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Introducción: La educación sexual es uno de los pilares básicos del desarrollo humano por cuanto potencia la autonomía de las personas y el desarrollo de una sexualidad plena. Objetivo: Este estudio buscó describir la percepción respecto a la educación sexual de adolescentes de dos establecimientos educacionales de Talcahuano, Chile. Método: Se realizó un estudio de corte transversal de carácter descriptivo con 309 estudiantes de dos colegios ubicados en la Comuna de Talcahuano, región del Bío-Bío, Chile. Se aplicó de forma presencial un cuestionario de autorreporte. Los datos fueron analizados mediante el software IBM Statistics SPSS v.22. Resultados: El 61,8% reportó recibir educación sexual en su establecimiento y casi la totalidad consideró necesario aprender sobre ello. Un 52,7% refirió que sus establecimientos generaban instancias para hablar de sexualidad. En relación con las temáticas que deberían ser incluidas en la educación sexual, «Valores, respeto, ética», «Anticonceptivos y prevención de infecciones de transmisión sexual» y «Amor y afectividad» fueron las más preferidas. Conclusión: Pese a la existencia de instancias de educación sexual en los establecimientos educacionales y a la transversal opinión de que es necesario aprender sobre este tema, existe una baja percepción respecto a su suficiencia.

Introduction: Sex education is one of the basic pillars of human development because it enhances people's autonomy and the development of full sexuality. Objective: This study sought to describe the perception regarding sex education of adolescents from two educational establishments in Talcahuano, Chile. Method: A cross-sectional descriptive study was conducted with 309 students from two schools located in the Talcahuano Commune, Bío-Bío region, Chile. A self-report questionnaire was applied in person. Data were analyzed using IBM Statistics SPSS v.22 software. Results: 61.8% reported receiving sex education in their establishment and almost all considered it necessary to learn about it. 52.7% reported that their establishments generated instances to talk about sexuality. In relation to the topics that should be included in sex education, "Values, respect, ethics", "Contraceptives and prevention of sexually transmitted infections" and "Love and affectivity" were the most preferred. Conclusion: Despite the existence of instances of sex education in educational establishments, and the transversal opinion that it is necessary to learn about this subject, there is a low perception regarding its adequacy.

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The use of alcohol and other drugs is a major public health problem in adolescence. The implementation of evidence-based prevention strategies is still scarce in the global south. This study aimed to evaluate facilitators and barriers to the implementation of the Icelandic prevention model of adolescent substance use (IPM) in Chile. We conducted a qualitative study of stakeholders during the implementation process of the IPM in six municipalities of the Metropolitan Region of Santiago, Chile. We convened six focus groups with parents and professionals from schools and municipal prevention teams (38 participants). Recordings were transcribed and submitted to a six-step thematic analysis. The following facilitators emerged: Participants valued the contribution of the IPM to articulate existing programs and teams, its community focus, and the local data obtained through the survey. There were also several barriers: Those included resistance to adopting a foreign model, the tension between generating local strategies and looking for measures to ensure the fidelity of the implementation, socioeconomic differences between and within municipalities, low-risk perception and supervision of parents in Chile, and a culture that generally does not discourage adolescent substance use. Implementation of the IPM was largely accepted by the stakeholders who agreed with the community approach of the model. The main barriers to consider were related to cultural and socioeconomic factors that need to be addressed in further research and may limit the effects of the model in Chile.

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Two new Andean species of Hoplopeza Bezzi are described and illustrated: Hoplopeza colombiana sp. nov. and Hoplopeza rafaeli sp. nov. These species are the first record from the Andean ecosystem of Colombia. In addition, the genus is diagnosed, the first description of the female terminalia, as well as a key and distribution map of the Andean species of the genus are presented.

