Urbanization, migration, and indigenous health in Peru.

INTRODUCTION: We compare demographic, socioeconomic, and anthropometric characteristics and blood pressure (BP), between rural and urban Peruvian indigenous women. These are preliminary results from a project on urbanization, migration, and health. METHODS: Data were collected cross-sectionally (2019) and compared between a rural (n = 92) and an urban (n = 93) community. RESULTS: Height: µ = 148.3 ± 5.0 cm (range = 137-162), weight: µ = 62.0 ± 11.5 (range = 37.5-108.7), median waist circumference = 89.0 (IQR = 15.8, range = 64.0-126.0), BMI = 28.3 (IQR = 6.2, range = 16.7-40.0), with no significant rural-urban differences. Systolic but not diastolic BP was significantly higher in urban versus rural women (median = 110, IQR = 18, range = 80-170 vs. median = 120, IQR = 10, range = 90-170, p = .002 and median = 70, IQR = 17, range = 50-100 vs. median = 70, IQR = 10, range = 60-100, p = .354), respectively. CONCLUSIONS: Despite major lifestyle differences, there were no anthropometric differences between rural and urban women. Higher systolic BP in urban women may reflect social/economic stressors rather than dietary factors.

Retiro de elementos de osteosíntesis en trauma maxilofacial / Osteosynthesis elements removal in maxillofacial trauma

Resumen Objetivo: Analizar la prevalencia y los factores en la remoción de elementos de osteosíntesis (OTS) de pacientes tratados quirúrgicamente debido a fracturas maxilofaciales. Materiales y Método: Estudio retrospectivo descriptivo, donde fueron incluidos todos los pacientes con diagnóstico de fractura maxilofacial y tratados mediante reducción abierta y fijación interna rígida en un intervalo de 10 años, en el Servicio de Cirugía Oral y Maxilofacial en el Hospital Clínico Mutual de Seguridad (HCMS). Resultados: En un total de 807 pacientes intervenidos, con un rango etario entre 22-66 años, fueron utilizados 2.421 OTS. Entre ellos, 58 pacientes (7,2%) fueron sometidos a un segundo procedimiento quirúrgico, retirándose un total de 129 OTS (5,3%). La principal causa de retiro fue infección (41,1%), comúnmente de carácter tardío. El tercio inferior facial fue el más afectado, específicamente, la zona parasinfisiaria. El 39% fue retirado antes de los 12 meses de posicionados. Conclusiones: El retiro de OTS, posterior a trauma maxilofacial tiene una baja prevalencia. El sitio más afectado es el hueso mandibular y la mayoría se retira dentro de los primeros 12-24 meses. La etiología es variable, sin embargo, la infección se mantiene como una de las principales. Los hallazgos sugieren que no sería recomendable realizar este procedimiento de forma universal para todos los pacientes.

Aim: To analyse the prevalence and factors regarding to osteosynthesis elements (OTS) removal from patients surgically treated due to maxillofacial fractures. Materials and Method: Retrospective study in which all patients with diagnosis of maxillofacial fractures and treated with open reduction and internal rigid fixation were included, in an interval of 10 years, in the Maxillofacial Surgery Service of HCMS. Results: In 807 surgically treated patients, with an age between 22-66 years, 2.421 OTS were used. Among them, 58 patients (7.2%) underwent a second surgical procedure, with a total of 129 OTS removed (5.3%). The main cause of removal was infection (41.1%), commonly of a chronic nature. The lower third of the face was the most affected, specifically, the parasymphysis region. 39% of OTS were withdrawn before 12 months. Conclusions: OTS removal after maxillofacial trauma has a low prevalence, the most affected site is the mandibular bone, within the first 12-24 months. The aetiology is variable, however, infection remains one of the main. The findings suggest that it would not be advisable to perform this procedure universally for all patients.

Complete Genome Sequences of 17 Clinical Campylobacter jejuni Strains from Chile.

Campylobacter jejuni is the leading cause of bacterial foodborne disease worldwide. Here, we report the complete annotated genomes and plasmid sequences of 17 Campylobacter jejuni strains isolated from patients with gastroenteritis in Santiago, Chile.

