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Considering the high prevalence of respiratory infections in hospitalized infants with Respiratory Syncytial Virus (RSV), the objective of this study is to determine the direct costs of this infection.Prospective longitudinal study in infants under one year of age hospitalized due to RSV during 2015. The patients were divided into 2 groups, Group 1 pa tients without risk factors and Group 2 patients with risk factors (prematurity, oxygen dependence, bronchopulmonary dysplasia, heart disease, immunocompromised patients), comparing each other variables such as nutritional status, gender, breastfeeding, discharge diagnosis, radiological diagno sis, length of hospital stay, among others. Direct costs for hospitalization were estimated according to the fees of the National Health Fund (FONASA) and the Modality of Institutional Care (MAI).The total patients admitted in the period were 260: 234 (90%) in Group 1 and 26 (10%) in Group 2. The average hospital stay for Group 1 was 7.3 days (SD+5.1) with a median of 6 days, and 13.6 days (SD+16.3) for Group 2 with a median of 7 days (p0.05). The direct costs associated with RSV hospitalization were on average CLP $ 413,529 (US$ 632.1) for Group 1, and CLP $ 744,260 (US$ 1,137.6) for Group 2 (p0.05). There was also statistically significant higher cost for Group 2 due to tests and drugs (p0.05) and costs per day of hospital stay (p0.05).These values, known for the first time in the national reality, confirm the high cost of these infections and particularly in risk groups.

Introducción: El uso de la profilaxis antibiótica en la cirugía hemiaria con malla es controversial. El propósito del presente estudio es establecer la efectividad de la profilaxis antibiótica (PA) en la prevención de la infección del sitio operatorio (ISO) en la herniorrafía con malla efectuada en forma ambulatoria con anestesia local. Material y Método: El estudio observacional analítico se realizó dentro del Programa de Cirugía Ambulatoria del CRS Cordillera, en dos grupos consecutivos de pacientes, el primero que se sometió a PA mediante lgr de Cefazolina® intravenosa, inmediatamente antes del procedimiento quirúrgico, y el segundo en el que se prescindió de ella. Los controles postoperatorios se efectuaron al 7º y 30° día por un cirujano del grupo. Se diagnosticó ISO con la presencia de exudado purulento, con cultivo bacteriano positivo. Resultados: El estudio se efectuó en 955 pacientes operados entre 1998 y 2008. En el primer grupo, constituido por 245 pacientes se usó PA, en el segundo grupo de 710 pacientes se prescindió de ella. Las variables demográficas, antecedentes mórbidos y la duración del acto quirúrgico fueron comparables en ambos grupos. Se registraron 2 casos de infección en el primer grupo (1,05%) y dos en el segundo (0,35). Esta diferencia no fue significativa. El germen aislado fue en todos los casos el estafilococo dorado. Conclusiones: La tasa ISO en la hemiorrafia inguinal electiva ambulatoria con malla es baja y no se modificó con el uso de PA. Su empleo indiscriminado no aparece justificado en estos pacientes. The use of antibiotic prophylaxis has been questioned in the inguinal herniorrhaphy with mesh. The aim of this paper is to give account of the efficiency of antibiotic prophylaxis (AP) in the prevention of wound infection in the elective inguinal herniorrhaphy with mesh under local anaesthesia in an ambulatory basis. In the present observacional analytic study, 955 patients were operated upon with a mesh technique during a 10 year period, .in the CRS Hernia Centre in Santiago. In the first group of 250 patients, lgr Cefazolin® was administered iv one hour before the operation, in the second group of 710 patients no antibiotics were used. Demographic variables, associated diseases, the length of surgery were comparable in both groups. The same team of surgeons work in both groups. Wound infection was defined as the presence of pus in the surgical wound associated with a positive bacterial culture. The rate of wound infections was 1.05% of the first and 0.35% of the second group. This difference was no significant (p < 0.08). The isolated germ was a Staphylo-coccus aureus in all cases. The treatment was ambulatory in all cases. The rate of haematoma and funiculo-testicular fluxion were low. We conclude that the rate of wound infection in mesh herniorrhaphies is low and that the antibiotic prophylaxis does not improve these results. Its routine use in these patients is not justified.

