[Features of patients admitted for COVID-19 at a regional hospital in the Chilean Araucania Region]. / Características clínicas de pacientes ingresados por COVID-19 en un Hospital de alta complejidad de la región de la Araucanía-Chile.

BACKGROUND: The Araucania region in Chile had the greatest COVID-19 incidence and lethality in Chile Aim: To describe the clinical characteristics and evolution of patients admitted for COVID-19 in a high complexity Hospital in the region of La Araucanía-Chile. MATERIAL AND METHODS: Review of medical records of the first 169 patients aged 55 ± 17 years (50% women) admitted for COVID-19 between march and may, 2020 at a regional hospital in Temuco Chile. RESULTS: The most common comorbidities of these patients were hypertension, diabetes, and obesity. The symptom triad of cough, dyspnea and fever was present in 85%. Less frequent symptoms were diarrhea and vomiting. Biomarkers at admission such as ferritin, D-dimer, among others, were significantly higher among patients who required admission to the Intensive Care Unit. The presence of cough, dyspnea and fever were significantly associated with longer hospitalization time and requirement for mechanical ventilation. Hypertension and obesity were significantly associated with longer hospitalization stay. Eight percent of patients died. CONCLUSIONS: Symptoms such as cough, dyspnea and fever and specific biomarkers on admission were associated with a worse evolution of adult inpatients with COVID-19.

Supracondylar humeral fractures in children: current concepts for management and prognosis.

Supracondylar humeral fractures are the most common elbow fractures in children and represent 3 % of all paediatric fractures. The most common cause is a fall onto an outstretched hand with the elbow in extension, resulting in an extension-type fracture (97-99 % of cases). Currently, the Gartland classification is used, which has treatment implications. Diagnosis is based on plain radiographs, but accurate imaging could be limited due to patient pain. Based on fracture type, the definitive treatment could be either non-operative (type I) or operative (type III/IV); however, when handling type II fractures controversy remains. Neither pin configuration have shown higher efficacy over the other. Complications are ~1 %, the most common being pin migration, with compartment syndrome as the most devastating. Overall, functional outcomes are good, and physical therapy does not appear to be necessary.

Establishment of Transgene-Free Porcine Induced Pluripotent Stem Cells.

Although protocols to generate authentic transgene-free mouse and human induced pluripotent stem cells (iPSCs) are now well established, standard methods for reprogramming porcine somatic cells still suffer from low efficiency and transgene retention. The Basic Protocol describes reprogramming procedures to establish transgene-free porcine iPSCs (PiPSCs) from porcine fibroblasts. This method uses episomal plasmids encoding POU5F1, SOX2, NANOG, KLF4, SV40LT, c-MYC, LIN28A, and microRNA-302/367, combined with an optimized medium, to establish PiPSC lines. Support protocols describe the establishment and characterization of clonal PiPSC lines, as well as the preparation of feeder cells and EBNA1 mRNA. This optimized, step-by-step approach tailored to this species enables the efficient derivation of PiPSCs in ∼4 weeks. The establishment of transgene-free PiPSCs provides a new and valuable model for studies of larger mammalian species' development, disease, and regenerative biology. © 2024 The Authors. Current Protocols published by Wiley Periodicals LLC. Basic Protocol: Reprogramming of porcine fibroblasts with episomal plasmids Support Protocol 1: Preparation of mouse embryonic fibroblasts for feeder layer Support Protocol 2: Preparation of in vitro-transcribed EBNA1 mRNA Support Protocol 3: Establishment of clonal porcine induced pluripotent stem cell (PiPSC) lines Support Protocol 4: PiPSC characterization: Genomic DNA PCR and RT-PCR Support Protocol 5: PiPSC characterization: Immunostaining.

Efficient derivation of transgene-free porcine induced pluripotent stem cells enables in vitro modeling of species-specific developmental timing.

