric cases in Medellín, Colombia. Methods: the researchers conducted an ambispective cohort study of singleton pregnancies with gestational ages > 24 weeks seen at the Clínica Universitaria Bolivariana (CUB) with suspected subclinical intra-amniotic inflammation/infection between January 2011 and December 2021 (n=75). The relationship between the use of antimicrobial treatment and maternal and perinatal clinical outcomes. Results: after conducting an analysis of clinical, para-clinical and laboratory evidence, the most statistically significant findings included abdominal pain, acute vaginal bleeding, and the presence of amniotic fluid "sludge" found during ultrasound cervicometry. The use of antimicrobial therapy was 1.88 times more common among patients with amniotic fluid "sludge" when compared to those without the presence of this clinical finding (CI 95% 1.23 to 2.88), p=0.0009; it was 1.43 times more common among patients experiencing uterine dynamics (CI 95% 1.06 to 1.94), p=0.050. The median difference of leukocytes in amniotic fluid showed an excess of leukocytes per field in patients who received antimicrobials, a difference of 9 leukocytes (CI 95% 5 to 25), p <0.0001. Preterm labor was more frequent in patients in whom there was a clinical indication for the use of antimicrobials (RR 1,58 IC95% 0,96- 2,61). After adjusting the analysis by time of latency between the suspicion of infection and labor, it was observed that the use of antimicrobials reduced the rish of preterm labor by 46% RR 0,54 (IC95% 0,35- 0,83). In culture-positive patients, the median latency period until birth was 4 (IQR 0-9 weeks) and 11 (IQR 8-15 weeks) in culture-negative patients, with a median difference of 6 weeks (CI 95% 1 to 10). Conclusion: among patients with suspected intra-amniotic inflammation/infection, antimicrobial therapy is associated with a lower risk for preterm birth, and lower latency period among culture-positive patients.

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Resumen Trichophyton benhamiae es un dermatofito zoofílico. Puede causar tinea corporis, tinea faciei y tinea capitis. Se caracteriza por producir lesiones inflamatorias, sobre todo en niños. El objetivo de esta publicación es describir 7 casos clínicos de pacientes pediátricos atendidos entre julio del 2019 y enero del 2020 en nuestra institución. A los pacientes se les solicitó estudio micológico convencional, con posterior confirmación con MALDI-TOF MS y secuencia-ción del ADN ribosomal. Se aisló e identificó T. benhamiae como agente etiológico; el nexo epidemiológico fue el contacto con cobayos. Estas son las primeras descripciones de infecciones causadas por T. benhamiae en Argentina. Al realizar estudios micológicos convencionales, este agente puede confundirse con otros dermatofitos, por lo tanto, se requieren herramientas como MALDI-TOF MS o la secuenciación para llegar a un diagnóstico definitivo. Es importante contar con datos epidemiológicos, como el contacto con mascotas no tradicionales, para una presunción diagnóstica adecuada.

Trichophyton benhamiae is a zoonotic dermatophyte that can cause tinea corporis, tinea faciei and tinea capitis, producing inflammatory lesions, especially in children. In this publication, we describe 7clinical cases of pediatric patients that occurred in our institution between July 2019 and January 2020. All patients underwent a conventional mycological study. The identification of fungi isolates was confirmed by MALDI-TOF MS and sequencing of the ribosomal DNA. T. benhamiae was identified as the etiological agent, whose epidemiological link in all cases was the contact with Guinea pigs. This is the first description of infections caused by T. benhamiae in Argentina. This dermatophyte can be misidentified as other more frequent dermatophytes when performing conventional studies. Molecular technology should be used to reach a definitive diagnosis. It is important to have epidemiological data from patients such as contact with non-traditional pets, especially Guinea pigs, for an adequate presumptive diagnosis of this dermatophytosis.