COVID-19: manejo de cuidados intensivos pediátrico / COVID-19: pediatric intensive care management

The appearance of a new nosological entity named by the World Health Organization (WHO) as CoVID-19, which is causing a global pandemic, has meant a major medical challenge. This article tries to concentrate the most important aspects in the management pediatric of the severe CoVID-19 patient, reviewing the existing literature with emphasis on ventilatory, hemodynamic and other affected systems management. It must be taken into account that due to the high possibility of contagion, it is necessary to review the protection measures for health personnel in the procedures that are routine in the seriously ill patient.

La aparición de una nueva entidad nosológica denominada por la Organización Mundial de la Salud (OMS) como CoVID-19, está causando una pandemia mundial que ha significado un desafío médico de gran envergadura Este artículo trata de concentrar los aspectos más importantes en el manejo pediátrico del paciente CoVID-19 grave, revisando la literatura existente poniendo énfasis en el manejo ventilatorio, hemodinámico y de otros sistemas afectados. Hay que tomar en cuenta que debido a la alta posibilidad de contagio se hace necesario revisar las medidas de protección para el personal de salud en los procedimientos que son de rutina en el paciente gravemente enfermo.

Urine Extracellular Vesicle GATA2 mRNA Discriminates Biopsy Result in Men with Suspicion of Prostate Cancer.

PURPOSE: Prostate specific antigen has limited performance in detecting prostate cancer. The transcription factor GATA2 is expressed in aggressive prostate cancer. We analyzed the predictive value of urine extracellular vesicle GATA2 mRNA alone and in combination with a multigene panel to improve detection of prostate cancer and high risk disease. MATERIALS AND METHODS: GATA2 mRNA was analyzed in matched extracellular vesicles isolated from urines before and after prostatectomy (16) and paired urine and tissue prostatectomy samples (19). Extracellular vesicle GATA2 mRNA performance to distinguish prostate cancer and high grade disease was tested in training (52) and validation (165) cohorts. The predictive value of a multigene score including GATA2, PCA3 and TMPRSS2-ERG (GAPT-E) was tested in both cohorts. RESULTS: Confirming its prostate origin, urine extracellular vesicle GATA2 mRNA levels decreased significantly after prostatectomy and correlated with prostate cancer tissue GATA2 mRNA levels. In the training and validation cohort GATA2 discriminated prostate cancer (AUC 0.74 and 0.66) and high grade disease (AUC 0.78 and 0.65), respectively. Notably, the GAPT-E score improved discrimination of prostate cancer (AUC 0.84 and 0.72) and high grade cancer (AUC 0.85 and 0.71) in both cohorts when compared with each biomarker alone and PT-E (PCA3 and TMPRSS2-ERG). A GAPT-E score for high grade prostate cancer would avoid 92.1% of unnecessary prostate biopsies, compared to 61.9% when a PT-E score is used. CONCLUSIONS: Urine extracellular vesicle GATA2 mRNA analysis improves the detection of high risk prostate cancer and may reduce the number of unnecessary biopsies.

Improving the screening of tuberculosis in patient admitted in a secondary care hospital of La Habana.

INTRODUCTION: The reduction of tuberculosis reported in admitted patients in a community hospital in La Habana (Cuba) was identified as a quality gap and priority for action. The objective was to increase by 50% the number of bacilloscopies and smear-positive tuberculosis confirmed by December 2017. PATIENTS AND METHODS: A quality improvement initiative was conducted from January 2017 to December 2017 in a 300-bed secondary care teaching hospital. The improvement project was addressed to patients admitted with respiratory infections (upper or lower). The baseline was considered the period from January to December 2016. The intervention period was from January 2017 to June 2018. The intervention includes training activities for medical staff, monthly monitoring of bacilloscopies performed and feedback and analysis with leaders and departments. RESULTS: During the baseline period seven patients were confirmed with pulmonary tuberculosis and 160 bacilloscopies were performed (mean 40 bacilloscopies/quarter). During the intervention period were confirmed 22 cases of tuberculosis and 577 bacilloscopies were performed (mean 96 bacilloscopies/quarter). CONCLUSIONS: The number of bacilloscopies and sputum smear tuberculosis was successfully increased in admitted patients using the staff education, monitoring, and feedback as intervention measures. The next steps of the project will be focused in achieve the sustainability of the intervention, evaluation of educational needs of medical staff and design training activities accordingly and, screening of latent tuberculosis infections using of tuberculin skin test in selected high risk admitted patients.

