Resumen Se informa un caso autóctono de rickettsiosis por Rickettsia parkeri, ocurrido en junio del 2018 en la zona selvática del Parque Provincial Urugua-í, Misiones, Argentina, región sin registros previos de esta enfermedad en humanos. Se describen los aspectos epidemiológicos, ecológicos, clínicos y de laboratorio necesarios para el diagnóstico oportuno y el tratamiento adecuado. Se resalta el hecho de considerar a las rickettsiosis como diagnóstico diferencial ante un paciente con síndrome febril agudo exantemático; el antecedente epidemiológico de exposición al vector característico de la región, garrapatas del género Amblyomma, es un elemento fundamental.

Abstract We report an autochthonous case of Rickettsia parkeri rickettsiosis occurred in June 2018 in a forested area of the Urugua-í Provincial Park, Misiones, Argentina. No previous records of this disease in humans have been previously reported in this region. The epidemiological, ecological, clinical, and laboratory features required for a proper diagnosis and adequate treatment are described here. The fact of considering rickettsiosis as a differential diagnosis in a patient with exanthematic acute febrile syndrome is highlighted, being the epidemiological history of exposure to the vector (ticks of the genus Amblyomma) an essential element.

Resumo Colletotrichum é um dos gêneros fúngicos mais importantes economicamente, afetando uma ampla gama de hospedeiros, especialmente em cultivos tropicais e subtropicais. Atualmente já existem diversos registros de infecção por micovírus em Colletotrichum spp., sendo a maioria dos já identificados classificados na família Partitiviridae. Ocorrem registros também de micovírus pertencentes à família Chrysoviridae. Compreendem vírus de genoma de (+)ssRNA e dsRNA que podem ser ou não envelopados. Ainda não foram identificados micovírus com genoma de DNA isolados de Colletotrichum. A infecção por micovírus pode ocorrer de forma latente, mas já foi observado em Colletotrichum spp. o fenômeno de hipo e hipervirulência. Além de influenciar no comportamento patogênico, a infecção pode causar mudanças fisiológicas importantes como alterações das características morfológicas, redução do crescimento vegetativo e redução na produção de conídios. O estudo com micovírus em fungos fitopatogênicos traz uma alternativa ao controle químico que é um método capaz de causar danos irreversíveis ao homem e o meio ambiente. Sob a perspectiva agrícola, os micovírus podem contribuir para agricultura sustentável como agentes de controle biológico. Isso porque obsevam-se mudanças importantes na fisiologia fúngica resultando na perda total ou redução da virulência desses patógenos.

Abstract Colletotrichum is one of the most economically important fungal genera, which affects a wide range of hosts, specifically tropical and subtropical crops. Thus far, there have been several records of mycovirus infection in Colletotrichum spp., primarily by viruses of the Partitiviridae family. There have also been records of infections by mycoviruses of the Chrysoviridae family. Mycoviruses are (+)ssRNA and dsRNA genome viruses, which may or may not be enveloped. To date, no mycovirus with a DNA genome has been isolated from Colletotrichum spp. Typically, mycoviruses cause latent infections, although hypo- and hypervirulence have also been reported in Colletotrichum spp. In addition to its effects on pathogenic behavior, mycovirus infection can lead to important physiological changes, such as altered morphological characteristics, reduced vegetative growth, and suppressed conidia production. Therefore, research on mycoviruses infecting phytopathogenic fungi can help develop alternative methods to chemical control, which can cause irreversible damage to humans and the environment. From an agricultural perspective, mycoviruses can contribute to sustainable agriculture as biological control agents via changes in fungal physiology, ultimately resulting in the total loss of or reduction in the virulence of these pathogens.