Sus scrofa domesticus (pig) has served as a superb large mammalian model for biomedical studies because of its comparable physiology and organ size to humans. The derivation of transgene-free porcine induced pluripotent stem cells (PiPSCs) will, therefore, benefit the development of porcine-specific models for regenerative biology and its medical applications. In the past, this effort has been hampered by a lack of understanding of the signaling milieu that stabilizes the porcine pluripotent state in vitro. Here, we report that transgene-free PiPSCs can be efficiently derived from porcine fibroblasts by episomal vectors along with microRNA-302/367 using optimized protocols tailored for this species. PiPSCs can be differentiated into derivatives representing the primary germ layers in vitro and can form teratomas in immunocompromised mice. Furthermore, the transgene-free PiPSCs preserve intrinsic species-specific developmental timing in culture, known as developmental allochrony. This is demonstrated by establishing a porcine in vitro segmentation clock model that, for the first time, displays a specific periodicity at ∼3.7 h, a timescale recapitulating in vivo porcine somitogenesis. We conclude that the transgene-free PiPSCs can serve as a powerful tool for modeling development and disease and developing transplantation strategies. We also anticipate that they will provide insights into conserved and unique features on the regulations of mammalian pluripotency and developmental timing mechanisms.

The threat of home eviction and its effects on health through the equity lens: A systematic review.

The aims of this review are to gather and systematize the currently available evidence on the effect of the threat of eviction on health and its eventual spillover effects, to assess the quality of the selected studies, and to describe how these findings vary with respect to dimensions of social inequity. We conducted a literature search in March 2016, which yielded 2208 unduplicated articles. The title, abstract and full text of these articles were reviewed by three independent pairs of researchers. We performed a quality assessment of each article, and evaluated whether health inequities had been considered. We selected 47 articles for this review, of which 86% were from Anglo-Saxon countries (mainly the US), and 75% were published after 2009. Most studies used either a cross-sectional (32%), cohort (28%), or qualitative (17%) design. The majority (55%) assessed mental health as a key health indicator, and a notable proportion assessed physical health (38%) and health-related behaviours (19%). Many of the studies evaluated more than one of these health indicators. The average quality score was 7.4 (SD = 1.5). Evidence from these selected articles revealed a general consensus that individuals under threat of eviction present negative health outcomes, both mental (e.g. depression, anxiety, psychological distress, and suicides) and physical (poor self-reported health, high blood pressure and child maltreatment). However, the distribution and extent of these outcomes depend on inequity dimensions such as gender, age, ethnicity and territory. Furthermore, qualitative studies highlighted some of the pathways that may connect the threat of eviction with its health outcomes. The threat of eviction will likely continue to be a major issue in the coming years, so it is important to conduct further research to create effective interventions and courageous policies to tackle this problem.

Características clínicas de pacientes ingresados por COVID-19 en un Hospital de alta complejidad de la región de la Araucanía-Chile

Background: The Araucania region in Chile had the greatest COVID-19 incidence and lethality in Chile Aim: To describe the clinical characteristics and evolution of patients admitted for COVID-19 in a high complexity Hospital in the region of La Araucanía-Chile. Material and Methods: Review of medical records of the first 169 patients aged 55 ± 17 years (50% women) admitted for COVID-19 between march and may, 2020 at a regional hospital in Temuco Chile. Results: The most common comorbidities of these patients were hypertension, diabetes, and obesity. The symptom triad of cough, dyspnea and fever was present in 85%. Less frequent symptoms were diarrhea and vomiting. Biomarkers at admission such as ferritin, D-dimer, among others, were significantly higher among patients who required admission to the Intensive Care Unit. The presence of cough, dyspnea and fever were significantly associated with longer hospitalization time and requirement for mechanical ventilation. Hypertension and obesity were significantly associated with longer hospitalization stay. Eight percent of patients died. Conclusions: Symptoms such as cough, dyspnea and fever and specific biomarkers on admission were associated with a worse evolution of adult inpatients with COVID-19.