Effect of 5% transdermal lidocaine patches on postoperative analgesia in dogs undergoing hemilaminectomy.

OBJECTIVES: To investigate the effect of 5% lidocaine patches on postoperative analgesia in dogs undergoing hemilaminectomy. MATERIALS AND METHODS: Client-owned dogs undergoing hemilaminectomy for a single acute intervertebral thoracolumbar disc extrusion were enrolled in this prospective, randomised, blinded clinical trial. Following methadone administration, anaesthesia was induced with propofol, and maintained with isoflurane in oxygen and fentanyl infusion, in both groups. After skin closure, two 1∙5 cm wide 5% lidocaine patch strips were attached along both sides of the wound in dogs allocated to Group L. In Group C, the two lidocaine patch strips were applied but the transparent isolating liner was not removed. Postoperatively, all dogs received a non-steroidal anti-inflammatory drug, gabapentin and diazepam. Methadone was administered according to the short form of Glasgow Composite Pain Scale with pain assessed every 2 hours for 48 hours by observers unaware of the treatment. RESULTS: Thirty-nine dogs completed the study. Demographic data, end-expiratory fraction of isoflurane, fentanyl consumption, anaesthesia and surgical times were similar between groups. The number of dogs requiring postoperative methadone and the number of doses of methadone administered were not different between groups. No macroscopic skin reaction was noticed once the patches were removed. CLINICAL SIGNIFICANCE: In this setting, 5% lidocaine patches did not provide additional postoperative analgesia in dogs undergoing hemilaminectomy.

Modelo de asistencia integral del parto: concepto de integralidad basado en la calidad y seguridad / Comprehensive delivery care model: concept of comprehensiveness based on quality and safety

RESUMEN Introducción: A nivel internacional existe un interés por disminuir el uso excesivo de tecnologías durante el parto, inclinándose hacia el desarrollo de modelos de atención personalizados y respetuosos. Chile concentra una de las tasas de cesáreas más altas en la región, muchas de ellas sin justificación clínica. En este contexto, un proyecto FONDEF desarrolló y probó un modelo de asistencia integral del parto (MASIP), considerando la participación activa de la mujer y familia y menos intervenciones innecesarias. Objetivo: evaluar la efectividad de MASIP en comparación con el cuidado estándar del parto. Metodología: A través de un diseño experimental aleatorizado y controlado, se compararon los resultados de calidad y seguridad de MASIP con la modalidad habitual de asistencia del sistema público en Santiago de Chile, para la población de embarazadas de bajo riesgo. Resultados: MASIP resultó ser más efectiva que la asistencia tradicional en términos de calidad con los indicadores de bienestar materno, disminución de medidas de conducción y de atención de parto innecesarias. La frecuencia de cesárea disminuyó durante el período del estudio en ambos grupos, en comparación con un registro histórico de la misma población. En términos de seguridad, los indicadores mantuvieron el estándar alcanzado en las últimas décadas en ambas modalidades, pese a que el modelo integral se caracteriza por tener menos intervención. Conclusión: MASIP es un modelo seguro y de mejor calidad para mujeres de bajo riesgo del sistema público de Chile que el cuidado estándar. Intervenciones futuras para mejorar la experiencia de las mujeres y familias, deben incluir en su diseño los componentes de MASIP.

ABSTRACT Introduction: Worldwide there is a need to reduce the use of excessive technology during childbirth. Consequently, there is an interest to develop respectful and personalized models of care. Chile has one of the highest C-section rates in the region, many of which are not needed. A FONDEF project developed and tested a comprehensive health care model in childbirth (MASIP), considering active participation of women and families and less unneeded clinical interventions. Objective: to evaluate the effectiveness of MASIP in comparison with standard care. Methods: a randomized controlled experiment was conducted in one public hospital in Santiago Chile. Two arms were compared: MASIP vs. standard care. Low obstetric risk women were included. Variables of interest included quality and safety measures. Results: MASIP had better quality results, such as maternal wellbeing and less clinical interventions. During the study c-section was lower in both arms in comparison to a historical record of the same population. Safety outcomes were similar in both arms. Conclusion: MASIP is as safe as the standard care but it has better quality of care. Interventions to improve users' satisfaction and experience should consider the components of MASIP.

Carbon burial and storage in tropical salt marshes under the influence of sea level rise.