Resumo O guaranazeiro [Paullinia cupana var. sorbilis (Mart.) Ducke] é uma espécie de grande importância econômica e social no Brasil, pois é o único produtor comercial de guaraná no mundo. O método de propagação vegetativa indicado para a cultura é a estaquia que visa produtividade, tolerância e uniformidade das cultivares clonais, isso porque a reprodução por sementes possui lenta germinação e alta variabilidade genética, o que nas variedades tradicionais é um fator indesejado. Fatores genéticos podem interferir na capacidade de enraizamento da cultura. Estudos buscam alternativas que possam melhorar essa condição e potencializar o sistema produtivo. Uso de reguladores de crescimento, microrganismos promotores do crescimento vegetal, variação de substratos e adubações, tem sido estratégias utilizadas. Ensaios preliminares sobre a taxa de enraizamento caulinar e germinação de sementes com uso de fitormônio exógenos não demonstraram efeitos expressivos em relação à não aplicação desses indutores. O uso de rizobactérias, apresenta-se como atividade promissora em muitas culturas, ainda não foi demonstrado na cultura do guaraná. Por outro lado, a influência de diferentes substratos sobre o enraizamento, já demonstrou resultados significativos em função da taxa de enraizamento. A adubação das plantas matrizes conforme recomendação do sistema de produção para a cultura, comprovadamente é um procedimento eficiente. Constata-se que ainda são escassos estudos voltados à melhoria da propagação do guaranazeiro, demonstrando que novos protocolos precisam ser explorados, ou que os protocolos já utilizados sejam revistos sob outra perspectiva. Paullinia var Mart. Mart (Mart. Ducke Brasil mundo produtividade clonais genética indesejado produtivo vegetal adubações utilizadas indutores rizobactérias apresentase apresenta se culturas lado eficiente Constatase Constata explorados perspectiva (Mart

Abstract Guarana [Paullinia cupana var. sorbilis (Mart.) Ducke] is a species of great economic and social important in Brazil, as it is the only commercial guarana producer in the world. The vegetative propagation method indicated for the culture is stem cuttings, which aims at productivity, tolerance, and uniformity of clonal cultivars, because reproduction by seeds has slow germination and high genetic variability, which in traditional varieties is an undesirable factor. Genetic factors can interfere with the rooting capacity of the crop. Studies seek alternatives that can improve this condition and enhance the production system. Use of growth regulators, microorganisms that promote plant growth, variation of substrates and fertilization, have been strategies used. Preliminary tests on the rate of stem rooting and seed germination with the use of exogenous phytohormone did not demonstrate in relation to the non-application of these inducers. The use of rhizobacteria, which presents itself as a promising activity in many cultures, has not yet been demonstrated in the culture of guarana. On the other hand, the influence of different substrates on rooting has already shown consistent results as a function of rooting rate. Fertilizing the mother plants as recommended by the production system for the crop has proven to be an efficient procedure. There are still few studies aimed at improving the spread of guarana, demonstrating that new protocols need to be explored, or that the protocols already used are reviewed from another perspective. Paullinia var Mart. Mart (Mart. Ducke Brazil world cuttings productivity tolerance cultivars variability factor regulators fertilization nonapplication non application inducers rhizobacteria cultures hand procedure explored perspective (Mart

Abstract A 67-years-old woman with hypertension, obesity as previous diseases, presented to the emergency department due to cough, fatigue, fever, and dyspnea. ST-segment elevation was visualized during monitoring, troponin was positive, the coronary angiography was negative; the ventriculogram and transthoracic echocardiogram documented apical akinesia. The RT-PCR was positive for SARS CoV-2; the diagnosis was takotsubo-syndrome.

Resumen Se presenta el caso de una mujer de 67 años, con antecedentes de hipertensión arterial y obesidad, que acudió a urgencias por tos, fatiga, fiebre y disnea. Durante la monitorización se documentó elevación del segmento ST anterolateral e inferior y elevación de troponina; la arteriografía coronaria no evidenció lesiones significativas; en el ventriculograma y en el ecocardiograma transtorácico se documentó acinesia apical. Se confirmó RT-PCR positiva para SARS-CoV-2; se consideró como diagnóstico síndrome de takotsubo.