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The genetics of allorecognition has been studied extensively in inbred lines of Hydractinia symbiolongicarpus, in which genetic control is attributed mainly to the highly polymorphic loci allorecognition 1 (Alr1) and allorecognition 2 (Alr2), located within the Allorecognition Complex (ARC). While allelic variation at Alr1 and Alr2 can predict the phenotypes in inbred lines, these two loci do not entirely predict the allorecognition phenotypes in wild-type colonies and their progeny, suggesting the presence of additional uncharacterized genes that are involved in the regulation of allorecognition in this species. Comparative genomics analyses were used to identify coding sequence differences from assembled chromosomal intervals of the ARC and from genomic scaffold sequences between two incompatible H. symbiolongicarpus siblings from a backcross population. New immunoglobulin superfamily (Igsf) genes are reported for the ARC, where five of these genes are closely related to the Alr1 and Alr2 genes, suggesting the presence of multiple Alr-like genes within this complex. Complementary DNA sequence evidence revealed that the allelic polymorphism of eight Igsf genes is associated with allorecognition phenotypes in a backcross population of H. symbiolongicarpus, yet that association was not found between parental colonies and their offspring. Alternative splicing was found as a mechanism that contributes to the variability of these genes by changing putative activating receptors to inhibitory receptors or generating secreted isoforms of allorecognition proteins. Our findings demonstrate that allorecognition in H. symbiolongicarpus is a multigenic phenomenon controlled by genetic variation in at least eight genes in the ARC complex.

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Atopic dermatitis (AD) is a chronic disease of the skin with significant pruritus and phases of exacerbation and remission. The hallmarks of AD are changes in the epithelial barrier and chronic inflammation. This condition is associated with an increased risk of developing mental disorders such as depression, anxiety, and suicidal ideation. It has been proposed that psychological stress may impact on immunological factors with an up-regulation of mediating neuropeptides at the level of central nervous system and secondary involvement of endocrine glands, peripheral nervous system, and immune resident skin cells. This article provides a concise review for dermatologists on the psychodermatology of AD, in order to highlight the putative common pathways between the dermatologic and mental health issues in this illness.

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Trichophyton benhamiae is a zoonotic dermatophyte that can cause tinea corporis, tinea faciei and tinea capitis, producing inflammatory lesions, especially in children. In this publication, we describe 7clinical cases of pediatric patients that occurred in our institution between July 2019 and January 2020. All patients underwent a conventional mycological study. The identification of fungi isolates was confirmed by MALDI-TOF MS and sequencing of the ribosomal DNA. T. benhamiae was identified as the etiological agent, whose epidemiological link in all cases was the contact with Guinea pigs. This is the first description of infections caused by T. benhamiae in Argentina. This dermatophyte can be misidentified as other more frequent dermatophytes when performing conventional studies. Molecular technology should be used to reach a definitive diagnosis. It is important to have epidemiological data from patients such as contact with non-traditional pets, especially Guinea pigs, for an adequate presumptive diagnosis of this dermatophytosis.

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There is widespread concern about the increase in cases of human and animal infections caused by pathogenic Vibrio species due to the emergence of epidemic lineages. In Colombia, active surveillance by the National Institute of Health (INS) has confirmed the presence of Vibrio; however, in routine surveillance, these isolates are not genomically characterized. This study focused on the pangenome analysis of six Vibrio species: V. parahaemolyticus, V. vulnificus, V. alginolyticus, V. fluvialis, V. diabolicus and V. furnissii to determine the genetic architectures of potentially virulent and antimicrobial resistance traits. Isolates from environmental and clinical samples were genome sequenced, assembled and annotated. The most important species in public health were further characterized by multilocus sequence typing and phylogenomics. For V. parahaemolyticus, we found the virulent ST3 and ST120 genotypes. For V. vulnificus, we identified isolates belonging to lineages 1 and 2. Virulence gene homologues between species were found even in non-pathogenic species such as V. diabolicus. Annotations related to the mobilome, integrative mobile and conjugative elements and resistance genes were obtained from environmental and clinical isolates. This study contributes genomic information to the intensified surveillance program implemented by the INS to establish potential sources of vibriosis in Colombia.