Prevalencia del helicobacter pylori y factores asociados en escolares de la etnia Shuar Del Cantón Sucúa ­Morona Santiago, 2014 / Prevalence of helicobacter pylori and associated factors in schools of Shuar Ethnic from Sucúa - Morona Santiago, 2014

Introducción: Según la OMS, más del 50% de la población adulta está infectada con el Helicobacter Pylori, con prevalencias de hasta el 90%. La mayoría de contagios se produce antes de los 10 años de edad. Desde el des-cubrimiento del H. Pylori (1983), se lo ha relacionado con la úlcera péptica, gastritis, reflu-jo gastroesofágico e incluso, cáncer gástrico. Metodología: Se realizó un estudio transver-sal analítico. La muestra estuvo conformada por 250 niños escolares de la etnia Shuar del cantón Sucúa. La prueba utilizada para la detección del Helicobacter pylori es la identi-ficación de antígenos en las heces por inmunocromatografía. Para establecer la signifi-cancia de asociación de variables se utilizó el OR con su intervalo de confianza al 95%. Resultados: El promedio de edad fue de 8.8 años (DS 2.0), con predominio de las mujeres (54.4%). El 56.4% consume agua potable, el 71.65% vive en hacinamiento, el 42% tiene servicios de letrinización y el 49.2% cuenta con servicios de alcantarillado. Se encontró asociación significativa con el nivel de ins-trucción OR 1.68, IC95% (1 ­ 2.84), p=0.049; le-trinización OR 1.99, IC95% (1.17 ­ 3.36), p=0.01; deposiciones al aire libre OR 4.32, IC95% (2.13 ­ 8.77), p=0.000.Conclusiones: La prevalencia de Helicobacter pylori es alta en la población escolar de la etnia Shuar; está asociada a un nivel bajo de instrucción de los progenitores y una inade-cuada infraestructura de servicios básicos.

Introduction: According to the WHO, more than 50% of the adult population is infected with Helicobacter Pylori, with prevalence ra-tes of up to 90%. Most infections occur befo-re 10 years old. Since the H. Pylori appeared (1983), it has been associated with peptic ulcer, gastritis, gastroesophageal reflux and even gastric cancer.Methodology: A cross-sectional study was conducted. The sample was formed by 250 Shuar school children from Sucúa. The test used for the detection of Helicobacter pylori is the identification of antigens in the feces by immunochromatography. To establish the sig-nificance of variables association the OR was used with a 95% confidence interval.Results: The average age was 8.8 years (SD 2.0), with women predominance (54.4%). The 56.4% consumes drinking water, the 71.65% li-ves in overcrowding, a 42% has latrine service and 49.2% has sewerage service. A significant association with the level of education OR 1.68, 95% CI (1 - 2.84), p = 0.049; latrines OR 1.99, 95% CI (1.17 - 3.36), p = 0.01; outdoor fe-ces OR 4.32, 95% CI (2.13 - 8.77), p = 0.000 was found.Conclusions: The prevalence of Helicobacter pylori is high in the Shuar school population; It is associated with a low level of parents edu-cation and inadequate infrastructure of basic services.

Plastías esternales en Hospital Regional Temuco / Sternoplasties in Hospital Regional Temuco

Entre 1976 y 1990 hemos tratado 14 pacientes (1,04 por ciento de nuestro quehacer quirúrgico) portadores de deformidades graves del peto anterior torácico. Necesitaron 19 intervenciones con 0 por ciento mortalidad y 47 por ciento de morbilidad dada fundamentalmente por seromas. Los resultados cosméticos subjetivos para el equipo quirúrgico fueron buenos en 78 por ciento , siendo menos satisfactorio para el enfermo y su familia. Son todos casos de deformidad severa. Proponemos reemplazos esternales con malla de Marlex y/o turn over como primera operación en casos seleccionados