ABSTRACT Introduction Clitoroplasty constitutes an important step in feminizing surgery for congenital adrenal hyperplasia (CAH) ( 1 ). In this video we present a technique that aims to preserve clitoral sensitivity and engorgement while minimizing the risk of neurovascular lesion. Materials and methods We present a video of a three-year-old girl with history of CAH classical form, PRADER-III, who underwent clitoroplasty. After an initial endoscopic evaluation of the urogenital sinus, the clitoris was degloved and a rectangular incision was made on the ventral corpora cavernosa 15mm above the corpora bifurcation and 0.5 mm below the coronal sulcus. The cavernous tissue was partially resected. The upper and lower borders of the rectangular gap were closed by a 5-0 PDS running suture similar to the Mikulicz technique. Next, the edge of the glans was deepithelialized to reduce its size. For improved clitoral positioning, the clitoris was sutured to the pubic fat. From that point onward the procedure followed that of a standard vaginoplasty using the en-bloc technique ( 2 - 4 ). Thus far we have performed this technique in 33 patients, with 31 of them being girls with CAH and 2 being women with clitoral hypertrophy. Conclusion Corporoplasty is a simplified technique for clitoroplasty, with the advantage being that is faster and safer than the technique that involves the dissection of the neurovascular bundle. In addition, corporoplasty has the possible benefit of preserving the cavernosal blood flow that permits the engorgement of the clitoris during sexual arousal.

Resumen La hipertensión arterial secundaria es poco frecuente y está asociada con una causa que puede ser tratable, por lo cual su diagnóstico y tratamiento oportuno son importantes. La orientación diagnóstica se hace con base en los datos obtenidos en la anamnesis y examen físico del paciente buscando posibles etiologías. Se presenta el caso de un hombre de 63 años, con hipertensión arterial resistente, sin otra sintomatología ni antecedentes personales o familiares. Se realizaron estudios iniciales que documentaron hipopotasemia, lo que hizo sospechar hiperaldosteronismo primario, se solicitaron pruebas complementarias con aldosterona plasmática elevada, actividad de la renina plasmática baja, además con imagen diagnóstica por resonancia nuclear magnética que mostró nódulo suprarrenal derecho. Se considero llevar a adrenalectomía derecha, con reporte de patología compatible con adenoma cortical adrenal. Durante el seguimiento en atención primaria presento adecuado control en cifras de presión arterial con disminución del número de medicamentos antihipertensivos requeridos.

Abstract Secondary arterial hypertension is rare, it is associated with a cause that can be treatable, for which its diagnosis and treatment are not important.The diagnostic orientation is made based on the data obtained in the anamnesis and physical examination of the patient, looking for possible etiologies.We present the case of a 63-year-old man with resistant hypertension, without other symptoms or personal or family history. Initial studies were performed that documented hypokalemia, which led to the suspicion of primary hyperaldosteronism. Complementary tests were requested with high plasma aldosterone, low plasma renin activity, in addition to a diagnostic magnetic resonance imaging that showed an adrenal nodule. A right adrenalectomy was considered, with a report of pathology compatible with adrenal cortical adenoma.During the follow-up in primary care, patient presented adequate control in blood pressure figures with a decrease in the number of antihypertensive drugs required.

RESUMEN Objetivo Identificar factores asociados con el reingreso hospitalario en pacientes con trastorno bipolar (TB) en un hospital psiquiátrico y desarrollar un modelo explicativo del riesgo de reingreso. Método Estudio observacional longitudinal retrospectivo a partir de base de datos secundaria aportada por el Hospital Psiquiátrico Departamental Universitario del Valle. Estadística: análisis de supervivencia utilizando un modelo de regresión Cox. Se definió como variable dependiente el riesgo de reingreso y como variables independientes algunas sociodemográficas y clínicas. Resultados Se obtuvo una asociación estadísticamente significativa entre el riesgo de reingreso y las variables: falta de red de apoyo al no tener acudiente HR=1,33 [IC 95% 1,02-1,72; (p=0,034)] y falta de adherencia al tratamiento HR=2,33 [IC 95% 1,87-2,90; (p=0,000)]. Conclusión Para disminuir el reingreso hospitalario por TB, se deben priorizar las intervenciones en los casos de pacientes que no tengan acudiente y haya inadecuada adherencia al tratamiento; esta última, a partir de la percepción por parte del médico especialista. Enfocarse sobre estos dos factores puede incidir sobre los reingresos.