There has been limited research on measuring potential differences in leaf gas exchange of Arracacha (Peruvian parsnip, Arracacia xanthorriza Bancroft) cultivars, as affected by different environments, as well as its relation to storage root-yield. The present paper reports field measurements of leaf CO 2 assimilation rates ( A ) for five contrasting cultivars grown at two different high-altitude locations. Using a design of plots chosen at random with three repetitions, commercial root production was determined in the two locations at different altitude (1580 and 1930 m). Daily leaf gas exchange was repeatedly monitored with a portable open-mode infrared gas analyzer at different times in both locations during the growth cycle. Root-yield, leaf area and dry weight were measured. Significant differences in leaf photosynthetic rate and in specific leaf area (SLA) were observed among cultivars. Cultivars with high SLA, had high CO 2 assimilation. Mean ( A n ) and total ( A tot ) of CO 2 assimilation and SLA were significantly correlated with storage root-yield across cultivars and locations. The three cultivars with the greatest commercial root production also had the highest maximum values for A and the highest specific leaf area, indicating that these two parameters can be used to select for highly productive cultivars of A. xanthorriza .

La presente reflexión se enfoca en el análisis de las representaciones y experiencias de racismo y exclusión en relación a matrices socioculturales que los migrantes haitianos identifican como posibilidades de inserción en la sociedad chilena. Contextualiza el proceso en un determinado momento histórico, social y político tanto en el país de origen como de destino; desarrollando junto con ello los conceptos de neorracismo y racismo sutil para describir experiencias, prácticas y cogniciones presentes en los discursos de los y las migrantes haitianos/as en Chile. This analysis focuses on the representations and experiences of racism and exclusion in relation to socio-cultural matrices identified by Haitian migrants as aspects that could improve the chances of integration in the Chilean society. It contextualizes the process in a particular historical, social and political moment both in the country of origin as that of destination; developing along the concepts of neo-racism and subtle racism to describe experiences, practices and cognitions present in the speeches of haitian migrants in Chile. Esta reflexão centra-se na análise das representações e experiências de racismo e exclusão em relação a matrizes socioculturais que os imigrantes haitianos identificam como possibilidades de integração na sociedade chilena. Contextualiza o processo num determinado momento histórico, social e político, tanto no país de origem como de destino; desenvolvendo junto com isso os conceitos de neo-racismo e racismo sutil para descrever experiências, práticas e cognições presentes nos discursos de os/asmigrantes haitianos/asno Chile.

In this paper, we study the role and impact of workers’ empathy — or the interdependence of workers’ preferences — on the business cycle. We show how empathy affects managerial practices and how it impacts labor market outcomes such as wages and employment. To this end, we consider a labor market in which a firm’s manager chooses the set of workers to hire and how much to pay each worker. We explore how managers react to labor productivity shocks. In economic expansions, managers elect to raise wages and to hire more workers. However, in economic slowdowns, managers may find it optimal to freeze both wages and employment. Moreover, consistent with Bewley (1999), in times of severe economic downturns managers respond by reducing workforce, but not wages. The rationale of these asymmetric responses to productivity shocks is that a profit-maximizing firm is reluctant to cut wages, as that choice may trigger a low morale equilibrium, affecting its profits discontinuously.

The problem of enforcing two-variable nonlinear interaction code provisions within a spectral superposition approach to design, is addressed. An analytical procedure based on the linearization of the interaction curve through a set of tangents or secants is developed. Safety with respect to the interaction curve is approximated by requiring safety with respect to that set of straight lines. For calculating the required estimators, the cross-estimator based formula for estimators of the linear combination of variables, derived in a companion paper, is used. The analytical method developed was shown to be equivalent to a graphical method proposed by Gupta, based on inscribing an estimator ellipse within the interaction curve. The analytical method is more straightforward and handles the directional maximum in single-component excitation, which the graphical method does not. The analytical method is much easier to apply. However, if a study calls for actually drawing the estimator ellipse, straightforward construction methods are presented, making unnecessary a cumbersome equivalent modal response approximation that had been suggested. The inherent antisymmetry of the spectral superposition formula, and its implications, are discussed. The effect of static loading and of symmetry of the interaction curve is also analyzed. Within the analysis of an example, the work required for the application of the procedure for nonlinear interaction for design purposes is discussed. It is found that its implementation can be achieved through a very simple function written for any standard numerical computation software package. The example also makes quite apparent the advantages of the analytical over the graphical method. The application example, which considers the design of a concrete column in a simple 10-storey building structure, shows the overconservativeness of a design based only in the standard estimators. The design criterion used in the example is that of the most unfavorable direction of a single-component earthquake.