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The increasing population in urban areas in the last decades requires an effort to understand the geochemistry of contaminant elements in urban soil. Topsoil plays a crucial role in the exposure of Potentially Toxic Elements (PTEs) to humans through ingestion, dermal contact, and inhalation. In Chile, the last census revealed that 88.6% of people live in cities or towns and only 11.4% in rural areas. This study presents the first systematic geochemical survey of urban soil in the city of Valdivia, in the South of Chile. Topsoil samples (0-10 cm depth) were collected in less disturbed locations within the city at 130 sampling sites using a grid of 0.25 km2 squares covering a total area of approximately 30 km2. The concentrations of Al, Fe, Na, Ca, Mg, K, Ti, Be, V, Cr, Mn, Co, Ni, Cu, Zn, As, Mo, Sn, Cd, Se, Pb and Hg were measured. The results showed that high concentrations of Cu, V, Zn and Pb are located mainly in the city's northern area and exceed international soil quality legislation for agricultural use. Data processing comprised plotting of individual spatial distribution maps and the use of a combination of multivariate statistical methods. Hierarchical cluster analysis and principal component analysis identified three element associations. The two element groups V-Al-Ti-Fe-Cr-Co-Mn-Be-Ni and Ca-Na-K-As-Mg are interpreted as a dominant lithological origin related to the most pristine soil conditions in less populated areas. By contrast, the Sn-Pb-Zn-Mo-(Cu-Hg) association presents a significant correlation with urbanization indicators, including vehicular traffic and industrial activities developed since the end of the nineteenth century in Valdivia.

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Resumen Introducción: la respuesta hipertensiva al ejercicio (RHE) se asocia con alteraciones en mecanismos que controlan la presión arterial (PA). Aunque se sabe de su valor pronóstico, la evidencia de su validez diagnóstica es limitada. Objetivo: evaluar las características operativas de la RHE para detectar la presencia de hipertensión arterial (HTA). Métodos: estudio transversal de validez de una prueba diagnóstica que incluyó personas de ambos sexos, con edades entre 40 a 60 años, con sospecha de alteraciones de la PA. Se definió una RHE por cifras de PA sistólica mayores de 150 mmHg luego de la prueba del escalón de Dundee. La presencia de HTA se definió con monitoreo ambulatorio de la presión arterial de 24 horas. Resultados: se incluyeron 124 pacientes con edad promedio de 50,5 ± 5,9 años. El 54 % fueron mujeres. La frecuencia de RHE fue del 57,3 %, mientras que de HTA fue del 78,2 %. La RHE tuvo una sensibilidad del 59,8 % (IC 95 % 49,5 a 70,1), especificidad del 51,9 % (IC 95 % 31,2 a 72,6), valor predictivo positivo del 81,7 % (IC 95 % 72 a 91,4), valor predictivo negativo del 26,4 % (IC 95 % 13,6 a 39,2), LR+ de 1,2 (IC 95 % 0,8 a 1,9) y LRde 0,8 (IC 95 % 0,5 a 1,2), para detectar la presencia de HTA. Conclusión: la RHE, durante un esfuerzo submáximo en escalón, no presenta buenas características operativas para detectar HTA en pacientes de edad media con sospecha de alteraciones de la PA. Por tal razón, no se recomienda como método de diagnóstico.

Abstract Introduction: Hypertensive response to exercise (HRE) is associated with changes in mechanisms that control blood pressure (BP). Although its prognostic value is well known, the evidence of its diagnostic validity is limited. Objective: To evaluate the operational characteristics of HRE to detect the presence of hypertension. Methods: A cross-sectional study to assess the validity of a diagnostic test, which included middle-aged (40-60) subjects of both sexes, with suspected BP alterations. HRE was defined as systolic BP levels greater than 150 mmHg after the Dundee step test. The presence of hypertension was defined with 24-hour ambulatory blood pressure monitoring. Results: We include 124 patients with an average age of 50.5 ± 5.9 years; 54.0% were women. The frequency of HRE was 57.3% while that of hypertension was 78.2%. HRE had a sensitivity of 59.8% (95% CI 49.5 to 70.1), specificity of 51.9% (95% CI 31.2 to 72.6), positive predictive value of 81.7% (95% CI 72.0 to 91.4), negative predictive value of 26.4% (95% CI 13.6 to 39.2): LR + of 1.2 (95% CI 0.8 to 1.9) and LRof 0.8 (95% CI 0.5 to 1.2) to detect the presence of hypertension. Conclusion: During a submaximal step test, HRE does not have appropriate operating characteristics to detect hypertension in middle-aged patients with suspected BP alterations, therefore, it is not recommended as a diagnostic method