Coastal vegetated habitats can be important sinks of organic carbon (Corg) and mitigate global warming by sequestering significant quantities of atmospheric CO2 and storing sedimentary Corg for long periods, although their Corg burial and storage capacity may be affected by on-going sea level rise and human intervention. Geochemical data from published 210Pb-dated sediment cores, collected from low-energy microtidal coastal wetlands in El Salvador (Jiquilisco Bay) and in Mexico (Salada Lagoon; Estero de Urias Lagoon; Sian Ka'an Biosphere Reserve) were revisited to assess temporal changes (within the last 100years) of Corg concentrations, storage and burial rates in tropical salt marshes under the influence of sea level rise and contrasting anthropization degree. Grain size distribution was used to identify hydrodynamic changes, and δ13C to distinguish terrigenous sediments from those accumulated under the influence of marine transgression. Although the accretion rate ranges in all sediment records were comparable, Corg concentrations (0.2-30%), stocks (30-465Mgha-1, by extrapolation to 1m depth), and burial rates (3-378gm-2year-1) varied widely within and among the study areas. However, in most sites sea level rise decreased Corg concentrations and stocks in sediments, but increased Corg burial rates. Lower Corg concentrations were attributed to the input of reworked marine particles, which contribute with a lower amount of Corg than terrigenous sediments; whereas higher Corg burial rates were driven by higher mass accumulation rates, influenced by increased flooding and human interventions in the surroundings. Corg accumulation and long-term preservation in tropical salt marshes can be as high as in mangrove or temperate salt marsh areas and, besides the reduction of Corg stocks by ongoing sea level rise, the disturbance of the long-term buried Corg inventories might cause high CO2 releases, for which they must be protected as a part of climate change mitigation efforts.

Necesidades psicosociales y características de una intervención online para apoyar a las madres adolescentes / Psychosocial needs and characteristics of an online intervention to support adolescent mothers

OBJETIVO: Identificar las necesidades de las madres adolescentes chilenas y las características de un servicio para apoyarlas. MÉTODOS: Se condujo un estudio cualitativo, utilizando grupos focales y entrevistas con madres adolescentes del área sur oriente de Santiago de Chile. Se realizó un análisis temático utilizando el programa Atlas.ti versión 6. RESULTADOS: Se realizaron tres grupos focales (n=22) y siete entrevistas con madres adolescentes. El principal tema emergente fue la necesidad de incorporar intervenciones basadas en Internet para apoyar a las adolescentes. De acuerdo a las participantes, la intervención debe incluir acceso inmediato a información (específica para el embarazo y habilidades parentales), apoyo de pares y continuidad del cuidado. CONCLUSIÓN: Las madres adolescentes tienen necesidades particulares y estas pueden ser cubiertas por un espacio virtual seguro que entregue información, apoyo profesional y de pares continuo. Nuevas intervenciones deben incluir en su diseño las características tecnológicas nativas de este grupo y utilizarlas para apoyar a las madres adolescentes de manera efectiva.

OBJECTIVE: To identify the needs of teen mothers in Chile and the characteristics of a service to tackle them. METHODS: A qualitative study was conducted. Focus groups and interviews were conducted with teen mothers in the South East area of Santiago, Chile. Thematic analysis was conducted assisted by Atlas.ti version 6. RESULTS: Three focus groups (n=22) and seven interviews with teen mothers were conducted. The main emerging theme was the need to incorporate Internet-based interventions to support teen mothers. According to the participants, the intervention should include immediate access to information (tailored for pregnancy and parenting skills), peer support, and continuity of care. CONCLUSION: Teen mothers have particular needs and these could be address by providing a safe and virtual space to access information, continuous professional and peer support. New interventions should include within their design the IT- native characteristics of this group and use them to reach teen mothers effectively.

Conflict and desire into question: The tension of individualization in couple relationship experience in Chilean young adults / Sin conflicto y sin deseo: las tensiones de la individualización en la experiencia de pareja de jóvenes chilenos

Resumen Este artículo busca conocer y comprender las tensiones en las dimensiones de amor, sexualidad e intimidad en la experiencia de pareja en jóvenes hombres y mujeres de nivel socioeconómico medio y bajo, residentes en la ciudad de Santiago de Chile. La sociedad chilena ha vivido importantes transformaciones sociales y culturales que han impactado las formas de parentesco, en particular, las relaciones de pareja. Desde una perspectiva fenomenológico-hermenéutica, se analizaron e interpretaron los relatos de vida y el material recogido mediante grupos focales de hombres y mujeres entre 18 y 25 años. Los resultados evidencian tensiones y ambivalencias en el lugar dado al otro de la pareja en jóvenes chilenos. Los quiebres de los mandatos sobre la pareja, vinculados a la experiencia del conflicto, dependencia y deseo sexual, implican el despliegue de estrategias de regulación que tienden a minimizar las diferencias ya sea a través de la comunicación que intenta hacer transparente el mundo interno al otro, la evitación del conflicto o la suspensión de la relación.