Modal spectral superposition for single-direction excitation is reviewed, with special attention to the intervening cross-directional estimator. A method for calculating this cross-estimator in terms of three standard estimators, the x-, y-, and 45°-direction excitation estimators, is presented. Addressing the question of the signs of cross-estimators, it is shown that the problem dwells in double-sum superposition formulas rather than in the cross-estimators themselves. In that respect, it is shown that in a double superposition formula, the modal coordinates of strongly coupled modes must enter with the same sign, so that there is no loss of information in the suppression of signs in spectral ordinates. This discussion is in itself a deterministic justification of double-sum spectral superposition formulas, showing that for closely spaced modal frequencies, the formula is an approximation rather than estimation. A formula is derived for the estimator of a linear combination of two variables, equivalent to calculating the estimator by directly applying the spectral superposition formula to the linear combination of the modal components of the two basic variables. It only requires the cross-variable estimator, in addition to the standard estimators of the two basic variables. It is stressed that contrary to common belief, statical or kinematical linear combinations can be checked or otherwise used, if the appropriate cross-estimators are retrieved from analysis. Cross-estimators are interpreted as the product of the standard estimator of one variable times the pseudo-synchronous value of the other variable. The appropriateness of the synchronous value concept is verified, and it is used to propose a member single or double curvature criterion.

We compare two instruments to regulate a monopoly that has private information about its demand: fixing the price or the quantity produced. For each instrument, we consider two classes of mechanisms: sophisticated (screening menus) and simple (single menus). We characterize the optimal mechanisms for every instrument and make between- and within-welfare comparisons. When demand is unknown and marginal costs are increasing, the sophisticated price mechanism dominates that of quantity, while the sophisticated quantity mechanism may prevail when marginal costs are decreasing. The simple price mechanism dominates that of quantity when marginal costs are decreasing, but the opposite may arise if marginal costs are increasing. We explore what proportion of welfare gains achievable by sophisticated regulation can be secured using simpler mechanisms and also discuss the case regarding private information about the monopoly’s costs

We investigate the effects of players’ mutual empathy, or the interdependence of players’ payoffs, on their behavior and welfare. To this end, we augment the conventional game-theoretic framework by allowing players’ utilities to depend not only on the strategy profile being played, but also on the realized utilities of other players. We call the resulting framework an empathetic game. Generally, in these games players’ utilities are not reducible to preferences over strategies due to novel feedback effects; thus, standard solution concepts, such as the Nash equilibrium, cannot be applied. We extend the notion of a Nash equilibrium to these settings by endowing players with consistent beliefs regarding others’ payoffs. We show that under mild assumptions our solution concept is well defined. We then apply the framework to analyze how mutual empathy affects strategic interactions, and find that it qualitatively changes players’ incentives. First, empathetic games can generate excessive multiplicity of equilibria owing to many supporting beliefs. Second, we uncover a new source of inefficiency, called payoff inefficiency, as players may coordinate their beliefs on socially suboptimal solutions to the interdependent payoff system. Finally, we show that these two features are common in sympathetic (altruistic) games, in which the payoffs of all players depend positively on others’ payoffs; however, payoff inefficiency never occurs in two-player antipathetic games, in which payoffs are negatively related.