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Background: Tubular damage has a role in Diabetic Kidney Disease (DKD). We evaluated the early tubulointerstitial damage biomarkers in type-1 Diabetes Mellitus (T1DM) pediatric participants and studied the correlation with classical DKD parameters. Methods: Thirty-four T1DM and fifteen healthy participants were enrolled. Clinical and biochemical parameters [Glomerular filtration Rate (GFR), microalbuminuria (MAU), albumin/creatinine ratio (ACR), and glycated hemoglobin A1c (HbA1c)] were evaluated. Neutrophil gelatinase-associated lipocalin (NGAL), Hypoxia-inducible Factor-1α (HIF-1α), and Nuclear Factor of Activated T-cells-5 (NFAT5) levels were studied in the supernatant (S) and the exosome-like extracellular vesicles (E) fraction from urine samples. Results: In the T1DM, 12% had MAU >20 mg/L, 6% ACR >30 mg/g, and 88% had eGFR >140 ml/min/1.72 m2. NGAL in the S (NGAL-S) or E (NGAL-E) fraction was not detectable in the control. The NGAL-E was more frequent (p = 0.040) and higher (p = 0.002) than NGAL-S in T1DM. The T1DM participants with positive NGAL had higher age (p = 0.03), T1DM evolution (p = 0.03), and serum creatinine (p = 0.003) than negative NGAL. The NGAL-E correlated positively with tanner stage (p = 0.0036), the median levels of HbA1c before enrollment (p = 0.045) and was independent of ACR, MAU, and HbA1c at the enrollment. NFAT5 and HIF-1α levels were not detectable in T1DM or control. Conclusion: Urinary exosome-like extracellular vesicles could be a new source of early detection of tubular injury biomarkers of DKD in T1DM patients.

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Four new species of the sciophiline genus Eudicrana Loew are described for the Eastern and Central Andes of Colombia-Eudicrana silvaandina sp. nov., E. chingaza sp. nov., E. maculata sp. nov. and E. merizaldei. These are the first species of Eudicrana described from the extreme northern range of the Andes. The altitudinal distribution of these species in the paramos and high Andean forest ecosystems is restricted to 1750-3660 m a.s.l. and some other information on the environment is briefly discussed. A key for the Colombian species of Eudicrana is provided and a discussion is elaborated on the position of these species within the genus.

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BACKGROUND: Severe mental illness (SMI) among imprisoned individuals is a global health concern. Quantitative research indicates on average mental health symptom improvements during imprisonment, however, it cannot reflect multifaceted factors influencing the course of SMI. This study aimed to explore the subjective course of SMI during imprisonment and to identify influencing factors. METHODS: The study has a 3-year-follow-up design of imprisoned individuals in Chile. We conducted semi-structured interviews with 10 men and 9 women at follow-up who had either major depression or psychosis (severe mental illnesses) at baseline. We included individuals who deteriorated, remained stable or improved their mental health according to quantitative assessments. We explored the subjective course of their mental health condition during the follow-up period. Qualitative data was transcribed and coded using NVivo Software for quantitative content analysis. Qualitative data was also manually coded and was subsequently analyzed using the thematic analysis method with an inductive approach. We developed the final themes using the results of this analysis in combination with the inclusion criteria. RESULTS: The mental health of 10 individuals subjectively improved, 6 experienced deteriorations, and 3 did not perceive any change. Good infrastructure, structure/occupation, intrapersonal resources (will to change, spirituality) and supportive relationships were identified as factors improving mental health. Factors deteriorating mental health were identified as bad infrastructure (e.g., no running water and bad housing conditions) and crowding, lack of psychological treatment, exposure to violence, interpersonal stress (conflictive relationships and separation from family), perceived injustice through sentencing, intrapersonal stressors and previous medical conditions. DISCUSSION: SMI in prison can improve in a supportive environment under certain conditions. These conditions include the improvement of infrastructure (housing and healthcare), the opportunity to work or study, protection from violence during imprisonment, and to develop intrapersonal resources and family relationships. To reduce SMI in prisons the improvement of these conditions should become a priority.