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RESUMEN Las dietas basadas en plantas (DBP) se caracterizan por una alta ingesta de alimentos de origen vegetal y evitan parcial o totalmente los productos animales. El objetivo de esta revisión fue recopilar evidencia sobre DBP, sus tipos y su efecto en principales factores de riesgo cardio-metabólicos (FRCM) modificables. Se encontró que existen DBP saludables y no saludables. Algunas DBP saludables son: vegetariana, mediterránea y DASH (sigla en inglés de la dieta Enfoques Alimenticios para Detener la Hipertensión). Estas promueven la ingesta de alimentos de origen vegetal "saludables" (frutas, verduras, legumbres, semillas, frutos secos, cereales integrales, palta, aceite de oliva y/o canola) y, una reducción gradual de todos los alimentos de origen animal, especialmente carnes rojas y procesadas; evitando alimentos de origen vegetal "menos saludables" (cereales refinados, fritos, productos de pastelería, alimentos con azúcar añadido). Las DBP no saludables, se caracterizan por una alta ingesta de estos alimentos "menos saludables", y se asocian con mayor riesgo cardiovascular, por el bajo aporte de antioxidantes, micronutrientes, fibra dietética y grasas insaturadas. DBP saludables pueden disminuir el riesgo de diabetes tipo 2, hipertensión arterial, sobrepeso y obesidad. Han mostrado mayores beneficios cardiovasculares en comparación con dietas tradicionales, reduciendo significativamente: HbA1c y glicemia en ayunas en diabéticos; presión arterial sistólica y diastólica en hipertensos y prehipertensos; índice de masa corporal en sujetos con sobrepeso/obesidad y mejorando el perfil lipídico en sujetos con dislipidemia. Patrones de DBP saludables, como el tipo vegetariano, mediterráneo y DASH son recomendadas para prevenir y tratar los FRCM.

ABSTRACT Plant-based diets (PBD) are characterized by a high intake of foods of plant origin and the partial or total avoidance of animal products. The objective of the current study was to compile the evidence on types of PBD and its effect on the main modifiable cardio-metabolic risk factors (CMRF). Healthy and unhealthy PBD were found to exist. Some healthy PBDs were: vegetarian, mediterranean and DASH (Dietary Approaches to Stop Hypertension). These promote the intake of "healthy" plant-based foods (fruits, vegetables, legumes, seeds, nuts, whole grains, avocado, olive oil and / or canola) and a gradual reduction of all foods of animal origin, especially red and processed meats; avoiding "less healthy" plant-based foods (refined, fried cereals, pastry products, foods with added sugar). Unhealthy PBDs were characterized by a high intake of these "less healthy" foods, and are associated with greater cardiovascular risk, due to the low contribution of antioxidants, micronutrients, dietary fiber and unsaturated fats. Healthy PBDs can lower the risk of type 2 diabetes, high blood pressure, being overweight, and obesity. They have shown greater cardiovascular benefits compared to traditional diets, significantly reducing: HbA1c and fasting glycemia in diabetics; systolic and diastolic blood pressure in hypertensive and prehypertensive patients; body mass index in overweight / obese subjects and improves lipid profile in subjects with dyslipidemia. Healthy PBD patterns, such as vegetarian, Mediterranean, and DASH are recommended to prevent and treat CMRF.

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BACKGROUND: Length of stay (LOS) for inpatient psychiatric services is an important factor with serious drawbacks when it is extended more than needed. Impacts on economy, social functioning, and stigma can hamper improvement and affect the patients' experiences on future mental healthcare. Predictions of which patients have a higher chance for prolonged LOS have been extensively researched. Previous systematic reviews found consistent predictors of both longer and shorter LOS. However, they do not provide an estimate from the pooled effect sizes. Furthermore, to our knowledge, there is no meta-analysis on the influence of these factors. The primary objective of this study will be to provide point estimates on the effect sizes of all studied predictors of the LOS of psychiatric inpatients. METHODS: We will conduct a systematic search in PubMed, MEDLINE, EMBASE, and PsycINFO for observational studies evaluating the effect size of independent factors on the length of stay of psychiatric inpatients. Prospective and retrospective cohorts that assess the influence of predictors through the reporting of standardized regression coefficients will be included. We will provide a qualitative synthesis of the findings from each study and perform a meta-analysis from pooled regression coefficients that were adjusted for other variables or confounders in order to obtain a point estimate and confidence interval for all factors extracted from the included studies. DISCUSSION: The results from this study may provide more accurate predictions for mental health institutions, psychiatrists, mental health service providers, patients, and families on the prognosis regarding the length of stay for needed inpatient care. This information may be used to anticipate individuals with a higher chance for prolonged hospitalization to plan the necessary interventions for these specific situations. Considering both the benefits and disadvantages of longer and shorter stays, the pooled estimates for independent factors may be used by mental healthcare providers and patients for informed decision-making. The results from this study will also update results presented in previous studies and identify the strengths and limitations from the current available evidence. SYSTEMATIC REVIEW REGISTRATION: PROSPERO ID CRD42020172840.