ABSTRACT Objective To identify the factors associated with hospital readmission in patients with bipolar disorder between 2011 and 2017 in a psychiatric hospital in order to develop an explanatory model of the risk of rehospitalization. Method Retrospective longitudinal observational study based on a secondary database provided by the Hospital Psiquiátrico Departamental Universitario del Valle. Statistics: Survival analysis using a Cox regression model. The risk of readmission was defined as a dependent variable and some sociodemographic and clinical variables were defined as independent variables. Results From the multivariate model of Cox Regression, a statistically significant association was obtained between the risk of readmission and the variables: lack of support network due to lack of retentive HR=1.33 [95% CI 1.02-1.72; (p=0.034)] and not having adherence to the treatment HR=2.33 [95% CI 1.87-2.90; (p=0.000)]. Conclusion In order to reduce hospital readmission due to bipolar disorder, interven-tions should be prioritized in cases where patients do not have a guardian and there is inadequate adherence to the treatment; the latter perceived by the specialist doctor. Focusing on these two factors can influence readmissions.

ABSTRACT Objective: The aim of the study was to describe the clinicopathological profile of patients diagnosed with liver, bile ducts or gallbladder cancer. Materials and methods: Between 2006 and 2017, 89 patients (57% female; mean age: 62 years-old) with these cancers were diagnosed at two national hospitals in Lima, Peru. Results: Most patients (64%) had advanced stages of disease. Anemia was more frequent in patients with bile duct and liver cancer and in advanced stages. Hypertension (HTN) was frequent among liver cancer patients (32%). The analysis by age showed that HTN was more frequent in patients over 50 years. Likewise, people under 50 years had more frequent history of previous infections (50%), Hepatitis B (HBV) being the most common. Conclusions: This study describes the baseline clinicopathological characteristics of a malignancy poorly studied in Peru.

RESUMEN Objetivo: El objetivo del estudio fue describir las características clínico-patológicas de individuos diagnosticados de cáncer de hígado, vías biliares o vesícula. Materiales y métodos: Entre el 2006 y 2017, se diagnosticaron 89 pacientes (57% mujeres; media: 62 años) con estos canceres en dos hospitales nacionales de Lima, Perú. Resultados: Los resultados mostraron que, independientemente del tipo de cáncer, 64% de los participantes habían sido diagnosticados en estadios avanzados. La anemia fue más frecuente en los pacientes con cáncer de vías biliares e hígado y en estadios avanzados. Se observó mayor frecuencia (32%) de hipertensión arterial (HTA) en el grupo con cáncer de hígado. El análisis por edad mostró que en los pacientes mayores de 50 años la HTA fue más frecuente. Asimismo, sujetos menores de 50 años reportaron antecedentes de infecciones previas en mayor frecuencia (50%), siendo Hepatitis B (HBV) la más común. Conclusiones: Este estudio describe las características clínico-patológicas de base de una neoplasia poco estudiada en el ámbito nacional.