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[This corrects the article DOI: 10.3389/fpsyt.2019.00716.].

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Introduction: Innovative and interdisciplinary approaches are needed to improve mental health and psychosocial outcomes of people with criminal justice involvement and their families. Aim of the study was to assess effects of the participation in a theatre project on the mental health problems of people with criminal justice involvement and relatives. Methods: We conducted structured diagnostic interviews and in-depth qualitative interviews with five participants performing Shakespeare's Richard III in Chile. Three participants had been imprisoned prior to the project, and two were the parents of a person who died in a prison fire. Qualitative interviews followed a topic guide. Data were transcribed, and a six-phase approach for thematic analysis of the data was used. Results: Substance use disorder or major depression was identified in all the participants. Participation in the theatre project was experienced by the respondents as having a positive effect on the mental health conditions. The research registered the positive experiences of role identification, emotional expression, commitment with group processes, improved skills to socially interact, to be heard by the general public and society, and positive perceptions of the audience (including relatives). Discussion: The study raises the possibility that there may be improvements of depression and substance use problems through the participation of people with criminal justice involvement in a drama project. Wider scale research is recommended on the possible effects. The approach may be an alternative to psychotherapy and medication for some individuals.

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BACKGROUND: Recent studies have suggested that there is an earlier age of onset of puberty in healthy boys. However, no study has determined the age of pubertal development in boys with type 1 diabetes (T1D) and compared the results with a simultaneously recruited group of healthy children. OBJECTIVE: The aim of this study was to evaluate the age of pubertal events in boys with TD1 and determine whether the duration of diabetes, metabolic control or insulin dose are associated with the age of puberty in boys with T1D. METHODS: Boys aged 7 to 19 years with T1D (n = 148, age 12.9 ± 3.0 years) and healthy boys recruited from schools (n = 388 controls, age 12.8 ± 2.2 years) were studied. A pediatric endocrinologist evaluated pubertal development. RESULTS: Boys at genital Tanner stage 2 and the final stages of puberty (genital Tanner 4 and 5) were younger than the control group (P = 0.005, P = 0.003, and P = 0.015, respectively). Both groups of boys had a similar age of pubic Tanner stage development. There were no cases of pubertal delay observed in the T1D cohort. There was no association observed between metabolic control with pubertal timing. T1D adolescents had lower height-SDS than the C group at the final stages of puberty. CONCLUSIONS: Boys with T1D who are treated with modern insulin therapy appear to have an earlier age of onset and an earlier age of final pubertal events than a simultaneously studied group of healthy children. These data suggest that pubertal delay is not a frequent problem for male T1D patients.

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"Children with special health care needs" (CSHCN) is an emerging and heterogeneous group of paediatric patients, with a wide variety of medical conditions and with different uses of health care services. There is consensus on how to classify and assess these patients according to their needs, but not for their specific diagnosis. Needs are classified into 6 areas: a) specialised medical care; b) use or need of prescription medication; c) special nutrition; d) dependence on technology; e) rehabilitation therapy for functional limitation; and f) special education services. From the evaluation of each area, a classification for CSHCN is proposed according to low, medium, or high complexity health needs, to guide and distribute their care at an appropriate level of the health care system. Low complexity CSHCN should be incorporated into Primary Care services, to improve benefits for patients and families at this level. It is critical to train health care professionals in taking care of CSHCN, promoting a coordinated, dynamic and communicated work between different levels of the health care system. Compliance with these guidelines will achieve a high quality and integrated care for this vulnerable group of children.