Abstract This paper intends to learn and understand tensions in love, sexuality, and intimacy dimensions according to the experience of couples ranked in middle and low socioeconomic status, which inhabit in Santiago de Chile. Chilean society has gone through significant social and cultural changes that have had an impact on kinship forms, especially in couple relationships. From a phenomenological and hermeneutic perspective, life narratives and material collected from focus groups of men and women between 18 and 25 years old were analyzed. Results evidenced pressure and ambivalence in regards to the Chilean young´s conception about the role of the other. Breakdowns in couple agreements, associated with conflict, dependence, and sexual desire involve in motion of regulatory strategies tending to minimize differences, either through communication, that might see through the other's inner world, or conflict avoidance, or the end of the relationship.

Effect of Ag Addition on the Electrochemical Performance of Cu10Al in Artificial Saliva.

In this work we proposed to evaluate the corrosion resistance of four different alloys by electrochemical techniques, a binary alloy Cu10Al, and three ternary alloys Cu10Al-xAg (x = 5, 10, and 15 wt.%) to be used like biomaterials in dental application. Biomaterials proposed were tested in artificial saliva at 37°C for 48 h. In addition, pure metals Cu, Al, Ag, and Ti as reference materials were evaluated. In general the short time tests indicated that the Ag addition increases the corrosion resistance and reduces the extent of localized attack of the binary alloy. Moreover, tests for 48 hours showed that the Ag addition increases the stability of the passive layer, thereby reducing the corrosion rate of the binary alloy. SEM analysis showed that Cu10Al alloy was preferably corroded by grain boundaries, and the Ag addition modified the form of attack of the binary alloy. Cu-rich phases reacted with SCN(-) anions forming a film of CuSCN, and the Ag-rich phase is prone to react with SCN(-) anions forming AgSCN. Thus, binary and ternary alloys are susceptible to tarnish in the presence of thiocyanate ions.

Perfil de morbilidad otorrinolaringológica en niños con síndrome de Down / Ear, nose and throat disease profile in children with Down syndrome

Introducción: Los niños con síndrome de Down (SD) tienen mayor riesgo de desarrollar enfermedad otorrinolaringológica (ORL). Recomendaciones internacionales sugieren realizar tamizaje auditivo precoz y control periódico por especialista. Nuestro objetivo fue caracterizar la enfermedad ORL en niños con SD y proponer una recomendación adaptada a nuestra realidad. Pacientes y método: Estudio transversal, descriptivo, en niños de 6 meses a 15 años con SD. Los datos se obtuvieron por medio de entrevista a los padres y revisión de fichas clínicas. Resultados: Se analizaron 134 pacientes, con una edad promedio de 44,5 meses. El 78,8% de ellos presentaba enfermedad ORL, siendo la más frecuente la rinitis alérgica y otitis con efusión. El tamizaje auditivo estaba alterado en un 25% de ellos, el 50% de los mayores de 3 años con estudio de sueño tenían apnea obstructiva del sueño. Los niños de mayor edad tuvieron estadísticamente mayor frecuencia de enfermedad ORL. Conclusiones: Esta serie muestra una alta frecuencia de enfermedad ORL en niños con SD, lo que refuerza la necesidad de realizar tamizaje auditivo, sospechar e identificar las apneas obstructivas del sueño y derivación rutinaria al especialista para optimización de las condiciones auditivas que permitan el mejor desarrollo del niño con SD.