Resumen Antecedentes: El avance en oncología ha contribuido a ampliar las indicaciones quirúrgicas de las metástasis hepáticas (MH) del carcinoma colorrectal (CCR). Objetivo: Analizar las diferencias en la supervivencia global (SG) y en determinadas características clinicopatológicas entre pacientes con resección R0 (margen tumoral > 1 mm) y R1 (margen < 1 mm). Método: Estudio retrospectivo con 144 pacientes con MH de CCR intervenidos con intención curativa entre 2010 y 2018, divididos en dos grupos en función del margen de resección (R0 y R1). Se comparan la SG y 17 características clinicopatológicas. Resultados: Ambos grupos son homogéneos y comparables en todas las variables estudiadas: edad (p = 0.158), sexo (p = 0.675), ASA (p = 0.502), localización del CCR (p = 0.793), estadio tumoral (p = 0.280), quimioterapia (QT) adyuvante poscolectomía (p = 0.664), sincronicidad (p = 0.983) y localización (p = 0.078) de las MH, CEA al diagnóstico (p = 0.735), QT neoadyuvante (p = 0.403), hepatectomía mayor/menor (p = 0.415), complicaciones (p = 0.822) y mortalidad posoperatorias (p = 0.535), estancia media (p = 0.960), QT adyuvante poshepatectomía (p = 0.791) y nueva hepatectomía (p = 0.530). Tampoco se observaron diferencias significativas en la SG a 1, 3 y 5 años (p = 0.160) entre pacientes con resección R0 y R1. Conclusiones: Consideramos indicada la hepatectomía en pacientes con MH resecables con posibilidad de conseguir resecciones R0 manteniendo suficiente remanente hepático, independientemente de la afectación microscópica final del margen tumoral.

Abstract Background: Criteria for resectability of colorectal liver metastases (CRLM) have been expanded over the last decade along with the improvement in chemotherapy. Objective: Analyze the differences in several clinicopathological characteristics and overall survival (OS) between patients who underwent an R0 (tumour margin > 1 mm) or R1 (margin < 1 mm) resection. Method: Retrospective study including 144 patients with CRLM who underwent a potentially curative liver surgery between 2010 and 2018. Patients are classified according to their surgical margin status (R0 or R1). OS and 17 clinicopathological variables are compared. Results: Both groups are similar and comparable in all the studied variables: age (p = 0.158), sex (p = 0.675), ASA (p = 0.502), tumour location (p = 0.793), tumoral stadium (p = 0.280), post-colectomy chemotherapy (p = 0.664), CRLM synchronicity (p = 0.983) and location (p = 0.078), CEA at diagnosis (p = 0.735), neoadjuvant chemotherapy (p = 0.403), minor/major hepatectomy (p = 0.415), post-operatory complications (p = 0.822) and mortality (p = 0.535), average hospital stay (p = 0.960), post-operative chemotherapy (p = 0.791) and re-hepatectomy (p = 0.530). No significant differences are found in OS a 1, 3 and 5 years (p = 0.160) between patients with R0 and R1 resection. Conclusions: We consider indicated hepatectomy in any patient with resectable CRLM in whom an R0 resection can be achieved maintaining an adequate hepatic reserve, regardless of the final microscopic resection margin status.

Summary The present study aims to analyze the association between academic stress and psychological well-being, and the role of academic procrastination in this relationship, in a sample of undergraduate students. The sample was composed by 391 undergraduate students from various universities in Lima Metropolitana - Peru. The Spanish adaptation of Ryff’s Psychological Well-being Scales (SPWB), The Cognitive Systemic Inventory (SISCO SV-21) and the Academic Procrastination Scale (EPA). Results show that procrastination and academic stress are negatively related to psychological well being. Moreover, presence of stressors and symptoms associated with academic stress, and procrastination are relevant predictors of psychological well-being; however, the interaction between both variables did not represent a significant effect; therefore, it is concluded that there is no moderating effect of academic procrastination in the relationship between academic stress and psychological well-being. Instead, procrastination was found to play a moderating role in the relationship between stressors and the development of symptoms associated with academic stress.