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BACKGROUND: Rapid early ponderal growth is associated with adverse metabolic risks in young adults born at term. AIM: To determine whether there are differences in body composition, resting energy expenditure (REE) and metabolic variables between preterm children born with very low birth weight (VLBW) either appropriate (AGA) or small (SGA) for gestational age and whether these differences are related to an early period of weight gain. METHODS: 67 VLBW preterm (40 AGA, 27 SGA). Body composition by DEXA, REE by indirect calorimetry and blood sampling at age 6.7 ± 0.5 years. RESULTS: VLBW SGA children were lighter, shorter, had a lower waist and hip circumference, HDL cholesterol and lipid oxidation rates than their AGA counterparts (adjusted for age, sex and BMI). Birth weight correlated negatively with total body and trunk fat mass. In a multivariate linear regression analysis, we found a positive association between weight gain in the first 3 months of life and total and trunk fat at age 6 years and a reciprocal association with REE at age 6 years. In contrast, the weight gain rate at 6-9 months of life was associated with higher REE and lipid oxidation rates at 6 years. A higher weight gain rate at 9-12 months was associated with a higher lean mass at 6 years. CONCLUSION: An early fast-pace weight gain in VLBW infants may have detrimental consequences for metabolic health later on.

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CONTEXT: Adhesion molecule deficiency type 1 is a rare disease that should be suspected in any patient whose umbilical cord presents delay in falling off, and who presents recurrent severe infections. Early diagnostic suspicion and early treatment improve the prognosis. CASE REPORT: The case of a four-month-old boy with recurrent hospitalizations because of severe bronchopneumonia and several episodes of acute otitis media with non-purulent drainage of mucus and positive bacterial cultures is presented. His medical history included neonatal sepsis and delayed umbilical cord detachment. Laboratory studies showed marked leukocytosis with predominance of neutrophils and decreased CD11b and CD18. These were all compatible with a diagnosis of leukocyte adhesion deficiency type I [LAD type 1].

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CONTEXT: Adhesion molecule deficiency type 1 is a rare disease that should be suspected in any patient whose umbilical cord presents delay in falling off, and who presents recurrent severe infections. Early diagnostic suspicion and early treatment improve the prognosis. CASE REPORT: The case of a four-month-old boy with recurrent hospitalizations because of severe bronchopneumonia and several episodes of acute otitis media with non-purulent drainage of mucus and positive bacterial cultures is presented. His medical history included neonatal sepsis and delayed umbilical cord detachment. Laboratory studies showed marked leukocytosis with predominance of neutrophils and decreased CD11b and CD18. These were all compatible with a diagnosis of leukocyte adhesion deficiency type I [LAD type 1].

CONTEXTO: El deficit de moleculas de adhesión tipo 1 es una enfermedad rara que debe ser sospechada en todo paciente que presente un retardo en la caída del cordón unmbilical, además de infecciones graves a repetición. Un sospecha diagnóstica precoz y un tratamiento oportuno mejorarán el pronóstico. INFORMES DE CASO: Se presenta el caso de un niño de cuatro meses de edad, con hospitalizaciones recurrentes a causa de bronconeumonía severa y varios episodios de otitis media aguda con drenaje mucoso, no purulento, y cultivos bacterianos positivos. Su historial médico incluye la sepsis neonatal y el desprendimiento tardío del cordón umbilical. Los estudios de laboratorio mostraron leucocitosis marcada con predominio neutrofílico y disminución de CD11b y CD18, todos compatibles con el diagnóstico del tipo de deficiencia de adhesión leucocitaria 1 [tipo LAD 1].

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The functional significance of tyrosine 207 of Saccharomyces cerevisiae phosphoenolpyruvate carboxykinase was explored by examining the kinetic properties of the Tyr207Leu mutant. The variant enzyme retained the structural characteristics of the wild-type protein as indicated by circular dichroism, intrinsic fluorescence spectroscopy, and gel-exclusion chromatography. Kinetic analyses of the mutated variant showed a 15-fold increase in K(m)CO2, a 32-fold decrease in V(max), and a 6-fold decrease in K(m) for phosphoenolpyruvate. These results suggest that the hydroxyl group of Tyr 207 may polarize CO2 and oxaloacetate, thus facilitating the carboxylation/decarboxylation steps.