Introduction: The children with Down syndrome (DS) are at increased risk of ear-nose-throat (ENT) disorders. International recommendations suggest early hearing screening and periodic specialist evaluation. Our goal was to characterize ENT disorders in children with DS, and propose recommendations for the Chilean population. Patients and method: Cross-sectional, descriptive study, of children with DS, between 6 months and 15 years of age. The data was obtained by a health interview to the parents and review of medical records. Results: We analyzed 134 patients with an average age of 44.5 months. The 78.8% had ENT disorders, the most frequent ENT disorders was allergic rhinitis and otitis media with effusion. Hearing screening was abnormal in a quarter of the patients, 50% of children over 3 years of age had obstructive sleep apnea diagnosed by polysomnogram. Older children had a statistically higher frequency of ENT disorders. Conclusions: This series shows a high rate of ENT disorders in children with DS, which supports recommendations for hearing screening, high suspicion of obstructive sleep apnea and routine referral to an ENT specialist for prevention and aggressive therapy in order to reduce hearing loss and improve development of the child with DS.

[Ear, nose and throat disease profile in children with Down syndrome]. / Perfil de morbilidad otorrinolaringológica en niños con síndrome de Down.

INTRODUCTION: The children with Down syndrome (DS) are at increased risk of ear-nose-throat (ENT) disorders. International recommendations suggest early hearing screening and periodic specialist evaluation. Our goal was to characterize ENT disorders in children with DS, and propose recommendations for the Chilean population. PATIENTS AND METHOD: Cross-sectional, descriptive study, of children with DS, between 6 months and 15 years of age. The data was obtained by a health interview to the parents and review of medical records. RESULTS: We analyzed 134 patients with an average age of 44.5 months. The 78.8% had ENT disorders, the most frequent ENT disorders was allergic rhinitis and otitis media with effusion. Hearing screening was abnormal in a quarter of the patients, 50% of children over 3 years of age had obstructive sleep apnea diagnosed by polysomnogram. Older children had a statistically higher frequency of ENT disorders. CONCLUSIONS: This series shows a high rate of ENT disorders in children with DS, which supports recommendations for hearing screening, high suspicion of obstructive sleep apnea and routine referral to an ENT specialist for prevention and aggressive therapy in order to reduce hearing loss and improve development of the child with DS.

Corrosion Performance of Fe-Cr-Ni Alloys in Artificial Saliva and Mouthwash Solution.

Several austenitic stainless steels suitable for high temperature applications because of their high corrosion resistance and excellent mechanical properties were investigated as biomaterials for dental use. The steels were evaluated by electrochemical techniques such as potentiodynamic polarization curves, cyclic polarization curves, measurements of open circuit potential, and linear polarization resistance. The performance of steels was evaluated in two types of environments: artificial saliva and mouthwash solution at 37°C for 48 hours. In order to compare the behavior of steels, titanium a material commonly used in dental applications was also tested in the same conditions. Results show that tested steels have characteristics that may make them attractive as biomaterials for dental applications. Contents of Cr, Ni, and other minor alloying elements (Mo, Ti, and Nb) determine the performance of stainless steels. In artificial saliva steels show a corrosion rate of the same order of magnitude as titanium and in mouthwash have greater corrosion resistance than titanium.

Electrochemical Study of Ni20Cr Coatings Applied by HVOF Process in ZnCl2-KCl at High Temperatures.

Corrosion behavior of Ni20Cr coatings deposited by HVOF (high velocity oxygen-fuel) process was evaluated in ZnCl2-KCl (1 : 1 mole ratio) molten salts. Electrochemical techniques employed were potentiodynamic polarization curves, open circuit potential, and linear polarization resistance (LPR) measurements. Experimental conditions included static air and temperatures of 350, 400, and 450°C. 304-type SS was evaluated in the same conditions as the Ni20Cr coatings and it was used as a reference material to assess the coatings corrosion resistance. Coatings were evaluated as-deposited and with a grinded surface finished condition. Results showed that Ni20Cr coatings have a better corrosion performance than 304-type SS. Analysis showed that Ni content of the coatings improved its corrosion resistance, and the low corrosion resistance of 304 stainless steel was attributed to the low stability of Fe and Cr and their oxides in the corrosive media used.

Targeting cancer stem cells to suppress acquired chemotherapy resistance.

Acquired resistance has curtailed cancer survival since the dawn of the chemotherapy age more than half a century ago. Although the application of stem cell (SC) concepts to cancer captured the imagination of scientists for many years, only the last decade has yielded substantial evidence that cancer SCs (CSCs) contribute to chemotherapy resistance. Recent studies suggest that the functional and molecular properties of CSCs constitute therapeutic opportunities to improve the efficacy of chemotherapy. Here we review how these properties have stimulated combination strategies that suppress acquired resistance across a spectrum of malignancies. The clinical implementation of these strategies promises to rejuvenate the effort against an enduring challenge.