El objetivo de este estudio fue determinar los valores hematológicos y bioquímicos de juveniles de paiche Arapaima gigas criados en cultivo intensivo. Los juveniles (peso inicial 71,72 ± 23,89 g y longitud inicial 20,45 ± 1,42 cm) fueron estabulados en cuatro tanques de 900 Lcon recirculación de agua (temperatura 25,90 -1 -1 ± 0,44 °C; oxígeno disuelto 1,43 ± 1,12 mg L ; pH 6,74 ± 0,2; nitrito 0,41 ± 0,62 mg L y amonio 16,17 ± 9,03 -1 mg L ) por un periodo de 154 días. Durante los primeros 40 días, se mantuvieron a una densidad inicial de 200 -3 -3 peces m y posteriormente a 150 peces m . La alimentación se realizó tres veces al día con un alimento ® balanceado (Aquatech , Naltech, Lima, Perú; composición proximal: 42% proteína, 10% lípidos, 12% cenizas; tamaño de partícula: 2,5 y 4 mm). Las muestras de sangre se obtuvieron en cinco muestreos (124, 137, 138, 142 y 143 días) con jeringas descartables conteniendo EDTA al 10% para la determinación de los valores hematológicos y bioquímicos. Al final del experimento, los peces alcanzaron un peso promedio de 832,6 ± 173,1 g y 47,4 ± 2,4 cm de longitud total con una supervivencia de 91,9%. Los valores hematológicos 3 -1 y bioquímicos promedio fueron: hematocrito (Hto) 32,2 ± 1,4%; leucocitos (Leu) 5,2 ± 2,42 x10 µL ; 6 -1 -1 eritrocitos (Er) 1,3 ± 0,21 x10 µL ; hemoglobina (Hb) 10,4 ± 0,90 g dL ; volumen corpuscular medio (VCM) -1 249,9 ± 40,2 fL; concentración de hemoglobina corpuscular media (CHCM) 32,3 ± 2,5 g dL ; hemoglobina -1 -1 -1 corpuscular media (HCM) 80,6 ± 13,8 g dL ; albúmina 2,26 ± 0,82 g dL ; glucosa 54,83 ± 43,09 mg dL y -1 colesterol 104,63 ± 43,89 mg dL . Los valores hematológicos y bioquímicos se encontraron dentro de los rangos reportados para esta especie, mostrando condiciones fisiológicas normales al estar sometidos a condiciones intensivas de cultivo.

A three-dimensional model for approximate inelastic analysis of buildings is presented herein. The model is based on a single macro-element per building storey. The inelastic properties of the model are characterized by the so-called ultimate storey shear and torque (USST) surfaces. Different algorithms for the construction of these surfaces, as well as their applications in building modelling, are presented and discussed. Two alternative procedures are developed to integrate the force-deformation constitutive relationship of the macroelements. The first one follows the exact trajectory of the load path of the structure on the USST, and the second uses linear programming without ever forming the USST surface. The accuracy of the model and integration procedure is evaluated by means of the earthquake response of single-storey systems. The model and integration procedure developed is finally used to compute the inelastic response of a seven-storey R/C building. The results of this investigation show that the model proposed, although approximate, can be effective in estimating the inelastic deformation demand of a building. It also enables the engineer to capture and interpret important features of the three-dimensional inelastic response of a structure even before performing any inelastic dynamic analysis.

Prolactin (PRL)-releasing peptide (PrRP) is a strong candidate stimulator of pituitary PRL transcription and secretion in teleosts. However, the role in control of extrapituitary PRL expression or its effects on innate immunity are unclear even in mammals. To study the possible presence of PrRP in peripheral organs, PrRP expression patterns and their effect on innate immunity were characterised in SHK-1 cells and head kidney (HK) leukocytes purified from the salmonid, Salmo salar. We detected immunoreactive cells in leukocytes from blood and HK of S. salar and found that PrRP mRNA was abundantly expressed in these cells. We have recently reported that physiological concentrations of native PRL, downstream of neuropeptide PrRP were able to induce expression of pro-inflammatory cytokines and the production of reactive oxygen species (ROS) in HK leukocytes and macrophages from S. salar and Sparus aurata. It is of interest to note that in this work we have revealed that synthetic PrRP was able to induce expression of pro-inflammatory cytokines (interleukins) IL-1β, IL-6, IL-8, IL-12 and PRL. We also show here that PrRP increased both (ROS) production and phagocytosis. Taken together, our results demonstrate for the first time that PrRP may be a local modulator of innate immune responses in leukocytes from S. salar.

We present the case of a 63 year male patient, natural from Lima. He has been in a cattle zone seven years ago. His illness had an insidious start and a progressive course; from a month ago he had malaise associated with nausea, abdominal distention and occasional vomiting; denies weight loss. In the clinical examination was lucid and stable, and without jaundice. The abdomen was soft without signs of peritoneal irritation; in the left flank there was a large mass with defined limits, painless, attached to deeper layers. Auxiliary tests: CBC: eosinophils 5.74%; the levels coagulation, biochemistry and electrolytes were normal. Total protein, albumin, bilirubin levels, aminotransferasas (ALT an AST) and alkaline phosphatase were normals. Arco V: 248 (N22) and positive Inmunoblot to Echinococcus granulosus. Abdominal ultrasound showed two cystic formations of 161 x 95 mm and 146 x 130 mm, that moving the left kidney and spleen. Axial tomography was interpreted as a large ovoid formation (12 x 18 x 27 cm) dependent on spleen, lobed, hypodense, with rounded focal areas with less attenuation in the peripheral area; without contrast enhancement, compatible with hydatid cyst Gharbi III. The surgical intervention was a partial cystectomy plus external drainage; the surgeon found a giant splenic hydatid cyst, occupied the left hypochondrium and the left flank; had thick walls, daughter vesicles and clear liquid inside. The cystic lesion was attached to the descending colon, stomach, and left diaphargm. We present this case because the splenic hydatid cyst is rare, even less as a single site, and their prevalence does not exceed 1 %.