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Phosphoenolpyruvate (PEP) carboxykinases catalyse the reversible formation of oxaloacetate (OAA) and ATP (or GTP) from PEP, ADP (or GDP) and CO(2). They are activated by Mn(2+), a metal ion that coordinates to the protein through the epsilon-amino group of a lysine residue, the N(epsilon-2)-imidazole of a histidine residue, and the carboxylate from an aspartic acid residue. Neutrality in the epsilon-amino group of Lys213 of Saccharomyces cerevisiae PEP carboxykinase is expected to be favoured by the vicinity of ionised Lys212. Glu272 and Glu284, located close to Lys212, should, in turn, electrostatically stabilise its positive charge and hence assist in keeping the epsilon-amino group of Lys213 in a neutral state. The mutations Glu272Gln, Glu284Gln, and Lys212Met increased the activation constant for Mn(2+) in the main reaction of the enzyme up to seven-fold. The control mutation Lys213Gln increased this constant by ten-fold, as opposed to control mutation Lys212Arg, which did not affect the Mn(2+) affinity of the enzyme. These observations indicate a role for Glu272, Glu284, and Lys212 in assisting Lys213 to properly bind Mn(2+). In an unexpected result, the mutations Glu284Gln, Lys212Met and Lys213Gln changed the nucleotide-independent OAA decarboxylase activity of S. cerevisiae PEP carboxykinase into an ADP-requiring activity, implying an effect on the OAA binding characteristics of PEP carboxykinase.

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OBJECTIVE: To verify whether chemotaxis is in part an oxidative process mediated by reactive oxygen species (ROS). DESIGN: In this prospective study, after removal of seminal plasma, the sperm suspension received no treatment (control), ROS formation by stimulation with phorbol 12-myristate 13-acetate (PMA), antioxidant treatment (with catalase), or PMA stimulus in the presence of catalase. At time zero and after 3 hours of incubation, the percentage of capacitated and oriented spermatozoa and the ROS levels were determined. SETTING: Andrology laboratory in a medical research institution. PATIENT(S): Normal semen was obtained from eight men. INTERVENTION(S): The semen samples were evaluated to determine the effect of ROS production by stimulation with PMA and/or antioxidant treatment (with catalase) on the percentage of capacitated and oriented spermatozoa. MAIN OUTCOME MEASURE(S): The sperm capacitation, chemotaxis and reactive oxygen species were assessed before and after PMA and/or antioxidant treatment. RESULT(S): Prolonged exposure to high quantities of ROS decrease the sperm chemotactic response, probably because of oxidative damage of the cell. However, this effect may be reduced by the addition of antioxidants like catalase. CONCLUSION(S): Similar to capacitation, chemotaxis seems to depend on the production of ROS, but in the latter process there may be a critical level of ROS necessary for chemotaxis to occur.

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The functional signifcance of tyrosine 207 of Saccharomyces cerevisiae phosphoenolpyruvate carboxykinase was explored by examining the kinetic properties of the Tyr207Leu mutant. The variant enzyme retained the structural characteristics of the wild-type protein as indicated by circular dichroism, intrinsic fuorescence spectroscopy, and gel-exclusion chromatography. Kinetic analyses of the mutated variant showed a 15-fold increase in Km CO2, a 32fold decrease in Vmax, and a 6-fold decrease in Km for phosphoenolpyruvate. These results suggest that the hydroxyl group of Tyr 207 may polarize CO2 and oxaloacetate, thus facilitating the carboxylation/decarboxylation steps.

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Saccharomyces cerevisiae phosphoenolpyruvate (PEP) carboxykinase mutant Ser252Ala, affecting the conserved Walker A serine residue, was characterized to elucidate the role of this serine residue. The substitution did not result in changes in the protein structure, as indicated by circular dichroism, intrinsic fluorescence spectroscopy, and gel-exclusion chromatography. Kinetic analysis of the mutated enzyme in both directions of the main reaction and in the two secondary reactions showed an approximately 50-fold increase in apparent K(m) for oxaloacetate with minor alterations in the other kinetic parameters. These results show that the hydroxyl group of serine 252 is required for proper oxaloacetate interaction.

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