Dolor y medicina complementaria y acupuntura / Pain and complementary medicine and acupuncture

El objetivo de este artículo es entregar información documentada sobre la situación actual de la Medicina Complementaria y la Acupuntura en Chile, su definición, reglamentación, mecanismos de acción y evidencia. Busca orientar sobre el uso de estas herramientas terapéuticas que son cada vez más solicitadas en el país.

Caracterización del perfil epidemiológico de las llamadas alCentro de Información Toxicológica de la Universidad Católica (CITUC), en el año 2010 / Characterization of the epidemiological profile of calls received at the Poison Information Center of the Catholic University (CITUC), in 2010

Objetivo: Describir y caracterizar el perfil epidemiológico de las llamadas recibidas en el año 2010 correspondiente a exposiciones, por el Centro de Información Toxicológica de la Pontificia Universidad Católica de Chile. Método: Se realizó un estudio retrospectivo y descriptivo de las llamadas registradas por el CITUC durante el año 2010. Se analizaron los siguientes datos: número total de llamadas, lugar de la llamada, circunstancia de la exposición, tipo y número de los agentes involucrados, vías de exposición, tiempo desde la exposición, género y edad de los pacientes. Resultados: Se registraron 29.592 llamadas. 45,2 por ciento de las consultas provenían del hogar y 53,2 por ciento de instalaciones médicas. 69,3 por ciento fueron exposiciones accidentales y 27,6 por ciento intencionales. Los medicamentos se presentaron como agente causal de una exposición en 58,4 por ciento de las llamadas, seguidos por los productos de uso doméstico (18,7 por ciento) y plaguicidas (5,8 por ciento). La ingestión fue la vía de exposición que predominó en un 79,3 por ciento del total de casos. 41,0 por ciento del total de las llamadas, se realizaron dentro de la primera hora post-exposición. Las exposiciones en niños menores de 14 años correspondieron a 51,6 por ciento de las llamadas. Conclusiones: Los medicamentos constituyen el principal agente involucrado en intoxicaciones. La principal vía de exposición es la ingesta y el principal grupo de población afectado son los niños menores de 14 años,. Estos indicadores muestran la necesidad imperante de desarrollar campañas de prevención e información avaladas por el Ministerio de Salud, respecto al correcto uso de los medicamentos, como también la introducción del envase resistente ala manipulación de los niños y la educación de la población.

Objective: To describe and to characterize the epidemiologoc profile of the entering pone calls in 2010 belonging to exposures by the Centro de Información Toxicológica de la Pontificia Universidad Católica de Chile. Method: A retrospective and descriptive study of pone calls registered by the CITUC has been made during 2010. The following has been analyzed: total pone calls number, place of the call, exposure circumstances, kind and number ofagents involved, exposure way, time from exposure, gender and age of the patients. Outcomes: 29.592 phone calls were registered. 45,2 percent of the questions came from home and 53,2 percent from medical institutions. 69,3 percent were non intented exposures and 27,6 percent were intented. The drugs were the causal agent of exposures in 58,4 percent of the phone calls, followed by cleaning use products (18,7 percent) and insecticides (5,8 percent). Swallowing was the predominant exposure way with 79,3 percent of the total. 41 percent of total of phone calls, were made in the first hour after exposure. The children under 14 years exposure cases, were were 51,6 percent of total phone calls. Conclusions: Medical drugs are the principal involved agent in intoxications. The main way of exposition is swallowing and the major population group involved is children under 14 years. These indicators shows the need of developing prevention and information campaigns supported by Secretary of Health, oriented to right use of drugs, as well as the use of safety drug boxes for children and population education.

Local adjuvants in surgical management of bone metastases.

Curettage is one of the most common method for surgical treatment of bone metastasis. Local adjuvant improve most commonly used for improving the effect of curettage in local cancer surgery may exerted their effects either chemically either physically; in Orthopedic Oncology the most common are phenol, liquid nitrogen, laser, and cement. This article reviewed the main characteristics of the most common chemical and physical agents used in bone oncology, emphasizing the toxic effects of some of them, especially phenol and liquid nitrogen.