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BACKGROUND: Colombia has one of the largest populations of internally displaced individuals by an armed conflict. However, there is no data demonstrating its effect on health, particularly in adolescents. PURPOSE: To describe the prevalence and associations of mental illness in the adolescent population displaced by violence in Colombia. METHODS: We conducted a secondary analysis of the 2015 National Mental Health Survey (NMHS), which provides data of mental health issues (SRQ), mental health disorders (CIDI-CAPI) and sociodemographic characteristics. RESULTS: Of the 1754 adolescents interviewed 5.3% (95% CI 4.1 to 6.9) mentioned a change in residence due to violence. Among them 38.5% lived in poverty compared to 23.6% of those non-displaced by the conflict. Suicidal thoughts and suicide attempt were present in 19.8% and 9.1% of displaced adolescents respectively, compared to 5.8% and 2.1% of non-displaced adolescents. The prevalence of post-traumatic stress disorder (PTSD) and any mental health disorder (measured with the CIDI-CAPI) was higher in the displaced population 12.3%, 11% respectively, in contrast to 2.1% and 7% of those non-displaced. Finally, anxiety and depressive disorders were more common among displaced adolescents. CONCLUSION: A higher prevalence of mental health conditions and disorders is observed among displaced adolescents.

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Congenital candidiasis infection often presents as a skin rash with variable involvement of nails and mucous membranes. Isolated nail involvement is rare, may present late, and can often be managed with topical antifungal medication. We report a case of congenital candidiasis limited to the fingernails that resolved completely within 3 months with topical treatment.

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Hoy, más que nunca, se habla de proteger a las poblaciones o grupos más vulnerables para garantizar igualdad de oportunidades y evitar discriminación. Sin embargo, es importante reconocer que aquellos denominados vulnerables son jurídicamente sujetos de especial protección que ameritan un enfoque diferencial de parte de los tomadores de decisión.

Today, more than ever, there is talk of protecting the most vulnerable populations or groups to guarantee equal opportunities and avoid discrimination. However, it is important to recognize that those called vulnerable are legally subjects of special protection that merit a differential approach on the part of decision makers.

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BACKGROUND: Latin America harbors some of the most biodiverse countries in the world, including Colombia. Despite the increasing use of cutting-edge technologies in genomics and bioinformatics in several biological science fields around the world, the region has fallen behind in the inclusion of these approaches in biodiversity studies. In this study, we used data mining methods to search in four main public databases of genetic sequences such as: NCBI Nucleotide and BioProject, Pathosystems Resource Integration Center, and Barcode of Life Data Systems databases. We aimed to determine how much of the Colombian biodiversity is contained in genetic data stored in these public databases and how much of this information has been generated by national institutions. Additionally, we compared this data for Colombia with other countries of high biodiversity in Latin America, such as Brazil, Argentina, Costa Rica, Mexico, and Peru. RESULTS: In Nucleotide, we found that 66.84% of total records for Colombia have been published at the national level, and this data represents less than 5% of the total number of species reported for the country. In BioProject, 70.46% of records were generated by national institutions and the great majority of them is represented by microorganisms. In BOLD Systems, 26% of records have been submitted by national institutions, representing 258 species for Colombia. This number of species reported for Colombia span approximately 0.46% of the total biodiversity reported for the country (56,343 species). Finally, in PATRIC database, 13.25% of the reported sequences were contributed by national institutions. Colombia has a better biodiversity representation in public databases in comparison to other Latin American countries, like Costa Rica and Peru. Mexico and Argentina have the highest representation of species at the national level, despite Brazil and Colombia, which actually hold the first and second places in biodiversity worldwide. CONCLUSIONS: Our findings show gaps in the representation of the Colombian biodiversity at the molecular and genetic levels in widely consulted public databases. National funding for high-throughput molecular research, NGS technologies costs, and access to genetic resources are limiting factors. This fact should be taken as an opportunity to foster the development of collaborative projects between research groups in the Latin American region to study the vast biodiversity of these countries using 'omics' technologies.