Resumen El presente estudio tiene como objetivo analizar la asociación que existe entre estrés académico y bienestar psicológico, y el rol que ejerce la procrastinación académica en esta relación, en una muestra de estudiantes universitarios de pregrado. Participaron 391 estudiantes universitarios de pregrado de diversas universidades de Lima Metropolitana - Perú. Los constructos fueron medidos a partir de la adaptación española de las Escalas de Bienestar Psicológico de Ryff (SPWB), el Inventario Sistémico Cognoscitivista (SISCO SV-21) y la Escala de Procrastinación Académica (EPA). Los resultados indican que la procrastinación y el estrés académico presentan una relación negativa con respecto al bienestar psicológico. Además, la presencia de estresores y síntomas asociados al estrés académico, y la procrastinación resultan ser predictores relevantes del bienestar psicológico; sin embargo, la interacción entre ambas variables no implica un efecto significativo. Por lo tanto, se concluye que no existe un efecto moderador de la procrastinación académica en la relación entre estrés académico y bienestar psicológico. En su lugar, se halló que la procrastinación ejerce un rol moderador en la relación entre la presencia de estresores y el desarrollo de síntomas asociados al estrés académico.

Resumen En la atención médica y en la investigación en salud resulta indispensable favorecer la toma de decisiones de los pacientes y/o participantes bajo el principio de autonomía. En particular, esta capacidad, consignada en la Convención de los Derechos de las Personas con Discapacidad, se concreta mediante la detección de necesidades de asistencia, ajustes y apoyos que dan paso a una plena y efectiva capacidad de ejercicio. Las reflexiones bioéticas hechas desde la perspectiva principialista, personalista y de los Derechos Humanos ofrecen elementos para potenciar la autonomía de las personas con discapacidad, promoviendo la figura de asistencia personal y enfatizando el interés superior, la gradualidad y la revisión judicial permanente como principios de figuras sustitutivas.

Abstract In medical care and health research, it is essential to promote decision-making by patients and/or participants under the principle of autonomy. In particular, this capacity, stated in the Convention on the Rights of Persons with Disabilities, is made concrete through the detection of needs for assistance, adjustments and support that give way to a full and effective capacity for exercise. The bioethical reflections made from a principled, personalist and human rights perspective offer elements to enhance the autonomy of persons with disabilities, promoting the figure of personal assistance and emphasizing the best interest, gradualness and permanent judicial review as principles of substitute figures.

RESUMEN Pinus hartwegii Lindl. crece entre 2500 y 4300 msnm en las montañas de México y América Central. Información sobre indicadores reproductivos en una población es útil para describir el estado reproductivo de una especie y éstos pueden estar influenciados por variables ambientales. El objetivo del presente estudio fue evaluar la variación de indicadores reproductivos entre altitudes en poblaciones de Pinus hartwegii. Los conos se recolectaron entre 3600 y 4100 msnm en el Monte Tláloc (MT) y el Nevado de Toluca (NT) en México. En cada cono se determinó el número de semillas potenciales (NSP), óvulos abortados en el año 1 (NOAA1), óvulos abortados en el año 2 (NOAA2), semillas vanas (NSV), semillas llenas (NSLL), peso promedio de una semilla (PPS), eficiencia reproductiva (ER), eficiencia en la producción de semillas (EPS) e índice de depresión endogámica (IDE). Las variables ambientales se obtuvieron con el programa Spline. Los coeficientes de correlación (r) se calcularon entre indicadores reproductivos y variables ambientales. Se encontraron diferencias significativas entre poblaciones y entre altitudes en NSP, NOAA2, NSV, NSLL, PPS y ER, mientras que no hubo diferencias significativas entre poblaciones para EPS e IDE, aunque sí entre altitudes; tampoco se encontraron diferencias significativas entre poblaciones ni entre altitudes para NOAA1. El coeficiente de correlación fue alto (r = 0.929) entre NOAA2 y precipitación en septiembre y octubre; también éste fue alto (r = -0.829) entre ER y heladas tardías en primavera. Algunos valores de r fueron moderados entre indicadores reproductivos y variables ambientales; por ejemplo, el coeficiente de correlación fue 0.786 entre NSV y temperatura media anual, de 0.714 entre el NSLL y temperatura máxima media del mes más caliente y r = -0.642 entre NSP y temperatura media mínima del mes más frio. Los valores de los indicadores reproductivos mostraron variación entre las poblaciones y entre altitudes dentro de poblaciones de Pinus hartwegii.