We report the case of 48 year old female patient without a history of significance importance.(refuses blood transfusion). She complaint of diarrhea of four months of duration and weight loss of 8 kg. she added episodes of hematochezia and severe anemia requiring transfusion. An intrahemorrhagic colonoscopy was performed detecting three ulcerated lesions. First at 10 cm from the anus, one in transverse colon distal, another similar ulcer in the proximal transverse The biopsies showed ulcer granulation tissue, abundant macrophages with intracytoplasmic structures consistent with histoplasmosis. Tests showed no tuberculosis or intestinal parasitosis. HIV testing (ELISA and Western Blot) were positive. The CD4 (78 cells) and extrapulmonary histoplasmosis were the criteria defined stage AIDS. The extrapulmonary histoplasmosis defines stage IV in immunosuppressed patients with HIV. Lower gastrointestinal bleeding colonic ulcer secondary to Histoplasma is a rare form presentation as a diagnostic manifestation of AIDS.

We report the case of a 35-year-old male patient, with a history of six months of pallor and dyspnea associated with severe iron deficiency anemia and positive fecal occult blood tests. Endoscopy of the lower and upper gastrointestinal tract, and a small bowel follow-through were performed, but did not reveal the origin of the bledding. Later, a capsule endoscopy study were performed and detected an elevated area - not well defined - with active bleeding in the jejunal portion of the small bowel, for that reason we decided to complement the study with a double balloon enteroscopy, that allowed us to see more clearly the jejunal lesion: an elevated and ulcerated lesion; the area was marked with India ink to guide the surgeon. In the surgical intervention a resection of the involved jejunal segment was performed; the study of pathological anatomy established the diagnosis of jejunal angiodysplasia. We present this case of obscure gastrointestinal bleeding to emphasize the diagnostic utility of capsule endoscopy and double balloon enteroscopy.

We review the case of a 14 year old patient complaining of 5 months of bloody and mucous diarrhea, abdominal pain, fever and 10 kg weight loss. At the beginning she received cotrimoxazole and then chloramphenicol with no success. With the suspicious of tuberculosis she was treated for a month with the corresponding drugs with no clinical improvement. Colonoscopy revealed the presence of punch - like ulcers, deep linear ones cobblestoning and skip lesions. The histological analysis showed severe distortion the colonic mucosa, ulcers, granulation tissue, lymphoid follicles and a trend towards the formation of granulomatous lesions. The clinical, endoscopic and histological features were consistent with Crohn disease. The activity index for it was greater than 450. The patient received 60 mg bid hydrocortisone but switched to 20 mg bid methylprednisolone at day 10th. After 10 days and because she was doing worst refractoriness to corticoids was considered and 5 mg / kg Infliximab was started. At the third day of treatment symptoms improved dramatically and one week later was almost asymptomatic. Similar dosage of Infliximab was repeated at weeks 2, 6 and 8. Currently the patient is being treated with 75 mg azathioprine as maintenance therapy.

Acute serum amyloid A (A-SAA) has been considered a major acute-phase reactant and an effector of innate immunity in all vertebrates. The work presented here shows that the expression of A-SAA is strongly induced in a wide variety of immune-relevant tissues in rainbow trout, either naturally infected with Flavobacterium psychrophilum or challenged with lipopolysaccharide (LPS) or CpG oligonucleotides (CpG ODN). Nevertheless, A-SAA was undetectable by Western blot either in the plasma or in high-density lipoprotein (HDL) of infected or challenged fish, using either an anti-mouse SAA1 IgG or an anti-trout A-SAA peptide serum, which recognise both the intact recombinant trout A-SAA and fragments derived from it. However, the anti-peptide serum was the immunoreactive in all primary defence barriers and in mononuclear cells of head kidney, spleen and liver. These findings reveal that, unlike mammalian SAA, trout A-SAA does not increase significantly in the plasma of diseased fish, suggesting it is more likely to be involved in local defence.