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El objectivo de la investigación fue explorar las vivencias de la atención perinatal de usuarias lesbianas en la Región Metropolitana, Chile en 2016. Se trata de un estudio transversal exploratorio con enfoque fenomenológico, usando la estrategia muestral bola de nieve. Fueron realizadas entrevistas en profundidad con análisis de contenido. Se han experimentado vivencias favorables de las usuarias lesbianas sobre su proceso de gestación, parto y puerperio y un trato inclusivo y antidiscriminatorio de los proveedores de salud. Hay una aceptación generalizada de los profesionales de salud hacia las familias homoparentales y a la visibilización de la homosexualidad. El empoderamiento y la autoestima de las usuarias entrevistadas es un elemento que favorece la relación médico-paciente. Sin embargo, las alternativas para acceder a la maternidad no se encuentran asequibles para toda la población debido al alto costo que poseen.(AU)

The study aimed to explore the experiences of perinatal care of lesbian users in the metropolitan area of Chile in 2016. It was a cross-sectional and phenomenological study with snowball sampling. In-depth interviews were carried out and the reports were interpreted using the content analysis technique. The interviews revealed positive experiences by lesbian users during their pregnancy, childbirth and postpartum periods, and an inclusive treatment, with no prejudice by healthcare providers. There is a broad acceptance by healthcare professionals of homosexual families and the visibility of homosexuality. The empowerment and self-esteem exhibited by the interviewed users favor the doctor-patient relationship. However, the alternatives to achieve motherhood are not available for the entire population because of their high cost.(AU)

O objetivo do trabalho foi percorrer as vivências da atenção perinatal, de usuárias lésbicas na região metropolitana do Chile em 2016. Trata-se de estudo transversal de exploração com abordagem fenomenológica, utilizando a amostragem em bola de neve. Foram realizadas entrevistas em profundidade, com análise de conteúdo. Foram observadas vivências favoráveis das usuárias lésbicas acerca de seus processos de gestação, parto e puerpério, e um tratamento inclusivo e sem discriminação dos prestadores de saúde. Existe uma geral aceitação dos profissionais da saúde em relação às famílias homossexuais e à visibilidade da homossexualidade. O empoderamento e a autoestima das usuárias entrevistadas é um elemento que favorece o relacionamento médico-paciente. Porém, as alternativas para alcançar a maternidade não são acessíveis para toda a população, devido ao alto custo que elas têm.(AU)

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Fundamento: las prácticas clínicas son un componente esencial para la formación de los estudiantes de Obstetricia y Puericultura, porque permiten aplicar los conocimientos teóricos adquiridos. Objetivo: identificar los estresores que influyen desfavorablemente en los estudiantes de segundo y tercer años de la carrera de Obstetricia y Puericultura de la Universidad de Chile, durante las prácticas clínicas. Métodos: se realizó un estudio transversal y descriptivo en la Escuela de Obstetricia y Puericultura de la Universidad de Chile durante el periodo marzo-diciembre, 2016. Se utilizaron métodos teóricos para la fundamentación de la investigación y empíricos: el cuestionario Stai para medir el nivel de ansiedad y el Kezkak, que mide estresores en las prácticas clínicas. Resultados: se identificaron los estresores que afectan la práctica clínica de los estudiantes de segundo y tercer años de Obstetricia; se constató, a través de la aplicación del cuestionario de Kezkak, que los más altos se relacionan con las competencias, la impotencia e incertidumbre; y como menos preocupantes, las relaciones interpersonales y la implicación emocional, entre ellas la muerte de un paciente, esta última dada por la inexperiencia en la atención a enfermos terminales; el cuestionario de Stai indica que la ansiedad/rasgo es mayor en comparación con la ansiedad/estado. Conclusiones: las situaciones de estrés que viven con mayor intensidad los estudiantes se deben a la inseguridad que representa enfrentarse a situaciones nuevas y al miedo a no saber responder con un dominio adecuado de las competencias, más que a un rasgo de su personalidad.