SUMMARY Pinus hartwegii Lindl. grows between 2500 and 4300 masl in the mountains of Mexico and Central America. Information on reproductive indicators in a population is useful to describe the reproductive status of a species, and may be influenced by environmental variables. The objective of this study was to evaluate the variation of reproductive indicators between altitudes in Pinus hartwegii populations. Cones were collected between 3600 and 4100 masl at Monte Tlaloc (MT) and Nevado de Toluca (NT) in Mexico. The number of potential seeds (NPS), aborted ovules in year 1 (AOY1), aborted ovules in year 2 (AOY2), empty seeds (ES), full seeds (FS), mean weight of a seed (MWS), reproductive efficiency (RE), efficiency in seed production (ESP) and endogamy depression index (EDI) were determined in each cone. The environmental variables were obtained with the Spline program. Correlation coefficients (r) were estimated between reproductive indicators and environmental variables. Significant differences were found between populations and between altitudes within populations for NPS, AOY2, ES, FS, MWS and RE, while there were no significant differences between populations for ESP and EDI, they were present between altitudes; neither were significant differences between populations and altitudes for AOY1. The correlation coefficient was high (r = 0.929) between AOY2 and precipitation in September and October; it was also high (r = -0.829) between RE and late frosts in Spring. Some r values between reproductive indicators and environmental variables were moderate; for example, the correlation coefficient was 0.786 between NSV and mean annual temperature, it was 0.714 between NSLL and mean maximum temperature of the warmest month, while it was -0.642 between NPS and mean minimum temperature in the coldest month. The values of reproductive indicators showed variation between populations and between altitudes within Pinus hartwegii populations.

Abstract Introduction: Adverse childhood experiences (ACEs) have been associated with the acquisition of risk behaviors and development of chronic and mental diseases since adolescence and in adult life. Objective: To identify the knowledge and the frequency pediatrics residents ask about ACEs with. Methods: Through an online survey sent to all resident physicians of the 2017-2018 academic year of a tertiary care children’s hospital, demographic variables, knowledge, use, training and barriers to interrogate and search for ACEs were collected. Results: 21% of residents answered the survey; the majority were women (70 %), less than 5 % of participants were familiar with ACEs, 31 % enquired about them in parents and their children, and 71 % considered having some barrier to interrogate about them. Conclusions: Participants in this study showed limited knowledge about ACEs, which had an impact on the frequency they enquired about them with in their patients and their parents; at least half had the perception that it is beyond the reach of the pediatrician to identify them.

Resumen Introducción: Las experiencias adversas en la infancia (EAI) se han relacionado con la adquisición de conductas de riesgo y el desarrollo de enfermedades crónicas y mentales, desde la adolescencia y en la vida adulta. Objetivo: Identificar el conocimiento y la frecuencia con la que médicos residentes de pediatría interrogan sobre las EAI. Métodos: Mediante una encuesta en línea enviada a todos los médicos residentes del año académico 2017-2018 de un hospital pediátrico de tercer nivel, se recabaron variables demográficas, del conocimiento, uso, entrenamiento y barreras para interrogar sobre EAI. Resultados: 21 % de los residentes respondió la encuesta, la mayoría fue del sexo femenino (70 %), menos de 5 % de los participantes estaba familiarizado con las EAI, 31 % interrogaba sobre ellas a los padres e hijos y 71 % consideró que tiene alguna barrera para interrogarlas. Conclusiones: Los participantes de este estudio mostraron un conocimiento limitado sobre las EAI, lo que repercutió en la frecuencia con la que preguntaban al respecto a sus pacientes y padres; al menos la mitad tuvo la percepción que identificarlas está fuera del alcance del pediatra.