Background: clinical practices are an essential component for the training of students of Obstetrics and Childcare, because they allow applying the theoretical knowledge acquired. Objective: to identify the stressors that adversely affect the second and third year students of the Obstetrics and Child Care of the University of Chile, during the clinical practices. Methods: a cross-sectional and descriptive study was carried out at the School of Obstetrics and Child Care of the University of Chile during the period March-December, 2016. Theoretical methods were used for the foundation of the research and empirical: the Stai questionnaire to measure the level of anxiety and Kezkak, which measures stressors in clinical practices. Results: stressors that affect the clinical practice of the second and third year obstetrics students were identified; it was found, through the application of the Kezkak questionnaire, that the highest are related to competencies, impotence and uncertainty; and as less worrisome, interpersonal relationships and emotional involvement, including the death of a patient, the latter given by inexperience in the care of the terminally ill; Stai's questionnaire indicates that the anxiety / trait is greater compared to the anxiety / condition. Conclusions: the situations of stress that students live with greater intensity are due to the insecurity that represents facing new situations and the fear of not knowing how to respond with a proper mastery of the skills, rather than a feature of his personality.

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Objetivo: describir los cambios microscópicos in vitro de 27 cuerpos de prueba elaborados en amalgama de plata de tres marcas comerciales (Contour® Kerr®, Admix® SDI® y Nu Alloy® Newstethic®) sometidos a altas temperaturas (200ºC, 400ºC y 600ºC) observados mediante microscopia electrónica de barrido. Materiales y métodos: estudio observacional descriptivo, de corte transversal y de naturaleza pseudo-experimental que analizó el comportamiento in vitro de 27 cuerpos de prueba elaborados en tres marcas comerciales de amalgama de plata (Contour® Kerr®, Admix® SDI® y Nu Alloy® Newstethic®) sometidos a altas temperaturas (200ºC, 400ºC, 600ºC). Resultados: las tres marcas comerciales de amalgama de plata empleadas en este estudio tuvieron un comportamiento similar, excepto en el comportamiento de los nódulos de plata. Estos aparecieron a los 200ºC en Admix® SDI® y a los 400ºC en Contour® Kerr® y Nu Alloy® Newstethic®. El análisis en microscopía electrónica de barrido y espectrofotometría de la superficie de los cuerpos de prueba evidenció el aumento estadísticamente significativo (p<0,05) del porcentaje de peso atómico de Hg, Cu y Sn. Conclusiones: los cuerpos de prueba de las tres marcas comerciales de amalgama de plata sufren cambios en su microestructura en la medida que aumenta la temperatura. La formación de los nódulos de Ag fue explicada como una consecuencia del comportamiento de la fase gamma 1 de Ag-Hg al aumentar la temperatura, la cual empieza a disociarse a los 200ºC en Admix® SDI® y a los 400ºC en Contour® Kerr® y Nu Alloy® Newstethic®.

Objective: describe the in vitro microscopic changes of dental amalgam test bodies subjected to high temperatures observed by scanning electron microscopy. Materials and methods: descriptive observational cross-sectional study of pseudo-experimental nature that analyzed by scanning electron microscopy (SEM) the in vitro behavior of 27 test bodies elaborated in three brands of dental amalgam (Contour® Kerr®, Admix® SDI® and Nu Alloy® Newstethic®) subjected to high temperatures (200ºC, 400ºC, 600ºC). Results: the three trademarks of dental amalgam used in this study had a similar behavior, except for the behavior of silver nodules. These appeared to 200ºC in the test bodies of Admix® SDI® and 400ºC in the test bodies of Contour® Kerr® and Nu Alloy® Newstethic®. The analysis of scanning electron microscopy and spectrophotometry at the surface of the test bodies showed the statistically significant increase (p<0.05) the percentage of atomic weight of mercury, copper and tin. Conclusions: the test bodies of the three trademarks of dental amalgam undergo changes in their microstructure so long as the temperature increases. The formation of silver nodules was explained as a consequence of the behavior of the gamma 1 phase silver-mercury with increasing temperature, which begins to dissociate at 200ºC in the test bodies of Admix® SDI® and 400ºC in the test bodies of Contour® Kerr® and Nu Alloy® Newstethic®.

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